CIHM
Microfiche
Series
(Monographs)
ICMH
Collection de
microfiches
(monographles)
Canadian Instituta for Historical MIcroraproductiont / Institut Canadian da nriicroraproductiont historiquas
Technical and Bibliographic Notes / Notes techniques et bibliographiques
The Institute has attempted to obtain the best original
copy available for filming. Features of this copy which
may be bibliographically unique, which may alter any
of the images in the reproduction, or which may
significantly change the usual msthod of filming, are
checked below.
Coloured covers/
Couverture d« couleur
Covers damaged/
^ I Couverture endommagte
□ Covers restored and/or laminated/
Couverture resUuree et/ou pellicula*
n
Cover title missing/
Le titre de couverture manque
□ Colour**! maps/
Caites giographiques en couleur
□ Coloured ink (i e. other than blue or black)/
Encre de couleur (i.e. autre que bleue ou noirel
Coloured plates and/or illustrations/
Planches et/ou illustrations en couleur
Bound with other material/
Relie avec d'autres documents
D
, I Tight binding may cause shadows or distortion
^ ' along interior margin/
La reliure serr*e peut causer de I'ombre ou de la
distorsion le long de la marge interieure
□ Blan
with
Blank leaves added during restoration may appear
iin the tent Whenever possible, these have
been omitted from filming/
II sa peut que certainei pages blanches a|outies
lurs d'une restauration apparaissent dans le texte,
mais, lorsque cela etait possible, ces pages n'ont
pas ete film^s.
L'Institut a microfilm^ le meillcur exemplaire qu'il
lui a eti possible de se procurer. Les details de cet
exemplaire qui sont peut-itre uniques du point de vue
bibliographique, qui peuvent modifier une image
reproduite. ou qui peuvent exiger une modification
dans la methode normale de filmage sont indiques
ci-dessous.
□ Coloi
Pages
Coloured pages/
da couleur
Pages damaged/
Pages endommagees
n
Pages restored and/or laminated/
Pages restaurees et/ou pellicul^s
Q Pages discoloured, stained or foxed/
Pages decolorees, tachetees ou piquees
n
HSh
Tr
Pages detached/
Pages detachees
Showthrough/
ansparence
□ Quality of print varies/
Qualite inegale de I'lmpression
n
I 71 Inclu
lid Com,
Continuous pagination/
Pagination continue
ides index(es)/
Comprend un (des) index
Title on header taken from: /
Le titre de TentCte provient'
n Title page o* issue/
Page de titre de la li
□ Caption of issue/
Titre de depart de la li
n
ivraison
vraiton
Masthead/
Generique (piriodiques) de la livraison
S Additional comments / Pagination is as follows: p. 11-258, [1]-16.
Commentaires supplementaires: Copy has manuscript annotat lon.s .
This Item IS filmed at the reduction ratio checked below/
Ce document est filme au taux de reduction mdique ci dessous
lUx
14X
22 X
."bX
]0x
!
1
1 — \ —
L, I .,_u_j —
/'
1 1 !
MX
itx
20X
2«x
l%\
3:«
The copy filmed h«r« has b««n r«produc*d thanks
to ths ganarosity of:
Academy of Medicine Collection
The Toronto Hospital
Tha imagaa appaaring hara ara tha bast quality
possibia conaidaring tha condition and lagibility
of tha original copy and in kaaping with tha
filming contract spacifications.
L'axamplaira fUmi fut reproduit grice i la
gAnArositA da:
Academy of Medicine Collection
The Toronto Hospital
Las imagas suivantas ont iti raproduites avec la
plus grand soin. compte tenu da la condition at
da la nattat* da l'axamplaira filmA. at en
conformity avac las conditions du contrat da
filmaga.
Original eopias in printed papar covars ara fllmad
beginning with tha front covar and ending on
tha last page with a printed or illustrated imprea-
sion, or the back cover when appropriate. All
other original copies are filmed beginning on the
first page with a printed or illustrated impree-
sion, and ending on the last page with a printed
or illustrated impression.
Les exemplairas originaux dont la couvartura an
papier est imprimte sont filmAs an commandant
par la premier plat at an tarminant soit par la
darniire page qui comporte una empreinte
d'imprassion ou d'illustration, soit par la second
piak, salon la cas. Tous las autres exemplairas
originaux sont filmis an commandant par la
premiere page qui comporte une empreinte
d'impreasion ou d'illustration at an tarminant par
la darniAre pege qui comporte une telle
empreinte.
The laat recorded frame on eech microfiche
shall contain the symbol ~^ (meaning "CON-
TINUED"), or the symbol y (meaning "END ").
whichever applies.
Un des symboles suivsnts apparaitra sur la
darniire image de cheque microfiche, seion le
cas: le symbols — »> signifie "A SUiVRE". le
symbols ▼ signifie "FIN".
Maps, plates, charts, etc., may be filmed at
different reduction ratios. Those too large to be
entirely included in one exposure are filmed
beginning in the upper left hand corner, left to
right and top to bottom, as many frames as
required. The following diegrams illuatrata the
method:
Les cartas, planchea, tableaux, etc.. peuvent itre
filmte A des taux de reduction diffirents.
Lorsque le document est trop grand pour ttra
reproduit an un seul clichi, il est film* A partir
oa Tangle supArieur gauche, de gauche k droita.
at da haut an bas. en prenant la nombre
d'imeges nicessaira. Las diagrammas suivants
illustrant la m^thoda.
1
2
3
1
2
3
4
5
6
4
'1*^7
felt'ij
"P^HWfMMHMH
!#iS I
M >
H rr -
J fit .-
as and Text?
of Human Anatomy
i;i -f
,!*-
i;
#t#
Sobotta=Me Murrich
mmmmmmttimmtmmm
-«J*
,41
^1
'41
,!. J
I
l:i?xl^ I
t.:~:«^.
ATLAS AND TEXT-BOOK
HUMAN ANATOMY
BV
DR. JOHANNES SOBOTTA
PKUFESSIIR OK ANATOMY IN THK IMVfcRSITV OK wi'K/BrKi,
KDrrKi). \vi 111 AnniTioNs. bv
J. PLAYFAIR McMURRICH, A.M., Ph.D.
PROKKSSOR Ol- ANATO:\1V IN THK INULKSIIV oj Ml. Hit. AN
VOLUME I
BONES, LIGAMENTS, JOINTS, AND MUSCLES
IVith 320 Illustrations, Mostly in Colors
I'll! I Mil I nil \ \N-|i 1 .i\p. iv
W. B. SAUNDERS COMPANY
1906
gp,^
Co[>yright, i()o6. by W. B. Saunders Company
M. m SAUNOCMS CO
^M I L AO e L P>H l<
m^m/mR^
EDITOR'S PREFACE.
There can be no question as to the value of a gwxl Atlas of Anatomy as an aid to
the acquisition and retention of correct ideas regarding the structure of the human hodv and
the relations of its various parts. Anatomy, at i.-ast the descrii)tive ])art of i;, is k-arned onl-
when one can call up a mental picture of the part in ([uestion, and volumes of description wih
do less to furnish a correct picture than will a single dissection or the inspection of an accurate
illustration. This is especially ;rue as regards relational anatomy, and without an accurate
know'ofjgc of the relations of parts the student or practitioner will find hims.lf sadlv at sea in
his a^ plication of Anatomy to diagnosis and treatment.
To both the student and the i)ractitioncr, therefore, a good Atlas must prove a great boo-
to the one in enabling him to imjjress upon his mind wliat he has seen in the laboratorv, without
recourse to the pernicious "qui/.compend," which is but a Tantalus , up, to the other in
recalling the mental image more or less blurred bytim( , The !)resent Atlas, with its wealth of
accurate illustrations and its thorough though concise desc, :ptive text, is presented to Knglish-
speaking students and practitioners in the full confidence that it vvill prove of the greatest value
to them.
The work of the Editor in adaj)tin.., the Atlas for English readers has largely been conlined
to changes in t'-e omendature and :n the airangement of the text. In the (.riginal (Jerman
edition the text and Atlas were separate \.)lumes, the Atlas pro; er being i)rovide(l with a
descriptive epitome of the > irts re.<resented in the various figures. It has siemed 1k>i, both to
the publisher and to the ixlitor of the pr-sent edition, to unite the text and Atlas in a com-
mon volume, much repetition being thereby avoided and the usult being still a volume of con-
venient size. The translation of the German text ha< been done l;y Dr. \V. Hersev Thomas.
As to the nomenclature emi)loyed, it is es.sent.ally that projxjsed by the Hasel Committee
on Ana'omical Nomenclature, the tenns being, h()we\er, for the most jiart .Xnglici/.ed. In the
section on Myology thi' Latin terms have been retained throughout, since usage has already
made many of them familiar in their da.ssical form and it seemed i)referable, for uniformity's
sake, to use that form for all. A fe>v terms may be found sor ewl.at unfamiliar \n luiglish
speaking students of anatomy, and when these are used the more familiar term lias "been
added in parentheses. The adoption of a uniform code of nomenclature is of such great im-
portance that the slight inconvenience which the i)resent generation may exjjerience in the
temporary use of a double set of names for a few structures will be more tlian counterbalanced
by the advantages which a universal terminology will eventually olTer.
TiiE Editor.
University of Michigan, April tn, iyo6.
m
^£M
t-K*
TXT if']
.J^Wty-it
AUTHOR'S PRbFACE.
When I was invited by the publishers to prejiare an atlas of descriptive anatomy at a time
when f^'ood atlases were in abundance and the wants of the jjrecedinj; di>ennium had been
largely su|)plied, I did not accej)! without due retlection as to the demand for such a work. I
believed that this Jemand could be 1 t tested by hu -g -^fudents use the existing atlases in
their dissections. This test demonstrate!, not only t ossible ])oi)u'-irity of an approi)riate
work, but in many respects em[)hasi/.ed the i.icessity prei)aring an atlas which would be
handy, practical, not too comjirehensiv. nnn-'i-d with illustrations true to nature, and
specially adapted for the use of medical stude-.'s in the dissecting room.
My first thought, conse(|uen ^ vas to pn •.• e an atlas which would sui)i)iy the ])ractiial
wants of b<>th the student and the . , sician. Jt .s not an atlas fur the finished anatomist. The
admirable a..as of Toldt contains a vast number of well-chosen illustrations, but it is so com
prehensive that it is difikult for the student to pick out what he actually needs, and, owing to
its high price and the fact that many of its illustrations are not true to nature, it has not met
with great favor from the student body. In the present atlas ilie aiir. lias been to limit tiie
material to what is absolutely necessary.
The first volume has been comjjiled as an atlas esi)ecially adapted for use during dissection,
and the illustrations have consequently been arranged to conform to the usual miliiods of
instruction in anatomy. The fundamental princii)le of the work lias i)een to avoid any unusual
presentation of the subject which would make the recognition of well known relations more
dilVicult for the beginner.
To die best of my knr.wledge this is the first anatomical atlas in wide h muhicolor lithograiihy
has been employed. .Mmost the entire myology has been illustrated in this manner; of the
thirty-four plates in this volume, thirty were made by this method and the remaining four by
the so-called three (four) color process. The other illustrations wee made by the so-called
half-tone method, the complete adajitability of which is alumdantly demonstrated by the ])!( -
tures. .\dditional explanatory figures and diagrams ha\e been rei)roduced by simi)le line-
etching. \() woodcuts have been emjiloyed, since the failure of the latter method to produce
illustrations true to life has been distinctly sh )\vn by several of the newer anatomical atlases.
It leaves entirely too much to the discretion of the wood-engraver, whereas the photomechanical
method of reproduction depends entirely upoi_ the impression made upon the photograjihic
plate by the original drawing.*
* It has bee - <l;iimc(l for the wvKxlrut that many d.-siKna'' 'is may !«■ rut in lli. matrix, so ihal r.firrm c lines
arc not necessary. To my mind, this ndvantafri' is not of mu( h val..i-, since it is (|uite a limited one. I.iihographv allows
of a much freer sul)sequent addition of Ih.- desinnations to whatever extent they m.iy seem d.-^irahle, and when sm::!!
they are not so illegil)le as they fref|uently are in the wcKKlriil. Sinie it is undoubtedly true that a large number ..f
reference lines are inelegant and confusing, they have Ix'cn made in as few instances as possible, and where many dcsigna-
'3
H
author's preface.
In order to insure the accuracy of the illustrations, all of the preparations were photoRraphed
and the photograph was made exactly the same size as the intended illustration, lenses of the
longest possible focal length being .mployed to avoid perspective distortion * In the great
majority of the illustrations i)hotographs were employed as the basis of the drawings- Figs
167 to 171 are direct reproductions of photographs, and Figs. 178 and 181 were made from
photographs which ha<l been touched up. Only a few illustrations are diagrammatic and in
such instances it has been so stated in the titles.
The illustrations pDduced by the half-tone method have been made much clearer bv the
use of a number of colors. A buff color has been employed for the bones in the pictures of the
joints and of the muscles, and ^arious colors have been used for the different Ix.nes of the skull
and in the topographic views of the cranium.f No illustration has been omitte.l which would
make the relations of the parts more readily understood. Microscopic and topographic anatomy
have been disregarded to a certain extent, although enough has been given to serve as an outline
for the subsequent volumes, which will be more topogra,,hic than descriptive in character. The
i)arts have been designated according to the Basel nomenclature.
The original drawings for this Atlas were executed by .Messrs. K. Hajek and A. Schmitson.t
The former gentleman, who will also furnish the illustrations for the subsequent volumes, has
performed his diflicult task with such special aptitude and cleverness that the remaining volumes
promise to be even better an.l to exhibit still greater uniformitv in the metho,l of pnHiuction.
A number of the specimens from which the illustrations were made are in the collec tion of
he Anatomical Institute (Wur.burg), and I take this occasion to express mv special thanks
to Profess<.r btohr for his permission to employ them in this work. The majoritv of the joint
preparations all of the muscle dissections and some of the iK.nes, 1 have mvself'prepare.i for
the Atlas. In addition to tlie photographed specimens, other .lisseclions have been made and
compared, so that every illustration in the book has an individual character, with the exception
that marked anomalies have been corrected. The muscles have been given a bright red < ..lor
such as they exhibit in a fresh body after they have been exposed for a short time, although
less intense tones have been selecte<! than those of the natural mu.scular and fattv tissues
The i.ubhshers have .spared nothing to make the illustrations excel those ofall other works
in character and to equal if not excee.l those of the majority in number, in spite of this, how-
ever, the prite of the work is much lower than that of most other atlases.
Tin; AiTnoR,
tions were necessar, ,h.y have Invn .lis.r.l.u.e.l over several h.ure.. I„ some ins.anees e,plana,„rv .„„|in. ,„ hin«. h.ve
^:::::i i:;i^;r""- ■"■^'""'-^ '-"-' ''-- " '''^"-"•- -'-^ -"■ '"-^. - >■ '■■-" --'^;
* In a few eases in win, 1, |,er.,,eetive .listnnion was feared even when len,es of the lonR-st f,„ al l.nRths were en-
£:;!:,;"■■ ''"'■' • "^" '•^"-'-^^■>'^'" -half .he si.e of ,he ..esirH ilh.s.ra.i ,n.l ,he ,„!„., ,, . ^^.^J^LZy
in h, J.;;;:z::,;t ::;::;::' "- '""- """•■ ■■- -'-- -^ "-■"•" ••^' •"•■ »-"■■ - ^ < ^a,,,,,,, . - he ,„ ,.„e
t AtxiUt ten uf Ihl- i||n»lrat!..>r!-. •••. !!;;■ •!!::; ■^,:,-
sulMijuenlly eomplet'd liv Mr. Ilajek
rit-ti r;y \\ . Fn ytag, .ii,iv»iNn iiia.stei in the I niversily, and
CONTENTS
Ifitroduction 17
Osteology I,,
Gexkrai. ( )sTi:()i.or,v uj
Special Ostkoi.ocv 22
The Skeleton of the Tkink 22
The Xcrtcbrul Column 22
The Trui' \'crtt'lir;c 22
Till' C\rvi\ al \iTti'l)r:i' j ^
The Thiiraiit Nertehnr 26
The Lumhar \erteljra- 27
The False \'ertel)r:e 2S
The Sacrum 2S
Ihe ('onyx ^q
The X'erteliral ("oluniii as a \\ iKile ;o
The Develoiimeiit of the Verlehral Col
umn . I
The kihs [\\[ ,2
The Steriuim -^
The Thora \ . ^
Tile Develo|iment of tin- Rilis ami of tne
Sternum .^
Variations in the Skeleton of the Trunk '^5
The Skeleton t>F' THE Hi; \i) ^f,
The Anterior Aspect of the Si- nil \h
The Lateral As|)ect of the Skull ,7
'I'he i:\teri\al Surface of tin Uase of the
Skull ,,,
The Internal Surface of the iia^e of the
Skull ^,
The Superior Aspei t of the Skull 44
The Inner Aspect of the Cranial Vault or
Calvaria 44
The Hones of the Skull 44
The Craniiil Hones 4r
The ( )n ipital Hone 4^
The Sphenoiii Hone 4-
The Temporal Hone ^i
The I'ariet.il Hone i;,,
The Frontal Hone ^
The Fthnioirj Horif t. . |
The Inferior Turiiinateil Hone f)4
The Lachrymal Hone 64
The Skeleton 01 the Head (Cnnliiiiinl) p,,,.
The Nasal Hone (15
The \"onier 6:;
'The Maxilla 60
The Talate Hone (xj
The Zxuoniatic lione 70
The \ian<lihle 7,
'The Hyoid IJone 7^;
'The ( )rliital Cavities 7"^
'The Nasal Cavity 76
'The Roof of the Oral Cavitv, the Hani
I'^.late -. 78
'The I'ter\!;opalatine I'ossa 78
The Infratemporal l''ossa 79
'The Sutures of tlie Skull 70
'The Skull of the Neu horn 81
'The Skei ETON or hie Iatki mitii s 82
The Skeleton (IE thi Cimm r i;\rKi\in\.. 8^
'The Shoulder (iinlic 8^
'The Scajuila 8^
'The Clavic !<■ 85
The Humerus 85
'The rina 87
The Hi<lius 88
'The Hones of the Hand 8()
'The Carpal Hones 8()
'The MetiUarpal Hones iji
'The Hones of the I'ini;ers ()2
'The Sesamoid Hones of the Haml <)2
The Skeleton of the Hand as a Whole ()2
I'm Ski I troN or Tilt l.oui k lAikiMin . . . qt,
'The I'ehii (iirdle ij^
'The Innominate Hone (j^
'The Femur ((7
'The Patella ,,,,
'The Tihia ()()
'I he I'iliula 101
'The Hones of llu FiMit 101
1 he 'Tarsal Hones 102
'I'he 'Talus 102
Thv CilrHHHi- ic;;;
Thi' Navii ular Hone 10?
'The ("ulioid Hone 104
i6
CONTENTS
i
PAGE
The Skeleton of the Lower Extremity
The Cuneiform Bones 104
The Five Metatarsal Bones 105
The Bones of the Toes 105
The Sesamoid Bones of the Foot 106
The Skeleton of the Foot as a Whole 106
Syndesmology ^°1
General Syndesmolugv 107
Synarthroses 107
Diarthroses 108
Special Syndesmoi,o(;y 1 10
Joints and Lioaments of the Vertebral
CoLiMN 1 10
The Connections of the Vertebral Bwiies .110
The Intervertebral Articulations 1 1 1
The Ligaments of the Vertebral Column. . .111
The Articulations of Sacrum and Coccyx. .113
The .Articulation of the l'i)()er Two Cer-
vical X'ertebra' with Kach Other and
with the Occiput 1 13
The .\rticulations of the Ribs with the \er-
tebral Column and with the Sternum. . 1 16
The .Artici-lation's and Ligaments of the
Head 117
The Temporomandibular .Articulation 118
The Inde|)endent Lii;aments of the Head. 118
The Lipaments of the Hyoid Bone 1 iq
The Joints and Ligaments of the Upper
Kxtrkmity iig
The SterniH lavicular .Articulation i k)
The .Acroniiiiclavicular .Articulation 1 20
The Lipaments of the Sca|)ula 1 20
The Sill lulder- joint '21
The Llbow-jiiinl 122
The I)i>tal Radio I'Inar Joint .md the In-
terosseous Membrane 1 23
The Joints and Ligaments of thi. Hand... 124
The Joint> of the Carjius 124
The Carpal Lipaments 1 2(1
The Unper joints 127
TirK Joints ani> Ligaments of the I'kiak
(liHKLF 128
The I'ehic Lipamei.tv. Synarthroses and
Diarthroses 128
The liidepen<lent Lipameiils of the I'elvi: 1 21)
Tlie I'llvis as a Whole 130
The Hip- joint 131
The Knee- joint 133
The Articulations of the Tibia and Fibula . 13(1
PACE
The Joints and Ligaments of the Foot ... 137
The Joints of the '^oot 137
The Ligaments of the Tarsus 139
Myology '42
(jEneral Myology ^4^
Special Myology i44
The MrscLF.s of th . Trunk 144
The .Muscles of the Back 144
The Short Muscles of the Xeck 155
The Fasci;e of the Back 1 56
The .Abdominal Muscles 157
The .Abdominal Fa.scia- 163
The Diaphrapm 164
The Thoracic Muscles 166
The Pectoral Fascia- 170
The .Muscles of the Neck r 7 1
The Prevertebral Cervical Muscles 1 76
The Fascia of the Neck 177
The MfscLES of the Head 177
The Musdes of the Fai e and of the Scalp .178
The Fascia of the Head 184
The Mis( les of the C er Fxtremity — 185
The Muscles of the oulder 186
The Mu>cles of the I ;ii)er .Arm 188
The Muscles of the 1 urearm i<)i
j The Muscles of the Hai.d ig8
I The Muscles of the Thenar l.minence iqi)
' The Muscles of the Hy|>othenar Fminence 200
The Inlerossei and Lumbricales 200
The Relalinnsof the Fxtensor Tendonsand
their Sheaths beneath the Dorsal Car-
pal Lipamenls 203
The i;\teM>cir Tendons of the Finpers 204
The TeiKJoiis and Synovial Shcatlis of the
Flexor Teiiilons in the Palm 205
The ['as(ia' of the Cppcr Fxtremity 207
The Most Important Bursa' of llir rp]HT
JAlremitv 20H
The Mcsi I fs of the I.owtR Fxtremity — 2og
The Musi les >'( the Hip 210
The Muscles of the 'Fhiph 214
The Muscles of the Lep 2l()
The Mus. l.s i.f ihc F<K.l 224
The Sviii'i 1.1 1 Sheaths of the FimiI 22q
The I'asiia of the Lower Fxtremity 231
The Most Imi>ortant Bursa of the I^)wcr
F--:ir!mity =3,1
Index 2^7
rAOE
-•137
-■137
--I39
..142
..142
..144
--I44
..144
•-■55
..156
• -I57
..163
. .164
..166
..170
..171
...76
..177
. . . 2CK)
. . .210
...214
...210
...224
. . .22Q
. . . 2? I
WIT
• ■ ' -.1.1
...H7
ATLAS AND TEXT-BOOK
HUMAN ANATOMY.
INTRODUCTION.
Human anatomy treats of the structure of the human bo<Iv, in contrast to physiology-,
which treats of function, ami it is usually sulxiivi.le,! into general anatonn an<! special anafm,; .
General anatomy is practically synonvmous with histologv, an.l treats of the structure of the
comixment i)arts of the both .
Special apntomy is usually termed .iescriptive or systematic anatomx , since it consists of
the simple description of the dilTerent parts an.l systems of the My. It' is conse(,uenlly com-
lK,se,l of a number of sulxliyisions: OsteoloRy, treating of the U.nes; Syn.ie.smology, t'reatin-
of the jomts and ligaments; Myology, treating of the muscl.s; Splanchnology, treating of the
yi.scera; Angu.logy, treating of the yessels; Neurology, treating of the neryous system; an,! of
the description of the organs of S])ecial sense and of the skin.
Descriptiye anatomy, considere.l from the special standpoint of die mutual relations of the
in.liyidual parts, ,s termed topograpHi, anatomy, and that branch of anatomy -.yhi.h ha. to
do with the deyelopment of the Ixxly is designate,! Kmbnologv .
To in.licate the rela!ion> .,f the different parts of the IkkIn to ,ach other or to the lK,dy in
general, certani technical . vpro.ions are employe.!. In des. ril.inu' ihe position of a structure
a i> always to be asM.me.l that ilu' lK.!y is in the ere, t p,.>t,.re. Tl,.. m,.,lian plane .lixi-les tlie
b..ly into two alnu,st similar habes* sin.e man, like th,. nuijorilN of animals, i> bilaterally
.symmelruv.l. .\ny plane of th,' lunly u hi, I, is parallel t,. th,- mclian plane is t.-rnu,! w;^.,//,,/
(from tlu' sagmal sutur,., see page 7,,,; di,.se whi, h ,>ass thn.u.J, the Uxly hon/.onialh are
terme,! Iwrn.n,,.,/ or Iransr.rs., while v.rnV.d planes at right angles to th.. m,dian plan,- are
kn..wn as /.„«/<// phmes, sin.,- th..y are pandl.l to the for.hea,!. If a part is siu.ate,! n.arer
10 the mcban plane, 11 ks .lesignalnl hil,rn,il ,.r mnfi.il; while if it is m,.r,. remol,. it is sai.l to
Ik. ..y/, W or h,/rr,.l. The ,!ir.., tion toward ihv n.clian pla i, spok.n ..1 as i,n.„nl and the
<)|)lM)sile .lirecti.in as imlwani.
Th,- wonis niumal an,l .xt,r,u,l ar.. also ..mpioye.l in nf,.r..n,.- t,. l!,.- ..niti.s of th.- 1h.,1v
• \ltim„«h ,l„. I.il.a.ral sy,„m,trv U no, ,o,„|,l,„ in ,l„ ,„lull IkhIv, i, i, ,.rf.U .luonfi .ml.ryoni, lit,-.
i8
INTRODUCTION.
or to the inner or outer surface '.'' i portion of the body; in this connection it is frequently better
to substitute the word superficial for external, and deep for internal. Above and below, like
all other designations, refer to the irect i>osition of the body, and this direction may be frequently
better indicated by the terms cranial and caudal. In front and behind refer to the anterior
and posterior surface of the body, but this relation may be more accurately expressed by ventral
anrl aorsal.
Special additional designations arc to a certain extent necessary for the extremities. In
this connection, proximal means nearer to the trunk and distal more remote. In the forearm
it is preferable to use the words radial and ulnar instead of outer and inner, since during prona-
tion (see page 123) the inner side is directed outward and vice versa; and since the pahn cf
the hand and the sole ni the foot are designated respectively as the volar and plantar surfaces,
the words volar and plantar are used to indicate the position of parts situated upon the corre-
sponding surfaces.
OSTEOLOGY.
GENERAL OSTEOLOGY.
The greater portion of the skeleton of the human body is composed of bones, the remainder
consisting of cartilages, and since the lx)nes consist largely of lime siilts they are miirh lirmer
than tl- • cartilages, which, though harfl, arc nevertheless flexible. The i)arts of the skeleton
are either j .aired or single, the latter being in the minority.
The bones of the human body van,- greatly in their form, shape, and size. The largest
bone is the thigh bo,>c or femur; the smallesi are the sesiunoid bones of the harJ and the auditon,-
ossicles. According to form, we usually disiinguish between Inn or tiibii/ar hon<s, broad or
fat bones, and short hones, while bones ])ossessing air-confdning cavities are also calkxl />«<■(/-
tnatk l.ims.
The long brrics have in general a cylindrical shajjc and are found only in the extremities.
With few exceptions, they consist df a middle iK)rtion or shajl dliapliysis) and of two ends or
cxtranitics {cpip/iyscs*). The shaft contains a cavity, the nudullary cavily, w is filled wilh
bone-marrow, and it is on this account th.U these ijones are also termed //(/' ix)nes. The
bony sub.-taneeof their shaft surrounds this medullary cavity and, on account of \\. firm slnirture,
is know 1 as the compact substance, in contradistinction to a less .knse sjKingy substance, which
consists of a fine network and forms llie greater portion of tlie extremities of the lx)nes with
the exception of a ver>' thin outer conipat i layer of c )rliial substance.
Tile long i)ones of the human txxly are found only in the skeKton of the extremilies. They
are as follows, the ckivicle, the humerus, the radius, the ulna, the five nietaeaq)al JHrnes, the
l>ones of the fingers and toes, the femur, the tibia, the !".bu!a, and Uie metatars;il lx)nes. Tiic
ribs are classified with tlir Hat Ixmes.
The broad nr flat bones are markedly llattened one direction rind have the sliajje of
llat or curvid pkiics. Their central portion ((insists ot spo-gy l>one, the cortex In ing fonued.
ho\ever, l)y a more or less thick kiyer of comjiact corlieal substance. In manv iii^tauds tl cy
are i.r-vi.ied with well markeJ iinnesses. In the tlat Ixnies of the skull the spongios;i i> kno\ n
a> the (///)/,)(•, while the la>ers .if compact subs! ukc are designated as the outer i'nd inner vitreou.-
laMvN The llat Ixiius of the human IhkIv are: the sternun-, the scapula, tlu innoiiiiiiale l«.nes,
the rii)s, and many of the ( raniai Ixmes.
The ■ lort bones have an irregular fomi and ; ■ one ot liuir diameters giialh e\((((ls the
others. ..ley consist almost entirely of spongy ti--ue, their e()mpa( t ((irti(al laver be iiii,' fre
f!licn!!v VI-
thi--
Tht\ are freijUeiit!\
ii: :
♦ Tlic 'crnis I |ii|iluMs am! rxin mil'i« .in rii.l. as a rulf,
I'xtrcmiiit-, usually mnlain |Mirtiim^ uf ilu- ilia|>liv>JH a- we
'9
in 1,'i't'!! '.:', groiijjs, as in liii carpus aini i.nMi.-.. 1 in-
nuii^nidus, siiHi- llir |Mir;ii.i,, ,if \\h- Ikiiics iI, -ii-ii.iif il
a^sLj..
._^JkijJ
20
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
most important short bones of 'he human body arc: the true vertebra?, the carpal bones, the
tarsal bones, the patella, and the sesamoid bones.
In addition to the long, flat, and short bones there arc a number whic.i cannot be ciassiCcd
in any of the three cate<;ories. These are designated as irregular bones ; as a rule, thev repre-
sent transition forms between the broad and flat bones, as in the cases of the sacrum and of
many of the cn-.nial bones. Among the latter there are also some— for e.\ami)lc, the temporal
bone and the occijjital bone— which in a portion of their extent are typical flat hones, while in
their remaining jjortions they would be regarded as belonging to the group of the short or irreg-
ular bones.
.AH the varieties of bones may possess prominences which take the form of projections,
ridges, and ])roce.«ses of the most viritd shapes. .-According to their size and form, they are
designated as tubercles, tuberosities (rough, more or less jironounced projections), spines, crests
(rough lines or projecting ridges), processes, condyles (also termed condyloid or articular processes),
epieondylcs (/. c, j)rojecli()ns situated alxivc the condyles), and outgrowths {apophyses). In
a similar manner many bones possess excavations {jovece or josser), impressions, grooves, furrows
{sulci), notches (incisurir), perforations {joramina), slits {hiatus), and canals. The enlarged
rounded ends, particularly of the long bones, are frequently called heads, while the constriction
situated beneath tliem is known as the neck. All bones poss ss larger or smaller foramina for
the entrance of the nourishing l)lood-\ sscls; these are known as the nutrient joramina, and
are particularly large in the shafts of the larger long bones, where ?hey lead into a nutrient canal,
which extends into the medullarv cavity.
Thi hones of the human body are usually studied in the n.acerated condition, /. e., after
their soft j.art.-, iia\e been removed by putrefaction. The bones of the living bo<ly and of the
dead subject, however, consist not only of bony substance, but also of a series of soft tissues,
some of which jjartly resist jiutreiaclion, so that the "entire bone" is composed of the following
constituents: (i) The actual Iwn;- tissue; (2) the jjeriosteum; (3) the articular cartilage; (41
the hone marrow; and (5) the nutrient ves.sels and nerves.
Th.' mai.iMti-.l liimc n priscms nut .,nly lli>- l«,m-ash, ,'. r., tlic <alcium salts of llio iKinc, but also lonlains otlur
orcatii, (onslilucnts, Tlu' In.in- Mil.slaiKi' .(insists ihrmi, aliy ..i alinoM tuo-thirrls inorKanii , ami of a litllt- miw than
ontthiril orKanio mali rial; tin- latlir is hi.-lly plalin or oss, in, an.l ni.iy ]h- dfmonstratril in lh<- furni of Ih.' so-<alIicl
Imni'-iartilaKf by .xtra.linK tin- (allium .salts with a. i.K. Tl,,. ii„,r(;anic .onslitu.-nts of bom an-, (allium larbonati-
(aU.ut 85.5 |.ir i.nl i.ialiium |ilios|,l,alr (al«.ut o per i int.1, i ali ivmi lUiori.le (alK)Ut ,;.5 per n nt), and maRncsium
|.n..s|ilialc (about 1,7; piriint.), anil may b. il.monslral.il by hialinKlhf drivd boni' to incand.'S( in, c. limh llii- bone
larlilaKi' and tin- , al. in.d bom- main llic original sha|a' 01 tin- bonr from whirh Ihcy were obtained, tliu orRanii and llu-
inor^anii 1 onstiiui ills bring inlimalily intirniin>;lii|.
I he actual bony ti? -le apptaiN in two ni(>(!ilications, which jiass into each other, how
ever, wi'huut ileniaixat he conijiac t Mih>b(ine and the >p.ingy sul^laiuc. The former lui>
a dense and ap|iarenli\ |Uiti' iinil'orni stmiliire, while the spongy suifsiance conM.sls of a line
network of Iwrny trabet uhe, whit h al lirsl sight seem to be without delinile arrangement.
In reaJilx, howe\-er. the :in liiioi tnro of tli(. cTu>n.r, ^iilj^i. ,«,.,. jo i„. .,,, .,,, : r--!ir
. / i'""r .: '••'•■■'•■ 11 ! t - n ;..;,, 1:1a . .
Its parts are arranged in siuli a manner a> to pnxiiiie a tirm and resistent structure with the
greatest po^bihle sa\ing in weight, and a careful examination of its trabecular and plates will
GENERAL OSTEOLOOY. 21
show that they arc placed so as tc lie in the direction of the greatest pressure or muscular trac-
tion exerte:i upon the bone, and cvcr>- bone or part of a lK)ne formed of sp. -v substance con-
tains, consequently, several intersecting systems of trabecule which cross each other mostly at
right angles (Figs. 167 to 171).
Almost nowhere in the Ixxly do we fmd Ixiny tissue uncovered, as it is enveloped either
by articular cartilage or by periosteum. Articular cartilage covers the ends of two lx>nes form-
inn a joint, a.s in the extremities of most of the long bones; the remainder of the lx)ne is envit-)ped
by f)eriosteum, a fibrous connective-tissue structure van,-ing thickness, whiih is of great im-
IX)rlance for the nou-ishment, growth, and regemiation of the bone. Articular cartilage i.;
hard but elastic, and consists of the so called hyaline cartilage. Its thickness varies gnriK in
difTerent bones, Ix^ing sometimes only the fraction of a millimeter or in other cases amounting
to several millimeters. (I )r ihe mo:v minute structure of tone, jieriosteum, articular cartilage,
and lx)ne-mar-ow, see Solxuta's "Histology," Saunders' "Medical Hand Alhues.")
The bone-marrow appears in two varieties, the red and the yellow, TIu- ycll„w marrow
is really fat tissue, and is found in the medullar)- cavity of the long Ijones of the adult, while
in young individual- these spaces are Idled by red marrow, a soft vascuiar structure, whiih is
also situated in the liner medullar,- spaces of the adult Ix.ne Ixtwetn tin sp.,ngv trahecuke.
The vessels nourishing the lx)ne are found cliiell\ in the medullar- cavit\ and ].eri()sirum,
but they also occur in the bony tissue itself. The nerves, on the contrary^ are found princinallv
in the periosteum, the bony tissue having no ner\es, and the articular cartilage luither nerves
nor vessels.
In certain regions of the hur.an Ixxly, ewn in the a.lult condition, jxirdons of the skeleton
arc formed by cartilage, as at -he anterior extremitiis oi' ilij ribs, and sin.e lartilage is clastic
and flexible, it jjlays quite a (V rent functional role from dial of lx)ne. These canilages are
enveloped by a connective tiss,'. covering, the p,ricli>mdriu»;
Willi rcfrnncc to tti.^ .i,v,-lopm.-nl .,f h„n,., |nv„ v^rioiirsuf l«,n,. furi.^mion an- r.TORnizal.I,.. ThrKr.-al tnaj<,rity
of thr Lotus ar.. lai.l down l„ .artilap. ai a <mam sta,?>- . f f.tal .iinloimi. nt, an.l llu-s.- l«,nrs, whi, h arc tint, pr.for.tt.-.l
in .artilagr, stan.l in contrast with those «hi<h an- fornu.l l,y th,- ,linrt ossifi.ation of , onnc. tiv tivs,,,., the s,,-, .,l,,l
itifmliraiious iK.nrs, .■.vampl.s of which arc to !„• foi„„l in ihc majorilv of tlu- Hal . ranial Inincs an.l in n,,,„v of ,h,. fa, iai
bones. (For a minute dcMription of the processes of o.sili, alio.., s, ,■ SolK.tla'. " Ilistolo^-N .- Saiin.lcrs- ■■ Mdi.al II m.l
Atlasi's.")
During the transfornialion .,f the ^artila^'in.uls inlr, the iK.nv skcl, ion. a pro, cs. «hi, I, lie-in. carlv l,ui pr,„,>,ls
slowly an.l la.sts very long, usuallv nol l.einn completed unlil the lw,niv lifih vcar, ^-.called .emers .,f ,„si,„ „ion
apiH.ar in the cartilaginous portion^ of ihc skel.ion Tlu-c , enter, nuv U- si„g|,. ,.h,.rt l«,ne , or, as is uM.allv the
ta.se, multiple, and .sometimes they .u,ir in relativch large nmnlHr. an,l are s,,me«hal irn-gulariv arranged (a- in the
sternum). I sually, however, particul.irly in the long !».»,■. of the estremi'u , the , enter for the fulur.' shaft of the U.ne
the diaphvsial center, appears firs,, while the en.ls or epiphyses s,i|| r.ma.n artilaginou., an,l each epiphvsis laler ,le.
veU.ps at least one ami f^.,,uentl^ several s.'parate centers of ossil,, ,,iion (the evcepiion- .,re giv, n npon pag,' y ■> whi, h
not only apiK-ar at a much later peri,Kl than the .liaphysial enter. Inn long after hirlh an Mill -, parated fn.n, !h. ,,n
ler for the .haphy-is hy a layer of > artilag,-. This is term,,! ihe epiph^.ial line (syn, lumdr.u. .,>,/ I,ys.;.s), and ,1 linally
disapfiears and the Ixjiie Injcomes obsilitd lliroughuut.
..^Ai- r»,«ipvv;f>i:
'^*^.
32
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
SPECIAL OSTEOLOGY.
The human skeleton may be Ecpara'ed into three chief divisions: (.\) The skeleton of the
trunk; (H) the skeleton of the head; (C) the skeleton of the extremities.
I-'rom the stan(ifM)int of embryology and t-voiution the skeleton should lie divided into: (i) The axial skeleton,
»'. c, the vertebral eolunin with its adnexa and the greater part of the base- of the skull; {2) the appendicular skeleton,
/. r., the skeleton of the extremities; and ( ^^) the membrane and viseeral bones, /'. f., the Hat bones of the rranial vault
and the facial Ixmes, and those portions of the skeleton which re|)resent the visceral or branchial skeleton of the lower
vertebrates.
The skeleton of the trunk is formed by the \ertebral column and its appendages (the ribs
and the sternum), the skeleton of the head is re])resented by the skull, and the skeleton of the
extremities is further sulxlivided into the skeleton )f the uj)per and that of the lower extremity.
The Skeleton of the Trunk.
The principal portion of the skeleton of the trunk is the vertebral column, which is com-
posed of a series of ])arts, the verlebrcr. A ty])ical vertebra consists of a body and of arches,
these latter being sulxlivided into a posterior or dorsal and an anterior or ventral arch. The
posterior or dorsal arches surround the spinal cord, while the anterior or ventral arches, in the
form of the ribs, are well de\eloped only in the thoracic portion of the vertebral column and
are rudimentan,- in the remaining vertebras they surround the vegetative cylinder of the body,
the intestine. While the dorsaJ arches are firmly united with the bodies of the vertebra-, the
ribs are jjaircd bony arches articulating with the thoracic vertebne behind and anteriorly with
a sj)ecial bone, the brcast-lx)ne or sternum.
The entire series of the vertebra; form the s])ine or vertebral column, and the thoracic ver-
tebra- with the ribs and the sternum form the thorax. The skeleton of the trunk consequently
consists of the vertebral column together with the thorax.
THE VERTEBRAL COLUMN.
The TRUE VERTEBRiE.
In the vertebral column two main subdivisions may be recogni/.ed. One subdivision is
formed by the true vertebrcr, the other bv the jalse vertebra-, the former being separate bones
connected by ligaments and joints, while the latter are united by bon\ tissue to form larger
hones. The entire human spinal column consists of thirty-two to thirty-five vertebra-; of these,
twenty-four are true vertebra- and eight to eleven are false vertebra.-. The true vertebra; may
be separated into three sulxlivisions: (i) The cervical verttbra-; (2) the thoracic or dorsal
vertebra-; and (^ the lumbar vertebra-. There are seven cervical, twelve thoracic, and five
lumbar veri. Ijra-.
.■\ typi(al vertebra is comijosed of: (i) The bod; ; (3) the vertebral arch; and f_^) a num-
ber of ])rocesses.
THE VERTEBRAL COLUMN.
23
The body (Figs, i and 2) is composed of spong\- substance enclosed by a thin layer of cor-
tical compact bone. It presents a superior and an inferior plane or curved surface, an anterior
surface markedly convex from side to side and slif,'htly concave from above downward, and
a posterior surface which is concave in Ixjth directions. The posterior surface usuallv presents
one or more larn;e nutrient foramina and, with the vertebral arch, completes the enclosure of
the spinal foramen (joramen vertebralr). The arch consists of somewhat I'lrmer tissue than
the body and forms from a half to three-(|uartcrs of a circle. The ]>ortion continuous with
the body on each side is known as the pedicle or root (radix arcus irrltbrtr) (Vv^. i), antl presci '~
a notch upon both its ujjper and its lower surface {the superior and '.njcrior irrtcbral iwlclns)
(Fig. 2), the notches of contiguous vcrtebne (the inferior notch of the upper vertebra and the
superior one of the lower vertebra) together forming an intervertebral foramen whi( h commiini-
transverse process. /,
proceai.
spinous process
,. . suptnon/ertebral notch
superior arlicular r\: rv
process
SUpenordimi facet
forhcadofnp\ <
matiersc jjroeas
facet for
luhercleof
rib
h 'Or demi facet Inferior Inferu. ^
fo, .eadofrib mlebral articular
' ' notch firoeess
A vcrtcljra seen from above.
Flo. 3. — .A vcrtilr >oen from the siili-
cates with the spinal canal. The superior intervertebral notch is usually the shallower; the
inferior one the dce[)er.
The processes of the vertebra- consist of the articular jirocesscs (Fig. 2), for the ])urpose
of articulation with neighboring vertebra-, and the spinous (Pig. 2) and transverse processes
(Fig. i), which serve as ])oints of attachment for the mu.scles. Even,- t\ ^ ''-al vertebra j)ossesses
four articular processes, two superior and two inferior, and these bear articular surfaces which
are correspondingly named. Of the remaining jjrocesses, the sjjinous process is single, while
the transverse j)rocesses are paired.
THE CERVICAL VERTEBRE.
Of the seven cervical vertebra-, the two uppermost ones, the first or atla^, and the second
or axis (epistropheus), show marked deviations from tlu- type. They are also known as "rota-
tor\'" vertebra;, in contradistinction to the remaining vertebra- (tle.xion vertebra-l.
The general characters of the cervical vertebra- (Figs. 4, 5, and 6) arc \.s follows; The
24
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig. 4.— The cervical vertebra; seen from behin(i and partly from the side (f ).
Fir,. 5.— The fifth cervical vertebra seen from above ( } ).
Fig. 6. — The seventh cervical vertebra seen from above (|).
Fig. 7. — The atlas seen from above (|).
Fig. 8. — The axis seen from above (J).
bodies arc relatively small, low, oblong for quadrilateral with rounded corners), and thev in-
crea.se in size from above downward. The Ixxlies arc smaller than in any other region of the
spine, and their u]5pcr surfaces are concave from side to side and slightly con\e.\ from before
backward, while the lower surfaces an.- concave from before backward and slightly convex from
side to side. As a consequence of this, the upper surface of every vcrte})ra projects laterally
beyond the body of the \ertebra ne.xt abo\e
(Figs. 3 and 4).
The arches of the cervical vertcbne (Fig. 5)
are of medium height and ari.se by a pedicle which
is directed outward and backward. Together with
the body, the arch surrounds a s])inal foramen
which is ver\- wide, especially in its transverse
diameter. The articular proces.ses (with the e.\-
cc[)tion of tho.sc of the upper two vertebra') are
])laced obliquely, so that the plane of the articu-
lation pa.sscs from above downward and from
before backward, and the articular surfaces are
consequently in a midrlle position between a hori-
zontal and a frontal jilane, tho.sc nearer the skull
approaching the horizontal position, and those
ncarci the thoracic vertebra; the frontal plane.
The transverse processes (P'igs. 5 and 6) of
all the cervical vertebrae arc perforated by a large round foramen {joramcn Iransvcrsariiim),
a peculiarity which distinguishes the cervical from all other \ertebra'. Furthermore, the ends
of the transverse proces.ses are ])rolongcd into two Uibercles separated by a groove (sulcus itrni
spinalis) (Fig. 5), situated u])on the surface of the transverse ])rocess.
The anterior nwt (if the tr.insverse iiriiiev-;, whii h passes cliret lly oulwaril from the ImkIv of the vertelira and is
.separated from the |K)slerior root by the foramen transversarium, the sulcus ncn'i spiiuilis, and the eonslrietion between
the two tutjercl s, is known as the eostal proeess {processus coslarius), and represents a rudimentary rib adherent to the
true transverse process whieh is represented by the posterior root. This eostal process is ok asionallv independent,
especially in the seventh rervieal vertebra, and forms then a cer\i(al riti.
The s])inous processes (Figs. 4 and 5) arc for the most part small, somewhat downwardly
inclined, and distinctly bilid at their apices.
From the third to the sixth the cervical \ertebra; arc typical. The seventh (Fig. 6) is dis-
tinguished by jjossessing a long spinous process which is rot bifid and is directed downward.
Fig. jj. — Cervical %ortebra' seen from in front.
(idoiUo, i process
I ransvcrst
pivoss
vr lor
'III iirtiiv
S/)iiii>iis prori'ss
Arch
Siipniiir iirliruliir
fiicil IpiiHrssi
I I'riinicii
iiisvirsiirhiin Body
\'!h I :.'!■ iiihririi- •'/
/'.'-;. )/>;■ iiihriilr .'I
Hi!.
iviiith iirvirul
VI itilirii
Spiihni^ pr.nrss
Odoiiioiil proii.^<.
(iiiilirinr iirliniliir
fllCCti
Superior drlinilur Pant
Siiprn'or iirliniliir
fiiirt tpr(>ii\\)
f lo. 0.
I'o^ttrior tiiluirlr
Infrrior Body
iirliaihir
facet
H<r, S.
Siipnior
articular
I'llCCi
(jri'i'vc for
vertebral artery
/ raiisvcr-<e /troccss
f oranien traii^vi r<ariii
I alcral ma
.\nl, -ior tiiher.le
r.vv-?:^!!^ ^
THE VFRTKBRAI. rOI.I'MN.
25
and in these respects the form of the vertebra approaches that of the thoracic vertcbr.T. Its
spinous jirocess is the uppermost one discoverable by paljjation, and the bone is therefore al
known as the vertebra prominens. The anterior tubercle of its transverse j)rocess is eitlu
entirely or abiost entirely absent, and the foramen transversarium is usually smaller than in
the other cervical vertebra*.
The first cervical vertebra, or atlas (Fif;s. \ and 7), is characterized by a seriis of negative
peculiarities. The body ."s absent, but in its place we find an anterior arch, opjiosite the custo-
mary posterior arch which the lx>ne a..^o ])os';"sses. The spinous process is also wanting, its
place btinK taken by a jirominence known as the ])osterior tulxTcle, correspondini,' to which
there is an anterior tubercle upon the anterior arch. Finally, instead of articular processes,
it possesses two upper and two lower articulaiuif; su' faces, and lx)th the superior and the infc rior
vertebral notches are absent.
In the atlas there are distinj^uishable therefore : anterior arch, a jjosterior arch, and the
connecting lateral masses, which are thi- stron ;est portions of the Ijone. The anterior arch is
shorter and weaker but hi<,dier than the posterior one; anteriorly (ventrally) it presents a slight
projection, the anterior tubercle; i>osteriorly (dorsallv, /. c, toward the spinal v,;mal) a round
hallow articular surface (joi'ea articidaris dentis), for articulation with the txlontoid jirocess
or dens of the axis (the second (^irvical vertebra).
The posterior arch of the atlas bears ujion its posterior surface a short i)roji(iion, the pos-
terior .uberclc, a rudiment of the spinous process, and is the lowest of all the arches of the
cer.'ical vertebra- (and in fp.ct of all the vertebra?). It is Hat and broad, howewr, and presents
U])on its upper surface near the pedicle a furrow wliieii is sometimes shallow and sonnlinies
broad and deej), and which is (K:cu])ied by the vertebral artery. This i,'r(H)\c is ndt infrec]uenlly
bridged over and converted into a foramen or short canal with a rough inner margin.
The inner portion of each latend mass of the atlas (tuberositas atlautisi projects markcdlv
into the anterior juirt of the sjjinal canal, so that the latter is converted into a smaller anterior
comi)artmcnt, for the reception of the odontoid jirocess of the axis, and a larger posterior com-
partment. This j)Osterior compartment is really the spinal foramen and lonlains the spinal
cord. U])on the upper surfaces of the lateral masses are the u])i)er articular surfaces for the
reception of the occijjital condyles. These surfaci's are Ix'an-shaped and, correspon<iing
to the convi'xity of the condyles, they are concave from anteriorly and withir to posteriorlv
and without. In the middle they are constricted and occasionally divided. On the under
surface of the lateral masses arc found the inferior articular surfaces which serve for ariic ulalion
with the second cervical vertebra and resemble the similar surfaces of the other vertebra- more
than do the superior articular surfaces, possessing plane, but slightly incluied (almost lidri/ontal)
surfaces.
The transverse ])rocesses exhibit the s;ime characteristics as the transverse processes of
all the cervical vertebra?, but are larger. Like the others, each jiossesses a foramen trans\er
sarium, i)ui the sulcus nervi sfjinaiis and the tulKTcles are al)sent.
The second cervical vertebra (Figs. 4 and 8), or axis iepislropheus), so calkd be(ause tin
occiput and the atlas rotate ujwn it, is on the whole a typical cervical vertebra, except thai its
body has adherent to it the original body of the atlas, whiih t'orms the odontoid process idens
.1 ,>ri(i"V' "
.•^ '"5^^
r-rt'- 1
ATLAS AXD TEXT-HOOK OF HirMAX AXATOMY.
9.— The tenth to the twelfth thoracic and the first and second lumbar vertebra^ seen from the side
and sliijhtly from Ijehind (J).
Fig. 10. — The tenth thoracic vertebra from above (',).
Flc. II. — The sixth thoracic vcrtelira from the side (|).
Fic. 12. — The third lumbar vertebra seen from above ({).
epistrophei) and projects into the anterior compartment of the spinal foramen of the atlas. This
odontoid j)roce.ss is conc-shapec! with a rounded apex, and presents an anterior facet for articu-
lation with the anterior arch of the atlas and a posterior articular facet which is not alwavs dis-
tinct. Instead of articular ])rocesses the ujiper part of the body presents corres])onding articular
surfaces for connection with the atlas; tliese surfaces are slii^htly con\ex and bu; 1 trille inclined
from the horizontal.
The spinous process {Y\'^. 4) is fairly well developed and always distinctly bifid; the trans
vet'se i)roces.se-. on the contrary, are smaller than those of the atlas and their lulxTcles and sulci
nervi spinalis are likewise absent, although there is usually a shallow groove for the second
spinal nerve on each side Ix'hind the superior articidar facet. The inferior articular |)roces.ses
are more inclined than the superior ones, and already show the characteristics of those of the
flexion vertebra'.
The fciramina transversaria of ihc- artinilatnl <or\ii il vcrtrtira- form ' canal for ihc passage of thr vcrti'liral arlory
ami vein (the fornirr runs ■ .mxf.'n the u|i|kt six only). The markeilly ilevelopeil anterior tiihiTi le of ihe Irnnsversi- pro-
ress of ihe sixth cervical vertel)ra is known a^ the < arotiil luherrle or IuIhti le of ChassaiRnae {luherciilum cnrotkuni).
THE THORAQC VERTEERJE.
On account of tin independent de\cloiiment of the ribs in the thoracic region, we Imd no
fused costal rudiments in the thorat i( vert( l)r;e such as (Kcur throughout the remainder of the
true vertebr.e, ami the thorat ic \erlebra' are consequently of the jiurest ty])e.
Their Ixxlies (Figs. (), 10, 11, and 21) increase in si/.e and height from alx)ve downward.
In the ui)|>er thoraiic certebr.T their surfaces are elliplital, like those of the cerxical region,
but as we jiass downward they betome rounder, then cordifomi, and fmally reniform in the
lower nn nilxrs of the series, which approximate the form of the lumbar \erlebra'. And not
only do tile iKxlies iK'conie largir. but their lateral diameter especially is increa.sed as they gradu-
ally approach the form of the lundjar \ertelira'. Their (dniigiious surfaces are almost per
fectly tlat. The spinal foramen (Fig. 10) is not only absolutely, but even relatively smaller
tlum that of th tervital vertebra', and in the upper memlnrs of thi' scries it is roimded, wiiiK
in th( lower <'. it is rather triangular. The upix-rand lower margins of the Ixxiieseach present,
imtnedialel} in front of the petlicles, a demifatct for the head of a rib (Fig. 11 ). The first ami
the two (or three) lowest vertei)ra', however, thuw de\iations from this arrangement, the former
having an entire facet u|M)n the upper margin, anil each of the latter (Fig. ()) ]iresenliiig an entire
faiel toward the niiddle of ihi 1mm1\ of (he Mrlebra.
The arti' ul.ir surfat e^ for the he.ni^ ol the rit^^ are plaied on two ailjad-nt thorat it vertelira' in ^iii h a manni-r
Ihiit eaih \erteliral niarnin i|ihs not rei eive exaitly ..I'l half of the arlii illation, hui lowani Ihe lower eml of th( seriis
if ii^-ith-r iw--'!:i,-!---f i!-.-rmir-
^m'WM
i'nci-t f(V haul <>/' rih
Superior (irtinilur proass
Spino:!^ /Vi'iv
/(•///// r/ionnu
vrrtchni
iwclfih t/iiviii/r
vrrtrhrti
I irsf linnlnu
vi rliinu
I rmiwi' -.r priii<-^ ^
I iiiil h'r tii/irnii-
ill rih
Siip,rior uriirtihir
prOd ■.^
i't rJi
I /". 10.
Siiiih>:i^ pr.'ii
liiliiiiir (inidiliir iiiiHf.\
Spiiu'ii-^ pu'ii
Sn/hru'iui'iiii/'ir pr,h
/ /iff/'V, r\t' pitUi '•'*
/■'A- '-'
M^Sl^llM..^^
■'i%/:i^.:::i.i^.j»^^^-k
THE VERTEBR^VL CvJi-UMN.
27
ally the tenth also, possesses an entire rostal facet 'Fig. 25). These vertebra; which [x)ssess an entire facet have typically
n<i inferior facet.
The arrhfs of the thoracic vertebra' (Fig. lo) are hi>;h and thick. The articular })rocesses,
with the excejjtion of tliose of the twelfth \ertil)ra, he almost in the frontal jilanc and are placed
so that tile almost round and slij^htly concave inferior surfaces l(x>k forward, while the >lightl\
convex -aperior ones look backward, the surfaces forminj; part of a thick cvlimler the axis of
which lies in front of the vertebral body. The superior processes are ver\ ]in>miniiit, while
the inferior ones project but slij^htlv.
Th( long transverse processes (Fiji;. 10) are strongly develojicd. They are directed back-
ward as well as outward, and have thickened club-shaped extremities. The anterior surfatr
of this thickenin.!^ usually ])resenls an a])i)roximately circular, slij,'htlv conia\e arliiiilar face!,
for the accommodation of the tubercle of a ril); this facet is wantinj;, however, in the eleviiilh
and twelfth vertebra' (Fij^. q), and the transxcrse i)roce.ss of the latter often shows a \ariable
develo])ment, freipiently consistinf^ of *■ 'veral irrej^ular tubercles.
The spinous processes (Fif^s. (), 10, and 2?) a^ ' nj; and three-sided, and are directed ob
li()uely downward, one border looking U])ward and one surface downward. Those of liie midiile
vertebra" of the series overlap each other like the shingles of a roof ( Fig. j ? ). That of the twell ih
vertebra (Fig. (j) resembles those of the lumbar vertebra'.
'I he twelfth thnraiic vertebra (ami scimetinies ihi- eh venlh aUo) i-. the only one that 1 an Im' <le,-,iKnalr(l as atypical,
since it exhibits several characteristics ..f the lumbar vert4bra- (the shajH' of the spin.jtis pn« ess, body, ami spinal forani.-n,
the |K)sili.in of the articular priHcsses an<l the appearand of the accessory ant] ni.ininiillary pro. esses ii|i.)ii llic nidi-
mentary transverse proies.ses). The facet f.)r the head of the rib alone sIiohs the Iriic nature of the twelfih lhor.ni.
vertebra, just as the fatets upon the boilies (and transverse proii>ses) ,ir( the surc-t points of ideniilication for the thorai i.
vertebra' in general
THE LUMBAR VERTEBRA.
The lumbar vertebra- (Figs, o, 12, :i, and 2;,) are the largest of the true wriebra'. The
bodies in partiiular are large, very high and broad, and have plane reiiiform siirtaces, /. c,
they are convex anteriorly and concave j)0.steriorlv. The anterior surface is distinctly cuniavc
from above downward and convex from side to side, so ih.il the up|)( r and lower siirfatts of
the bodies are con.'<iderably liroader than their middle portions. .Also the Itodies of the lower
lumbar vertebra- at least (and especially of (lie fifth) are disiincily higher anteriorly than pos-
teriorly (Fig. j^).
The arihes of the lumbar vertebra (Fig, 12) are strongly dtvelojied an<l \erv high, but
show no further |.eculi,iniies; the spinal foramina are ,sm;dl and appn .imalelv triangul.ir.
The articular processes are well formed and projeit markedly bolli alxive ,in,l below, and the
articular surfaces are slighll\ curved and are almost in the s.igiiia! ,.i,ine, the tomavity of the
upper surfates looking backward and inward while the convexity o, ih( lower ones i> directed
forward and outward. The surlaiis represent seitioiis of a lar^'e hollow < vlinder. whose axis
is situated, not in fnmt of the vertel.-ral bodies, as in the thoracit region, but iH-hin.l ihi in lU hind
the spinous process), and the inferior pro( e>ses of each vertebra are n)nsei|uentlv oMrlappeij
laterallv In the superior processes of the next su(ceeding one. The infi rior pnM'esses of the
iiilii Miiibr.i are united wiiii the U|iper arlii ul.ir proic.s.ses o| Ihr sai ru"> 1 see jiage jcj).
» ,-.fey 5
28
ATLAS AM) TEXT-BOOK OF HUMAN ANATOMY.
Fig. 13.— The sacrum seen from behind (dorsal surface) (j).
Fig. 14. — The sacrum seen from in front (i)elvic surface) (|).
Fig. 15. — The sacrum seen from al)ovc (ba.'^e) (J).
Fig. 16.— Horizontal section of the sacrum at the level of the second sacral foramina (J).
Fig. 17.— Median lonjrituchnal section through a sacrum, showing the synchondroses between the n-
vidual vertcbnu (j).
Fig. 18. — The .sacrum and coccy.x seen from the side (*).
Fig. ig. — The coccy.x seen from in front (j).
Fig. 20. — The coccvx seen from behind ( {}.
The transverse ])r()ccsses of the lumbar vertebra? (Fig. arc lonR, (lirccted almost at a
right angle from the sjjinal column, and <listinctly comijressed from before backward. They
represent ru(limentar\- lumbar ribs and are therefore really the costal ])rocesses,* while a small
])rojeclion situated at the base of the "transverse jtrocess," tlie iiccrssiiry pmrss (Figs. 9 and
12), corres])onds to the lrans\erse ])r()Cess of the thoracic vertebra'. Tiiis accessory process is
characteristic for the lumbar vertebra-, and although .sometimes ])Oorly niaiked, it usually a])-
])ears even in the twelfth thoracic xerlelira. The superior articular jirocesses of the lumbar
vertebrx- also exhibit another round roughened protuberance, the maimmtUiry process (Figs.
gand 12).
The sjii JUS jirocesses (Figs, q and 12) are very strong and high and are distinctly com
pressed from side to side. The_\- extend directly backward and show a slight thickening at
their apices.
The False Vertebr.e.
The false \ertebra', whidt are \ariable in number, form two lx>nes, the .sacrum and the
l(HC\ x.
THE SACRUM.
Tite sacrum is that ])ortion of the \crubral u)lunin which is connected with the jieKic
girdle and completes the latter posteriorly; it cons-i|" ntly forms a i)ortion of the |)elvi> itself.
It i> a broad, uir\cil, nuMlcrat-'ly flat, shovel shaped bnin- 1 Figs. 1;, and 14), which is broad
and tiiick above, and narrow and thin below (Fig. iSi. I it there may 1k' distinguished an
anterior relatively smooth surface, concave in both the sagittal and tr:ins\er>e dircdion--, ami
known as pehic surfaii, bciausc it looks toward the pehic cavity, and .1 posterior exlreinely
rough dor>al surface. The broad iijiper surface of tlu' s.icrum is c:dle(l the base and the lower
angle the ajiex.
The pchii surface presents a number of traiisverM' ridges, usuallv lour, which connect
fur pairs of irregtilar rminiltd foramin.-. known as the anterior sairal foramina. The ridges
corresixmd to the jumlion-, ol the ii\e originalb ^ejiarate sacral \trtebra' of which the bone
i> composed, while the >.u r;d I'oraniina indicate tlu juiutioiis of \hv Ixxlies with tlu- lateral jiro-
ces.ses (costal and transverse proce.^se.-i. The anterior sacral foramina communicate pos-
• Tticsi- priKC"
tic ( ,i-.ii>n:illv f.rrm Miiallcl iil.iliiniiii.il ur lunilur rili>
EmfM^amm
^!n " .*
v^^:-. '^-vi?'?^ y^-
BV-
'^'■A^^-S^i
^mmsm^^mm
0^-
•5 3
l^^f
'N..
'X.i
S;T%5^
Miilidil sdcnil
Posterior sdcrol rnst
forninai .^ lnlmrrl<bnil
Ihl^l- of M/I77/W
.% iiin t \ i I It ih
Sacral f S) Jorunni,
''"""'JiK
V Wi^:
Sii/ii nor
inliriiliir
I'ronss
fiir 10
I hinl. loiiilh ,iiul tillh i,>,i\i;riil
vi rlihrui
'^. liA'^^i'^mit!:-
liL-rt^Nfii
THE VERTEHRAL COLUMN.
2()
tcriorly with the spinal canal and extend laterally as gnxives which gradually become shallower
and are finally lost upon the lateral masses of the Ijone.
The portions of bone situated external to the sacral foramina and which are jjarticularly
well developed in the up[)er ])art of the sacrum, where they articulate with the pelvic girdle,
are designated as the lateral masses (partes hiUralcs) (Fig. 15). Their lateral surfaces exhibit
large ear-shaped articular surfaces, known as the auritular surjaccs, which articulate with the
pelvic tones, an<l occur chiefly ujion the first, to a limited extent u])on tlu' second, and even
upon the third sacral vertebra (Fig. 18). Behind the auricular surfaces there is an irregular
rough impression, the sacral lubcrosily (Fig. i.:;), which is united by a ligament with a similarly
named i)art of the jielvic lx)ne (see ])age 95). .\t the junction of the base of the sacrum and
the pelvic surface there is a feebl\ marked line, the sacral portion of the ileoi)ectineal line (linca
lerminalis), which separates the true from the false ])elvis.
The up[)er surface of the sacrum (F'ig. 15) also possesses a slightly uneven surface intended
for articulation with the lower surface of the fifth lumbar vertebra. The form of this surface
exactly fits the corresponding surface of the Inxly of the fifth lumbar \ertebra and ixhibits all
the character; ics of a lumbar vertebra, including a superior vertebral notch and a superior
articular prtKess.
The dorsal surface of the sacrum (Fig. i ^"1 has four jiairs of rounded foramina which ex-
acilv corresi)ond in their position to the anterior ones. In addition, it exhibits a series of ])arallel,
rough, frequently interrupted ridges, a median single ridge, and two rows of paired ri<lges. The
median ridge, known as the rrcsl, consists of the more or less fused spinous j)r(Kes.ses of the
five .sacral vertebra', and is more pronounced than the lateral ridges. These (Fig. i,0 are sepa-
rated by the posterior sacral foramina, the inner ridge known as the articular en si and thi' outer
one as the lateral crest. The former is, as a rule, the least jironounced of all tlu- ridges, and
is formed by the fusion of the articular jirocesses of the sacral vertebra-, only two of these |>ro-
cesses on each side retaining a certain degree of independence, the su])erior ])nKe.s.ses of the
first vertebra and the inferior ones of the fifth. Tb.e former lie at tlie ba>e of the s;icrum and
are called the superior articular processes of the sacrum ; they articulate with the inferior articular
])r(Kes-i s of the last lumbar verlel)ra and are ei|ually well fomied. Their articular surfaces
arc ])laceft midway between the sagittal and the frontal plane. The articular crest is ((inlinucd
downward on i-ach side o\er the apex of the sacrum and usually jirojects beyond it as a horn
like process called tlie sacral cornit. This process is the modified lowennosl articular )inicess,
and is unitt'd b\ ligaments to a similar process on the coccyx.
Tlu- lateral sacral crest is lo be regardi-d as fornu-d by the fusion of tlu- tran>\irse proces'-es
and forms a nnigli riilge which i^ occasionally interrupted.
Tlu- sacrum is traxersed throiiglunit its lengtli b\' a canal 1 1'"ig. 17) whiih !■ tlu- dii-ed con
linuaiion of the s|iinal canal and is known as tlu- sacral canal. It is toK-raiily widt- in the ujiiicr
part of the sacrum, but ra])idly diminishes in Ixuh its .s.ij,.aal and transx-er.se diaiiuters as it
descends. It terminates externally Ixtween the sacral cornua as the saa-al hiatus ( l-'ig. 1^1,
and is connected wiiii the anterior and ])oslerior sacral foramina by four short ii-a ,,\'erse canals,
ilu- iittm-rrtihrii' jorantlnu (Fig. 1(1).
The jjosterior wall of the sacral canal is formed cs.sentially by the completely fused arches
i^^^XjIUA^
3°
ATLAS AND TEXT-BOOK OF HUMAr; ANATOMY.
Flc. 2 1 . — The vcrtel)ral column seen from in front (§).
Fig. 22. — The vertebral column seen from behind (§).
Fig. 23. — The vertebral column seen from the left side (J).
of the sacral vertebrx. The inter\-crtcbral foramina corrcsiwnd to the similar structures in
the true vertebra' ; but in the latter there arc no openings comparable to the sacral foramina,
at least not in the bony spinal column. This is due to the fact that the spinal nerves divide into
an anterior and a posterior branch within the sacral canal instead of outside of the spinal canal
as in the true vertebra-, or, to go back a stej) Turther, it is due to the fact that whereas throughout
the scries of true vertebra' the ribs or costal processes remain distinct from one another, in the
sacrum the costal ])rocesses, which are rci)rcsented in the lateral masses, fuse together and a'.^o
unite with the transverse processes, so that the intervertebral canals are closed at their outer
ends.
The a])cx of the sacrum presents an elliptical surface for articulation with the coccyx, and
at its sides there is a shallow notch which is converted into a foramen by the transverse process
of the first coccygeal vertebra and the connecting hgaments (sec page n.^).
THE COCCYX.
The coccyx (Figs. 18, iq, and 20) is a small bone of variable length formed by the fusion
of four or tive (rarely three or six) (juite rudimentary vertebne (vcrlchnr caudalcs). The first
vertebra alone shows some vertebral characteristics, since there can be recogni/.ed in it indica-
tions of transverse processes as will as of the up]ier articular ])rocesses which are transformed
into the ciuryi^ial coruiia. The transverse processes also freiiuently a])])ear in the second ver-
tebra in the shajic of feeble indistinct i)rojections, but the remaining coccygeal vertebne are
irregular, rounded jiiece , (,f l)<)ne. None of the coccygeal vertebr;e ])ossesses a trace of \ertebral
arches or of a spinous process, and the individual vertebne are united either by syi nondroses
or (more rarely) by Ijony tissue.
Thi' sacrum sHdws ivpicjl st\u:il dilTirciu is, since it is Ijrcwdir. shortiT, ami less curviil in tlic ft ni.ilc than in the
male. Nut infrc(iui-nllv the lir-l sai ral vertebra remains jiartlv c.r cm n eiuirely inilejiendent (Ihc lnntl'iis<iir,il irrlcbra),
and the first coccvgeal vertebra frequently fuMS with the sacrum, in which laM' the sairal and cixcygtal ii.rniia are also
united by tjiiny tissue,
THE VERTEBRAL COLimiN AS A WHOLE.
The vertebral column is completed by its ligamentous connections and particularly by the
intervertebral di.scs situated between the IxKlies of the vertebra- (see page no). If the bony
\ertebral column be observed from tile side (Fig. 2;,^ its marked curvature al once becomes
apiKirent. This curvature is manifold, the cervical portion of the column being convex ante-
riorlv, the thoracic |)ortion markedly toncave anteriorly, the hmibar portion decidedly convex
anteriorlv, and the sacrum concave anteriorly. .\l the juncti(m of the lurnbar ])ortion with
the sacrur!% where the convexitv of \]w former passes into the concavity of the latter there is
a inarkeil angulation (ailed the promonlory. Tiie curvatures of the vertebral column are sub-
ject to individual variation.
y- 1- . , . 5fc^A---'
('iTviCdl
irrli'bnn
1 lioracir
verlfhnic
I iiiiibtir
viilihriii
Murium
li:hi\-iiiihnil
loranniiii
M
'•^ia"v -r' '*'n
rttii
f
KOlft
Tin: VKRTEBRAl, COI.UmX.
31
In viewing the vertebral column from in front (Fif;. 21) h will be noticed that the sacram
is bv far the broadest part of t'n' spine. From here ii]iward the vertebral column becomes
smaller until the fifth thoracic vertebra is reached, whence it commences to enlarKe as it ascends.
in the upper cervical refjion the column again decreases in size, but the alias is broader than
the bones which lie below it. .\ study of llie ])roiile of llie sjiinal column (Fig. 23) shows, liow-
ever, that its greatest thickness is found in the lumbar region.
Just as the anterior surface of the verleljral column is completed by the intiTvertebral discs
between the bodies of the individtial vertebra', so too the s])aces between tlie arches are simi
larlv filled by ligamentous tissue. These spaces are largest in the lumbar region and between
the two upper cervical vertebne (Fig. 22), in the latter instance becau.'-e the arcli of the atlas
is extremely low.
The spinal canal (caiuiH; i-irlchralis), lormed by the spinal foramina of the individual
vertebra?, has not, therefore, a uniform bony boundary even in the region of the true vertebra',
but at intervals is covered in only by membranous structures. It communicates laterally with
the intervertebral foramina (Figs. 2.^ and t,6), each of which is fornn'd by two Ncrtebra- alx)\e
it is continuous with the cranial cavity; and its lower end is formed by [hv satnil liidlu.s, wliicli,
however, is almost completely closed by ligaments.
There are twentv-three pairs of interverteliral foramina, six in the cervical region (see page
26), twelve in tlie thoracic region, and live in the lumbar region. Those in thr lumbar region
are the largest, while tliose situated between tlie cervical vertebra' are llie smalksl; between
the atlas and the occiput there are no intervertebral foramina \\liate\er, and those between tlie
atlas and axis are only ])artially limited by Ixnu. The lowermost intervertebral foramen lies
between the fifth lumljar verteljra and the upjier surface of the sacrum. Tl'.e intervertebral
foramina in the cer^•ical region are exactly l)etween tlie transvirse proces>es, whili' in the thoracic
and lumbar regions thev are in front of them (Fig. 23).
THE DEVELOPMENT OF THE VERTEBRAL COLUMN.
As far as tin- (l>-v.Io|iliU'm of tlic Lony virlil^ral ...Uinm i-, .Miu.rr.M!. la.h Mrulira ari~is from ihric .mlir-. ..f
os>il»ati..n, i.iu' fur tin' .icily ami oiu- fnr . ai h lialf ..f ilu- \,ruliral ar,h. Ossili. ali.Mi . ..iiiiiirni .s at llir i ii.l ,4" ihc
sriiinil mc.nih c.f iinhrvi.iiic lif-, llu- . ,-nti rs fur thr ari Ins a|.|.cariiiK scim-^hal rarli. r tliaii tlv-c f.ir iln l.ml} i?ul al-o
giving risr t,i llu- ilitTiTint v, rtcliral ].nKiss,>. In adiHliun tu tins,- ihiif ( ,nli rs, a. . i — iry (. nl. r^ .l.i. Iu|. , i,n-.i.!. r.l.ly
laliT, at the age of puli' rly or even sulisfi|ui-nlly, an<l .ii.i«ar as ttal (lis, s on ihr api.t-, ,,f ih, >|'in..ii, ami ira"-v r-r
|iri>'i-sscs, on llio niami illary )ironssfS of the lumliar v.rtrl.ra-, ami on ih.- u|'i.,r and lo",r ■ irfa.rs of tli.- \. :l.!.ral
ho.liis, Th.'s,- iiiiphysc do not uniti- witli the- nniaind.r of tin- v.rlt'.ra until thr groMti oi -In- l.ody ha^ 1.,, nconi-
,,lrlr,l.
In the first yr.n ..f lifi' till- two centers for thr vcrtel.ral .in hi-s unilr. i:i tli.' tiiivd year the ar. In^ 1,. . onu- jouird to
the l.odies, uiiile the ipii'hyses remain distimt until the twenty-tifth year.
In the atlas thi iinlir for the l..idy is wanting. The anterior an li ren- lin- . ..riilaeiiiou-. f. ■ ., l.nLMinie, ii. I ..--ify-
in« unti' the first v.ar, and not uniting with the posterior an h until the fifth or sixth >ear. The two , . nters fur ihi pos-
terior arih remain .separated until thi- thinl year.
In the axis there is a eenter for tile Lodyand a similar om- (..riginaliy doubl. i foi the odoiUoj ;,roeesv. n.,th Muile
:„ ,u,. !hird vear.
The s.iiral virK-bra- ossifv in a similar mann.r to the true virlelira-, in (a. h tin n i- .i single . ■. lit. r f^r the liod>,
two for ea. h ar. h. epiphyseal plate , and spei ial ventral eenters eornsp,,mling to the sa, ral -il -. 'i he l.odv and an he.
e.f the filth sa. ral vertehr.i unite first (se.ond yearl and then f.ill.iws the union of [hr !i...lv aii.l ar. he- ..I ih. Iii m r-
1,-hra (fifth and sixth yiMrl, while I.,my uni.m l-nv,en the l.o.lu's ii.,es n..l ... . ui until th,' tw. nty-hflh y. .r,„ lat.-r.
In the r.Ki ex the frst verlehra is ossified at hirth, the last one not until the Iweiuieih \e.ir
32
ATLAS AND TFATHOOK OF HIMAX ANATOMY.
Fig. 24. — The first rih of the ri^ht siilc .seen from above and from the siJt (J).
Flo. 25. — The scconil rih of the riijht side seen from above and from the side (I).
Flc. 26. — The |iosterior extremitvof tiie .seventh rib of the rii^ht side seen from behind and partlvfrom
below (§).
Fk;. 27. — The seventh ril) of the left side seen from behind (ij).
Fli;. 28. — The seventh rib of the left side seen from within (^).
THE RIBS.
The ril)s nosta) helonji; to tlial iimilcd ^roii]) of skeletal sefjmcnts which remain partly
lartilaj^inous throu.ijhout life, .\ttenlion may first be (lireded to tiie tM)ny ribs, of whieh then;
are twelve pairs (Fii,'s. 2.\ and :;o), < orres])on(lin,i; to the nurnbir of llu' ihoraiie \ertebra-.
The ribs are not tubular Ixmes, but llat \n)n\- slri])S of considerable lenj.;th. Tliose in tlie
middle of the series arc (juitc uniform in shaiK', only the up[)er and lower ones show in^ certain
deviations.
In a ty])ical rib the foiicnvini; parts may he rccoirnized:
I. The haul, the posterior (vertebral) slijjhtly thickincd end. It presents an arlituhtr
surjiUi' (Fit;. 27), which is opposed to the Ixxiies of the vertel)ra', and is marked b\- a median
ridfie, the rrr.sl, wiiich <iivi(les it into an upjier and a lowir artiinlar surface for llie two \ertebral
iKxiies with which it articulatis.
.'. The Jictk, a con-iriclion situated external to tiie lic.id ( Fij;. 28). Its upper margin is
formed by a rid.^e, (n.s7 oj llir H((k, whiih is sejiarated from thi' Ixxly of the rib by a rough emi
nence, the /itbirdi, presenting a facet for artidilalion with tiie lrans\erse process of a thoracic
vertebra.
3. The hoilv, the longest part of the rib. Tliis i^ placid vertically ;ind is distinctly tlatlened
from without inward, .so that an e\ternal ami an internal surfaci' may be recognized; near the
ttdxTcle it [iresenls a rough surfaie, the .i(i,i,'/c of the rib (I''ig. j8). The i;b i> at first tlirected
outward, Iwckward, and downward, but at the costal angle it turns tijion il-elf and pa.s.ses for-
ward. On the inner siirfaie of the lower margin of the iMHly theri is a gn>o\c. the rosldl f;r<nn'f
(Fig. 2H1, whidi gradually Ixiomcs shallower a^ it a|ipioache^ ilir .interior (ostal <'xfremify,
and lauses the lower niaririn of the ril) to he sharp while the ujipcr oik- is more rounded. .\t
its anterior i'.\tremil\, the Ixxlv of the rib presents a roughened, soniewhil -hallow surfai e for
the reception of the costal cirtilage.
The t\]mal ribs arc the third to the tenth, the tirNf two and the la-l two c\hibiling icrtam
]ieculiaiilies. The first rib (l''ig. J^l is short and bio.id; it is not placed \erlic,dl\ but almost
hori/ontally, so that an upjier and a Iowit surface m.i. ..c reiogni/.ed in il- posi( rior portion,
and an ujiper or outer and a lower or inner surface in its anterior jxirtion. It- head has no
en -1, since the tirst rib usually arti( ulale- with tbr Ixxly of the fir-t tiiorat ii \crlebra only
and "o! wall two .uljacent vertebra', and its angle loincides with the tulxTcle. Near th(
anleriwr e\iremil\ of its Ixxlv lliere is a low rough protuberance, known a- the ■H'llim- luhrnh-
01 lnhinit Oj I.isjriinr, fur tlu in-erlion of the scalenu- .inlicus niusile,and iMliiiid this tulMnle
mt^
THE RIBS.
33
there is a broad shallow groove, the sitbilavian groove, for the subcla\ian arttn-, and close
beside this groove a roughened surface for the insertion of the scalenus medius muscle.
The second rib (Fig. 25) resembles the first and, at the same time, the tw.jcal ribs a- \v(il.
It is longer tlian the first rib, but its posterior jiortion shows the >ame [lecuiiar torsion of the
Ixxiv, so that one surface looks outward and u])war(l while the other is diretted downward and
inward. The position of its anterior extremity is txpical, an,i it posses>( s a capitidar crest,
although the tubercle and angle still coincide. A roughness, tin- tulKidsitv, scr\is for liie origin
of one, or sometimes two digitations of the serratus magnus muscle.
The eleventh I I'ig. 21)) and esjiecially the twelfth ribs (Fig. ,;o) an -liort and but slightly
curved. The crests of the hea<l are wanting and the tubercles ha\e no artii iilar surfaic, being
either merely indicated or entirely absent. The costal sulci, especially that of the twelfth rib,
are ver}- indistinct o' ' -t wholly wanting.
The Ijonv ril)s i 'n length from the fir>i to tlu' se\enth and tiun decreaM' downward
to the twelfth. The riljs present a cur\ature which mrrc^poniK to that of the thoracic
wall and is known as lue surface cur\ature. It is only in the la-cs of the first and the posterior
portion of the second ribs that the outer doweri border (orres])onds to thi' thora(i( wall.
liy torsidii runalurr is imam llu' tor-imi of tin- rilis ii|'iiii thrir a\i -. ^ h li a lur^ioti i- {■■iiTiil in llu iirM and sr. fitul
ritK, sinie lluv pax froni a liuii/oiilai inln an uliliiiuc plane. Inn .1 ( irl.iiii aminini uf inr-hm ,il-n m(.iii^ in thi inidillr
(ly|>iial) ril)s .is ilu-ir anurinr >\lroiniliis pass fnini a vrrtiral In ,in oliliinic plani-, -■> thai ilic ii|ip<r margin i- ■Uniiul
piisIiTiorlv. ( )n tlic other hand, only the anterior ( \tn niities of the luo lower rili~ are \< rtii .1!, the posti rior l■\lrelnilie^.
having their ui>per Iwinler direeted liackward ili^;. j;'.
The costal cartilages conned the bony ribs with the sternum, but it is only in the upi)er
se\-en ribs that the sternal connection is a diri-(t one iFig. ,vt). '['he eighth, ninth, and tenth
ribs ha\e a common cartilage whitli is (imtinuous with that of tin- sr\(nth, anil the ele\cnth
and twelfth ribs ha\e free ends with short lartilaginous apices. C'onsei)uenily true ami jiihe
rihs ma\ be recognized, the true ribs being the tir^t to le sevinth and the false ones the eighth
to the twelfth. The eleventh and twelfth ribs are also ti ined /loiiling r//iv.
The ( osial cartilages are Hat, are placed Nirtically like 'he ribs, and tin ir margins are rounded,
posses>ing neither grooves nor ridges. Their length rapii i,- ini reaMs from the I'lrst to tlu' se\enlh
and then decreases marked];,', the eleventh and especial the twelfth ribs having merely car
tilaginous apices; the first (ostal cartilage i^ also \(n- ^l^orl but broad. The laitilages, par
ti( ularlv of the middle ribs, """dme di>limt'' wider as tin v pass toward the sii imim.
The tirsi and second cari.lage-' are iiu lined slighll\ downward toward the sternum (from
aNixi downward .md from without inward), the thini isc iitl\ hori/ontal, and from llu' fourth
downward tlu re is an inireasing iiK linalion from IkIow u|iward anil from witiioiit invvard (Fig.
H !. The cartilagts of the si\lh to the tenth ribs are often ipiite bioad and artii ulate with e.u li
other b\ variously formed jiroccNses jias.^ing upwarl and downward; they form s\ in hoiidroses
or, as is usuall\ the tse, diarihroMs, and by their union there i> formed an arch like lowir
Ijonier for the thorax, the (oslal an It.
mt"
ig^
34
ATLAS AND TEXT-BOOK OF HIMAX ANATOMY.
Fii;. 2g.^Tlie eleventh ril) of the ri^ht side seen from liehind (j|).
Fii-.. ;,o.— The twelfth rib of the rijjht side seen from behind (j).
Fir.. 51.— The sternum seen from in front (J).
r ic. ^2. — The xternum seen from the left side (\).
THE STERNUM.
Tlie breast bon., or sternum, is a single, Hat, oblong Ixwe. It lies a])proximatelv in the
frontal jilan',- and fonns the middle ].()rtion of the anterior wall of the thorax, and bv its articu^
lation with the clavicles, it ccmi .letes the shoulder girdle anteriorly. It is compostxl (Fig. 31)
ot Ihrei. distinctly separated portions placed one aUne the other, an upper broad handle, the
nunnibrium, a middle piece, the body or gladiolus, anrl a lower jjiece, the xiphoid process. The
three portions are either separated b\ cartilage or are united by tone; the former condition
prevails between the nianubriimi and |l.e Ixxiy {syncliomlrosis stcrnalir), while the latter ol)tains
between the body and the .\iplioid process. .\t the synchondrosis k^tween the manubrium and
the l^xiy there is usually cjuite an obtu.se angle, o\Kn [wsteriorly, the nni^ulus slrnii {aii^i^ir oj
Louis). TW .sternum is not exactly in the frontal plane, but is i)lace(l somewhat obli.|i 'ly,
so that the upiier end is considerably nearer to the vertebral column than the lower one, a rela-
tion whi. h is also partly due to the curvature of the vertebral column isee jjage 14).
The manubrium is considerably broader than the ixxly of the lH)ne, and is broadest alH)ve
and narrowest below; its anterior surface is sli^,;itly convex, an.l the postirior surfa.e slightlv
concave. The upj-er margin i^rcsenls ihree rounded notches, a median shallow inUnlaviaihir
or juf^ulur notdi, and two lateral deeper clavicuhir iioldirs. which are covere<l with cartilage
and acamimodate the sternal en<ls of the clavicles. Immediately i)elow each clavicular notdi
there is a notch 1 Fig. ;,2} upon the lateral margin of the sternum for the reception of the broad
costal cartilage of the .,rsl rib, whic h is joined to the sternum in this sifialion by a svnchon-
drosis, and each side of the lower end of the manubrium pn >ent.s a demilacet, for articulation
with the cartilage of the second rib.
The body is usually narrowest alnnv, gradually widening as it dc^sccnds, until it attains
its greatest breadth in its lower third, and tiien ra])idly narrowing again as ii ai.i>roaciic's the
xiphoid ]iroccss; it is occasion.illy, however, of iiiiilorm width throughoul. Its nearly tlat
anterior ivenlrali surface- i> called the pbiiium stmuilr, and sometimes presents transvei- ■ lines
(Fig. :,.\\ which indicate the original fusion of several parts situated one alx)ve the other.
.\1 the margins of the lx)dy i Fig. ',j\ are found not. lies for the cartilages of the six h)wer
true ribs, liiat for the second rib Uing sitiiaied at tlu junc lion of the manubrium and the Ixxly,
that for the sixth nb .m the lower mai gin of the Ixxly, and that for the .seventh in the angle
Ulween llie Innly and the xiphnid protess. The notches for the fifth, sixth, and seventh libs
lie c lose logc the r, an.l the fourth note h is situated Ixlow the middle of the entire Ixme.
Tl.e xi/dioid pronss varies greatly in shape and ^i/.v. It is always markedly narrower
lltroi ill.. lwwl\- i.t"r..»* •...t.d.. .... r_ ...I,. .11. .-^.-•1 • I • . . - * . .,.,
•"• i-"^t- o, v-.n •■,!i-,-ii-. caniiagino-.i:;, ann it is sonuiin.i s julloialed. 1 he
female sternum is usually shorter and broader than that of the male.
i
Hv;. 20.
f-'ij^. 30.
Iiii;iiliir iitilih
( Idviiiiliir
llOfi/l
Xiit(/i fi'i-
first r,h
.\ol(h lor
■'iTi'nd rih
\olili lor
lliirj nil
XoU'/l for
foiirth rih
\ <tii! for
fifth rih
\otrii lor
si\th rih
Solch 10.
^rfOlth ri
Manubrium
Body of sternum
Xiphoid process
( litvinihir 'ii'tih
\ot(li lor tii-sl rill
Manubrium
Xi'lrli fiir siioril rih
Soliii for f/inj rih
Body of sternum
.\\<lih lor fill rih rih
Xi'Irh lor mtli rih
Xolih lor -.iKl/i rih
Xi'lilt tor \rvriilii rih
Xiphoid process
f-if!- il
/ik'. iJ.
.
stt-v
THE THORAX.
35
THE THORAX.
The thorax (Figs. 32 to ,^6) is formed In- the twelve thoracic verte})ra', thi- twelve pairs
of ribs, and the sternum, and i^ an approximately conical cavitv, wide open alxne an.l below,
and with the ajjcx directed ujAvard.
In it there ma.\ be recogni/cd an iipjier openin- and a much lari^cr lower one. The superior
thoracic aperture is formed by the first thoracic virtebra, the first rib, and the upper nmn'in
of the manubrium. Like the cross-section of the thorax, it is renilorm in shape' ,on account
ot the projcctinR vertebral lj<xlies), and is placed not horixontallv but obli.|uelv, Ixinsr directe.1
downward an.l forward so that at the end of expiration, the ujij.er margin of thJ sternum usualh-
corresixmds to the junction of the .second and third thoracic \ertebr;e.
The inferior aj.erture is of very irregular form on account of the noi . situate.l Ixiween
the costal margins and the lower end of the sternum. It is Uiunded posieriorh bv the twelfth
thoracic vertebra, by the twelfth and then by the ele^cnlh rib, and anteriorh bv" the costal mar
Sins and the xiphoid pr.xe.ss of the stirnum. The angle between the coital' margin and the
xiphoid process is known as the .^uhroshi/ or iiijni'<tcnia/ aiii^lc.
The anterior wall of the thorax, formed by the sternum and the costal cartilages is con-
siderably shorter than the posterior one, formed bv die vertel,ral K.lumn. .\lx)\e the difference
amounts to the height of two entire ^■ertebra^ while below it is usuallv (accor.iing I., the length
of the xiphoid pnxess) n|ual to three, sime the lower end of the xiphoid process ordinarily is
opix)site the ninth thoracic vertebra. The lateral wall formed bv the ribs is still longer than
the ix)sterior one 1 Fig. ,^51, the lower margin of the twelfth rib extending downward to the level
of the second lumbar vertebra. On either side of the Ixxiies of the vvrtebra, which project
markedly into the thoracic caviiy, there is a broad gr(K)\e, the pulmomirx i^roovc. The trans
verse or frontal diameter of the tlu.rax is considerably larger than the .sagittal or sterno
vertebral one.
The spaces situated between ihe ribs are known as the inUnoshil spaas, and are ele\en
m numIxT, the lowermost one, that Ixtween the eleventh and twelfth ribs, being verv short
I heir direction naturally corresponds exactly to that of the adjacent ribs, but ihev are con
.siderabl; wider than these structures, es[)ecially in front Ix^tween the cartilages.
THE DEVELOPMENT OF THE RIBS AND OF THE STERNUM.
Tl,c osM.ka.i.,n ,,( ,lu. nlK ,„k,. ,,l..,. , Liwl. ,„„„ a ,.nu. ulu.l, .„,,„... ■„ ,l„. l,.„ly ..i ,i,.. HI, M.nul.un.ou.lv
ith tl.. M-nUTs „f Uu. vcrtelm,.. S,,,,,. Urn.. ..ft.T |,ul..T,y .piphysc-al , .nfr, .,,,,„.ar („r ,lu- lua,b an.) lul,,.. I,.. a„.i
U„s, ,l„ n,.l fusr uill. thr main |.,,rli.„, ,,| ,|;,. I,,,,,,. i,n,il ,„t,.r il„- l«,ntv lilih ^,„
n,r manubrium,,,- tl„- s„.rnun, i> usuallv form,-,| fn,„, a sinnl.. „u. 1.,.., uhil, ,1„ U.h i, .1, ^, I,,,,. ,1 (ron, a „u,„-
,..r ,„ m„ 1,., ,f„ur L, IhirU.n., uhu 1, an (n,|u. „.l^ arra„K,-,l in ,«■„ mor,- „r l.-.s ,l,M,n, , l„n«itu.linal r„«,. A. a rul.
.lu.r..,sl,u,on..,..n.,.r(„r,h, xi,h„i,| ,,r.„,..s. . .s.ifi, a.i.m „f ,1,.. sU-rnun, .l„.. n„, i„ ,in un,il ,lu- f.,ur.h,„ .iMli
n,„nlh „f ,.ml,ry.,ni, l,f.., an,l in llu- .vi,,h„i,| ,,r„..>s n.,1 until fn,m thr mmH ,., |I„. tu, nli,lh y,,,r.
VARIATIONS IN THE SKELETON OF THE TRUNK.
Su,HTn,un,rar,^UTUl,ra. a„- ,„„„.„n„ . |,r.>.n,. |,ar,„ u!arl> ,„ th. l„„vr ,„„u , ,1„. v.-n.-hral u,lumn Ka, run,
urn ,ar v.ru ,r..,, N,., ,nfro|U..n,ly ril„ ar,- f„rnu..l fr„m .h.. ,,.s.al ,,r„,...s,.s ,.( ,h, ... n,l, , ,.r^ i, al an,| ,.f ,]„. ! ,.,'
lumbar v.Tlrbra-, an,| ar,. .1, .iKnab.l a. .,rvi,al an,! knnbar ribs r.s,,.. ,iu Iv. -11,,. las, hunbar u,,,!,,., s,„„,,„„„
36
ATLAS AND TEXT-HOOK OF HUMAN ANATOMY.
p,(, ,, _Thc thorax toijethcr with the left shoulder sirdle, seen from behind (I).
p,,.; :' _'rhc thorax together with the left shouUler (girdle, seen from in front (>)•
r,.",t-The skeleton of the trunk, divi.led by a medium lon.itu.lin.l seefon, together w.th the
shoulderandpelvicgirdles, seen from the left side (J.
Fk-, ,6 -The skeleton of the trunk, divided by a median longitudinal section, together w,th the
shoulder and jadvic girdles, seen from tlie median line ^ J.
a..,,,, a „n,., n,a. .,u, „ .,.uu. .ii„ iho ..run, .,„. i. ,„ ,. r.^ira., . ;; -:;;;;;;^:::;r::;:;,;::r;i;:
,,,t!,- ,0) ;.n.l t!u- iK.sUTior arch of ,!«• atlas and the i-m-ns rq,rrs.-nUnK tW arch, . ol tlu
fail l/. ..,.ifv, s.. that the spinal >anal nmains ol-n postiTicrly (rhach,.s<h,s..).
TlK. ribs froiucntly fork near th, , „s,.„ hon.lral articulations, the tw,. ,,.,r„„ns .., (nrnu-a u.ualh u■ul■n^ a.a.n,
^,. th.it a fiiK-slration of th- rib is proiluiid. . , ., \i ii,,. „„n<Ti'n(l of the
tie* ur.
THE SKELt TON OF THE. HEAD.
The .um total of the l>ones of the head is designated as the skull or crannm antl this por-
tion of tl.. skeleton differs front the others in that all of its constituents, with the cxccpt.on of
the lower jaw, are llrmlv united evt n in the macerated con.lition (the exact nature of the union
is described untler "S; ndesmology,'^ page 107), so that special means are re<,u.re<l t« ^pand.
the imiivi-lual hones froni < a< h other, and such a separation is not usuaUy successf,^| tf he n h-
vklual is too 0I.I. A skull the iK^nes of which have been isolate<l, is known as a dis.ir.tculatcd
'''" The complelelv fonnc.l adult skull is an extretncly complicalc.i structure, some of the
in.livi.lual parts being unite.l n, such a ntanner that it is cpiite difficult to rccogni.e ihent. Sonn-
; , es, intlcci, are scarcely visible in the perfect skull, owing to the fact th.U they are ^ a grea
extent covere.1 or overlappe.l by the other cranial bones. Before describing the imhs dtta
cr-nial Ix.nes it will be a.Uantage.nis to consi.kr briefly the skull as a whole, in onler ,0 obtain
.n'i.lea of the topography of the ntdividual tranial lx>nes and of their chief corn,K.nent parts
The skull will therefore be siudie.l first front in front, then front the si.le, from below (without
the inferior maxilla,, ami from above, looking dt.wnward upon the great crania cavitywhich
.nclo>es the brain, and hnally the outer and inner aspects of the cranial vault will be consulere.l.
THE ANTERIOR *-3PECT OF THE SKULL.
If the anterior as-eet of the skull (l-'igs. .^7 an.l ,^S. be examine.l, it will be seen that the.
,.onv forehead (/n... is formed by ihe vertical portion of the jnnUal /,.,„• art. 1 that tow.trd he
vcrt'ev a slightiv sernite.l suture, the .>ronal sulurr. separates the vertical plate o. the Ironta
from the two panual ho,us. The fron.nl l».ne also forms the upper margin of the ..rl,it, an.l
.,/„r /.,
r !):!}!: h\
!,>■
at the outer margin of the orbit it is separate,! from ihe Contiguous -v^-<;»;<i/:r or Jn--,-..-
a suture, the --v.^tm./a. ;..i/./ suU.n: The pr.K-ess of the fre.ntal l.,ne articulating with the
/.vgomatic l..ne in this situalio. is known as the c.v/cr«./ angular or .v,',>m./;<- V.ccs.s. o
either s,de of the fronlal lx,ne will Ix^ observe<l the anterior inferior or sl,l„noulal an)-lc of the'
a.
irivical vrrldtni
C.lnviili'
SlTO'h
nfihriiiiii
lUivriith rib i'- '
ImiJ'lh rib
I irst lumbar vertebra
f'llS. 15
femur
S/i//ir 01 i^rhiuin
Tin: I.ATKRAI, ASl'IX'T OI THI kill
parietal Ijonr, which is sci)arai. .; from tiif ^rralcr win- ..i ihi finnoid lr„u 1>\ ik- snli,r.,
parietal siilurr. A \»,vvw of the Innporal hoii, i> alx. \i,-.il)K- on 0-. .murior asi.c( i of tin kull.
Be-low the \( n:, • ilatc of the frontal l«)ne are ihe lar-e o,!,iial (aviii,-. ih, ,t,Mvate- jH-rtion
of whose roofs are toi nied bv the orbital plate.> of the frontal l)on. . wlii, h arlieulaU Aith ili.
orbital surface of the ;;reater win,i,'s of the sphenoids, ilie intervi iiin.4 .,imire Ik mu llu spli-'w
jroiilal siilun: thev are sejiaraied ironi the le>ser u iiii,' of the spheiiuid- bv ih, sii /,, rior orf.ial
/i.ssiirr hhnwidal jissiin). 'IIk' s>>hniozyoomati< sitHirr \> situated in di, outer wall of ih. .rbi!
between the .i;reater whv^ of llx' sphenoid and the /y.i^omane bone, llu kitler formin- a part oi
the outer wall of the orbit, a,- well as the outer r.nd a portion of die lower ni.irtrin of di. orbit.
I"he iMMiy brid>;e of ihe no-. i> plaeed belwetii the twoorbiial ea\ih. «, and in lhi> -iiualini.
the frontal lx)ne artiiulates on either side widi ihrei bones which. Irum within oulward, are
the nasal bonv, the na^al or -noUal prouss of ine maxilla, and llie l.ulirymal hour. Vhv inter
venin,^ sutures are called tlu nasojronlat. the ■ixillary. and the jroulohu hrvnial -utures,
'I'hi' two na^al Ixmes, which form the mai . ,„, of the lH)nv brid,m oi the iiom-. are .ep
arated from each other bv the nilrni,i-..i! Miliir: , and from the nasal proc c-,- o| llie m.ixill.i 1)\
the iias,niu!.\i/lary suliirr. V\\v\ form ih.' ui)i)er Ix.undarv of the anterior nar,- la />, rliira piri
/Dniiisi. which are l)ounded ihrou.i,'liout the rest of their c ircumferc iicv b\ the two maxill,, .
These two l)one> are .separated in the median line by the iiil, niutxillaiy Mitiin\ and die frontal
or na^al j)rocess of each is separated from the' cc)rres|K)ndin,i,' nasal Ixmc' by the nasomaxillary
siitun; and Ijorders externally ujx.n the lachrymal bom (for a detailed description -cv die orbital
ca\ily, |,a,i,'c 731. The maxilla also forms the inner half of the llcH)r of tlu' ..ibit and .-i the
interior orbital mar<;i!i, the in';, rior orbital i.^plirnonuixillarytjissnn. in llu lloor of llu' nrbil
sejjaratin.i,' the maxilla from the ,i;reater winj; of the- sphenoid.
Below the inferior orbital mar.Liin, in the body of the maxilla, is i!,,' injranrhital joramni.
and in the anterior nares can be seen the lx)n\- nasal septum* and also ih,- „„>„/ naidia Uurbin
aled hones), particularly the inferior ones, which jiroject from the outer wall of ih,- nas.il fe,ss.,.
.\t die junction of the intermaxillary suture with the lower m.-ii^'ins of the anterior narcs ,h,iv
is a bony siiine. the anterior nasal ■^piiie. The :yi^oniaiieoinaxiii,!ry suture separate s tin- maxilla
trom the /yijomalie Ixine, who.se malar irface is xisibl, i-f the- anteri.ir \iew o| the skull. Tin
I'lwer portion of the maxilla forms the loolh luaiint,' aiveotar proei ss.
Finallv there- is the maii.lihle ,,r lowe r jaw. lis middle p,>rti..n or 1xhI\ pn.sents a loranien.
the- mental joramen, an.l the- in,,th bc-arin- alv,olar f>oriion: lot-ithei- si,lc (and s^meuh.il fore-
shortened in the- liijurci ihe ramus.
THE LATERAL ASPECT OF THE SKLTLL.
The kiteral aspect of the skull : id.^s. ;;(, and .\o< ccniains a number of bones uhi, h ha\e-
been idrcady ecinsidered in ihe- description of the anterior cranial ic-ion. .\bo\. uid anierioriv
we observe that the frontal bone- is separalc^d from the p.iri l d bone- bv tin- eoro,;.i! uilure. and
from tnc jjreater wmir of i-> sphenoid b\ llu- sphenoironlal :,!ure. The :\\:;om.:!ieojrontal
iulure separates the /},<,'onia!ic jirocc-ss of the frontal boiu from du jronlosph, noidal proeess
* Ml
e .iiilcrii.i |"irtiii;i ,,f tin- n.is.il M |iiuni
artiln).'iiiou.T.
38
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
m
•i
of the zygomatic bone, and the temporal ridge commences at the zygomatic process of the frontal
bone and passes backward in a curved manner over the frontal and parietal bones.
Behind the frontal bone is seen almost the entire parietal lx)ne. It is limited anteriorly
by the coronal suture and is separated from the occipital bone ])osteri()rly by the lambdoid suture.
Its lower border articulates with the greater wing of the sphenoid by the s plieno parietal suture,
wuh ii.e squamous portion of the temjwral Inme by the squamosal suture, and with the mastoid
jwrtion of the temjwral lx)ne by the parietomastoid suture.
The only inirlion of the oecipital bone visible in the lateral view of the skull is its squamous
portion, which is se!>arated from the mastoid prtxess of the temjxjral lx)ne by the occipitomastoid
suture.
Below the frontal and parietal lx)nes, the temporal surface of the greater wing of the sphenoid
is visible. It is separated from the zygomatic lx)ne anteriorly by the sphenozygomatic suture,
and from the s(iuamous jxjrtion of the temporal Ixme [wsteriorly by the splienosquaiiuisal suture.
The first jwrtion of the temporal bone to attract attention in the lateral a.spect of the skull
is the s<iuamous [wrtion, from which a long jjrocess, the zygomatic process, i)asses almost hori-
zontally forward to arti( ulate with the short temiwral pnKes.s of the zygomatic lx)ne by the
zygomaticotemporal suture; the two j)r(Kes.ses together forming the zygoma or zygomatic arch.
The origin of the zygomatic pnxess of the temjxjral Ijone marks the termination of the inferior
tem{)oral line as it |)asses from the parietal to the lem|M)ral lx)ne.
Below the inferior tem]K)ral line there is upon the lateral surface of tlir skull a slightly
depres.scd area, the planum temporale, fomied by the tem|K)ral and parietal lx)nes, the greater
wing of the sphenoiil, and a smalt jxjrtion of the frontal Ixme. In tin zygomatic region the
planum temporale deej)ens into the temporal fossa.
The portion of the temporal line situated ujHin the temporal Ixme forms ai)proximalely
the anterior Ixmndan, of a second jMirlion of the tem|K)ral tx)ne visible in the lateral view of
the skull, the mastoid portion, which derives its name from a Ntrong conical prolulierance, the
mastoid process.
.\ third jKirtion of the tcmi^ral Ixme to Ix' seen in the lateral cranial rigion is the tympanic
portion, and is situated inunediately Ixiow the r(H)i of the /\goma, forming the outer and lower
circumference of the large ojjening of the Ixmy external auditory meatus (meatus acusticus
externus}.
In hxiking at the skull from the side, the malar surface of the zygomatic Ixme is directed
toward the observer. In the lateral asi)ecl of the maxilla thiri' may be obscrwd (as in the
anterior view ) the anterior nas;tl spine, the frontal pnxes.>, the nasomaxillary suture by which it
articulates with the nasiil lK>nes, and the alveolar jirwess, whiih is vi'reele<l toward the simi
larly named iKjrtion of the mandiijie.
In the lower jaw we see thi' Ixnly with ilu mental foramen, and almost at right angles with
the Ixnly, tlu ranui>, the upper portion of which is divided by a derp notch, the sigmoid notch,
intn two imxessi'S, the coronoid and the condyloid pr<Kes>es. The articular surface of the
(ondvloid prmess rests in a lo.->sa of the temjxiral Ixme situated Ixlow the riK)t of the /ygoma,
ihc nuvniibuiar or glenoid jcc.sa.
S^Sli
:-JH I
,!<»
//X'. t7.
nasal process of maxilla
lachrymomaxillarv suliirr
sphenofror.tal suture
supriiorhilal margin
internasJ ^'"■<""''
suture •"'""•''
nasofrontal suture
^^\ '^^^
S*,
Jrontomuxillary suture
',
/^
5v
orbital surface
\ 'j
^\.
of orbital plate
\frontal bone
(vertical plate)
/
'^W
of frontal bone
^
^
\ \ /
. ;/
/
\
lachrymal bone
\ \ \
/'*
/■'-'
4\ ■
sphenofrontal
\ ' \
■■/;
/■ -^'-i
f/M
suture
\ \
■J
\Mk
sphenoparietal
/
Ip+'Jl
suture
parietal bone
< ^pheniyidal tingU >
Sirfatfr
u'int; fl/ fphennii/ ,.,
/tt'm/wral surface >
zygomatic process I"
orbital plate of ^-
frontal bone \
sphenoidal fissure
h
•eater wlf
^ sphettoid
\ jfyeontafi
i'. bone
sphenomaxillary \
fissure
infraorbital marsrin
nasal bone
nasal septum
alveolar process
of superior maxilla
anterior nasal spine
if
nuxrlla I
-Vf^
r
rr
i I >;
V,
mandible
(body)
Fig. 3S.
,'/'.
temporal bone
zyiromatico-frontiil
Z' "•••/. \ i suture
sphcnozyiioniatic
suture
nasomaxillary
suture
zyi^omatico-
maxillury
suture
infniorbifiil foramen
ramus of mandible
inferior tiirhinalcd hone
>.j
mental foramen
iutcrmn miliary suture
Ki^s. .<7 aiul .Vs. The -kul' sofii trtim in trmU ('-).
In tl^. .*^ the tVontiil liono i-* vi^ilct. tlic rTi;i\ill.'i \i'lln\\. the splirtmicl ^rci'n. tin- p.uirtJiK
lirnwii. Ihf laclii' nials .uul \iinui pink, tlu' ctliniDiil (Mannc thi' /xgoniatii' pin' stri'nkid. tin- nwindilili'
i/liii' !il(i-ttki-ti ami ilie tia>di*i una Itiiipoi .ii<« while.
i
r c
_ "^
it =
is ^
h.
"m^
1
iMHI
THK F.XTERXAL SURFACE OF THE BASE OF THE SKIM..
39
THE EXTERNAL SURFACE OF THE BASE OF THE SKULL.
The inferior asjjcct of the human skull, exposed by the removal of tlie lower jaw, jiresents
an extremely irregular surface (Fi>,'s. 41 and 42), and is termed the external surface of the ba.se
of the skull, basi:> cranii externa, to distinguish it from the internal surface which forms the
floor of the cranial cavity.
Passing from before backward, there may be noticed first the bony [ilate of the hard palate,
\.hich is Iwundcd externally by the alveolar process of the maxilla and the upper row of teeth.
It forms the bonv ] ' lition separating the oral and nasal cavities, is lomposcd of two bones
upon either side, the pnlaliiie process of the maxilla, forming' its anterior two thirds to three
quarters, while the j)OSterior third or fourth is furnished by the horizontal portion of the ])alate
Ijone. It is trawrsed in the median line by the median palatine suture, the anterior extremity
of which contains the incisive joramen, a pit like depression, which leads to a canal of the same
name. The palate lx)nes are sejjarated from the y)alatine processes of the maxilla by the trans
verse palatine suture, and at the posterior extremity of the median jjalaline suture, the two lK)nes
terminate in a sjjine, tlie posterior nasal spine. The posterior free margins of the horizontal
plates of the palate bones form the lowc r lx)undar\- of the jjosterior nares or riioanir. the i)OS-
terior outlets of the Ixiny nasal foss;e.
To the outer side of the hard palate is seen the short, broad zyi^oniatic process of the maxilla,
which articulates with the malar Umv by means of the zyi^omaticomaxillary suture. There is
also to be seen tlie anterior extremity of the injerior orbital or si)henoniaxillary lissure between
the upi)er jaw and the greater wing of the s])henoid l;one. The zygomatic arch, fornud b\ the
junction of the zvf^omalic process • f the temjioral l.x)ne with the temporal process oi the zygo
matic Ijone, is distinctly visible.
A large portion of tlie external surface of the ba.se of the sk'.dl is formed by the splienoiil
bone. The greater wings are almost entirely visible and are limited posteriorly and externally by
the sphenosquamosal suture, their foreshortened temporal surfaces, already noticed in the lateral
view of the skull, being seen to unite with the infratemporal surfaces,which are actually situated
in the base of the skull, at a distinct angle marked by a rough ridge, the injratemporal crest.
The posterior margin of this infratemi.oral surface is separated from the contiguous i)etroiis
l)ortion of the temporal l)one by the sphenopetrosal fissure, whi( h is lontiniious internally with
an irregular foramen, the joramen lacerum. The extreme postiro external angle of the greater
wing of the sphenoid, the spine, is (lireel>'d toward the temporal Ixme, and preseiUs a round
opening, the joramen spiiiosum, whicii leads into the cranial cavity and transmits the middle
nieningeMJ arlerv. In front of this is a larger oval aperture, llie joramen muile, tinough whieii
the mandibular division of thi' trigeminal nerve emerges from the cranial cavity.
In the middle of the base of the skull a -lait of tin Ixxly of the sphenoid U>ne is visible
between the two greater wing>, but itsanteri lortion is jiartly concealed. It will I h- observed
that the |)o,sterior margin of the bony r d ..ejitum, which in this jirejiaration repres Us the
septum choanoruiii, is forme<l f)v the von. r, which articulates with the Ijody of the sphenoid
')y nitans of a broad basi', known as the ala vomeris.
.\ .strong process, the pteryf^oid process, which is divided lengthwise into two jilates, projects
I'
I
40
ATI.AS AND TEXT-BOOK OF HUMAN ANATOMY.
downward from the bofly of the sphenoid. The broader, larger, external plate is termed the
exleriml pteryf^oid plate, and the narrower internal one, the inlcrnal plcryt^oid plate, terminates
below in a small h(x)k-like process, the hanmhr process {hamulus pterygoideus). The pten,-jToi(l
process of the sphenoid lx)ne articulates in this situation with the horizontal plate of the palate
Ixjne and also with a prcxess of this lx>ne, its tuberosity : processus pvramidalis), which is dirccterl
backward and outward and fills the gap Ix'tween the external and internal pterygoid plates,
consequently aiding in the formation of the pterygoid jossa, which occui)ies the inte'rval between
the two plates.
In the j)alate lx)ne, at its junction with the pterygoid |)r(.cess of the sphenoid, there is a
larger anterior foramen, the (-realer palatine joramen, and usually se\eral smaller posterior
oi)enings, the lesser palatine foramina.
The iK)sterior half of the external sur.ace of the base of the skull is formed by the two tem-
poral bones and by the occipital lx)ne. .Ml the four portions of which the temiK)rai Iwne is
comjiosed are \isiljle, naniel\-, the inferior surfaces of the petrous portion, of the mastoid portion,
and of the tympanic portion, and a |)art of the squamous portion. The apex of the petrous
portion lies in an irregularly shajied opening, the ioramen laeerum: it is se[)arated from the
sphenoid bone anteriorly by the sphenopetrosal fissure and from the ...cipital Iwne posteriorly
by the pctro-occipilal fissure. The mai,toid jx.rtiim articulates with the occiiiital Ijfjne b\ mean's
oi the occipitomastoid suture.
Of the >(|uamous portion, one sees mainly the zygomatic process (forming a jjortion of the
zygomatic arch) and the mandibular jossa, which accommwiatcs the condyloid i)rocess of the
mandible and presents anteriorly the articular eminence. Of the mastoid' portion, there is to
lie sen the mastoid process {processus ma.Uoideus), which has a deep gr(«)\-e, the digastric fos.sa
(inci.sura mastoidea), upon its inner surface, and. at the side of the oci ipitomasloid suture, an
op.'ning, the mastoid joramen. The tNinpanic portion, with the meatus audilorius exiernus,
is placed Ix'tween the m;Lstoid procTss an<I the mandibular fos>;i, and in front of it there is a'
fissure, the (ilaserian fissure (fissura petrotympanica).
Th.Te are many foiunn'na and fossa- uix)n the ven,- rough and irregular lower surface of
the petrous portion of the temp(,nii Ixme. Slightly to tiie inner si.le and in front of the mastoid
process is 111,' pointed styloid process, between the mastoid and styloid processes there is ;;n
oi)ening. tii< stylonuistoid Inramcn; to t],e inner si.le of the styloid process there is a radier iWxu
dei.ression, the jugular jossa, leading into th,' iraniai cavilv through an irregular opining, the
juf^ular joramen; and to the inner side and in front of ilie jugular fossji there is a round opening,
the external orilire of the uirniid canal.
Thr occipital hone forms the large remaining i«.rtion of the external surface vi the i)asc of
the skull. In the adult s,<ull it is unitol with the sph.'noid so that its basilar portion is continu.ais
.anteriorly uilh. ihr bo,ly of th- sphenoid lione without demanation. Posteriorly the basilar
portion forms the anterior margin of the joramen mof^num, whilr ihc portions of bone external
to this foramen, known as the laliral portions^ pres.^nt ih,' two large occipital condyles, by means
ot which the skull articulales with the lirst ceryi.;il yerir!,r.:i ,,.• aiLi-. Tl!.. hjisf of .■:!! h eo.ndvlc
is perforated by a short (anal, the hypoglossal or anterior condyloid ,onal, while the termination
of a similar canal, the condyloid or posterior condyloid, is \isible behind the condyle.
Fit;. 41.
i^fs^i'^v^r
aid YPineris
horizonlnl portion of /lalan
ho"(' .
himtidl /ili-n-t;oiil /tloif:
zvnomalic horir llcmpori:! •.urjnn')
ixtcriiiil ptiiyiioiil I'lotr ■
infratemponil surface oj
gmilfr wing ol sphenoid '
sphenoparietal suture
nrliiiiiiir eniiuenee -
fonimai spiiiosiim
jonimcii /anriim ■
orifice of eiirotiil ennui - -
-H'lomastind foramen '' ,
incisive t'onimrii
'•''^ ^ meditin inihiliiie suture
'4 \ .,■ • ■/Hi/titi/ir iinxrss ol' •di/urior
innxillii
iran^verse palatine .uluie
■Kviiomanc process of maxilla
zvnomatieo-maxiilarv suture
po^tirior nw-al ••pine
ZVjroilllltic (trcli
infraienipoiul er '^t
Sfdu nosquaniOMi! suture
niutieole-npoial
suture
foriimin ovale
•.phenoiielro^ul lt^>nre
prohe in hypoglossal ennui
petrooeeipitui fi^sitre
styloid /iroeess
jllgllhll fossil ';
mastoid j^roove
mastoid foramen ■'
occipital cond'Je
londyloid fossa
foivmen imiamiiii
portion t^non r TF-<J. . . /; i eMemal nnilih'iv nieulns
oeeipilonni^loui ^nln>e
mastoid /iivccss
■tornU't,':<l ^nli.ee
CxtefiKil occinilal /iroliilH'ranee
ffer. 42.
inferior niicliul line
superior niehal line
I'i^rs. 41 ami 42. 'I'ln' -knll >c>'n tron
1, .isr. 4: Ihr vari..u. I.."irs are r,,!,,,-...! as in tif;. i'' .'xrHit li.at tl,.^ ■ ■ npitai .->
uilli lid ami the luilaliiif- are bliiL-.
1 lu'liiw. tlu' uulor -url.iw uf ihr huso 1 ' , ).
m
cribriform
ethmoidal spine //taie
fr ■^■iten caecum
jiigiim ethmoidale
optic groove ^•
^i-ita gain
. fronto-ethmoidal suture
sulci arterios!
olivary eminence
optic foramen
anterior clinoid
process
fonimen rotiindum
sulcus arteriosus t
foramen ovale
fonimen spinosiim
trigeminal impression
inrmiiil Mulitory meatus
jugular foramen
Orilerwr com/mrlmeiit)
lambdoid suture
jugular tuhercle
..,,.„ ,„,„■: nunwi hvpOglOSSa! Ult'l!
remains of the spheno-nrnpital su:.ire ^^,.,,,„„; ,„•„/«/"/
synchondrosis ,r. i nrouihe
ranee
Fi:. 43.
l-ias. U^ und 41 Th. inner -urhu - •'
l„ li". 4'. the •.ari..us 1^ ^>es an
ihe bav
otl a> in I
sphenofrontal suture
dorsum -ellae
coronal suture
carotid groove
siiiunoparktal suture
^/•henosquamosa/ ^utuir
foramen lacerum
squamosal suture
mlirior I'l •■■fill iinwrf
pttro-OfCipitii' ''*'
hiatus lulhpii
jugular joi . "
sigmoid -oove
rondyloii: cunat
mastoid •i-iimen
transvtKe g ■>■'<'
4
!'f
! »:
THK INTERNAL SURFACE OF THE BASE OF THE SKII-I..
41
There is further to Ix." ()l)served the entire nuchal surface {planum niuhale) of the squamous
l)ortion and r. foreshortened portion of tlie planum oiripilalc, the lx)undary Ixtween 'le two
portions Ixing formed by a rough line, the suprrior nuchal, which extends laterally from the
central rxlirnal orcipital protuberance. Below the upi)cr line, the nuchal surface is crossed by
the injcrior nuchal line.
THE INTERNAL SURFACE OF THE BASE OF THE SKULL.
By the interna! urface of the base of the skull (Figs. 43 and 44) is understood the lloor
of the cranial cavit\- which is expose! by sawing horizontally througli tlie !x)nv cranium and
removing llie ealvariuni. It is (<)nca\( , and contains the so tailed cranial fossa-, of which llii n-
are recogni/.ed ar. anicrior, a ntidillc, and a poslcriiir jossa (Fig. 4.;i. All tliree fos>a' n-,eil in
a saddle like elevation, the sella lureiai, which is a portion of the Ixxly of the sphenoid Ixme and
is situated somewhat anteriorly to the middle of the cranial cavity.
The anterior cranial fossa is relaiively tlat. The greater portion of ii> tloor is formed
by the orbital jjlates of the frontal bone (Figs. 4;, and 44), whose Upper surfaces are dirccled
toward the cranial ca\ity and are known as the cerebral surjaa's. They ])risent peculiar eleva
tions and corresixmding dtpressions, called n>pei lively cenbral lUi^a an<l dii^ilale impressions,
and they also present gr(M)ve> for IjIikmI vessels. The two halves of the fnml.il bone an- .~e])a
rate<l anteriorly b\ a ridge, the jronlal cresi, which (omnienci ^ at a foranii i\, du jorameii arcum.
and posteriorly the orbital ])lates of tiie frontal bone articulate with the li^xr wing> of tlie
s]ihenoid b\ the sphenojrontal sulure.
Lving Ixtween the two orbital plates of the frontal l)one and txtmding from the foramen
ca'cuni to the sjihenoid Ume there is a thin Ixmy plate, ( liaraiteri/.ed by Uini; ])erf()rated by
numerous forandna. It i^ the cribrijorm plate of the ellimoid bone, and it ])resenl> in its nudian
line a (ond) like t livation, the rrisl<i j^alli, and articulates with the frontal Ixnn by mean> nf the
jronto ethmoidal suture.
In the niedi.in line behinil tlu 1 ribriform plate ni the ethmoid is ^een the iu;.;uiii ^phenoidali
of the sphenoid iione witii tile ethmoidal ^pine, ami to (ilher side arr ob^erved tin- lesser :ci)ii;\
of the lx>ne. tin se laltt r ari-ing from eitlur side of the Ixxly of the sphenoid bv two nxtis whidi
ei.dosc an o])eniiig, tlie opiii joraiiiiii. Xe.ii- the mII.i turdca, the Iomt win-; of either side
proic( t> nilo the middle uribr. I I'd^si a,> a -hurl, ^lighlly curved, hixik like pnKe», thi anterior
tlinoid proiiw.
Tile middle cranial fossa i> mui h deeper , and larger th.m \h< anterior om, and i- divided
into two halvi> by a marked meilian elevation, the sella tuntm. In ihi- tliere may 1k' re(og
ni/.ed tin lii'.;li back of the saddle, tlie dorsum ulhr. with tin hypophyseal jossa in front of
it, and, -till fiirtlur anleiiorlv , the olivary imineme \iuher< uliim srllo ). In iron! >n ihi lallti
i> a grixive, the optie ^romr 1 \ulius i hia\matis 1, and a M(ond gnxivc , the larotid i^ro<ne, i■^ >i!natecl
on each side of the sella tunica. .\ >hort distance tx hind the dorMim sella- \\i find the spin no-
• ;/>.'* i' xf '1 •<-■••■ Kir'ii! "I'-t! '•••• ..1.^1. :...i. .1,.^. ii.. !„.,... .Ill', i,..i,.... I, ill., luwiv
of the Sphenoid anil the otiipilal Ixme and i> the remain^ of the -viu hoii<iro-i-> originalh s( jiaral
ing the two lx)ne-. (>ee page 4; 1.
r i
42
ATLAS AND TEXT BOOK OF HUMAN ANATOMY.
To the outer side of the sella turcica we sec the cerebral surface of the greater wing of the
sphenoid bone, which is sejjarated from the overhing lesser wing of the s])henoid by the superior
orbital or sphenoidal fissure. The remaining boundaries of this surface are the same as those
seen on the external surface of the base of th.' skull, namely, the sphenoparietal and spheno-
squamosal sutures, the foramen lacerum or sphenopetrosal fissure. \ear its origin from thi'
Ixxly, the greater wing of the sphenoid bone contains three orifices; the joramen rotundum,
Kl.i. 45 -Tl..- iiiii. I «»rfa<r ..f ihr l,,is, i.f Ihf skull; ihr ani. rinr (.«.a is (oluml l.lur, Ihf mi.l.llo f.«.a «hil.', ,in.| tlu-
|«i«liTior fc~>.a pink.
directed obli(|iuK antirjo.lvand leading int.. a short canal, the /oram/« mw/c, and the joranun
spinosum.
In addition to the greater wing of the sphenoid bone, the n(H)r of the middle cranial fossa
•>. .nrmc!. .!y !.•:• <!■-<•, sr;!l --rirfarc of the squamour. poriinn ;)[ thr timjM)i,iJ ix.iic iiiid in the an
terior surfa( e of the petrous iK)rli()n, the posterior surface of the |)etmus |)ortion and the mastoid
ixmion helping to form the ll<H.r of the posterior ( ranial fossa. The bcnindnries of the tem|K>ral
»l
THE INTERNAL SURFACE OF THE BASE OF THE SKUI.I..
43
bone in the middle fossa are also similar to those observed upon the external surface of the base
of the skull, namely, the s plicnosquamcsal and squamosal sutures and the joramcn larrrum.
U[Xin the cerebral surface of the squamous portion of the temj)oral, commencing; at the
foramen spinosum. there is a groove, the suku.-< arlcriosus, which is continued by manifold rami-
I'lcations uj)on the inner surface of the cranial vauli. UjOTn the apex of the ))etrous portion,
which is in contact with the body of the sphenoid, there is a shallow depression, the Irii^nniiiiil
impnssion for the Gasserian ganglion, and at atjout the middle of its anterior >urfaie there
is a slil-like opening, the hiatus canalis jacialis (hiatus Fallopii), while u])on it> su|)erior margin
there runs a shallow groo\e, the superior petrosal j^roove.
The posterior cranial fossa is the largest of all. Its n(V)r is formed by only the (Kcpital
and temi)oral lx)nes, the lioundaries between which in the jxisterior fossa are the pelro-occipital
fissure, the juf^ular joramen, and the occipitomastoid suture.
Upon the [KJSterior surface of the i)etrous ])ortion of the temporal bone there is a large,
round, irregular opening, the internal auditory meatus {porus uustieus internus).
The jugular joramen, situated between the temjmral and occipital lx)nes, is formed in tiic
following manner. Each of the two l)ones possesse.-> a corresponding notch which is so sub
divided that the jugular foramen consists of a smaller anterior and of a larger posterior com
partment, the former giving passage to the glosso-i)haryngeal, pneumogastric, and spinal
accessor)- nerves; the latter to the internal jugular vein.
In tile iM)sterior foss;i the mastoid (mrtion of the temporal l>one exhibits a curN-.tl groove,
the sit^moid j^roo^'e, which begins at the posterior com()artment of tht jugular foramen and is
at first situated on the lateral portion of the occipital bone, passing in a curve around the
jujiular process, which is directed toward the temporal Ixine. In the mastoid portion of tlu
tem|)oral lione is thv inner (cerebral) orifice of tlie mastoid joramen, and at the jun<tion of tin
tim])oral, parietal, and (Heijjital Ixmes, where the lamlxloid and (Kcipitomastnid sulures iHconie
continuous, the sigmoid gnxjve Ixnds at almost a right angle into the Iransrerse i^roove, so thai
the posterior inferior angle of the parietal Ixme, tlie iiui\toid ani^le, also aids in its formation.
The transverse gnx)ve passes across the inner surfaci' of the s(|uamous puriion of ilu (xcipilal
lK)ne as a markedly shallower gnx)ve to a nudian ( niiial elevaiicn, ilu' crucial niiiiumc, whose
(inter forms the internal occipital proluhcronn .
The (crebral surface of the (xdpiial lK)ne forms by far lln L'leater iiorlii-'i of ihe I'oor of
till |>osterii(r foss;!. Its basiinr portion forms a jiortion of the su called ciii'ny .1 steeii lx)ny
incline p,i>sing from the back of the sella turcica to ihc lK)rder of the foran-n, ..lagnuni; the
anterior |M)rlion of ihe clivus is formed by that part of the Ijodv of the sph- ,ioul which is situated
anterior to the original spheno o( cipilai synchondrosis. Al the outer side of tlie eli\us there
In the shallow, injcrior petrosal f^romr, which is formed In tin juiii lion of tin (xcipilal and . 11
jHiral lx)nes in the |)etro ixcipital fissure.
The hileral portions of the cKcipital !x<ne, situated to i iiher .side of the foramen magnum,
present two rounded pmjections u|x)n their cerebral surfac ■. the jugular tubercles, whose Iwises
■^X'- trtivernd b\ the {)rrVh>us!y nH'nlionn! hyjnigins:^ii or anicrior condyloid cnnai, and Uiiiiid
the jugular iinxess (usually in the Ixginning of the sigmoid gnM)ve) is situated the internal
extremitv of the condvloiil canal.
44
|i t
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig. 46. — The skull seen from aix)ve (i).
X = foramen parii'tali-.
Fig. 47.— The inner surface of the roof of the skull (calvarium) (1).
The posterior margin of the round jnramcn maf^num, situated in the mifkllc of the posterior
fossa, is formefi by the s.-juamous jsortion of the ociii)ital, which exhibits, Ix'low the transverse
groove, two concave depressions, the inferior occipital joss(C, which are separated by a median
riilge, the inUrnal occipital crest.
THE SUPERIOR ASPECT OF THE SKULL.
The super'"-)r aspect of the skull (Fif;. 4O) is much less comitlicated. It shows only four
Ixmes, the vertical [KDrlion of the frontal, the large surla^.s of the two parietals, and the apex
of the squamous |M)rtion of the occipital. The visible sutures are the coronal suture, thi' s;igittal
.suture, si'parating the parietal Ijones throughout their entire length, and the lamlyl-)id suture,
which forms an obtuse angle with the sagittal suture. In the parietal Ijone, on eilher side of
the sigittal suture and at alxnit the junction of the third and fourth (|uartei>, there is an orifice,
the parietal jonimeii. and the foreshorlenc<l temporal line can als(> Ik' seen.
THE INNER ASPECT OF THE CRANIAL VAULT OR CALVARLA.
The inner surface of the cranial vault (Fig. 47 1 corn-jionds to the outer surface ^viili sliglu
differenies. It presents the .s;ime Ixines, frontal, parietal, and (k< ipital, and the siime ^uture~.
the coronal, s;igittal, and lamlxloid. Upon the inner surface of thi sjigiita! suture wi find a
shallow groove, the saf^iltal i^roove, which comnKnces at the crest of the frontal Ijone and pa.s.si>
Iwickward over the jjarietal to the iKcipital lK)ne. The it rebral surfaces of all the lx)nes of the
cranial vault show \ascular gr(K)ves, the sulci arteriosi: they are found in griatest numlxrs
upon the parietal Ixtne and. next in fre(|uency, u|)on the frontal Ixme. Small inconstant de|)res
sions, often of inion^id'.ra))le depth and situated i)articularly along the sigittal suture, are desig-
nated as the jovcolic f^raiiulares or pacchionian depressions.
THE BONES OF THE SKULL.
After this consideration of the skull a-- a whole we tu"-. 1" llu desiriplion of '.hi iridi\idual
Ixmes of the skull. These nia\ be divided inln two groujis: ( 1 ! the Ixmes of tile cranium (. raniiini
nrehritli 1. and 1 -" llu Ixmes of ilie fau [cranium visc<rate). Thi' ( ninial Ihiihs art the ouipilal
IxiMi . the s[>lunoiit Ixtne, the two lim fioral Ixmts, the two paridiil Ixtnes, tin jrontal Ixiiie, and
tilt illimoiil Ixtm. The latial Ixtnes are the na^al Ixmts, tin totlirymat Ixmts, thi vomer, the
injerior turbinolnl hones {concha nasates in'jcriores], the 'iiaxillo, tin pitl.iU boms, the zyjtioniittii
Ixme-.. tilt iiiiiwlihli , and llu liyoiil Ixme.
I'lr liiituMif llif ^kiill iiiuviIm. (n I la^^ilii-.l aniinlitiK In Ihr mHli>Kl ni ilitir (livilti|imfm fsif |iiim- jt I, ami (runt
tlii^ Hi a nil jM lint thiv .in' (ptitr hfttr<n;r!n.«ti., ^trm turf>; -^umi- of thfiti. .(h li a-- ttms*' nf tin- lia'.r nf ittc s^ull, arr »', vcl-
ii[«il 111 I hi' |iriiiiupli ' atlilaKiniiii- ■ i iiiiiint. «iitii arr iialiuii'. .i( llir \i-< i i.il -kiU lull, .iiitl muui an -.n > .illril n ah lug
I
s
M
lu
i¥y
I
THE BOiJES OF THE SKULL.
45
or dormul iM.n.s which serve to close in the cranium, the upper ,x.rtion of which is unrepresented m the .arflapnuus
primordial skeleton. Only a part ..f the cranial l»nes are preformed in cartilage, the nu.jonty be.nK formed by d.re.t
ossification of connective tissue. Those- which are preformed in cartilaRe are al.so known as pnmord.al In.nes, and they
are the occipital, with the exception of the upper part .,f the s<|uamous ,K>rtion, the phenoid, w,th the exception of .he
internal plate of the pterygoid process, the entire ethmoid and the inferior turbinal, and the petrous and mastoid ,K,r-
tions of the temporal. . ■ •. , .1 ■ , 1
The cranial In.nes formed in membrane are the upper part of the squamous porti.m of the .,,,,, ,.tal, the ,K,net..ls,
the frontal, the s,|uamous and tvmpanic porti.ms of the temporals, the vomer, the na.sais, and the lachrymals.
The onlv portions of the visceral cephalic skelet.m which are preformed in cartilage and are to Ix- regarded as
primordial bones are the hvoid and the small auditory ossicles situated >vithin tlf t.n,poial lK,ne. The follo«w.g bones
of the face are f.,rmcd in membrane; the maxilhe, the palate bones, the internal plates of the pterygoid processes of the
sphenoid Inine, the zygomatic bones, and the mandible.
)
THE Cranial Bones.
THE OCCIPITAL BONE.
The occipital lionc (Figs. 48 to 51) is comi)osc(l of tiirec jKirtions which arc not shari)ly
separated, and of these portions one is i)aired and two are single. They are termed the basilar
portion, the laUral portions, and the squamous portion, and are groupctl alK)ut the joraimn ;«(/,(;-
num in such a way that the basilar jwrtion is in front, the lateral jwrtions are to cither side,
and the stiuamous portion is Ix'hind the foramen.
The basilar portion of the adult skull and the body of the sphenoid Ijonc arc united by
osseous tissue (Fig. 51), but up to the time of puberty they are articulated by the splinw-oaipital
synchondrosis or fissure (see page 47)- The lower .surface of the basilar portion, which lomis a
[)art of the external surface of the base of the cranium, lies almost horizontally, but the cerebral
surface i)asscs oblitiuely from alx)ve downward and from iK'fore backward and forms the clivus
(Hlumcnbachii). The inferior surface (Fig. 50) presents a median projection, the pliaryufical
lubinl,', for the attachment of the pharyngeal ajmneurosis, and to cither side are roughened
surfaces for the in.sertions of the rectus capitis anticus minor and major muscles.
The surface of the clivus (Figs. 4,^, 44- and 51) is slighth concave and its lateral margins
exhibit a gnnive, fre(|uently c|uite shallow, the injerior petrosal f-romr, which forms with a similar
gr.Kive of the temi)onil iK.'ne (see page 55), over the pctro-occipital fissure, a tl,..nncl for the
inferior ))etros;d sinus of the dura mater.
The lateral portions, also termed the condyloid portions, extend posteriorly, and gradually
become broader and thinner as they i)ass into the .sciuamous portion of the Ixmc. The ir most
important structures are the condyles (Figs. 41, 4-', 4^, and 50), which are situated upon their
inferior surface and articulate willi the first cervical vertebra. The articular surfatrs of the
tondyles are reniform in shape and are markedly conve\, particularlv from Inforc backward;
they Cxtend from the anterior margin to alxiut ojiposite the middle of the foramen magmmi,
hut only their posterior halves iHirdir directly uixm this opening. Uehind the tondyles ihcre
i^ a depression, the c(.'«t/v/(>a/ /.•••sij J rg. 4r'-, w. in HT ii.-.i c.uuii c.i ..i.e. fin
a so tailed emissary forainen, and the base of the condxle is traversed from side to side by the
hypofilosuil canal (Figs. 4c; and 50), through which the twelfth cranial nerve, the hyiH)glo.ssal,
leaves tlic skull.
46
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fu;. 48. — The occipital bone seen from behind (i).
Fig. 49. — The oc(i|)itaI bone seen f-om in front (i).
Fic;. 50. — The occipital bone seen from below (J).
Fig. 51. — The occipital and sphenoid bones seen from above (i)
fused with the middle one.
The right anterior clinoid process is
Upon the outer margins of the lateral portions of the Ijonc, projecting toward the temporal
bone, there is a prominence, the jugular process (P'igs. 48, 49, 50, and 51), in front of which
is situated a notch, the jugiiler notch, which is sulxlividcd by a small iitlrajugiilar process (Figs.
50 and 51). into a small anterior and a larger ]x)sterior compartment. By apposition of the
notches to corresiwnding notches of the temporal lx)nc there is formed the jugular joramen
^F'K'^- 43 snd 44), which is divided into two comj)artments by a ligament extending between
the corresjwnding intrajugular processes (a^e page 55).
The inner or cerebral surface of the lateral jwrtion of the occinital exhibits a blunt pro-
tuberance, the jugular tubercle (Fig. 51), above and to the outer side of the internal orifice of
the h\ix)glossal canal, which consequently passes through the lateral portion of the bone, below
the jugular tubercle and alx)ve the condyle. Heside the jugular process and beginning in the
jugular notch is seen the commencement of the sigro'd grooir (see ]jage 43), which cur\es over
the cerebral surface of the jugular process.
The largest jwrtion of the occipital tx)ne is formed by the squamous portion, which is flat
and moderately curved, and in which an internal and an external surface be recognized.
It is lx)unded by the (xrcipitomastoid suture, forming the mastoid I- r, ar,.i )V the lambdoid
suture, forming the lambdoid border, and its apex is situated at the posterioi vtrcmitv of the
sagittal suture.
The most striking formation up<m the rather markedly concave internal or cerebral surface
(Fig. 4()) is the crucial rmincmr, the ridges of which form four shallow fossa-, two superior
occipital josstr and two iiijerior occipital jossa: Tlie middle of the iross is formed by the internal
occipital protuberance, while the inferior median limb, the internal occipital crest, [)asscs to the
posterior margin of the foramen magnum. The remaining three limbs are gnxnes produced
by the venous sinuses of the dura mater; the two lateral ones are called the transverse grooirs
and the sui>eric)r one is the posterior extremity of the sagittal gnnrce (see page 441.
The external surface of the scjuamous portion (Fig. 48) is markedly convex in lx)lh the
sagittal and transverse directions, and is divided into two surfaces, an inferior nuchal surf:'ce
[planum ««(7/(j/(), roughened for the insertion of numerous nniscles, and a superior smtxither
triangular occipital surface (planum occipitale). These two surfaces are .separate<l by the
su|)erior nuchal line, a roughened ridge for muscular attachment, which passes in a curvwi
direction from the external occipital protuberance to the occii)ito-mastoid suture, and a short
(lislaiue above ilie linea su|)eri()r we observe the somewhat more sharply curved litwa suprema.
The entire jjlanum nuchale, from the external (Kcipital jirotuberance to the foramen mag-
num, is traversed by the external occipital crest. From alxiut the middle of this crest, and parallel
to the linea su|)rema, there pa.s.ses outward the injerior nuchal line, ujwn which there arc fre-
i
L
Planum ccdi>itiile
I xlenuil cccipittil itivtiihrranct
/ "'."'^^1^^^ l.itiiii niichdc ■<iii>miui
I'laniiin niicliaU'
Superior niichnl line
Squama occipitalis Jf
'nferior niiclnil line
Comlvloid ecinnl
I'hiinini iiiichdle
Lateral portion
('('ndyloid tossa
Hvim^lflssal eaniil
f'onimeii ni<i<>nnni
liisiiiliir /imeexs
Oiiipitiil eondvli'
lixlerntil iHcipiliil cresl
S(i!iitt(tl i;roove
hlr, VS.
'/'n/wsiv/v <'V(>('iv
Inlirnul occipitiil
fimtn/ieniine
Inlertiiit cccipilnl cresl
JiiiTiihir /I'lUi
IjinilultUil border
Sii/ierior tiecipilal
fossa
liilerior oeeipiliil
lOs'.ll
Mi/sfi'id lionler
Condyloid riini/l
/ii!;nlar Inherrle
Hvpoi^lossid canal
( tccipilnl condyli
P M
Basilar portion
I'iir. 10.
r- »i
'.ifm^'^'^y^i.
Basilar portion
Hv/iof^lossa! ainal
/iitm/iii^ii/iir />ro(iss -^
I'ltarvngi'iil tiihervlr
I ortiinni nuif^tniii!
ihii/'iral ioiuIyIi'
Jdi^nliir notill
Itiiriilar process
^ . i0 Lateral portion
Fif;. 50.
Si/iKiiih'iis /),'rnoii
I lontiit honlcr
liififii'r iiiiclliil liilf
I'hiiuim iiiitiiii/r
I'lllictlll
iiiwlr
.\itleiirr Elhnio- ri^^iti;
clinorit Optic itirl t)livnry Oftric
/^/I'lV -^ 'groove s/)i'!i proft^^ lommftt
Siiiitiiihnis lunJer
I'l'^ltTior cUnoid prongs
lillriiiti!;iil(ir /iroas s
liii;iilur iH'Icli
I- in. il.
Pttiiiidl
tiiivje
Si;j;nhnd y/'iKH'i
/ tVtiiiirii rolinuliim
I 'Vltllhll (M'l//r
/ iviiiiicii f./iiiicisiiin
I ill nil I II
Splhiu'-oicipiliil syiirlioiiiln'-'i-^
lui^iiliir liil'i'i'iii
lii!;ii!iir pri'irss
.WisiDiil ItonSiT
I aiiihilohl I'urJir
: H:
: i
I
//•|7//M<7 -( I'liU'VI
^n, ^j
r
■ .1
If!
f
m
'^*«ahi
THE BONES OF THE SKUI.I..
47
f
qucntly two particularly wdl-markcl n^ught-ntd ri.iges, the crrsi jor Ihr rectus aipith poslnus
mahr muscle and that for the rcclus minor.
The rdalions of the occipital hone t(; the nuiKhljoring b<incs of the >kiill liave been pre-
viously dcscribcfl on pages 3S and to.
Onlv the basilar ,,nrtion, the lat.ral ,...,. i.,.,s, aiM .h. 1, .,r ,.,-.. of Ih.- squamous ,K,r.ion ar. ,,n-f..nn..<l in
cartilage, the u|,,„.r part of the .n.uamous ,.om„. ah. planun-, , . , i,,i,..l, ) l«nR form,., in n.emhrane. At the ..^.n-
ninsrof the fourth fetal month, four (or five) ooin.s c,f us.ifuaiion ,.|.,H-ar. one in the ba»lar port.on. one u, ea>h lateral
norL.an.l one ...r tw„) in the lower par. of .l,e s,,uam..u. portion. The upper part of the s.,uaM,ous port.nn ,.
'eparately formed, and i.s partly isola.e.l from the nmain.ler of the l.one un.il after birth by a suture, the .H/«r„ „,n,.!os.,.
-.Imetimes the part of the s,,uamous p.,rtion vvhi. h is r„.t pref-rnu-.l in -arula.e renjains tndepen.lent Irum the per-
-,..en. . of the sutura memlosa, and forms the triangular .. i„„rf,arir,..l,- ( . i,,..). Inr a lon^ tmte after b.rth (ur,.,l
the end of the f..urth year) the h.ter.al portions are se,.arated fmm the body and fnm. the lower part of the s.,uamou,s
I)onion by thi- .interior and posterior intrronipit.:! synchonJros,^.
THE SPHENOID BONE.
In its form the sphenoid bone (Figs. 51 to 54) some\vhat resembles .. v. .iged in>ect. It
consists of the following parts: (i) The body; (2. the two gm//<T ^■iui^s (al.-o called the ln„-
Ihi.' iwo hsscru'iniis (also tailed the orft/A;/ -a'/»,?.v); (4) the pUryt^oid processes.
poraliL-ings)\ (,V)
tr~x.
tempo
f I surface
orbital surface
infratemporal pi^"^
' surface b'V*' ^
\ . 7 \ \ ^f orbital crest.
iphenomajcillaru
surface
Fio. 5:!. — The sphenoid bone seen from in front.
In the adult skull the .sphenoid is lirmly united to the oeeipital hone, the two together formnv.;
one large bone, the os basihire (I'ig. 51).
The body of the sphenoid (Fig. 52) forms the renter of the hone, from whieh all ihe other
portions radiate. Posteriorly it articulates with the oteipiial bone {spheno-occipita! synchon-
drosis, see page 4.s\ and anteri-r!y with the .■thmoi,! hn-ie. Its uimer '-nrfare is formed by
the sella turcica (Fig. 54); its lower surface forms a jiortion of the external surface t)f the base
of the skull (Fig. 42) and articulates with the ala vomeris and the s].henoidal process of the
palate bone. It contains a cavity communicating with the nasal fossa-, the sphenoidal sinus,
48
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig. 53. — The sphenoid bone seen from in front (j).
Fig. 54. — The sphenoid bene seen from behind (|).
which is completely divided into two [wrtions by a siiRittal septum which is rarely situated
exactly in the median line. The two sinuses communicate with the posterior superior portion
of the nasal fossoi by means of irregular openings in the anterior surfa'e of the Ixxly of the s])hem 'd
Iwne (Fig. 53). The greater portion of the almost rectangular anterior surface of the lx)(ly
(Fi^s. s-> and 53) is formed by two thin, appro.ximately triangular bony ])latelets, the sphenoidal
lurbitiatcd bams (concltm sphcnoidalcs), which, although usually unite<l with the sphenoid, are
to be R'ganle<l as ijortions of the ethmoiel; they are frequently continuous with the ethmoid
and may Ix; represented by a number of small indejK'ndent lx)nes {ossa Birlini). 'They
form the inferior margins of the a|K'rtures of the sphenoidal sinuses, and in the neighborhood
of the ai)crtures some small fossx which close in the jxistcrior ethmoidal cells are freciuently
\isible.
The anterior extremity of the septum of the sinuses appears upon the anterior surface of
the Ixxly of the sphenoid in the shape of a low ridge, the sphenoidal crest (Fig. 53)- It is con-
tinuefj U])oii the lower surface of the body of the sphenoid, where it Ixromes more pronounced
and forms the sphenoidal rostrum, to which is attached the ala vomeris.
The upper surface of the !xK!y (Figs. 43, 44, and 51) is the most stningly marked surface
of the lx)ne. Its most striking structure is the so-calk-d sella turcica (see al.so page 41), which
is that ]K)rtion of the upper surface of the Ixxly which Ixlongs to the middle cranial fossa, smaller
portions of the IxkIv helping in the formation of the fl(H)rs of tlie anterior and of the posterior
fos-sa-. The jKjrtion in tlie anterior fossii is a plane surface in fnmt of the sella turcica, con-
nc' ting the two les.ser wings, and is calletl the ;h,i;«w sphenoidair; towarrl the adjacent lamina
cril)rus;i of the ethmoid Ixine it presents a process, the ethmoidal spine (Fig. t;il, the shajie 01
which varies greatly in dilTerint individuaLs.
Behind the jugum sphenoidale at tlie anterior margin of the sella tunica there is a shallow
groove, the optu i^roow (sulcus chiasmatis), so (alle<l Ixrause it lontains tlu di-cus.siition or
(hiasm.i of the "jUic nerves (Fig. 51). It is continued on either side into the optic joranuv,
wiiic h Kails itiio tlu- orbiud caxity.
Hehind the uptii gnH)ve the Ixxly of the sphenoid presents a flat elevation, tlu itiivary emi
neiue (tulhrniluin sella 1, \]\v margin, of wiiii h somdinus give origin to tin inconstant nuddU
fliiiotd pr(Hes;es, and U'twirn the iminen<e and the higli back of llu- siiddlt, the dorsum siila.
lli( n i> siluatecl a ratiier deep, slightly cllipti. al de|>»Ts.sioii, the hypophyseal jossa, which Uxlges
the pituitary Ixxly or hypophysis. On cai li Mdi of this foNs;i dure is u|iiin tin nxit of Mie grcilc r
wing of the sphenoid a >-ha!l.)vv but rather broad gnxvvi, situated at llu ju;i(lion of llu upper
•md lateral surf,u(s of the Ixxly of the sphenoid Ixme and limited externally low.ird the greater
wing of the -phenoid by ;i fi.U' Ixmy piiitdtt, tlie lin)iula (Fig. ^\). Tills gnx-ve i-- calleil ihi
larolid .i;n ntv ( ' ig. i;4i, since it Uxlges tlu inlrrnal lanilid arliry.
The dorsum sell.e Ixarv u|M>n 1 ithir sidi slightly [xjinted shar]> (orners, the posterior liinoid
proiessi - hi hind llu dorsum s, ll.i ,1 |.()rtioii of tlu 1 livii ^o Ix long- to tin Ixxly of ihe sphenoid
frontal border
Orhitiil ^11 r Hue
ronimen rotiimiiim ol prahr wing:
Lesser wing^
Arrrriin of <rhn„'„l„l siniK Sunrrior orln/,,1
Sphfumliil liiihilliltcl ''■""' '■
honf
Spliciioii/iil irrst
Millar horiirr 'Wi^
liifriitimporiil ^nrfun
S/ilif/ioniii \illaiy snr/iiir
■7 Iniiponil siirfiur
(>/' i^rriilir wiiii;'
lii/riilrm/'onil ruli;r
'*^-' J "'I'll
mini /itnygoiil pliilr J
//if. 57.
S/IIIIOIIS /l/(l('C>.'>
Purviiniialdtiiir groove
/ \/eni(il plerygoiil plute
I'tiivgoi.l //■•■-lire
H imiilar proee^^^-
flllhlltl 'tllt'h
.'I ^irnii'i
l)or--iiiii /'.isf. elinoiil proe.
"'■''''" .\iit. elinoiil proe
I csvcr Willi;
■i
■ If
I'.ineto!
iiiiale
S"/;A//? iirlerio^iK
$\ nam 011%
I'onler
( iiroliil gi'ioie
I'tfrvgoiil eiiiiiil
hihrifii pleryi:oiil
pintr
Spnioii\ proee^^
(iiOf I lor I 11^1,1, III, I'l lul'e
seiiplioiil 'civv(
^/ 'inio-oi, //iihil y
-v'lthoiiilri'^i^i >
/ \leiiHil pferxyoiil plile
lloninlii' /"iii/o
IS
i '■
til' il.
I \i
THE BO.\'ES OF THE SKULL
49
bone (see also page 43). -hich thus aids in forming a part of the flo<,r of the ,K,sterior cranial
'""l^!?",SLior surface of the body of the sphenoid .>one (Fig- 54) is adhen.nt ,0
.he I^pil^ U.ne. In young indivi.iuals. if a synchon<lrosis st.ll ex.sts, the surtace .
^""IC'I,;:::;': plrfon of the lower surface of the .x.ly of the sphenoid, l^e the anterior on.
1 tu Kriaicr 1 shhcnoidcl rostrum. On this surtace there
forms a »--d=^^,;'f;,;;;'^;.^^„ " Lais, the inner of which i. the ,.sip>u.yn,eal aural
:ng ;;r:.x hr:rr^:::x:e whic.; is t... ..,..,/ pro.. ..f ,he ptery... pn.ess
,Ki.r -11 i< the *//<Jrv«j?»'a/<<Jfw/ (Fig. 5.1) (seealso page 51). . -^
'm 1 , n 1 urfac! of ,he Ix.ly of the sphenoi.l l.ne give origin to the two g:.ater w. gs
of thl'l-lllid, while the pterygoid processes arise fron. the lower surface o. the hody of the
'"^Thc lesser or orbital wings are narrow, almost horizontal l.ny plates -^}--^ ^^^^
. . iZ- suhenoid t..ne bv two rcK.ls which surround the opl„ loram.M ,lMg. 5.). 1 hur
xnd .4, It leads into tl,e orbi- and its gr.at.r p-nion is .los-d In a mcmb ran . . M
"1^: to the nerve. ..f the ocular muscle, ahc .Hulomo.or. th. al.iucensanclh.. trochlea- ,.
UK r.rst or oph.halmi. division of the trigeminus, an.l to the ..p^r.or ophtha m.. nn.
The grea er or temporal wings of the .phcnoid a,i.. .n.m th.- lateral --f- ;
,..,v of tl! .plunoid bv broad r..,. it, .hi.h are situated ,1.... op.aung. th. ,.-n.K.J n ^ ^-^
H mr.,m<« ..„/, and tlu- lor.mrn spinosum (Fig. ;- >. The tora.nen n.lu.Klum lead. -1 l.qu.lv
:,.' ' Ir .h du- l...:^' into ,h: sphenotnaMllary fo.a „o.so pUr.,o,„., .and tran>-
; I , nlvilh^v nerv.. Mhe second division of the trigendn,.. Th. .uram.n ,na ■ trav...
C 1 . in a ver.i.al .lir.-t..,, an.l tnak.. its ..i, upon the ext.rnal sur.ace ., th.^ Ik^c o. h.
ull l.e page V,. an.l Fig>. 4. and ,..; h .ran.nits tlu- man.libular n.rv.. ,.he th.rd .l.vM,
:!;7h.!^ri^.n'nus,. The f-ramen spinosum pursu.-s ,h.. .un.. .lirot.on and g.v.. passage ,0
the miildle mining, al artery* liiimilv
The gre,.,.r wu.g, lik. th.- less., on., i^ pra. ti. allv hori.o, tal. it , .-^. , u.v .l.-..n, tl
.e,nr.. 1 surfaces, ti; .en/.,,/, th- orl.U,!, and the ,n„por„L and tlu -v n.-, aUo U n. ...n.,..l
TPiJlZ^Irr ,Fig. .n. th.. verv rough margin .lin.t.d to.anl tl,- front d , a -.,o,na,.,
, ,, u n.l,Mr,lH,l >Ul...ual. ,ml.'...rrr.tly,.„..,i,.n»! l-">'i" '"-l^ ■•' "" ■I'''"
mill ,1, ,.1. a Ulwr.li llif for.imrn rnliiMilmii .ui'l ,A. Ill- 111 ."I'O"' '■■"""" '
n.,i,l 1.1 ihr.M r.«.tv .1 mi.l.lli- lir 1 n-.l, Mli...t..l lHl»...iin. i„i,i,,i, llu f..riiiiT n\ac
...,«..„ .h.. f.irani,- m.un.tun, ;in.l ,1,.. ,,,h. n..*.l..l O^Mir. , ami „ v. r, -.a,ri,« ,Ki.l.ru., ...u, Ik.mi.i.Uh ,,
an.! .|.,n.m.m. TW laU.r, h.,«.i.i. > an «ar,.lv I,. r.R.ir.lr.l a, a r.K,!.
1
m
so
ATI.AS AND TEXT-BOOK OF HUMAN AXATOMV.
I
border, in contart with the zygomatic bone, and a squamosal border* direrted toward the tem-
poral lK)ne. The most external jjortion of the greater wing, which is in contact with the parietal
lx)ne in the spheno]'arietal suture, is known as the parietal angle, and its most jjosterior, jjointed
portion, which is directed toward the pet- :'s portion of the temjwral Ijone, is called the spine
(Fi«s. 53 and 54). The cerebral surface is distinctly concave and exhibits the interna] orifices
of the joramen rotundum, m-ale, and spino.-,nm (Fig. 51), the last receiving its name on account
of its location in the spine. t It also cKcasionally shows digitate impressions and cerebral juga
(see i)agcs 41 and 61), and a suteiis arteriosus which is continued from the temjKiral bone.
The ahnost plane, slightly concave, (luadrangular orbital surjace (I'igs. 38 and 53) is thi
smallest of the three surfaces. It forms a jjortion of the outer wall of the orbit, and in this situ
ation its zygomatic border articulates with the zygomatic lK)ne by nu:in> of the sphrnozygomatie
suture. The sijhenomaxillary or inferior orbital fissure sei)arates the greater wing from the
maxilla, and at the margin of this fissure, the orbital surface jkjsscssc's a sharp edge, the orbital
crest, which sejiarates it from the sphenomaxillary surjace (Fig. 53), a lower iK)rtic>n of the tem-
]K)ral surface. In the vicinity of the superior orbital fissure the orbital surface exhibits a lx>ny
spine of variable development which is called the spina recti lateralis and is the j-oint of origin
for the muscle of the same name.
The temporal .surjace (Figs. 3c), 40, and SS'I '^ ^y ^'•^'^ l'^'^' liirj.'"--^' o^ t'lc three surfaces ..f
the greater wing of the sjihenoid and is distinctly angulated at the level of liic injratemporat
crest (see page 3c)). Tlie almost vertical portion of the tem]K)ral surface, situcted above this
crest, forms a iK)rtion of the planum temporale (see ])age 38), while the portion >ituated IkIow
the crest is divided into the more horizontal injratemporal surjace and the triangular splunv
maxillarv surjace b\ a ratlu r low ridge wliich is called the splienomaxillary ridg<. The spheno
maxillarv surface 1 Fig. 53) lcx)ks rather anteriorly and overlaps the rcK)t of the |ilcrygoid prcness,
while the infratemporal surface is directed more to the side, and jiresents the external orifices
of the foramen ovale and the foramen spinosum. Jt forms tile jiostcrior wall of thi pleryiio^
palatine (sphenomaxillary) jossa (see jjage 781, and contains the anterior or external orifice nl
the foramen rotundum. It is sharjly separated from the orbital surface by th. orbital crest
I Fig. 53).
While the greater and U-ser wings of the sphenoid are practically horizontal, the third
pair of ])nKes>es, tlu pterygoid processes iFigs. 53 and ;4i, pass abvio-t Miticallv down.vani
and are aiijiosed 1 Fius. 41 and 4.>i to the posu rior surface of thc> maxill.i (>ee page 071 and to
the iiard |)alate (-ee page 79), forming the lateral l)oiindarie>- eif tin- posterior iiares, F.ac h
pteryi^'oid pnHcs> arises from the lower surface of tin \»«\\ of the sphenoid by two rcMJts, Ix'twceii
whiili is the plirygoiil '\'idian\ lanat (Fig. ^},), uhjeh runs almost liori/.ontalh , il- anterieir
extremitv being in the ptervgeipal.itiiie fossii, and its |iosterior one in llie loramc n laecrum.
Heleiw the |)ter\ge)id canal the pteivgoid process di\ielc-s into two lamella, tlu intirmit and the
t\l,riiiil pterygoid plate, '{"he internal jilate i> narrower and .ilniost vertically placcel, while
* s<i n.inieel "he rr ii hcmli r^. ei|iiiei Kh vi|u.iiiiijus Ixireimi uf ihi 1. iii|K(ral l«'eie j in the reaion 'if ihi -I'lii ii")» Irn^il
ti,.urr ' '•et paui- C'f il i> <.e!ie»i Iht ftiltttS'll ftt'rtirr,
i C)( eaMi>ii.illv ill! fiirunuii spinosum i^ imly ii.iniall> Imiilnl In Ihe- ^|i!ieniiiil U.iii-, i f., il i> »ini|il>. k mn. Ii in
!h. spine.
THE RONKS OF THE SKUI.I,.
51
the external plate is broader and directed more externally. Between the two is situated the
pterygoid jossa, which is nanow above, wide below, and open iKisteriorly, and whose anterior
inferior lx)undary is formwl by the tuberosity o; , ;ramidal protess of the palate Ix.ne, which
closes the space, the ptcrvgnkl notch, between the two plates.
At the base of the internal plate there 1. a small elliptical fos.sa, the scupboul jossa (Pig.
54), to the outer side of which, toward the spine, there is a shallow -hk.m', in whi( h is situ.ited
the'cartilaginous iK)rtion ..f the Eustachian tube which connects the mid.ile ear with the naso
pharynx. M its lower end the internal plate terminates in the slender h(X)k like hamular i)ro(ess
(humulus ptcrygoidms) (Fif;s. 5;, anfl 54), the gnx.ve at the ba.se of this Ixin^- called tiie iMmulor
i^rooz'c and forming a puUev for the tendon of the tensor vi li jjalatini.
Beside the scai)hoid fos.sii is situated a small, flat, rather trian^^ular pnKes.-, calk-<l the vaginal
process (Imj,'. 54), which is directed toward the si)henoidal rostnjm; together with the sphem.idal
process of "he palate bones it aids in the formation of liie pharyngeal canal (sir page 49I.
Ui.on the anterior surface oi the pterygoid process, running downwanl from the anterior
extremity of the pter%goid canal, llure is a shallow grcK)ve, the pterygo palatine grome (Fig.
M), which, with similarly nami-d grooves upon the i)alate and maxillary Ix.nes, forms the pterygo-
palatine canal, who-c ■ xternal orifices are the pa'atine foramina of the har.i palate (see i)ages
40 and 7R).
Since the sphenoid Ix.ne is almost ixa.lly in tin- (enter of the skull and has relations with
i„,tli the cranial and the ta( ial ".x.nes. it ailieulates wiili a large numUr of the Ixmes of tin- skull
.see page ',7 ct seq.). These are the <k ( ipitals, the tempord, the (.arietal, the frontal, the ethmoid,
the maxilla, th. zygomatic, the palate, and the vum, r. al>.. forms a portion of \\u- .interior,
middle, and ix- -.'rior cranial fos.s;e. of the orl)it, oi the r,as;il l.'v„c, of the tem].orai foss.', of
(he intf,*t<miK)rul fossie, and of thi' sphenomaxillary foss;i-.
!«■ ...li.l Ih.it lii' iHlin li.mi i> |ir.l..rmr(i in < .irlil:iKr "iili ill'-
s :i:i.| il\. -I'll- '"'il il tiirhinalnl U.iii-., 'a hii li ari' ilrvi lopcil
A- rcijanl^ ■=»- 'li ■' I'^nnirnt .if tin- ^plir-iui.l, ll r.\,
,.«ctiti<>n .d ihr iiiumal plali-; '■! lt»- pliryK^i.l [ircH ,
i„ „„.ml,r:in- .K,rt....i.m l«-«iM, i.mar.i ill. . „.! of ,l,r „■,„„.! f.t.,1 nwnih U..l..t.-.l . .nl.r. a|M"ar ,n -h,- ..nl.n
in.l |«.-trri..r ,«.rl.>.n, ..f ih. l««lv of Ihr Nmu-. m, ihat l..r a time itu r.- ;,:. i«,, ^l,ll, noi.l l..n.-. ,i- il u.r. , .,,i.i.,lr,l
1„M„.I llu mhiT. Ihr l.-r vunK. uHm- from .|h..,,I . , ntrr,. .,. .L, ..l-. ih,' iin al.r «m«^. ih, . , nl> r- f.., ,!»■ lath r
,K,. i„rmin._' th. ,.v„rr |.l,.t,-, ..f th.- ,.trrvn..i.l ,.r.«.-w,. I h.- 1,-,, r « inK^ unit- v,,i), ih, ant. r...r . ml. r ..I ih. lu..K
,,f ih. . h..i..i.i l«-lvvrcn till- sixth an.l m v,-nlh 1. 1..I month-, ih.- iir. :,i, r «ini.'-, .L. n..i ui.iU "Uh in. |....|,ii..r , , m, t
„„„| all.-t bif.h, an.l th.- !«.. hah., of the t.«ly of Ihr .,.h. m.i.l .1-. .v .1 unit.- nnlil .ifh ■ l.irlh, an.l th.n I..U -|..N.h. ...
Ill ll m intrrsf-'nrniuiltil ivm-lnmilro^ir i-vi^t-* (or a lonn linn-.
1 h. .... rnal plate of th, |.|.-rvK..i<l |ir.«Ts-, i^ form.-.l in m.-ml.r.im-. i.ut ..".n iinil. - ■ ... ih. . v. i.th h Ial m..nlh .
■viih the .■M---.ll ;.laf- Th.. -|,h.n.ii.l,.l Mrhinat.-.l l..n.... a|.|«-ar mu. h Ial, r an.l .1.. n..i unih- vnlli ih. U-U ..I Ih.-
-|,h.-n..i.i until .!■ ,Mv oi ;..l„rtv ami ,il ih.- vim, lim, th. -,.n.-n..-.. . i|iilal ,m,. h..n.lr..~i- ,..mm,-„,,., 1.. ,lK.,|.i..-ar,
Th. ^|.l- ....Mial siiuiv an- . .luring . h.l.lh..-l, I.ut in. n-a-H-« , ,.nvi.l,-ral.lv i.i t-M.m .luring lat. r hh-
Variation. ,-,r.- lm|U.-m in th, si.lunoi.i l»,n., su, h as th.- ,« , iirr. n. .- ..f mi.l.ll. . lin..i.i pp^.-s.-- (m-.- paR.- \S<
nii.l tlu-ir hMm ^-n' . .• anterior ..r p,,st.-ri,.r ,lin.,i.l pr.«.-s^.s. 11. ..s.ili. ..lion of ilu pi, rv,-..,,......., hv;.,n..fit i m-,-
paiP 1 "i ih.T.- is !».,! mli<-i|ueii(l>- (..rm.-.l .. ptriv.Oifinoin />r. .,...( />f-,w.'5vi(f Ciiinin:)
THE TEMPORAL BONE.
111. h-mporal Imhu- (Figs, c;^ to (>V i- siluah.l in Ih, ial. nil p.:ri of ih. Iia-. oi tli, -kiiil,
:,ml loim> portions of til. middle and i«)>te,i()r iranial fos-a-. Ipon eillu r -i.le ..lu- ..f ili. I. m
iw.t ll lione- ("'IN li. (he largi gap in tlie (»v hasiuirr (sir pages 40 .inil 1;
I.
- 51
I if
52
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
p,c 55.-The right temiwral bone seen from the outer (lateral) surface (\).
p,P,' 56.— The right temporal Ixme seen from the cerebral surface (j).
Each temporal iK.nc consists of four portions: (1) A squamous portion, (2) a petrous por-
tion; (3) a mastoid portion; (4) a tympanic portion. The petrous portion ts also tcrme.1 the
^'"m^ squamous and mastoi.l portions arc placed almost vertically, while the pyramid is
practicallv 1 .,ri«.ntal. At the external auditory meatus, the in.lividual portions of the tern,x,ra
rxne rc'..ouped in such a manner that the smallest portion, the tympanic portion, is sUuated
!n from of anil below the auditory canal, .he mastoid ,K,rtion is bc-hind. the squamous portion
above, and the petrous portion inteinally and anteriorly.
THE SQUAMOUS POKTION.
The squamous portion of the temporal tx>ne (I-igs. 5,^, .0. and 57) consists of an approxi-
nt.telv semicircular ' criical bmv plate which is concave internally and convex externally An^
" r V Trticulates - Ki,. ,., and 40) with the temporal surface of the greater wing of the sphenoid
bv the sphenos,uamo., suture ^spUenoiM border), and superiorly with the l^-tal .x.ne by
means of the suamosal suture i parietal harder, sc-e page ,8). A deep notch, the parretai noUl.,
"".mm<Kla.es the >phenoid.l angle of the parietal Ix.ne an.l separates the squamous portion
from the mastoid iM.rtion, which is situated inferiorly and iK.steriorlv,
l-he ..,onJ proeess ,Fig. ,0 springs from the external surface o the ..uamous portion
„f the .em,K.ral In.ne and aids in .he formation of the zygomatic arch, by ar,u uhmng w„h the
temporal pnxess of .lie /.vgoma.ic U,ne by means of the zy,omali.otemp<.al su,ure. 1. .s alt^o.
2.onta a, it> origin, but later i, ro.a.es through alK.ut .p degrees, ., that it assumes a vertical
position and forms a l..nv pnxess tlmened .mm side to side. Its ,x,s.er.or prolongation alxnv
the external au.litorv meatus form, a s,. p.am.stoid rid.e. which ,K,stenorly U'cme^ conl.n.ou-
Nvi.h the terminal iH.rtion ol th( inicri.r temi«.rMl line (xe I-ig. 3.)).
Th. part of the ..uamous .H.r.ion whi. h lies Ix.low .he zygoma forms par o-h.- ..U,n
surface of the Ix... of th, .kull and i^ umscqucntK almoM lioruontally place! (Mg ,H) and
,„,rdcr. upon tlu infrate,n,«.ra! surface o, ,he greater wing ol the ^plum.ul 1-me, It is th.TC _
for., advatnageoa. .0 .ulKliv.de the s.,uamou- ,K,r.ion o( tin- ,em,K,rai Ik.uc into a larger .eriteal
portion and a smaller hori-.ntal portion.
In tl,.. v.r,i.al portion ,1,. r, mav W re.ogni/ed an cx.ernal t.mp,nal surjare and an uu ,,.al
cerehral un,,,,. Mh. l.m.r ,. al,M.nt in d,e horizontal ,H.r.ion.. The .em,...ral .ur ace h.rms
, par. of the planum Innporale an.l of the jossa /,m/..n;/rv .see Fig. V)., a>,.l .. usuallv .mm, h,
„ ,.,gh it. lo'r po„ion mav sometimes U- roughened by .he origin of the ,.m,..ral mus. le.
I, present- a .hallo. ,r,«.v. for the middle ,em,K.ral artery, k-ginning ,,l..ve ,he external audi-
lor nieatu. and running up\\aid. 1 •;, „
• \, ,u. i. .n. -f .he h. •i^ontal and vertKal parts i- -itnated .he roof of the external au. n„r>
meatu. ,.,e nma.nn,. . .1- >. ,he aud.torv canal Uing fonne.1 by .lu- tsmpanu ,x.r„.m, and
j„,, .ilH.v, ,h.. ev.emal audi.o,^ meUM.. „ tin -ransi.ion into the mastoid ,K,r..on, .here is
fre.iuen.ly foun.i ., -nn'l b..!n .p-n,. ti'v ^uprammlal ^pme ilm. ^^\.
f'(in'iii)' honfir
(iivnvf for iiuild/t Uini'onil iirtriy
I'vinponil line
."iin'dii/ iiott'li
Siipniiiii'iilnl s/^iiii
M<i<ti>ut /(irdiiiru
Ori'ipildl boiilir
(mastoid portion^
Mii^'loid i^nun-r
Mii''li'itf porlion
Mii-!(inl piiur^'
Squamous portion
(Iniiponi! ••iir/'dcc)
Snhi'ni'iiuil honlir
Artiriiiiir lUiiiuiiir
1,;.,,, / /'f nvrw'n/tiiiiir //>-.»/(•
Tympanic
portion ' >''''"''' niiilifiny uniitii^
I
I'liiiildl /'I'lilir
t'i'fihiii/ ^infill'
\iriiiiti riiiiiii:ir-
SpfltHOiJiU hof .<■/
Petrnii^ portion
Siilmri'iiilli' /I'^vJ
lilhnitit iiiltlilor'' iihiitii'i
lnfi'iiiH /iiri(>\ii/ t;"':>\'i
flif'H/ilf il.^U If
I iiS. '■>(>.
^™
THE BONES OF THE SKULL.
53
portion, the articular eminence, vv-h.ch .s .1.. parUaU, '-- ,^ / ^^^^ ^,^.„, .Here
the zy,on.atic process surround the --chbu a fos- fr^.n^^ ^^^.^^ ^_ _^^^^^^^,^ ^^^^
tremely ^ou^h and sharp, and, in t^e ^^l)'^™-,;;' ;;:r;;tl - of t^^ sph.nos„uan,osal
..uan^osal suture, and it is separat.l '--'-!;:;;;:;^;:Ll/ ,.,.-■. l.s cerebral
usually even in the adult, by a n..re or less ..s.^.ed -^u , h P ^^ .^^ . ^. ^_. ^^^. ,^^^^^^,,^,^
surface consists of only a vertual I""^'""; -^';^;^ i^^ " I iu,. and digiuUe impressions.
of the middle meningeal arter>-, .Kcasu.nally exhibits cereb.al juf,.,
THE MASTOID PORTION.
The mastoid portion of the temporal ,.ne ..^s. ., to .S. ji^ves U. na.,e H^m t . -. • ^^^
toid process, the mos, important structure of t^ ,.^u oH - > ;^^^^^^_^ .^^ ^,^^,,^„,_ |„,, ,,,
notch it articulates with the masto.d angle ot "^ I-- '^ 7; J^, .oaifHo'uasWid su,.^. ~ee
..ccipital.x,rcleraraculates.jthd.es,u„,..ru^^^ ..n
Fi,,. 42). In the lem,H.ral Ix.ne U.elt the mastoui iK „.,,nious p..rtion; it is se,a
,;;„;...../ ;...0, upon d.pej..us,...,.^ ;,, ^^,^„ ^^^, ,,,
rated from the latter dunng ^'.ath h^ M sgu ^^^^^^.^^ ^^^^^^^^ ^.^,^,,.,^^^,
Incomes more or less oblit. rated .n later hU. J^ ^ ^^^^ ;,,,,,,,, ,„,,,.
surface, which .n-ars the mastoui process, an 1 an -^ ' ^ ^ ^^ ,.,„sid.rable part nf
The ,u.:.loid pr..uss is a broad, conual. l.n, ^^^^^ '^^ ^ ;„^. „„„,,, „„ , ,Ki«.
U. mastoid ,.rtion, an.i presents --!;-;;-;: ^l,: ^1 ;:!;;,.. .hue ,- a .>a....ver
^8). Internal tu thi. notch, l^tween it a»d tlu Kcipn
jjn„.ve for tlv occipital artrrv. „,;,.loid |,<.rlinn, i- the ma.st.uil
::;"::;',r;,^r riJs'i:.:;^..- ■ •• "••■ -- »-
•^uture. . , nMii- ■' broad Kr.H.\v, the v/,i;»fMW .1,'r'W
The cerebral .urface of tlu masUud pnK.--^ '"; ; .^J'^ „urn..stoid enu^^arium ,ri,.
(see ,.'.> F... 4,.). ^^•hich usualK o.mam^ tlu ;-;;;:;_,, „,. ,„..,„;,„ surfa, e „f
S^n In ihis sni.ati.m the m-.-toi ! i ••• -u o,r. .tlv
the inraniid. L.wn i.tlv duisIohI oi: iTis^-. ')i
The mastoid i.HKCss .umains nmup.us a.. spa>. ■ L Avn
Ik. .1
^^ AT1.AS AND TEXT 1500K OF HUMAN ANMOMV-
,,, „._Thc ri.h. ten^poral Lone seen fro. the -cerebral surface and fro. the apex of .he i^trous
portion (\).
p,£. c;8.— The right tem;.oral bone seen from below (1).
jrj,. -g -The right temi)oral bone of a new born elilM (;])•
Vui 6o.-The left temporal bone of ^:yZ:'l::!t'rluL^ ..a.oi.l ,.,.nion. vdlow, a™, th- ..M-i.
In 1-igs. VI ami fra the s(|uamous iwrtion i» i;^ . n, tnt p. ir )u
jH)rtion
ivhiti'
the Ixmy tissue and even expand it. lhc\ arc connciu
thf tympi-'itc antrum.
< .^ h;..f „ ,inu for muscular at-a.hnunt which tho skull ,,...sesscs, ami it r.<civcs
Th,. n.asl..i,l |,r.H.s> is one of the - hu ,. .,n.. for mu longisMmus capitis n.usdcs.
„„ i„..r,ion^ ..f .he .ern,Klei.lon,as,oi.. and o, p..,,...^ .>^ ^^^'^^ Several ,.„enin«s may 1. presen, in ,he
The mas.,.iu n,„>l, «ive. ..riRin to the posterior l,en^ o " < ''^ ^^ J^^, ^^,j ^„„,, „,, „a,u,i,l i-roce,. .> also
vi,i„i,v ..f the mastoid foramen. The depression Ixs.de the supram.al.l sp.ne
called the masloiil /"S.vi
- £ PETROUS PORTtON.
The petrous ,>ortion or pvramidt.f tlu ten.poral hone (Fi,s. ,6 to 58) forms a port.n. o.
.ranial cavity and ^^^ ;^^'';^^^^ ' ^^^'^^^^r ^^r^^^ - di^inKuiJhe.l internally an
forwanl and from w.thout tn.ard. ^ ';-;;;;;, ."'^,,^i;,, ,,,,,,, ,;., there is a superior,
rrr:;;: :=:-"- — >- - --- -^--
an anterior, an 11 p-.r^bral <virf:i' -s from the external one.
thetworemainins^'lxjrdersseiian.tet^ ccrtDrai uni , i,h ,h.. tvmi.anic portion,
The netmus ,>ortio>i in the adult is directly cont.u.ous external, a .ih the ^>'^I'^""^^ ''
an,l ii^a. Interior surfat. l.rders u,K,n the squamous pt.t.n >^- -- - / -
I- niL.e -) tntl uiKjn the snhenoid. bone ^sphvopHrosal l,ssur,\ Tht .>■ an. a,.. " u
which is emlK'-Lled in the petrous portion of the hont . Lpnn th. ant
also a small slit like orilKt, tiic luuu, / ,,,,-,mid and to tbc foramen
the Kreat superficial petrosal nerve pasM s toward the apex of tlu psramid
lacenim in a groove (Fig. 57)- • i; ,i, .,-,. is i senmd smaller opening, ihe
Eternal and anterior to the h.atus --"^ '^ ' . :f:. ^he les.er superhcial
petrosal nerve, u hit ii alst, passes forwani to ihe region o. tne ltd... -
Squamous port/on (n-relmil siir/'iint
Z\'goinatic process
Tegmeii fornmen
I'llivsqiiiimosal fissure
Aperture of super, tvm/innie carmluulus
( ■ groove far itunll ^uperj. prtro^ol nerve}
MiisciilotiilKir Cdiiiil
Inlermil orifiee of eiiri'tiil eiliiill
lmi're>^i:> trii^emini
Pyramid
(irome for i:mi: superl. petn'<nl time
fliiilii-. Itilhiipii
Fif:. 57.
I'drietiil notch
Mastoid portion
Muiioid Sifiiiioiil i;roov(
Arcuule fonimen
SllluirCIHtte lOSMl rmmeme
/v^oiiHitic
proces\
Articiiliir
emitieiicc
Miinitioii''!'- lo^^ii
l\'!rorv"i;'>rnii fi^^ure
1 'iii;iniil firocc^s
I \l. (iiiilfterv nieiitii^
•S/r/i'/i/ /i«i(V
.lf(/^^l/l/ /"I'll".
M(C-l(ii(f ".''(iiii'i
<inhH-e lor occipitiil iirl.
.\\n\toiil foniincti
S/i/iciioi(liil border Si/iiiiiiioso
'■"'.'""'' '""f" mostoiti
4'^^ Wuseulotulmr e,w„l ^,,,„,.,.
'• '• liil.orilieeoleiiroiiileiiiiiil -^
'^'^ . l/'( I of pyramui j
^t- X, / <Y. orilUe of
' •'-^«^ etirotiil etiriill
f iieolieolvifipiliut
euriitt
l-elro.,:! /,p>-.;
/ \t ,1/xiriiie ot
inpntedintti^ eoetlleih
Inlrniilgnlnr /vv., s-
\l,l~to:il riimilhiiliis
flll^llllU fO-'^il
l\lomii~toi,l loniiiii II
( )ccipit(il
horilcr
(mastoid 's^
portion)
I ii^. 'i!A.
I
!•
■i\m
I ii'. 00
THK nONF.S OF TIIF. SKUI.I..
The rather thin Ixmy plate of the petrous i)ortion whieh form- 'he anterior surface of llie
pyramid between the hiatus eanahs facialis and the arciiate eminence, and which extends to
the ])etros(|uamosal fissure, is the roof of the nii<ldle ear or tympanic cavity, and is called tlie
Ivgimn lyinpani.
Near the ai)ex of the |)etrous portion the anterior surface exhibits a depression of xaryini;
shape, usually but a slijjht excavation, which is known as the" /r/> )«/)«(/ impression [V'v^. 571
and l(xlj;es the semilunar ((iasserian) f;anf,dion of the trif^eniinal nerve.
The sui)erior Ijorder of tin ramid, which separates the two (irebral surfaces from each
other, shows upon its surface a shallow furrow, occasionally emi)hasized by pronounced elevated
marf^ins, the superior petrosal i^nxnr, which empties into the siijctnoid ^roo\i'. Like the latter,
it contains a sinus of the dura mater.
The i)ostcrior cerebral surface of the jietrosal ]K)rtion is almost vertically ]ilaced and torir>
a portion of the posterior cerebral fossa. .\t al)out the middle of the ])yramid, nearer the superior
than the jiosterior Ijorder, it exhibits an api)roximately round openin},', the inleriial nudilory
jortimeu (Fi^'. 56), which leads into a short canal, the iuleriuil uiulilory menliis, which lodges
the facial and auditory per\is.
.\l)ove and somewhat external to tlii- ojieninK -"t' immediately Ixlow the lK)rder of the
])etrous portion, there is a dejiression, the suluimmle jcssn il'ii;. 501, the conca\ily of which is
(iirected toward the ai)ex of liie pyramid. Sometimes it is bul sliuhlly marked, thouf,'h it is
distinctly dcyeloped and very larjie in the infantile skull; it contains a pnKcss of the dura mati'r.
Helow and external to it, and al :ibout tiie level of the orilicc of the internal meatus, there is a
slit like oril'ice, the external aperture oj the aqiKrihultts vestihuli {V'v^. =;()), which is open exter
nally and below, and accommo;!aies a process (tiie d\ictus endolym|ihaii< u-; of tlie membranous
ear.* In the vicinity of the anterior ) )riion of the posterior lH)nlcr there i- a cjuite shallow
j,'rooye, the injerior petrosal i^roov, il'i^. 5(11. which, ii>i,'ethcr with a simii.irly named j^roovc
of the (KTii)ital Ixme, forms a channel in tiie petro-occipital fissure for the inferior petrosal -inu-
of the dura mater isee also I'ii,'. |;i.
The |M)sterior Ixirder of the |i\ ramid is separated from tiie ociipital Inuie {the ba-ilar .ind
lateral [Kirtions) bv the jielro occipital tissiire and the jufiular foramen. It iireseiil- the iiii;iitar
notch (Fij;. ti(>), (iirres]!ondin),; to the similarlv named notch of tlie cKcijiital l)one, and also ii>u
ally an intrajiif^ular process isee jiage 4(1^.
The anterior Ixirder is sejiarated from the ba-e of the ,i,'reater wini; of the s|.lunoid hone
bv the sphenopetrosal fissure and by the joramen lacerum: the apex oj the pyramid i- in ((Mii.ut
with the lateral surface of the Ixnly of the sphenoid lionc-. At the foramen l.uc rum, 1 lose to
the actual a]H'X of the jiyramid, there Is an irregular opening;;, the intirnal lamiiil joramen >■,'.
57), which leads into the carotid canal, a short canal which Iraveisis tin- iii.u r h.ilf of du pc!rou>
portion of the temporal Iwine and IcKlj^es the internal carotid arfcrx .
Kxternal to the inleriial carotid foramen i> situate<l the ciitr.mci io a canal whiiii passes
into the middle ear iH'neath the lej^men tympani, the mustuloluhar lanal il"\^. ^- K -11 i.illed
Inrause it contains Ixtlh the tensor t\iiipani muscle and tiie lui>taclii.in tulu- i-ee also page si I.
5
i < I
•A unmvi- nin^ (nun llu rMirii.il .ijmiiuh' "I llu .ii|U.iilui ici^ m-iIKuIi !•■ iIh juciul.ir rwilili.
56
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig 6i —The left temporal bone dividerl through the axis of the petrous portion (J).
Fig 62.-The right temiwral bone divided in a plane passing through the external auditory meatus and
nearly parallel to the axis of the i)etr()us jwrtion (i).
Fig 6, -The right temporal bone divided in the upp-r half through the axis of the jKtrous ,»rt.on
and iK-low horizontally, the wall o." tne canalis musculo-tubarius beuig partly chiseled
away to show the septum (]).
In this situation the spine of the sphenoid insinuates itself into the angle Ix'twccn H'o anterior
border of the pvramid and the cerebral surface of the scjuamosal portion, so that the groove
for the Eustachian lube (see page 51), running ui>cn the inferior surface of the sphenoul bone,
leads into the orifice of the musculotubar canal.
The external surface of the petrous portion forms part of the external surface of the base
of the skull. It presents quite a numlxT of noteworthy structures and is the roughest ami nu,st
uneven surface of the bone. At its junction with the mastoid portion there is a rounded opening,
the slylomasloi,l joraw.n (Fig. 58), the external orifice ..f the jacial canul, which traverses the
temiHjral bone in a curve and Uxlges principally the facial nerve.
In front of the stvlomastoid foramen is situate^.! the slyloid proa-ss (Figs. 55 and 58), the
remains of one of the' bran( liial arches. Sometimes it is short ami thick ami sometimes it is
ven- long* and it is usuallv place.! in a sort of lx)ny sheath, the vuaiml process (Fig. 55).
which is mainlv in contact with the pr<xess anteriorly and Ixlongs to the tymiuinic jiortion.
The styloid pnxess gives origin to three muscles (stylohyoi.ieus, styloglossus, and slylopharvn-
Rt'us)- ft- 1 1
To the inner side of the slvloi.l process, toward the posieri-.r lx)rder of the pyramid, there
is a roumled or an o\al «iepression, the JHt^ulxr jnssa (Fig. ^l„ which borders uiK.n the jugular
notch. It lodges the upp. r extremity of the internal jugular vein (bnllms vcmi- pif;ularis upcnor),
and at the Ijottoni of it a small canal, ihe iwisloi,! tanaliailus (see page 58), bc-gins as . groove.
Near the jugular fossa, toward tlie apex of the pyramid and close to its posterior U)r(ler, is situ-
ated the small funnel like orificr oj llir nqwidiutus (uvuilkulns) anhlar (Fig. 58).
IkhimI the jugular fossi and internal to tlie stvlomastoid foramen, the j.osterior border
of the pvrami.1 presents a somewhat roughened suiI.hc for articulation with the oc< ipital lx)ne.
In front of the jugular fossa and separated from il by a narrow ridge, there is a large, almost
circular foramen, tlu .xUrnal carotid jnramm (Fig. 5,81, which lea.is into the carotid canal, tlie
|K.slerior wall of which presents a numlxr of small foramina, the external orifices of the uiroluo-
Ivmpiiiiic cut ilicii'i, for the nerves of llie s;ime name.
lietween the external .arotid foramen, the jugidar fos.s;i, and tlie external orihee of the
a.|ua-ductus cnhlea', there is a small ami sometimes iKx>rl> marke.l depression, the p.ln>sal
jo^s.1 (Fig. 581, which (..mains the inferior aperture of the tympanic canaliculus, which trans-
mils the tvmi)anic nerve, internal and anleri.ir lo the external caroti<l foramen, ami towanl
the f..ramen huerum there is a roughene.1 surface f.-r the origin of the levator veil i-alatini
mu.scle.
* Thr pr<H.ss .m tin- trm|H,r.l >«.n. is fn .|mn.l.v .|Uiu- short, 1ml it may U- < .mt.nm.l as a In.ny s|m> uI. in .i..- .ijio-
hyoid ligament («»• pag<- iii)i.
Ext. srmiciir. rniuti
Sii/tii: sriiiinirii/(ir i niuil
['/■■itil'ii/i
liitfnnil iiiulilorv tit
i'acial
caiiiil
m.^
^•L
('tiiotid aiitiil
rvtiiptiitt'i- (intnitii
Stylo/It
Mif-li>i(f (v//.s
n<,r. 01.
i-l Ml
txtiriKii aitiltttvy
IttC.tttts
.\lii<t:i'<l rxtifti.il
iclh siittic. Sitpcrior srtiticitriildr aiiiiil
I'itniil , . ., ,
I islthtilf
I'lVttioiitory
litlmtal (itiditorv iitritlif<
('(xii/i'd
Intiiiiiil inifiiv 01 ciiivriil iiiiiiil
Slyhiiil
l\'iti/>iitii('
(tttlniJii
CitlVtiil I'dlllll
I V'lipnittc attHiiiit
ni' III
.l/(/,s7ii/i/ iii/'i
' ,' .\trtiitfr nititii till
I niiiiinii' I'ltr fnciii! rattnl
I'lWtionloiy
<\i:olt, iiittill
I \r>iiiii/ iitiilitiK V ntriittf-
I XllTlllt/ I'll/iff III
i;tr ' iiitiiil
\\ii-itili<tiil>i,i iiiitiil
y
i
THK BOXES OF THE SKULL.
s:
The anterior portion of the external surface of the [)yrami(l, the fjreater |)art of wliiili is
concealed by the tympanic i)ortion, forms the inner wall of the cavitv of the middle ear.
THE TYMPANIC PORTION.
The tympanic portion (Fij^. sO i^^ a small, slightly curved portion of the 'emporal lx)ne
which Ijecomes secondarily adherent to the remaininjj jx)rtions and is represented in the new
Ijorn by a simple ring open aljove (Fij^. 5()i. Outf^rowths from this ring fomi liie anterior,
posterior, and inferior walls of the external auditory meatus, l\- orilii 'f thi , and the outer
wall of the tympanic cavity.*
A process of the tegmen tympani, the itijirior process, is ])ushe(l in Uiueen the s(iuamous
and tympanic jwrtions internally. It is lx)unded upon ■■ -.e side by the pre\iously mentioned
petrosf]uamos;d fissure, and u])on the other by a second grof.ve, the pdrolymponh or Gltisi/ian
fissurf,i Ixith of which unite to form the lympaiiostjuamosal fissure. The tympanic ])orlion is
separated from the mastoid |)ortion iiy the lympanumastoid fiysiire, which contains the outlet
of the mr.'toid canaliculus. The tymuanic jxirtion also forms the Tiiginal process (see page 5()).
.•\t the inner I'xtrrmily of thi' cMcnial ■„ .ililnry nualus, lowaril ihc l>ni|aniin;, iliiri- i- a lirdilar iinnvi. ilu- lyni-
panic i;ro(Ke, iinly tln' uppiT c,ua(lrant <i{ which is wanting 1 1. c, ihr inirlinn (if \hv (>niii\c nut fciriniii li\ ihi- lun|iariii
I'cirlion). This pr<HnT (»ivi's attaihmcnt to the tympanii mi'iiliraiu-.
At thf margins t>f the jrroovf. and (f»nsf(|ucntly of the tynipanir \n\: rioii, ihtrc arc I\vo sniall lion\- spii ulrs. known
as the qrriittr and lesser spines, and, furtherniore, in this situation t'nTe i> a noti h iK-twfen the tympani) portion and
the upper wall of the meatus whi( h is furnisher! !)y tlie s<]uanious p« rtion ; iltiv i^ i ath d tbi txwptniu unhh
THE MOST IMPORTANT CANALS OF THE TEMPORAL BONE.
In the temporal Ijone there is a scries of tanals wliirli transmit \essels oi nerves, or usuall\-
vessels and ner\es together. The most important of t!' s are the following:
The jacidl canal (Fig. fii) contains, in addition to !)lo<Mi-\essels, tlic seMtilh cranial nerve,
the facial, which g.ves olT two branches during its coi'.rse in the temporal bone. Tlie .an;i' nia\
be divided into three portions, which are placed appi'oxiniati Iv at rigiil angles to taih otlitr,
so that the cinal is bent upon itself in two sitiiaiions. 'I'he Inst I\mi portions of tiic canal are
horizontal, the las one is vertical.
The first por.ion of the ca ; •' rims from the internal auditory meatus to tile lialiis r..l!o|,ii,
and therefore almost n' right angles to thi' axis of tiie pyramid. The sitonc' portion begins
at the hiatust an ' lies almost exactly in the axis of the pyramid in the inner wall .if tile tynipanuni
{panes labyrinthica), atx)ve the so called jeiieslni ovalis ijeiies/ra vestihuli\. Tlie tanal finally
bends verticallv downwani (at the pyramiilal eiiiineiicc of the t\m|)aniMii) and terminates at
the stylomastoid foramen. Just before its termination it gives oil a canaliculits cliordic lyiiipaiii,
which pas.ses oblitiuilv u])war.l and forward to enter tiie tym]ianum. It transmits a l)raiuh of
the facii'l ner\e known as liie iltonla tympani, whiiii traverses ilk' tvnipanuni and it axis this
cavity through tin- petroiymj.anic fissure.
it
i
I i
t i
!!
i ■
* ( >n ;im»uni nt ihcir rcialiiMi In iht' scn-^t- of hcarirm ihc remaining -irudurc'^ {lavitif
thf ptirnus portion \\\\\ N- (on^iilcnd in <|i tail in \hv scitii'ii upnn nrj^an^ «>f spn i,| ^t-HM',
rate foramina.
J Tht U'nd of the (anal in ihis situation i> lalhd llu i^fuUulum c/ thr /,ni,jl iutial.
( anal-, * ti i s'tuali'i in
58
ATLAS AND TEXTBOOK OF HUMAN ANATOMY.
Fk;. 64.— The outer surface of the riijht parietal Ijone (i).
Fig. 65.— The inner surface of the rij^ht parietal hone (4).
While the facial canal is the longest of the canals of the petrous portion, the carotid canal
(Fics. 6t to 63) is the widest. It is al.so Ix'nt at a right angle. It commences at the external
carotid foramen u|)()n the external surface of the petrous jiortion of the temporal and passes
at first almost \erticalh- upward, in ct^ntact with the anterior wall of the tympanum; in the
immediate vicinity of the c chlea it bend.s at a right angle and then runs almost horizontally
in the axis of the ])yramid to reach its irregular and frequently incomplete superior orifice at the
aj)ex of the j)ctrous portion. Fine canals, the carotkolym panic canaliculi, lead from the carotid
canal into the tymjjanic cavity.
The mtisculoliibar canal (Fig. 6;,) runs jiarallel to the carotid canal and in such immediate
proximity to it that jiortions of lx)th canals have a common wall. It begins at the inner side
of the apex of the i)etrous portion of the temporal bone upon the anterior border of the jiyramid,
between the jjctrous portion and the horizontal jjart of the squamous portion, and runs aj)-
I)roximately in the axis of the pyramid. .\n incomjilete horizontal septum which proceeds from
the inner and j^osterior wall (Iwrdering ujjon the carotid canal) separates an upper smaller
compartment, the semicanal for the tensor tymjjani, from a larger inferior one, the semicanal
lor ti. ■ Eu.stachian tulx'; lx)th compartments have their exits in the anterior wall of the tym-
panum. Tlie canal contains the tensor t_\Tnpaiii muscle and the Eustachian tube.
The tympanic canaliculus, for the nerve of the same name, proceeds from the ])etrosal
fossa, and at first passes vertically upward into the inferior wall of the tvmpanum to be con-
tinued as a groove, the ,?mnr oj the promontory, upon the inner wall of the tympanic cavity.
It then leaves the tymjianum as a canal jjassing from its upjier wall to the sujxTior aperture
of the tympanic canaliculus on the anterior surface of the petrous ])ortion, where it rommunicates
with the cranial cavitv.
The mastoid canaliculus Ixgin^ in the jugular fossa as a groove, crosses the lower jjortion
of the facial canal at a right angle, ,ind terminates in the tymiianomastod fissure. It transmits
the auricular branch of the pneumogastric nervc'.
In adcliiif.n l,j ti, .lir-rrlls of the rna.stui.l pro., s, i|u' tomixiral txino also loiuaiiis a larger eavily, the lyvipanic
.iiitnim (Kig. (),). (For a d.laileil desrription see the ^peiial sense organs.) 'this is in conneelion with the mastoid cells
behind and with the niuseulotubar >anal in front. It is not separated from the evKrnal auditory meatus 1)V osseous
tissue liul only l)y nienihrane.
In the devel.ipment of the temporal Ixme, the jH'trous portion antl the mastoid prcKess are developed in (cmimon
from the cartilapn.ms auditory vesicle, and the squamous and tympanic (xirtions are added later as supplenuntarv
l).mes. The styloid process has no eonnertion whatever with the remaining portions of 'he temporal Ixme and arises
from a jxirtion of the branchial skeleton.
CommcniinR at the Ihinl fetal month, ses.ral .enters appear in ,hc cartilaginous auditory vesi. le an<l subse.iuenilv
unite to foni. a common origin for the pelr.ius and mastoid portions. The latter is not ilistin. llv developed even at birth;
a mastoid pro. ess gradually forms, but it is n.it dislina until late in childhood. The first center ..f ossill, ation for the
-.quamous portion appears toward the end of the second fetal mr.nth, and the tympanic |M>rli..n ossifi.'S at about the same
time as the nvramid
In tbv temporal Ixme of the new-born (Fig. 501 the tympanic portion has the shape of a ring ..pen alx.v,-, and is
known as th.- „<inuli,s lymp.muu^: it is at first merely r.ttached to the remaining Ixmes. .\ very distin, t suture, the
Piiriital foninun
Si/n;il/(il border
Occipital uni^le
( )ccipitii!
border
I rotiliil
llll''lc
Siii'i rii'r riirti\)nil
l'i>iru>r 'ifi/'t'iiii
I roil III!
Ihiidcr
I nr. 04.
"^plhlioidill
(lll''lc
i r
Mii^toid (iiioic Si/iiiiiiiosid liortlcr
Sni'ittut border
I'iiriclii! foninicii
I'roiiliil
(iii<;lc
f roil til/ ^
border \
Spill iioidill iii.ob
Siii^iitiil i^roovc
< Iccipildl iiiii;!e
Sulci (irteinf-i Si/tuiiiioyiil lioider
►, , Ociipiliil
hordir
I ill. <n-
\ Mii^toid limbic
Sitiiiioid L;roo\<
|1 'f 1 '
f 1
I I
i t
^•Si - :.
THK BONKS OF THE SKULL.
59
squamosomastoid suture, indications of which may he visihh- in :uluh lifo, sqiaratcs ihi- sf|uam<iii> fmni the mastoici jHir-
tions. The hone also varies considerably from that of thi ailull in other respects, ahhoURh all the portions an' already
united by osseous tissue. I-.spec iaily large in the new-born is the subareuale fr>ssa
During the first years of life the tympanic porlion develops by the growth of the annulus tympanic us lo a trough-
Uke structure, and it is as the result of this growth that the bony meatus is formed. There nevertheless remains a .on-
stant unos.sined portion o? the inferior wall of the meatus (Fig. Oo), which usually doses in during the fifth vcar. The
mastoid proces;, iH-comes distinct at this time, but does not ccntain air-cells until the time of puberty.
The- styloid process, ari.sing from the second cartilaginous branchial arch, l.^sil"les l.ile and sul>ser|Uently beo.mes
connected with the temporal bone.
THE PARIETAL BONE.
The parictrl bone (Figs. 64 and 65) i> a topical Hat Ixinc which arises from the membranous
cranial cap.sule ant! is not jjreformed in fiiniiage. It is one of the simplest of the cranial Intnes,
is distinctly (]uadrangular in shape, and is markedly curved lx)th in the sagittal and in the frontal
direction. It presents for e.xam.ination U\n surfaces, an external convex paricia! siirjarr, anil
an internal concave cerebral surjace.
The four borders of the Ixine are named rcspecti\ely the jnmlal, the sdi^illnl, the oeeipilal,
and the squamosal Jxjrdcr, and by them the Iwne articulates (Figs. ,:;8 and 40) .11 the coronal
suture with the frontal bone by its frontal border, at the s[)henoparietal, .sf|uamosiil, and jjarieto-
mastoid sutures with the greater wings of the si)henoid and with the temporal l)one by the stjua-
mosal border, and at the lambdoid suture with the (Kcipital Ixtne by the (xcipital torder. In
the sagittal suture, the s;igittal lx3rders of Ixith parietal Ixjnes articulate with each other (Fig.
46). The anterior, superior, and posterior margins are markedly serrated, ( orresponding in
character to the sutures isiiturcp serraltr); the inferior margin, however, is lK\elec! and its
external surface is overki' ,ii the squamosal suture by the mari,'iii of the temjjoral lx)ne. The
four angles of the bone arc the jronlal aiii^le, the anterior superior angle, formed by the coronal
and saguial sutures; the splieiwh I aui^h; the anterior inferior angle at the s])henoi)arietal
suture; the occipital angle, the posterior superior angle, formed by the sjigittal and lambdoid
sutures; and the mastoid angle, the jiosterior inferior angle, at the ])arietc)mastoiil suture, lilling
out the parietal notch of the temporal lx>ne. The most acute angle is the sphenoidal.
The external or parietal surface (Fig. 64) presents at its point of greatest curvature the
parietal eminence. Relow this nn the superior and iiijerior temporal lines (see also Figs. t,i)
and 40), the latter Ix'ing much more distinct than the former. Relow these lines the external
surface of the iiarictal tone form.T a portion of the planum temporale (see Fig. 31;).
In the vicinity of the sagittal suture and near its posterior extremity is situated the pariet '
joramen, a so called emi.s.sar>- foramen. ;ximctimcs the internal and sometimes the external
nrilice is wanting; the fonncr leads into the sagittal gnxive.
The most striking structures upon the cerebral surface (Fig. 65) are the extensive grooves
for the l)l(xxl-ves.sels, sulci artcriosi, of which, as a rule, there is a well-marked anterior and a
less pronounced posterior one. They are for the branches of the middle meningeal arler>- and
are accurate moulds of these vessels.* The cerebral surface also exhibits two other grooves
which acc<>mino<late wnous .sinuses of the -n mater (s t al.=o page 44); tiie sagittal Ix.rdtr
* Much more rarely uilri veiiosi also occur. On the other hand, the >.mmcr cernent of the sulcus arteriosus is
not infnc|uently converted into a short canal l>y a biidge of os.seous tissue (>cc I-jg. 65).
i .
\
II
6o
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig. 66.— The frontal bone seen from in front (4).
. (G. 67.— The frontal bone .-cen from behind (i).
presents one-hall of the sagitlal gromr, while the mastoid angle contains a small portion of the
sif^moid gromr (see also Figs. 4.:! and 44)- Digitate imi)ressions and cerebral jiiga likewise occur
and granular jnrokr j^ranularcs {Pacchionian depressions) are still more common.
The parietal iK.ne ilevel.ips in meinl)rane in the thinl : \a.\ month fnmi .1 renter of (>ssifir;itiim situated in the pari-
etal eninenee. I-.ven in the new-lxjrn the bonv tralxeulie show a distinit radiation from this point.
THE FRONTAL BONE.
The frontal Ijone (Figs. 66 to 69) consists of a vertical a' hcd portion and of a horizontal
portion. The vertical ])ortion Is known as the jrontal porlion and the horizontal portion is
composed of two orbital plates, and a small median nasal portion. \v the orbital margins the
horizontal and vertical ])ortions become continuous.
The frontal portion, the main jxirtion of the entire Ixine, articulates in the coronal suture
with both paiietal Ixmes by its parietal border (Figs. 3<) and 40) and in the sphenofrontal suture
with the greater wing of the sphenoid Ijone. It forms the entire frontal porlion of the cranial
vertex and presents two surfaces for examination, an external 'jrontal surjace and an internal
cerebral surjace.
The jrontal surjace (Fig. 66) is m..rkedi\- convex in lx)th the sagittal and the transverse
direction and i)resents some distance above the orbital cavities two feebly projecting flattened
elevations, the jrontal eminences. Immediately alx)ve the orbital margins and parallel to them
are two slighllv ])P jecting ridges, the superciliary arches, the develojjment of which varies con-
siderably in dilTerent individuals; the Hat area between these two ridges is called the glabella.
The remainder of the external surface is sm(K)th, although there may be a slight roughening
in the median line which represents the remains of the original jrontal or metopic suture.
The supraorbital border is situated at the junction of the vertical with the orbital plate. .\
]>ortion of it is furnished by the zyi^omatic process of the frontal Ume, which also forms ])arl of
the external orbital margin and, in the latter situation, articulates with the frontosplieaoidal
process of the zygomatic bone in the zygomalicofrontal suture (Figs. 37 and ,^S). The temporal
line commences at the zygomatic process and separates the frontal surface of the frontal portion
of the Iwne from the small temjjoral surface, the latter surface, almost in the sagittal i)lane,
fomiing a portion of the planum temporale and being that ])art of the frontal tx)ne which bordi
ujK.n the temporal surface of the greater wing of the sphenoid bone.
Immediately alxne the sUf)raorbital border there are foramina, which may be represented
h\ notches of var>ing depth in the border itself. The inner one is designated as the jrontal
notch or joramen (Fig. 65), wh'' he outer one is known as the supraorbital notch or joramen*
(Figs. 66, 68, and 69).
The inner rir cerebral surjace nf the front 1 jxirtion (Fi«r. 67) presents a median rifigc upon
* The supraorl)iial noKh is much more fre<|ucntly [.resent as a foramen than the frontal notch; sometimes b<'th
of the notches form a single shallow groove.
T
I he
I iviildl ciiiiniiHc
I'lin'iliil
honirr
Frontal portion
fiviitdl Gillian
Sii/iirr/7i(iry
iiir/i
Orbital portion
'orhiliil 'iiirfairj Sii/iriior/'ifii/
fcninii r
I i<:. ()<).
Sii/ii n'l'r
ti/ii/'itni/ litir
liiiiijonil
■•iirfiiir
Nasal portion froi,U,l spin,- Snpr.iorhiuil „ot,h
Siii^itliil i;ivi}\;-
I'liriildl
bordci-
('nrbnil
siiifan- I'f
In'iitdl
portiiiii
:. Oi.
(Wr/ini/ siiifiiir (of orhmil pnitioii)
I ■'•■'■ "!,n rruhittii
I iviiiiil rirsi
f idiilii/ -.pinr
Mil
(|
i
It
THE BONES OF THE SKUI.L.
6i
its lower portion, the jronlal crest, which extends to the joramen ctrcum (see pa^e 41), and is
continued superiorly as a groo\e, the commencement of the sat^iltal tiromr (see page 44). The
cerebral juga, digitate impressions, and sitki artcriosi upon the cerebral surface of the orbital
portion are sometimes continued ujwn the inner surface of the vertical jjlate, as there is no dis-
tinct boundary between the cerebrfil surfaces of the two ])ortions of the bone. The foramen
ca;cum is sometimes situated entirely within the frontal bone.
The two orbital plates of the frontal lx)ne are separated by a deep notch, the ethmoidal
notch (Fig. 68), which articulates with the cribrijorm plate of the ethmoid lx)ne. They jH)s.sess
two surfaces, a superior cerebral surjace, which forms a portion of the anterior cerebral fos.sa,
and an orbital surjace, which constitutes a portion of the nK)f of the orbit. The cerebral .surface
(Fig. 67) is .separated from the ethmoid bone by the frontoethmoidal .suture (Figs. 4.^ and 44),
and is in contact with the lesser wing of the s[)henoid lx)ne at the sphenofrontal suture. It
is almost flat and exhibits quite di.stinct cerebral juga and digitate impressions, as well as the
sulci arteriosi of the anterior and middle meningeal arteries.
The orbital surjace (Figs. 68 anti 6()) is distinctly concave, and forms the largest part of
the r(x)f of the orbit and also a jwrtion of its internal and external walls. In this situation it
articulates (Figs. 37 and 38) with the greater wing of the sphenoid Ijone by the sphenofrontal
suture, with the lamina papyracea of the ethmoid Ixjne b\' the fronlcK'thmoidal suture, and with
the lachr>i ,d Ijone by the frontokulirymal suture. The apjjcarance of the ethmoidal notch
as ^een from the inferior surface of the frontal bone between the orbital surface is (|uite dilTerenl
from that which it presents from the cerebral surface. It is not limited by a simple suture, but
its U)rders are rather broad and irregular, and are j.roviiled with small depressions, the ethmoidal
del>ressioiis, which comjjlete the air c ills of the ethmoid bone. In the septa Ix-twei n the ethmoidal
cells there are two gr(K)ves or can;d>, an anterior ami a jjosterior, which run resjx < livelv to the'
anterior and posterior ethmoidal joramina, situated beside or in the jrontoethmoidat suture; they
give pa.s.siige to the ves.sils and nerves of the same name.
The portion of the orbital s\ rface which is in the inner wall i-t the orliil alwavs presents a
•small (iei)ression, tlie trochlear depression (Figs. OS and tv)), and sometimes a small ix>ny spicule,
the trochlear spine, Inyth of which are m. named on aiiount of the IiI.I'k artilaginous |)ulley of
the superior obli<|ue musi le bi ing attached in this situation. In the out. r portion of the orbital
surface Uneath the /ygomalic process there is situated a shallow depression, which lodges the
lachrymal gland.
The nasal portion of the frontal Inme il'igs. <>() and 67) i> the small me.han portion situated
between tlie ()rl)ii,il (avities and jirojecting somewhat below the frontal jHulion. It [K)ssesses
a very irregular roughened Ixirder, known as tlie nasal border, for artiiulalion with the na.s;d
Ixme and the frontal process of the maxilla, and its inferior surfati is marked In a l)on> ridge,
the jrontal spine, which, together with ilf roagh nasal l)order, articulates with the Ix.nes which
fonn the skeleton of the nose.
rile frontal Ixme. like many of the (ranial lK)nes, contains a (avitv, the jrontal sinus (Fig,
102), or, accurately speaking, two cavities, which are sei)arated by a septum usuallv jilad'.! to
oiif Mde of the meiiiaii iinr, Liki- the majority ol the liony sinuses lliev communiiate with the
nasiil cavity, the communication in this instance Ixing etTected by the two ojienings (Fig. 67)
-*n;,
ii
! 2
62
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fio. 68. — The frontal bone seen from IjcIow (^).
Flo. 69. — The frontal Inme, the f;realer part of the ethmoid, and the nasal hones in place, seen from
below (i). The frontal bone is while, the ethmoid yellow, and the nasal pink.
Fir.. 70. — The ethmoid bone seen from above ( } ).
Flc. 71. — The ethmoid lM)ne seen from the side (}).
Fic;. 72. — The ethmoid Ixme to^,'ether with the ronrh:e sphenoidales, which are united with it, .seen
from alx)ve and jKirtly from Ijehind (j).
situated between the frontal si)inc and the ethmoidal notch. The development of the frontal
sinuses is subject to j^reat individual variation; they are generally larger in advanced life than
during youth, and they are always situated at the base of the frontal jxirtion, esj)ecially behind
the su[)crciliar\- ridges, the prominence of which is actually dcjjendent u|M)n the size of the sinuses.
They frequently also extend into the orbital plates for a varying distance, and are sometimes
enormously developed and markedly distend the frontal lx)ne in the region of the sujx;rciliar\-
ridges.
Thi' frontal Ntm* is <lcvelojK'fi ontiri-Iy in nu'mt)rani.' from two rompictt'Iv separated j^ortions. whieh prow from
two <enters of ossifuation in the frontal eminenees; theM' 1 enters, like those of thi' parietal iKine, apinar tovvaril the end
of the serond month. Kven in the new-l>om the two halves of the frontal l)one are eoinpletely separated hy the frontal
suture (FiR. 105), whieh diK's not ilisiip|H'ar until the serond year of life and may sometimes 1h' present in th<' ailult. ami
is then .ilso termed the ineli>/>ii- suture. ,\t .il»mt the time it dis^ippiars 'in frontal :,inu.ses Upii m divelop anil tlnA
enlarge r]uite gradually until the time of jiutx-rty, when thiy ini rease n; re rapidly.
THE ETHMOID BONE.
The ethmoid Ixine (Figs. 70 to 7,^) forms the median portion "f the nasi! skeleton; antl
its iribrijorin fi/iilr aid.*; in the formation of the lloor of the anterior cereijnil fos.sa. In the
artituhiti'd skull ihi largest ]iorti(U! of the ethmoid is (dncealed by othtr Ixmes; it is (|iiite
centrally placi-d and anidiialis with several of the cranial Ixines ;inii with the mujorit. of the
f.,iial Ikhhs.
It has, as a whole, an irngularK- tubiial form, and |irrsints a median and two lateral iK)r-
tions. Till fomn r tonsisis nf a siiiali hnri/nMlal plate, the irihrijurni philc, and <if a larger
\ertical plale, whiih (onsisis of a sniail lliit kcned porlinn situated alH)\e the iribrifomi plate,
the (rislii f^iilli ( I'"ig. 711, and id' ,1 larijt r ptirlion, tiie fx rpi mlidihir pliil( . siuialed Ulov ihe
cribriform plate, wliidi aids in the formation id' llir lK)nv nas;il septum (I'ig. 7,<).
If till' median portion .'( thetthnioid tmne Ih' o|,s(Tved fnitii in front or troin Uiiittd. or. still U'tter, in iross-5M'(-
lion ( \\\i O'Si, it "ill Ix -"111 to In' shaind like .1 d.ixxer, tile h.indle of whii h is formed hy the 1 rista ualli, the Ruard liy
the cril'riform piatr. .iiid the M.ide In i!i. |n r|H ndii ul.ir | late.
.Xltachcnl to the lateral margins of the lamina i ribrosii are the tw. 'ultnil massts, .ilso ti rmed
the illimoiiliil l.ihyrinllis, whit h art air-containi ig structures with thin lK)ny walls, and form
a part of the oiitt r walls of the na.sal foss.e and a part nf tin inner wall "f the orbit.
rile (riMii i;iiiii 1 Figs. 70, 71, ami 7;! is a [loiniiMi ]nm\ ridge siiuaitd in liu sagittal jiiane;
it is hioh in front and low behinil, and gi\ts attaihiiietii to ihe fal\ (enbri. The crihrijorm
plait I Figs, (m), 70, and 7^1 is an approximately rectangul.ir plati' siliiatetj Ulwitii the cranial
«L-^.:
I roili'mr spiin
Sii/ieni/idiy iirch
I lontiil s/iiiir (ilahilld
I ivrlilrnr ili;tii''< </ciii
Sifininrhiliil iiuuxin
il siir/iKV of
hitiil /lortiint
/[■i^i'iiiiitir
Anterior (niii.oiaal loraniiii , ,
I'oslmor fthmoiitdl foivmcn iiolifi I'limotdiil ,/r/iirs^ioiis
/7". (kS.
Ill
Siipidorliitdl iioliii
Drpnssioii for .-''
IdchrvnidI daiiil /
/yi;o/ihitii' /iroi'i'is
Mur /imrc^s firrn:-
1 <timtnr
Cli^td f;d//i i f'I'di
tii^. 70.
Ii<'. ()').
( rihrjorin pldtf I'ir/iriidini/dr /i/dir of itlrnoiil hone
( n\lit
I iiiiiino ;id/i,'rdiiii
A/iii /irortw
11/,/,//,
I ihmoiiidi ■ ',^ "'t'.',',;""'
'■'// Per pen- I middle
'"pi'JtV '"""" '""""■'
f'k'- '"■/.
V ■■<'llld/ \ldlls
Hk' 72.
\'hi iii'iilii!
liirhiiitiliil hoiii
I f
i
it^
mmaam
.'~Mkdt
THE BONES OF THE SKULL.
63
and nasal cavities, and it con .cnt'i forms a portior the roof of the nasr.l fossas. It jios-
scsses a number of irre<?uL. rounde^l foramina, thn .;h which ])as.s the olfactor>- nerves
from the olfacton,' bulb, which -csts upon the cribriform j)late; the nerves for the most i)arl
continue their course downward in small lx)ny gr(M)ves ui)on the nasid septum and the
lateral nasal wall. The most anterior foramen, frequently incomplete, ^ives passa>,n to the
anterior ethmoidal vessels and nerve. In front of the crista p;alli, the cribriform i)late sends out
two small, somewhat (|uadrangular, Ijony platelets, the ahir processes (Fij.^. 70), which pass
toward the base of the frontal crest of the frontal bonj and usually complete the foramen ciecum
posteriorly (Figs. 43 and 44). The cribrifonn plate is situated in die ethmoidal notch of the
frontal bone and articulates posteriorly with the ethmoidal spine of the sphenoid Iwne.
The perpendicular plate (Figs. 69 and 73) extends downward in the spacv lx>twcen the
two lateral massis and forms the anterior superior portion of the bony nasal septum. It is
approximatelv pentagoi. d in shape. Its anterior superior border articulates with the frontal
spine by the frontoethmoi'hl suture; its anterior infericr lx)rder is continuous with the
cartilaginous nasal septum*; its inferior border ardculates with the superior ix)rdef of the
vomer, which forms the remainder of the tony septum; its jwsterior lior ier articulates with
the si)hen<Mdal crest of the Ixxiy vi the sphenoid bone by the sphenoethmoidal suture; and it,-
supc.-ior Ixjrdcr is received bet .vccn tvo ridges upon the inferior surface of the rrihriforni ])late.
The ethmoidal lahyririns or lateral masses are ])aired stnictures. Their cavities are more
or less comi)letely subdivided by numerous fine ix>ny ])latelets into the ethmoidal cells, which arc
onlv j)artially situiited within the ethmoic' Ixme and are frequently cl(xsed in by neig 'ng
tones, particularly by the frontal.
\Vc may ionsii|iicnllv (li>iinKuisli th.- rthmoidal alls pnijxT. i r., th<is>- nhirh ,iri actually inil..s»'(l within tin-
I'lhmoid Ixinc hv the I, inina papyraroa, from thoM- whii li an- ilosiil in liy the Inints adjaunt I.) ilu- cilin-'ii! ( :lii- Innlal,
la>hr\-nial, sphomiidil, maxillary, and palatini- ivWs).
The external surface of the labyrintli finTns a jmrtion of the inner wall of the or!;it (Figs,
o; and qO). It is (juadriLteral in form, and, on aitount of its iMreiiu thir. less, is known as
the /. .('«(/ papyraeea (Fig. 70), al'hough it is also known as \\\r 's planum. In the nrbital
cavi'v it articulates anteriorly with the lachrymal Ixme, inferioriy witli tlif niaxill.i, ])osteri()rlv
with tile palate Ixme (the orbital surface) and superiorly with tile r l>itai plate of the Ironlal l)(me,t
the two (thmoidal joramiiui (see jiage ()i ) king siiuated either ch. ,i to (-r ac tually m iht froiito
ethmoidal sv.ture (Figs, ijs and 06V The margins of the adjacent iM.nes .lici more or less in
ilcsing in thr .llimoidal eel',-.
The internal wall of the echmoiik I labvrinth (Figs. 101 awl ioj> forms the ujiper i«)rti<in
(It the tnitc! nasiil wall, and from it two lliin rough Umv platis, v.Ikkc free margins are sliu'htlv
rolled up, ()roject into the nasal fossa; iliese ale tlu- short ^u prior and tin longer middle
turbinitled bone (< 'lue iiasales suptrior ,t media). The , interior extremity of thr middle
turbinated tone a,.iculates with the ethmoidal crest of the rroiital prints-, of the mavilla, wiiile
lr!l
* In tliissilualiun llir piTp.ndii ul.ir plati- i- usually (jnov.-il |..r ili. .111 1. limi lU <if tlu 1 artilam- ^f Ihr imwiI vcpmn
it is rari'ly placed r.iartly in the mi-dian lini- liul usu.dlv d<u,it<-i to one -id<
t These suturrs have been pn-vinusly noieil and tluy «ill tie lonsidered in detail u|"in paRi 7<(.
II
64
ATLAS AND TEXT-BOOK OF HUMAN ANATO>ry.
H f
its posterior extremity is attached to the similarly named crest of the palate bone. Between
the sui)erior and middle turbinated bones is situated the superior meatus ot i ic nose, whicK is
short and developed only in the j)osterior portion of the nasal fossa-. Between the middle and
inferior turbinated bones (the latter structure iK'ing an independent bone) is the middle meatus,
in which, covered by the middle turbinated bone, there is a bulging of the ethmoidal wall, the
ethmoidal bulla, a rudimentar>- turbinated bone, and another rudimentary turbinal (the osnaso-
turbinale of the mammalia) is the sickk-shaped uncinate process (Figs. 8i and 102), which is also
covered bv the middle turbinated bone. It articulates with a j)rocess of thi inferior turbinated
bone (see below) and helps to close the orillce of the maxillarv' sinus. Between the uncinate
process and the etlimo-lal bulla is a wide fissure, the injundibulum, which leads both into the
orifice of the frontal sinus and into the ethmoidal cells; its orifice in tne nasal fossa is known as
ihc hiatus semilunaris (Fig. loi).
The ethmoidal cells communicate partly with one another, partly with the air-cells of the
adjacent bones, and in all cases, either directly or indirectly, with the nasal fossae.
The ethmi)i(l txme is cnmplrti-ly |>rrfn\-mc(i in cartilagi-. Ossification commi-nccs late (in the fifth month of cm-
Ijrvonic life) and pr<x icds from the lamina papyraiea and the middle turhinated Ixme. In the new-lxJin. the two lal)v-
rinths h.ive air. ady ossified as far as thi' superior lurtiinateil Ixme, hut thiy are n . connected, since the crihriforni and
[HTix-ndirular plates do not possi-ss ossitu centers unti the first year of Ufe, when they gradually elTect a bony union of
the two labyrinths. Tlie remainder of th;- perjiendicular p.aK' does not ossify until the fifth year.
THE INFERIOR TURBINATED BONE.
While the two upf)er turbinated bodies arc portions of the ethmoid Iwnc, the inferior one
(concha nasalis injerior) (Figs. ;(), 81, 82, and ()8) is an indejiendent structure and it is also the
largest of the three. It is a thin roughened lK)ny plate, the free margin of which is turned upon
itself and slightly rolled up. It consi>ts of a b<Kly and of three jirocesses.
The narrow, leaf-shaped body is placed in the sagittal ])lane. It is convex towanl the nas;U
sejituni, concave toward the lateral nasal wall, broader in front than behind, and isjirovided with
manv depressions and small foramina. The anterior portion of the lateral Ijorder articulates
with the conchal crest of the maxilla (Figs. 81, 101, and 102), and the posterior jwrtion of this
Ixirfler is attached to the similarly named crest of the jialate Ijone.
The largest of the three processes is the maxillary process (Fig. 82), which is directed down-
ward tnd outward, and closes a considerable portion of the orifice of llie niaxillar}- sinus (see Hg.
101 1. The lachrymal process (Figs. 61 and 821, passing forward and upward, articulates with
the lower lK)rder of the lachr>nial Inme by the lachrymocont hal suture, and forms a jiortion of
the wall of the nasal duct (nasolachrymal canal) (Fig. ;()). Thv ethmoidal process (Figs. 81,82,
and 102) is directed ujiw,!- nd backward and artictilates with the uncinate jirocess of the
ethmoid Ixme in the regio the orifice of the maxillary sinus.
The inferior liirliitialed 1. .n. ussjfi.s in immediate connection with the ethmoid Ixmi- in tin- fifth month of em-
bryonic lifi .
THE LACHRYMAL BONE.
The lachrymal hone (Fig. 781 is an approximateh' rectangtilar bony plate, ven- thin and
frequently even perforated, situated in the inner wall of the orbit between the frontal jirocess of
THE BONES OF THE SKULL.
f>>
the maxilla and the lamina papyracea of the ethmoid bone (Fips. 95 and 96). It articulates
with the nasal portion of the frontal bone above, with the inferior turbinated l)one bel v, and
extends inward as far as the nasal fossa (the sutures are considered ujjon papie 79).
It presents an external or orbital surjace, and an internal or rtlvnoidal surjaic, which is in
contact with the ethi-'ioid bone. The ethmoidal surface closes in the laihrymal tells, and a
sniall {x>rtion of it aids in the formation of the outer nas;d wall in the middle meatus, as it
articulates w'th the lachrvjnal process of the inferior turbinated lx)ne by the lachnimoconchal
suture (Fig. loi).
The anterior ]K)rtion of the orbital surface exhii)its a widi groove which, together with a
similar groove on the frontal ])roc 'ss of the maxilla, forms a dejjression for the lachr}mal siic
(see Fig. 77). The jx>sterior bouni.an,' of this ile])ression is the poslrrior lachrymal crest which
extends downward into a hooic like irocess (bent up anteriorly), the hamulus lacrimalis (Fig.
78). This is situated in Jie lachrymai notch IxHween the frontal process of the maxilla and the
orbital surface of the Ixxly of the same Ijone (see page 67). The posterior jwrtion of the orbitai
surface, situated Ix'hind the lachninal crest, is smooth.
[The laihrymal liono is formni I'v ossifiiation iif mcmlirano and usually develops from a single cirUir whii h a|i|Hars
during tli' liird or fourth month of fetal lifr. ( )i i asion.'lly tworcnIiTs apj.rar, from onr of \vhi( h the harv.ulus ili'vrlo(is,
and moR- rarely a number of centers cki ur, in whii li ease the Ixme is represented hy a numlxr of se|ii Mle parts — Ku]
THE NASAL EONE.
The nasal bones (Figs. 86 and 87) are two Hat, elongated, tr:ij)ezoidal Ixines, which meet
in the median line to form the bridge of the nose (Figs. ^7 and ,v*^'- The interna al suture
separates the short internal margins of the i -o Ixmes, while the external margin of each, consit'er-
ably longer, articulates with the front;.' oeess of the maxilla b\ vhe nasi)ma\illar\- suture.
The shorter and thicker sujjerior margin is in contact v'th the nasal |.orti )n of the frontal ]x)ne
by the nasofrontal suture; the longer and thinner inferior margin forms ihe upper ljoun<lar\-
of the anterior nares (aperlura pirijormis) and give^ allachjnent to the cartilaginous nasal
skeleton.
The slightly conca\e inner (nasal) surface of each Inme ])rL'sents a groove, the ethmoidc!
grooi'f (Fig. 87), for the anterior ethmoidal ner\e, and in tiie neighljorlKKxj of this are one or
more line foramina, the nasal joraniina, leading to the slightly iimvex external surfaic of the
Ixine. Roth the sui)erior and inferior margins of the lx)ni- are usualiv irregidarlv serrated.
[I-,a( h nasiil lx)n<' is <leveloped from a -.inKle center i>f ox-.ili. alion whic h appears in r.enibrane at atxml the third
month of fetal life. At birth the length of the Umes hardly excwds their breadth. — Si) ]
i IH'
THE VOMER.
The vomer (Figs. 73 to 75) of the adult skull is a tlat single Ixine, approximately trapezoid
in shape, which fonns the inferior and (Xjsterlor )K)rtion of the lx)nv nasal seittum (Fig. 7^1.
its upper end is thickened and spread out into two plat's, the ahr (Fig. 741, which articulate
with the inferior surface of the Ixxly of the s])henoid Ixjnc in such a manner that the sphenoi(kil
rostrum is received between them, while the vaginal i)rotes.ses of the pterygoid prcness and
5
66
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig. yj.—The osseous nasal septum seen from the left side. The frontal, sphenoid, maxilla, and palate
bones, and al^o the lamina cribro! a of the ethmoid and the ala vomeris, have been sawed
throuf^h close to the median line. The ethmoid is yellow, the vomer (e.xcept the cut sur-
face of the ala) pink.
Fig. 74.— The vomer seen from behind (\).
Fig. 75.— The vomer seen from the side (}).
Fig. 76.— -The right maxilla seen from the inner surface (\).
Fig. 77.— The right ma.xilla seen from the outer surface (}).
the sphenoidal process of the jialate bone (see page 70) arc applied to their margins.
The pxjstcrior border of the vomer forms the septum choanarum; the narrow anterior border
articulates with the cartilaginous septum of the nose and the anterior portion of the nasal crest
of the maxilla; the superior lx)rder is attached to the peq)endicular plate of the ethmoid; and
the inferior one is firmly fixed to the nasal crests of the maxilla and palate bone (Fig. 73).
The vomer arises during the third month of fetal life as two plates situated one on either side of the upper part of
the cartilaginous septum of the nose, which subsequently disappears, so that the two plates become adherent after
birth, with the exception of the ala-, which remain separated throughout life.
THE MAXILLA.
The maxilla (Figs. 76, 77, a.id 79) is a paired lx)ne which forms the center of the facial
skeleton, all portions of which arc more or less intimately connected with it. It assists in the
formation of the orbit and forms a considerable portion of the nasal fossx and of the roof of the
mouth.
It consists of a bmly and of four processes, the jrontal or nasal process, the zy_qomatic process,
the palatine process, and the alveolar process. Of these, the aheolar process is directed downward
and the frontal process upward, while the zygomatic and palate ])nKesses extend in the hori-
zontal plane, the former externally, the latter internally.
The body of the maxilla is irregularly cubical, and contains a large cavity, tht. maxillary
sinus (Figs. 70, 79, 97, and ()&}, also known as the antrum oj Highmore. In the body there may
be recognized four surfaces: the anterior, the nasal, the orbital, and the injratemporal.
The actual facial surface of the bone, the anterior surjace (Fig. 77), is convex, and i'-
sui)erior loonier forms a ])ortion of the infraorbital margin. Helow this margin is an irregula.
rounded opening, the injraorhital joramen (Figs. ,^7, .^jS, and 77), which gi\es exit to the vessels
and nerves of the siime name and is the termination of the infraorbital canal. Below the infra-
orbital foramen there is a (lei)ression, the canin( jo'isa, which gives origin to the musculus caninus
(levator anguli oris). The anterior Ixirder of the facial surface forms a portion of the lateral
l)<)undarv of the apertura pirijnrmis (anterior naresi.and at the infraorbital margin the surface
becomes continuous with the triangular orbital surjace, which articulates with the lachrymal,
zvL^omatic, and ethmoid Ixmes. but is se[)arate<l from the greater wing of the .s])henoid by the
inferior orbital (.sphenomaxillary) fissure (Figs. 95, 96, and 97). This is a smooth surface;
it assists in forming the tloor of the orbit, and exhibits a gradually deepening groove, the injra-
orbital firo(n\' (Fig. 9O), along which there is fre<iuently to be observed an infraorbital suture.
Crista gal/i
Cribriform plate of ethmoid
Frontal sinas
Nasofrontal suture
Nasal bone
Perpendicular
plate
f-'rontal process of maxilla
Vertiral portion of
frontal hone
Sphenoidal rostrum
Sphenoidal sinus
(liody of sphenoid Iwne)
(iltie vomeris
Ethmoi-
dal ■
cres
Fig. 73.
Ineisive canal
Vomer
t'rontamaxillary suture
Frontal process
.Ma vomeris
I'teryooid process
Posterior nasal spine
I'ah, 'ine p-oerss Palate bone (horizontal portion)
of maxilla
Fig. 74.
.-^■^^K.
,!/(((■ vomeris
J^
^
Maxiilarv sinus
Septum
ehoihiarum
I'terynopuhiline (;roov
Palate process
I iiehryinal border
tmhivnuil rh>tt/l
/'ni,
fill Mil fat
luherosity „,.,,„,,/ ^ lnfn„;l„t„l m,,,^,,
of maxilla
Infraorbital t;i\ •0V(
Frontal process
(anterior
al
Ineisivi canal f^jcr, 7(j.
Infratemporal . . <| fe'
surface \>^\
.\lveolar foi amino
Zygomatic process j 'j*'.
' ^
"^^■^m
THE BONES OF THE "KUI.L.
67
The infraorbital groove pratlually leads into a canal, the injraorhilal canal, whirh runs to the
infraorbital joramen. The inner margin of the ortiital surface presents a notch, the lachrymal
notch (Fig. 77), which accommodates the hamulus of the lachrjmal Ixme.
The infratemporal surface (Fig. 77) is situated Ix'hind the zygomatic process, toward the
infratemporal and sphenomaxillar>' fossie, and represents the j)Osterior surface of the Ixxlv of
the ma.xilla. It bulges somewhat posteriorly, forming the tuberosity, and jiresents a pteryf^ofx-
tine grome (see page 79), and also from two to four small foramina, know, us the alveolar i,..a-
mina,* which transmit the nerves and vessels of the sami name. The superior internal angle
articulates with the orbital process of the palate bone.
The nasal surface (Fig. 76) forms the lower portion of the outer wall of the na.sid fossa;
it exhibits a large irregular opening, the ori/ice of the maxillary sinus, .^bove this orifice there
are usually fossa and depressions which close in the incomplete maxillary cells of the ethmoid
bone. Only a small part of the anterior jjortion of the na-al surface is ex])osed in the lateral
nasal wall, the entire roughened posterior jwrtion of this surface tx^ing concealed by other Ixjnes,
namely the palate bone, the inferior turbinated bone, and the Mncinate process of the ethmoid
(Fig. 81), which considerably diminish the size of the orifice of the maxillan,- sinus (see also
page 69). Refeen the orifice of the sinus and the frontal process there is a deep gr(X)ve, the
lachr lal grooin iFig. i)o), which is converted into the nasolachrymal canal by the lachrvmal
bone and the lachrymal i)rocess of the inferior turiMnated Ixine (see page 64). The transition
of the nasal surface to the frontal pnKcss is indicated by a rough ridge, the comlial crest (Fi".
76), for the attachment of the anterior portion of the inferior turbinated lx)ne {concha msalis
inferior) (see also page 64).
The upper extremity of the frontal process articulates with the nas;il jiortion of the frontal
bone by the frontomaxillar)- .suture; its inner margin is in contact witli the na.s;d txme bv the
nasomaxillary suture, and its outer or lachrymal border is oj)ix)sed to the lachrj'mal Ixjne along
the lachrymomaxillan.- suture (Figs. ,^7 and 38). It narrows as it passes upward and presents
an external surface, forming the lateral portion of the lx)ny nose, and an internal surface, directed
toward the na.sal cavity. This internal surface is seppr'ted from the nas;d surface of the Ixxly
of the lx)ne by the conchal crest, and parallel to t' are is a less ])rominent ridge, the
ethmoidal crest, for articulation with the anterior pi . the middle concha of tlie ethmoid
bone.
The external surface of the frontal process presents the lachrymal f^rooir, which, together
with the .similarly named gnxjve of the adjacent lachrymal bone, forms a : iressinn for the
accommodation of the lachrymal sac. The sharj) anterior Ixirder of this tossa is called the
anterior lachrymal crest (Figs. 77 and qs). The frontal ])rocess also forms tlie largest i)art of
the lateral lx)unflar>- of the apertura piriformis.
The zygomatic process (Fig. 77) is broad, short, and three-sided, and terminates in a rough
articular surface for the Ixxly of the zygomatic lx)ne (zygomaticomaxillary suture). The maxil-
lar)- sinus extends into the ba.se of the jjrocess.
* These lca<l into small c anals, thi- nlveoliir cinnls. \vhi<h '.ontain the nerves and ves-sels fur the molar teeth anil
terminate in the posterior alveoli, while the alveolar (anals for the c anine and incisor teeth i)roteed from the fl<K)r of the
infraorbital canal and run within the thin anterior wall if the bfxiv of the maxilla.
M
68
ATLAS AND TEXT-BOOK OF HUMAN ANATOM\'.
Flc. 78. — The left lachry -ul hone seen from its median surface (i).
Fn.. 7g. — The lower half of the facial portion of the skull which has been divided horizontally, seen
from above (|).
Fir.. 80. — The rifiht maxilla and palate lx)ne, seen from the inner surface ({).
F'lo. 81. — The rifiht maxilla, palate bone, inferior turbinated bone and part of the ethmoid, seen from the
inner surface (\).
Fig. 82. — The inferior turbinated bone seen from its lateral surface ({).
In Figs. 79 and 81 the maxilla is coloral yellow, thi- sphenoid green, the palate lK)ne blue, and the ethmoid
orange.
1 I
I
The zygomatic pn« es.s fornix; the lower portion of the outer iii.irgin of the inferior orbital (sphenoma.xillary) fis.sure,
and is eonlinued as a Hal proie», the orbital plale, ujxm the orbital surface of the IkkIv of the Ixme in su( h a manner
that it forms the floor of the original infraorbital gnxive. In young .subjeets thi; orbital plate is always separated from
the other Ixjnes by the iiilrnorhilal suture, whieh is also frerjuentiy observable in the adult skull.
I he alveolar process i.s convex externally, concave internally, and contains eight of the si.x-
tecn u])]XT teeth. It is directly continuous with the lower surface of the Ixxly of the lx)ne, is .sepa-
rated from the frontal jjrocess by the )iasal notch (Fi<r. 77), and forms the inferior and a jwrtion
of the lateral boundar)' of the apcrtura piriformis. Both alveolar processes arc in contact in the
median line in the intcrmaxillarv- suture, and their superior margins form the anterior extremity
of the nasal crest and the anterior nasal spine. The free inferior margin of the process, the
limbus alveolaris, contains the sockets (alveoli) for the roots of the teeth, and these are sei)arated
from each other by the interalveolar septa. The r(K)ts of the front teeth particularly cause the
walls of the alveoli to jjroject externally and in this manner produce the juga alveolaria (Fig. 77).
The apices of the posterior alveoli are situated immediately beneath the maxillan,' .sinus
and are separated from it only by thin layers of Ixjne (Fig. 98), and at the summit of even,- alveolus
is the orifice of an aheolar canal (see page 67). Posteriorly the alveolar jjrocess is directly
continuous with the tuljcrosity, anteriorly with the palatine process.
The palatine processes ( F"igs. 7()an(l loolof the two maxilhe articulate in the median line
in the anterior ])ortion of the middle palatine suture (Figs. 41 and 42) and form the largest portion
of the hard ])alate. Each presents a sli;,',tly concave, relatively smcxith nasiil surface, which
forms the floor of the nasal fos.s;!, and a markedly concave, extremely rough palatine surface,
which is directly continuous externally with the alveolar process. In the median line Lmmcdiatcly
behind the junction of the two alveolar i)nKxs.ses each palatine process exhibits ujx)n its j)alatine
surface an incisive notch, and the corres])on(ling notches of the two lx)nes form the inferior
o|)ening of the incisive foramen (F'ig. 100), which has two orifices into the nas;il fos.s;e, one on
either .side of the bony nasal septum (Fig. 78). The jialatine surface (Fig. loo) also jwssesses
rough longitudinal ridges and gnxnes, the palatine spines and f^rom'es, the latter accommodating
the ve.s.sels and nerves of the hard palate.
Ujwn the nasal surface of the palatine proccs.ses the thickene-t! and roiled uj) margins of
the two Ixines unite in the median suture to form the nasal crest (Fig. 70), into which is inserted
the inferior margin of the vomer. To either side of the anterior extremity of this crest is situated
one 01 the nasal orifices of the incisive canal.
/niitsviTsr /iii/iitiiir siiinir
Inf. ptcryf^oid /'trnxcid piViYss
Ext. pter)'frnid plate plale
Depression for
lachrymal sue
Hamulus lacrimalis
Fig. 78.
Posterior
lachrymal
crest
Nasolachrymal
canal
Inci.'^'vr foramen Na'ial ,\pertiira /lin/ormis
crest
.'1^'"'''?" r.thmoidal cnst
^.%,^ff """ of pah't, hone ^ i , ,■
ijir I i^rooYe ■ i^plienopalattne
t'i'' 70.
notch
I iieinatr
t/iroct'ss of illimoid hone
I tithnrital * ^^,
nasal /„„„.
Fig. 80.
r.thmoidal process
.1,' 'llary /iroeess
l-inliryaud process
I i/iin,<i,/,i/
i<f inhr.
m
>'■'. '■
{
//>. 82.
l-i<'. SI.
m-
m :
THE BONES OF THE SKULL.
69
In the skull of the new-born and of the child the hard palate always shows an incisive
suture, which is also frequently observed even in adult life (Fig. 100).
In thi- fetus \iolh {hv im isor lei-lh and thiir alvioli arc situatiil in a special Ininc, thi' inlrrmaxillary hove or iw inci-
sk'tim, whiih also forms ihc anlcrior jMirtion of the hard palate. Although the portion of the incisive suture inditating
the Uiundary iH-twcen ihi' intermaxillary Ixine and the alveolar piotess usua..y ilisappears liefore hirtli, the iiKisi\e suture
upon the hard palate is maintained for a eonsiderably longer time.
The upper jaw is formed in membrane towanl the end of the sei ond fetal month, from four or five ( enters of ossi-
fication, two of which form the intermaxillary l)one and remain independent longer than the others, whiv h usuallv unite
as early as the fourth month of fetal life. The infraorbital suture is another indication of the <omple\ origin of the
maxilla. The upper jaw of the new-lxirn is considerably flatter than the fully developed bone, and ihi- alveolar
process is entirely wanting, lirst a|i|iearing with the ilevelopment of the teeth and not Ixing lompletely formed until a
considerably later periml. The up]»er jaw contains a maxillary sinus even during fetal life.
THE PALATE BONE.
The palalc bone (Figs. 8:5 to 851 is a llat ])aited lK)ne, very thin in certain places, wliich is
ap])lied to the posterior ]>ortinn of the maxilla and also articulates with tile splienoid (body
and pterygoid processes) and with the inferior turi)inated Ijones. It consists of two rectaiioular
txiny l)lates placed at right angles ti> each other, one, the Itnrizonlal pUile, being in the hori/onlai,
and the other, the perpendicular plate, in tile sagittal plane. The palate ixme also posses.ses
three ])r')cesses.
The Iwrizuntal plates of the two p.ilate Ixmes form the ]iosterior portion of the liard pala'e
(Figs. 41, 42, and 100). They articulate willi each r>tlier in the posterior jiortion of the midille
jialatine suture, and with the palatine processes of the nia.xiila in ihe transverse palatine suture.
.\t the ])osterior extremity of tlie median suture tlie two palate ixmcs logetlier fonu the posterior
nasal spine (Figs. S? and 100), as well as the ]io-.HTior iiorlioii of the nasal cresi upon the nastl
surface of the hard palate (Fig. 7S1, and their ixistcrior margins form the lower boundarv of
the choana' (Figs. 41 and 42). The rough ])alatiiie surfaci' of the hori/oiiial \<\mk- (Fig. too,',
like the similar surface of the palatine pn«(s,> of the ma\illa. exhiUil- jialaiine spines and grtMives,
and also presents, near the posiero external aiigK, the x'''""'"' palatine joramm. one of the
oriliies of the pteryi^opalatim laiial. The nasil surfac,- (JMg. -,,1^ lioweM-r, i- snxMilh anil
distinctly concave, like the corresponding surface of the palatine prods- of ihe maxilla.
'ilie perpendicular plate of the jialate Ix.nt' i- narrower and thinner, but loni.'cr ili.in the
hori/.onlal one. Its maxillary surjace (Fig. 84^1 is a].plied to ihr lough siirfatf of llir poslcrior
portion id" the na-al surface of the maxilla and abo partl\ lit- i;i from of and parlb closes iln
orifice ot tlu ma\illar\ sinu-. Its internal or i;./,v.;/ surjace d-'ig. 85) forms the posterior portion
of til. Literal n.isd wall 1 Figs. 101 and 102), and pn-enis two hori/oiilal parallel ii<lges, a disiiiii I
interior one, the (omliai cresi (Fig. 85), for the ailaihment (d" the inferior Itirliinated Ihmk (I'lu's.
101 and 102), and a less pronounced sujierior one, thi' ittimoidal crest 1 Fio. ,S(i. for the middle
turbinated lx)ne. M the posterior berder of ihe perpendii ular plate lliere is a ;'.; "'ve, llu
ptcry,i;o palatine t;roo-ee (Fig. 84!, which, with the >imilarlv nanuil grooves of the maxilla (see
• 'K ,••; -'"'I ■■: 1:1: |-f. ._i^--!i! j)nn.vr-. td ;iie rijiiie;;ia:! iione ; see riU'. ^ ^ :, iorjo- !iu p!,T\-:^,:p.;;.l
tine canal, wlio-e inferior exiremity is the |ire\ioii-lv mentioned i:rcaler palatine Jorannn. Iti
ils vitinily are also the orifices of .several smaller lateral tamilication-, the palatini niiials. mosi
70
ATLAS AXD TEXT-BOOK OF HUMAN ANATOMY.
Fig. 83.— The r.uiu i)alatc bone seen from behind (j).
Fig. 84.— The rijjht palate bone seen from the outer surface (\).
Fig. cSs. -The riijht palate bone seen from the inner .surface (}).
* = surface whicli lompktis the pliryKoid fossa.
Fig. 86.— The left nasal hone seen from the outer surface ({).
Fig. 87. — The left nasal hone .seen from its inner surface (}).
Fig. 88. —The right malar hone seen from the outer surface (}).
Fig. 8q.— The right malar bone seen from the temi)oral surface (\).
of which perforate the pyramidal process and end on the hard jjalate as the lesser palatine
j Oram ilia.
Of the three j)rocesscs of the ])alate Ixine, the pyrniiiidnl process or tuberosity passes back-
ward from the junction of the two ])lates of the Ixine, fillinK in the jjtervgoid notch of the ptcri'-
goid processes of the sphenoid bone and coinplelin},' the pterj-god fossa.
The other two prcKes.scs, the nrhiial and the sphenoidal processes, are given of! from the upper
portion of the perpendicular ])late alxive the ethmoidal crest, and arc separated from one another
by a deep notch, the sphenopalatine notch (Fi^'s. 84 and 85). The inferior surface of the body
of the sphenoid bone con\erls this notch into the sphenopalatine jorainen (Fig. 102), an imi)ortant
communication Ixtween the ptcrxgopalatine (sphenomaxillary) foss;i and the nasal cavity,
which gives passage to ves.sels and nerves (see page 78).
The orbital process (Figs. 8;, 8^, and (>0) is the anterior and larger of the two processes,
and is directed outward. Its upper surface forms the most [wsterior [Kjrtion of the floor of
the orbit, articulating with the lamina papyracea by the j)alat(K'thmoidal suture and with the
orbital jwrtion of the maxillu by the palatomaxillary suture. Its anterior surface is closely
ajiplied to the maxilla, while the internal one has an irregular Ixjundan.- and articulates with
the ethmoid lab\rinth, where it assists in closing in -^ome of the ethmoidal cells, the palatine
cells. The orbital jjrfxess is also in contact with the external surface of the Ixnly of the sphenoid
bone by the s])hen(X)rbital suture, and forms I'.ie posterior |)orti()n of the inner margin of the
inferior orbital ispheiiomaxillarv ) ri>.sure.
The thin i)osteri<)r splienoidal process iFigs. 8;„ 85, and 101 1, directed internally, is a])plied
to the ala vomeris. to the inferior surfice of the b<Kly of tlu' sphenoi.l Ixwc, and to the sphenoidal
conch.e (sphenoiila! Iurbin;.ted lx)nisi, and also ]iartly closes the orifKc of the sphenoidal sinus.
Tlu' (..ii.iU- Uiiif is fMrtniil in nitmhrani in llic ihir.l f. i.il nmnlli an. I is aln-ail\ .Ksitiid at .ilmut ill. im.l.il,- ii(
thi' f. t.il lit.-, but likr !hi' uj^Hi jaiv il is ralli.r sh..rt in 111.' nnvl>..rn
'111. ..rliil.il -iirfa..- ..f ihi- ..rhiial pr'Kcss is s.ini. linns iimisd.illy larKi-. an.l ili.- width ,,f th>' |nr|u ii.li. uiar plate
is sulijril I.) Rrcat indiviilual \.iriatii.n.
THE ZYGOMATIC BONE.
The zyKomalic cr malar Ix.nes (Figs. 88 and 8<)) are three sided, flat, strong bones which
form the prominence of the cheek. They artic\datc with the fnmtal, .sphenoid, and ma\illar)-
l><)ni'>i ^Fi"* '" a"'l •>*** Tn.l ..l.j.> >• ills lis., •j.^s. ...... .1 I...,.,. U.. _. ft'- 1- !-• ' I •!
over the temporal fossa (Figs. T,q and \o) (the suiures are dest ribed upon pages ^7 and 80).
The small orbital plate. ], laced at right angles to tht malar surfaie, a.ssists in the formation of
Orbital pnurss
Sphenoiildi pmrss
Siihciiopalatine
notch
Orhiliil
piVff^s
Horizontal plate
I'oslirior
IHISIll spi'/ii-
Maxilliiiy siir/'df
f-'i'r. 84.
I 'tiiygopaliiliiir !>roovc
if^rcatir /nihitiiit' fontnien)
Xiisii/ lofiinuii
Hfr. SO.
I roiitii-
s/i/iiiiiin/ii/
<>r/>itii/ siirftin
\
I 'tnys^opiiliiliiw !,'yvi()i'/'
Perpendicular plate
Orhiliil piiH
t thmoi-
iliil
.V
V'ss
>/'//f fii*/iu/i/' ' nut,!'
-V
I'yniiniiltil
fig. Si
f-'i''. S5.
I ( s^(^ /I :,'iin:li
I I'm 'III n
lhiiii<ii!iil I'/iiiMv
\ii^iil fonriu'ii
filr. S7.
I IVIll,<
Vi;omiil!,<i-orl>itiil l',>niiiniiii /-a V''"'"'"'/i"'
. MM iii'.i. . . .
ihhiliil \iiiitirr
/ilOii^-.
/v:;,;i.,i,n,''"f"'i' '■"•'' ""■''•""
hiltil /{
■,iii>in ^
1 1 tniiiiriil ntjt.
^Ill/ill yllliilll
1 1 ill/l,'l,l,' -.III lilil
^ 1 1:
it^.
'. SO.
-"..- (
^?^ %
1
3&Ji'
-*fe- -^^^i
I
THE BONES OF THE SKULL.
71
the orbit. Tho malar l)Gnc i^rcscnts three surfaces, the \add or malar surlacc, the poslcnor
or temporal surjace, and the orbital siirjace formed by the upper surface of the orbital ,)late.
The or6//a/ .w(r/arr is slightlv concave and its anterior border forms part of the infraorbiial
margin (Fig. 95). It articulates with the orbital surface of the greater wing ol the sphenoid
bone is usually separated from the orbital surface of the maxilla hv the injcrwr orbital (spheno-
maxillary) fisurn; and forms a portion of the fl(K,r and of the outer wall of the orbu
Upon this surface is the zvgomaticoorbilal joramnt (Fig. 88), lea.ling into a branching canah
whose cNtcmai orifices are the zvi^omaticolcwporal an.l zviiomatirojaaal joramnu,, although
frequently these two canals are entirely independent of each other, in which case there are two
zygomaticoorbital foramina (l"ig. 88).
The quadrilateral malar plate possesses a convex malar surface and a s. ghtly concave
temporal surface. It articulates bv me.-ms of its anterior rough margin with the zygomatic
process of the maxilla, an.l in common with the orbital plate it gives off the jroutosphnuwtal
procns (Fi"s. 88 and 89), which j.asses ui)wanl. forming the outer margin ot the orbit, and
articulates with the zygomatic process of the frontal U>ne an.l the zygomatic Ix.rder of the greater
wing of the sphenoid tone. The temporal process ,,asses posteriorly to form th.' zygoma bv
articulating \vith the .'.vgomatic j^rocess of the temporal Iwnc (Figs. 39 and 40'. I he sutures
between the zygomatic and the adjacent lH)nes hinv been previously r.ote.l (page ^7\ ''md will
be reviewed in another place (page 80). The malar surface a,ovs the zy,>;omaticojae,al joramev
(Fig. 89); the temporal surface, the =\\qomalicolempor<il jorameit (Fig. 88).
icnics tci <lfVoli.|) about itir '.n'RinninK ..f thf ihinl f.ial ni'ituli
ns of the bum- iiri- M-parated ivcn in ailuU
Thi- zvg(imali( t»)ni' h furnicil in mimliriini anil iiimmcnu-s tci ilfvi'|i>|)
from two scimrati' (I'ntiTs of os.silKaliim. In r^ri insUinri'S the tw purUn
: : lumr. whi, h n, ,v iK. socn a, aU.u, U. ..1- of ih.- , sine .ho bon,-!,.. anally push.-, ou,..n. . nnn.
i,. .l.:v.lopn».n, an.l .luring ih. Rnnv.h „f th. in-,livi.lual, i. bapp.ns .ha, in on.-half of .h. -ponnu-n. .h,- .rh,.al .urla.
no lonpr forms ono of ihr l>.mn.larirs of thr nf.rior oil.ital ( -uhcnomavillarvl hssurr.
THE MAT'DIBLE.
The I le (Figs. 90 to 9U is a singk In.ne, an.l i^ the only t)one of the skull whi.h is
connecle.1 remainin^ b • bv a joint instea.l of by sutures. It consists ot two main
,K>rtions, a u„ly an.l two rami. Fhe upper en.l of eacli ramus is composed of two |.r(K-esses.
an anterior pointed corom,i<l l>roress an.l a i.osleri..r roun.le.l eowlyhul proee^^ (I'lg. .),V. tl.
two being separatc.l bv the ,wl< I, oj the ma,„tible isi^moi,! ,wt,ln. The body of the nian.lible
is an apprt.ximately paral..loi.l Ix-nv i>late fn.iu the ,,osteri..r extremities of wliu h ihe ram.
pass vertically upward. Its inferior margin is terme.i the base of the mau<i..,le; ilie su,,en.,r
margin is the alveolar portion, an.l contains, in the adult, sixteen dental ahv-.h L.r ilu' low.r
teeth which are separated fn.rn each ..ther bv the int.n.h. ..lar s.pta The free margin of
the alveolar ,.r..cess is calle.i the alveolar border, an.! the n-.l^ -f th. t.etli, parti, ularly thus,,
of the front ones, expan.i the thu, b.ny mas. ..f the pr.Kcs. an.l pn,.lu.e hngitu.hnal n.lg.s
uiKin the surface of tiie Ikiuc, the alveolar juf^a (Fig. <)o).
' „.. .,.,,. , f, , f .L,. L ,1.. ..(■ .1... ...... ,i;M,. ..sliiliils ;i ri)ii(di ni".)ie. liiHl,
i in- iiii.i.ili 01 Uu external surlace ol tnv DOvi-. -i " - _ .
the menial protuberame (Fig. ^ro), which marks the uni..n ol the orginallv separate lialves ..1
the tone (Fig. 8„i, an.l to < ilher si-ie of this projection an.l lowani the base of the man.lible
72
#1
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig qo.-Thc mandible seen from in fn.nl (\).
Fig". 9. -The mandible seen from the outer surface {{).
r- , TV.P mindible seen from below (\)-
p;;;: ;li -^ilftf the mandib. seen from the ^ner surface («.
FIG. 94.-The hyoid bone seen from in fron and abo^e (-,)•
. .. ... :.... Al.ve ana to the ^^^^^^ ^Z:^:^^ ^^^^^^^
joranun, giving exit to the vessels and ^^^^^^^^^ greater portion of the body of
:,f ,H, .nandibnlar m]erior JaUal) canal, -^^^^^^ ^J^^^. ,f ,i i^ody a smooth ridge,
the mandible. There is also to be o^^senc^ ui n t o U ^^^^^^^^^ ^^^^^^.^
the oblique li,u. which passes downward f-m U. r k> c ^J ^^^^^^^ ^^^^^^^^^^^ ^^.^^
a^vay, and finally entirely disappears somewhat to the
90 and 90- . , , I f ,h,. i^mdible (Fi"s. 02 and c),V) exhibits, to either side
"^ The internal surface of the bcxly of ^^e ™hbl ^. ,,^_ .^ ^^,^.^,^,^,,,
of the median line, a shallow deprc.su,n -'- ^^^^ ^ 2, a J. this there i. a ,hort, rough,
Uu. mser-ion of the anterior IxUy of the '»'f- " ^^^X' a paired structure an.l son.etimes also
irregular prominence, the ,.«/././>;-, ^^^^^^ ^'^^ ,,,,,,hvoid and geniohvoglossus
shows a further transverse sul.ln.s.on; .t «'^^ ""^^, ^^^^^^'.hallow depression which lodges
niuscles. To the outer side of the mental spme ^^ ;;';,,, „L is the termination
Uu. sublingual s^divary gland, and between tesb ^^^^^ ,„., from alx.ve downwanl
„f U.e rough ,„yloM Inn: which i;--;/:2le3 gives nri.in to the mvlohvoid nmscle.
,„.,„ uu. inner surface of the l.dv of he - -d Ic^.m ■ . ^^^,^^^ ^^^^^^^^^^^^ ^^ ,^^
■ A certain distance below the mvloh>oKl hue th r. *^ „„, ,,,,u-
-:, i::,;::;;:":, .;::::--:r::i:;:;.: - ^. « - --" •"-
Mon for the .ubmaxiUary glan.l. ^ ^^^ .^„,l ;, ,^,jh broader and
K.ch ramus forms almost a r„bt -fl'-^^^^^' ,,;,,, ,,,. ,,.0 ,,nKesses. an anteri..r
„„„,, ,Han the IhkIv. It passe, upward, '^ -' " ;;'^ J;^^, ,, „,■ notch of the mandible
anonoul and a ,,o.tenur .n,uHo„! I^rou • , whuh arc scparat .
ahe Mi-moid notch). ,.vi..rnal surface and an inl.rnal surface.
The ramus, like, tl.c lx>dv of the bone, poss.^se. an U mal . ^^^^^^^ ^^^^^^^^^ ^^^,^_ ^^,^^
, ,.nion of the latter being directed toward ^ ^^^^ ^ ,,^ ,,^, i„^,,,,„ of the masseter
for :hr insertion of llie internal pterygoid muscle. ^^ ^ _^^^ „,„„.r,hnlar iiuirrior dcnlar)
Al .dHHU .he middle of the rann.s uie. -^-^-;;--:;^ ,;,„„i , ,„„./* which passes
/«nimnMFig..,,V.thesupenoron.-'-.ngofth. m.,m//
, , , v„n,l Ih. numal fwr..nur. aln.oM tu tlu nud.an hnv ..n.l
,i... ,„T .,,,..11 l.,u r,,l r..mitK:,nM„. «h. h L-l ." "'^' '^l'"" "' '^'^ "''"""•
^■f^K?a^
■„ tv. .f<;::',-(TS
■ nir iin-TTi-mimiTrriia—Mi
()l)liiliii' liiii
Miiiltil l\<niiiifii
Mtnldl liihiirh .Wiiitnl proiiiliirdiur
'Body
Ramus
//''. 00.
1 m
.\lvi;<!,ir /•.".III
< 'iimiii'/tl /mfif^
Body
WiiiliJ liUii/iuii
Wild/ I'l till niaiulii'l:-
I'll lyi^iHil lipris^iitii
;-^, lliiiil 01 i;<inlvli<nl pioif^s
Ramus
f II'. III.
Il;.^h' illlil\^itilli- lllh,i\-\ll\-
n
liiis
^
I'
-:*Md
^^^smm^MM'^^A^Lii.^^^
fi<r. ()4.
lii/irivii/v
Miindihiihir
fi'iiiini'n
1 //.■/,■
Ivh'hvoiil liiir
Siil'liiiiiiuil ili'pirssioti
AUntiil '•piiii
\\>ri/t Of i\'ii,lv!oid
//-'. Oi.
Malta/ spinr
Sn/fft/n.\fi/iiry ilrpnssioti
it
:^. ^>s'f:^sm^^mm^ss^si£^^mm
THi: BOXES OF THK SKIILL.
73
obliquely through .nc mandible to the mental foramen and transmits the inferior dental vessels
and nerve. A thin tongue-shaped bony plate, the lingula, overhangs the anterior margin of
the foramen.
The coronoid process is llattenefl from side to side and terminates in a more or less sharp
apex which gives attachment to the temporal muscle. In the ])r()longation of its anterior mar-
gin runs the previously described oblique line, and passing from its base to the region of the
last molar tooth is a ridge, the buccinator crest (Fig. 93), for the origin of the buccinator muscle.
The condyloid process terminates above in a condyle, whose head (Fig. 91) is sei)arated
from the base of the ])roccss by a constriction known as the neck (Fig. 92 ). The articular surface
itself is ellipsoidal and its longitudinal axis is i)laced almost transversely, although directed
somewhat ])osteriorly, so that the condyloid jjrocess, in contrast to the coronoid, is c()m])ressed
from before backward. U])on the anterior surface of the neck of the condyle there is a shallow
pterygoid depression, which receives jiart of the ins-rtion of the external ptengoid muscle.
The lower j.i\v is formed in memhrane about Mt< kel's c arlilane, u larlilagc c.f the visceral skelitcm wliic h niark^
the position of the adult mandible. The first center of ossifuation ., ipears in the M'lond fetal month u|H)n Uith si(Us
externa! to Meckel's cartilaKe; a second center appears above the first, and the tv.o unite in su( h a manner that ihey
form a groove which is open alxne for the reception of the teeth. Kven a', birth the tvso halves of the mandible are usually
separated by a synchondro.sis, and they do not unite until the first year. Tlic mndyloid proi ess is preformed in c artilage
and is developed by the <Iire( t transformation of the cartilage into bone. The Icwir jaw of the ncw-lxirn is very Ion,
possesses no alveolar portion, and the ramus is still but pcxirly developed and f..rms a very obtuse angle with the body!
THE HYOID BONE.
The hyoid bone (Fig. 94) is a small horseshoe-shajied structure situated in the base of the
tongue; it does not articulate with the skull but is connected with il Ijy the stylohyoid ligament.
It consists of a bod\-, from either side of which proceed the f^reater and the lesser cormia.
The '■ )r/y is slighth- curved horizontally, the anterior surface being rough and slightlv convex,
the ])()sterior one smooth and slightly concave. Tlie i^realer cornua are long and thin and are
connected to the Ixxly either by b.)ny tissue or by cartilage, more rarely bv fibrous connecU\e
tissue or by a joint. They i)ass horizontally outward from the Ixxly of the bme, and are directed
backward and ually slightly upward, their ends exhibiting a l)ulboiis thickening. The lesser
cornua are fretjuenlly cartilaginous, and arise clo.se to the ba.ses of the greater ones; lhe\ are
directed ui)ward, howe\er, and also outward and backward. They are much shorter than ihe
greater cornua and are connected with the styloid process of the temnoral lx)ne 1)\ the stylo-
hyoid ligament. The nature of their attachment to the iiyoid bone is subject to considerabk'
variation.
The hyoiil Inme is i.."-'.,niK(l in larlilage and arises chiclly from the seiond lir.mc hi.il anh (ih. lucid art hi, the
greater lornua, however, representing the third .m h. The body ([wo centers) and the greater .ornu.i (omnienM in
Ossify at birth, the lesser lormia at a imu h later perio.!. Sometimes the 1i-smt ..irnu.i extend f.ir into the stylohyoid
ligament (see page no), just as the styloid proiess does, the two l,ones having ,i .ommin embryonii origin.
THE ORBITAL CAVITIES.
Each orbit (Figs. 95 to ()()) is a (|uadrilateral pri.sniatic space having the shape of a tall
horizontal i)yramid, the apex of which is situated i)()steriorly in the region of the optic
»r»nn
§k^
mmmi!^Mmii^M$M.t^^w^mm
4c,''
■:i :,r'
74
ATLAS AND TEXTBOOK OF HUMAN ANATOMY.
Fic. 95.— The left orbit seen from in front {]).
Fk;. 96.— The median wall of the left orbit, the outer wail having Ijeen removed {\).
Fk;. 97.— The outer wall of the right orbit, the medirn one having l)cen removed (',).
In all these figures the frontal Imne is vi,>let; the ethmoid orange; the lachrymal pink, the sohenoid creen; the
nasal, parietal, and zygomatic Iwnes white; and the palate bone blue . b .
foramen. Its base is a quadranj.'lc with rounded comers, and foiros the entrance to the cavity
(ad litis orbita).
The four walls of the orbit are designated the superior, the internal, the cxtem.ii, and the
inferior. Since thcic is no sharp dividing-line between the superior and internal and between
the internal and inferior walls, and also since such a dividing-line is partly absent between the
external and superior wall, the pyramidal orbital space [jossesses for the most part no sharj)
angles; inrleed, posteriorly the pyramid has ])ractically but three sides.
Each orbit is formed by seven bones: the frontal, the sphenoid, the ethmoid, the lachrymal,
the maxilla, the zygomatic, and the luilatine. The sutures Ijetween these bones arc descrilied on
pages 79 and 80. The upper wa'; 'ir the nxif of the orbit (Fig. 95) is formed bv the orbital
portion of the frontal Iwne, and in '.he jjosterior portion also by the lesser wing of the sjjhenoid
bone. It is horizontal, smooth, and slightly concave.
The inner wall ^Fig. 97) is formed anterioiiy by the lachrvTn: 1 bone and posteriorly by
the lamina papyracca of the ethmoid lx)nc and by a sn.iU portion of the ala parva of the sphenoid
(near the junction of the inner wall with the roof). Below the lamina jiapyracea, the orbital
surface of the maxilla extends upward from the tloor upon the inner wall, and its frontal process
also forms a narrow jrortion of the inner wall, internal to the lachrymal Ixine and immediately
adjacent to the internal orbital margin. The inner wall of the orbit is approximately vertical
and its anterior jtortion exhibits the fossa for the lachrymal sac.
The floor of the orbit (Fig. 99) passes quite gradually into the inner wall, and its posterior
I)ortion is separated from the largest (jxisterior^ portion of the outer wall by the inferior orbital
(si)henomaxiliary) fissure. Its greatest [lortion is formed by the o^-bital surface of the maxilla,
only a small posterior jxirtion being formed by the orbital j)rocess of the i)alate bone. In the
anterior portion of the orbit the zygomatic bone also forms a narrow strijj of the lloor, but the
extent to which it takes part u subject to considerable variation (see page 71). The inferior
orbital wall is quite sm<x)th and is abnost exactly horizontal (slightly inclined outward, forward,
and downward).
The outer wall of the orbit (Fig. 97) is the most i.solated of all, since the two orbital fissures
separate from it the remaining walls in the posterior portion of the orbit. I'he inferior orbital
(si)henomaxillar\) fis.sure scijarates more than half of the length of the outer wall from the lioor,
and one-third of its extent is sejiarated from the roof by the .superior orbital (sphenoidal) lissure.
It is practicallv formed by two Ixjnes. the orhit.n! s'.irf.xr nf tb.- ^^natcr -.ving of the sijhenuitl
bon<' contributing the posterior portion, and the orbital surface of the zygomatic Ixine the anterior
})()rtion. The latter i)ortion, however, also contains a part of the orbital i)ortion of the frontal
bone, which extends downward more or less from the roof. The outer wall of the orbit is slightlv
-f^m •
'm^tg:kMimmsmk,
^^J^5^^.c*'st$ -"'-''J^-^-'i
I ntnifui pa/'y/iurn
Siifmiorhiiul Lthm.->iilal
■" 'tt'h Jhniminu
/ lontottiaxillary <utii
Xd'^ul hoiw
I rui'iini liiriini/ii"!
/'rt ryi>,i/iii/nrt'i'- t.i-y,/
Ih'Uiil ii[v,,<li
hi". 97
1 m
' i %
y?- —
THK nONKS OF THK SKUI.I,,
N9I<
concave and is not exactly vertical, but directeii somewhat from aljove downward and from
without inward.
The margins of the orbit are known as the sujjraorbital and the infraorbital. They are,
of course, connected at their extreiiiilies by the lateral walls of the orbit.
The supraorbital margin (Fig. 9ft) is usually sharjjer than the inferior one: it is fornu'd
by the frontal lK)ne the vertical plate and the zygomatic proce>-) and contains one shallow
notch or two <leeper ones, the supraorbital and jroiilal noli lies or joramiita (Fig. ();), which tran>-
mit the frontal and sujjraorbilal vessels and nerves. The frontal hone exiends lower down
internally than it jIocs externally. The infraorbital margin (Fig. t/j) is formed internally ijy
the maxilla, and externally by the zygomatic ixjne, these Ijoncs extending intirnaily and
cxtemallv as far as the frontal lx)ne. \ i)orlion of the internal margin (Fig. ();) is furnished
by the anterior lachrvmal crest of the frontal prmess of the maxilla, and its smcxHhest jvortion
is .situated alK)ve this crest. The external margin (Fig. 97) is formed by tlie zygomatic l)one,
particularly by its frontosphenoidal process.
The following foramina and fissures lead either into or from the orbit:
1. The opllc joramcii (Fig. 9O), situated in the nnit of the lesser wing of the sjilunoid lx)ne,
leads from the cranial cavity to the apix of the orbit ami tr.msmits tlie optic nerve and th(
ophthalmic artery.
2. The supirior orbital (sijhenoidal) jissurc (Fig. 95), between the greater and lesser wing
of the si)hcnoid, also leads from the cranial into the orbital cavity and ininsmits the ojiiithalmic,
oculomotor, trochlear, and alxlucens nerves ;md the .sujierior ophllialmii vein. This fissure
se])arates the outer from the U])i)er wall of the ori)it. Its inlern;il portion i-. wide; its external
j)ortion i.s narrow and closc<l by a membrane.
,V The injcrior orbital (s])henoma\illary) fissure (Fig. 05), Ixlwien the maxilla iiid the
orbital process of the ])alate lK>ne on one side and the gre;iter wing of tile sjiheiioid Ixme or the
greater wing and the zygomatic lx)ni' on the other, le;ids from tlie pterygopalatine (spiunoni.ix
illary) fos-sa into the orbital cavity and transmits the infraorbit;il vessels ;ind nerve. It .separates
the outer wall from the tlix)r of the orbit and is larger antem exti rnally tli;in it is ])ost('ro
internally. The external boundary of the fissure is furnished l)y tiie crista orbiiali^ nl ilie
greater wing of tlie sphenoid txme.
4. The sujfcrior oi)ening of the uasolai hrymal iitasal) canal (I'"ig. 1)9), in tiie fos.si fur liu'
lachrvmal sac; tliis canal leads from tiie orbit, d into liie n;isiil i .. il_\ .iiid traiisniit> the na>o
lachrymal (nas;d) duct.
5. The anterior itlimoiilal joramcii (Figs. <); and ()(>), jiiissing from tlie orl)it;d to the cranial
cavity and transmitting the iinterior ethmoida' essels and nasal luTNe.
6. The posterior ethmoidal joramen (Figs. <)^ and 96), le:iding into tht- nasd cavity and
transmitting the posterior ethmoidal vessels. Hoth this and the preieding foramen are siluate<l
in or to one .side of the frontiHthmoidal suture in the inner wall of the orbit.
7. The zyeomaticoorbilal joramen or jorainina \V\'^. (j;!, in the outer wall of tlu o-bl' i.ass
through the malar lx)ne to the teni]M)r:d fossa and to the f;ue, and tran->niit the ner\es ,in i Is
of the same name or tluir brarulus.
8. '{"he entrance of the injraorbital laiial (for the vessels and nerve uf the same name),
ti
76
ATLAS AND TKXT-BOOK OF III MAN ANATOMY.
Fig. 98. — .\ frontal section tliroujili the anterior part of the skull, showing the orbits, the nasal fo.ssx,
and the ma.xillary sinuses (i).
Fli;. t)(). — The lloor of the left orbit seen from above, the roof havint; been removed (}).
Fli;. 100. —The maxilla, palate bone, and lower ends of the jiterygoid i>roeess of the sphenoid, seen from
the oral surface (the hard yialate) ( [).
leading, to the infraorbital foramen, is situated in the lloor of the orbit, ll commences al
the inner end of the inferior oruital fissure as the infraorbil il .groove {Fi<,'. ()q).
Q, The jronlal and supraorbital joramina, situated ' the supraorbital marf^in.
The orbit contains the following depressions or fossa-:
1. The jossa jor- the ladirymal gland (Fig. 69), on ihe frontal lx)ne beneath the outer
])ortion of the sujiraorbital margin.
2. The trochlear (lcpr(!:sioii (Fig, 68), also on the frontal Ixjne, where it passes into the
inner wall of th'- orbit, for the attachment of the iiuUey of the superior obli(|ue nuiscle.
_S. The jossa jar the lachrymal sac (Fig. ()<;), situated in the inner wall of the orbit Ix'twcen
the anterior lachrymal crest of the frontal process of the maxilla and the posterior lachrymal
I rest of the lachrvmal Ixme.
The onlv groove in the orbil i^ liie liijraorhilal i^ronvc (Fig. {)H), u|)on the orbital surface
of the l)0(lv of the maxilla.
There are several ]irojections into the orbital cavity. These are the anterior and posterior
lachrvmal (rests which fomi the fossa for the lachrymal sac, and a Ixinv spine u])on the greater
wing of the sphenoid lx)ne near the outer margin of the superior orbital lissure, the spiiir jor
the cxirnial rrcliis muscle ( I'"ig. ()()\. 'Fhe frontal bone occasionally presents a trochlear spine
alongside of tile lim iilear depression.
Till iirMl.il u.ilU v;u\ KN .Illy in lluir lliii liiii ^■,. Tin' ihiiun ^1 w.ill i> ihi' iiiiur ■me, Imlh in ihc riKinti ni tln'
lamina |>.i|'yr,i,i .1 "1 llic (llinioiil %iiu' .mil iiNo in ih.it of ihr lai lirynial Ixmi'. llir latl'T lumr even Ihiiik .nmitiniis
(l(fiiliM Tlu r"A "f llir '■rhil nut infn<|uiiilly inntainN .i |iiirliiin of \\n- fnmtal sinus, in whiih lax- it h, holloa.
Till null r w.ill is u^u.ilK ilu' ihii ki I.
THE NASAL CAVITY.
The l)on\ nas;il cavity (J-'igs. ()o, loi , anil to.' i issubcHvided into two symmetriial na.sal fossiu
b\ ilu iiavil se|)tum, which is fii<|uently obliinu and not exactl;, in thi median siigittal plane.
I'he i.uitv i-- liighi'st jiisi beiiind tile aiiUrior nares and gradu.diy Ihioiiu's lowi r toward the
|ios|i rior nans, ;ind nine of liu- Imuhs of thi- skidl the nasal, frontal, etiinioid, sphenoid, maxilla,
palate, infiiinr turbinated, lailiniiial, and \oiiur take part in its formation. In cat h nasal
fossa the re may tie ri < "ni/ed a riMif, a HcHir, an internal w.dl, .ind an evternal wall. The anti rior
opening of ilu two iMin nasal fossa' is knnwn .is ilie apertura pirijormis (anterior naresi, wliile
the posterior upeniiig of eai li i> the choaiia. I'he former i I'igs. ;; and ?8| i^ Ixmndeil l)y the
niisal Imni's ;uid b> tilt frontal pninsses and iKwiies of tin maxilla, wiiile eai h t lioana (posterior
iiari-i (Figs. 41 and 4J) !'« imunded by tlie palate iMiiie. the internal plate of thi' plen'g'>id
pHMess, and tin IhxIv iif ilie sphmoid Ixini'. Tin nnif of the nasiil cavity is forme<l anteriorly
hv till twd nasal ixines ,uid liy ihi ; isal portions of tin frontal Ijoiies, in the middle b) the
^
f:-^] Cireater wiiif; of ■i/i/niioid Prr/icmlini/dr plate tjk
I ronliil hone
Mdxi/liiiy •iiim.
A/viV/iir /(/(iccvs of
ri''. OS.
/Vi'oriKilir hone
/yi^oiiHilieotnmilhiiv \iiliire
■ orl'iliil lissiire
hiliil ennnl
Tooth
Inferior nm.dl nieatn^
' ^tiinut pitiy I lloir.onldl portion
i^oi.l phite """' /'''"'
l\ntinidiil pioe.
of pnliite hone
/ 'nliitine ^piins
f'\ I I'lilotinr /noii \\
i \ of nnnilhi
Muliiiii /iii/iiliiir ^iiliire
lit;. 11)0.
ne/)re\sioii
for liirhrv-
iliiil ■iiie
(H(fiohirhrv
mill rannh
/\XOiniitieomii Killorv '^iiliire
Infrnorhitiii groove
! f '
/ v- w.
~, ,.-»'..T_ f.'i
s-v,,^,
THE BONKS OF TJIK SKI I.I.
cribriform plate of the ethmoid, and jwsteriorly by the IxkIv of the s})henoid. It is curvid so thai
its anterior and ])osterior ]>ortions also form, so to spea!;, an anterior and a posterior wall.
The lloor of the nas;il f .ssii (Fis- 79) i^ formed by the upi)er surface of tlie iiard palale.
composed of the palatine prinesses of the maxilla' and the hori/onial ])lates of ilie pala'i' Ixmes.
The internal or median wall is smooth and of sim])le composition, the anterior ])orlion
being incom])lete in the Ixmv skeliton. The external wall is extremely comi)li( ated. Tin
median wall (FI.l;. 72) is the ;/<i,s(j/ scjiliDii, the antero-superior portion of which is formed by tlie
])eri)endicular ])late of the ethmoid bone, tlie postero inferior portion by the vomer. It i.-
attached atx)ve to the frontal crest of the frontal lione, l)elow to the nasal crest of the hard palate,
and behind and at)ove to the s])henoidal crest and r istrum.
The ext rial na.s;i! wall iFii,'s. 101 ard 102) exhibits three ])eculiar foliate prominences
the free mar^^ins of which are rolled uj) upon tiiemsehe-; these are the liirbiiuiird hones or
tondur ihisalfs.
The inferior of these is an indei)endent l>one, the courlui nasi injirior. It is the largest
and longest of the turl)inated Ixmes, while the superior is the smallest anti shortest. The superior
ard middle turbinated ixmes are pnuesses of the ethmoid lx)ne.
The outer portion of each na.s;d fossa is div id'-d into three (anals by the three urbinated
Ixincs: the suprrior meatus, Ixtween the suinrior and middle turbinated lx)nes; the middle
meatus, txtween the middle and inferior turbinated Ixmes: and the injerior meatus. Ix'twcen
the inferior turbinated Ixme and the tloor of the nasal fossa. .\lx>ve the su])erior turbinated Ixme
in the su])erior meatus is situated a deft like recess known as thi' sphenoethmoidal reeess.
The iK)rti(m of the nasid foss;i situated Ixtween the imier margins of tiie turbinated lx)nes
and the na.sal se])tum is termed the common meatus oj the nose.- tile posterior portion situated
Ix'hind the ])osterior extremities of the turbinated Ixxlies i> known as the »</.v(' pharynx or naso-
pharynreol meatus.
The external nasal wall is formed by the following lx)nes: the ethmoid (su|)erior ]X)sterior
f)orti(m); the nasal surface 01 the fnmtal process of the maxilla (superior anterior |x)rti(mi
and the nas;il surface of the Ixxly of the lx)ne (inferior anterior portion); the vertical jilate of
the palati' lx)ne (posterior iiif:rii)r ]H)rti(m); the inferior turbinated Ixmic linftrior middle
]x)rtion); and the 'imer surfaci' of the lachrymal lx)ne ((piiti' a small portimi in tlie aiiterinr part
of the middle ineat.i- '.
In additio!! to ;;m- main nasal lavity there is a series of acci'ssorv ia\ities; liuse are the
air lontaining cavities of the tnajority of the cranial lx)iies, parliiularly of the maxilla, frontal,
sphenoid, and elhtnoid.
There is a large nimilxr of openings lending into the nasal ( a\il\ .
((( ) The foramina of the i ribriform i)!ale of the ethmoid lx)ne in the roof of the nasd t avit v,
transmitting the olfactory nerves and the anterior ethntoidal vessels and ner\is.
ift) The superior orifice of the imisive lanal iFig. 7()), on either side of the nasal n\-\ in
the llfxir of the n;vsal cavitv, which transmits the terminations i>f tin anterior palatine xessejs
and nerve.
(f ) The inferior orilicc of the nasolachrynial lan.d in iht inferior meatus, which contain-.
thi nasolachrvmal duel.
iv??:^:;'^^;::.^
78
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fir,. loi.— \'ic\v of the lateral wall of the rij,'ht nasal fos.^^a, the nasal scjnum havinp; liccn removed (IV
Fic. 102. — View of the lateral v.all of the right nasal fossa, the middle turbinated bono having been
removed (i).
In Ihcsc limins tin- frontal lione is vioht, the 1:i( hrynuil pink, the rthm< i ..r;iTij;i-, thr maxilla villiiw, the
palatini' blur, thi- sphinoid Rnin. anil thr iithir lionis whiti-.
Fic. lo.v- -The left pterygopalatine fossa seen from the side, after the n nioval of the zygomatic bone (i).
Tlu' ma.xilla is yiliciw, ihr pal iti- l«'ni- blue, the sphcni)i(l pn in, and thi- 7.yf;omatir and tLm|K>ral lionis white.
!(/) The lihilus scwiliiiuiris (Fig. loi), in the middle meatus in the region of the infundib-
ulum, which leads to the orifice of the frontal sinus ( Fig. 102 ) and to the openings of the anterior
ethmoidal cells; the middle meatus also contains the orifice of the maxillary sinus.
(<) The ojienings of the midd'e and jMisttrior ethmoidal cells in the superior meatus.
(/) The upper and posterior portion of the nasal cavity contains the sphenoethmoidal
recess, the orifice of the sphenoidal sinus (Fig. 102), the small posterior etiimoidal foramen
(leading into the orbital cavity and transmitting the vessels of the same name), and the spheno-
fxiUiliiic jonnihii (Fig. 102), whiili accommodates the ganglion and vessels of the same name
anil communicates with the plerygojjalatine (sphenoma.xillary) fofsa.
fc^
-i
THE ROOF OF THE ORAL CAVITY, THE HARD PALATE.
The nxif of the oral lavity ( Fig. too) is f )rme(l by the hani ])alate. It is a markedly concave
elliptiial bonv jil.ite, composed of the jialatine ])r(H esses of the maxill.T and of the horizontal
jwrtions and 01 part of tiu' ])yramidal processes or tuberosities of the palate lK)nes. It jiresents
in the median line the median i)alatine suture, upon which a bon\- swilling, the torus pdlaliiius,
is occasionallv observed; it also contains the transverse palatine suture and sometimes the
remains of the incisive si'tuir. .\l the anterior extremity of tlie median suture is situated the
single incisive foramen, by whiih the bony oral cavity cimimunicates with both bony na. .il
fossie; ]M)ste'-'orlv in llie iiori/onial plate of each jiahite Ixuie is the greater jjalatine foramen,
and the pvramidal proci'Ss contains the lesser ])alatine foramina (inconstant 1. .Ml these foramina
are the orificis of the pler\gopalatine canal.
THE PTERYGOPALATINE FOSSA.
The plir\!^opalatine or sphciiciihixilhiry jossit d'ig. 10^ ) lies between the anterior surface
of the jiterygoid process of the sphenoid bone, the ]Hri)indii iilar portion of the palate bone, and
the posterior exlreniiiy of liie maxilla. It i> funnel shaped and is continued direttly downward
into the iitervgojialaline canal, whicii is bounded by the same three bones. It opens oMt supe
riorly into the interior orbital (si)henomaxillary i lissure which •inumicales with the orbit
and e.Mernallv the ]iterygomaxillary fissure connects the ])terygopalatine with the infratem
fKiral fossa.
Ojjvning into the pterygrjjKilatinc t<>--n an- !!"• j^'r^imrn rnitirJum. by which it communicates
with the cranial cavity, the pirryKi'i'l canal, which passe-> horizontally backward in the root of
the i)terygoi(l process, and the spin no palatine joramm, hading into the nasal (a\ity. 'i'he
fossa contains the sphenopalatine ganglion of the niaxillary nerve as will as arteries and veins.
I'rontiil
sinus
Crista iralli -^'feSS
Nasal hones ^ ■
Sii/iir/or Inihinated hone
Parietal bone
I einporal hone
Sphenoidal sinus
liasihir portion of orripital bone
/yi^onuitie areh
rlulr
/-VtliillhilroUiluil!
tm-::ri!rti
ll'nfii^ ^iiinliotnri\
I ninsverse palatine sntiire
f-'itr. 101.
I rontal s.
Ori/iee of
frontal ■<i>ni
MiMIr tio-
liiiatrtt /)(>//(
Orifiir
IllUlt. ^Itlll>
( 'fttii.:1fi
/imr
mtixata/
AtttiriiU'
Infratemporal
fossa
Foramen
ovale
Spine
of sphenoid
I'teryij^opalatine fos->a
Pyramidal proee^^
of palate bone
' Hamnlar proee--s
Alveolar foramina
'orm plate <
Sn/irrior turbinated hone
'ifiee of ■^phen-^idal sinifi
Sphenoidal \inns
rior. 11)2.
iliilnw foramen
nntidai eri\l (if /lalate hone
inferior tiirhinaled bone
Hg. W'i.
I ':''.
Incisive eanal
e^
Kl^
THE BONES OF THE SKTTI.I.. 7Q
The ptcn-gopalatinc canal, proceeding from the pterygopalatine fossa, is formed by the union
of the pterygopalatine grooves of the pterygoid process and of the palate bone and maxillary
lx)ne; it gives otT tine canaliculi which pass to the nasal cavity, and finally subdivides into a
number of canals which terminate in the palatine foramina.
THE INFRATEMPORAL FOSSA.
The injratemporal (zyjiomalic) j:'ssa (Fig. lo,:!) has only a partial bony boundary, and is
directly continuous alwve with the temi)oral fossa at the infratemi)oral crct of the greater wing
of the sphenoid bone.
It is situated between the infratemjxiral surface of the greater wing of the sphenoid bone,
the infratem])oral surface and tuberosity of the maxilla, and the externa! i)late of the pterygoid
process. It has no external or posterior boundary.
The Sutures of the Skull.
The sutures of the skull are subdivided into the long sutures of tlie cranial vertex and the
short sutures between the remaining cranial bones. The long sutures are named according to
their shape, the shorter ones according to the bones which they sei)arate. Several separate
sutures are freiiucntly grouped together and named as a single suture; for exam]>le, tiie fronto
ethmoidal suture.
The coronal siilinr (Figs. 37 to 40) is situated between the ])arietal margins of the frontal
and tlie frontal margins of the parietal bones.
The siitiilliil 'Uturv (Figs. 45 and 46) is situated between the sagittal margins of the two
parietal Ixmes.
The lambdoid sitttiri' (Figs. ,v). 4°, 45, :iri<l 4(>) i^ situated between the occipital margins of
tile ])arietal Ixmes and the lambdoid margin of the (xcipital.
The siiiKimostu siiturr (Figs. 39 and 40) is situated l)etween the sfiuamous margin of the
parietal Ixme and the parietal margin of the squamous ])ortion of tii( temporal.
The oca pilomasloiil sulitir (Figs, y) and 40) is situated between tl'.e (Kcijiital margin of the
mastoid portion of the temi)oral bone and the mastoid margin of the s(|uamous portion of tlie
occijiital. It fre(iuently contains the mastoid foramen.
riie Ixiricloimisloid siitiin (Figs. V) and 40) is situated between the mastoid angle of the
parietal bone and the ])arictal notcli and a part of tlie mastoi<l jiortion of tiie temi)oral
lK)ne.
The sphnw parietal suture (Figs. ;,() and 40) i> situated i)etween the siilicncidal angle of the
])arietal bone and the parietal angle of the sphenoid inine.
The spluitojrontal suture (Figs. v> ^'n'l 4°) '^ situated between the frontal margins ol tiie
greater and lesser wings of tiie sphenoid bone and the orbital portion of the frontal \xmv.
The spiioi.'oihiiai ^u!Uiy io siuiatcd between the anterior m.irgin of the external ^nrfao' of
the l)()dy of the sphenoid bone and the orbital pr(K ess of the palate bone.
The sphnirllimoidJ suture is situated lietween the crest of the sphenoid bone and the
l)OStcrit)r margin of the perpendi( ular jjlaU' of the ethmoid.
i y-:
i H
So
ATIAS AND TKXT-BOOK OF HUMAN ANATOMY.
I> '
The .\/)liciwsquamosiil suture (Fi)»s. .^g and 40) is situated between the squamous margin
of the greater winj' of the sphenoid Ixine and the s])iienoidal margin of the temporal bone.
The jrouUnlhmoidal suture (Figs, j?;, },f>, 4,^, and 44) is situated between the inner margin
of the orbital portion of the frontal lx)ne (the outer margin of the ethmoidal noteh) and the
outer margin of the cribriform plate of the ethmoid, Ix'tween the posterior margin of the nasal
portion of the frontal Ijone and the anterir • margin of the cribriform plate (joramoi rrrnim),
and also iKtween the upi)er margin of th ■ lai . ])ap\Tacea of the ethmoid and the inner margin
of the orbital [wrtion of the frontal Itone. 1 tie latter portion of the suture i.s in the inner wall
of the orbit and frequently contains the etlimoidal foramina (Fig. (/)).
The nasDJroiital suture (Figs. ,57 and 38) is situated between the nasid jxirtiim of the frontal
bone and the upper margin of the nasal Ixine.
The intcrnasol suture (Figs. 37 and 38) is situated between the inner margins of the two
nasal Ixincs.
The jroiitoiiHixillary suture (Figs. 37, 38, and 95) is situated Ix'tween the nasal portion of the
frontal ix)ne and the frontal process of the maxilla.
The jrontdaelirymal suture (I-'igs. 37 and 38) is siti'ated Ix'tween the orbital ])ortion of
the frontal 1-H)ne and the u])per margin of the lachr>mal bme.
The zvgomatieojronlal suture (P'igs. 37 to 40) is situated between the frontos])henoidal
process of liie zygomatic bone and the zygomatic (external angulrr) process of the frontal.
The splunwzyi^^omatk suture (Figs. 39 and 40) is situated between the zygomatic margin
of the greater wing of the sphenoid and the zygomatic lx)ne.
The zygonmtieolem poral suture (Figs. 39 to 42) is situated between the tem]>oral process of
the zygomatic bone and the zygomatic process of the temporal Ixme.
The zy fiomatkomaxilUiry suture (Figs. 37 and 38) is situatetl Ixtween the zygomatic bone
and th. zygomatic pnxxss of the maxilla.
The nasomaxillary suture (Figs. 37 and 38) is situated between the frontal process of the
maxilla and the outer margin of the nasal bone.
The etiimoideomaxillary suture is situated at the junction of the inner wall with the floor of
the orbit and separates the lower margins of the lamina papyracea of the etlinioitl lx)ne from the
orbital surface of the body of the maxilla.
The laclirymoconclml suture is situated Ix-tween the lachrymal process of the inferior tur-
binated lx)ne (concha nasalis inferior) and the lachrymal Ix) le.
The laehrymomaxillary suture (Figs. 31) and 40) is situated in the inner wall of the orbit
between the lachrymal margin of the maxilla and the r.nterior (and inferior) margin of the
lachrymal lx)ne.
The huhrymoethmoidal suture is situate*! in the inner wall of the orbit Ixtween the lachr\mal
lx)nc and the lamina papyracea of the ethmoid.
The intermaxillary suture (Figs. 37 and 38) is situated Ix-tween the alveolar i)rocesscs of
the two maxilUe.
The palatomaxillary suture, in the floor of the orbit, is situated Ix'tween the posterior margin
of the orbital surface of the maxilla and the orbital process of the palate twne.
The palatuelhmoidat suture is situated immediately alongside of the preceding suture
n
THE ROXF.S OK TIIK SKUM..
8t
betwc.,,1 th. iMsttrior extremity of the lamina papyraca ot thr .thmoid an.l thr orl.i.al pro-
cess of the ]>alati- lK)ne. '
The media,, palati„e suture (Figs. 4,, 4,, and ,00) traverse., the hard palate in the median
hne.
Th^lrcisversr pahthie s,U„re (Figs. 41, ,2, and 100) is sitnate,! Ix'tween the palatine pnx •
c.s.ses of the maxilhe and the horizontal j)ortions of the palate IxMies.
The following sutures an- inconstant: the wjraorbilal ,„l„re (see pag.' r/,), the „ie,sive
suture (see page 6()), the t>elrosq,ta,„osal suture (see j.age 51), the sq,ia,ru,so„uisto,d s,Uure ,see
page 5,) the sphe„o„,axillary ,v«/«r,. (between the pterygoid process ami the IxkIv of the max-
illa), the jro„lal or ,„etopic suture (see ])age 60), ami the sutura me,idos„ (see page^/)
I he petrooecipital and sphe„op,'trosal jissures are filled uith librotarlilage (jetrooccipilal
and sphenopetrosal sy,u:lu>ndroses *).
The Skull of the New-born.
The skull of the new-born (Figs. .0410 ,of.) differs in manv respects from that of adult
hfe (sc^ he development of the indivi.lual l)ones of the skull). Th^ verti. al plate of the occipital
bone s^fll exh.btts the sutura ,„e„dosa (l.^igs. ,05 an<l .c/„ an.l ,. separated from the lateral por
.on.s by the posteru,r „Uraoceipital sy„eho„dros,s: the late.al portions are sc-parate,l from th.
basilar portton by the anterior i„traorcipital sy„cl,o„dros,s. The two hahes of the Ixxlv of the.
sphenoid are st.ll separated by the i„terspl,e,ui.lal sy,ulu,ndr„sis and the splu,woccipUal vv«-
chond, osis separates the .sphenoid from the occipital lx)nc.
In the tem,K,ral lx,ne may Ik- observed the ty,npa„ie a,„tulus, one of the most strikin.^ forma-
tions of the skull of childh.xxJ.and also the sq,uv,.oso„.,.to,d suture, whici, still completelv sepa-
rates the squamous an<l the petrous (together with the. mastoid) portions. The two'halves
of the frontal l^,ne are separated !,y the jrnutal suture, an.l t.,.. iueisive suture is still visibl.. in
the ma.x,lla that .s to .say, in the har,l palate. The maxiUa an.l the mandible are still ui
d. Teren ly shape.1 rom the a.lult stru. tures. an.l the latter lx,ne exhibits a n.edian sutu... Th
fiction of the cranial vault. In •!,. lines n, the sutures there are more or less narn.u mem-
branous connecti.ms of the ...,n,igu..us Ix.ny n.argins, whi.h f.>rm large spaces partuular" n
or lo,Uuul,, and s..x of them may 1h> recogni.e.l, tw.. of whic h are single an.l t^a, .loubk-
.. Ih. lro„ta/ or anterior fo„u,„elle ,Fig. ,05) is the largest of all an.) is .,ua,lrangular in
shape, the short .l.agonal being situate.1 in the transverse ami the k.ng .liagonal in th.. ..n t 1
\.^^o halves of the frontal Ix.ne and the two [.arietal lx)nes.
2.Th.- oeripitnl or posterior j„„ta„eii, (Fig. ,05. i> small and triangular, an.l is situat.xl
at he junct..,n ..f the sagittal ami iantUloid sutures, between the two pa...tal l>,nes an
vertical portion of the occipital Ix.ne.
II
lill
5-i|
* Trui syn. li,„„lroses ,xiM in ilio skuil only iluring rhildliood.
82
ATLAS AND TKX T-BOOK OF HUMAN ANATOMY.
Fig. 104. "Skull of a new-born child from the side (]).
Fio. 105— Skull of a new-l.orn rhild from above (']).
p,(.„ ,06. -Skull of a new born child from behind and
.w(]).
, The f.vo sphenoidal ]o,itancllrs (Fig. 104) are of medium size, irregular m lorm, jKK.rl)
defme.!, and situate.l between the parietal angles ..f the greater xvings (.f the s,.heno.d l..nes
and the sphenoi.lal angles of the parietal Ix.nes. in tlu' location of the later-.levelo,.e.l sphmo-
parictal suluns and the contiguous bonv margins. , ,- v,
4 The two mastoid jontancllcs (Fig. 1061 are situated between the mastoul angles ot the
parietal bones and the parietal notches of the tcm,)oral bones, extending outward to the neigh-
boring U,ny margins. They resemble the antero-lateral fontanelles in respect to their si/.e,
shai)c, and boundaries. .
Bv thr progressive ossification of the flat bones of the cranial vault, the- lontanelles bec.,nie
closed 'in the t.rsl vear of life, rarelv later, the frontal fontanelle closing last (at the end of the
first or the beginning of the second vcar). .\t the same time the coronal, sagittal, an.l lambdoid
sutures develop, whereby small lx)ny areas frequently remain as independent structures within
ihe sutures, and are known as supernumerary hones, Wormian hones, or ossa sulurarum. They
are particularly common in the sagittal and lamlxloi.l sutures, where they are sometimes
j.rcscnt in large numbers and are occasionally of considerable size.
The Skeleton of the extremities.
The skeletons of the upper and lower extremities are more or less similar. They are com-
posed of: (I) The girdle of the extremity, and (2) the free extremity. The shoulder gin le
is com,x>sed of the scapula and the clavicle; the pelvic girdle of the two pelvic Ix.nes The
skeleton of each free extremitv consists of a proximal, a middle, and a d.sta segnunt, these
being represented in the upper extremity bv the bone of the ann, the In.nes of tlie toream., and
,he Ixmes of the han.l, an.l in the lower extremity l)y the thigh-U.ne, th.. rx.nes of the leg, and
,he U)nes of the fcK.t. The skeleton of the pn.ximal segment of each extremity ^;oris,sts ..f a
single tenc: in the up,K-r extremity, the Innnerus; in the lower one, ^h. /enu.r. The muUlle
segment is fonne.1 bv two bones: the radius an<l ulna in ,he forearnv, the /,/». and lihula m
Ihe k- The distal se-rmcnts, the hand and the f<K>t, contain a number of Ix.nes, those o the
h-in.l bc-ini' sulxlivided into the carpal bones, the meUuarpol b.n.s, and the. phalanges of the
fingers, and those of the foot into the tarsal bones, the melatarsal l...nes, and the phalanges ol
jY^ ^,,,i.;... .\.o ...ntain a number of sesamoid bones; tiiey occur in the u])iier ex-
tremity only in ti-' hand; in the lower extremity they are to be foun<l both in the foot an.l also
in the region i.f the knee (the knee-caj) or patella).
/ nuiltii I ■ nfiiii
Sphnioid (I'nlantUi
liiT. 104.
I lOlltil/ /<";f,/,'/,-Yi-
I Vlliptllili' illllilllll>
iM.nil l\n:- .\\u-.:,>,.l
!hMti<"l I'fhl fi^inn'IfUt'
I'/ i'(<7- I'llth
futuj ^TOh/
I'll) :i till I'llliilillt
I )tripital ti'itlanrHi
Siitiirn ruiiilo--ii
{II
Oi'ii/iiliil jouliiiiiiif
llVlllill ^Ill/Ill
Si/iiiiiinnis porlioii
i^f luripitiil
I'lirieliil
tiniiuiiir .
Siimrn
•nrnilosd
Mastoid
foiUiindh-
t itlciiil /'>'rr!'"/
I'/ /( IHI>0!lll
ot li'itl!h'nll
Miinhriiiiii
lYIUpillll
liiti-nuil p'l 'vvvitl pliili
I'll/nil' Ih'tli
I 1,'llllli foillilllllli
I till J piildtt
()'■ iitri-'iMitti
Sii'^illiil \iiliiir
^■.piiinii'ii- p,<rliiiii ■>! OitipiUil
I'iiT. mo.
Ihlipitlll ':l>ltllllli/l-
^mm^m.
1
ri
t ?
'ik
THE SKELETON OF THE UPPER EXTREMITY. g,
THE SKELETON OF THE UPPER EXTREMITY.
The Shoulder Girdle.
Unlike the pelvic girdle, the shoulder girdle is n„t completelv closed, but remains open
posteriorly, ,ts posterior constituent, the scapttla, having no direct or indirect .onneciion with
the c<,rresponding lx>ne of the opposite side, while the anterior skeletal portion., the clavicle.
close the shoukler girdle anteriorly by their connection with the manubrium sierni. IJoth con-
stituents of the shoulder girdle articulate with each other, and the free upper extremity articu-
lates with the scajjula.
THE SCAPULA.
The shoulder-blade or scapula (Figs. 107 to no) is a dcridcdlv flat bone which is verv
thm m places and exhibits several marke.l processes. It articulates onlv with the clavicle and
the humerus; otherwise it is completely free and the sur-
face resting against the ribs i-, sei.arated from them bv the
intervening muscles. It is triangular in form, and there
may c()n.sef]uently be recognized in it three sides, three
angles, and two surfaces. According lo the i)osition ,)f
the scapula when the arm lies close to the side of the
body, the three angles are designati'd as the inkrnal
(superior) mi^lv, the iujcrior mti^l,; an<l the external aiif^lc.
The margins are the iitlernal or vertebral (Ixtween the in-
ternal and inferior angles), the ■superior flutween the in-
ternal and external angles), and xW exlerual or avi/lary
(between the external and inferior angles). The anterior
surface, directed tow. ml the ribs, is iirmetj the eoslal sur-
jace, and the |>osterior one the dorsal surjace.
The costal siirjace (Fig. io(,i is rel.uivily smcM.th and
somewhat concave, the shallow deprosion King termed
the suhua pillar jossa, from the subscai)ular mus< I,- which
arises from i,s surfa.v. Several rough lines, the line.r n.useulares, .on,me,ue al the vertebral
margin and pass outward almost transversely across the surface.
The .lorsal surja.e ,Fig. 1081 is rough; and is suUlivide.l'into two portions bv a marked
roughenc.l ndge. the spine, which commences at the upp.T half of ,1,,. v.rtebral margin as a
'iMlten,.! pn.j.etion and g.a.lually Incomes mor.. elevated as it passes out.ar.l. The small
upper area „ known as the supraspinatons jns.n (Fig. ,071. ami the larger lower one as the
injraspnuuous jossa; Ix.th of these names Uing .lerive.l from the muscles .0 which the fossx-
givi- origin.
'rill- Vi-flihr.tl /i^iw//..* .,( »U.. ......I. ,-,1 , _^ I i_ » t
.. ...r n..r...r ..) ,.,. -,,,j,,j., ,.,],„ ,(.„„„, ,}-^ ^,_.^, , ^^ ^^^^, ^^.^^.^j^. straight, but pre-
sents .. slight angle at the origin of the spine. The upper ami lower portions of the U.rder are
thickened; the middle portion is thin.
Flo. 107.— Thr tlcrMl Mjrf.iir .if iln I, ft
Si a|)ti!,i.
I
«.^s«i^Lm-.
84
ATLAS AND TEXT HOOK OF HUMAN ANATOMY.
Fig. 108.— The dorsal surface of the left scapula (J).
Fig. 109.— The costal surface of the left scapula (J).
Fig. no.— The left scapula seen from the outer angle and axillary border (J).
Fic. III.— The left clavicle seen from below (§).
Fig. 112.— The left clavicle seen from above (§).
L 1-
This iH.rdcr receives the ins..rtion of ihf sorralus .iw.Rnu . : is.le. whid, also .-xten.ls outwar.l up<m tin- costal
surface in the Wdnity of ihe su,Krior an.l inferior angles, so tha the >oslal surface presents two shallow tr.angular arras
for the attachment of muscles, in ailditioii to the subscapular fossa
The supfrior border presents a notch, the scapu!ar nolcli iFios. 108 and 109), which may
be either deep or shallow, and to the outer side of this there projects from the superior margin
a .strong, curved, hook like i)rocess, the coracoid prorrss (Fig. io()). This arises by a broad
base between the scapular notch and the outer angle, and is at first di.ectcd ui)ward and .omc-
what forward; it then becomes narrower, makes a distinct turn, and passes forward and out-
ward to end in a roughened a])e.x.
Tile uxillary border (Fig. no), so called Ix-cause it is directed toward the axilla, is slightly
thickened ami roughened, particularly toward the external angle. .\ furrow separates this
elevated Ijorder from the anterior surface of the lK)nc.
The inUrnal anisic is eit'-.r a right or an obtuse angle; the injirior one is acute with a mark-
edly rounded apex. .Vt the external anj^k is situated the so called head of the scapula, whi. h
l)resen'^ the articular surface for the head of the humerus, the t^lenoid envily (Fig. no), which
•■ m(M)th, slightly concave, and shaped like a pear v Jih the apex upward.
.\lx)ve the glenoid lavity is a small surface, llie supraj^lenoidnl tuberosity (Fig. no), which
gives origin to the narrow ctird-likc tendon of the long heatl of the hi.eps, and tx'low the cavity
there is a larger, markedly rougiuned surface, the iujroi^leiwid.il tiiberosily, which giv -s origin
to the broad strong tendon of the tri(Ti)s. The hea.l of ihe scapula is sejiarate.l from the
remainder of the \xmr l)y a slight ( onstriclion calleil the "<(/■.
The .-'pine of the scapula (Fig. 108) arises by a iiroad base from the dorsal surface In-tween
the sui)raspinalous and infraspiiuitous fossa', and gradually becomes higher as it passes from
the vertebral iH)r(ler to liie net k of the Inme. It i)as.sts over the neck, overhangs the glenoid
cavity from aiM)ve and beiiinti. and terminates in a strong, broa.l, llattened process, the aeromion.
Internal to its apex, the airomion presents an elongated, Hat, articular surface for the attach-
ment of tile airomial end of the ilaviile.
The s...pula is pretorn,.-,! ,„ , artiU*- .luring I, lal iif.-. 'l-hc hr.l . ci.l, i of ossifi.ation apiK-ars it. the ihir.l month
of embrvoni. life m the reKion of the ne, k. but os^lIm .ilioi. pr.«e.sl, ,o ,lowlv that iarff- areas are stiil . artihiKinous in
the „e«-l».rn 1 >urinK the lirst ve.ir of hfe an in.lei-n.l. nt center api^ars in the .oracoi.l pr.H ess,* from whi. h i- forme.i
the Knater |«.riion ..f this pr..j.-.tion .\l the aRe of pulK-riv s|k-, iai .piphysi-al centers make th.-ir apin-aran.e, in the
a|.. , aT..| th.- base ..f the .oraM.i.1 priness, in ih. .i.r..mi..r. lusuallv several .enlen.), in Ihe base ..f the siapula. in the
inlirior anRle, in Ihe Rlenoui lossa lusuaiiy s.iti..'»iiai iaietj. ^ .ii h. tii' iinrgin t;f ihr -,p;nr '-f ilir ^. Aj.iik, ^mi
(even earlier, in Ih. I. mh yearl in th.' .Mernal anRle ..f th.- »■ .ipula in th.' r.-Rion ..f the ori«in of Ih.- bi.eps lemltin.
• In reptili ., l.ir.K. ..nil ili. lomst mammalia th.- lor.i.oiil pro, es.s is an iinlepen.lcn! bom-.
Inltrmi! tiiii;lr
Scapular iiatrh
Sii/iriicr
('oraroid /j/vcc^.s honl,r
f/!/. lOS.
S/i/fir
1 iTlrhnil
I'oritir
Infiiii'r iiiii;!i
Siih^ia/iiiltir /('sm;
hiliriiid aiw/t
/'.>ri/t»- Siufnilaf
\,rlil'nii Iwnlri \ .V
/ htfiii' i:iil<<iiliiii\
.\ii,iiiiii>il Ai titular s."»/i/ir lU luranihiii
(A'nnv/il
(il(7iiiiil (i/i-.'/c
1 Ki'ltirv lu'iilrr
/>■-•. 10>K
lalii-'in aiii;,'
rn
mm^
"TM:
#.^:i
'Mr.
A
■s
■si*
I
^ it
i 1
J t
■ ■i
|! I
III
r '
^n.
THE SKKI.F.TON OF THE IPPER EXTREMITY.
85
'"' '^:scapu.ar n....h is son^U.nes .„.v..ea int„ a foramen l,y a bri-ige of osseous >issue.
THE CLAVICLE.
The ..,.,v/, ,Fi„,. o. a.,, o,ns .n s-»i.»H -'.^1" '7-;^-^';;;r:::j:r:;;:^^^^
™:^r:- t^j:;:^:.;^::;* r;r =::: c::::u: - .^^». >
a„,n,ial cn,l i, da..™™! a„,l ""»'- ;'" ™*:,i,t V, ,L .h. ...r lavi.nlar a„i™.
;^:r:;r::::™:;:;"":»"™s»i«:"" ...v.™»r.. .- .»-
an.l also a small smooth articular fact for conncct.on ..ih the acromu.n ^^^^ ^^^^^^^^^ ^^ ^^
TH.. .lavU. is ,...for„,.l in . anila.-. T>,.- ,.un ;;;';:-;;;-:'^:;:r, :';!:!;, o,.v .H. sU.n.U ,.,. „os-
:;r :r:;,:trr :^;::t\;:;i;':::;;:;:;i-;^^ ..„. .... . ... ..... ....
THE SKELETON OF THE FREE UPPER EXTREMITY.
THE HUMERUS.
.r- , , MO , ,6) is ■. tvnical Ion., hone, h is composcvl of a Inn;. mi.l.lK-
Tho luimmis (Imrs. n;, to nO) is a up ;,„Vr/<'r cMa-mitii>.
-r;:,;!r:::r:::;;:^r;::r:';:::i:;':!::. ^ - "•""■■'
''''"""'■ , , , .luu.ll.rf.., lh^in..•r^,..„s,,(..■Mll.r.I-|'i"^>l"-
„.i« ,,, ,,,infras,,in.>tu. iH,, - . ,. -M. an.l „r,-..nno <l '^ '^•- '"-^^^ .., .^ „„.,, „ „„ , ;,r„la,, . th- --".Ion of ,..,•
t J,s,a,ular L.s. 1. T.,,. u,,,., M-u..n of „„. ■"'-"« -«^' J^„„„ ,„ „ ,,iv..r,i. uUun of „„ . a,,.,!- ■ f
;;:n,,u.a.lof .,■ l,i...,.srunsin.h.- gnH-vv an.l . a,.ompan»,l .n ... n,.
rW shoulilrr-joint _ ! • ! !
.u.,o. ,.. tui. . ...s. a, th. junction of th. u,.. ...mitv an-i >- ■ ;;;^;; ;-;;; ;;;;;::::,
,i,,uc, «hi.h sul.s..,,u.n,ly «ra.l«all.v a.su, .-s ., .haraCr of ,.u, . .TUlaK
86
ATLAS AND TEXT-BOOK OF HITMAN ANATOMY.
Fig. IIS-— The left humerus seen from behind (J).
Fir,. 1 14.— The left humerus seen from in front (i).
Fig. 115.— The head of the left humerus leen from above (4).
Fig. 116.— The lower end of the left humerus seen from below (i).
diminution in the thickness of the lx)ne. forming what is called the surgical neck, because the
humerus is easily broken in this situation.
The upper jwrtion of the shaft of the humerus is almost cylindrical, while the lower |)ortion
is ijrismatic and flattened.
Passing downward from either tulxTosity uj)on the ui>pcr portion of the shaft there is a rough
ridge; one is the gmilcr luberciilar (bicipital) ridge, which gives insertion to the ])ectoralis major
muscle, and the other the lesser tubercular (bicipital) ridge, into which the latissimus dorsi and
teres major muscles arc inserted. The intertubercular (bicipital) groove is continued down-
ward between these ridges for a short distance and they form its lips (Fig. 114)-
Below the greater tubercular ridge uyKin the outer and posterior jmrtion of the shaft there
is a large, Hat, roughened surface, the deltoid tuberosity (Fig. 114), for the insertion of the deltoid
muscle, and at atxnit the middle of the shaft and upon its inner aspect there is a roughening,
which is rarelv distinct, for the insertion of the coracobrachialis muscle. Near this rough surface
there is a large nutrient foramen (Fig. 114) which leads downward into the lx.ne as the nutrient
canal.
In the lower half of the .shaft three surfaces, an antero-interual, an aiitero-external, and a
posterior, can Ix' recognized. The two anterior surfaces are separated from each other by a Hat
elevation and from the posterior one by the shaq) ex'.erml and internal borders of the Iwne (Fig.
114). The external border commences Ixlow the deUoid tulxrosiiy and is sejjarated from it
by a shaUow groove jor the radial (musculospiral) nenr (Fig. 114). It is sometimes termed the
musculospiral groove, an<l gives attacliment by its margins to the outer and inner heads of the
triceps muscle. It pursues a spiral course alx)ut the middle of the humerus, passing from above
downward and from within outward and gradually disiipixaring Ixlow.
The lower i>ortion of the shaft becomes llatter and broader, and its lateral Ixirders nm
downward to terminate in two rough projections whitli are known as epieondyles (Fig. 116),
the sharj) outer iH)rder passing to the small exttrnal epieondyle an<l the inner one to the more
])n)minent internal epieondyle. The posterior surface of the internal e])i(ondyle presents a
shallow griKive for the idnar nerve.
Iklow the epieondyles is situated the lower articular surface of the liumerus (Fig. i if'> which
articulates with the Ixtnes of the forearm. Tln> articular surface ])resents a separate area for
each lx)ne, a large trochlea with a median gnxne being situated inlernallv for the idna and a
smaller hemispherical mpituliiin externallv for the radius. .•\lx)ve the trochlea and upon liie
anlero-interna! surface ;i the level of the ejiicondyle there is a moderately deep dejiression. which
is known as ihc coronoid /dwc/ (Fig. 114) becau>e it accommodates the coronoid process 01 the
ulna when the arm i^ lle.xed, and alx)ve the capilulum, upon the lower portion of the aniero-
$i^
hJ^^^
(jmitir tii/ifirlr "4^
Upper
extremitv
m n
Haid
Hmd
f ^-i
Aniitoiiiiiii/ III! I;
Siinrmil inrh / csscr liibarlc
IftTrtllll'iiriiiiir i,v.'.'lf
(jmilii tiihcirh'
w \
l.csstr liihrmi/iir //(/i.'V x-%
(iinitrr tiilnrathir
rids^c
Shaft
(innn'i' for nidial iicnw
Niilriiiit
fonimm
f n
'I n
Ddloid liilitnic
m
tiiT. Ill
f%r. 114.
1
Lower
extre-
mity
t \ii null
t'lvivndylf
I nirhiiti
Intd'tiilhiriiliii
ai'OOVf 1 ^
AiKitiiiiiinil '
turl;
(iri'iilif
lii/'cic/r
l't>stfii<>r siirhiir
liitrnnil hordir
Aiiliiv-iiili'niiil ••iiifiuc
C.onuioid I'ossii
O/ccniih'ii I'ossd , ,
Inti'niiil
Intiiiiiil cpiiviidylc
rpi(Viidy/i'
(iiV''vr for
ii/iiiii iiirvc
I (\^(r tii/iiii/i
I ivihiiii
I yirnid/ \/
ininiiidvlc 1 jc.. 3
//../,/
('<l/lillllllHI
ii,i^. in.
I \t(rinil bordir
A/ilin'-cxtmiiil
'•iirfdiT
Rddia! fossil
I \tiriHil
ifiroNily/i'
(ii/iiliiliiiii
hilriiuil
iihinr mivf
livrli/ni
//;'. IK).
I i
mL^£.\
Jfe-^
4.'^:-^
THE SKELETON OF THE UPPER EXTREMITY.
external surface, is the much smaller ami shallower radial jossa (Fig. 114) for the hea.l of the
a Ur Oppo ite to these two foss. upon the lower portion of the postcr.or surface ,s suuate.
Tbroa.! cleq' depression, the olnrano,. lossa (Fi,. n.,., ^vhich accomn.Klates the olecranon
when the arm is extended.
fron, tw., .,r more epiphyseal centers. The ..iaphyseal '-';;;';'•;,;;, '^ J, ta.:i'ha,.,,Uen follow .hose for
,i,aginou.s a, hir.h. During .he f.rs. year a cen.er ^'M''--- J^ ^ ^ /^ *^;,;, h, , .n.l separate centers for each
the capitulun,, the greater tulK-rcle, the lesser tulH-rcle, an,l tmal y J' ^ ^^ ^ ,,, ^^„ J^^ „f .^^ ,„,„, ,„,, ^he
epicon.Me which appear between tW tenth a.. <- ^^;-; ^J ^ ^ i^o.^ur t^nil fron, the twentieth to
disappearan.e of the synchondroses iK-tween the epiphyses an.l the diapiiN .
the twenty-second year. ,i,:„ _- ,,.,,„t in.l sometimes even perforatid The
Between the olecranon an.l c.,n,noid lossa- the humerus ,s - "^'"^ ^ ^i ^"^ ^ tlev.rs and pronators of
epicondvles serve as points of muscular origin, th.- ,nter„al one «■;■"';'«; .X' 'ner N.r.ler of he hunvr^
the forearm, the external one to the superf.cial extensors. .M«,ve the n r a, M - "-^^ ' ^,^_^.^,,^
occasionally presents a second pr.K-ess. ktjown as the -'^--"J' ;' ''X: ^,,,„ , ."".^ , ,,, ,.H,h is interrupted only
lower than d.K-s the external portion, and ,ts sur ace represents an ^^J^r^^^^^ ^ ^„„,,.^^,^^, ,„,,,,„„. and
by the thin bony plate between the coronotd and olecranon fossa,-. The cap.tulum 1
is scarcely visible from Iw-hind:
THE ULNA.
The ulna (Figs. ,17 to no) is a three-si.led prismatic long tone which is thick alx,ve ami
quite small Ix-bw. It is composed of a shaft and of a superior and an inferior extremitv The
s rong upper exlrcmilv presents a semilunar or .greater sigmoid mU h (F.gs. , .7, no, and ,-4),
which articulates with the trochlea of the humerus an.l is cons.riCen ,n .ts mul.lle. Is anterior
portion rests upon the upper surface of the coronoid Process (F.g. uy), a broa.l beakd kc pr..
ection .lirecte.1 anteriorlv. an.l its posterior portion rests upon the anterior stirfac, of a v n
trong bonv process, th- olecranon, which forms the tip of the ellx.w ami projects ,,uUe a distamt^
alK.ve the cor.noid process. The external or radial si.le of ihe proximal exlremUy ..he ulna
presents a notch, the radial or lesser sigmoid noteh (Fig. i .6). for the hea.l of the radui., and
passing downwa,,! from this eavily there is a rough longitu.linal ri.lge. ,\.. supinator ../,M ig.
117). Immetlialelv below he coronoi.l process is situaie.l a broad roughened area whuh is
directed anteriorly, an.l is termed the tuberosity (Fig. iiy).
The olecranon receives the in.-rtion of the large triceps ntuscle, the extensor of,.,., foreavn. an.Mhc su,,ina^.r
ridge gives origin f, the grc-a„-r p.rtion of the supinator brevis muscle. The bra. htaUs .,nn, us ,nu.s. K- ,s >ns, r„ d tnto
riulH-rosity an.l the coronoid process also gives crigin to por-ions of several of the n,us, le- ^ - the forcarn,.
The ^ha'it of th- lK,ne IxTomes much ihinner ami more rounded towar.l iN lower extremity
so that while the tn.ne resembles a three-sided prism in its upper i-ortiun, ,t becomes cylindnra
in its lower fourth. In the shaft mav Ik- reognized an anterior volar, a posterior or dorsal ami
an internal or ulnar surjace. The inlernal surjace is separated from the posterior t.tie by the
dorsal border, antl from the anterior on, bv the volar border. The third l.nnhr ,s ^-^^V ^^'^^
is directed tt)war.i the ra.lius; it seiuiraies liie anteiiui liuiu th> j.-'-stcrKn Mtif-:-.-.- .:nd •'-<•••'"'
the interosseou rid^r (Fig. 1.9). The volar surjaee contains th- nutrient joramen, trom which
a nutrient eanal passes towanl the ell^.w within the tx.ne, b> otherwise the surface cdiibits no
peculiarities.
88
ATLA A.M. Tior-I^OOK .p hUMAX ,'U\AT0M\ .
Fig.
117.
-The
Fig.
iiS.
-The
I'IG.
119.
-The
Fir..
121.
~ The
Fic.
122.
-The
Fic.
'2.V-
-The
Fk;.
I -M.-
-The
Fi(,.
I2v-
-The
'§).
left ulna seen inr.^ uic > i(( ;• ..urf;i((
left ulna seen fr,,m Jjchi.M J)
left ulna seen fr' m in front if).
left radius seen from in front (jjj.
ii'ft radius seen from the inner side f^).
left radius seen rom liehind (J).
upper extremines of the radius and ulna seen from .hove and somewhat in ,r„nt r-
lower extremities of the radius .nd ulna seen from below (| ,. '
.
I
- f
n
■i».ai »,rf,„ ,., ,h, „„i,„,„„, ,,,„„ ,H, „„„„ ,;„„„,;„„„ ^„, ,^,, ,;;„■', v;';;;;;';,,,; "
THE RADIUS.
The r«rf/«. (Fij,s. ,_ . to 135) is the outer of ih. two bones of the for.ami
to the ulna, U ,s narrow and thin above ami broad and thick below
h.snp.norcM/y Fi. ,241 i^ forn .,1 bv the di. -like /;,-„/ of ,1„
constriction bel-.v the head bein. designated as the .,r^, whi, h potion of ,he' ,..
■ in ' on;:
xmi . ,! distin'
< s e\ iindrii
dortal bonit
dortrl hordtr.
I-"IC^ \20.
volar border ^°
ulna
-Iransv.-D-L >cilii.ii i '-rough I
'f the t-'n-arri!, t.i
■■' till- mi
io//t~ Itordtr
• I'-dr;
The upper surface of the hea.l exhibits a de. -essed irt^
humerus, and the upper . ;:rumfere,ue ui nv .nannn 01
ciimjirniti- (Fi^. uj,.
Below the neek the upj.. r p„r;,un of ti:. x,l,r surfa
projection, the /»/)-rw//v (Kiir:-. .. ■ • -■ ■.,^.,1 t -. . f„ -.
The shaft of the radius, lik ihat of ,, ,- ulna,'is'l!liap..d like
three surface, are arran,e,l in a ,in.ilar mann,- ., that volar ,/,
volar .xna dor., hordrr. .M :m inur. sana rid,, . .av b. re ^niVed
sur;
he
resi-n!-
i|)ltl
(/;■//( .
(he
ouirh, marked
i»s nniscle.
prism, and the
. r<i/ .s»r/(7rc.v, and
The interosseous
l^}^
. ,f
()/,> IlltVl
in front (]).
Its ladial
iif)). anrl a
119). The
artilugi'.
i'hysc.-, ;„ar
I.-. iMci jit.rs
Thin ,. .,i
in ■ (jnii
.i distini I
-■v iindrii
ihv
£H
/>-
, niaikcxl
IStlf.
, and
the
litres.
and
tnjsscoiis
Siiiii/iiiii,
110: h
Rinli.::
ili'fih
Cii/'ilii/iini
'^iipiiui' '/•
/
sill •^iirtinr
l)or\iil !iOfii
liift mill -^iiiti,
Dorsal -.iildi'i
Si'iiildthtr
'trii
Sfy.'iHi! pnnr-.
iiv:i'!:t ;■.•:■ 1 •
r
III'. 117.
/7'r. IIS.
II!'. Il'l.
:
■ejtrS
tinid
S,Vl!
I ii/ifiosily
Xiitnciit /i'.iimnt
Aiiiailiir Hmd .
cinuiiil'i-irinr
I iihnosilv
Shaft
1 'oliir iiirfinr
l.ntt-ivs^i\<ii^ ndi^i
I \trniiil ■.iir/'dic
l>,ir^ti! siirliU(
1 hhir ihUi',
Ciiya'
iiifiiiiliir
s irhiif
siylo
■tl /i/,iirs
,s7i7ii/(/
liibnvsiiv Ulna
,1/ i,iiliii\
/V'l/'V
Doisiil Imrdir
DiV-^iil ^irltiir
fit: 12 i
//A'. fJi
( Ill/Ill!
iiintii/tir
•■III hill
j 1
UlnM Radius
aiF:
I if
r II
u
It^t
h i
1
THE BONES OF THE HAND. 89
ridge is situated opposite to the similarly nametl ridge of the ulna, and is only the shaq) margin
possessed by the radius, the two remaining margins having markedly rounded edges.
The three surfaces of the radius exhibit no structure of particular note, except that the
volar surface contains the nutrient foramen, the nutrient canal, like that of the ulna, passing in
a ])roximal direction through the compact substance into the medullary cavity.
The broad inferior extremity (Fig. 125) is flattened, so that a volar and a dorsal surface are
distinctly differentiated. The interosseous ridge terminates below in a slightly excavated surface,
the ulnar or sigmoid notch (Fig. 122), which articulates with the capitulum of the ulna. Opposite
to this surface^ upon ihe radial side, the styloid process (Figs. 121, 12,;?, and 125) j.rojects Ixyond
the Ijone; it li broader and less pointed than the corresjwnding pn)cess of the ulna.
The volar surface of the inferior extremity (Fig. 121) is smooth and slightly concave; the
dorsal urface is traversed by ridges (Fig. 12.^*) which separate distinct grooves for the ten.lons
of the extensor muscles of the hand and of the fingers, a particularly deep one accommcxlating the
tendon of the extensor pollicis longus muscle.
The distal or carpal articular surface is directed toward the carpal bones; it is concave and
usually distinctly suljdivided into two facets (Fig. 124), by means of which the radius artic ulates
with the scaphoid and semilunar Inmes.
The ra.liu> is simnwhnl shorlir than lh>- uhia and the two iK.ms an- s,> nlattil that 'he ulna pnijn ts ..msiikral.ly
bcyon.l the pnixinial cn.l of thf railius anil the ra.liu> -vKn.ls Ih'V.ihiI the iliMal cvtrcmiiy ..( the uln.i. Hoth 1.,ti.. , ..■
(ur.c.l, 1.UI in an upix)sili- ilimtinn, s" tliai th.- ..in.anli.s of the tw.i l».ni-< arc .lir.-.tiil tmv.inl va. h hiIht Thr uln.i
also cxhilrils a siiuhl |iir-.ion.
In supinalion Ix'lh 'ooni-s of thr foriann arc- par.ill.i an<l llu' intiTos-i.-ou> riilK's an- op|K>sitr on.' another ( fiR
1 JO); in pronation the Ix.nrs are . rost.cl, -inie the inferior , xtremity of the ra.liiiMlo«elher with the han.l) rotates aU.ul
the ulna. «hile ih.- h. a.l of th, ra<lius routes in the radial not. h ..f the ulna. In a.Mition lo ih.ir ,.rli. ulalion, «ill. . a, h
other, the ra.lius arti. ulates with th<- humerus an.l ihe . arpal l«mes. hut the ulna arli. ulal.s with the humeru- ..nly
The <level..pnient .,f th.' ra.lius is similar to that of th.- ulna. Th.- . .nler f..r th.- iliaphvsis appears in th.- ihir.l
r.-tal m..nth, while th.- nuelei f..r the ,-piplns<s .lo n..t ap|K..r until th.- tifth y.-ar, th.- up|K-r epiphvMs l„inK .lev.-l..iK-.l
fr..m a single.. -nter. .\. ..-ssory nu. l.-l api>.-ar still later in the tuUnle an.l in the styloi.l pnKOss. s ..f the ra.lius. Ossi-
fi. ati.in is n.it ..»mpl>-l. until th.- twenti.th yen^.
The Bones of the Hand,
the carpal bones.
The eight Ixmes of the carpus (Figv ijO to i.^i) arc arrange.! in a pnivinial .iii.l a i!islal
row. I'a.-s.sing fn>m the radial lo the ulnar side llie pro.vimal row (i>ntaiii^ the iiavi'u!,.. or
scaphoid lM)ne, the lunate or sentihnu.r \nmv, the triquetral or (Utuijorm Ik)iu , ami in i>isijorm
)K)ne. Passing in the siime dirt-cli.>n, the distal row i.-, .()ni|W)sc.il of the 'greater mullaiifiular
lione or Iraptzium, lesser ntnllanfiuLir Ume or the trapezoid, the os laptlatutn or os magnum,
and the hamate or uncijorm lione.
The l)<)nes of the pn>\imal row (reall> the lirst three only) are not siliiated in a straight
line, but are curved .so as to form an arch niili it i- ^ligiiiU tonse'. jiritKiniaiiy an.i markedly
concave distally (Figs. 128 and 121/). In the distal row the capitalum projects markedly lowanl
the jiniximal row and is accommcxlatt d In its (opcavity.
ti
^•^^
Z,i^t
90
ATLAS AND TKXT-BOOK OF HUMAN ANATOMY.
Fig. 126.— The lower ends of the bones of the forearm, and the carpal and metacarpal hones in their
natural positions, seen from the dorsal surface (i).
The- preparalion was ma<lc from a frozen hand, \vhiTi'l)y ihi' rilativc |H>sition i-.' tlu l)onis loulil !»• pirKi lly (iiliTmined.
Fig. 127. — The same prc|)aration seen from the volar surface (i).
Fig. 128. — The hones of the left hand seen from the dorsal surface (l).
Fig. :2g. — The same preparation seen from t'e volar surface (i).
Fig. 1^0. -Frozen j)reparation of the hones of the left hand, together with the lower ends of the radius
and ulna, seen from the dorsal surface {■).
Fig. i_y. — The same preparation seen from the volar surfaie (I).
All the bones are irregularly sha])ed and arc difTicultof description. The navicular (scaph-
oid) bone is cllijisoidal; its distal surface is excavated, and the radial Ijorder of its palmar
surface is j)rovi(led with a rough tubercle (Fig. 127). The lunate (se...ilunar) lx)ne is shaped
like a half-moon, the triquetrum fcuneiform) resembles a short three-sided pyramid, and the
])i:;if()rm b<jne is irregularly spherical. The greater ara[)ezium) and lesser multangular (trape-
zoid) bones are irregularly cubical and the [)almar .surface of the former exhibits an elongatcxl
flattened elevation, the tiihcrcle (Fig. 127). The capitatum or os magnum is the largest lx)nc
of the set, and its length is much greater than its breadth; its i)ro.\imal end is large and forms
ihe head of the lx)ne, which is co\ered with cartilage. The hamatum (unciform ) is also large
and irregularly wedgc-.shaptnl, and its j)almar surface is provided with a tlat, slightly curvai
process, the liumuliis or unrijorm process (Fig. 129).
The caq)al tjones do not lie in a single plane, but form an arch which is convex [wsteriorlv
and concave anteriorly. The concavity is increased by the two bony |)rominences which are
situated u|><>n U)tli the radial and the ulnar sides of the j)abiiar surface of the carpus and fomi
the carpul i^romr. The radial (aq)ai eminence (Figs. 127 and 1,^11 is formed !)y the lul)eriles
of the navicular and greater multangular Ixmes; the ulnar eminence, by the jtisiform bone and
the hamulus of the hamatum.
The small, almost splier'cal j)isiform Ixme is situated only in the palmar surface of the car])us;
all of the remaining caqial lx)nes possess a roughened dorvil and palmar surface. Hoth surface:
of the four Ijories situated at the radial and ulnar margins of the caqjus, the navicular (scaphoid)—
greater multangidar (trai)cv,ium ), tri(|uetnim (cuneiform), and hamatum (unciform)— are con
nccted by lateral, radial and ulnar surfaces but the numerous remaining surfaces (numernus
on account of the irregular shapes of the iMmes) are smcxxh articidar facets covered w iili cartilage
for articulaticm with c.uh other, with the radius, or with the nielaiarpal b. nc s.
Th( piriform Ixini' has but a simple articular facet for c onnec tion with the triijuetrum (ciun i
fomi ), but all of the remaining carpal Ixmes have several .arlicvdar surfaces. The most imitoriatit
of these are the following: the navicular isca])hoicl) and lunate (semilunar) lK)nes each ]M)ssess
a i(in\c\ articular surface which arlicidates with the distal end of the radius; the lri(|uetrum
i- mil connected with the ulna, however, but with an intervening disc of c-arlila«e. Of the ioints
U'tween the proxim.il and the distal row of the carpal Ixnes, the most important is that Iwiween
the convex surface of tlu head of the capitatum and the concave surfaces of the lunate and
navicular Ixincs.
Bjkte
(lius
lar
the
K;
•><
- ri
r
'
-r
u
Ill
3 5 5
S
■53
r
'isHbmiJm'
■■■ ^- '-
THK nONF.S OF THE HAND.
01
The greater multangular articulates with th. Urst metacarpal lx,ne by a , l.sl.nctly sa.l.lle-
shapll sur^c^; the lesL multangular ,trape.,id) articulau-s with the see..n,l the cap.tatum
(OS magnum) with the thinl, and the hamatum ,u,uif.,m,) with the two remammg metacarpal
btmes (Figs. 126 and 127).
,hc luna.um .se-milunar) 1k.,u, for the n^'^' " •' • J ^ ,.,„„ilunar) a,„l hamamm (undforM,); on ih,- Kr.-afr
,nuUan«u,ar ,.ra,„.iun,) [''-^^^^X;: mJ ^ r S-^i-i i^- the a.i.u.ar face. indu,... ..,.■ ^n-a.c. ,.,r-
r r rrir:;a;:tr :rr;:=r:r^^ ^^ ^-^ •> --- >--
truni, anil lunalf lionc. :,-... f„ ,„, smuli- nnliT In llu- i aiiitatum ami
..„ll,f::,ri:;= ::.;:tr:i:rr™::,;;::;:::.:'::;::i. „ < ... »- >
in the- pisiform not unlM ihc twelfth y.-ar ..r . ^, . ,.t> r. . . ,,.„,,„, ,„„„ .^ ,„,r,i„n of llu- skeleton situated
.tJr— ■:r::;;=:.r:;:>.J:;:;ri^^^
5;' bl is dearly re,,resentc;i. In the a.lult it is t.sualh fused with the nav.eular, form.ng Us tulxrd, .
THE METACARPAL BONES.
The five mclacarpal bones (Fig. ,.-6 to .;,i) an typical long bones in which may be recog-
nizcci a proximal extremity or base, a slu.jl, and a distal extremity or lna,L Fhe bases art.cuate
with the distal row of carpal bones, the hea.ls with the proxmial row o the phalanges. I he
metacarpal lx,ne of the thumb is the shorlest. .hat of the index-f.nger the longest, an.l they grad-
iiillv decrease in leni'th toward the little linger. , , r i
-Tt^Ws of th: metacarpal l.>nes are irregularlv cubical and thicker than the shaft; that
of the metacarpal Ix.ne of the thumb beavs a sa.Ulle shaped surface for arf.culat.on w.th the
^. tium, an. the remaining ones present, in addition to the ar.uular a.e.s .r the carpal
Zes, lateral surfaces for articulation with each other. Th. base o. the dnrd metacarpal bone
presents a styloid process (Fig. 128) which is directetl tt.ward the rathal side.
The base of the Hrst nut.uarpal t».ne h,. :. single anu ui,. surf,.e. that of the .e,,,nd h,„ ihn , ^ a snuU r.i,l, d
Zt. a radial one for the third, and an ulnar one for the fdlh ntetaearyal bone; and ,he '' ;;'>'''':' 7, '
forearm.
, . . . -. -. , ..•.•,.!...,..,,. .,t;.->n <-.f tlvi! Mf the thumb, is appro.xi-
The shaft ol cam metatarpai IaHk. .-un .... i ..i.L|it..i.. ..
matelv three-si.led, and possesses a pnl,n.,r and a .lorsal bonUr The palmar ^^^^^^^^^
flat as it passes towani the base, while the dorsal In.rder w.dens out .nto a surface as U
approaches the head.
ill
.//i
•JvT
*l,-\ .■
f ^
-i^^ if
92
ATLAS AND TKXT-BOOK f)F HC.MA.V ANATOMY.
The heads of ihe bones are provided w ii'i sphen\al articular surfaces, and their sides present
depressions which >erve for the attachment of li;^anunt>. Their hases (will; the exception of
that of the freely movable bone of the thumb) are closely ai)i)ro.\imated, bu: both the shafts
and the hi ads are separated by large ini. rspaccs which are known as the htterosscous spaces
(Figs. 12b n<\ 1271. Hetween the heads these spaces are tilled by ligamentous masses, between
the shafts b\ ^lu^cles.
Xiii.rdinK 1. .lie t.i'.i'mcnts (if most authors, the niitar.irpal Ixmcs (\i\. lup from a diapliysi'al (enter in the midcDe
of the Ixme and from an ejiiphyseal renter in the head; only thi' metacarpal Ixine of the thunil) liilTering in that its epi-
physeal O'nler is in the tiast' Oeeasionally the third metacarpal has a separate renter for its stvloid pnKiss. The
epiphyseal centers do not apix'ar until after birth, while the diapiiv-Mal center appears very early (in the ninth week)
before the centers in tin radiu, .ind in the ulna.
THE BONES OF THE FINGERS.
Each finger bus three l>jnes or phalanges, but the thumb has but two (Figs. 128 to 131).
These are designateti as the j)roximal or first j)halan.\, the middle or second phalanx, anfi the
distal, terminal, ungual or third phalanx. The thumb has no middle phalanx. The phalanges
diminish in length a> we pass towani the finger-tips, so that the terminal jihalanges are the
shortest, and the longest ])halanx is the proximal one of the middle finger.
The phalanges are long txmes com[K)sed of a proximal extremity or base, of a sliajt, and
of a di.stal extremity or Iroelilra. The bases of the j)roximal phalanges have concave hemi-
sjjherical s(Kkcts for the heads of the metacaqial Ixmes; the articular surfaces or bases of the
remaining jihalanges |)resent a double concavity sejjarated by a metlian elevation.
The shalls of the phalanges have >har]) lateral Ijorders, and their dorsal surfaces are con-
vex, their |)alniar ones ])lane or slightly concave. The short Ixxlies of the ungual jihalangcs
terminate in a rouL'li horseshoe ^ilaped expansion, the uniiiial tuberosity (Fig. 1,^0). The distal
extremities of the jin.ximal and middle phalanges exhibit small fos.sa', similar to those u])on
the heads of the melacariial 1joik>. for the altachtmnt of ligaments, and tlii' nutrient canals
run towani the finger-ti])s, in an opposite direction to those of the other bones of the extremity.
The jihalangc'' are (leveloj.. d like the nuta. ari>al bone of the ihundi, each phalanx luing ossified from a (enter in the
shaft and from an t-piphyseal (enter in the proximal extremity; there are no centers for the viistal ends. The proximal
phalanx ossifies lirsl (third month) and then follow the middle and the terminal phalanges.
THE SESAMOID BONES.
In addition to the lH)nes jirevioush' described, the hand also contains a \ar)'ing number
of sesamoiil bones. Two of these are constantly found at the metacarpo]>halangeal joint of the
thimib, and occasionally others occur at the simihir joints of the index and little fingers, but
in the latter situation they may Ix' replaced by fibro-cartilage. In the thumb they are usually
covered with cartilage ujion one side and are connected with the articulation. There is also
usually a sesamoid Ixjne at the interj)halangeal joint of the thumb.
THE SKELETON OF THE HAND AS A WHOLE.
The metacarpal and ])halangeal Ixjnes do not lie in one ])lane, hiil form a curved surface,
convex uj>on the dorsum and concave in the palm; in the metacarpal region this curve may
.mmmnsim^mm^^m'
THi: SKKI-KTON OF THK I.OWKR KXTRF.mTY.
')3
be. consi,lc-rably increas«l or diminished by th. muscles of the hand. I he convex, y of ,ho <ior.a
surfaces reaches i,s highest point at the metacarpal 'K>ne of the .ndex-lm^er and r<,m th.s pom
deelin.. graduallv toward the metacaqml Ix.ne of the little lm«er and abruptly towar.l that
of the thumb. The so-called dor«U surfaces of the metacarpal U,ne and ot the two phalanges
of the thumb are .llrected externally and th.ir lH>rders, instead ol d.eir surfaces, are conse.,uentlv
din te,i toward the dorsum of the hand. The -lorsal .urface of -he metacarpal Ix.ne of the
little tin XT is also directed somewhat toward the ulii.ir side.
Wl- le the inelacan)al lx,ne of the inde.x-tmger i. -In longest, the- phalanges of the middle
nnge .re longer than those of the index-fmger, so thai the middle linger is the longest hnger.
The I .h: es of the ring-fmger are also longer than those of the mdcx-lmger.
in corr, ^pondence with the functions of the- hand as a prehensile organ the hngers are
well u -loped aa<l take up almost half of the entire length of the hand. 1 he length of the
can:'us 1. ' "out onc-si.xth of the entire length of the hand.
THE SKELETON OF THE LOWER EXTREMITY.
The Pelvic Girdle.
The pehtc girdle consists of the two innominatr boms and in contrast to the shoulder girdle,
which is closed anteriorlv onlv, it is also closed posteriorly by the articulation of the mnommate
bones with the sacrum. ' The connection of the bones of the pelvic girdle is also much firmer
than that of the Ixmes of the shoulder-girdle. Together with the sacrum, the two innominate
bones form the hony pelvis.
THE INNOMINATE BONE.
The inn.minale or coxal hone (Figs. 132 to 134) is :i single bone in the aduU only. In
the new-born and until the age of puberty (Figs, i ' ", and i.^^') it consists of three tones
sc'parated bv cartil; {svnchon.lroses)-the iliuw, the jyuhis, and the isrhuim. .Ml three
bones are in contact in the acetabulum and unite at about the age of puberty to f^m the
innominate bone. The portions of the ilium, pubis, and ischium which unite in the aceta-
bulum are the thickest i,arts of tin ir respective liones and are designated the hodtcs.
The ilium forms the iipjier portion of the innominate Inine; it is the largest of the three
Iwncs and forms the upper third of the acetabulum. It consists of a body an<l ol an uj.per
jKirtion or ala. . .
The pMs forms the anteroinferior portion of the innominate Ixine and the anteroinferior
third of the acetabulum. It is separated from the ischium by a large foramen, the obtnrnUw
joramin, except at the inferior boundan- of the foramen, where it is attache.1 to the ischium
by a synchondrosis which disappears Ixfore the age of puberty. It is composed ot a body and
_f jwo rami. Th<' superior ramus ^Fil' Mt^ ^orms the upper lK)undar\- of the obturator fora-
men, the injerior ramus, the anterior one.
The ischium forms the iKistero- inferior ix)rtion of the innominate Ixnie, the ])ostero-
inferior third of the acetabulum, and the inferior and posterior Ix.undary of the obturator
94
IS !
I? t
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fio. 132.— The right innominate bone seen from the outer surface (i).
p,f!^ i33.-The right innominate bone seen from the inner surface (i).
forair.en. It is composed of a body (Fig. i.u) and of two ram,, a superwr and an inlerwr
ramus which, like those of the pubic bone, font, Ix.undaries of the obturator foramen
"; the a. ult innominate l.-ne the thickened and somewhat const r.cted port. on o the bone
u,K.n whose <,uter surface is the acetabulum, gives off a U,ny plate, the ala of the .hum F.g.
^r" which passes upward and presents an external convex an.l an internal concave sur ace.
Hciow and in front of the acetabulum, the middle portion of the U,ne sends out a seeon.l plate,
which is „erforated bv the •)bturaU.r foramen (rami of ihe pubis and .sch.um .
rie'ala of the ilium (Fig. 1,7) i^ shaped like the horns of a buck, -t -t Uu^ t.ps n
the ,.id,lle it is fre.,uentlv as thin as paper. Us superior marg.n .s markedly th.ckened and
^:; and is known Is the en., of the ilium, and upon this crest a. "^-^;""^^ 'r;;:;::^ ^
b. 'he attachment of the alxlominal muscles. They a>e most .l.st.nct .n ,he m.ddle of th .1 ac
crest where it is thickest an.l reache., its greatest height, and are terme.l the cMer„J, the
intenwl. ami the »»;</<//<• //7>.v of the crest (Figs. .,^^ and .,U'- . . ,_.
Xna.riorlv the crest of the ilium end> in a spine, .he aulrri.r su!>,nor sp.nc (F.gs. ,,. U.
,U)' and at the ..osterior extremity of the crest there is another less pronounced sp.ne, x\u- ^os-
X superior sli,. ,Fig. .,... helow the posterior superior spine, and separate,! from ., by
a shallow notch is the pos.rior u,,r,or spnu, an.l l.tow ,h.s tin; l---;;.--^- <; ^
innominate Ix.ne presents a deep paralx.loid noUh, .he ,reat saaUc notch ,l-,g. ..,2,, .ho
Tpper lx,un,lary is' formed by .he posterior margin ..f the ala, and .ts antero .n.er.or one b>
ihe Uxlies of the ilium and isdiium. ,,,■,• ■ •■ . 1
Below the an.erior superior spin. a. the anterior Ix.rder of the Ixxly of .he .hum >s s,.uated
Uu. Irior inlrrior .pin.- \v^^. ... .0 „4>. ^ i> pla-i a, a greater <..s.ance ..m t e an er.-r
.u,,eri,.r spine than .s .he po.teri..r inferior from .he p.,>ter,or super,„r one. and .s s„ua,c,l >m-
media.elv alx.ve the uj.per and anterior margin ol .he ace.alndum.
T ;e^.ernal ..riue of .he .,/. of .he ilium , Fig. .,.. is rough and convex and presen.s
,hree .ouuh line^ which indica... .iu- area, of origin of .h. gkKeal mt.de. 1 hese h.ies are
'cM«nat.d as the posterior or sup-rior, the ani.nor or nuMr. an.l .he ,„/,n,>r ulu.eal l.nes.
Th ...... ,iur giu..'d line i. alm..s. v..r.i,al an,! run^a.n.s ,he p..s,..rior por..on .. th.. ala
'f h ilium .0',,.. upper l.un.lary .,f .he gr.-a, .,a.i. no,.h. and .he .nal. an. - u- ,u ,
• . .• 1' .1 .....ii-iw nil V eius mu- . !.• ani tun ns ikmii
^^hi.h i. l-ninds giv.- nng:n to a por.ion nt .l,r glulau^ niaMiuis mu
"""•;•;;::;;::.,..„ .i,. pa.... ...kwam ,n an ar.,.., n,am..r f ,he an,..ri„r s..per,or
..i... i, i. a. .,rM almoM h„ri.o„,al, .hen mark ver.ieal. a,i.l .r..ls near ,h. ..oen.-r hn. a
,-!,;. upper n.arg,n of .iu gr.a, ..ia.u f-ram.n. The ..rfa.e of .he ala .n.h,de.l U.ween .. an.!
the superior line gi\... ..rigin ... the glut., u- m.diu. mus. 1... , . ,.,
The inferior lin.. ,- . • Toi-lerabU s.,.,r.er .han .he an.eri..r -me. 1. ...nmum..- lH..we..p. .h.
.„U.ri.,r su,K.n.,r and a: ..ri-.r inferior ,.ines an.l pa.-s..s ba.kwar.l ah..., hor....,,.a v ab.,u^
,h.. a.e.abulum to the middle of th. great .ciatU foramen. It .s but ^hgh.ly curv,,! and .> ap,
^ ill flip ill ^Jili
Il I
! ■
|l|
THE SKELETON OF THE I.OWES EXTKKMITY.
O'i
to Ix' ihc least distinrt of the thri-c lines. The surface included Ixtween it and the anterior
gluteal line )<iMS oriijin to the fjluta'us minimus.
The inner surface of the ala (Fij,'. i^i,) is composed of two portions, of whii h the larjjer
anterior one is ^iii,'hlly e\ca valid and is known as the iliiK jossii, while tht' posterior one is uneven
and is furdier ^,ulxlivided into two areas, an antero inferior one, the (iiirjaihir siirjua (Fi^. i.Vs'-
for articuUiiion with the similarly named surface of \\h- sacrum, and a i)ostero sui)erior .xtrenielv
rough one, the liihrr.tsily c/ Ihc ilium fFig. i iSN "'I't'i (<>rresi)onds with the >iniilarly name<i
surface of the >;Krum. At the Ixirder of the auricular surface there is a distinct gr(K)ve known
as the fiaraf^Unoiilal !iro(Ki i Fig. i.^,',i.
The iliac jossa, th( middle of whiih i> fre'|uently as thin as paper,* i> sei)arated from the
remaining iKirtions of tlie innominate Inme (the IkkK of tiie ilium, the juihis, ami the is( hium I l>y
a line which is continued ui>on the jiubi- and is known a-, the .iniuili- liiir ( Fii;. i;;i. I hi>
line forms a jiortion of the divi.ling line ix'tween the true an.l tiie false pel\i^ the Irrmiiui! ulio^
prrtininl) liiif, and is con>e(|uently also known a> the ili.r.- jiortion of the terminal line.
The body oj III,- ilium forms the upi-er portion of tlie adtalnilum (see jiai^e o'n and a por
ti(m of the ooundary of the great siialic notdi. It i> dinttly (ontinuou^, jiariit uiarly upon
its inner surface, with the ala of the ilium alH)vc, and in the adult with the lx)dies of the pubis
and isf hiimi Ik'Iow.
The pubic bone is intimately connecte<l by its Ixxly with tlu' ilium and with the ischium,
and form> a portion of tlie acetabulum (see ])age ()6!. .\t the juiK lion of tiie Inxlie- of ilu- pubis
and ilium then- i> a low rounde<i elevation, the iliopr, linnil rmimiin- (I'i.u. r v^'. "hi. Ii l« longs
to iKilh Ixines in llie ailult after the ossification of the s\ ni hondloM-.
Passing downward anil forward from the Uxly of the pubic Ixnie i- tin approximately
three sideil superior ntmus (Fig. i;,;>. "'i>''i '^ praitiially hori/oiiial, an<i forms the upper
lK)undar\ of the obturator Coram, n. Its anterior .Air.inity, whi. '. al>o gi\c> origin to the
inferior ramus, iiresenls an oblong surface, tii.' \vm/>/;y,N/.v (Fig. i.^;i,for arli. idation willi the
Um* of the op|K»ile side, and tht anterior surface is directed forward and oiiluard, ih. iiilc nor
one inward and I'orw.ird, and the iiostcrior one tow, ird ilu inti rior of the \»'.\\-. I he upper
l)order presents a sharp edge, the <r,si of th. pubis iFig. i,^s'- ^^1''' '' represents tlie . oiitinu.it ion
of the ariu.ile- line of the ilium and is the- pubic portion of th. iliopei tineal line. 1 h. . r. si t. r
minales ,int. riorb m .1 small proj.-. ti.^n situated alKuu a Imgetbte.t.lth from die s,inpli\si, .ui.l
known as the /i//'(n/, or e/)/»e of liie pul)i> (Figs. l.;-'an.l i,U ■
At the- juneiion of the superi.ir ramus with llu' IhmIv of ilu p. ibis ilie p.ist. rior or |«l\ie
surface of the I Mine presents :i broa.l sl,,ill,,u gr.H.vc, tin ohiiir.ilor aroov, ^ I'ii;. 1 ;ji, wIihIi ^ra.lii
.illy fades away .is it jiasMs inwar.l upon lii. interior surfa.i- l.iwar.l the ,,|ilur,it.a loranien.
1 he sharp ridge which forms the inner iHHindary of the' gr<M.\e- is '.nowii as the ,<l<lur,iU>r riilf;r
(Fig. i.^n.
The obturator gnwiv. is usuallv Iwiiin.le.l in front ami IhI.iw by a jinMis, diricied |..wai.l
thecibtiirai.ir foramen, the anlmor obiur,ili>r liilurn, il'ii;. 1 ;<i, ami a jK.-ti-rior iK.umlarv i-. some-
limes furnished bv u p,isltri»r obturator liih' r,l,-, win. h arises from th. i- liium .iinl is .ilse, .lin e t. .1
' Simirtimis llier.' i~ .1 (•■ramin in tin- snu.ilMm
96
ATI.AS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig. 1.^4.— The rifjlit innominate bone -^Tn from in front (J).
Fir. r.jj. -The rishl innominate l»,ne <^ , (,., or six-vear-ol,! . hiki seen from the ^nner surficc ' ■ )
rio. I {(). /lie same seen from llie outer surfa '';
toward the obturator forannn. Bd.Min these two lulxTcles is .strct. iv.ri the upper manrjn of
the ojjtiirator menibrnne (see ])age 129).
The injrrinr ramus of the pui.is is Hatter an.l i-ossesses but two surfaces, an anterior and
a posterior or pdvic surjar, . It pas.ses obli<|uely downward -..m] outwani from the symphysis
an.l i> ronnerted with ihe inferior ramus of the ischium at the site of a slight eonstri.tiun.
The ischium is shaped \er) nnich hke the pubis, and in the adult its fxxlv is intiiiialelv
connected with those of the ilium and pubis. It f,,rms the antero inferi.,r Ixnindai^- of the
^rcat saatir noUh. and in this situation j.resc'nts a shaq) triangular projection, the spiw iPi-
132). Hilow the si)ine i> ;,ituated the hssvr snatic nolch, whi. h is not .so deep as th,- ^rreatiT
one an<l is forme.1 entirely by the ischium, its inferior lx)un<larv Ining furnished bv th( 1 irge
rough tuberosity of the ischium (Fig. ,32), which forms the main portion of the outer surfice
of the superior ramus. From the tuIxTosity, the thin flat inferior ramus pa.s.s<.s for^var<l ,an.l
upwanl (iMg. i;,4). forming almo.st a right angle with xhv .superior ramus of the ischium To
gcther with the inferior ramus of the pubis, it forms the lower lK>undar\- of the oi.tunor foramen
The acetabulum (Fig. ,.,2) is formal by the Ixxlies of th.. ilium, pubis, and ischium but
dividing lines Ixtween its component portions are visible in vouthful individuals onlv It is
a hemis,,hencal cavity with elevatt.l margins l.K.king directlv outward, an.l onlv theanterior
inferior |H.rlion of the margin toward the obturator foramen is incomplete; this gap is known
as the tiiilahuliir or cotyloid iiotrli.
The ll(«.r of th,. acetabulum is cominrsed of two dilTerentlv shainnl i>orlion>. 'Ilie larger
portion, the srmil,n„ir surjace (Fig. ,32). is sm.K.ih and covere.1 with cartilage; it forms the
upper and lateral portions of the cavity and eMen.ls downwar.l to the U>rders of the cotyloid
notch. Ihe remaining .|ua<lrale area ...mmenc.s at the lx)nlers of the ac.tabular not.h- it
:- rough and uneven and is known as the .intdbiihir jossii.
The obturator foramen (Fig. ,.,4) is a large ..pening. the shap<. of which is subject lo
considerable individual vari.ition; it mav Ix' either oval or triangular, ii, long.-st diameter Uirg
transverse, in some cases and vertical in others. Its JK.rders are t..mied bv the r.mii of the
-s. hium and of the pubi,, and are for the most par- sharp, being Hat onlv where llu- ob.ur.itor
groo\c' runs into the- foramen.
«n.l .n. or h. |.u1.k I I„ , ...mr f„r tl,.- ,l,um ,|,,K..rv (n .1,.- ,,nr„rn,...t ,:.r„|.,«. ,„ „„■ u«in„i„K .,( ,1.. „,i,.| f., .1
momh .,:. U,r , c ., h.u ,.. ,H.,inni„K ..f -h. fourth „...mI,, h... for ..... ,. ,„ I ftf.h ,„o .„ , ,
i". :x;;' • v",;""r""'-.; ' "" '" ""■ '""-• '"• "''"■"'^"^- ••' -"^ '- '""- -" "■•■ ^!-'- '-' "- - -'-^ "
ZuZm!"] " T '"" '"' ""■ '""'''^ "" ' ■' ""'"^"'"^ "-"■'' ^-'^ '■•'--'■ ^" '"•• — h '" .i«h,
*o.,.u of .,..,,.1 „u.nno„ u, o,„. a' • ..„• ..„,..■ , „.,, of ,!,.. ...un,, o,,.- ,„ „„. ,uU.r..i,v of th. , , hi.,,,, .,n,. i„ Z
in of
r ami
>llVS!S
.15.
1 '
tn
h
1
i
!
1
THE SKELETON OF THE LOWER EXTREMITY.
r:;t .,:::; ;t':::,:;:::: "'r :;;;;;*:rr-, .,* ,... ... ,..„. ,., -n -■ - -• -
to the twenty -ftllh year.
The pc-lvis as a whole is considered upon page 130.
THE SKELETON OF THE FREE LOWER EXTREMITY.
THE FEMUR.
The Innur (Fi.s. :,- to uO is the lar.es. l,n, bone of the human 1h.1v, and consists of
a sut»ru'r cx,rn„i!y, a ./,«//, and an inirri,.r ..Irr^.y __^ . ^^^^^^ ^ ^^_^^,^
Ix'low and to the inner side of ine niuKlit 11 i„. 1,1 •
.,„ „l,li,,u..lv ,n,n,-a..,l cylin.Ur, .1,. sui^Ti,,, l..r,l,r l.ms »!-"• " ' ' ' " ; ^ , „,„„.,
„„,, Th, „«.r «m-milv „( 111.' I«.n,, M il,o marpn ,.l .1... n,.,k. | a. •..■..« i»" lar... u. n,
uni. 1 ni ii^nr t.Miwiii, -iiiii hill, ni ol nanuroii.^ mux U>.
The LT-,.'- /r,.. //<;»/. r is amsi.leral.lv larger than ihe K.s>er one and ,. M.uaud cxU n.tllv , n m
rV^ : .. .r ponion of the superior ex.reniily of ihe fenu.r. 1-^ h.hli. curvt-tl ='I-, ' ^
;,:„„,„,;..,, .hi.h ;.. ...nip..sed uf uw di.in.l l>p. .n .H„r :,nd an ,.M .
";;;,,;;, ,„U,:middU „f,h.. >..,„.„ ,:„,.,.. U appn.MmaUd,ln,nl,ven.., nd i>..n,
. in 111. (.m;,le the :.nRle .MM'^' ''■ ' •• "K>" """'■ , , ,, ,, ,., ,,„ „„„
, The intent- l„ n -- ..-^ ■.■ u-i ,.■ ... ,e--..t ,„.,.,, t,.,u, „. - .-..:.,.
the im, a asjura
i,!...f
98
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig. 137. — The riRht femur seen from behind (f).
Fig. 138. — The right femur seen from the inner .>;urface (%).
139. — The right femur seen from in front (J).
140. — The ujjper end of the right femur seen from behind (J).
141. — The lower end of the right femur seen from below (J).
Fig. 142. — The patella seen from in front (}).
Fig. 143. — The patella seen from behind (|).
Fig.
Fig.
Fig.
the upper and the lower extremity of the bone, passing toward the trochanters above and to the
epicondylcs below.
The outer li{) of the linea aspera passes upward to a long broad elevation, the f^luteal luhcr-
nsity* (Fig. 140), which is usually tlat but markedly roughened, and receives the greater fwrtion
of the insertion of the gluta-us ma.ximus muscle. The intem.al lip becomes less distinct as it
jiasscs u])ward and is continuous with the intertrochanteric line. Parallel to the ui)per part
of the inner lij) and somewhat to the outer side of it is situated a second rough line, the pectineal
line (Fig. 140), for the insertion of the pectineus mu.scle.
Toward the lower extremity of the femur the two lips of the linea aspera gradually diverge
and fomi the lx)un(laries of an almost plane triangular area'ui)on the [xjsterior surface of tho
l)one, the fx^pliteal surjtue (Fig. 157). Upon the line, above its middle, there are usually one or
more nutriint foramina which lead into canals jjursuing a dis'inct upward (proximal) directi(m.
The sliajt ol the femur exhibits a distinct curvature, which is convex anteriorl\ (Fig. lyy),
and ujKJn its anterior broad pt)rtii)n there may be distinguished an antero-inti'rnal, .in antero-
extemal, and a ]K)Sterior surface. The linea aspera furnishes either the origin or the insertiun
for a large number of muscles.
The iiijcriot rxircmily of the femur is ver}' broad, and jiresinls two convex ciikMcs
I Fig. T37I, a larger inlmuil londyli- and a smaller txlrrnal condyle, which are directeii |h)s1i ri('rlv
and are separated from each other by the iulcrcomlyluid jossii, an inlrrcondyloid line se|..ira'ing
this fos.sii from the popliital surfaci. Anteriorly 1 1'ig. i") the cartilaginous surfaces of both
(ondyles are <i)iitinuous with an artiiuiar surface, the punUar siirjitir. which is concave from
.-^ide 111 side ami convex from alxne downward, so ijiat the entire articular surfiue of tlu' lower
end of the fcniur i> shapi<l sonuvhat 'ike a horses'-oe. .Mhjvc the conu\'.s upon llu- latiial
>urfaiis i>f the lower end ot the bone are -ituated two rough and slightly ijrcniinen; processes,
the epiciiiid} les 1 Fig>. 1^7, !,^8, and 141 I, whicli are lemieii tile Inlirniil ij>iiondyle and the
ixlcrihil ( picoudyh . The lowir portions of the lips ol the line:' asjH ra run downward to the
cijicond\le>. wiii. h gi\i origin to the ga>l^u^llemiu^ muscle.
I.ikt- liii'^i "I ll" I'lii^; Ikiiii-. ilif I1 iiiur i^ iI>mIi'|i,,| (rojn .1 ni.iplnM .il .mil l»i> [iriiii.ir'. i|n|ilnsiM| c riilrrs. Tli'-
ciia]ili\-i .il • ' iiu ; iiiipi .ir» .1- r.i'l;. .1- tin- -ivrnihunk of .tnlirvciiii lifi . .inil \\U\U ilir Ii>wir riiiplnsi'al ici.lir
I- u»u.4Uv vi^ilili- .tl litrlli, l!u < riiii r lt>i tlu- hen) ut ilti- ti-titur ilm . tint ,i|>| r.it until .itirr tli, 1)1 i.tt tlu- rtut (if
(lu- nrsi vi'.irK \i a ;att r {m ri'Ml *[Miia! rpiphy-it al • cnUTN a|ijMar iti ilii ^*r( alt r fr-.hanlti ifourtti vciri .iiu!
in tiir loMT triH haiitrr ■ tlintii-iiih 'n fnurtrrntn vrar*.
Mlliiiu^l! Ilii 1 tfUr! fur tlu I«^>', r inulianliT aji,ic.ir^ !alt r iti.in .vw nf iIii- oiIut «pijilu>«al « i iittT-.. it i-. ii;r
::■, rjrv.-r-;- :r:t-' a :. -^r
jT'T!--u::ir.! ;-r--j:-i !:■■", ihi
Ilind
(jmit tmiiiiiii/ir Dninssici: on hcnit
Nirlt
(iniil tiiulumlir (imt! imhiintir
(111 lliilil
Inltifhil
Inliitrodinn-
Irrir liiif
I csser
Innluinlti
liitiiiitil rpiit'iitlylf
/ V
Irnii
I.' , V/l/|/(
In cnwl
liilrn i
n,!v
l'i(f /ilSM.
Inliiivi'dv
'lUll I'illl
Ins- Ii7
Piitilliir ^niiiiii
f'hs Jin.
/:- ns.
•Jfjrr.
i !
i ,
Head
I'littUar siirfiii-e
,W,rk
(heat troilnintir
/
fiximiii! :/
f/)iivi!((vlr •§
J»>- 1
Inlmuil i\rtineiil liiii
'■/"'"'"''■''■ hiinr lip oi
liiiiti iispfni
Li
/ XlillKll ^H
Intmviiihiiml Ji'ssn
hi>r. 141.
InliTinil nmdyli'
liiiirtivilKiiilmc
tnnlutntir
li<r. 140.
Oliilivl
tiilnivsilY
Oilier lip
ill' liiirii
ii-'/iiiii
i
JidSf
fiasf
Api:\
liiT. 142.
Apr.f
Aiticiiliir siirfiiir
hi'. 14 i.
i
mmm
THE SKELETON OF THE LOWER EXTREMITY. QQ
first to unite with the shaft of ihr fimnr (seventeenth yearl; then fcillmvs the union of the titichanter majnr, then
that of the heail of the femur, and finally (at the twentieth year) that uf the lower end of the f.miir with the
shaft of the Ixine.
THE PATELLA.
The patella (P'igs. 142 and 143) is a Hat, rounded, disc-like bone whieh is nothing more
than a large sesamoid bone in the tentlon of the (|ua(lricei)s fenioris muscle. The ui)i)er Iwrder
is broad and is call( the base, and the lower jwrtion of the Ixjne terminates in a point, the apex.
The anterior surface is rough; the j)osterior is smooth antl covered with cartilage for about
two-thirds of it.s extent, this cartilaginous .surface being ai)i)osed to the iialdlar surface of the
femur and known as the articular surjacc. The posterior surface of the ajiex is not covered
with cartilage and is rough like the anterior surface.
The patella is formed from a single i enter uhieh dixs not ap|>ear until the fourth year. Ossification is not
comfilete until after pulxTty.
THE TIBIA.
The tibia (Fig.s. 144 to 147 and 150 to 152) is the inner and by far the larger of tlu two
bones of the leg. It is composed of a superior extremity, a sliajt, .mil an initrior extremity.
if
'\
■ \i\
I
I
internal bonJer
external erest.
/ f . \ ,' antrnur erftt
[<}' inteh.-i5cous
errs/ tihin
Flc. 147— .A .section of ihe Nines of ihr cms taken at alnrnt the middle- of iluir IcriRlh isc h. mali/ed).
The superior extremity is tlic thitkcsi portion of the lM)nc. It jiresents two condvits
(Fig. 1511, whiih artiddale wiih tile lower end of the fmuir, and are knov ,■> the internal
and external eondyhs. They exliihit ui)on their upjier siirfatis two roim<led, Iri.ingular, sliglillv
coniave areas, the internal and external superior artiiular surjacc, for the femoral condvles,
whose Kmiavitits (espeiially that of the external one) are mnsiilerablv less than the toinexities
of the femoral condyles. These areas are .separated by a median elevation, the inter, on<l\'ioid
cmineme or spinous process, whit h presents two small tidnTt les, the internal and external
i'llrrconjyioiil tubercles, and in front of and Inhind the niiinence are small shallow deprosions
which are known respecli\el> .i> the anterior and posterior inlcrcondvloid /ovv- (Ki.,,r. i:;,).
The artitular r.uffacer, arc iKnindcd by the aln ^.,t Veriicai ijuii> niaigii. ••■ liK- upper i mi
1 1
I
lOO
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Flc. I44.'-The ris^ht tibia seen from in front (5).
Fi(.. 145. -The rii;lit tibia seen from behind ( = )■
Vii. I46.-Tiie riyht tibia sen from the outer surface (s).
p„. ,48.— The right nl)uia >een from the inner surface (s).
Fio^ 149.— The right tibuhi seen trom the outer surface ( = )■
Fig i<;o-The til)ia and fibula seen from behind (p.
F,r." , .' -The upper end> of the tibia and f.bula seen from above (\)
F,,' ,^ -The lower ends of the tibia and fibula seen Irom below (i).
osily (FiR. .44). The entire upper end of .he t.l.ia is bent sl.ghth backvNarcl
of the Ijone (Fig. i4''l- , . ..^ Tt ;< iViirU it its iunction
The shajl of the tibia is of a distinctly triangular pnsmat.c form. t . thick "^^^ J^^
.. .e ..,>^;;-^;^->. - -; -;;r:: r—:^ "tde: ::d z:j.
T Tr'";an nU., o ^.i Fi.'. 4. --e.hat S-shape.l and beginning at the lower
Mb in^ c '1 .1.0 i^rrual and ,.lrrnal surjacc, while the e,uall>- shaq-
n.arg,n of ^'^^. ^^T^';:^^^'\^ ,;,,,,,, ,,,,„, „u. nbula (Fig. 147). is si.ua.e.l between
;;::=:;:? ^.Z:::^:' W third bord.. . .he ti... is .unded; . separate, .he
S£SSS3iE =====
*'»*■ "■^' '" "• "■ ;"•■ "'T' 't'l", :::;'" »:^ ;;;r;::;;r :;.".;; i':,i-»
licit bcini^ covered with cartilage
f'xtcnuil
Infrtif^liiioid
miirii'i"
Iiitirnal
IntmomWIoid nninaiiY Xninihr s„rf,„r
lor Jilnitd
Superior „
extremity ^^
liilinm! (■■ukIvIi
liiUrmd siirfdCf
I'oplihvl lini
I ibiihir y^. .»
notill
Inlirior iirliiiihir sinlihY
lio. 144.
hiltrihil
niii/livlii'
(hvovi- ,<>i iiilri/ui/ iiiiillivhi'-
n>'. rn.
i'.xtinml
sinldcr
Shaft
Xrliailiir sinUiiT
,1/ mnllivhi'^
InlVrior (iilmiliir
■^lllldii
//.'. 140.
Inferior extremity
lii'iii," iiili.llliir -.ll hiic
I I
i.l
i
-. \
A iitciii'i-
crest
Articular s.irface Apex (f-
of head Imid
Superior
extremity
rosterior crest I xteri al ;
creii I
Siitrient
foniincii
Intcnuil siirfiice
Shaft I .^tennil siirfncc
Hani
AiHerioi- Cif-'i
Arliiiiliir
surface ot
iiHillecliis
Aiiiitii:!- iitrriro
f'osterit.r
•iiirfiice
fig. l-fS.
. Inferior exti-emity
I'croiicdl
sulcus
r.r. 140.
I \icnnil
UlllllCl'lu-
:■!.} iJ /I'VMi
Tilhinnlly ol lll'iti
f-ig. IW.
hihiiinl ..■iiilr'liii
/'croucdl
sulcii'^
[iliiiiliii ..iiiuu; 01
I \rirniil ivnilvlf
11,11.1 of III'"'"
Ailiiiilii' ■•"I-
l,i,r 01 i'llrr-
„.il HUlll'OllI'
.]/:r\ 01 Ik'I'I
Inrrrrtiil inlfiroii
tlvlortl tiil'iiilt
I'o.l. nor mtfn-on.Moul /.'-"" ^ ^^_^ ^^, u,U-r,on,hloid Ulhnl.
l„„no, olloolor -'»/.„.■ 01 llho
i-<'. h2.
if I
1!
iiil
Mill
i
11
;i 1
J ■
1
r 1
^
^fttsa
Jd^'...
:;^;r^
F'?^^^
THE SKELETON OF THE LOWER EXTREMITY.
lOI
The diaphyseal center of Ihe tibia appear^ in the seventh week <if emtiryonii life, liul usually several days later
than that of the femur. The upper (proximal) epi[)hvsis ossit'ies immediately before or after birlh. the distal one
not until the iK-ginning of the second year. The lower epiphysis unites with the shaft in the eighteenth, the upi>cr
in the twenty-.seeond year.
THE FIBULA.
The fibula (Fiffs. 148, 140, 151, and 152) i.s a .slender bone, and although its upi)cr extremity
is situated lower than that of the tibia, it is but a trille shorter than that lK)ne, since it ])rojects
below it (Fij^. 150). It is situated ujmn the outer side of the leg, and is composed of an upper
extremity, a shajt, and a hr'vr extremity. The sujjerior e.\trem-'v is formed by the head (Fig.
148), the inferior by the external malleolus. The head is dist..K v thickened as comi)ared with
the slender shaft of the txiiie, and its upjiermost j)ortioii, whidi is t ,e( ted outward and somewhat
backward, is known as the apex. It jjresents a small llat articular facet (Fjo. 148) for articulation
with the tibia.
The sJiajt of the fibula is of a distinctly triangular ])rismatic form, and its three surfaces are
ir'i rnal, external, and posterior (¥\g. 147). The three Iwrders are very sharj; and do not ])ursue
straight course on account of a distinct torsion of the lower end of the bone alxiut its longi-
tudinal axis; they are known as the anterior, external, and internal erests, the anterior crest
separating the internal and external surfaces, the posterior crest tiie i)osteri<-r and internal
surfaces, and the external crest the ])osterior and external surfaces. The inn surface also
presents a feebly developed border, the interosseous ridge (Fig. 148), so that the libida may \k'
said to |x)ssess four Ixiniers. The nutrient foramen is situated slightly alxjve the middle of the
posterior surface and at a lower level than that of the tibia; il leads into a canal wiii(h is
directed downward
The tibia and the nbula have, therefore, different relati<!is than do the radius and the ulna, a
surface of the fibula (internal surface) being directed toward a lK)r<ler of the tibia (the interosseous
ridge), and the similarly named surfaces of the two Ixines do not lie in the same planes (Fig. 147).
The inferior extremity of the tibula is formed by the external malleolus, which !:. longer and
more iminted than the internal one. Its inner aspect i)resents a llat articular surface (Figs. i.j8
and 152), which is immediately contiguous to the inferior arlitular surfaic of liie tibia, and its
external circumfereme is marked by a shallow groove for the tendons of tiie two jieroneal muscles
(Fig. I4()). .\longside of the articular surface there is always a de[>ressi(>n for the attachment
of ligaments (Fig. 148,-.;:).
'I he dia[iliyseal i enter of the fibul.i appears somewhat later i that of ihe tibia (eighth wi'ek of fetal life), and thi-
epi[)hvseal centeis develop at a cimsi<lerably later period, the ini' nor in the M'Cond anri the ..iiperior in ihe third or
fourth year. The inferior epiphysis unites with the ^h.ifi U-fore the supirior, .1^ i- the i.i-r in Ihe tibia, but ihe uincin
of .h cKcurs later than in the tibi.i-
THE BONES OF THE FOOT.
The skeleton of the foot (Figs. 15,:; to 155), like that of the hand, consi.sts itf three divisions,
the tarsus, the metatarsus, and the plialanf^es.
i
0' r» .-:-fi.i' ::\i.
I02
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fio. IS3.-A frozen preparation of the bones of the foot seen from the plantar surface (|).
Pij, i54._The same prepa.jtion seen from the dorsal surface (|).
pjg i55._The same preparation seen from tlu outer si(' ■ (5).
Fio. 156— The right talus (astragalus) seen from below (i).
Fig. 157— The right talus (astragalus) seen from above {\).
THE TARSAL BONES.
The tarsus (Figs, m^ to i^s) consists of seven l>ones. (i) The talus or astragalus: (2) thc-
calcaneus- (x) the navicular or scaphoid bone; (4) the cuboid tone; an.l (5 l<> 7) Uwcxfrnat
middle and inlerml cuneijorm bones. Only in the distal portion of the tarsus, where the cuboid
articulate, with the three cuneiform bones, is there an indication of an arranger, 'in nws as m
the caq.us, and in further contrast to the hand, a single tarsal bone articulates wi,h both bones
of the leg, while the can)us articulates with the radius only.
THE TALUS.
The talus or astra<^alHS (Figs. 156, 157) is ^ short hone, irregularly cuboid in shape and is
composed of a bodv and of a head, the constriction between the two being termed the neck.
The bodv IS the thickest an.l most posterior portion of the bone. Its upper surface presents
a cartila-^inous trochlear surface, the trochlea (Fig. 157), -ith which the tibia and fibula articulate,
ami it possesses three .surfaces, a largo superior one and two smaller lateral or s. The superior
surface i. convex in the longitudinal (sagittal) axis of the bone and concave from side to side; it
is broad anteriorlv and narrow posteriorly. The lateral surfaces are ahiiost hat and approxi-
mateU triangular, the external one being much larger than the internal. The externa surface
is known as the external malleolar surjaee; it forms the outer side of the astragalus an.i is a,n-
tinucd upon a strong process of the bone, the external process (F.gs 154 and 156), which is
directed outward. The internal surface forms a part of the inner side of the astragalus, he
remainder of which is rough, and is terme.l the .Uernal malleolar surface Behin.l the trochlea
and directed backward is the posterior process (Fig. 157^ which is notched l^- a broad groove
for the tendon ot the flexor hallucis lonRUS.* The lo'^rr surface of the bone (I-.g. 156) presents
a <listinctlv concave, abnost transverse, ovoi<l articular facet, the posterior articular facet, for the
calcaneus,' whose outer portion lies upon the lower surface of the external process, while its inner
and posterior portion is upon the correspomling surface of the posterior process.
In iron, of this articular facet is situated a broad groove, the sulcus tab (fig. 155), which is
wider externallv than intemallv ami the floor of hich is roughened. Together with the similar
groove of the calcaneus it f,.rms the sinus of the tarsus, which is Idled by ligaments.
In the region of the neck the lower surface of the astragalus in front of the si.u > :ali i.resents
an oblong, ^lightlv • -ex, artictdar facet, i.arallel to the posterior one, and known as the
middle articular facet Un i.e calcaneus, and l.>rdering upon this, and forming a portion of the head
of the talus, is a small, slightly convex elliptical anterior articular facet ,or the calcaneus
(Fi;.;. 156'!.
* Tlicrc mav
„nsrqvK.ntly Ik- ,li.tin«uishe<l upon thr (-"sU-rior i.roci-ss an h,U'r,u,l an.l an cMcrm,l tubercle.
PhMlanges
Meta-
tirsas
Hases of
meta-
tarsal " ■ "
bones
Tuberosity
jf meta-
tiirsal I'
Oroove ''''
tendon of
freronacus
lonfin.-i
I iherosiiy of
filboitl boms
fixternul
timeiform
hone
Tarsus
niiiitiinx III of itiiiit It
I'Inilnnx II i>/ iHii't II
nhiihin V / !>/ i/ZyvV //
\\
llivil el' liilii-'
livchliii of lulus
I'xliriiii! fiiviTS'i
Ol llllll'i
( iilniiirii'i
I xicniul itioiis-' oj tiilurosily
of ailro'iiu'^
fi.ir. li''
liihirosily of ailaiiti
(iiitcniii! pnri's^J
lis/. n4.
J" ■
•■ !i ,: . . I . ' -'■»' if- i-'r Wvrk'i
1
-
1
I
I i
•13
J"
t/5
if
1 it
I -
a
i'^r!.
=1 .li'^'^
THE SKELETON OF THE LOWER EXTREMITY.
lO':
The neck is <listinctlv conslricte.l only upon the uj.pcr ami outer surface; upon the lower
and inner aspect it is not 'sharplv defined from either the head or the body .>f the bone.
The I,ea.l of the talus (astragalus), the rounded anterior extremity of the bone, presents an
ellipsoidal articular surface for articulation with the navicular bone.
Th.. pos„.ri,. ,,r„...ss i, sHm.-unn. an in,l.,,cn,Km U..u; a,„l is Uun ,l..i«n.u,..l as .lu- ,. >.„„..,„. U r,.pr,.s..n,s
uhal is usually an in(l.']KnilaH Urn- in thr lo'vcr viTli-l)raU'.s.
THE CALCANEUS.
The a,lca,„us ,Fi,s. . s8 to ,60) is the largest of the tarsal bones, an.l fornis the postero-
inferior portion of the tarsus. It articulates with the talus iaslr..^.!,.) by nu.ui. o, ' --•■ '™ -
facets an.1 with the cuboid bone, an.l has its longitudinal ax.s .hrected from behmd loruanl and
hli'ditlv from within outward. . , . , , ■, ;
The nudn portion of the Ix.ne is terme.l the b<nly. The ,.osler>or t luckened extremUy .
known as the >ub,n.i,y an.l projects posteriorly far beyon.l the remain.n, bones of -h'' f-'t; > >
plantar surface presents two pro esses or tubercles, the h.UnuU an.l n:lrnu,l proass (1 „. .,V,
a„,l in front of the lulxrositv is tlat and cvere.l by the l.,n« plantar hKanunl ,see pa^e uO-
Up..n the upper aspect' ..f the calcaneus (Fi,'. .60^ n.n be ..bserve.l the three acets f..,
,,„„,;ui.,„ wi,,; Ihe ,alu> .astragalus); they are known as the posUrior, „ud^, an. a,.r,,,r
,rnn,l.,r ja.rls. The posteri..r is the largest an.l is marke.liv convex, the mul.lle an.l an enor
are ^l.htlv oncav.. an.l the anteri..r is the smallest. Th.. mi.l.lle facet hes upon the susten a
.ui.,m tali'. an.l la^tween the nn.l.lle an.l posteri.>r i> a ;.r.>ove, the sulru.s n,lnn,n. winch » wuler
evternallv than internallv an.l. together with the suU us tali. f..rms the si,u,s o, ihr l.nsus
The' mark...llv conca^.. internal surface .,f the cal. aneu> (Fi,. . 58) presents a broac process
,,,^. ,„,,,„„,„!„,„, „li, which projects towar.l the talus ,astr.,alus, an.l bears th.. muldle face,
f.,r arti. ulation . i.h that lx>ne. Below i, is a bn.a.l «r.«.ve. the .lirect contmuati.m ..f > ,t upon ,h..
,K>M.ri..r pnKess .,f the talus (astragalus), kn.nvn as th,. ,r,.,.r,. /or llu //..v.r h.Uuas /,.»,».
\ similar but shall.nver ,r.Hne is situate.l u,,..n the otiurwise Hat vert.cal external ^urfa.e
of ,he lH>ne (Fi..^. . ..... the peroneal s^roov,; ami al.ne this there is usuallv a sn,all blunt pn.jec-
ti,.n km)wn as th. Innlihar iperonml) process.
Th, anterior surface of the calcaneus pa-sents a sa.l.lleshape.l tacet, f..r ar,uula„..n ^^>lh
the culx)i(l bone.
THE NAVian.AR BONE.
The ,u,vieular ..r sraplwi.l In.ne (Figs. .(., an.l .6.) is situat.'.l at the inmr m.Ic ..f the
tarsus be.w...n the talus (astragalus) khiml an.l the three .uneif..rm b-n.s m lr.,nt .1m«s. 15s
.,„d . ; It^ l"ng aNis is place.l transversely to the axis of the f....t, ami i. i^ cmux anter,..rly.
markcllv cn.ax, i.os,eri..rly, ami .listinctly cnv.'X uiK.n its .lorsal surface. Near th.. mner
lx,r.l..r.)f tliei^antar >urfa.e it presents a strong rouml.d/«/«mv//y.
Th.. ...ncave p..steri..r >,.rfa... .>f th.. l.me (Fig. .(.,,) f..rms th.' mm ket for th.. lua.l ..t the
talus (astragalus.; the slightlv ...nv.x anteri.,r surface (Fig. .(-.> exhibits thne facets f.>r ,h..
three cuneiform lx,nes; an.l the external surface presents a small nat inconstant facet for the
cuboid bone.
I
i I
I i
104
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
riRht calcaneus seen from the inner surface (5).
right calcaneus seen from the outer surface (;).
right calcaneus seen from above (i).
right navicular hone seen from behind (J).
Fig. 158— The
Fig. 159 — The
Fig. 160. — The
Fig. 161.— The
Fig. 162.— The right navicular bone seen from in front (
Fig. 163. — The
Fig. 164.— The
Fig. 165.— The
Fig. 166.— The
right cuboid bone from the inner surface ( j).
right internal cuneiform bone si( n from in front (j).
right middle cuneiform bone sccii from behind (|).
right e.xternal cuneiform bone seen from behind (j).
THE CUBOID BONE.
The cuboid bone (Fig. 163) is situated on the outer side of the fool, 111 front of the anterior
extremity of the calcaneus and behind the bases of the fourth and fifth metatarsal bones (FIrs.
133 and 154). It is irregularly cul)oid in form and its inner border is longer than the outer one.
Its dorsal surface is convex, its anterior surface jjresents two articular facets for the bases of the
fourth and fifth metatarsal bones, and its posterior surface is .siiddle-shajied and articulates with
the caliancus. The internal surface (Fig. 16;,) presents a flat articular facet for connection
with the external cuneiform Ijone. and a small inconstant one for the na\icular, and the external
surface is narrow and forms a part of the outer U.rder of the foot. The i)lanlar surface presents
a llatlened tuberosity (Fig. 15,^), in front of whi. h is situated a bro; groove, the peroneal groove,
which is lined with cartilage and accomnuxlates the tendon of the p^ loneus longus muscle.
THE CUNEIFORM BONES.
The three cuneiform Ixines (Figs. Mn to i()()) are situated between the navicular and the
bases of the first three metatarsal U)nes, and, as their name indicates, are more or less wedge-
shaped.
The internal or first cuneiform bone (Fig. \<^) is by far the largest and also the longest
of Ihi three, and it has tiie narrow edge of its wedge directed dorsally, so that its plantar surface
is much broader than the d<.rsal surface. Its internal surface is directly continuous with the
narrow dorsjd one; the anteri.ir s.miUinar surface articulates with the base of the metatarsal
l)one of the great toe; the i)Ostcrior triangular surface articulates with the naxi. nlar Inme; and
the external surface is in conliut \vidi the middle cuniiforin and with the base of the second
metatarsal Itone, and exhibits articular facet', for both.
The middle or second cuneifoim bone Fig. i(>5i is the smallest and the shortest of the
three. The thin edge of its wedge is direUed downward and is almost concc led between the
external and the internal cuneiform Inmes; ii> base forms part of the dorsal surface of the foot,
and its posterior surface presents a triangular articular fai . t for the navi. ular In.ne. The middle
( unciform also articulates with the second metatarsal, and with the external and intirnal cuiu ifomi
Inmes. „ • , i
Thf external or third cuneiform bone (Fig. if/)) is some what larger (especially in length)
than the middle one. Its thin edge is likewise directed downward and its broadest surface looks
Po<itmor nrtiriihr facet
M Ukl 1 1' (lit i III I 111- facet
A ntcriiir articular facet
Articular liicet
for ciilioid
Sa^tciitacaliiiii tan
Anterior articular
facet
Miildle
articular
facet
Sustenta-
culum tali
fi.r I5S. iiroovefor tnuion luherositv
, il"- iZru. Iiii'cr rroccss Of
haUm-is loii-iis tuherositv .
I'ostcrior articular facet
Sulcus calcanci
Middle articular facet
Anterior articular facet
Articular l |
facet for ' \
Articular facet
for cuboid
Sulcus
calcaiiei
Po\terioi-
articular laerl
Hodv
/ 4". it)0.
lulicrositv
cuboid
1 ubcrosity
,. . ,.„, Iiocblciir iiroccss
Outer /aocc^s ' I'nvneal aivove
of lii'ieivsily llfr. IVI.
lifr. 101.
Articulw facel
(Head of talus)
Articular facet (mid cuiiciloim hoiicl
Articular facet
,. ii'il- cnncilorin hour'
Articular facet
I metatarsals l\' and I 1
rig. I()2.
Articular faci't
i,yt eiiiiciliiriu boiiei
Atllittlill Ittirl
(/liiM i'l miluliii':il III
I io. Ill/
,4i riiiilii'- h'i't'f
Iil;. Itn
Articular facet
ie\t euiieiform hoiiei
fll'. I Hi.
Ar^inilii' III'''
.(>/, iU'tfirorni iuinr)
Annul'" I""' .
ii'iiliii l'i"iri ^\
Aili'Ul'ii hurt
I'lll't'lil th"tll
I if,'. 100
I
:. 1
'i !
t-l
u
m
11
i*»-i*
THE SKELETON OF THE LOWER EXTREMITY.
105
..a.! .'^ .0... of the foot. T, .niculate. .i.h .he navicular, cul..!. and .iddle cuncUo...
and v> . the second, third, am! urth metatarsa. bones.
THE FIVE METATARSAL BONES.
r:zt.:-i::i^:'^t:t:.'f::p^^^ -. »...■ »-< '^^
„, ,h. nr,, ,-»«,., a broad plamarpr,,..™,.,, ,1, '"^^''^^^^ „^, ,„^,„„,, „, „„ „■„„
. , f , hi- hisc .il ihr first pr.stnts ;i sint;!' f:i' <■'
inl.rnal un.ifor.n, an.l tw,. lal.nd , u ,H for ,h. .h>r 1 "' ' ■ ■ '^^^' ", „;,„;.! ■ m- for Ih. .M- rn,.l , un.if .rm. ami an
..U.rnal.,n..for.h..f..unhm..,a.ar.aUK,m.; '';'' '"^ Y^ ' ^ ^ , ,,„,1,„„, .-.f.h m.-.a.ar.al ...m-; un.l .h..- -a.- of
;;:.^;;;t;r:;c,::;:"';i- -:f:::r a„„ .,„ ^ ..-^•^ .-^ - --- --- --
Ti. .,.. or .he n..aa.a, ,.n.. panic.a.v .hose "f t.u. s^l .. d. I;^^;^;-— —
,,.,er .oward .heir heads and e.hii,,, a — 'j-;^- ^^'^^ .^rian.ular pr.sn.a.ie
the dors..m of the .".k,.. In eon.ras. to the.r quadrangular ba.cs,
^"-:rhe ... of .he second . .he .d.h .e.a.arsa, -;;^;;;;; -;;::-'::;:: \:r:iz
compressed f-om >ide to side. Thev presen. -';'"- V"^'^!^^; ,,., f„, ,,ieula,i..n w„h
•iir-ion, .hich e..end far ..p. he , anUr s.r .ee ; ;^,^;;;'; ^ J^,^^,, „„„..„., ,„. „.•
•he l,ases of .he ,,rox,mal phalanges On .he la.c U _ .^^_ nH.....ar>al hone
a..achn.en. of hga.en.s. an-i t^ 'f"-.-' j :,:';; l,,. ,.o eo,..ant sesan.oi.l hones
presents .wi. concave articular faiel>, sei)ar.u..l in
of .he grea. toe.
THE BONES OF THE TOES. PHALANGES.
Ler ,o.t ar- . o.sideraMv ..orU-r an.l .nore ^i>"''>- ;- -;; ^. ^ „ „„. , ,,„., .i,H
In other respec.s ,he phalange. ,.t .he .,k. are ahn.M , - >' ^ ,,,,,,„^,,
U.e exception of irregularities ..f devel.,pnten, . nch :m. . u .i^^ .^.^^^ J^^^^,^ ,^^
of the .wo outer toes an-l are lar,..h ,., W ..urflmt.-l ... . u .-> >■ ^ ^^^^^^^^^^^^,^.
,.n,.. .,f these two toes are -"l^i'^^'- .>r.. U..dlv e en .h - 1 ^^^^^ ^^^^^^^ 1^^^^
and in all the toes it is onlv the pr„untal pha ,n«e- da . a ^ ^^^^^ ^^^ _^^^ ^,_.^^,
A. in the hand, each ,>halans Kes..n.> a /.„sr and a Inn hl.„. an,.
phalanges termina.e in an »/Hi,w«J/ lul« rosily.
io6
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
THE SESAMOID BOf ; , OF THE FOOT.
Two sesamoid bones, remarkable on account of their sixe, are constantly found at the
metatarsophalangeal joint of the great toe (Fig. 153). Inconstant sesamoids are also found in
the tehdon of tlic peroneus longus muscle, at the interphalange;i '. joint of the great toe, and less
frequently in tlie tendon of the tibialis posterior muscle.
It \
u
THE SKELETON OF THE FOOT AS A WHOLE.
The skeleton of the fcxH (Figs. 153 and 155) difTers from that of the hand not only in the
numlxT and form of the component elements of the tarsus, but also in certain peculiarities, chiefly
due to the functional adai)talion of the foot as a sup])ort for the erect body. While the axis of
the hand is situated in the direct continuation of that of the arm and forearm, the axis of the f(K)t
is placed at almost a right angle to that of the lower extremity, and while in the hand the phalanges
take up alx)ut one-half of the length of the skeleton, in the foot the tarsus alone occu])ies the proxi-
mal naif and tin- metatarsus and f)halanges together form the anterior half. The phalanges
make up only a fifth of the entire length of the f(K)t.
The foot shows a much more ])' mounced curvature than do the relatively llat and closel'
approximated i ones of the hand, and this curvature is ])ractically a constant one. The convexity
is directed toward the dorsal, the concavity toward the plantar surface, and the dee])est jioint
of the concavity is situated at the apex of the middle cuneiform l)one, tlie dorsal surface of the
same l)one likewise forming the highest point of the middle portion of the arcii.
The arch of the f{K)t is supported posteriorh bv the luberosit} of the calcaneus and anteriorly
by the heads of the metatarsal Ijones. The tarsal arch is formed exchisi\ely b\ tlie tarsus and
metatan us and is o])en internally, since the inner lx)rder of the fiKit is much higher than the outer
one, which is in contact with tlie ground throughout its entire length. The sinus of the tarsus
'see page 102) is a striking formation which gradually becomes narrower as it ])asses inward
and l)ackward from the outer side of the dorsal surface. The tarsus is much narrower posteriorly
than anteriorly.
The i)halanges of the second lo the fifth toe do not lie in one plane even during extension,
but are strongl_\- cur\e(l with the ccmvexity upward and seem to Ix- Ix'nt ujion the heads of the
metatarsal Ixmes like claws, so that only their ti])s touch the ground.
The second toe is the longest and marks the longituflinal axis of the fcxit.
fsuall) till' imly tarsil lumc-. ikksc^miik I'l^nti-rs at liirlh an Ihi- i alrant-us (<ixth niniuh) ami llic- lalu^ (a-^lraKalusl
fMviiilh nidnthl; the icntor for the uiljoid apprars at alwut tlu- time of l)irlli. 'I'lir t-xttrnal i umiforni is ihi' l'ii>t iif
thrcr luniiform Uitiis to ossify (lirsl yi-arl, thf inliTtial is tile nixt (ihiril yearl, and the miildle one is the last, its
nation and that of the navii ular Ixine (KiurrinR respeetively in the fourth and the fourth to the fifth year. The lal-
aiieus alone has a <lis< -like epiphys<-al center u|Kin its posti-rior surface, lorresixmdinK to thi tulH-rosily. this aiF|K'ars
ill till' tenth vi'ar and fuses with the rest of thi- txme at from the tifteenth to the sixteenth vear.
The metatarsal Uims ossify niui h earlii-r than ilo the tarsid Umes and ossilii ation pri«eeds in a manner i|uile
simiUir to that of the mel,uarpal Ixinis The diaphyseal nui lei apjH'ar in the eirihlh to the ninth fetal wiik and the
I'piphvseal centers also are like those of the nietaiarp.il Ixmes, appearing in the third to ilie fourth \<.ir .ind not uniting
ollil liie <iiapll\stai >< iilel Ulllll ,lll< 1 puUliV.
The ossitHation of the phal inRcs of the foot als<i i orres|B)n<|j exaetly to th.it of ihe phalanges of the h.iiid The
diaphvseal centers appear in th>' third fetal nionlh, the epiphvs.-.d .enters in the third lo the fourth year, and the union
of the epiphysis with the di.iplivses. .is in the iiiitatars,il Umes. oeeurs after pulM-rty.
.•'•;.■;■■• ■'■•■ ,■
'^•■'^'■'^•^.^•..Nl'il-
til...,".. ;.'.:<-r;v^ ■.■•)- j;
5^,
I iiiiiilmliiiiil i/iviiliil' salioii
i'l till- iipiur txtirmily i>l llif
Iriiiiir
I oiiiiiliiiliiiitl i^i:Kitli'l
'•irfic'i I'l' till i;i/'\iiiiii^
I /.'. los.
Sift' -QsiiS
r
1'
-
'
!
-; i ;'
Fig- '69-
lontah section of the
'.""^;"i/r;;/(v oA """"•'■
I'iS-
171.
f/cr. 170.
'''''«'';;;!;::r'r^''S'''''''^'"''
.•V^f^v,!-';
Si/jrif"
; sic""" •
,;■ /,/»l/'(f '■'■'■
Ichiii
i, £
.; Is
' -T
iL
■
IS
\
It '<
I!
3jtJ
W^
i
?fij^
I
ita
,^J
i
SYNDESMOLOGY.
GENF.RAL SYNDESMOLOGY.
The bones of the bodv are connected . i,h each other in one of two ways. '^^^^^^^
Tie of cLnection, allowing of a nntch nu.re extensive ran«e of mot.on between the bones.
SYNARTHROSES.
The svnirthroses are classiUed, according to the character of the tissue connecting: the ends
Svmhoiid roses are
diaphyses of the long lx)nes (see pa-e 2 1). An example !> lurni.
rib to the manubrium of the sternum.
The syndesmoses .r, sub-'^'ided into two .roups, true sy,ules,noses and s,,uns ,.c pages ,
, in The true svnd c ^lose in which interosseous hgaments, which n,ay be e a>tu
and 80). The tn e s>nd ^^^^, frequently str..ngthene<l
actually connect "^^^-^,^;,, -^::;;- :;:;;,;;1 , ,!,„,. connected with the tibia by such
' . - , •■ mass does not con -
bv acccssor\' liijamer , , .■
e>, wnieii aie . ... i„,ny margms by means
nect the bones,
layer of |>eiio^toum (see jiai;
e- (yS).
In the mixed synarthroses or symfhyses the tissue conne^
cartilage. Typical' examples arc furnished by the connection
cting the e;-.', . of the bones is libro-
s of the bodies of the vertebr;u
:h,.
! I i
!i
] I
io8
ATLAS AND TEXTBOOK OF Hl'MAN ANATOMY.
by the inlerverlcbrdl fibrocarlilagcs, and b\' the connection of the two j)ubic Ixincs by the inter-
pubic /ibrocarliliii^f.
We occasionally find a combination of a synarthrosis (particularly the syndesmosis) with
a joint, as in the connection of the sacrum with the innominate bone, or .a lit alar spaces may
appear within the symphyses, and such arrangements are termed half-joints [ampliiar/lirosfs).
DI ARTHROSES.
The diarthroscs or true joints are characteri/id by congruent cartilaginous surfaces which
a separated from each other by a cppilhm- s])ace, and are provided with a number of struc-
tures, the majority of which ai ibsent in the synarthroses. These are the arlieular capsules,
the ;it ces,sor}- ligaments, and the articular cartilages. They may also be ])rovided with s])ecial
structures, such as the interarticular cartiuiws or menisci, diverticula of the synovial membrane
forming synoi'ial burscr, glenoiilal lips, joint cushions fdcsignr.tcd by fliffcrcnt names in he
dilTerent joints), and lx)ny locking mechanisms.
The articular capsule usually surrounds the cartilaginous articular surfaces of the con-
tiguous Ix)nes so as to form a completely closed articular ca\ ity. It consists of an external firm
fibrous layer, the fibrous layer, and of an internal softer vascular layer, the sy vial layer or
membrane. The latter gives off microscopic thread-like \ascular ])roces.-ies of irreg .ir sha])e, the
synovial villi, and occasionally it forms large structures; visible to the naked eye, the synovial jolds.
The articular cavity, usually a capillar}- space, is filled with a \ iscid fluid, the synovia.
The articular cajjsule varies in thickness; it is sometimes strengthened by accessory liga-
ments and sometimes interrupted, .so that diverticula of the synovial membrane jjrotrude through
its ojjenings and form syno\ial burs;e (see also juige 143), whose ca\ities are conse(iuently
vlirectly continuous with that of the articulation (communicating synovial burs;e).
Accessory ligaments form important com])onents of the articulations, and according lo
function the ligaments of the Ixxlv can be sulxlivided into the following classes: (i) Ligaments
oj fi.valion; i. e., those ligaments which firmly unite iwo bones, as in the syndesmoses. (2) Ke-
injorcing ligaments of the joint capsule; tiiese are more or less adherent lo the capsule itself,
but sometimes apijca"- as independent structures. (,V) Check ligaments, i. c, ligaments which
are ca])able of limiting certain movements of the joint. (4) Ligaments oj conduction, i. e., liga
ments whose function is to conduct vessels and nerves to a part of a bone. (5) Ligaments which
take the i)lace of b<me. These last are found in those situations where neither fi.xation, nor
inhibition, nor any other of the usual functions of a ligaiiH'nt is recjuired; they extend between
])ortions of the same !;!;ne or con wn a notch into a foramen.
The interarticular cartilages or articular discs (termed menisci when of a Durelv fibrous
character) serve to adapt mutually articular surfaces whii h are not com])letely congruent. They
are attached to the inner surface of the joint ca])sule and extend for a varying distance between
the cartilaginous ends of the bones. In the most extreme cases the\ (li\ ide the articular ca\ity
into two portions, so that the articular extremity of one bone is in relation to one side of the
articular di.sc and that of the other lx)ne to the other side. In such a joint the articular
extremities of the two bones are not in immediate (intact widi each other, and it is consequently
possible to distinuniish unilocular und bilocular joi'its.
GEXF.RAI. SYNDKSMOI.OOY.
109
;;*;-irr:r:.;^;r':;:^ir,»,... m .-. ^- -
or they may act as j.-int cushions. omnativ. li^^u. or nhrocarlil-
»"■' r v:x:-;"- is"r ™::::.- ". ' - ' - «^ - ^
part striking against a Ix-nyprop-u. on ^^ ^^^^^ .^ .^ ^^,^„,^„, ^^ ,,-„,^/,. ,„„,.
A joint is usually compose^! of -nU ' -'"^ ' ^,,^,^,^^i„„ „■ , j,.;,, or ,.oninns o, th.
Sometimes, however, three or nu.re 1-"^ ^ ^^ ,,,^^,,,„,,, ,,,,, „, wl.eh ea.e the jonU
socket arc. formed of connective t.ss 'e component, „
is lermc.1 a ,,-m/.m<m/ joinl. m,,,,;,-..,! acconUn- to the shape of lluir articular sur-
The joints of the human bodv --'- '^_^ ,^ ?^,^^ ,3, „,,;,, join,>; .., polvax.al
faces. These sulxlivisions are as loUows. (i) LmaNiaij
joints. , „f ,^^.^ varieties those with a tran>ver>e aNi^ an.l tli"-«-
The uniaxial joims ^^ J^^^^^ :i :::,::t:.: .r. variety is at ri.ht angles to the a.,
uith a l.mgiluainal axis '• - ' . ,^^. ,,,„ .j,,., are coincident,
of the moving bone and in the second Nanct> tin
1. UNIAXIAL JOINTS.
A -c Tl„. I,i,v'r hnn< or 'iiu'^lvmrn belongs in this (lass. 1 hese
,a, With a Transverse Axis.-llu/n. . . -_. ^ ^^^^^.^^^ ,,^^, ^,,,^^.^.^ ,„,,,,,
joints are broad an.l the articular ^^^^^^^^^^ , .L.esi.nding elevaii.n. Thi^ c.n-
Lhibi.ing a median excavation and ^^J^^ _^^,^^ ,,, ,,,.,a ai^placenun, of the hone,
formation together with -'-^ ^'^ ^ ^ .1 ,, ..Android and i. con.,uent.v hori.onud-
so that the axis ot motion comedo wUh h ^^^ -„^^,^^„, ^,^ Hexion and cxtensi..n. and m
The mo.ion> permitted by a gmglymoid 3 '"^' .'^ ' ;,;^,^,^ ., „f „u. ginglynu,> .,r hmgc
complete extension the bones fornj an ang e o o^ ^ ^. .^ , _^^
Join! are furnished by the iiiterpbalangeal ^ ^^ ^ ^^ ^ ,-,,, ..,,avaUon m the
=i:r:,tH:;:=^ j;-™--^^^^^^ , ,.
examples of this t""" of joint.
Ill
ill
m:m
H
l! ;
S I; i H
no
ATLAS AND TEXT-BOOK OF HUMAN ANATOMW
2. BIAXIAL JOINTS.
This class of joints includes the ellipsoidal or condyloid joint and the saddle joint.
In the ellipsoidal joint the convex surface of an ellipsoid of rotation articulates with a cor-
responding concavitv, and the two axes of motion, the lesser and the greater axis, arc placed
at right angles to one another, but both jiass through the same bone. An example is found in
the atlanto-occii}ital articulation.
The saddle joint is formed by the ajjproximation of two saddle-sha])ed surfaces, /. c, sur-
faces which are concave in one direction and convex in the other. Each surface alternately
forms a head and a socket, and the two axes are at right angles to one another but are situated
in different Ijones. The most typical saddle joint of the human body is the carpometacarjial
articulation of the thumb.
In reality the motions in the ellipsoidal and saddle joints are not strictly biaxial, but may
occur in any intervening axis between the two, and one of the two motions is fre(piently so lim-
ited tha; the joint practically becomes a ginglymus.
t !
3. POLY AXIAL JOINTS.
The only polyaxial joints are those with spherical surfaces, the spheroid joints. These are
sul)di\i(ie(l into two varieties, the ,(,'//'//",(,' /()/'«/s- or arthrodia and the ball-nndsockel joint or
eitiirllirosis.
In the at.iirodia a spiierical head moves in a spherical socket, but the articulating surfaces
are segments of very large si)heres, and may seem in some cases to be almost planes. Com-
paratively little motion can take jilate between the surfaces, and what does occur is more or
less of a glidiuL; ( harai ler. (iood examples of arthrodia are to be seen Ix'tween the articulating
processes of the vertebra'.
Ill the iiiiirlliroMS the arliiulaling surfaces are more extensive segments of smaller si>lieres
and the capsular ligameiMs are rtM.niyand relaxed, so tlial a considerable range of molion is
po^^ible belwciii the two Ixines. I'Npical ixamplt s of these ball and socket joints are to be
found in the sho\ilder-joiiit and hip-joint.
SPECIAL SYNDESMOLOGY.
JOINTS AND LIGAMENTS OF THE VERTEBRAL COLUMN.
THE CONNECTIONS OF THE VERTEBRAL BODIES.
Thi li(Mli(s of thi' true \irtebra' are ( onneiled by intenrrlehral /ilmhiirl!hn;es ( Kigs. fj;
to 1 7S i, eai h ol whi( h i Kig, i 71 ) cunsisis of an exiiTnal linn /iliroii^ /-/)/!,' ( oniposi'd of loni inlrii
and interw'MM bun<lles of (onne<ti\c li^sui', and of a (antral gelatinous or pulpy iimliwi, the
latter Iniiig firnily compressed within the librous ring an<l JHlwctn the adjacent v( rlebral sur
fate-. Ml thai it rises aixiw iln' level of ,1 hori/unt.il ni( (ion (,f the disc, .\mong other substatices
ll (oiil.iin- line (,trliiai;e and liie leiiiains of the c iiorda dor^aiis, an emljrvonic structure' wiiiih
imliiaies the future [xisiiion of the vertebral (i)lumn and is composed of a substance resembling
JOINTS AND LIGAMENTS OF THE VERTERRAI- COLUMN.
U I
naec The intcrvcncbral fibrocartila.cs arc attache! to the upper and lower surfaces of
The area .,f the intervertebral fibrocartaa«.orne.h. ^_ ^^^^^^ ^^^^^^ ^^^^,^. ^^,^^
surfaces between which thev --'"'1' Ct d r There L no hbrocartih.Ke between the
against the slightly concave ^'^'''';^ ^ ^^ ,,e„na and third cervical vertebne an.l
atlas and the axis; the first one .s situated b^^^^^" J^^ "*; .j,,,^,,^. ^,,, ,onse<iucntlv twentv-
,,. last one between the hfth lun.bar ver. n. ^^^J,^^^_ .,,, ,,„..,. unh in cir-
iodcJlble in the last one, which is situated .t the promontory.
THE INTERVERTEBRAL ARTICULATIONS.
- addition to the mixed .-'^---;;:; -^X^^^r ^^^^
bra. also articulate with each other by ^^^^^'^^ ^,^,,^, , Ucular pn.esses of the over-
articular processes of a vertebra art.culate ^^'^^^ ^ ';; ^,,^, ,„,i,,,a ,,. an articular
Iving l.me <see page .,), and the ^'^'f 7? ^^^^^ Vertebral region. There are no
capsule, which i> relaxed in the cervual -' ^ '^^, ,^^. ,^,„,,,„u. ..nnection. of the
:z:;;rCei:^rx-^- '■
THE LIGAMENTS OF THE VERTEBRAL COLUMN.
1 „f .«■„.. roui.-- thosi- whi.h run through-
The liganu.nts ..f the vertebral column are con,p...l o^^^^^K^^^^^^^^^
on, the en,irc leng.h of the vcrte,,ml "-;-;;' ^.^ J ^^ );;„„,. ,., ., .hi,h -here is an
U.uou> v.rtebra.. Ti. ,n>t «":;;;;;;!;,,,;,,; ,,„„,.„ i, :,nache,. ,„ d,e ant.ior
:r::;n:,:v!:;r;;Xa:^t;:.erver;ebran^ "--
invests their posterior surface-. .,„i ,S^) commence, al the phar^ ivjeal
U.,..Me up<.n the ba. of the ^Uull a. a ;-■•;;-;;;' '^XZ^U uni.cd t„ .he inter-
and il terminate, upon the anterm,- surface ot ,lu sa.n ■ ^^^^^ ^^^^^.^^_^^ ^^^. _^^^
,,,,,,,,, ubn.car,ilages, bu, i. -nly l'"- >' -"nc U. . - -I J__^^.^^^_,,^_^ ^^,„
,he periosleimi of the bodies ul the vtitii.ia. an i
.hort deep ones which ,...> from one veM, bra to ^^^']^'- ,„ „„. „.,,,i„r surface
i;!:,,^::!::;'I:;^trr;;:;;;::•''5:v^^^
rri::"::i::;^!''V;:.i;:::;::::::-":;'^"--- - ■ ■"■
1, is |ikewis.Momposed of a superhual and ot a Oeep la>e,.
I
I
S
J
I
I
j il
lj Ij
|i i
»'i.
112
Fig.
Fic.
Fir,.
Fir..
ATLAS AND TlCXT-nOOK OF HIMAN ANATOMY.
'7.V
'74-
i7.=;-
170.
Fi...
>77-
Fi...
■ 78.
Fic.
i7g.
Fk;.
180.
-The anterior longitudinal ligament in the lower thorad< p.^ ion of the vertebral eolun^n,
I tret her with the ■ osto vertehral ligaments seen from in front (,).
The n r t udinal h.ament in the lower tl.-raeie and upr^r h.mhar portions of the
ver.el.ral column. The vertebral arehes have been remove<l ( , )
ri.ht one-, are retained in their natural |.os.tion (j). . , , , . w...
-The pinor longitudinal li.ament an.l inter..ru.,ral .lbroeartila.es o. the lumbar vertebra-,
the vertebral arehes havini; been remove<l (J).
-_Mo!;:dh:al section taken at about 45 -l^'.-s to the me.lian plane through tour thoraeie
vertebra- to .show the eoslo-vertebral artuulations (i). , , , ■„ , a\
-The li-iments of the middle an.l lower thoraeie vertebra- and their nbs. s.en from l.eh nd .
Jr li^ment, of the middle and lower thoruie vertebra- and t e.r nb. .-en from the U f 1 s.h.
The ui.permost rib has been disarti. ulale.l and remoxed (}).
U widens opnusite each interveriebral bbroeartila,. , .0 wlmh it is firm y united, hut U is
,,, , .: "nn ted ,0 the l.xlies of the vertebra-, being separated front them '-; v>"-s plexuses.
ul. iti 11 .0 llH. l..ngi.u.linal ligaments, this group also eontains a portion of he .«pn^
s,iJ:stL.I. I. will be deseril.d subse.,uentb , however, together w„h ihe interspinous
li.rmu-nis wiih whi( h il i> intimately ronneeted. . , ,. ,,1.
^ The short ligaments of the vertebral <..lumn. eonne.ting e-,n„guous verlebra-, an .ib-
arehe- and th"-e lonneeting the processes.
' 17(11, are
divided into tho-^e connecting ihi
'""t c iVm. .lu. venebral arches, the U.unnU,, //.n-MFigs. 17. and lyb., arc
stron n U e cmposed almo. entirely of elastic ti.sue, ,0 whi. h .he. o.. ihcn- pron-iuncc
Iw .1 Ik'hc ihcir name. Thev e.tend anleiiorly as far a. du- po., "'-'-J- ;
ar„.ul.u- capsule, of the in.ervenebral ani.ulaiion. and -n.^u-ly < .;se ', u
I
With the exception of a dislim I
1 surface is absolutcK -ni.H.lh aii.l i- dire.ll\ .onlinn.ui>
lU their ela-licity ihex keep .lu posterior wall
llir artu ul.i , .
rinil . \cept a. th> siiuaiion of the in.crvcr.ebr.il loramina.
^,n„„, in .he me,lian line, '.beir in.ernal ^urfacv is absoluieK
:;';;:'":;:;:;•:";,;:::::;, r;,:;!,:.:::. ."m'-- - --r T
'::'::,■:„;;,,:;:; ;;;>;.„, „.,..., - ■«-"■" "■■■ '"- > ■" ' ' -"■ "■
III ••. l.i-i -mil •ire slroivc-l below and Wcakis. abo\c.
'"':;t;: ::;::«;«.- '^i- ■= > *.»-,„;,.„.,„ „., .„..,,,,. ..».....■
,r,„,s,... Ill ,lu- Mrt.l,.-a-. .!u ) are par.uularly dcv.l.ip.-d ,., Uu
(ni.uding the lr,in>ver-e pr
|i.,,raii< and hunbar region^.
.. ._ ..._, .i.,..,.i, .,,■,,..•■•.! in \h.v liiiubar region.
,!„■ y,i[>Msl=iiwlis //>/»".»/ I Fig. 1701 whuli con
,.|„,.ssc, (if 1 iinligncni-- verteiir.i'
Ihev are (onlimioii-. anit riorlv
and aliaiii on n
uiih .lu- ligamenl.i d.ua and ]
lilt l. ihe a|
Misit riorh with
;:L. „, ilu spinous processes and form, an independent ligamen,. 1 lu ni.erspinous
■toMrik
Anterior eonio-
:rim.^vrrsr <•
iiliami'tti^
Aiitirior
l()nf;itiiiliitiil
lii<iinuvt
liiliivirlilinil h'l'inii-n
IlltilspllliUt^
lii^iiiiiiiil
fw. 174
i<<. I7'i.
hilfniiUl'i.i: lilnonlillhij^i-
f I
hr,i! /!,■!, Ii
I njiiiiitiiliini Ihniliil
mmsmi
m^s^E^m^^mi^'^ss^
m^^^^m
I '!
i,
Mia^'>:M«i^
l.ifrtl-
ments
of
costal
neck
Ril's
W'llchntl boilv
Artiaiiiirjaii
■Is for (vstiil tnl'irdcs
meiiU:
flin-d
Posterior
Iniiiiiliidimil
liiianirnt
ertfbral
iirrhrs X
Fio. 170.
liUmirliniliir luHiiniiit
Intnrtilfhnfl lor.inun
I li^dtiieiit oj io^tiii
nirl<
Sdcnini
I'dslrrior
ivsto-
rniiisvrrsr
lii^uiiwnl
Inr. 177.
Inlinrrl.hnil
li/in'i lilt: lit;''
I iiluirti- I'l "''
11
yR/^la^'JJS^
^ .Si^S
r
m
i |i
■ i' "
6 I
1 i
!:
S
iH
JOINTS AND LIGAMENTS OF THE VERTEBRAL COLUMN.
'.S
and supraspinous U..n,cnts a. found t^-^^^^^^^ -!;-;;;- ^Llli:!.:"';^ '^X
cervical vertebra- they forn. the n,.»u;^u,n «m/.MP g- ^9;;;"^^,^„ ,,„,,,,,,,, process
although relatively poorly developed m the human sujeU — n .^ J^^^^ ^
of the seventh cervical vertebra (vertebra l--'^ ^^ f a "Iterior vertical band .hich is
:::rb^rr;=;i'r:^--n^^^^
I t^ps of the spinous processes of the remaining cerv.cal vertebnc.
THE ARTICULATION OF THE SACRUM AND COCCYX.
The ape. of ti™.. and the Hr. ^^^^j^^ ;-;^t:z:rr;:l r i: " H^s"
,v,„/,/n.,W,s- and by a number of relatively --^'-^''" /.5;; ,^ ".j.^" ,.,), to either side are
.;f .Je'two Ixmes is situate.l the anUnor -"•--;'^- j ^' ' i^^^, j , process of t..e
the /--' 7-7-"' ^ZZ fl'min^T^f n-1 Lin, an.l posuiiorK there are
first ccK-cygeal vertebra and thcrcb f"'-"]'"J^ ' ^^ superficial and a deep one.
The ../>../,>•/„/ posterior sarrocoay,.,! n,a,un; ^'^f^^°^^^:^^°^. ,,,, ,i,,p i,„s,rior s.rro
coccygeal cornua, an.l closes m the ^'"^Jtcr port ^^^^ ^^^^^^.^^ ^^^ ^,^^, ^^^^^
tudinal ligament.
T. e... . .„e ...... ...u.n .e .'-^■-■;' ^r '"kC:!:: ^i-^::^:": :::;::;.::! ,:; ■• ::
rtn:i^::'r; ■ ::rr ::r ::x.x;:; •.,.,„..... ... . .,..,.. ..< ... „,
of its indiviilual mi,'"ii'i'^.
The A«a„,o-oc=ipUa. and .he A..a„.o-«ia. Articulation. -J... ..^>vn,™,._^^
,»„!, a,lan,„-.«ipi.al am,„la.i,„» an.l .1h; » l!'"';.'' .■';,,,„„,„,,„ a,, .«Ti,ii.al
;::;i:^ :;:::;;::- ;>--'':.;;;::.: i. ^ a,,,.
an art 11 u!
sur
n.temblinii; ^i cone.
The axis of rolalinn
respont
Is to the long axis of the otlon
itoitl p
Thi artit u
lition between tlie oi
Ion
toid 1'
Lss and the anterior
ih of the atliis i^ a im\oI
I giJ
'^^^S^-^l^
.ML. M
\ (
11
IT4
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig. i8i.— a frontal longitudinal section of the sternum and costal cTtilapes (J).
Fig. 182.— a portion of the occipital l)onc together with the atlas and axis (e|)istropheus) and their
lifjamenls seen from behind. On the left side the capsule of the atlantoaxial articula-
tion has been removed (,'',,).
Fig. iS;.~.\ i)ortion of the occij)ital bone touether with the upper three cervical vertebra' seen from
in front. The ca|)sular li-^aments have been removed on the rijjht sii'e (,''„).
(■trochoid) ioint with incomplete articular surfaces, since the oftontoitl ])rocess is frc(|uently
covered with cartilajje upon its anterior surface only, its posterior surface arliculatinj,' with the
transverse li<;ament of the atlas by a .separate joint. Both joints have se])arate ca])sules; the
])osteri()r one is also regarded as a synovial bursa.
The paircci lateral articulations are ])ecu!iar in that both of the aiticidatinj,' surfaces are
slightlv convex, so that during rest there is only a line of contact. The rotation ettectcd by the
combined joints is consequently not in one plane, but assumes a spiral character.
occipiuii hituf
Dut'i mitrr
Antiriiir ■inl: n; ,:!!
Aniiruir ■irlini: ir snr/'i'C
11/ ixloiil i:J prorrss
Odtiiuiiid friirrs.
Biiily iij iixis
Iio,l\ <•/ f.rrii-.il
vcruhri III
M>itihr<iH'i ttclori'i
Po\ti'nor itrti'^uLir slir/:Uf
o! odontniti /)r/<f-rvv
( rut i-ltf lli^i!llt,)l!
Kiiiils III ccrviC'il nervrf
IX I ; niiiii bom-
I'i's.'rrinr >!ri 1; n'j <i:<is
SpiiUf.s pr .(1.^^ oj 'ixia
Via. 1K4. A nil
,i!ian lnnffitiMlin;il s.-dinn ihrounh ihc .itlanto-axial ailiiulation (artirukilio atlocpistroi.hica), somewhat
SI ht'itializi'ii.
The capsules of the atlanlo-a.xial joints are roomy and relaxed. The articulation is ])ro-
vided with a series of accessory lij^'aments which elTect an extremely tirm conncilion between
the head and the first two \ertebra'.
The Iraiisirrsr litidiHciit of the atlas (Fisis. i86 and 187) is .1 very stronj,' and I'lrni libro-
cartiia.ninous iiand whii ii i> allaihed lu ihc inner margins uf ihc lateral masses of the atla-;
it i)asses across the spinal foramen of the atlas in a curved direction, the convexity being jjos-
terior, and invests the odontoid jirocess of the a\i> tdcns rpistrnphti) behind. It divides the
s])inal foramen into two compartments, a small anterior one for the reception of the o<lontoi(l
Jf ~
t!
CM
CO
' ! 1 '
I i ''
\V I ,3; 3
-'^''frs
t
o
(J
/.
ll'
P
.t/.
r (
^
p
7 "\
\^
\
\
\
'v
"S. ^
~^i^
^
1—
>.
■**
•
—
&■•
&
&
^
^
t:
'"•
'^
2
■^
"^
■f
■-C
' w
«j
'>j
■iiiii
JOINTS AND IJGAIIF.NTS OF Till. VFRTI.HRAI. COI.IMX.
r r:
process anrl a larger posterior one for thi' spinal cord. The i ortioii of tl.e liuanunt whirh i^
in conlaet with the [Kisterioi- .surfaee of the odontoid process is I'oven'd with eartilaf;e and there
is (usually) an articulation in this situation.
From the middle of the transverse li!,'amenl of the atlas are given off two vertical fa>cicuh',
one of which jjasses upward toward the occipital hone and tiie alianto occipital t:'end)rani\
wliile the other pa,-ses downward and is inserted into the jiosterior surface of the body of tlir
axis ('epistropheus). The combination of these fasciculi with the traiis\er>e ligament forms what
is known as tlie crwiiitc lit^nmciil '. Fig. tS;).
The joint jw^sesvo tliree other ligaments which arise from the odontoid process of the a\i~.
a small weak rjiiddle ligament and two strong lateral ligamenls. The middle ligann-ni i- known
as the apical odonloid Ht^iimdil (Fig. i8S) and runs from the li|) of :he (nlontoid pnniss to the
nuirgin of the oicipil:'.! Iv ne. I' is a ouite thin and insignificant structure and has scarcelv an\
mechanical function. It contains remains of the chorda dorsalis (see page i lo).
The strong ligaments extending laterally from the (xlontoid jirocss are the alur lii^anini/s
(Fig. i88), and they i)ass oljli(|uel\- upward toward the inner margins of the londvles of the
(K-cipital hone. They attach the (xlonloid process to the skull and act as check ligamenls for
the atlanto axial joint. The cruciate ligament jiartly covers them when \ieweil from behind.
The ligaments arising from the odontoid jirocess and tile transwrse liga-iieiii of the
atlas are separated from the wrtebral CMial by a tirm broad ligamentous ma>--. the Irdoria!
membrane (Fig. 185), which forms a smooth surface exhibiting in relief the umlerhing odontoid
process and alar ligaments. In the skull it i- loiuinuous with, the dura mater, and below it i>
continued into the deeper layers of the po-tercir longituiiinal lig;cment. It i> separate I iVoni
the atlas by a ])le\us of veins.
.\ further jieculiarity of the articulation of the lir-,t two cer\iral vertebra' wilh the occinul
is furnished by the allanlo-ocrifiital iobluraior) invmhraiiis, which >rr\e to close the broad spate-.
which exist between the atlas and llu- occiput. Tiie anhrinr alianto ocd pilal labliiralor) num
hranc (Fig. i8_;;) fulfils this function upon the anterior surface of the iwo \-ertebr,e; it is stretched
bi'tween the >ccipital bone and the anterior arch of the atlas and i> adherent to tlu' uppiT
extremity of tlv anterior longitudinal liganu'nt.
The paslcrior allanlii-OK ipilal {obttiralor) mrmhranr (iMg. iS^i i- to be reuanlid as reiire-
scnting the uppermost jKirtion of the ligamenta llava, although il ha> not the ela-:ir slructun-
ot the latter li ^anient, and is much thinner. It closes in the sjiace liei"ven the occiput and the
posterior anh if the atlas, le;i\ing apertures for the jiassage of ves>rl> , nd nerve>, and is con
tinned in thi' interspace between the atlas and axis, taking the plate of the first ligamentum
tlavvuu.
In tli<- atlant(i-oriipii;il :\rtiiul.->tion tliiTc i-; |irMilii;illy no nicninirnl |HTmiai-rl .\\vm\. ili. -liurt N.i^iii.ii .i\i,, liiii
till' I liicf riiiivrmiTit o( rurs about tlic liiiri.^ont.il and tr.in^vcrsi- axis am! i ■moists of tln' nml.ii iiinvrnirnl- ..I llu !u nl
In the atlanlii-axi.ii arli. uiali.in ihc ac lual mtatinn nf the lu;ul ..nurs .il>.mt a Mili a\U |ia~-in>; il".nii;!i llu-
r«!i.lii,.i,i |.i.Ki>.^ oi liii- aM>. 'I'mi' main juitii ail-, a^ a jiuiii-juinl, inn liic- nualion i- i hi. i hy tne alar liganHau^ and
aniuuiils to .diout 40 dcKm, uidy in lai h dim licm; the' laturai jrnnts allow nf a ^jiiral niotiun.
■.i. ■
tt6
ATLAS AND TKXTIiOOK OK HtMAN ANATOMY.
Fk;. 1.S5,— The lertoriul membrane seen from behiiKi. The |K)^terior portion of llie oetipital bone and
the arches of the three ujijier cervical verleljra' iia\ebeen rennned, as well as the cap-
sular ligaments of the rii;ht side ({'„).
Flc. iSf).— The atianlo-iHlonloiil articulation. The odontoid process (iAhv cpistrophi-i) and the ankrior
arch of the alias have been cut (,",,1.
Flc. 1.S7.— The cruciate li|,Mment after removal of llie icitoriai membrane. Tlie articular lapsuli-- have
also been removed on the ritiht >ide (-,'',5).
Fk;. iSS. 'Flu- alar liu'amenl- after removal of the cruciate liirament. 'Fhe articular cap^ule^ as in the
lirecedini; l'i,i;ure ( y',, I.
THE ARTICULATIONS OF THE RIBS WITH THE VERTEBRAL COLLTMN AND WITH THE
STERNUM.
The posterior extrePiilies of the rilis an- connected with the thoracic vertchne by arthrodial
joint- iFigs. 172. 1 ;(), and 17.S to 180); their anterior extremities (Ki.i,'. 181) articulate with the
sternum or with each other by means of either arthrcMJial joints or synchondroses. The anterior
extremities of the Iwo lowermost ribs are not attached to any portion of the skeleton.
The ribs are (oniiecled to the vertebrtL' t)\ a (loid)le arlii ula'M:). The head of each rib
articulates with the iKwiies of two adjacent vertebra- (the e.xccptions are {;i\en U])()n pa>;e '(>) and
the tubercles of the ribs, with the exception of the last two (-.ee paj;e J71, articulate with the
transverse ])rocesses.
'File arlictdaliuns of ihe luads of the riljs, with the excei)tion of the uppermost and the two
lowermost, ail ^ haracteri/.ed by the fact that the intervertebral librocartilage between the two
vertebne forminj,' the articular cavities is continued, as the iiilirartidiliir lii^nmiiil (Fij;. 17S),
as far a- the (rest upon the heail of the rib, and divides the arlic idalion into two ( omiiartments.
The weak articular capsules are reinforced by ihe niitlalr (stilluli ] lif^,iitiiiils (Fiiis. 172 and iHo),
which arise from the head of the rib and radiate to the lateral surfaci's of t!ie IxKlies of the
V( rtebra' forniinn the aniculation.
'Flu i()\lo Iriiii^Virsi iirliailiilioiis havi- lajiacious (ajisules and are cliarac teri/.ed by ikis.hss
ini; i|iule a luimlKT of reinfon inf.; or c lui k ligaments. 'Fhe posli lior surface of the ca))sule is
ninforccci bv a -hort tense lig.sment, the lii;am(iil aj llu (oslnl luhinlr ipuslrtior a-slo Innis-irrsc
lii^iimiiil] (Fig. 17c)), which is app|-oxiiiiately (|iiadratigular and composed of ])ara!lel t'jbcr-, and
c xteiicls outward and slitrhtlv upward from tin lip of the iraiibVerse |)roiesN to the posterior sur
face of the neck of llie arlic ulaliiig lib.
'Fhe lii;iim(iil oj llir iinl.' imiddh ' <ni,i /n/)/v;vr?c or iiilrrossioii.'i lii^ami)!!) (Fig. 17S) almost
ccimpletelv t'lIK ihe s]iacf between the neck of ihe rib and the transverse proiess of the thoracic
Vertebra. Il i- hori/onlal and passes from llu- anurior surface of the transverse process of ihe
vericliru lo llu posterior surface of the neck cif the rib. 'Fhe kisIo Iniiisfrrsi {sufurinr w^lo-
trdinvirKi) lii^amrii!^ run between the po'-te-rior extrc-miiicv cif the ribs and the iransverse jinn-
esse-, anil eae li mav be regarded a- coiisi-ling of an iiittirior ancl a fioslcrior losln Iniii^vtrsi lii^a-
nil III, iMith of which ]nirsue ;i similar course from the net k of the rib to the transverse process
of the overlying vertebra. 'F'lu- anterior ligament (Fig-. 1 7<i and iH^i i- tolerably -iroiig and
apiiroximalely rhoml«)id in shape; it pasx - from the lower margin of the transver-e process
Oiripila/ Inuir
/iron's''
Arliiiiliir
tiiii^iili"'
Triiiisvnse pivrrxs
of trivicol viil. Ill
Mi'iiihiiiiui li'iloriii
/■(ir. 1ST.
Mar
l/i'iiiiii iil^
\rti(iihir
aipsiilr ^ -
('riiiiiih' lii;itnirtil
(■•ii/xrit'r !uiih)
l!ii-.i/{ir porlioii ,if
<>i('ipil<il ht'iir
Spinoii'i prof
of tixi^
I niiisyiTsi
li^iitiirnlof
iitliis
.\rfiiiiliir iii/i'-liirs
fl!' hSS.
,in.l r;,,^
- .>
[y^
ivT:
"1
9
— -^
[ll_KL
^m
()il(iilloiil /iron ■•
Itihlv Ol II MS
i^i^
I
Tin: ARTIcn.ATIONS AM) IICAMINTS OK TUV. IIKAH.
117
and frequently also from llie lower bonier of tlu' a.ijacent rib to the neek of the next lower rib.
The jiosterior li,i,'ament (Fiir. ,7,,) is niueh weaker than the anteriir one; it i> trian-ular in shape
an<l runs from the base of the transverse j.roeess (or ai-o from llu' articular ,.nHeC.> to the pos-
terior surface of the nrek of the next lower rii,. The two li,iran,ents form the l.oun.lari. . of an
opemnu, the coslo-tniii.sirr.u- jor.imcn, whieh -ives -'assa-e to the intercostal branch of the spinal
ner\e.
The m-.voment. of (li,. ril,s upon th.- v,Tt,-l,m- arr .onsi.l.T.il.lv lin,i..-.l l,v ih.- -urroun.li.u. , !„■, k lii-anunt-. Thr
iwo jo,„,s, that of .1,.- h..a,l a„,l ,ha. of ,1„. lulnn I.-, a,, ,o«,,l„.. a. a , nn,l., .,1 ar.i, „lal,o„ u I,,, 1, ,„,nak,.. „f ,1„.„ „ur,.
of a Pivot joinl, uhos.. axis corrrspomis to ,h,. ,„■, k oi tlu- ni, an,l i. ih.-rrfon- ahno-. iransv,,,,.. Tlu- nmumnn ,l,out
tills axis .s sue h that thr anKTior .■«niniii.-s r,f the ril.s an- ,kvatr,l, and the ,h.lan. <■ I,, t^^r,„ their anlrn.
and tl'.e vrrtiliral column is in, reascil.
nor rxtnniitics
Tl. ' cartilai;es are connecterj with the sternum partly In svni liondro^c , and partl\
by mov Is, the sIrnw-rosUi! arlini/.Hions (Kifr. ,81). The first costal lartila-c is always
united to ,R sternum by a sent hondrosis, biU l«l«een the anterior cMninili.s ,,rilu- second
to the sevei.dl costal cartilages and the sternum, however, there are usuallv true join.s. The
second sternocostal articulati.,n (and fr(<|ucnllv the remaining ones) alwavs contains an inirr
arluuhir li^amnit (Fit;. ,S,) whi.l, passes from die synchondro.sis betwtrn'the manubrium and
tlu iMHly of the sternum, ,.r from thr outer mar-in of the bodv, to the anterior extremilv of the
costal eartila-e an.l divides the joint into two compartments. This li-ument is inonstant in
the articulati.ms of the thinl to the s, vt„ih tuMal cartila-es with the .sternal b.,rder, and wh.n
It IS present it is fre(|uently so siiualed that the articulation is une<|uall\ suMiv i.led.
The anterior surfatvs .,f the articidar capsul.s of the sternocostal articulations are rein
forced by the rmlhUr lif;,„nnils (Fi^-. u)2) which arise from the ends of the costal cartilai^es and
spread out like fans up<.n ihe anterior surface of the sternum. The interlai ini; fibers of the
radiate lif,'aments of the lower tartilages form a m.-mbrane, the sUrual nnmhnni,; up,,,, ,l,e
anterior surfa.v of the lower pinion of He sternum, and are blended uiih the peri,.steum in
this silualion.
Joints, whi. h are known a.s the inhnlu „ lr.,1 i„i„ls, maN also be present between the tosid
carlila-es of the fifth to the tenth rib^ (see p ;e ,5,^1, an.l in the >1. rimm ilself there is a sl,r„„l
syiirliniidrosis fsee pa^e vD between the mam: )rium and IkkIv which frc,|uenll\ ha> a
cavity, and s<mietimes also a svnt hondrosis b, ten the bo.l\ and the \ipli,.i,| pro.ess.
The inlrno ' ' /,>,»„„/. ai. rtallv mtxlil. j fastia' whieh uill i,e uMi^dered in the d.-t rip
tion of the mus( les (see ]iHf^v Kii;).
an artitular
'Tlu- a. Iiiai rannf oi inoimn ..| \\\r , osial ..iriilaK. > I" ih.-
Hirlrrahlv iiii ri'.isrd liv Ihi- rla~liiilv of ihi- . .iriil.ii;. , ihinis vi-
ail simullamously ami in ihi- Mnii- manm r.
■-Iirno,o,|al aril, ul ,1101,, ,, ,|, III, innii, ,1, hui ii jsmn-
Ihe cosi,„,rli l.r.d .md lli,- , osi,,.i,rnal aril, nl.iiion.
THE ARTICUlAnONS AND LIGAMENTS OF THE HEAD.
Tl .• onlv movable joint bt Iween the b.,n.s uf the h , I is th, 1, nip,M,. masillarv articulation.
The remiiininK Ix'nes are unile,l by sutures, the termiii(,|,)ny of \vhi,h l...s alrea-h been discuss,,!
m
lif
ii8
ATl.AS AM) TEXT-BOOK OF HUMAN ANATOMY.
Fic. 189. — The right tompnro manclihukir articulation seen from the outer side (])
Fk;. igo. — The rijiht tempuro-mandiljular articulation seen from the inner side (', ).
Fii;. in. The rii^ht temporo mandibular articulation opened hv a sagittal section,
arWi iias been removed (\).
The zygomatic
n
in the sect. on ujKJn osteoloj^y. Considerable quantities of connectixe tissue are found onlv in
the s])henopetn)sal fissure, in the foramen huerum, and in the ])elr() occipital fissure {sphcno-
petrosal and pciro occ ipilnl synchondroses).
THE TEMPOROMANDIBULAR ARTICULAnON.
The temporomandibular articulation iFigs. i8(; to iqi ) is the joint Ix'twcen the condyloid
tircKcss of (he mandible and the nnuulihular jossa of the- tem](oral bone. It is completely
sulxliyidcd into an U])])er and a lower portion by an oblong, biconcaye urlkuUir disc (Fig. i()i),
which is adherent to the capsular ligament by its circum*'erence. The two joints which are thus
formed, namely, that belwei'n the mandible and the disc and that between the disc and
the mandibular fossa, act separately.
'Fhe articular capsule of the joint iF'ig. \q\) is rather thin and relaxed. It embraces the
mandibular fossa as far as its posterior non cartilaginous surface, the articular eminence, and
the head of the condyloid process, and i> insertecl into tlie neck of the mandible. Its external
surface is reinforced by a ligamc nt jiassing from the zvgoma to the neck of the condyloid process,
the Umporomtuidihular l<:\t,riiiil h.Urah lif^amrnl (F"ig. iSiji, ;ind it-- Jilxrs ]ia^> from abo\c-
downward and from before backward.
In tli( 11 ni]i"r"ni.inililn;I.ir anil ul.iiion llu' -"iki 1 i^ fdTiiK.l [Mrllv l.> ill. ;ii.ini!il>iil.ir fn.„.i and |>arll\ l.\ \\\v
anil iilar rinimn. 1 , and n\i r llir lalli r an a|i|iri>\inialrly cinirruinl surfai r im !'•> luad of tin ,ond\ ii i- I'nrnud l.\ llic
artii ular di-i . Tin two ii in|)or>>ni.ind)luil.ci- ar!i( ul iliun^ a. I sinwillaninu-li
Will- ilu- inc.ulli iv i>|.,iird ill. Iliad nl llu imidvlc nilh llic inirrarlii u'ar di>i Kliilr-. fnrwanl Uimn iliv irtiiular
I mini 111 1 . and wlnn ilh- nmulli i, . IumiI it -liii^ hai k into 1 n ni.imlilmlar lus-.i. llu- np, ninj? and 1 jn^inn of llic- nioiilli
arc (iinMiiucnllv aiii nr|i-d by a vjidint; uf ihr niaiidililc (.1 niidinK j"inii.
In aildiliiin t.. lhi> rntidilud fnrni of liinnf inimnu ill. llu .irlii iilalinn |.iivMv-.r^ a -i 1 mid kii d ■■!" mntinn. ilv laliral
i|i-|i|.iirnii nt lit I 111 niandilili in n fi rrnn- li. the- >ku'il. In ihi^ 1111 i\i nn 111 niu inndvluid In ad h main-, in llu- maiidiliulai
'iK-,! uliiii- ilir ulli. T aiKani 1 - uimn llu ariii ular 1 mini m 1 , 1 innviriunl uliii hi- ■' iii,s,i!,|i- \( h, n th,- mnulli i- ii| mud
tit Its ^naU--t (Ntcnl, linlh tlii' liin^r and llu- laur.il miivi nu ni> arr iniiiliiiud in ir .u I nt nia-lii alum
INDEPENDENT LIGAMENTS IN THE HEAD.
In the vicinity of the lemporoma\illary articulation, but without .in\ direct cimneclion
with tile joint, are situated two liganii ills, the spheaomanclibular ligament (i''ig. ii»oi and the
-tvlomandibular ligament (!''igs. ie;i and ic)2). Tin ^pluiwimiiulilnihir linaiiuiU arises
I'roni the under surface- of the greater wing of tlie splic-noicl Ixine near il« spine and is
inserted into thi lingula of llie mandilile. The styloiiuitulihiihir Hi^nmoil takes origin
from the styloid jirocess, which i- freciuentl} embedded in the ligament for some distance,
nrui ji.Ts^is til trii inner suriaic cd liu- .iugK- uf iJu- jaw. Rulh iig,iiiieiil> ,iic \m-:iIs and
resemble fasc i.i', and thi^ i^ partic iilarlv true of the stylomandibular ligament, wliiil. radiates
(lircelh into the fu.seia of the internal pterygoid muscle (bimtipharyngcal fascia, see page 184J.
i
iimiioivm iintilnihir Ui^nninil
/\Xt"ihitic inch
I
/a t'T/Ull
iiiuliti'iy
meatus
Miisloiil /innrss
Sivloiiiciiiili'/iiiliir lii^amfiit
(OllilvltVtl
ItroiTss
t-ii'. ISO.
Arliniliir iiiiiiiiihi-
h'lii/itirii/
lii'iii'
I'lliyLilUll /l^ll(■|'^^
SpllOIOK/ llOlli'
liiiipoidl hoiii'
SpUiiu'iiiiiiiili-
hiihir lii^iiiiiciil
/\i^i)miili('
hiiiif
.\itliiiliir (ii/i''il/r
Artitiiliir ilisf
( iHlHWill /)/l>i( >s
fin. l»l.
I IV. I'H).
!h
H
.:'^..-:|,;5S7^':i^;,5^^;1
•T *
<^y7..^^4^
'mm-.^^^-
THK JOINTS AND I.U.AMF.NTS OF THE UPPER EXTRKMITY.
liq
In addition to these structures, the head possesses another indq)endent hf;ament, the {>trry-
aospimus ligament, which passes fr.,m the spine of the sphenoid Ix.ne to the upper extremUy
of the outer plate ol the pter>f.oid process. Sometimes this ligament l)ecomes oss.hed, and it
then forms tlie ptery^ospinous process (Civinini).
THE LIGAMENTS OF THE HYOID BONE.
The Rreatcr comua of the hvoi.l are connected with the Ixxly of the h.nc either bv movable
joints or bv svnchon.lroses, or they arc united by synostoses. The lesser cornua are fre(|uently
cartilaginous and are connectc.l to the Ixxly by movable joints or bv syndesmoses.
Kach lesser cornu is connected to the styloid process of the tem|.oral Ix.ne by the slylohyonl
liganunt.
\ iKirtion t'\ lln' li'sscr cornu.
,r 1 r..a of . irtilni;.- noi .onncdc.l th thi- tn-ni,l lKim. somolini. , .•NtotiHs im.. ibi-
.,vl„hv„i,l li,:>,.cnt, an.l in a similar n,anncr .lu- stvlo„i pn„«s .,r ., ., mM t».ny spuuU- may .vu,.! '^^^^^^^J^^
mon.; Al, U,u.- ,«,r>i,ms, the k-sscr ...rnu, the s,yl,.hy.,ul liKam.nl, au. .h. stylo,.l ,,r.K,.s.,. hav. a ,..„„„on or,«,n ,„
thf si<cini! vi.-n'ral arih.
IE i
f 1
THE JOINTS AND LIGAMENTS OF THE UPPER EXTREMITY.
THE SiERNOCLAVICULAR ARTIOH-ATION.
The sternoclavicular articulation ( Kif,'. u)2) is the joint between the clavicular not(h and
the sternal articular surface of the clavicle. The two arliculatin- surfaces are incn^iruent,
but thev are adai.te.l ti. ea. h other bv the interposition of an arti.ular <iiM , whuii divides ihe
articulation int., two completely separated cavities, the articulation in this respect rex niblm-
the temporomandibular joint. The ed-es of die disc , the inner one in particular, are M.m.wliat
thickened. . ■•••.- i
The •irticular capsule i^ thin and rclaxe.l, but, c^xcvpl "n its inferior pcrli-.n, U is reml-.rced
upon ill sides bv sironj: liKaments. The mc.st striking <.f these is the sUrno, lav, uhr li^am.nt.
which is adherent t<. the anterior surlace of the capsuU'. The hiUrdaviau.n Ir^.m. nl is a sint^le
li-Mment which passers a. n.ss the jiiRular nolcl, al the ui)l>er mar-in nl tlu^ sternum and en
ne(t> the sternal ends of Ixith clavicles, tlnis reinforcing' the upper pcrtinns c,f die ca|.sule> ol
bciili ■.tenvHlavicular articulations.
llu' a>slo<t.ivinil,ir [rhomhoid\ li^^,nur,il i-, exceedingly slrc,n.^, and altlvni-h really an incle-
pendenl ligament it belonf;s In.m the functional standpoint to the Mcrnoclavic uiar articulation.
It extends between the carlilaue of the lirst rib and the' costal tubcrn>iix ol die . l.nicie . and
almcsl completelv fills the s,,a<T bctwcrn the sternal end of the claNi.le and llu- lir^t nb. lis
fibers are ralher'short and become tense when liie clavicle is but sliglul) aUlucted from the
thorax.
Tlv. .„.rn,«l:.vi,,.lar arliculalion is an ar.!M„.i.al join, ,in,l ils ran*;.- ..( mo.inn cv.ml.l I.. ,|L.itr .nn.ia.ral.l,- «■ r.-
i, n.,t for th.- n-inf„r.M,K liKam.n.s, |urli,ularly ,!„ , .M.„ l..v„ ular hRannni. « m. n unu,. ,. u..r, ,.... ,n,„k,.. ,l.g,..^
Slii,; m,„i.m .,f ,he. .lavi.l.. i- ...... mpaniv.l l.v a ,.r.,n„un,e.l movenun. ,.( ,lu ,.a,,ula. .n.- ih. ,lau.l.. R.-ncrally a, ,s
as a livcT f.ir the- latu r Ixmc.
Bb. 1
Mi
'-A:
. ' - .,'-;- \ ' ,^„
'1 ■, -. . -
*- _r r - ■ .' '^ '- "III'
ill
} i
H
120
Fic. iq2. — The
Fk;
I'lC.
ri(.
Fk.
Fl(.
ig?. — The
104. —The
105. — I'he
106.— The
11)7- A fn
ATI.AS AND TKXT-HOOK OF I.JMAN ANATOMY.
two sternoclavicular joints, tocjether with the lostostcrnal articulations of the two upj)cr
ribs, seen from in front. The right sternoelaviiular joint has heen opened by a
satrittal section (i).
left shoulder and acromiocla\ icular joints seen from above and from the inner surface (J),
left shoulder-joint seen fmni behind, the Ion}; head of the tri eps being cut and
the terminal jiortions of the suprasi)inalus, infras])inatus, and teres minor muscles cut
;;nd turned outward {'i).
left shoulder-joint seen from behind and above. The acromion process has been
removed, and ihe nei.uhborinj; muscles treated as in the preceding t'li^ure (}).
socket of the left ilder-joint after removal of the articular capsule and the tendon of
the biceps muscle ii).
)nlal longitudinal section of the shoulder-joint, parallel to the tendon of the long head of
the biceps ( j ).
THE ACROMIOCLAViaJLAR ARTICULATION.
The acrominc/d- • uUir arl'u illation (Figs, u),:;, IQ4, and i(>6) is the joint between the acromial
articuhir surface ol . lavicle and the acromial articular surface of the sca])ula, and it conse-
(juciitlv forms th.' connection between ihi two com])()nenls of the shoulder girdle. The articu-
lation ma\ contain an articular (li>c, but it is small anrl \aries greatly in the degree of its develo])-
menl; it is frerjuently incomijjete and often entirely absent. The up]ier iwilion of the articular
ca])sule is the strongest, and i.- still further reinforced by the acnimUiclaviitilar lii^aiiunl (Figs.
1CJ4 and J0), which connects the bones forming the articulation.
.\ >trong ligan-.entous connection between the acromial end of the clavicle and the scai)ula
is elTecteil 1)\ the loractulavkuhir Hi^tinunl (Figs. 11)3 and h)(i), which passes from the upi)er
surface of the base of the coracoid process to the coracoid tuberosity of the clavicle. The liga-
ment is comi)ose(l of two jjarts, an anterior tlat cpiadrangiilar portion, known as the trapezoid
lif^amntt, and a ]H)sterior triangular one, broad above and narrow below, the (())((;;'(/ linamrnt.
Between the two the siibclavius muscle is inserted.
'\'\v ;iinmiic>ilavicul;ir urtiiul.iiioTi ha^ hul 3. slight T:\n\ic of motion. Thi' roracoclavicular lig.imont acts as a
chcik ligamiTil, jii^l a< \hv . ii!,ioi lavii iil.ir IJKaniinl dcK-s in llii- sli-rniKlavicular articulation. Thf relative- position of
tin- two Ixmc-s, i.in -, .irtcly Ik i handed voluntarily, Imt pa^sivi- tnovrTin-nts, prmlui in^ a < liange in llif angle lic-twrtn
the two Ume^, ell ., oc i ur. The -niall, imlistim tly Imumleil, and usually ll.il articular surfaces allow of a liisplannienl
of the two hones, hut llse direction of the movenitnt is not determined hy the- slwpe of llu- articular facets.
THE LIGAMENTS OF THE SCAPULA.
There are three ligaments attached to the scajuda i Figs. \i)\, rc)^, and i()6) which do not
luiong to any of the neighlKiring joints. These are the loracoacromiai lif^amrnl, the superior
transverse lif^aweul. and the injerior transverse lii^ament.
The KiraniiK romial lii^ament (F'igs. u)^, it)4, and it)6l is a llal, tense, strong ligament whit h
connects the anterior margin of the acromion with the posterior surface ot the anterior e.Mremity
of the coracoid pnx ess. It is situated immediately alxive the shoulder joint.
The superior Innisi'erse /ii;ameut ( Figs. 193 and \>)^) is a shor', tense ligament which bridges
j»«t
Articnhir i\i/)siili
(AKiitl nirtilii!;!' I
(A^stiiiliiviitiliir
limiiiifiil
Miiiiiiliriiiiii
Si f mil/ sYiichoiiilrosi-i
C.ldvicli
ConiU'Cliiv iiiliir lii^iimeiit
il'onoiit /lorticii)
Siipiiior tninsnrsc ligiiniait
SliTiioiliiviiiihir lii^iiiiicnt
Riiiliiilc sliiiiiKv^/ii/ //;'•
/•Vi,'-. 102.
C.ostiil iiirti/(i!Si' II
C.onuoiliiviciildi- /ifTii/iti'iit ( fni/iiZ(>itl /iciiiiiiii)
Connviil /inurss
(AViiiV-(irn)iiii(i/ lif^diiieiit
Acromion
liitiiliibciriiliir miuoiis
••liidl/i
Snl'^i'o/iii/iins
I t'tii; hiiiil 01 biii/i^
. Ji
/ /<^ 103.
*^
/fj-;
AiroiniocUiviiiiiiir ligament
('oriiiv-nnvniinl lii;(imi'iit
Siipnispiiintii>
Infriispiiititiis
Amimioi!
Ti'irs minor
H II nil I IIS
Spinr ('/ scd/'iiiii
F-'i'' 104.
V.
' ;i
Mi
Sii/iriis/iiiiiitiis
liifnispiiHitii^
Siipcrwr trctiy'Virsc lii^iinunt Spine of ^iiipiild
Cormoid prociss y"^
Connvhiimrral !ii:iiii!nit
/ins iiiiiior
l.onfT hi-iid /loaw.nt ^v '
of triiips \
ti^. 105.
I »
Clttviilf
1 1 •ape'. ■ ii !U" twnt
Anvmh<,l(ivinili}r lii'diiu nt
\/r,viiJO/l
('ortiivi/,:. iiiilar /ii^iiiiii/it (C.oiwitl /nirlio/ij
C.ordcviil /'ivnss
Coniio-atiomiul /igami in
I union of lorii^ liriiil of hiirp
(i/iih'idiil lip
//''. lOh
I out; liCdil of trinps
('oiiK
ConuohiiiiiiTiil li''iiiii(
hittidihriailiir iiiikoiis slirnth
-/■...J... ,/■ / I. ...I ,*■ /,.* —
r r .'.•[IC:.' ',' ft".':,* •••r.-'f fj; r-."r/-~
ii\ ItV
■ i
|l f I
|i ' I ;
t I i
i^'
"Svi
Tin: JOINTS AND I.KIAMFNTS OF THK TI'PKK lATKI.MITV. I2t
over the scapular notch and converts it into a foramen. It is occasionally nphKcd by hone
(sec page 84). The su])rascai)ular nerve jjasses lieneath this li,t,'anient. while ihe transverse
artery of the scapula (suprascapular artery) passes over it.
The inji-rior transverse lii^amcnl (Fiif. n)-,) is much weaker than tlu' superior one. It (on
sists of delicate connective-tissue fasciculi which form a l)ridge iieneath the base of llii' acromion
where the sujjraspinous and infrasjjinous fossa' communicate wilh each other, and (oNcrs (crlain
small branches of the blowi-vesscls. The lif,'aments of the scapula belong lo that class of liga
ments which take the place of bony strui'ures.
THE SHOULDER- JOINT.
The shoulder-joint (Figs. 19,^ to 197) is the articulation between the glenoid cavity of the
scai)ula and the head of the humerus. The f^lfiioii! cavity is relatively small and very slightly
concave, but it is considerably enlarged and (leejjened by a markedly fibrous articular lip, the
glenoidal lip {glenoid lif,ament) (Fig. nK)), which surrounds the margin of the lH)ny socket.
In spite of this, however, the socket of the shoulder-joint is still considerably smaller than ihe
head of the humerus, and conseciuently doi 'lot interfere wilh the free movemeni of the latter
bone.
The articular capsule (Figs. 194 and 11)5) is roomy and relaxed, as must necessarily be
the case in a freely movable enarthr)sis. It arises from the margin of the glenoidal li|) and
is inserted into the anatomical neck of the hunums, and aUhougli il is in itself thin, it ac<|uires
considerable strength from its adherence to the tendons of the surrounding m iscles (supra-
spinatus, infraspinatus, teres minor, subscapularis) and to a reinforcing ligament, the loraio-
humeral ligament (Figs. 195 and k);). This ligatiunt arises from the outer Inmler of the ba:.>
of the coracoid process and passes, independently at ("irst and then inseparably connecti'd with
the UP1K.T and iK)sterior i)ortion of the capsular ligammt, to the insertion of the latter structure
in the neightx)rhoo<l of the two tuberosities. \ somewhat weaker lasiiculus strengthens the
inner jMJrtion of the capsule.
.\ i»eculiarilv of the shoulder-joint is that it lontaitis, throughout its entire length, the tendon
of the long head of the biceps (see page 188). This tendon, which arises from the supraglenoid
tuUrcle and is adherent to the ujjper portion of the glenoidal lip, passes through the articular
cavitv iK-neath the coracohumeral ligamen' and leaw^ it at the intertuberc ular gnniM-, Ining
accompanied for a certain distance outside of the joint 1)\ a tubular prolongation of the synoxi.d
membrane, the inlertulurrular miKoiis sheath (I'igs. n),? and 1071- ri'i> portion of the inter
tulxrcular groove is lined with cartilage. .\l the termination of the mucous sheath the svnovial
membrane is closely adherent to the tendon, .and il also extends Ix'neath the tendon of the uli
sca]ndaris muscle in the shape of a bursa which communicates with the- articular ca\ii\ (Fig.
icj<). This suhseaputar bursa has a very thin wall and is siluali'd iHtuath the concave anterior
surface of the coracoid i)rocess, Ixlween the coracohumeral ligament and the reinforcing libers
of the internal portion of the capsule.
Till' sti.mlilrr jiiint is ihr ninvt (rnly mm.ililr .irlii ul.tliuii in tin nuin luini.m UhIv, .md |Hrmils ut mi'viniinl^
in .ill iliriiti"n> 'I'lir i hiif imnfrntiil^ iiriv |Hniluluni munniinl- in I hi -.ikiImI pl.im . wliii h an- nmri r.xli-nsui mii
4 ;
Hi
■^
l'
122
ATLAS AND TKXT-BOOK OF HUMAN ANATOMY.
Fig. 198.— The left elbow-joint seen from in front (§).
Fir.. 199.— Ttie left elbow -joint seen from l)chin(l and from the radial side (?).
Fio. 200. —The bones v)f the left forearm with the interosseous membrane; the annular ligament has
l)een divided (J).
I Iff
I '
'!l
rinrly ih.m postcriorlv; r.iisinK .ind lowering iif llu' arm in a 1 oronal |iiani' (alMlurtion anil aildui ti<m, ihi- former motion
not ix.'inR possitilc U'vond a horizontal |ilanil; anil rmation of the arm alx.ut its longituilinal axis. During the move-
ments of the arm the eapsular ligament is thrown into folds \i\Mn unu side and made tense uixm the other and in certain
extreme positions it may ai t as a ■ ' -ck ligament.
THE ELBOW- JOINT.
Thi.' tllx)\v joint is a typical comijound joint, bcini; formed by the association of the lower
end of the humerus with the u^jjer ends of the radius and ulna, and so consisting of
three articulations. The trochlea of the humerus articulates with the .semilunar (f,'reater sigmoid)
notch of the ulna (the hiimiro ulnar artktilation), the cai)itulum of the humerus with the
depresserl .surface on the head of the radius (the humeroradial articulation), and the radial (lesser
sijjmoid) notch of the ulna with the articular circumference of the radius (the proximal radio-
ulnar articulation).
The three articulations are surrounded by a common articular capsule iFigs. i()S -. ■
which i> HHimv and relaxed, particularly in front and behind. It encloses the threi
th. lower end of the humerus (the olecranal, coronoid, anil radial foss;ei. is attached to 'i a
just below the tip of the olecranon, al the mar.nin of the semilunar (urealer si>,'nioidi not. .i, and
at the tip of the mronoid process, and the entire head and the fjreater portion of the neck of
ihe radius are situated wir'iin it. The only portions of it which are firm and tensi' are the lateral
ligaments and the annular lii'amrnt which surrounds the upjur end of ilte radius.
There mav be re»()i;ni/e:l a radial or external lateral lii^ament and an ulnar or internal
lateral lii;am(nt. The radial lateral lii^anienl { Im^'s. 1()8 and i.)()) ari-es from le estevnal ei>icon
dyle and jia^ses a> two fasciculi to the annular liKamenl, whh whiih a jiorlioii of ils tilnrs are
nmtinuous. The ulnar lateral ligament (Fi>;. luXl ari>e^ from lln internal ejiicondyle of the
humerus and passes in a radiatini: manner to ihe idnar iiiar^iii i>f the semilunar notch.
The annular lii^amenl (Fii;. ii)i)> i> a lirm teu'^e liuament wiiit h surrounds the liead of ilie
radiu-- like a slini; and fornix three fourths of ihe i ircumference of the so( ket for the pivot joint
of ihr j)ro\imal radioulnar arlii ulalion. ihe riMiaininj' fourth beinn; formed by the radial (!e>ser
-i^'inoid) tiiiiih of tiu- ulna. Tlie liijament .irises from ihe anterior margin of the semilunar
ijireatir simnoid) tioldi and is iiisirted inlo llie i><)siirinr margin of tin' nidial noUli. Hclow
it the lapsule is tliin, and at ilie ne( k of the radius forms a small proirusion wliidi is known
as the saeeuliir reiew.
The braihialis aniiiiis musLle passes ,.ver ihe anterior surface of the capsular li^jament of
the ellwnv jojnl 1 !■ iti. .!0i 1 and Mime of lis liUrs are inserted direttlv into this siructure. The
tritcps musde, jiartii iilarly lis middle head, holds a similar relalion lo the |K)sterior surface of
the cai>sule. from which liie lendon of ihe musde is separated by fattv ti.s.sue.
Intrniiil i/iin'/iilv/i
I 'I liar IdtiTiil iijitniuiit
/xtiniii/
i/iKvndvIr
Rii<1i<il
lulirni ■
lif;amiiit
Anmiliir
/i/jiimciil
fy'illhll'i
Xrliiiiliir
.'iipsiili'
r \teriiii!
Iiiltiiil
liiiiiinciil
iiriiiliir
lifidiiunt
iii(ti>n of
hi I I'll •<
Sriiii/iiiKir iidtch
MW
ik4
Aiiiniliir riii'^iili' of ili^tut
iiiilii'-iilmir iirtiinliitioii
fh'. 200.
Aiiiiiiliir
liiiamiiil
Arliiiilar
dtriirtitetrntr
('/ riutiw.
Iiiidoii of
liici/i-i
<)/i/i,/iii'
/ii-iiiiii III
llll'lll/inilli'
•
i ■■
Hi
<l
m
II i
-■>.—■ . —
THE JOINTS AM) I.IGAMF.NTS OF TlIK IPPKR KXTRFMITY.
1^,5
From a nhvsioloRical standiK.int the cl'oow is a combination of two jomts only, smcc the
humcro-ra.lial articulation does not ftmction as an independent joint. These two jomts are
the hinge j<,int of the humero-ulnar articulation and the pivot joint of the proxmial radu. ulnar
articulation.
Th,- n>..i..n „f the f.marm upon the arm i. not a pure hin^e motion, but rather that of a spiral joint, .ime the
f f h , .KhU , . n.l tlu. median ri.lge of the semilunar not. h reseml.le that of the worm of a >, rew. bron, a
r,.i.,.rfiv.- hones ire scareelv in eonlait ilurinR flexion. ■ ,r \
'''^^^■S:;::;.:!-:';:!::! -'u;;:.l"i"-.v passlveU. invoU.. in ,he p.... ment of .he pro.,,.. ra.,io.>nar ,oint
sinee t^'r!;:;;: :;;:.': in .he ...We. a,«,u,'ts ion. a.is, an,l the a-tua, pivot n,oven,ent takes p tee .n the prov
ana distal ra.lio-ulnar articulations. Both movements of the elhow-ioin. are , o.npie.elv „„l,.pen,lent,
THE DISTAL RADiaULNAR JOINT AND THE INTEROSSEOUS MEMBRANE.
The radius and ulna are connecte.l l.y a thin inlrrossrous mvmlmmc i Fig. :oo) which alny.sl
comple.elv nils Ihe spate intervening between the two b..nes of the forearn,. . .- at'aehe.l to
,he interosseous ridges of the two bon. s ami consists for tite greater part ot hbers wh.cit pass
obliquelv .lownwanl from the radiu. to the tdna. It does no,, however. eMen.l -o ,l,e t„.per-
moM part of the interosseous space and ,.osse>ses an opening in i,s lower ,.ort,on tor lite ,.assage
„f bl.KHl vessels. 11 represents a memi.ranous supplement m il,e bo.us ol the lotvarm. and.
lii<etheseslru(lu,es, it gives origin to various muscles.
,„ „i,li,ion lu the connection bv the interosseous membrane, tl,e radius and ulna are hel.
,ugt.tlH.ralM.l,v the .W/7".■/^^'^m■»/.l••ig>.r..,and.oo^ winch passe>nl,l,MUelvfn,,nllu;..,nMt,,,.
pro.es> of the ulna L-lhe lower margin of th. tulxTosity of ,he radius, .nd „ dtreclly ,n .onl.ul
Willi die tipper iiorlion of liie interosseous meml)rane.
The .li^hil r.dwiilmr hint (Figs. -o. to .0,1 i- 'lie joint betw.-en ih.^ ..rit. uiar , iirum
R.n.nce of the ca|,itt,lun, of' the uhta and th,. uin., isigtroi.l. n„.,h of ,h.- ra.lm. an., a K,,
,,.,ween ihe , apilulum of ihe ulna ami llic ar.i.uiar .Um whi, h st.pMr.tlc .h, h.:.,! ol liu- uin,,
f,„m Ihe iriqueiral -cuneiform, bon, . .Xnalmni.ali. il i> an indepen.Un, ,o„.,. bat 1, tun.l.on^
in assotialion with the, ovi,iial,-,i,iio ulnar arliculali.m.
Tl,e s.Hkel f,.r du .apiluhim .-f ih.- uh.a ■ Kig. -'O.-. i^ fonv.e,! b; ,„■ .Inar no,.!, ,. ,h.
rulius as well as bv the ,„-ncuiar dis. ; ihe portion of ,l,e s„. ket formd Us iW r,„bus ,- ah,,,,-,
verlital and that ft-rme.l bv the .lis.- is praCi.allv itori/or: .1, and . p..rlion ol ihe lai, ,;d s„rla.,
„ uvll i> the inferior surfatr of th.' .ap.udtim of ti,e ulna c,,„s..<|uenlly res,, ,n ih.^ s.„ ,.., 1 ol
;,,, i,.i,„, Tite a,licular cai-suie is so.mwlial r,H,mv and relave.l, and .. prol,,nga,,„n ol .1
k,iown as ihe s,.,.ul.,r nass, exten.is upwanl betwe. t, the Ihmu, ot ,h.- forearm ,.lH,ve iht K.,1
'" ''\\l'Zi,uLr ,li^r is allach.^l upon <.ne si.je to line tilnar margin of Hie .nnl.li,- r'"-"> >'''
the radius, where it ins-'psibiv merges in.o the <artilaginou> covering of this porl.onof tin bon. ;
i ;
i i
ill
m%
I. !
I r
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
lumd (i).
„,„„ ,h. ,«1» ,i.l.. it i. ..uclK,, ,« ...c ..yloid ,.-«» ot ,ho „,na, I™ rare in.anc, i. i.
jicrforalL'tl.
r il mt till' ulni which i~ simuUaniously
The movenK-n. in .h- .li..al ra.li.vulnar join, is a -••^''■;" '' ''"^^^nown as pronaiio,,. ,he radius is apphcd
earn., ou, in ,ho „n.xin,a, .aa.,-uh,a. ani.u,..,.n ^^ ^^^^^^^ )Lr. ,„ L ,.a.aUc. p„si,i„n of U. ,.o
„,,|i,,..lv to Ih. ulna, so ,ha. Uu- .wo bom-s . ros.s. f^^ l'^"^' , '^,.^,„^^ arlicula.ions ..asses .hrouRh .he hea-ls of Ixnh
aljout .he ulna amounts to about i8o degreeb.
THE JOINTS AND LIGAMENTS OF THE HAND.
Those of the carpus are: (.) The radn.arpal -;-'^ " "^ / .^^ - h nu/... m<7„i.r/>./
"""rle j:t:of .he angers indu.le the ...... ^.^/<./.'«.-/ -^/-''-'"- -^-' "^^'"" ^ '""^
blitilaitiiciil arliiiihilioiis.
THE JOINTS OF THE CARPUS.
ra.Uus an.l the triangular ar.ieular d.e ..nerpose. bet. n ^ " ^^ , ,^„„,,..
,.,., ,x,ne upon one side, and -he pn.Mmal -' -; !' ^^^Z J^ j .^ , ,„„, ,;;. ..her. the
navicular (seaphoi 1,. lunatum ,semdunar . and ''''I '.\^™;;\ •;.''. ^.J^^^ .cuneiform) lx,ne
navicular and lunate l.nes -!'->-';;j ^^^ ^^^i : r^^ "'- -^^''^^ ^"^"^
,vi,h the triangular ar.Kular d.se m su h a "^' "';,.^. ,^,^^, ,,„,„ f.,m a condyle.
;;;;=rrrrt::;-::::r--^^^^^^^ -'^
.*«-—«"■": -•■v'';''';x";;:::'';:":'"r';:!;"::"n.ai ani,- ,«.„ «,».!»,
i-n.ni liK Mi.ip. cii I. .•.M.y... ••„ in d livin in the coronal iliameler.
,,i,„. The curvature of the surfaces ,s ^'reat.r ,n the .ag.t.al ">■" " j„^,.,„„,
Iriir/is
fliiinaiis
Ohrranon fossa
Tendon of triceps
Snbaihineons olecranat bursa
Synovial cavity
Coronoiil fossa
/ ' */ I roctiica of hiiincrus
•aian vein
lirachiul ai icrv
( Ina
his. 201.
I Ina
Railiw.
Di^ta/ radioulnar articulation
Articular disc
I rii/iiclnitn ^ ,
Intercarpal articulation I':'-
I la lua I II III /.fi
(arponietaccrpiil articulation f. . , '
.Metai arpal hones
(Uipilaliiin
I iiiiatc hone
Radiocarpal articulation
\iivi(nl,ir hone
Radial lull ml ligament
\ (ireatcr niiiltan^iilar hone
>\ \ i.iini"ii,ttu<in*ta lit 'tt:iliiri."t
,'f rliiimh
\ \ Metacarpal hone
/(>-'/■ iiiiiltiin^ii'ar hone
\\\
w
m
fin. 202.
i
.1*
f
I \ '
i
im^
^,
THE JOINTS AND LIGAMENTS OF THE HAND.
125
the one side, and by the proximal facets of the greater and lesser multangular (trapezium anc
trapezoi.l). capitate (os magnum), ami hamate (unciform) bones upon the other. I he hrs
row of the carpal bones practicallv forms a socket for the head of the cap.tatum |os magnum)
and the proximal portion of the hamatum (unciform), and toward the radial, and to a certam
extent also the ulnar, side of the j<.int, the proximal row exhibits a convex and the .l.sta row
a concave surface, since the navicular bone presents a convexity toward the greater and lesser
multangular (trapezium and trapezoid) Ixmes. As a result, the line of the jomt .s not a simple
curve, but has an irregular CO shape (Fig. 202). , , , , ,• ,,1,,.
The articular cavitv of the joint is ver> complicated, since it extends from the actual articular
line both proximallv and distallv between the in.lividual carpal Ix.nes of Unh rows. It is sep-
arated from the rad'iocarpal joint by the previously mentioned ligaments, and sinular ligaments
connect the tones of the second row and separate the in.ercaq.al from the caq.o-melacarpal
articulation. The latter separation is incomplete, however, and these two articulations usually
communicate totween the capitatum (os magnum) an<l the lesser multangular (trapezoul) Ix.ne,
since interosseous ligaments are usually wanting in this situati.m. The thin articular capsule
exhibits no special peculiarities ami resembles that of the railiocarpal articulation
The articulatio» oj the pisijorm bom is a small unimportant joint between the contiguous
surfaces of the pisiform and tri<,uetral (cuneiform) bones, and is usually an independent art.cu
lation. As the ].isiform bone is simply the sesamoid bone of the llexor caq-i uhians, this joint
i. analogous to those situated between the sesamoid bones of the great toe and the hea.l of the
l-.rst metatarsal Ix.ne. The ligaments arising from the pisiform Ix.ne are similarly to be regar.led
as continuations <.f the tendon of the llexor carpi ulnaris; they are tlR. p,so hamate Ir^amnil
(Fi.r ^04), passing to the hamulus of the hamate (uncif<.rm) Ix.ne. and the piso^metacarpal
ligament (Fig. 204>, which pa.sses to the base of the fifth metacaq.al Ix.ne and sends prolonga-
tions to the neighlH)iing metacan)al Ix.nes.
Th. carpometacarpal hint iFig. 202) is the joint between the- bases of the secon.l to the
Ufth metacarpal In.nes and' the distal articular facets of the lesser muhangular (trapezoid), of
a small portion of the greater multangular (trapezium) (see page 01), capitate (os magnum i,
und hamate, unciform .'bones. The articular cavity, which is usually single, communicates,
as a rule, with tiie intercarpal juinl in the manner previously .lescribed. It is sometimes com
,„.sfd <.f tw(. separate articulations, eacli of whicii connects two metacarpal Ix.nes.
Th. b<.nes forming tlie carpometacarpal articulation are capable of <.nly sliglit m,.vemei,ts
and the articular ca].su1e is c..nvsp,.n.!ingly tense and llrm. In a<l<liti<.n to the previous y m.n
tioned surfaces, it also unbraces the lateral articular facets Ix^tweeii the bases ..f the ind.vi.iual
metacarpal Ix.nes (sir page (,.), and the articulation cnscpiently includes the concealed mter
metacari.al articulati(.ns. The articulation i> an arlhnKlium.
Tin. carpo metacarpal inint oj the thumb is the joint between the sad.lle shaped articular
facet at the distal ex.remitv ..f the greater muhangular Ix.ne (trapezium) an<l the base of the
metacarpal of the thumb, 'it is alwavs an independent articulation, communicating with none
uf the other carpo metacarpal jcnnt^ nor with .ny of the carpal ioin.s. From the shape of the
articulating surfaces the articulation is a siddle j..int, and although the surfaces are not com
jiletely congruent, it is the most j.ronounced saddle joint in the human body.
Mi
i :
V
IP
? I!
\
m i
I
i't.ls
i ■
\
! i
„6 ATLAS AND TEXT-BOOK OF HLMAN ANATOMY.
s:;--S:;!;::::;£=-rf^F
ligament havinjj Ik-imi removed (i).
Fir.. .o5.-ArlicuUuion.. of the middle finger >ecn from the sule (i). ^ ^
.hicf movomcnts of ,l,o hand .u- ncx.on, ..f --;^^'^^:^:J" 'jLi,,;,. ,, .,1.-, .n almost complete cinumduc-
Ix-ttcr. ulnar alxiuCion). Ify a cmb.naU.m .nc.c mo^cmcnt. !
tion of the haml. .,„,i ovtrn^ion The aN.-s of rotation of the tw.. liinp- joints are not
The , hicf nxnements of the jomts are "">"" •"' "^^^ ^ interseCinR ea.l, other.* During fe- . ,n of the- ra.lio
placed at ri^ht angles to the axis of the forearm, '- "^^^'^-^ ^^^ilar movement in th. int., ..n.u articulation
larpal articulation, the han.i .leviates to the rad.al ^'^'J^^^X^^^n.^ f.e other exten.ied, the movements in the
the han.l .leviate., to the ulnar side an< f..r -.rr^.'- '.„,.„, (ra.lia' ulnar abduction, as the ,ase may be)
a..is of the extremity neutralise each o.her, whtle the '^ '-■ ' ^ '^ "^ ; ,^, ,„„,,„,ms neutralise each other and
are more pronounced. If toth joints are iL^Ned or extend, d top th. , tl
,hc movements in the axis ,.f the extremity (nexiot, or ""■'-"";"; J' "^, ,„„,,,,,,, ,„, i, particularly true of the
The carpo-metacarpal articulauons are artlu.Kha ^J^^^^^ ^^,,.„ .,„ ,.,„„,;,, .,f Ute hand is increased
carpo-metacarpal joims of the secoml and thtr.l hnRcrs. T1k> mm U „„i,i„„ „f ,he little finger.
„r diminished, that is to say, during hollow.ng or natten.ng ■■' ' ^^^is ih m.'e extensive. Like all saddle joints
The range of motion of the carpo-nte.acarpal ynu of '^ hun. s mu ^^^ ^^^ ^^^^^^^^^ ^^ ,^^ ^^^^^^^^
it is biaxial, but owing to the incongruitv of the -"-'-"« ^^'^ '™ mav be so combined that actual circum-
more pronounced than those of the other. ''';■ -"rl; ^l m awav from the index-fmger,. addu. tion (toward
TZ:.^^:^J::^'^'^^^ r^;:r o;;1. to .. ...^... ...n. the .tter motion the con.
cavitv of the palm is markedly mcreaseil.
THE CARPAL LIGAMENTS.
:!;:v;r;:. «;u» a,:;; ,.; ,1. .„,,„ n.,™™. .-„„-„ ,.„,-„„,. .., »», „.,.,. .„.
1 iiL ui/».M.. r i,„„„,. .,,,,1 i< itt-ichi't Dartii'iilarlv in llic trit uetrai
U, the dorsal surface of the Urs. -^ -^;>;;;;;^ J ^ ^ ^ 2 r.uUocar,a, U,a„u:,> ,Fi«.
(cuneiforr^t) ..>ne. I he ---^'" ■^. ' ' ^^ ^^^^^ ., ,He articular surface of the caq-us
3041. is lonuer than the dorsal one, it ariM.. tiom inc ma _ ,„;„,,_, ,nc .na-mtim^.
and is inscrtetl not only intt, the tones of the lu>l nv., but a...- :utu th. ■ .p.... -
,. ,f ,1„. hmd his bein materiallv m.Klitied by the more n^cent studies .,f these
,This description of the -'"■"";:'; ;'„:':,, ,,,,,.1 l..nes cannot move upon each other; during ra.lial
•iniculalion-. It must not be suppose.l that th. two r »^ . i
Z^Z the navicular Ixine is markedly moved toward the adjacent l.nes.
CM
1-3
I'U
> <
! t
UlMh
mm^mtamimmF^-m
Tin JOINTS AND I.IOAMKNTS ('V li.i HANK.
127
The trait verse car ' (andrinr niiiuhi li^iur )il
which servo rcf. r.ter . of th, k.n- 1
unaa-sson-l.-amcni ;hc ca . It conm■ct^ wo car,.;.!
to th(. idius, and convciis the . 1 groove into a anal.
V\. n the 'or of the caq)a, mal are found . ic l.-ini, '
ran-al I" -lies (!-,'. 204): thcy rad ,ae toward thr h« d ni the
tlu W(//a/c carpal lif^amfiil.
The remainin<; carpal hgamch!> which urn, ihe . d
h,„,.. of the meta.aqial bones are d(si<Tnaled accordin- lo
intercarpal li.^amnils, the iv;/,;r and 'rsal carp" nui^i rpal ,
number and dorsal (four in number, has. ' mr«/.s (I-igs.
basal liganenls a situated in t' nter^^ la n ihe bases
ig. 2S2) is u ])ani. aly stronij liijamc nt
tendons in i>la(e i>er i)a<^e 205) !ha
but is ab' ilta(hed
hich
. onnecl th(
OS mai'nu'
iixidua.i
forniinu
- or I onnect ihem
''ion as the u.l'ir ,'
* and the vol
' 20) . Tlu '.'/'
melan'-pal h> vr
rvv
'lis
'iictacarp
T)
■/(j/flH,!, "/ arliciilai
.nes am' ihc ba-r-
,_ ir , ..rly sph( al, th-
irfaces of the hea f ti
.. t of the bones, so Hat
IS.
T
..f tb^
>urfaces
articular
almar a>
uurin'/ Mon they are
and .. rtxlial ty])es (.C'C/v
an e-cei. :;ion; ii rescml
The articular car
-einf' '■'•'I in several
headh ^ " th' metacarj -
>rr..ill deurt
a. (...nuicl durhifz extension are
IS ,,rc ionse(|uently a mixture of
rile nutacarpo-])halan,ueal joint
vi-'f;^
;nt.
)Ut ihev are
th
F1.NGEP
-05) ar. the joints 1^ n the heads
iialansies. AUhou.^i arliculatin.i;
nts are restricted b> linenl.-. The
■come M.mewhal cvlinurical ui)on the
herical, while
;j';i^lvmoid
'11 umib i>
■ ian-eal articulations and is a true giniilym.
■md 205) are thin and somewhat relaxe.
lalrral //,!,'() hic»/.^ are excenirically in,->erted into the
V. become ten>e during llexion of the phalan.nes; thev
es of the heads of the metacarpal bones c^ee page i)2
reinforced by the accessory volar lii^aiiiniLs (Fig. J04
he llexor tendons (see page 205), and hv the Iraiisvcrs.
M ilat strong ligaments connecting the hea.ls of the sen.nd
dorsal surfaces of the capsules are proteded by the d..r
.euro,es 01 m. .^e.. >... .^s^ 205), which are intimately connecte,! with them.
The nu-lacarpo phala,r>ical ioint oj the thumb always contam. two sesamoid l..nes (a radia
and an ulnar) (Fi.. 204), which are embedded in the articular capsule; th ^ 's .hivcc.
toward the articula .n are covered by cartilage. Sesamoul bones occa>...ia.,, ■ < ur n, tlu
melacarpo-phalang. ioint^ of the other lingers (see also page <)2 :.
which pLs from .he hamulus of ,hc han,.,. : .. iforn,. l,.,.-,- ,„ ,hc has. of ih.- „Uh nu-c, arpal ,k„„.. „ >.- ,h,
meUic.irptil ligamcnl.
arise tP
The a
which
capilulii
to tl'.c ti
a|X)neuro
ir surfaces of '
connec led wid
■(F(7)»CH/\ I Fig.
n ni< ;.. ^al lx)n
i of in. ngers (see
; ,.• il'
i
M
128
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig 206 -The female pelvis with its ligaments, seen from behin.i (§).
Fig 207 -The female jK-lvis with its ligaments, seen from l)elovv (s).
Fig 208 -The male pelvis vith its ligaments, seen from m front (j).
Fig 209 -The female pelvis with its ligaments, seen from in front (s).
Fig 210 -The male pelvis with its ligaments, seen from above (j).
Fig 211 -The female pelvis with its ligaments, seen from above (s).
.,ne extensive n-.auon is in,..,ssih.c. the phalanges an.. e.,nse„uentK- the fingers can be atx.ucte.. and a.Muc.ed. The
mc'taearpo-i.halangeal articulation of the thu,nl> is a pure hinge joint.
The dMal or inter phalangca! articulations (Fig. 205) arc the joints between the individual
Phalanges of the Imgers, the bases forming the articular sockets and the trochlear -rfa.^s co.-
stJturng the articular heads. The articulations are pure hinge joints. Lateral hgamcnts (I-.g.
20 T^the sial-s of the capsules prevent any lateral motion, an.l tlu^ articular capsules are roomy.
Volar flexion is the only movement of which these joints are capable.
It I
l> i
THE JOINTS AND LIGAMENTS OF THE PELVIC GIRDLE.
THE PELVIC LIGAMENTS. SYNARTHROSES AND DIARTHROSES.
The pelvic gir.Ue and its ligaments form the prMs (Figs. 2o(. to 2. . ami 2,5). which, unlike
,he II girdle, is complete l.ith anteriorlv an.l posteriorly, the pu I.k bone, being conneaed
antedorh 1^^. svmphvsiJ antl the p.hic ginllc complete,! posteriorly by the sacrum, whuh
•iriiculates with the two iHuclx.nes either by joints or half joints.
It s^ pin is p„l>is (Figs. 208 an.l 20.,. is a mixed synarthrosis connecting the symphysial
surfa ' o the -two pubic boius. These surfaces are coveretl with cartilage ""-> <'^^-l-;
^ them is niletllv a mass, consisting largely of dense connective . issue and par, v cif . bn^^
. t C. -hich i> ,erme.l the int.pulu, „l,roa,r,i,a„: This interpubi. tissue is ^-f^^^
;,;: ; lihind .,,.1 its ,H,s,erior portion frequently contains a space resembling an articular cav.t> ,
s„ thit the svmi.hvsis is ..mverte.l into a half joint (amph.:ulhn.sisi.
n Uuivsis is reinforce.1 by libers which pass across its upper margin fr.,m te pub.c
spine .^ one ide to that of the other; dus. (ibers an intimately connected w„h dte i,,U.,^b.
r ncirlilP'e ind form the superior pulu. li,,nu,,U , !■ ig. 2.0). 'I he lower margin of the s>m
r- 'rXf;::lf bv a more Llep^'den, structure. ,he arn.a. iinl.ior p.^in l,..^cnt (F.gs.
20^,'and 20«1, Which is approximately triangular and rounds oft the ,H.bic angle.
T cT-s Uricr con,Jc;ion of the peluc girdle is a paire.1 arbcula.ion which ;---;;
.„,roil.a, artnulation. It .Kctirs l.tween the auricular Hirfa. e of the sacrum -- --1;-^
n med surface of the ilitmt. and is an almost intntovable j-in,, a trtie am,,hiarthros.s h
:::;;; irregular surfaces of the two Ix.nes are scarcely adapted for reciprocal movements, and
, . i;.,__,.„. rr,..,o,i:n.r ihr articulation further insure ,ts immobihty.
'" TZ^^ ;;rbeing"comH;.«l bv .he auncular surfaces. ,h. innominate. In.n,. and tite
sac nl: f als^ h-id toother bv a strong ligament passing iK.ween the tul.ros.t.es of the two
■r^fSPHF
W
m
Short ,,ost. sacro-iliac. lig. f;^™;,
li^timi'fit
Iliolumbar ligament
Short posterior sacro-iliar lig.
(jreat tro-
chanter
I is-.er M/cw-V""''"''
ligaiiiiiit
I esser sciatir fornmen
iiij^iiimi! iifi'i 'liilli
Artii iilar viijiyiile Xmiati
Itgamenl
I
■ i
ii
,1/ hii> ioint
i i
\
1 1
:il
!t
l.iimhar vertebra l\
Anterior
\iiterior loiiiritiidimil lifiiimeiit
llioliimhiir //y
Anterior sujurinr
spine of ilium
Greiil Iroihantrr
inal li^.
itlar cii/isiile
hi/i joint
lliofimoral
it
■ i
i!
i >
ill
! 1
r
t ^.r "-•> ■.' '•*>\i t*:.'
f r
i
■
»
!
i •
1
i
I
't
1
1
lil
ih
Anterior longitudinal tig.
Lninhar vertebra IV
Iliolumbar lig-
Anterior saero-
iliac lig.
r
1 Great
\ ■ seiiitir
loiiiiuen
JH im
1 esser
.*. ^-^^
^K'^
••lititic
M---i^^m
foramen
Suiwrior piibie //■,'.
f-liT. 210.
: lllj
II
JM
It,:. 211.
fh
[ ■
!l^
i
ih
^
THE JOINTS AND LIGAMENTS OF THE PELVIC OIKPI.E.
129
space between the tuberosities of the .burn ami ^^^^^^^^^ ^ svndesmosis. but from
les are connecte.! anteriorly by an ^l'^'-^*-';-- , ' :^Li\:,,, ., ,h. ar.i.ui.tion,
the physiological stamlpoint, the syndesmos.s -J*^^; ^^ ,, ' ' , '"^.i^,,, ..^he entnv trunk,
since it firmly unites the pelvic bone to the ^^ -; J ' ^j ^ ,,,,t,,,: Ute ani.rior sarrn-
The sacrum and ilium are als., ---"^ ^ ^ ^^t Cands, con,,osed ..f transverse,
mac li.amnus (Figs. 20S, ^^°' .^"^ .,^'--^\;'"''^. ff,, Hor surfac of the sacrum in front of
oblique, and fre<,uenlly interlacmg hbers, from !!^ '^^ ™' .' j^. ^„ ^,,^, ,;„,, ....ninalis;
.he liosacral joint to the anterior surface oi the .hum, -< -^^ ^ J^. ,., „^, ,,,„^,,,,., ,
the ^.s/.T/<>r sacroiliac lif^amcUs (Pigs. 206 and 2,,^ "/.;;'"; \ j^^^ „f ^^ „,,„,,„, .,f
long and a short Ugament. The ./,<>. 7'-;,:;;';;;^:,^: hi "res, in the region
fibers which pass obliquely ^-"^^^ ;-;^; ^ ^,;:Z^,.,„ i. composed of superficial
of the posterior mferior spme. The loni, posUrwr s j,^^^^,^,
'TX^t^ :r T,;:ii,':r ii™!:;:-:';- .;.: ->.-- ,-." -;
iK)rtion of the dorsal suriatc rorresuond ng short ligament
the sacrotulnrons ii^rcat sacroscialic) Usamenl. It cosers in the corrcspon g
:::;;;r=e.;^:=- ■ r;::.;:";^ ^: >■ -.. - --.
but also w ith the sacrum.
THE INDEPENDENT LIGAMENTS OF THE PELVIS.
m n >«».«- -^'-»'' ;';-•'>■ :;7;',;';::;';^:r;;r:;:l'u.;t'; E"":i
of the obturator gn...ve, the opening, tlie obturator an,a. .1 ig. -H".
.1 .^ ■ .v.rnm.r is it passes downward, but again broaden- out n.ar 1
ll becomes narnmir as 11 pa..i ....-nwuinoiis li-ament I'OsUrimK , and the
inu, the tuberosity of the ischium. I. covers "-..r"' ?' ~;- '^„J.. ,^. ,„, ,07. is ..
:.... lijraments are a.lherent at their m.crsection. 1 he /.,/<//,. m ^'"" ''^^ , ,;,^,.;„
narrow- oblique c.mtinuation of the sacrotubenms ligament, which ,.assc., alon^ •
of the ischium ami pubis and gradually disapi-ears anteriorly.
■; 1:
v. i
1 :
■■ i i!
hi,
I'!
; !
f :
ii
130
ATLAS AND TEXT-HOOK OF HUMAN ANATOMY.
The sacrospinous {lesser sacrosciatk) ligament (Figs. 206, 207, 210, and 211) is more deeply
situated than the sacrotuberous ligament, and arises from the lateral margins of the lower {wrtion
of the sacrum and of the upjjcr [wrtion uf the coccy.x. It rayjidly becomes narrower and jiasses
almost horizontally forward and out\\ard, crossing the sacrotuberous ligament shortly before
reaching its insertion at the tip of the spine of the i.schium. Its pelvic surface covers and is
adherent to the coccygeus muscle (see Splanchnology).
The sacros])inous ligament converts the greater sciatic notch into an elli|)tical foramen which
is termed the ^reat sciatic (sacrosciatic) joramen, and the two ligaments, the sacrospinous and
the siicrotulxTous, convert the lesser sciatic notch into a foramen, the lesser sciatic (sacrosciatic)
joramen. This latter foramen is triangular with rounded angles and is separated from the great
sciatic foramen by the sacros])inous ligament. The sacrotuberous ligament forms a ])ortion of the
outlet of the pelvis.
THE PELVIS AS A WHOLE.
The following l)ones enter into the formation of the pelvis: the two innominate Ijones, the
sacrum, the coccyx, and the fifth lumbar vertebra; and its boundnrics are also partly formeHi by
the intcrpubic fihrocartilage, the obturator membrane, and the sacrotuberous and sacrosulnous
ligaments. The iliolum.bar ligament forms a jwrtion of the ])elvic wall.
In the pelvis may be recognized the jalsr or greater pelvis, and the true or lesser pelvis. The
former forms the llewr of the alxiominal cavity, am' is wide open above and in front and is btnmded
only ])artly by lx>ne. Its cavity is considerably larger than that of the true pelvis, from 'vhich
it is separated by the terminal (ilio])ectineal) line (Fig. 210). It is boumled by the al;e of the
ilium, by the fifth lumbar vertebra together with the jiromontory, and by ' two iliolumbar liga-
ments.
The true or lesser t>'''vis is a short canal, the greater ])ortion ot whose i. undarit'S are bony.
TIk' anterior wall is short while the ])osterior one is considerably longer, and it is open aljove and
Ixlow. The up))er opening is termed the superior aperture oj the pelvis or 'he pelvic inlet (Figs.
210 and 211), whose lx)undani- is formed by the terminal line, by the jjromontory, and by the upper
margin of tile inter|)ubic fibrocartilage. The terminal line is composed of a sacral, an iliac (the
arcuate line), and a ])ubic (crest of the ])ubis) jjortion.
The actual cavity oj the pelvis is lM)unded posteriori}- bv the concave ])elvic surface of the
.sacnmi and by the anterior surface of tln' coccyx; laterally by the jielvic surfaces of the IxKJies of
tile iMum, jiubis, and ischium (the lloor of the acetabulum), by the sacrotulxTous and sacro-
spinous ligami'uts, by the rami of the pubis and ischium, and by the obturator membranes; and
anteriorly by the symplivsis ])ubis with its lit;aments an<l by the anterior extremities of the I. '
|)ubic lx)nes.
Tile anterior wall of the ])elvic cavity is by far the shortest, while the |)osterior wali is the
longest. The |)osterior portions of the lateral walls exitibit two o|)enings, the un])er elliptical
greater sciatic foramen and the lower triangular lesser sciatic foramen; the anterior portions
contain the openings in liie obturator membranes whicii torm the obturator canals (seejjage I2()).
The upper more capacious jiortion of the pelvic cavity is designati-.l as the plane oj pelvic
expansion, while the inferior contracted |)ortion is known as the plane oj pelvic contraction
^tm
THE JOINTS AXT> LIGAMENTS OF THE PELVIC fURni.E.
13'
The inierior aperture oj the pelvis or pelvic outlet (Fig. 207) is bounded by the louxr margin
of tlu- symphysis (arcuate ligamenU, by the tuben.sitiesof the ischium, by the inferior ram. of the
ischium an.i i)ubis, by the sacrotuberous ligaments, and by the tip an<l the lateral margms of the
sacrum. These boundaries, unlike those of the peine inlet, do not lie m the same plane. he
coccyx forms the lo^vermost point of the pehic outlet, and next come the tuberosities ol the iseh.a.
whit-h project do\yn\yard, Nyhile the boundary curyes markedly uj-ward in the region ot the sacro-
tuberous ligaments and particularly at the lower margin of the symphysis.
The angle ^vhich the t\yo inferior rami of the pubis form \vith the symphysis is kno\yn as the
pubic angle (Fig. 209). It is rounded olT by the arcuate ligament to form the puh,c arch.
The pehis is not horizontal but inclined, the degree of its inclination yarymg in dillerent
indiyiduals, but usually ayeraging alx>ut 60 degrees. The plane of the peKic inlet conse.|uently
passes obliquely from aboyc downward and from liehind.
The pehis exhibits, as does no other portion of the skeleton, tyjiical sexual characteristics.
T his i. particularly noticeable in the true pehis. In the female the false peh i> i> lower, broader,
and flatter, and the ale of the ilium usually show a less marked curyature. Tiie true pehis
exhibits similar characteristics, an.l its cavity in particular is more caj ac.ous. In the ma e the
pehic inlet is heart-shaped (from the marke.l projection of the promont.m), while in the female
it is elliptical, and the pehic outlet ■ the male is also much narrower than in the female on account
of the conyergence of the tuberosities of the ischia. The pubii angle in the male peh is forms an
acute angle of alx>ut 75 degrees, while in the female it forms a right or obtuse angle «,o to 100
'^''^'^I^r'a more detailed account of the pehic diameters and of the pehis in its relations to
obstetrics tlu- reader is referred to the text-lx.oks ami atlases of topographic anatomy.
The inguinal or PouparCs ligament (Figs. 207 and 200) is not one of the actual ligaments of
the pehis but is a portion of the a,.oneurosis of the external oblique muscle ol the aUlomen. It
arises from the anterior superior spine of the ilium and is inserte.l into the spine of the ,.ubis.
An almost horizontal continuation of the ligament passes from its insertion to the upper margin
of the' h.)ri/.ontal ramus of the pubis, forming the lacunar ((Hmbernat's) ligament ( !• ig. • ).
THE HIP-JOINT.
The hip-joint or coxal hint is the articulation between the acetabulum of the innominate
bone and the'head of the lemur. The acetabular cavity is considerably deepened by a strong
circular iibroeartilaginous ligament, the glenoidal Up (cotyloi.l ligament) (l-ig. 2i(,), so
that the socket embraces more than half of the spherical head of the femur, and the
joint conscpiently iK-longs to that group of the spheroi.lal articulations which is known
as an enarthrosis. _
The glenoidal lip <Fig. 214) "f the hip-joint is triangular in cross-section antl stretch<-s acn.ss
the notch of the acetabulum, converting it into a cleft like loramen. This i-orlion ot the gle
noidal lip is known a'^ the transverse ligament (Fig. 214).
The acetabular fossa (Fig. 2.4) does not come into dlre.l contact wtih the cartdagmous
surface of the head of the femur and is not covered with cartilage, but by a cushion of fat and In-
synovial villi. From this fattv cushion, and particularly from the acetabular notch, there arises
1! I I
■|^
132
ATLAS AND TEXT-BOOK OF HITMAN ANATOMY.
Fig. 212. — The ripht hip-joint seen from in front (§).
Fig. 213. — The right hii)-joint seen from behind (§).
Fig. 214.— Socket of the right hip-joint after ( utting through the articular capsule and the round h'gamcnt.
The head of the femur has been remove<i (j[).
Fic. 215. — Section through the pelvis and the two hip-joints taken in a i)laiic almost at right angles to
the axis of the pelvis (ij).
Fig. 216.— The right hiji-joint opened through the anterior wall of the articular cajjsule.soas to show the
round ligament. The head of the femur ha.^ been drawn out of the socket and rotated
outward and backward (J).
' t
V'
-A
a broad characteristic lipimcnt of the hip-joint, the round ligament {ligamcnlum teres) (Figs. 214
and 216), which becomes slightly narrower and is inserted into the depression on the head of the
femur. This ligament is flat, and only its external i)ortion is formed of lirm connective-tissue
fasciculi; in its interior nutrient vessels pass to the head of the femur. It lies in folds u])on the
cushion of fat in the acetabular fossa, and on account of its length and soft structure plays little
part in checking the movements of the joint.
The strong articular capsule of the hip-joint (Figs. 212, 21.^, and 215) is markedly reinforced
In accc.sson- ligaments. It arises from the outer circumference of the glenoidal lip and embraces
not only the head of the femur but also the greater jK)rtion of its neck- .\nteriorIy it is inserted
into the intertrochanteric line; jiosteriorly it does not extend so tar, and surrounds only somewhat
more than the half of this portion of the neck of the femur.
The reinforcing ligaments are firmly adherent to the cai)sule of the hip-joint and are com-
posed of longitudinal and of circular fibers. The latter are known as the orbicular ligament (zona
orhicularis) (Fig. 215) and embrace the narrowest j)ortion of the femoral neck; they pursue a
cir(\ilar course within the innermost fibrous layers of the capsular ligament and are rather inti-
ma' ly ci nnected with ihc longitudinal ligaments. The longitudinal fasciculi receive dilTerenl
nannsacco: ling to their i)la(cs of origin, and since each of the three ])arts of the innominate
bom gives origin to one of the fast i( uli, they are (onseriuently known ;is the iliojenwral, pubo-
capn ''tr, and ischiocapsuh: 'igamrnis,
i 110 iliojcmoral ligamei:: (Figs. m2 and 2i()i is the strongest of the three ligaments and
is one (.f the lhicke,-t ligament- in the body. It arises in the region of the anterior inferior spine of
the ilium, iia-ses obli(|uely acro>- the .interior suri ;- c of the articular cajisule, broadening as it
goes, and is inserted into the entire length of the intertrochanteric line. The puhocapsular liga-
iiiitil (Figs. 2i2and 21O) arises from the horizontal ranuis of liie pubis and passes ac ross the inner
and posterior portion of thearticular capsule towanl the lesser trochanter. The iseliioca psular liga-
mcnl (Figs. 215 and 2181 ari>es from the Ixxly of the i-,i hiiini and runs in the jiosterior jiortion of
the capsular ligament; the majority of its libers pas.- into the /.ona orbicularis, but some of them
converge upward to the great trochanter.
The thinnest places in the caii:.;:;e of the hip joint are r-ilUalcd in it-^ lower j-ortiiin b.-'^veen
till jiubocapsular and the ischio. apsular ligaments, and above the zona orbicularis between the
istliiocajisular and iliofemoral ligaments. There is also a thin place in the aniero-internal wall
of the capsule between the iliofemoral and puljocapsular ligaments, and a communication occasion-
\'^
Tendon o/'^^^^y :j!
' rtiis fcmoris >^^ , '^-1
'i 1
lliofcmonil jU/ i
ligament Wi-^r—-
tiniir troclmnli-r J^'JiIm j^^
/9«-^ ' -111
/'li/'oeapsnliir ligament
lendi'n of
net 11^
Jeinoris
liinald
Artiiit/iir
(ilii/e'il liihiiv^ilv
/i\'. 21 i.
Iriiii'iyrrse lii^nnuut of lutlahiiliiin
III
m
rn^f
1 Mf!
1 s T^
'''1-'/..';'^.^' ^_JX^^^_^_^^
:im[m^.
fc v
<!.'■ '
itll
;i -
H
i i
I'ostirinr sacro-iliac lit;.
Siunil caiHil
i
Aiilirinr smro-ilinc li^.
Hciiit of Janiir
liitrivs-^ivus sdt o-i!iiii lii;.
Siinv-i/i(ii- <iitiai/(ilh>n
Sarivs/iiiii'ii^ lioiiiiii/il
Sdcivtiil'iivii'^ lit;'.
Ohiiinilor imwhniiir Arai.iU li,i;. of /uilih
l„t,r/,„/m- libwauHlufic '^'"""' ''■'-'■
/il'. 2/5.
Xrtiailiir ni/>'>ii/r
Ohiiiiiitor
nunihniiii'
lit:. 211).
r
f {•:■■
m
= i
i
I
.
i
i
i
I r
'■> 1 1
\\\
I •
THT; joints AXD MGAMKNTS of TIIK PKI.VIC CIRDI.I,. 133
ally exists at this -oint hctnc-cn the synovial cavity of the hip and the ilwpcctincal bursa which is
situated beneath the ilio{)soas muscle (see page 211).
The hip-joinl i, a l)all-an.l-s<Kk.-t joint, a>„l allhouRh thr smkrt cml.ra.rs murv than „nc-half „f ihr .nh.rical
head of th.. U-mur an,l limits th- rang., of motion to a sliRht extent, movements in all dire, lions ar.- possil.le Si„, ,. ,he
hea, of the femur fomts a mark.-,! angle with the avis of the hone, the as^s of mov.ment of the j,.int .Lh^s n tss through
but forms an a. ute angle with, that of the femur. The , hief n.ove.nents of the hi|.-joint are aNIu.tion ami a.Mu, tio,',
(siM-aration an.l approximation of the lower extremii . , llexi.m (anteriorlv) an.l .xtension (,iors.,l |l..,i„n is inn,o.,il,l,.
on acTount of the tension .,f ,h.. iliof.-,,. ,r.,l ligament), rotation, an.l , in um.lu.tion. Wh.., the joint is half M.-x.-.l (the
middle posi.L.n) all ..f the ligamenN .ire relaxed. In the upright position the iliof.-moMl ligaments are fnse a,,,!
steady the |h1vis upon the femora.
The roun.l ligament has n,> m.-.hani.al fun.tion whalev.r, hut a, ts .imply a. ., ligam.nt of ron.lu.li,.,, ,s.... page
.08). It IS ,H.asi,.nally wanting in man an.l regularly al.s..nl in many aninuls, „n,l is to U- reganl.-,| as an oriKinallv
extra-anieular stru.ture pn.bahlv .. po.tion of the ju'etineus mu^. 1.-, « hi, h has lH.en .lispla...,! into th.. joint The
head ,.1 the femur is hel.l in its so.ket m>t only l,v the strong . apsular ligaments hut also by atmosph.ri. pressure.
THE KNEE-JOINT.
The kncciohit (Figs. 2,7 to 222) is the articulation hetween the condvles (and the arlicul.r
surface for tlie patella) of the f. ,.„r an.l the .ondyles of the tibia, and the posterior surfa.e of ihc
patella is al.so passively involved in the formation of the articulation. DisregardinK' the p-,i. I|-, ji
will be noticed that, in contrast to the elbow, ody two lM,nes are inchulcd in the articulation as ,he
fibula IS completely excluded from ii.
From the form of its articular surfaces as well as on at couni of the manifold t hara. icr of its
.structures, the knee joint is one of the most complicate.' ,irti. ulaii.ms of the human l>.«ly Tiu.
arliculatinK surfaces arc incnuruenl, sin.e the n.n.avities of the cm.Mes of th.. til.ia'ari less
than the ...nvcMties of the con.lyles .,f the femur. Th.. j.mornl unul.lrs ai.. M.parat...! bv the
deep mter.-.n.iylar f.issa, an.l their posteri.ir p..rtions are spherit.d «hile their ant. riur stirf.L.s
ar.> cylin.in.,.1 ^id unif in fr.,nt ..f the inter.-.,n.lyl.,i.| fo»a to form th.. arii.ular surfa.e f..r
the pate la ( Kig. .201. Or.iinarily the .-on-lyKs .,f ,he femur pr...,,, tluir ex lin,|ri.,.l s„rfa...s
to the nbia ami th.. articulati.,M is .„nse.,uently a hinge j<.int. th.- inl. r. ,.n,M„id .mimn... ,>f the
t.b.a iH.ng re.. ,ve.l int.. the inter..,n.lyl.,i,| noi.h of the lemur an.l preNcnling lateral .lisi.la.,
ment of the art,, t.lating surfa.vs. The m..sl posterior portion. „f th,. f..n,.„a| ..m.Mcs, houexcr
ar.. .ph.rical, ami wh.n they rest u,H,n the comix les ui th. tibia, .luring llexin,-, ,., ,h, kn.. j.-int'
they form a .l.nible arlhr.Hlial j„inl. JMom the sh,.,,,, ,„• ,-,. „.,i,„|ating s„rfa...s ,h.. kn.e join,'
IS .-.insciuently a ginglym.i .irthr.KJial arti. ulalion.
I'lxm th.. comiyle .if ihe tibia are situal...l lu,. ,un,is,i, „l,i,h from ti„ ir „.,sitio„ .„,■ i.rm.-.l
the n.t.nu, ami the ,x,,r,u,l mnn.u.s , |.,g. ,,, ,. Th.v ar.. !„;, |,..,s..K . „,„ „.,1 u hi, ih.. .on
<lyles of th.. td.ia ami are atta.he.l onh lo .he .apsular ligam.nt ,,n,| to du in-, r. ..mM,.i.i
emin.n.e, ... that th.'v max b. mov,.,l ,,,,.,1, ihe surfa.., .,f ,|„ ,i|,i,,l .„m!vl.s. Th. ir . ,„.,„ ,|
margins are ihuk, ih.ir im, rnal margin, thin, ami duir . r.iss ,.. ,i„„. ,„. .|..i,|,,,|K ,,„,„;,
shape. I. ^
riu- h,„n,.,l n„„hn,s ,ihe h,l,r„<,l snuilumr n,tnh,,^,^ is narr.iw.r than th,- .m. rnal one
an.l .Iocs not form a ...mol.ie s.-mi. ir. le, but is ,. s. gm.nl ni a . in K- n h-se la.li.s is brg.r liun
that ..f .he external meni,. u>. TIk- , v/,W ,„n,i. „. . ,l„ , v/, n,„l v nnha.ar ,„r,il.,„ , is .dnioM
compleulv cutilar an.l is ..p.n .,nb at its p. inl .,f ,,tt,uhm.nt h. the inlercomh l.,i.l emineme
iiifl
134
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fio. 217. — The right kiiec-joinl in vxlcn>ion >een from in front (§).
Fn;. J18. -The right knee-joint in exlensi.m ^ecn from behind (§).
Fic-. 21Q.- The right knee joint in extension opened In two lateral incisions. The quadriceps nuis( le,
together with the jiatella, has ]>een reflected downwani (j).
Fir,. 220 The right knee-joint in llcxion after removal of the articular lapsuie and the lateral
ligaments (ij).
i
'-.h.
h is broader than the internal meniscus, and, as its radius is smaller, it covers the condyle of the
tibia except in the situation of its relatively small median hiatus. It arises in the anterior intcrcon
dvloid fossa of the tibia and runs to the ixternalinlercondyloid tui)eiTle, whili^ the internal meniscus
])asses from the anterior margin of the articular surfaic of the internal i inidyle to the posterior
intercondyloid fossa. The anterior lK)rtioll■^ of both menis( i are connei ted by fasciculi which vary
greatly in their development and are known as the lraiisirr.sc iii^amfit, and lluir thick external
margins are adheient to the articular capsule, the external meidscus being le^^ inlimatel\- adherent,
and hence more mn\able than the internal one.
In addition lo liu' niii>isci, the articular ca\it\ also contain- two iinportatit aciessor\ liga
ments. the < rm iiil lii^iimcnls 1 Figs. 220 and 2211, of w hich there ari' two, an aiilirior and a poslcrior.
Their anterior surfaces arc provide<l with a s\ no\ ial co\ering which passis as a septum through
the ]Kisterior portion of the arlii idalion, in I lhe\ are strong ligaments firmly connecting the tibia
will) tile fcnr ' Thex Inith arise frut he iiisi rcondyloid fossa of the femur and pass to the
lulxr(le>^ and iiiierc ond\ loid fossu' oi the libia. 'I'he anterior ligannnt has a broad origin on the
i ,ner surfac e of the external condvle of thi femur, and, iKcoming narrowi r, it passi^ lu the aiiti tioi
inlet, ond) loid fo.sa and to \\w atUcrioi- inicrcundyloid tulxTcle of the tibia. The posterior liga-
ment |iasM > from the outer surf.ii tof the internal conilyleof the femur to the ]«)stt rior intcrioti-
d\loi I fossa and to tin (orrcsponding tulxrcle of the tibia; it i^ flat ai its origin but rounded at it^
illM rtion, and is Usi'.dh stronger than the .iiitcrii.r ligament. l)i.ringri>l iM'milh \ion ), die two
ligament^ cross i.i such a wav that the anterior ('tie is in front ot liu posterior. 'lite lan.i r 1 usu
alh connei te 1 v ith the (sternnl nieiiisi us.
\\ ith the c\i ijilion of ( t rtain ili\crli( ul.i of ihe s\ no\ ial membrane, w lii< h w ill -ubsci|uetitl\
be doi li'icd, till' artitulan .(p'-ulc is .tllai lied to ihe m,irgin-of the ( arlilaginou^artii iilar surfaces.
ii» line of .iti.H hment upon the jio^tcrior ■•uifaie of itii' l\ mur i- indicated !i\ the inteicotulv loid
line, -o til, it the 1 iitirr ii; ell ond> loii] fos^a is sit 'la ted within the .utii ular iaMt\.
Ihe kiu e joint ]Hisses-.»s a number o! |ieculiarilii^: it- -\no\ial folds are mori' pronouiued
that! tlio-e of an\ other joint in tile bmh ; it- s^ no\ ial menibrane gives ol'f di\irti< ula, :.oi"i of
w liii h .ire of l.irgc si/( and pa-- beiii .ith tin 111 ighlrtuing nni^i li s; it is mui ii -tn nglhi ncd If. ihe
majotiix of -.hi overlving luidons; and the paii ll.i i>- imbedded in the aiilitior portion i.f tlie
arlii ular i ap'-vile .md fornv. the ininndi.ite anterior boundary of the artii iilar 1 a\ it\ .
rill ma jorit\ of tlu re m Ion ing lig.imi nt- of the km 1 loinl an adhen ril to the 1 ap-ulc tlu'ough
out ;he grciler portion of their e\'i ■, There an- luii lateral iiganienl--, the jihuhir .\\m\ the lil'ial
I, 111 rill lii;itit,, III. The /;/)/'.// tinhrihil , lii/i ml /i:;<iiiif iit il'ig^. j 1 7 and .'iHi ari-,i s from th' internal
ipiionil\li ,ind i» in'imalel) adherent to the lapsular ligament; it- ^upert'n ial lilnrs rvin to die
Articular miis
of kmr
Siipriifxiti'lliit
bursa
Iriitlon oj
i/iiiiilrice/is
I'dtfllii
f \t. rrtiihi-
III III III
•>/
piiirllii
I ihtthn
liilenil
li>i-
Dn'fi III-
friipn-
Irlliir
hiir-.li
Hem) 0/
Jihiii'ii
Intcniiil iiitermnsailar septum
(Tendon of adductor inaf^nus)
Tendon of f^astrocncmius ,■'
(int. Head) X-
(Juadrireps
finilini of ^rmi
iilfnihratnt-'ti'i
liliial lateral
lil^ament
Tihifi
Int leitntuiiliti'i
•<l imh,. II
I ihiiil hileiiii lit;iiiiiitil
I'alellar lit:iiiiinil
hf,'. 21S.
Temur
Arii. liar
capsule
trmltin o/
^ii^frflinrrttm^
It -I. hi'iidl
l\tsterior
capitular
I'ii-
I ihula
i! 7
It^. 217.
fl
iiji:
ii'|.
ii
mi
/ iliilhii
liilira/ li
(tuiilyle
Aihmlitr
Si!/iiii/ifilrlli
till I ••11
■^iiifiur for piilillii
ilclltir fi'/tl of yiioviiil iihinbninf
Inliriiiil ivmlvli'
r /I'/ih
ir r.i/i>ii/f
/'i'fii/iir \inlii(
lit:. 210
AiiliTiiir I mil,
li I'll "II III
Antiiior iii/iili'/iir
I ill
I iihiiii^ilv t'l lihiii
]\ i
I r !.
i
i i-
i
I
■'
St
s 1 11
ihfi
THE JOINTS AND LIGAMENTS OF THE PELVIC r.tRDLE.
'35
inner margin of the condyle of the tibia, while the shorter dee]) libers pursue a somewhat oblique
course and i)ass posteriorly to be inserted into the internal meniscus and into the infraglenoidal
margin of the internal condyle.
The main portion of the fibular (external^ lateral lif;aiiinil (Figs. 217, 218, and 2i()) is
separated from the capsular ligament by fatly tissue, and < ()nse(|Uently a])iiears as a lirm, inde])en-
dcnt, flattened cord which passes from the external condyle of the femur to the head of the fibula.
A deci)er and shorter portion of the ligament ( the short external lateral ligament ) is adherent to the
ca])sule.
The ])osterior wall of the capsule is reinforced b\ two ligaments wliich arc intimately con-
nected with the muscles which h.:ve .heir insertion in the vicinity of the kmc jninl. The iHiqiic
popliteal Uf^ament (Fig. 218) is a '-ontinuation of the tendon of the semimembraiidsu^ muscle ami
runs obli(|uelv from below upward and from within outward upon the iiositriur surfate of the
capsular ligament, in which structure it finally <iisapp(ars. The arcuate popliteal li\;ameut iFig.
218) pa.sses in a curved manner aljovv- the t"ndon of the popliicus muscle, llu' (nncasit}- of tlie
curve being directed ujiward. It runs from the region of the external condyle (if \\\r femur to
the jH)sterior wall of the capsule of llie knee joint, some 01 its libers pa^siI1g also to the iiead
of the libula and to the deeper fasriruli of tlie litiular lateral ligament, these libers being termed
the retinaeulum oj the arcuate lii^at.ieiit.
The anterior wall of the knee-joint is formed almost entirely by llu' linilon of the f|uadri( eps
cruris muscle and its ccmiinualions. The tendon of this mu-i le is really inserted into the Kmm' of
the i)atella, but it is continued onward as the llal but \ery strong patellar lii^amei.t i l'ig>, j 1 7 aii'l
222) which ])asses from thi' ti!)of the patella to the tuberosity oi' the liliia. Tlu' patellar ligament,
liowever, is indijiendi-nl of the knee joint and is not adiie.ciit to liie ( .ip ular lig:iment ; i; is one of
tht thickest ligaments of th.' IkhIv, an<l it is separ-Ued from tlie upper mil oi ihi- ti'i)i;i and from
the eaps'ilar ligament liy fall\ ti--.-ue and b; a ((Mislanl bursa, the n.ep iiijrapiih liar i>urs,t \V\'Z.
jj.'S wiiieh (joes not comni'inic aii' with ti;e syno\i.il i.uil}. Molli ihe p, lelia and "'e ariual
tendon of tlie ipiadriceps, howiver, directly form a portion of ilii' anterior loiundarv oi ihe \i'\\\\,
aiMl the ,i!!T, rior |iortion of dt ( ap^iil,;r liganu ni i- ai^o r,inton el !>\ l.i'.er.d iihrou^ 1 onlmu.dion-.
(if the i(u.ii!t.i I ]y-, wliieh are known as the inierne.t and <\liriial palillar ri iitaiula 1 1- ig. .'171.
The\ ariM trom tiie lali-ral margin^ of '.he patella, receive libi r- I'roni ilie va^ii upon either -ide
i>i'e |ia;;e 2 i ^), ;ind pas> .lownward to ihe lateral ni.itgin'- ol ilu 1 • >n • li - oi ihe liliia
Till s\no\ial l'old> of die knee joint are the alar jclih ! I'igs. jhj an i -'_'.' 1 and the palillar
synmial jolil V \ -ji!. 'ihe greaur portion of die al.ir lolN ! on-i^i oi liie f.iiu li-^sue uliiih i^
situa!e<l beliiiiil ■ ■' 1 lalellar Hi;;!!!!! nl, .'iiid i- 1 overe;! b\ ihe ^\ no' 1 1! Mn nihratie . lh.\ pi"|iit into
lit' iNllee joint doin either ^ide o|' iIk pai II. I. The palillor sMWeial juld i-- .1 .ibroll^ hand of
•.a!i,l)le ^i.'e whiiii uMially (onlains a < ()n-~ide;alile i|uanli'\ of fai ; it ari-i .. ireiii ihe anteiior
v\all of die 1 .Lp-'iie belAeetl I he two al.ir fold'-, w illi v\ hie ll il i^. 1 omiei led. .01. 1 i- i,i-i rti'd into llu
inleriondvloid tos-.i of the femur.
The largest di\erlli uhini of ihe -\no\i.il iiuinbr.iiie of llie joint 1- the \iiprap>il< liar hur^a
Fig. 222\ "hiJi eshnd^ U] ward beneath tin U-ndon of the i|ua(iri(ep^ lVni"K- l"or iliiin-i a
hand'-- brradih It .dwavs tommunii ali ■- \mi1i llu •~\rio\ial i.ivin. u^Kalh In i|uile ,1 Lu'lt
aiterture. and rei i ue- (he in>ertion of thoM libers of llu i|u.idric 1 p-. w hie h .ire tinned llu .irlii ular
r
'«
li
136
ATLAS AND TEXT-BOOK OF HVMAN ANATOMY.
t i
Fic;. 221. — The c<in(l\lc.-> of the tihia with the two menisci .ind the oiijrins of the crucial ligaments (j).
Fi(.. 222. — Sagittal section of the right knee-joint in extcrsiim. The section passes through the external
cond\ Ic of the til)ia ( j).
Flc. 22;,. — The right tiijia and fibula with thii) ligaments {{).
muscle of the knee (subcrureus) (sec page 215). The suprapatellar bursa docs r.ot lie directly
u]K)n the anterior surface of the femur, but is separated from it Ijy a cushion of fat.
There are two or three other considerably smaller diverticula of the synovia) membrane at
the i)Osterior portion of the articulation. These are the popliteal bursa, Ix'neath the tendon of
the i)oplileus, the semimembranous bursa, beneath the iendon of the semimembranosus, and the
internal i^aslroenemial bursa (Fig. ,■^04), beneath the tendon of the inner head of the gastrocnemius.
The last two bursa' may communicate.
Thin' :iri' other bursa' in the ncightxirhtioil of ihc knee-joint whiih have no ilirert relation to the articulation. In
adilition to the previously mentioned deep infrapatellar bursa, the>e are: the siihculnneous pre putelliir bursa (I'ig. 222),
a suIm utaneous bursa which is constantly found in front of the patella; the suhjuuial prepalcllar bursa, U'tween the fasi ia
and the tendon of tlu' i|Uadriit ps; the sublciuiinous prepatellar bursa, iKtween the ijuadriteps tendon and the i>eriosteum
of the patella; .ind the subcutaneous iiijra patellar bursa, which is situated in front of the pntellar ligament (se'_' also
IKiKi'234)-
As mi^ht Ik' supposed from the shape of the artii ulatinR surfaies, there are two kind.. >l nioti"i' possible in the knee-
joint, a hin(;e motion 1 Itexion of the lei^ and the return to the extended posit'on) and a Tiio\emf ai of rotation which is
[Kissible only when the kriee is flexeil. Rotation is imiMissible when the knee is extendeii, not only from the shape of
the articulating surfaces (sec page i v;l, but es|>eually on aciount of the tension of the lateral liKamenls, which are
relaxed only during llixion of die joint. The latenil ligaments e.lso prevent a lateral displacement of the iHines during
flexion of the artii ulation. The i .-ucial liRaments serve mainly to hold the fei ,ur and tibia together; they an' so situated
that ime of them is always tense in any position of the joint, the posterior lig.imi ill liiing tense durim; part of the move-
ment of llexion and part of the mo\ement of extension, and the anterior one during ilu wl.iile of 'lexi'in. The cruiial
ligaments also < ho k the movement of nitation.
The palell.i glides ui«in the surfan' of the femur, anil has no influence upim ihe nu-i liani.s-i of the ar.iculation.
During exten..ion of the joint it Is pulled upward by musiular action anil daring flexion it desc<'nds towar'I the ti* 1.
The funition of the menisci is rather to form an arlii ular 1 ushion than to sup|)li'n'ent aiifl dii'lH'ii the artirul.ir
sot ket. In sonie positions of the joint they ai t Imth as i usiiions and .is {Mtrtions o! tht artii ular sik kct. in other nosili*»ns
thcv at t onlv as cushions, .mil in still others 'licv exert no influenie wh never U|«>n the methaiii>i.i of ihe joint. Durine
soni',' of the movements of the arlitulaiion 1 v arc m.irkttllv ili^plated or strongly n.mprcM'il
! I ->
THE ARTICULATIONS Of THE TIBIA AND FIBULA.
The til)ia anl libuhi art tdiinriud '.\iih cnii other in ilirn \va\s: their u]iper extreniiiii's
iirticiilate liv means of ;i snidl joint, the tibio/ihular dilii uhilion; the Ixulics of the lx)iies are
(oniUiled 'jv tile inter(issei)ii!< mimbrane: ami llie lower extremities are united by tense ligaitients,
forming the tihio/ihuliir ^y.ultsmosis.
The libiiijihiiiiir ,irl'u ulalinn (l'"igs. 217, Ji8, 220, and 22},) is the joint between tiic liluilar
ani( ular surface of the tibia and tiie c;'i)itular articul;i, siirlace ol tlie libuhi. It is an arlhrodiuna
with altnost iilane arliiular surfai vs and ])ossesses strong aicessory ligaments, which reiL^Jree the
capsule anteriorly and ])osterit)rly and are known ;is the anterior and posterior ..v'tulcr lit^a
mrnls (Figs, ji.''', 220, ;ind 22,^). 'I'he tense ea])Stiliir I'gamenl snagi\ embraces the . tilagirious
surfaces. Tiiis artit illation may occisimi.illy commiinicat..' with the knee joint (through the
popliteal bursa 1.
'
Tmnsxrrsc lia;iimeiil
AiUirior iTuciul Ihvp infrupatellar bursa
lis- ^^^Bi^^to- I'litMir lis
Internal
meniscus
\ntirior ni/iilu/iir lisiinienl
/ \iiit>,i!
nuinlininr
i il I
? .:■
fill
L-4M- «» V
> .t«
iTld^.
THE JOINTS AND LIGAMENTS OF THK FOOT.
137
The interosseous membrane (P'ig. 22,^) resembles the iiucrosseous membrane of the forearm
very closel; and extends between the interosseous ridf^es of the two tones. It eonsists ehietly of
obhque fibers, the majority of which run downward from the tibia to the l'ilnil:i, aUhoUf^h some
l)ursue a course at right angles to this direction. Its upptr portion contains a large foramen for
the passage of blood -vessels.
The lihio/ihithir syndesmosis (Figs. 223. 224, and 220) is situated between the fibular
notch of the tibia, which is not covered by (artilage, and the internal surface of thi' external
malleolus. It is formed by two ligaments, rii ii in elastic fibers, the anterior and posterior lii^a-
ments oj the external malleolus (tibiofibular ligaments) (Figs. 225 and 22f>l, which are situ. .led
ujwn the anterior and ])osterior surfaces of the lower end of the two Ijones. They pass obli(|uely
downward from the tibia to the libula and are made tense when the broader jxirtion of the sujKTior
articular surface of the talus (astragalus) enters into the articular socket of the ankle-joint. The
lower ends of the tibia and libula may conse(|uently be passi\ely se|)arated for a certain distance;
this is, however, practically the only movement between the tibia and libula.
THE JOINTS AND LIGAMENTS OF THE FOOT.
The joints and ligaments of the foot will be considered separately, since many of the ligaments
of the foot l)elong to several joints.
THE JOINTS OF THE FOOT.
The joints Ix^tween the talus (astragalus) and the bones of the leg and those between the indi
vidual bones of the foot may be divided into the following gr(.ui)s:
I. The Artieulations oj the Talus {Astraf;alus), which include the taloerural artieulation
(the ankle joint), tiie taloealeaneal artieulation, the taloialeaneo navieular artieulation, and liie
calcaneoeuboid artieulation.
2. The tarsal Arlhrodia.
(a ) The intertarsal artieulations 1 the euneonavieular artieulation).
(/)) The tarsometalarsal joints illie tarsometatarsal and inlermetatarsal artieulations).
(■),) '\'\n- Joints oj till 'rorstiUrmitalarsoplialaufieal am] <lii;it,il \interplialane.ial : arliiula-
tionsi.
The ankle joint or taloerural artieulation ( Figs. 224 and 22(>i is the joint Inlween the astraga-
lus an<l tile two bonoof tile leg. The articulating surfaces are the trochiia of liie talus ujion
the (me han.l, and the inferior articular surface of the tibia and the articukir surfaces of ihe
internal and external malleoli upon '.he other.
The articular ca))sule, which surrounds the cartilaginous surfaces and is inserted toward the
neck of the astragalus, is thin; its anterior and esjiec ialiy its lateral portions are rather tense, while
the posterior portion is roomy and relaxed.
I- nun il^ inn. li.in .in. I in ^i. . .T.l.in, .• with Ui.- f.irin ..f ih.- artiml.ir -url'.n.>, tli.' i.ilm rur.ii .irii. ul,iti"ii i- :\ liinn.-
j..int, Ihr siKki-l i«f wlii. h. li.nMM-r. i^ f..rnu-.l In !«.. In.nis. A^ tin- syml. -.ni..>.i^ (.mni'itini? tli. lil.i.i .in.l llif (ilml.i
il.K's n.il at)S<)lutc-lv |iri.lii.l.- ni.>li..ii. \\w l>r.>.i.l aniiri..r p.irli.in ..( Ih. Ir.Hlilr.i ..( tin- lalus ..in li. a.. i.nini.j.ialc(l by a
f:
i \
}
1 ' !'n
138
ATLAS AND TEXT-BOOK OF HITMAN ANATOMY.
j.-j(- 224 _The anklc-juim seen from liehind (}).
F,,-.' 2^, .-Horizontal frozen section through the tarsal articulatmns (J)
Vu!'. a^l-Frontal frozen section through the ankle and ,.o.ter,or talocalcaneal jomts (i).
.,Ht sepa.u>„n .. .H.- ... .. .. u.; .n., .v.n .He n-. ^,;;:^^';:r;:::z^::r:: ciZu. 'T;:i:
dorsal flexion.
The talocalcaneal articulation (Figs. 225 and 226) is the joint between the convex posterior
r h r^ tee of the calcaneus and the concave posterior calcaneal art.cular .urface of he
arucular surface of ^^^ -^'; ^^^^ ^i„„, „{ ^he surface of a cone, the axis of wh.ch
"'t^Z "d ..u^- ^^^vhat obliMueK upward and forward. The articular capsule
Tnd .^hx This articulation occasi<,nally communicate^ with the ankl.-jomt
■^ 'H i: r : J!:^/.. ^^rticulation ,Figs. .., and .30) is U.e Joint ..rmed h, the head
f .t . s s,r-.g-.lus the anterior and n,iddle articular facets of the calcanetis, the po. er or
. ", r t t' n w ".dn^ar, and the navicular hhn,cartilage of the plantar calcaneon.tvuular
; e , . I j'.in> i^ ^' pronouncedly compound articulation, and includes an
l:^::ZXl,.^. ';ro...her wi,h .he talonavicular joint, it forn,s the transverse artuulat.n
o] the tarsus (C'hopaM's joint).
i- ,1... rln, .«.,.,,.„ ,h.. .-,.«aluM a,.,l ,1.; nav,, u.ar ...,,,«,. - ;« ^^ " , ' ,„ .„,. ,,,. ,,,.,,„,
„„, \, „ ,„ .,|,,.„„lal i..in.. »hil.- .1.,. ,al.,n.n„ular ar,„ula , . a ■ • ^ «^^^^^_^^_ i_ _^^^^ ^^ ^^^_^^_^ ^__^
„„„ ,,„..W ,,„!, ,.-iur n..i,,r.„ailv, >„ .1 lur,„« n,u, ;',;;„ ], ,„, ,,„,„.,,„, ,...„„, j .., „
-.."- -"' ""■ '■■'■»:": -'/■""■ :, :a:r:l; i u :: in aU., a,, ..>..!.. ..... in,,.. ,nar« f
i!
,„ „.„ ,., ., a,i >;:::;,::i:.::r::.h.,..,„...a, a..ia,i,.,.„ ,. ,... *.,.-.... au....... ..i,T...n,, a- 1, a,..
Th.. ..rthrodi. of .in. ,ar.u> coumM of a variaLI. number of .ingle or combine.l articulations.
....::;;:;;;;n::r,i.u,ar.avi.iesfre.,t.en,bint.co,™
f,.ets i. relativelv large, the numlHT of joints .s con.p.natnih smail biuivi.e
,rti. id ,r facets ,.o not all form in.lependent artindalions.
';:. .-'» j-:'-?::.;; ;:r,i;:;i,;r ;:'::;„:;:::" r:;:»t::;:
Tibia
Infnvs^nvis Mrfn- Intero^^ AUtararsai III
M.taUinal nineo-meUi- tuntil It ^rous
hon,- of """'^ ^'^- bii^iUli}:.
liiii't roe
larsottu-iiitatsaf
arliaiUuion It-Ill
Mefii-
tan>at IV
Ttirsometatnrsn!
jiunt of ^ivtit rot'
Int. inniif'onti
hone
Po^forior /a-.
of rxtfrnal
malleohis
Inft rossfoim
tntvirunei-
form lig.
Po^mior
tulo-fihiiliir
( iint'o-
tjitviailnr art.
P(f>tinor fti/o-
ailitifirn! litf.
Stiviiuliir
hone
( nfainro-
fihular ii^.
Inlonnvinthr
iirtnuUnnni
Ciitiartio-
nif'Ofti
arfic-
Fig. 224.
('oliuneal icni'on
ttilO'inlntnOtl V
f \lirmil nuilU'o'tits
f'lhulii
In/'iiior tirfitnlor
I thus \urf(H-f of tihui
Tolo-oilitinrn
arfiiuliition
Aitiniliir ^nrfiii
01 mtillfOlii
Ih/roiti li^timcnf
ruliU'intl umion f'<'f""""'i
/tlr, 225.
/\'^tfnoi fiilo-oilnvi- :!
ailhiittition
I io. J'JO.
tft\or diiiitoiwn hnvf^
t'tilnt'im^ I otm fi/u/rlin li^ttnttuf ■
i:!l
Tlir JOINTS AM) I.ir.AMKNTS OK THE FOOT. 139
surface of the cuboid and the corresponding surfaces of the navicular and ex(ernal cuneiform
bones. The joint also usually communicates between the internal and middle cuneiform bones
with the second tarsometatarsal joint, and is c()nse(|uenily a very complicated articulation.
The Uirso-mdalarsal arlkulation (Lisfranc's j(iinl) (Fig. 225), logethi'r with the hilcr
mctalarsal articulations t l'"ig. 225), form three sei)arate joints: one connecting the metatarsal lx)ne
of the great toe with the internal cuneiform bone; one connecting the ba.ses of the second and
third metatarsal bones with each other and v ith the middle and external cuneiform l)<)nes; and
the third connecting the fourth and fifth metatarsal lK)ncs with the culx)i(l Ixme. Thi line of Lis
frani 's joint has its most ])roximal point at the inner margin of the sole of the fool and its most
distal point at the base of the second metatarsal bone, so that a dee|) indentation is jjresent in this
situation. From this point the joint line jnirsues a markedly distal direction and then makes
a distinct curve toward the proximal portion of the foot.
The miivcmcnts in thi' tars,il .•>'lhroiiia .ire ixtrcmcly sliglu, sin<i- numi rous IciT^c ligaments limit thi' rangr i)f
niutioii vtTv ic)nsi(l<ral)ly. The slight n'.ovrmcnts whic li arc pussihlc su|i|ili'nn-nl tin- ihii f iivvcnunls nf the fiKU.
The nutatarso- phalanf:,cal and the digital [inter phaUuii^cal) joints reseml)le the corresjjonding
joints of the hand with .slight variations. The mei..tarso ])halangeal joint of the great toe in
particular exhibits a special mechanism, as two large st'samoid bones are imbedded in tiie plantar
surface of its cajisular ligament (see j)age io()) and transform the articulation into a .speeio of
hinge joint. .\ further ])eculiarity is the marked dorsal extension of the artic ular -urfaces, i>ar
ticularly those of the second to the fifth metatn a! Ixmes, which permit of a hy])erextrn-ion (dors;d
fk'xiim) )f the toes. These articulations also resemble hinge joints more than arthnKJia iginglymo-
arthrodial. Ossification is freipiently observed between the indi\idual phalango, particularly
in the little toe. The accessory ligaments of thesi- joints are similar to tho>e of the han<i ilrans-
virsf capitular (I'igs. 228 and 229), accessory plantar, ami lateral ligaments).
THE LIGAMENTS OF THE TARSUS.
The ligaments of the tarsus (I'igs. 224 to 2;,o) may be subdivided intn: '\> Tht liga-
ments lit the ankli' joint, < 2I the ligaments betweiii ilie astragalus and t'.e ealcane is, ;; j the
dorsal tarsal ligaments, 14) the plantar tarsal ii^aments, and i;; the inlernsseous larsil
ligaments.
The ligaments of the ankle-joint (Figs. jj4 ^md 22(1 to 22S1 canned tlie Imnes nf du leg
with tin- laliis (asiragalusi and the calcaneus, and ptn-ue a more or less \ eiiiial ilireitiim. I'.aih
of the iwo malleoli is connoted with the neighboring tarsal bones. The lidloiit liiianun' 1 1'ig.
2271 arisi's from the intirnal malleolus aiul radiates to the lalu: lastrai^alusi, the cah.ine'iN and
die naviitdar Inine. It is narrower at its nrigin, hroad at it - inserdoti, and is mmpo-e'i .it tour
separate ligaments: the anterior talo tiliial, the posterior lalo tibial, the cahaneo til ial, .,n^ ihi
tibionavicular lifianienls.
The anterior talo tibial 1 1 .^anient 1 Fig. 227) ]iasses to tlv antc.or extreivily of the neck n| the
talus i.istragalus) and is .ilmost lomiiletely covered by the cal'aneo tibial lii^amenl 1 Fiu. .'271
wiiieii runs to tjie margin of tlie susleniac uluiii laii. 1 he poslirmr l-tic libiai iii^anh in I ]•:•.. 24
■
140
ATLAS AND TKXT-BOOK OF HTMAN ANATOMY.
tr*^
Fi<;. 227.— The ligaments of the tarsus seen from the inner side (j).
Flii. 228.— Tiic ii.naments of the foot seen from alxne and from the outer side (J).
22Q— The nj,Mm"nts of the foot seen from the plantar surface (J).
^30— 'I'lii' ligaments of the foot seen from the dorsal surface. The talus has been remo\ed so
as to show the |)artiii|)ation of the navicular li,i,'ament in formini; llie socket of the
talocalcaneo-na\ icular joint {'{).
Vu
Fit
and 227) fjocs to the j)()sicri(>r process of the talus, and 'he liliio-iuivicii/.ir (Fig. 227) has its
insertion upon the dorsiil surface of ihi' navicular hone.
Lij^aments pass in a similar nianii. r from the external malleolus to the talus (astragalus)
and to the calcaneus. These are known as the aiilerior tiilo-fibuUir, the posterior talo-
jihiihir. and the Cukanco fibular lii;amcnls. The anterior lalo-fibidar ligamcut (Fig. 228)
I)asses almost liori/.ontally from the anterior surface of the external malleolus to the an-
terior margin of the trochlea of the talus; the posterior talofibular (Fig. 224) pursues
a corresi)onding course and connects the jiosterior border of the external malleolus with
the outer tubercle of the ])osierior ])rocess of the talus; and the caleatteojibular lii^amenl
(Figs. 226 and 2;;o) ]iasses somewhat ()bli(]uely downward and backward from the tip of the
external malleolus to th.' outer surface of the calcaneus. Upon this ligament run the tendons of
the two peroneal muscles isee i)age 222).
The ligamentous connections between the astragalus and the calcaneus consist of the rein-
forcing ligaments of the talocalcaneal articulation and of the ligamentous mass which occujjies
the sinus of the tarsus, the interosseous lalo-caleaneal lii^ament. The latter (Figs. 22-i and 2^0)
consists of a number of firm fibrous layers and forms a s])ecies of syntlesmosis between the two
Ijones.
The reinforcing ligaments of the posterior articulation of the two lK)nes are known as the
internal, external, posterior, and anterior talo eahamal lii^aments. The external and particularlv
the anterior ligaments, which bridge o\er the sinus of the tarsus, are connected with the inter-
osseous lig,.ment. The external ligament (Fig. 228) pas.ses from the outer and lower su'-face of
the neck i>f the '■ lus (astragalus) to the upjter surface of the calcaneus; the anterior ligament
connects the lower surfaie of the talus (astragalus) with the ujjper surl'aie of the calcaneus; the
IK)sterior lig-.ment connei is ti:e outer tubercle of the jjosterior process of the talus with the u])per
surface (tl the cahaneus; and the very narrow intirnal liganiint i)asses from he inner tuber-
cle of the i)osterior pnn-ess of the talus to the sustentaculum tali.
The dorsal and plantar ligaments of the foot are practically hori ontal, and are composed
partly of transverse and partly of longitudinal fasiiculi which lonnect niiiihtxiring bones and
i(>nse(|uenlly reinforce the arlicidar (apsules. The plantar ligaments are considerably the
strong! r, and some of them conned ibstant portions of the tarsus, passing over one or even more
lx)nes.
The dorsal tarsal ligaments are tho>e which connect the talus (astragalus) and thecal
(aneuswiih ihe t.avii ular and ihetuU.id l)<)nes. They are the f/cr.w/ /(//o-mnvrHA/r //(,',;>«(■«/. the
ilorsal I aleaneo naiieular lit^a.nent, and the bijureate lii^ament. The bi'jureate ligament ( Fig. 228)
connects tiie antero internal angle ul the calcaneus with the dorsal surfaces of the navicular and
■r.-
Tfl
|ii
I
Of-
i
■ ■7 ^-n
1 i
■ ^1
i '
i
:i
I
;1: 1
i
i i
■ 1
I Mi
: J
■ ii
1
i h-
m I
I I
N ! 1
Tninsverse capitular Mct,itarso-/>liiilaai:eal
ligaments aiiiailiitioits
I I'll g
/ilaiiliir Hi
leiidon of /moiiaeiis loiiiiiis
] /'Iciiiliir tdrsaiiii'idt.irsai //, •
rimttnr niiiit'iiliin-
nine'ltfrrii It^jtni'nts
Dorsal tarso-iintalarsal
r /iu'llllll'lltS
Oor^itl ntivitn/iin
ainrihn-iil lix'''
fir. 220.
Aruniliiy UitTt .'( luivinil.ir l\'ne
Navicular Jihrocartilag;i'
Miihlh- articular facet of calcaneus
lircrasscous talo-calc.iiical li^aunut
Anterior articuUir facet of calcaneus
I'aslerior articular facet of calcaneus
Dorsal
iineocul'oid
Dorsal
c.ilaneo-
cuhoiil Hi;:
icudon of
/leroiiaciis
hri\'is
/7^,^ 230.
Uli
n
^ I
THK JOINTS AND LIGAMENTS OF THE FOOT.
141
cuboid bones; it necessarily divides into two portions, one for each bone, known as the cakaKco-
naviciilar and the calcaneocuboid portions.
The navicular is connected with the cuneiform bones by the three ,iorsal mnicuhirnmn
jorm ligamaits i Fi-. 228). The first of these is the broadest. The cuboid an.l navicular Ih.ihs are
connected bv the dorsal cuhoideo-navicularlijiamcnt (Fig. 228); the cuneiform bones are connected
with each other by the dorsal intcrcumijorm ligaments (Fig. 230); an.l the dorsal euneoeiihoid
ligament (Fig. 2 -,o) runs between the external cuneiform and culjoid Ijones.
The connection between the bases of the metatarsal lK)nes and the tarsal bones is elTected
bv the dorsal tarsometatarsal ligaments (Figs. 228 and 2,^0); the bases of the metal; rsals are
connected with each other by the four dorsal basal ligaments (Fig. 228).
The plantar tarsal ligaments maintain the normal arch of the foot. By far the largeM
and strongest of them is the long plantar ligament (Vi'A^. 22A, 227, and 229), which is, in.l.ed. one
of the strongest ligament> of the Ixxly. It arises from the entire lower '.urface of the eali an- 11 m
front of the tubercles of the tuberosity, its width almost entirely covering the In.ne, and ii . i nng
longitudinal fasciculi are inserted into the tuberosity of the culx.id. From the main n^ ot the
licrament there are given otT superficial fasciculi which jiass over the tendon sheatli m the pen.
ncus longus situated in the culx^id groove, and extend to the base, of the outer metatarsal Ix.ncs
(secpage227, Fig. 312). . , ,. , ,-
The second strongest ligament of the tarsus is tiie plantar calcaneonavicular ligament ( !• igs.
-7 and 229), whose strong fibers i)ass obliiiuely between the sustentaculum tali and the na\ic
elar Iw.ie. The dorsal surface ot the ligament is covered with cartilage and contains the nam u
iarfihroc Milage (Fig. 2,^0), which forms a jxirtion of the socket for the head of the talus (astrag-
alus) (see ,)age i:,8). Upon the dorsal surfa. . of the loot tliis ligament is connected with the
tibio-navicular ligi-ment.
The plantar ilcaneocuhoid ligament is adherent to the dorsal surface ol \hv long j.lantar
h-ramenl and reinforces the i)lantar surface of the artirular caj.sule of the calcaneocuboid joint.
The navicular ami the cuneiform bone^ are connected by tlie plantar navinilarieaneijorm liga-
ments (Figs. 227 and 2;o); the culx.id am' the navicula.' bones by the plantar euhoideo navicu-
lar ligiment ('-ig. 2^o); the cuboid and th.; eMernal cuneiform bones by the plantar cuueo cuboid
ligament: and tl" ■ three .■vmeif..rm bones with each ..ther by the plantar intercuneijorm ligaments.
■[■here are a!>o plantar larso metatarsal ligaments and three plantar basal ligaments. -Aliieii pursue
a similar course to the corresj.om'ing dorsal ligaments.
The interosseous ligaments are those ligaments o. the foot wliiili are Mtnated neither up<.n
the dorsal nor the j.lanta, surface, but which connect contiguous surfaces (.f tfe tarsal (.r -netalar-
sal bones in those situations where no articular connection exists. Thex' really represent syn.ks
imses, and are found onlv between those bones which move ujion eac h (.ther but slightly, if at all.
In additi..n to the previ<.usly mentioned interosseous tal-.calcaneal ligament (Figs. 22(, and 2,^01,
these ligaments are tlu' interosseous cuneo cuboid ligament, i\k- interosseous intercuneijorm liga
ments, the interosseous ciineo metatarsal ligaments , particularly between the internal cumif<.rm
and the base (.f the seconr ctatarsal bone, where an interosseous basal metatarsal is wanting 1,
and the inieross.ou. i>u.ui nutaiarsa! ligamrnts. The uj>i.er and lower surfaces of some of these
ligaments are in direct ..ontacl with the cor .sponding dorsal and plantar ligaments.
li'.ili
l-'i
I t
Hi
i I i
W i
MYOLOGY.
GtNERAL MYOLOGY.
.Myolo<rv is the study of the nuisdus and of their arresson- stmctiiies, such as tendons,
aponeuroses, fasciie, intermuscular septa, tendin- is arches, pulleys, mucous hurs;e, tendon-
sheaths {vaj^irue mucosa-), tendon relinacula, and sesamoid lK)nes.
The musculature of the human Ixxly occurs in two forms which present both hi.tolojriial and
physiological differences (see "Atlas and Epitome of Normal Histolo,i,'y," Soboita Huber). The
actual skeletal muscles are composed only of striated muscular tissue.
The muscles form the fleshy jiortion of the b(xly, and are contractile structures which vary
considerab!'. in size and shape. A typical muscle is composed of a muscular brily, whicii forms
the greater jiortion of it, and of two ends, one of which is known as tiie orifiin. or linul, and the
othcT as the insertion, the origin beir that end which is attached to the usually more fixed i)ortion
of the skeleton and the inserion lh:u attached to the more freely movable portion, ijut the i)hysio-
logical relation of origin and insertion may be reversed. .\s a rule, both the origin and the
insertion ])ossess a tendon of varying length, which is usually con>iderablv tliinner than the
muscle
Muscles are distinguished according t.. their sha].es. A great many, jiarticularh" those
forming the mass of the extremities, are fusiform or si)indle-shaped, while others are broad, thm,
and llat; muscles whose length but slightly exceeds their breadth are designated short muscles.
Some musdes surround orifices of the Ixxly or canals, and their fibers are circularly a, ranged:
they are known as orbicular musclrs. or, if they serve to close orifices, such as the mouth, for
exam])ie, as sphincter;-. Those' muscles in which the fasciculi pass to a tendon develojied at the
side of the muscle are known as jiinnale or jjcnniform muscles, and if the tendon 1k' situated in
the middle and receives muscular fasciculi from either side, the muscle is said to be bijjinnate
or iji])enniform.
The majority of the muscles have a single head, but occasionally two, three. ■'- four heads
unite to form a muscular belly, producing a biceps, triceps, or (|uadriceps muscle. A muscle com-
posed of two bellies with an intervening tendon is termed a biventer or digastric muscle.
If mu.scles pass only over one joint of the body (particularly in the extremities), they are
known as monartir ''-.r muscles; if they extend over two main joints in their course, they are
called biarticula
Tendons occur in connectioi, with nearly all the muscles, and are comi)letely aljsent in the
sphincters onlv, though partly wanting in the orbicular muscles. Every muscle, however, has
not a tendon at both ends, it freiiuently hapjx'ning that onh tiie tendon of insertion is develoiied,
while the origin is purely muscular. The fibers of the tendcms of origin or insertion are \ery
Mi
t'ral r.
slenioi'liiiloiiuislciiil
I (I I, nil irrvicdl /'•
ii/)rmi(iriailiir /'.
cliivinilcir r.
iicioiiiiiil r.
iilnici.iviiii!iir r.
nil u! rr.
external rninti r.
internal rrnral r.
internal retromallevlar r.
internal mu'leotar r.
caleaneal r.
digital rr. of loot -
lingual rr. -
(1
FifT. 231. Regions of the human body.
yJLJSSi
auricular r.
fovea imchac
acromial r.
external cnliitnl r.
posterior eahilal r.
external
brachial r. -
internal
brachial r.
external
cubital r.
olecranal r.
posterior
cabital r.
volar
digital rr.
external femoral r.
txttrnni crural r.
extrrnul retromalleolar r.
\lor\ol of fool
cali-ii'cal r.
fifr. 212 Regions of the human body
h,
i
!
I
i «
■
■ 1
f j
m
superior palpebral r.
in/trior palpebral r.
superior labial r.
inferior labial r.
auriiitlar r.
V
pnal r /
/ /i's\/7 ■iiiprnibu'inibir lowU
/ui;iilar Iowa
/lir.Jii. Regions of the head and neck.
!
f i
li
perineal regions.
ruf
/vff. 234. Male perinviin, .
f-'iiv '2.'\^ f't'nUlli' !}i*!'!!ii'!i!!!
If r-
GENERAL M\'OLOGY.
143
frequently mixed with mu^cuiar fibers, so that neither a purely muscular n<,r a purely tendinous
origin or insertion exists.
The spindle-shaped muscles have cylindrical and frequently very long tendors, hut the tlat
muscles usually arise by means ■ ' f.attened tendons which are known as ti/xnicdosi's, and, mi
the cases of the tlat muscles, may serve as fasci;e for other muscles. The round tendons also
occasioiiallv form aponeuroses in the vic'nity of their insertions.
Broad tendino>>.s i)lates are sometimes found u])on one of the surfaces of a muscle in the
middle of its course, and a musde may ]>ossess ;[ lumber of tendinous interruptions, arranged at
more or iess regular distances from each other; these are termed Inidiiwits iiiscriplions.
The jascict are connective-tissue coverings which surround indix idual muscles oi groui)S of
muscles. They are fre<|uenlly adhere.it to their muscles and form their aponeuroses, an(i are
especialb- well develo;)efl in the extremities, where they form a common sui)erticid >hcalh for
all of the muscles. Some muscles do not possess fascia-, as, for example, the muscles sudated in
the skin, such as the i)]atysma and the majority of tlie facial muscli'<
The inlcrmisciihtr s.'pla are intimately connected with the fascia-, biing sheet like prolonga-
tions of those of the extremities, extending to \\\c i)eriosieum so as to f<irm jjartitions helwttn
groui)S of muscles having ■ similar function (synergists*); they f-c'iuently also give origin lo
muscles.
The Irmiiiwus arclir.: are iigamintous bands whiih bridge over vessi'ls or nerve- and i)ro-
tect them as thev i)ass through a muscle; they may also pass between wo neighlioring bones and
furnish a sujjport for muscular )rigin.
Pulleys or trochlea are for the jjurpose of giving the tendon of a nni .de a different dir . tion
from that of the liellv. 'I ■ tendon retimiiula operate .n a similar manner, and are found chielly
in those situations whc. .'tidons run in a bony gr(;ove. They hold tlie tendons lirmly m the
channel and prevent their displacement; a similar function is served by the V(ii;in(il liti<imenls
which maintain the tendon-sheaths (sic below 1 in ])ositi(-n.
The mucous hursce are thin walled cavities lillcd with a lliiid similar to that of the synovia
of the joints. They are found where muscKs or ten(h)ns i)ass over l)ony i)romininct., or where
tendons are inserted into a Ijone, and serve to prevent fricti(m l)etween the mi scles and tnidons
and thelK)ne. They are fre(|uentlv divr-ticula of the synovial membranes of tiie join-- (see
page 108).
The /(■))(/()« ,v/(('<;///,v or T(;,i,'/mr m//((»\rf- act in a similar manner; they surround the tendons
of tlie muscles of the extn mities (jjarticularly in the hand and foot) for a lerlain distance, ami pro-
tect the tendons from friction during action. They :u i)artly protected by retinacula, and partly
hy vine ulii.
Sesamoid hones are mechanical aciessories of the tendons in which they are usually embedded.
They are not necessarily bony but are often only librocartilagitious, and serve the puri)ose of
increasing the working angle of the tendons and of m iking it jiossible for the tendons to glide
over the joint. The i)atella (see page .)<)) is the largest sesanioi<l l)one of the Ixxly.
The stri.il.d niusc ulalun- u( tin- I-kIv, with f.w cxi.iuiims ariM-* fr..m llu- my.)tonH.i nl the t.irs.iii.-rnii, s.mimi,-.
Till- musi lllatun- of the Irunli aris.s .lircdtv from lli.s,- <lrii.lur.-s ami it-^ scKmrntal arr.iiimnu-ni . ..rr.s|).iniliiiR lo it;
* Mii-ii Un having opiHjsilr fun t;. ns an' irrmcil aiilanonisU.
1
Mi j.
144
y^T^AS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig. 236. — The superficial layer of the flat muscles of the back together witH the neij;hboring muscles
of the head, neck, abdomen, and buttock.
Upon the riglu side the rhomlxjiduus major and the teres major are re])resenied covered l)y fa.ii ia.
origin, ean usually In' distinctly recognized in the dee]>er layers of the muscles of the back and nei k. The muscles of the
alidomen and of the extremities arise seccmdarily from the myotomes. In man the musculature of the extremities is
very strongly develipped an<l eover^ the entire dorsal anil part of the ventral musculature of the trunk.
[In the following pages the cla.s.silkati(m ado])te<l for the muscles is a topographical one, an arrangement which Ix'.st
accords with a itlas ilesigned .as an aid for the lalxiratory. Such a classification, however, is in many cases faulty in that
it fails to ])rcseni the true morjihological relations of the mu.scles. sometimes grouping together musi les whic h have entirely
dilTerent morphological values, and sometimes separating in different grou[)s musi les whic h in reality are closely related.
.\t the close of each section where it seems necessary there will be found a brief mori)hological classification of the
muscles c)f which it treats. — Kd.J
i II
SPECIAL MYOLOGY.
THE MUSCLES OF THE TRUNK.
THE MUSCLES OF THE BACK.
The muscles of the back are arranged in layers and extend throughout the neck, the back,
and the lumbar region. The muscles of the individual layers may Ix' advantageously grouped,
Lumbar vertebra
r
Obliquus
abdominis
Tratjnrrsus alnlnminis inirruwi
rtitr layers nj
Kic;, 217.
I.iimtni-dttrsal jasda Lcn^ mt'scles Lunthn-diirsal Jiisciti
(posterior layer) of hat k \ posterior layer)
-Transverse .sectiim of the |Hjstcrior wall of the abdomen in the lumbar region isi hematic ).
according to ihtir shajie, in three subdivisions— the flat or surface muscles, the long muscles, and
the short muscles. The flat mu.scles are still further subdivisible into several la vers, some of
'n '
Semispinalis capitis -,
Splenitis capitis
Occipitalis
- Sternocleidomostoideiis
-Levator scapulae
- Sacrospinalis
^li~Obliquus abdominis cxteniin
Lumbar triangle
■ \\\
Fig 236
■' i
1 s
;■■ f
< E
! !
;
IH:
mmstsU
THE MUSCLES OF THE BACK.
145
which completely conceal the others; the superior layers are inserted into the skeleton of the upper
extremity ami conse(|uently are really muscles of the extremity. The lonj; ami short muscles are
jjortions of the actual musculature of the trunk, and are situated in the guww l)et\veen the
spinous j)rocesses of the vertebra,- and the angles of the ribs (or the costal processes of the
remaining vertebne), and many of them extend u])\var(l as far as the hea'l. The long muscles
of the back extend over a large number of vertebrx- 'ml in tluir su])e lal layers extend over
the entire vertebral column; the short muscles ])ass from vertebra to vertebra.
The flat muscles are also designated as superficial, the long and short as deej) muscles of the
back.
THE FLAT MUSCLES OF THE BACX.
The flat muscles of the back (Figs. 2,^6 and 238) are arranged in three layers which partially
over'ap each other. The first layer i> Id -med l)y the trapezius and the latissimus dorsi, the seccmd
by the rhomboidei and the levator scapulx, and the third tjy the serratus |)osterior superior and
inferior and the sjjlenius capitis and cervicis. The muscles of the first and second layers are
inserted into the skeleton of the extremities; those of the third layer find their insertions in the
skeleton of the trunk.
The First Layer.
The trapezius or cucullaris (Figs. 2,;f) and 256) takes its name from the trapezium formed
by the muscles of the two sides. Each muscle by itself is triangular, its longest lH)r(ler i)eing
situatc-d at the vertebral column. It is flat and sm(X)th; below, ami i)articularly alx)ve, it is very
thin, and it is situated in the nuchal, median dorsid, sujirascapular, scapular, and inlrascapular
regions. It takes origin from the following situations: from the inner half of the superior nut lial
line (extending to the linea supn na as a short thin tendon), from the external (M-cijiital protuber-
ance, from the nuchal ligament (by a muscular origin, sometimes by a short tendon i.i the upper
jKirtion), and from the s])inous i)rocesses and su])raspinous ligaments of all of the thonuic vertebne
(more or less tendinous^.
It is inserted into the i.,.p- '>f the acnmiial third of the clavicle, into the iniur margin
of the acromion, an<l into the jnglli of its upper border, and jiartly aJM) into the inner
portion of the lower border of ti.. jiine of the scapula.
The superior fibers of the trapezius pass from within outwani and from above abruptlv
downward to the lateral portion cf the neck (Fig. 250); t'' ■ middle fibers are tiie shortesi and p:is>
almost horizontally outwani; while the inferior fibers r, from within outward and from b.-|ow
al'ruptiv upward. Tendinous areas are constantly found at the origin of tiie trapezius from the
occiput, in the region of the seventh ciTvieal vertebra ami of the spines of the upper thoraeu
vertebra', and at its insertion into the inner end of the spine of the seainila ; the fil)ers coming from
the S])ines of the lower thoracic vertebra' arc alM) tendinous for a certain dis* .nci , and in the
region of the spines of lite upjier thoracic vertebne tiie museles of the two sides form a broad,
well-developed, trapezoid aponi'urosis.
.\t the occiput the trapezius joins the tendinous insertion of the -ternoc ' '. lomastoid. He
tween the two muscles, the s])lenius capitis and the levator scapula- are always iiarllv \ isijjle, and
if tile ui)per part of the tra])ezius is narrow, a jiortion of tiie seinispinalis capitis al-o ajijiears
li
I
1
i '
145
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
between it and the splcnius capitis. The deltoid has its origin immediately adjacent to the
insertion 01 the trapezius, and a small transverse muscle occasionally passes between the insertions
of the trapezius and the sternocleidomastoid; it is known as the transirrsus nucha- {Vig. 244),
and usually has a tendinous origin from the tendon of one muscle and passes to ihc vcndon of the
other.
The trapezius is supplieil hy the .icccssory none an<l by the ccnnr.il plexus.
(Jn aetount of the dilTerent directions taken by the fibers in different ixirtions of the trapezius the function of
the musi e is complicaled, and differs ac ording to whether all portions of the muscle contract simultaneously or individ-
ual ix)i ...ir.s contract separately. Its action .dso de()cnds upon whether the scapula is fixed or movable. The upper
jiortion of the tra|K'zius elevates the entire sli ider girdle, the lower portion pulls the scapula downward, and the middle
portion ilr:ius the .scapula backward toward the vertebral column. The sca|>ula is also drawn backward by the ,iciion
of the entire muscle, since the upper and lower fasciculi neutralize each other to a certain extent and aid the middle
portion of the muscle. If the shoulder-blade is fixed, the muscle turns the head; when both scapulx are fixed anil
the two muscles act together, the head is extended. The muscle may also fix the scapula. It usually acts together with
the levator scapuli, the rhomboidei, the splenii, and the other muscles of the l)ack.
!■
= !•■»
The latissimus dorsi (Figs. 236, 238, 269, and 272) is a broad, thin, triangular muscle which
becomes somewhat thicker toward its insertion. The upjur y)ortion of its oriirin is 1 rtlv con-
cealed by the tra])e/.ius, and it is situated in the median dorsal, the sacral, the lumbal he infra
scapular, and the scapular regions. Its origin is tendinous throughout, with the exception of
three or four accessory digilalions which arise from the three or four lower ribs. The tendon of
origin is furnished by the jrasterior surface of the posterior layer of the lumbodorsal fascia (see
jiage 156), by means of which the muscle arises from the s])inous jjrocesses of the lower li\e or
six thoracic vertelira', from the s])inous jirocesses of the lumbar \iTtel)ra', and from the median
ridge of the sacrum and the neighboring jjortion of the outer lip of the crest of the ilium. The
superior fil)ers nm almost horizontally; the inferior fibers ascend abruptly from within outward
and from Ijelow upward, and toward the insertion the fibers converge, and terminate in a tiat
tendon which is adherent to that of the teres major and is inserted with it into the lesser tubercular
ridge (the posterior lip of the bicipital groove) of the humerus. .\n almost constant bursa, the
lalissimus bursa, separate- the non adherent ])ortions of the tendons of the latissimus dorsi anri
teres major.
The tendinous surface of the ])osterior layer of the lumbodorsal jascia (Figs. 2,v'* and 240)
is widest in the region of the middle and lower lumbar vertebra", and it becomes markedly nar-
rower as it extends upward, and to a lesser degree as it ])asses downward. Between the U])j)er
border of the latissimus, the lower br rder of the tra])ezius, and the vertebral border of the sca])ula,
there is a triangular space, which is larger or smaller according to the ])osition of the scapula and
in which are visible a ])ortion of the rhomboideus major, small ])ortions of one or more of the
middle ribs with their intercostal muscles, and a segment oi the iliocoslalis dorsi. Upon the
neighlxiring dorsal surface of the scaj)ula, the dense infraspinatus fascia covers the infraspinatus
muscle, and a portion of the deltoid muscle, covered by its fascia, is also \isibU' in this situation.
The costal serrations of the lalissimus dorsi interdigitate with the inferior serrations of the
oblif|UUS abdominis externus (Fig. 247). Retween the outer Ixirder of the latissimus, the pos-
terio" border of the external oblique, and the crest cf the ilium there is usually a sm^'U triangle.
TITF. \rUSCLF.S OF THE BACK.
Is.
the lumbar triangle or triangle oj Petit (Fig. 236), in which a portion of the orij^in of ilic
abdominis intemus from the anterior layer of the luml)ar fascia (see i)am' i()o) is exju-'sed The
posterior border of the latissimus dorsi forms a part of the posterior bounchiry of the axillary
jossa, and the muscle not infrequently receives accessor)- fibers from the interior anj^le of the
scapula (the scapular digitation).
Since the latissimus is rially one <>f he muscirs iif the e\trvn,ily, it is sup|ilieil from the plexus liraihialis, its nerve
Ix'ir.R the thur.ieodnrsal (middle or lonR suhMapular) nerve.
The latissimus dorsi adducts the arm, carrying it backward and rotating it inward.
::;!
The St:concI Layer.
The second layer of the flat must ks of the ' -ick ( Fig. 2i,S) is coveretl by the trai)e/,ius, with
the exception of a j)ortion of the rhomix>idea. major, which is exj>osed Ix'tween the latissimus
and the trapezius, and of that pan of the levator scapuhe which is situated immediately beneath
the cervical fascia at the outer lx)rder of ;lie trajie/.ius. This la\er is not '•(.■i)resente(i beneath
the latissimus which directly overlies the third layer.
The rhomboideus major (Fig 2.:;8) is a flat and rather thin (|ua(lrangular iiui.scle which
arises from the spinous pcoces.ses and supras])inous ligaments of the upper four llioracic \ertebra'.
Its fibers are distinctly ])arallel and pass downwird to be inserteii 'nto the \ertebral Ixirder of the
scapula Ix'low the r(K)t of the sjjine. The muscle is freipiently rather intimately coniu-cled wiili
the rhomlioideus minor, and, according to the jjosition of tlie sca]iula, may Ije eitlier (|iia(hanguiar
or rhomlx)i(lal in sliape.
The rhomboideus minor (Fig. 2,vS) resembles the majnr in e\-er\' n^jied, l)iii i> nnu h
narrower. It takes origin from tlie spinous ]ir()cesses of tiie two lowirmost cer\i<al \ertel)ra'
and inserts into the vi rtei)ral margin of the sca])ula above the root of the .spine. Tiie two rhom-
boidi'i are separated by a cleft, which is usually (|uile narrow, and as a rule their origins are
distinctly tendinous (ajjoneurotic).
The rhoml)oi<lei are supplied from the brachial ple.xus by the dorsal ^-lapular nerve
toward the vertebral column and somewhat upward.
'I-hcy draw the s, apula
The levator scapulae (Figs. 2^58 and 25S) is the only one of the flat mu.scles which possesses
any considerable degree of thickness. Jl is an elongated muse K- wiiicii arises by four short
tendinous digitations from the posterior tubercles of tlie transxtrse pro( t-.s.sis of tiie four upper
cervical vertebue, tlie largest digitation coming from tiie ir-ins\ir.se ]iroiess of the atlas. Tiie
digitations unite to form a single belly wliicli ])asses outward and downward and is in.serled into
the sui)erior angle of the scapula immediati'ly alongside of the riiomboideus minor.
The levator scapuhe forms a portion of the lateral cervical regitm and is immediately ailjacent
to the ])osterior margin of the .scalenus ])osterior. Its origin is partly covered by the posterior
portion uf the stenioclcitlomasioid.
The levator scaimhe. like the rhomlxiidei, is supplied by the dors.il scapular nervi . It elevate-, the supirior angle ..f
the scapul.i .ind <on.se(|uently the entire shoulder-blade, thereby assisting the trapezius and the rhomlK)idei. When
the scapula is fixed, it can incline and rotate the cervical [mrlion of the vertebral column.
^I^i^^:^^^^t,^:;ii
^^fp-
y
148
ATLAS AND TEXT-BOOK OF HUMAN' ANATOMY.
i
Fig ,,8— The deeper lavers of the flat muscles of the back.
' " , , ■ ■ 1 ' 1 , „ , ,,t .m-iv on the rieht siik' thr rhom))oiiU'i have also been
si-rratus posU-ricir inl.Tior anil tii'low.
The Third Layer.
The muscles of this laver (Figs. 238 an.l 239) are situate.l partly beneath the rhomboidei and
panlv dircctlv beneath the iatissimus ami die trapezius. The two splenii are also covered at the.r
origins bv a muscle of the same lax er, the serratus iH^stenor superior.
The serratus posterior superior (Fig. 238) is a flat muscle, rhomlK„dal ,n shape whch
is tendinous for alntost half its breadth and is wholly or almost wholly covered by the rhomlx^K e..
1, arise^ bx an aponeurosis from the spinous j.rocesses of the two lowermost cerv.ca and of he
uvo uppermost thoracic vertebra-, passes outwanl and downward, and is mserted by four Hat
muscular .limitations into the outer si.le of the angles of the secon.l to the l.llh ribs.
„ i, suppli..! by ,h|. u,,p>.r nirs, „. fnunln inu-.,.tal nerve. U draw. ,he upper ribs upwanl an,l ba, kwar.l an,l
aii> ..^ a niusile iif inspiraliun In enlarniiiK ihe \h .rax.
The serra.us posterior inferior .Fig. 238) resembles the serratus posterior superior in
nruix respects, but it i. llatler an,l its libers run from within outwar.l and from below upward
1,'arise. from the anterior surface of Hk- posterior layer of the lumlx.lorsal fascia ,n common wuh
the im^.imus do.M, at lite level of the two lowermoM thonu ic and tile two uppermost lumbar
vertebra ■ it is at first a thin and in.Kpendent aponeuroM., but subse,|uenlly be. omes entirely
musctda,", ..n.l is inserte.1 into the lower b..nlers ..f the lower f..ur ribs by .ligitations whuh fre-
.|U.'ni!v \;;rv in ih.ir .Uv.lopmcnt or may be wanting.
.nu. nu,. 1. ,- ^applie,! bv ,he 1 r ,nln,h ,., nvelfh, in,er„.>al nerve. I. Mraw. .be inwer rib. ba. kwar-l and
,,„„,.!,;:, \Jher !,„„b in,.K„n.n .„ expirau,. ,., un>.r,ain, in eiU.er ease i,s .nlluen, e u,.,„ .be r.l.> ,s .er>
vli^ht H may in. rease lb, iei.-.i..n ..| ih, lun.bar l.i- i i
■lb.- splenius capitis - F,u. .3S ami 230^ i^ a strong, elongat..!, stra,. sh:.pe,l mus, !.■. uliich
,riM.. Us nu an. .,f the nu. h.,1 iiganun, lr..m th.. spinous ,.,... sses of tit.. low.T four or t.v.. cervual
„„|„.„nnl,.upp.r.w.,onh,v..,hora,iev.rt,b,.e. I, pa.^ses from within oulwani ami from below
,,„,,„, - ,nlv ...vere.l In th. trap, /ni., du' rh,..nbnidei, ami ttu- ^. rrattt. posLTtor sup.ru.r, ami
ll i,,:, , , i.' intn tiie .,ute, halt ol ,l,e upp.nm.st nuchal line n| tin- occipital b-wu^ .M.'mbng a>
(..,• ,. lb. nu-tuid pro. e... Tlu' ins.-rlion i. .ov.tvd bv the stermH le.,ln,m.sl.nd.
The splenius cervicis (Fig. 2m>^ i~ MU.ai.d unmcliatelv to th. nut..- sul. ..I tin- spleniu>
...,„i,,. It ,ui-..inimmediat.M,c...M,.n m ilu^ i.ittrr nuis. le fn-m th.- spimn,. pn.cess..s ot tlu^
,;J,.,, .;,. f„„„|, ,„ ,„.■ Itfth or sivth thora, i. v.„. b.a-, ami ,.asses ..bli.pi. Iv outward ami upwanl
.,.3 11,.! but rath..- sl.n,ler mu>.l., .0 b.- in.n.d into the poM.rior tub.n K . ol th.- transverse
,„-,He-M-> ..f du upper tuo or ihr.-c ..-ni.al v. rt.bra-. It^ in.-rtlo,, i. intimal.ly conne. t.d w„h
tl-,(- ,,riuin of lib- 1. \ator Mapuhe.
-,b, ,un .pl.nu .,r, -upph..l f .he p„-b-r,„, ,l.u-i..n, ,.f ,h. ^..-,..m,I .,..1.. .i«l.ll'_^
uiv.li-. •,( l'..lll -i,l, 1,1 in ,,.nnii,in. It"-v pni' li" '"-"i '" ■ " ■ '^ • ''■^■'^~ ■■■■'■ ■'■■
„, ,|„„.., ,b.: lun, .lu b.,„ 1 k' - ir'l "" ■"'• "f "" ""-"■"•"'« '""-"
• i, .il M,-rv,.- Wlu n 111,
1 ...,,v. |. 5 ..f .ini- >iil|.
ii^iS?-*'*^-.
Oiri/iitalis
Simis/iirialis capitis
Sternorleidomastoidfus
(Supraspinatusj
Teres major
I ntissimiis
Serratiis anterior -
I iiitssimm *
Obliquiis
aMominis internus
^ /
Hi
/li'. JiS.
^
«j'
THK MIISCLKS OF THE BACK.
149
THE LONG .MUSCLES OF THE BACK.
The long muscles of the back (Figs. 23Q and 242) arc sulxlividc.l int.. two layers accordinK
'o the direction of ihcir fasciculi. In the superficial layer, the spinolransvcrsalis, the hl.ers j.ass
from the spinous processes to liie transverse processes or to the ril.s; in the dee]) layer, th.- Innis-
irrsospiiialis, the\- jKtss from the transverse to the spinous proces.es. The sftnuilis. heloni^-
ing to the upi)er hiyer, is the only muscle j.assing from spinous ,u-ocess m spinous pnuAss.
The First Layer. The Spinotransversalis and Spinalis.
The muscles of this laver (Fig. 2,?<)l fill the vertebral groove between the spinous processes of
the verlebrx and the angles of the ribs, and extend over a large area of the vertebral column,
usuallv the entire length (,f the back. With the exccpti.m of a Miiall i.ortion xvliiili may heduectly
beneath the >kin, between tiie trapezius an-t the latissimus dor-i (see page 145'. 'h^T •''•c- com-
pletelv covered either by the Hat muscles (,: .■ I<ack or liv the poMrrior layer ..f the lumbar fa>c.a.
The spim.transverse fibers form a .ingle, large, (..mpli.ated nui-cle. llie s,t, ros piiuili^.
The sacrospinalis or nr,l„r spimr iFigs. 2,V) and 241 1 i- a l'>ng and Mrong muMiilar ma-s
wliich extends from the .lorsal -urfa.e of the sacrum and the en -t of the ilium t., the ^kuii. il
forms a .ingle mas. ontv in it^ louvr portion. dividLg a. it i.a.sis up\\,ird into t«o -Maratr
nvasdes, thi" external and weaker i!ion>sl>ilis and the internal and .trongir lon-i.ssiwu. <lorsi.
Internal to the latter muscle and a<lherenl to it is .ituale.l the spinalis, .0 tliat the .uperl'ii ial
layer of the Ion- mu.cles of the back is arranged in three longitudinal strips U]ion 1 iilu r .i.!e of
the vertebral ...lumn, a strong median one. the /,u/,,'/,v.;»n( ., an eMrrnal .mu , du- //;■,.M.^/.,//^, and
an internal one the spinalis. Before its division l\u- .aero.pinali- i^ a ihid. pourrful nuH.ular
ma-, who..- .urfaie i. sironglv aponeurotic and which ari.e. fmni the .lorsal .urfa.e u\ \hv
.a'erum, fr..m the spinous ;,ro.-e-.s ..f the lumhar v.Tlebra-. an.l In.m ih.' < r.'M ..1 ll'. ilium an.i i.
indu.leilbetwun the iw.. layers of tlu' lumbar fascia (seepage i.*.,. Tin- ilin,.,Mali^ luinb..nnn
an.l the lonui-imus .lor.i pass iipwar.l <!irectly from this ma-..
Till' iliocostalis I Figs. 2,vjan.! 2|m i, tin- .mi.r p..ninn .it tlu-a. r.i.pinali-, and i. ..>inp..-..l
..f three sub.liv i-i.m- the //ww/...;^ liimborum. .lor^i, an I .inids.
Tlu' ilionnlatis Inmhanim (Figs. j,;o and 241 ' ari.. - in t.>mm..n uiih llu- l.Migi-nnu- an.l
in-erl. inn. th. an^d.- .-I llu- lilth L, llu- 1 .■Iflh ril^. ■Hi,- Mip. rior inMiliun- an I.', m.an- ..f
1,,,,,^ irnd..n-, xvhil.' lb.' l-'.ur in-erti-n. aiv in th. .hape ..f ll. ^Iin m rraliu,,-, llu |..-A.rnu.-l ..!
whi. h i- the .ir.mmM .iml pa.'c- to tlu- l.iwer bonier ..f llu tw.lfili rib.
The greater p..niun ..f ihr "vigin ..I ihe ilio, nshil,-, ,!■'•■. i .Fig-. j,^.) an.l .mi i- .nv.iv.l by
,lu ili......lali-lumb..n.m. !la,i-.--lA m. an. ..I .p.. iai , ..-^.-in m naii.m. Imm iIu inn. r -i.l.-
„f the angles ..i the tv-illih t.. llu- ..x. nlh lib^ and i- in->. (L- b- thin. I.n.ion- xvhi. Ii pa.s t.. llu-
an-l.s ..fllu- siMh 1.. llu- fii-M ribs and I., llu iraiiM. r-.- pn... ss ..1 llu- la.i .. rv i. al \. ru bra.
" The iliiHO-'ali''- "Wins (Fig.. 2,;o. ^ \o, and .' 1 1 ;. ab., 1. rm. d llu nrii.ali^ .r. , n.A i;>, h a
.K-n.ler mu..i.- llu- ..riuiu ..f ^^Wwh i- imimaU-K ...niucU-.l uiih ilu ili.M.Mali-. .I.'!-!, ll ...nu--
In.m the upper .nul mid.lle rib. in a variabi.- mann. r ,,n-i b i.-. lU-d b> n.irn.u I. u.lnn. inin ihe
n-an-v.-r.e pn..e-^.c- ol" llu- niid.il.- . . r\ i. al \, rubra imm. .'..H.-K aL.ng.i.le ..| llu .. al. nu. po.
U-rior i.ee pau'e 17V, \\illi ll" "Hi-in "I «hi.h il ma;, b. .i.iiunnl.
, 1
1
It 1
i \
150
ATI.AS AND TEXT-BOOK OF in'MAN' ANATOMY.
Flc. 2^9.— Tlie superficial '-vcr of the lonj; musclo of the back.
All Ihi' flat mus<:k-s, thi- spli-nii and the iliiKOstalis of ihf Irft >i.li- liavf Win removed.
The longissimus, tlic inner ])()rti()n of ihc sai.rosi)inali.s is comi)OhC(l of three subdivisions
-the loiii^issiniK.'i dorsi, icn'icis, .-.nd capilis.
K,il,ll,iris liillgi
littUtiin > .'•ii L'(5
Miiilifniiii
• Tr'i>'S7'rrst' ftrinrsses
Srni,\fn''!>lhs
Kl... j(o,-I)iairr,im ..f ihe arrariRrment .if ilir varum-, portion-, of Ih. iranr-VTr-o-piimlis UeMU,..|nnali>. nmll(liilu«.
roialorr.*).
The l<iiii^:'.siniii\ dorsi i f-"it;s. _> ;(> and 241 1, in addilion to its common origin with the ilio-
cosi.iii^ iuini)oruni. riTei\e> an ■^^oi\ un^^iii- li lin ll".ili.s\ ( rsc ]iroccsscs 01 nis- tw. ,; ,;it'i.:'. n
vcrjf r;i-. Its insertions are arranged in an inlirnal and in an eMernal series, and are partly
Splenius capitis x
Longissimus capitis —
Splenius cervicis x
Longissimus cervicis
Nuchal Ug.
Splenius capitis
Sternocleidomastoid
Splenius cervicis
Levator scapulae
lliocostalis cervicis
Semispinalis
dorsi
Obliquus abdominis ext.
Serratus poster.
super ■
Spinalis
Latissimiis ilorsi
Serratus iiiitifiot
"^•Srmilus poster, infer
I
Nff. 230.
CcS?
!#[
-,?:
■
if.--
THE MUSCLES OF T " BACK.
151
fleshy, partly tendinous, and their digitations arc frequently yariable. Those of the internal
series are inserted into the accessory processc-s of the ui.l)er luml.ar yertebra- and into the trans-
ycrse processes of the thoracic yertebrie; those of the external series insert into tlie apices of the
transyerse i^rocesses (cistal ,.rocesses) <'f the upper lumlxir xerlebra- and int.. the ribs bet^veen
the angles an<l the tubercles. The serrations of 'he internal inserti.-ns conse.|uently pass to the
transverse processes and their homoloRues, while those of the c^xlernal series run to the ribs or
homologous narts.
Tlie lon^^issimus crvkis .Fi-. 2,;o, 241, and 242). also known as the tnwsvrrsahs an'uis,
is the direct 'continuation of the lonKi»imus <iorsi. h ari.e^ fn.m the transverse i-meessesof the
upper thoracic vertebra-, is situated immediately internal t.. the ilioeostalis cervu ,s, an, ,> inserted
by tendinous slii.s into the iransvei-e processes of the uj.p.r and n.id.lle crvical vertebra'.
■ The lo,r^issimus a.pHis* (Im^s. 2,,o, 241. and 2^2) i^ the only portion ot the sa.rospmahs
Nvhich extends uj) to the head. It is >itualed internal to the lon-issimus cervicis. with the on-in
of which it is fre(iuentlv unite.l, and arises by separate short ten.linous slip> ol variable .xlen.
from the transverse and articular processes of the middle and lower cervi. al Ncrtebra- ., ,d trom
the transverse processes of the up|,er thoracic vertebra-. Thi> muscle often presc-nt> a i.udin.nis
inscription, i. inscTted bv a short tetidon into the posterior margin of the mastoid pr.H.^s. and is
comi.lelely conceale.l bx' the splenius capitis. The iliocostalis and lon.L^issimus cervun :>nd the
lon^isvimus cai.ili> are situated beneath (in front of) the two splenii.
■ The spinalis (Fius. 2^., an.l 241 ) i- .omposed of the splm.lis .hrsi. nrvias. and r„ />//;.. ol
which the spinalis <l..rd alone is an in.lepen.lent and constant muMJ.-. the spinalis c. rvi, w b.ini;
inconstant and the sj.inalis capiti> a part of ihr semispinalis caj.ilis.
The spinalis dorsi (Figs. 2V, and 241. is intimat.lv eonne.l.d will, the t.nduuuis .,n;.;m>
„f the l.uv'i-inius .loi>i whi.h ...m.- tn-m the spin.uis processes ..f the lumbar vrt. 1.. an.l tak.'>
its ..ri.dn' partly fn.m these b.mv p..inls. It is situate.l al.-n-i.le ..f th.- spine, ot du ihora.u
vertebra- and c.aUain> i.am.n.us ten.lin.ais fas. i.uli. It take, it^ ..ri,.dn trom tl,.' ^pm.n.s ,,n..
i.sses ..f the ui.per lumbar an.l "f the lower th.-racic vertebra- an.l passo I., the sian.s ..| t h.
mi.l.lle an.l upper tii.M-acie vertebra-, bri.lging over one or two ..f the spin.uis ,,rocesse^ (Usually
tin- ninth .)r the .lintli an.l tenth).
The spinalis nrviris (Fig. 2 + 1) i> incnstant ami, when i.rcsenl, is fre.|Uenlly .|Uit.- ru.li
m.ntarv It is a verv sUn.ler muscl. which aris.-s fn.m the spinous i.ruoses of tin- Mxth an.l
..venth cervi.al vertei.ra- an.l inserts int.. the spim.us processes .,f th.' .-pistn.pheus (axisi an.l ol
the thir.l cervical vertebra-.
Xn m.on...n. nn..,ul,,r f.. i, uUh uln.h arises fr.,m ,h,- spi.vm, ,,n...-ss.-s of ,1„. Inn.r . .ni, a! l'"'' "IM-""--^,
(,..■ llUgl- i%2).
m
The Second Layer. The Transversospinalis.
The fibers ..f this laver (Figs. 2,,() t.. 242). i)assing from the transv.-rse t.. the spin..us
p.rocesses. rei-rcsent in their arrangement a portion of the original trunk musculatur.- whidi has
.Tlu> mu,>l.- lias alsu 1h-,-„ U-rm.-.i ih. rr„„..,Tw/» .apilis. •>,.- „.»,;,/. v.,, .„nor. a,M ,1,.- ,r.„ l.r!..,„.nl«iJ
3
W^"*
^ }
i
J
)
: ^ 1
1
;-t ! »
■it
if/
^i'^^
15-^
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Tic. 241. — The deeper layers of the loni^ mus'-les of the back.
On llie left Side the sacrospinalis has iK'i-n partly removed and the semispinaiis has been cut and reflected.
Flc. 242.— The cervical portion of the deeper lu.vers of the muscles of the hack, .seen from the side.
Tlic trapezius and splenii have been r<move<i.
un(li>rt;(ine but sli<,'ht changes. They are arranged in three layers, each of which is described as
a special muscle, although they are not separated by fascia-, but are distinguishable from each
other chieflv b\ the length of their fasciculi. The semispinaiis, the most superficial layer, has the
longest and conseiiuentlv the most slanting fibers, which bridge over from four to si.\ s])inous
]»roces.ses; the mullifulus, tiie middle layer, has fa.sciculi which pass over two or three vertel)ral
s])ines; and the rolatorcs, forming the dec])csl la\er, either extend o\er only one spinous process
(ro/dlon-s loiii^i) or j)ass to the next succeeding \ertel)ra {rotalnrcs hrrvi). With the exception of
ihe semispinaiis capitis, ail of tlie fil)ers of the transversospinalis end at the spinous process of the
axis. The semispinaiis is absent in the lumbar region, and the rotatores are situated chielly in
the thoracic region.
The semispinaiis (Figs. ^Vd ^41- and 242) consists of the snnispiiuilis dorsi, semispinaiis
irn-i<is, and scmispiiuilis capitis.
'I'he srmispiiialis dorsi 1 Figs. 2,^() and 241) and icrvicis (Fig. 241) are direcily continuous
without dc^marcalioii, ihe lowermosl fibers arising from the transxerse processes of the lower
tlioratic 'erteljnr, and the upperni.)st fascicidi terminating at the s])inous ])rocess of the axis.
The muscle is stronger and moP' lleshy in the neck than it is in the back. The fibers of the
semisjjinali- <iorsi are intermingled with numerous tendinous fasciculi and are also jjartly con-
neited with the spinalis dorsi. The muscle is completely covered by the longissimus dorsi and
the >emi>pinalis capitis.
The .••' mispiiialis iiipilis i Figs. 2,;(), 241 , and 2421 is a llat but rather thick muscle and is tlie
slnumest must le ni the neck. .\- a rule, it consists of two |iorlions which are se]iarated below but
adherent abo\e ai iheir in-t rn'on a slnmger external or .'•emis;)inal i)ortion and a weaker internal
or spinal ]iorli"ii. The -emi^pinal segment, sometimes termed the fcm/J/cv;*.?, arises by numerous
short tendinous --lips from the transverse jirocessesof the third cervical to the fifth or sixth thoracic
\trtebra', whilt the s])inal segment arises from the spinous ])ro( esses of the lower cerxical and of
the ui>per iliorai ic vertebra- (lite spinalis capitis -. This latter portion is characterized by a tendin-
i)us inscriptimi. ami hence is >umetimes termed the Idvcntir tcrvitis, aiitl sometii..es, when the
spinalis lapilis ;- ab-.eni, its origin extends to the transverse processes of the second to the sixth
ier\ical \'enebv,i . The external portion of th" muscle also usually jiossesses a broad tendinous
in^iriptini wIikIi i- situated ab(i\e tile middle trndim of ;he liiventer. Both portions ol the
musile unite and pass to the nucha! surfai c of the oci ipital bone, where they insert between the
siiperioi .iinl inferior nuch.il liius.
The multifidus ■ Fig>. J41 and 242! consists of the miillijidiis lnml>onim, dorsi, and (cniiis,
but tlicM- ^egmenl> (.iniiot be clearly (lemartated from each other. It commences below at the
:io-.!t'rior -iurface of tb.e .-aerutn and. ii/rniitiiiles .;dio\r .'it the siiinous iirocess ot the eiiistrophelis
laxisi. It i- >trongt>t in the lumliar region, where it lies direitl\ beneath the longissimu-^; it is
weakest in llif thoracic region, where it i< cuxcred by the semi>pinali-. dorsi; and in the cervical
Ttansversus itnrhac
Spknitis aipi'is
Splenias capitis x
Splenius rervicL
-cngisiimus capitis
L'ngir.'imus cervicis
lUocostalis cen'ids
Semispinalis dorsi
et rervicis
Sicr-iocU-ido-
maitoid
SiHrmiif cirvicis ^
ilioro;. talis cenicis
[■if:. 2tl.
'i^xt
i
' I
THE MUSCLKS OF TH . BACK.
153
region i. is partly concealed bv the semispinalis cervicis, to the outer si.le of which it i^ cu\ ere,l hy
lue semispinalis'capitis. In the lumbar region the greater portion of its libers arise from the a. ces-
sorv and mammillarv processes, in the thoracic region from the transverse processes, and m the
cervical region from the articular ],rocesses of the four lower cervical vertebne. The fasciculi
are interm'ixe.l with tendinous libers an<l generally extend over two or three vert.'bra', combining
Occil>itii! bone (misi!i:r firrlian)
Alias
Epistropbeui
Jn!crtrnvsv<rSitrti anuriorts
J lilt nruiisi-frsdrii N'!;trri"res •
l:.\Uriial ociijihal l-niliihi-r.iiio
Xiuiiiil ih^aminl
IntfTipiiitdes
y lull il li^diunit
-S/'inol.'i tiriirr^^ n,' nrvUill
'.'•'.'■'lira VII
I'lC. .-4 ,.— Diagr.im of Ihi- nrviral iin(Ts,.inal,-; ami intirtr,ui-v,r<arii an.l of ihr tin. hal Ht-aMunt.
t-' "orm a single uninlrrru]ited muscular layer, the deeper portion of wiiidi i> di-'.ingui<hable
onlv xvilh dilVi, ulty from the rotalores, i.arl of v.hose libera Mas- ir, th- -:mie dina lion ■: Fi;.r. .^)oi.
The •^Otatores are .oiiiiiosed of tlie rol,ilor,s loii-i and hn'r-i. Thev are Muail, llal, and
parllv tendinous muscles which lie immediately upon the vertebral an he> throu-hout^ the entire
-,!,!!vd rolumn. h'.'.t :ire ehiellv dewloiied in the thoraiic feL'ion. The rohUons hnvfs (Fig. ? |oi are
almost horizontal and j.ass from the transverse i^rocess of one vertebra to tlie root of the -pinou-
procos of tlie vertebra next above; tiie roluUms loiti^i (Fig. 240) extend over one or ^(.metimes
;!^;
^xM'^^'MW'^W
■^''
1 54
ATLAS AND TKXTBOOK OF HIMAX ANATOMY.
M1ii'
«M
two vcrtcbrie before inserting into the roots of the s])inous processes, iheir fibers having a
course parallel to that of the multifidus.
All of tin- lonf" muiiU'S of tho l>,uk :irc supplii'il l>y the posU-rior illvisions of iln- -ipin:!! lUTvis (nTvical, Ihorack,
lumbar, and sairal'.
""he niajorily of tin- lonp muscics of ihi- h... k have ilic sami.' funrtioiT^, If the nnis(li< of llu- twr) si'K-s ai 1 fojrithir.
till V liolil ihi' trunk utirif»ht. extend the vertiliral i olumn and ihe head, and liend Ihr head and vcrti-bral column bai k-
ward. During nnilaieral aili<in they brnd or rotate the vertebral i olunin toward the ( ontraeling sidi-. The stronRi-.t
action upon the h<Mil i^ ,\mu.1 b\ the two veinispina]i> i.ipiii-; «lirn ihey act loKether, they |iull the head backward,
but whin thiy act sinf-iy they rot„'r the head so that the fan- i- <lrawn to,.,;i 1 Ah opp v.-c side, „■ •; • onseijuently in
the opjiosite dire, tioii to that in whiih it is turned by the splenius capitis,
THE SHORT MUSCLES OF THE BACK.
The short muscles of the Ixk k are divided into two <;roui)s: those whieh are found ihrou^'h-
out the entire llexible vertebral column and those which are situated between the' a.\is and the
1 iilrrlril ttsirrS'irii tii -/li tii'S .
Ir.terlrr.m^vcriirii l.ilcr<lh-s
I iilrr^pinali ,
I'ir.. 2(4,— Diafjrant of I'r.e luni'Mr intcr>|,'in:di s and inti-rtransversaril.
atlas. The first f;rouj) is rom])0.=ed of two further subdivisions: the inhrspiiuilcs, bt.-tween the
spinous proees,ses of the vertebras and the inlirlrausvirsarii, between the trans\er>e ])roces.ses.
The second oroui) is also desifjnated as the short muscles of the neck.
The interspinales ! Ki.ys. 241, 24,^ and 2441 are -mall mu.sdes which are well developed
only in the cervical refj;ion and may be entirely wantint; throui^hout the thoracic \(Ttel)rMl column.
They are connected with the interspinous lif^aments and jiass from the spinous jjrocess of one
TITK MT'SCI.I.S OK Till: HACK.
I^;
vertebra to that of the next lower one, and in the bifid s])inous proeesses of the eerviral vertebne
they form paired j-truetuns. Like the majority of liie museles of ihc Ijaek, liuy do not im^,-.'
beyond the s])inous process of the epistropheus (axis).
The intertransversarii (Im,i;s. 24,^ and 244) are small, short, |)aired muscii's whieh eomurl
the transverse processes of nei.uhborin.H vertelira'. Thiy arr doubk- uiion bolh sidrs and are well
developed both in the eervical and in the lumbar verlrliral eoliimn. Tluy may \ic entirely abst'nt
from die thorai i( column.
In the cer\ical reijion inlrrtriinsvrrsiirii niilirinris and pn^lcrioris 1 l''ii_r. 2|,;i, \\lii(h run
l>e!-.veen ihe anlcior and po.-tiTior tubercles of du- trans, crsc proc c ssi -, arc dillcrenlialed.
Both muscles are .d)o,it L.|uallv developed: the anterior ones are situated in the anterior cervical
rather than in the luichal reijion.
The intertransversarii of the lumbar rcL'ion are (onijioscd of the wider and stronger inhr
trniisvirsiirii lalcrulis. runnini; between tin- transverse pronsses, ,ind the narrower and weaker
intertransversarii medialcs, whieh extend between the accessory and mammillary processes
(Fii;. 244I.
A- rl■l;,lrcl^ llirir fumti'.n ami innrrvali'in, tin- imrr^i'i!..il.^ and tlu intrrlran,\irsarii re-inililr the I"";' niu>cle
of ihf li.il k.
THE SHORT MUSCLES OF THE NECK.
The short muscles of the neck T''i,^-. J 41 and 2y)\ arc' the reeliis eafiilis pif^Urior majur. the
rcetiis capitis poslirior minor, \\\v rcc/n ■ mpitis iaiiralis. \W uhliiptiis lapiiis \ii p< rior. mm\ tlie
obliqiius capitis injeriar.
The rectus capitis posterior major Fii;. 2 in arises l,y a short tin. Inn fmni iln -pinous
proeessof the axis, runs ujiward and outward, becinninu' muc h i)idader. and inserts iiu" the middle
]>c)rtion of the inferior nuchal line of the occijiital bone.
'"'he rectus capitis posterior minor I'i;.^'. 2111 is i<)nsideral)ly weaker than ilu' major.
It is a small trian.^ular muscle wliiih arise- liy a shoit Icaidon from tin- iiosU-rior tubercle of the
atlas to the inncT side of and partlv bc-neatli the lectus major. It runs to liu inner third of the
interior nuchal line- of the occipital bone.
'I ne rectus capitis lateralis ^ I-'ii,'. 251)1 arises from the fansv.rse proce>- of the atke- and
inserts into the jui;ular process o! the' occipital bone. It rep. -calls the' uppermosi intertrans
\ersarius.
The obliqUUS capitis superior ii''i,Lr. -l'' ^'bo arises from ihc' ir.illsverse process of the
atlas, and runs to the outer third of the inl'erior nuciial line- of the oiciiiiial bone , where its |, ndin-
ous insenion jiarllv covers the rectus capitis posterior major.
The obliquus capitis inferior 1 Mi;. 241 1 is a rather >,tronL; ,d lleshy niusi k which runs
from the spinous process of the epistropheus (axisi to the Iran- -e process ol the atlas. It is
thick in the n'iddle and becomes narrower toward its ori.Ljin and insertion.
Till- -hurl iiui-i ii-s of tiir ni'i k an- Mi|i|iiini ii> liu |"i-.|, n..i ihvi-i..r. ..T ir.. lir-i .i rvi, ,<: nt rvr : .■.;;■.•: • :; ;:a: nrrvr;.
The funiti. ■-. of the -linn inu-. Ir- of the no I, pr.u li. allv .nTi-i-,is of ,i rotation or ,-\i,iisi.,n .., ihr hi ail. .lipi ii.l.nt
upon whetlliT thrv ail u|«in ..nr or l„iil\ Mil,-,, ■fhe rr. lei- neiiior . an onK ,AI.-ral ih. li. .i.l aM.linv^ iiiov. nu nl i , the
rc-rliis latiTali- ini line- the h, ,i.! lo one -i.lr. ih. olileiiiu- iiif.-rior and tlu- nuu- major roia;, tin- lioail in \\-' -amr
(lireition and are- iippused l)> the oliluiuu- -upiri or.
W\
I
156 ATLAS AND TF.XTHOOK OF HIMAX ANATOMY.
Fig -'4S --Suiicrfu-ial and second lavcrs of the abdominal and i)cctoral muscles seen from in front.
C^ii thi' rii;hl tide thu pctonilis major ami ihc ..l.li.nuis alKli.iiiinis i-xUrnus have been rcnic.v.-d.
IVlw.-.n llir rr,tiK<a|.iiis |.(,sl,Ti,>r maj-r an.l llu- ol,li,|.m. .apiiis suiKTlnr an.l inferior is Miualt-.l a >mall Irianglc
(the ,„b,„,ipilul iri.nii^lc) in whi, h i. >a|...^.-.1 i1h- |,..,l.n..r an li uf ihe alia-, . tosm.I by the vtru-brul artery.
THE FASa^E OF THE BACK.
In the dorsal r.-.irion there are liul two fa.siix worthy ol note, the- lumbodorsal j,!sri,i and l!ie
nuchal i<is,i,i. ■I'hc u!)i.i.T layer of the Hat nutsiles of lite hack is covered only by the .ueniral
sil]ierruial las( ia.
Tht' lumbodorsal fascia I-i-s. 3;/. 10 -\;S) is cnmpos.d ol two layers, the stronj^ posleri-.r
layer, whi- h i> .-u|ienii ially situated in the hack and form- the ai.oneiirosis of the latissinnis and
tlu'serratiisiioslerior inferior, and 1 lie anterior or dee;> layer, which i- (l\elo]ied only in the lumbar
region, w lure the lon.n muscles of the hack are included between the two laver,-.
•I'lu' posUrior l.ivr 1 Fi.u's. j^() and .\vS) co\er> the sacro.spinalis from behind and < Mends
alM)\e thi' U]iiierm<>sl ]iorlion of the lali-imus to the inferior marj;in ><\ ilic aponeuro-i- ol the
-erratus jio-tiTior sujierior. .\|iliou,i.;h the fa-i ia becomes .on^iderably lliiiini r alliv n cia-c - to
be the apoiuupwi- .,f the lalissimus, il u -ually ,-till contains distintl tendinous slip.s. In the
thorac ic re::i"u ihe po-lerior layer i> atla< hed laterally to the an!;les of the ribs, and i- covered by
the tra]ie/ius and by till rhomUiidii.
•Idle aiU.r'wr layr VvA- -'.ij' run- from the inn.T lip of the .rest of !h( ilium !o ihe twelfth
rib, .m 1 i- altache.l internally lo ih, iran-\erse i-r.Mr-se- of the lamb.ir \irtel)ra-. li- upper
niar;.'i.i form- ,1 lu-mer lendinuus band v.iii.h pa--e- front the tran-ver-e pn»,— of the hr-t
lumbar \erlehra to the twelfth rib and i- known a- the hinih,>a>:i.il uxl.nuil <,nii,il,> //,t,w;»c)i/
I Kiu. -'51 1. 'Hie anterior layer i- -ilualed betwt tn the -ac rosi)inali- md the (|uadr,uu- lutnborum,
an-l at the outer niaroin i<\ the sai rosjiinali- ilu' two l.ivers unite .md ;;ive ori^'in lo several of the
aUlominal mu-i K-,
'I'he ihln nuchal fascia i- -iluaU'd bene.nh ih.' impe/ius and .d-o pa.rlly b.nealh the rliom
lK)i,|,i. It i- <onlinuou- belnw \\\h the uppi r porli-ni of the luml)odor-al fa-cia and eslernally
widi the fa-ci,i of the niik, .md tlie f.i-. i.eof t!ie two sides .ire ((.nnected ill the median line with
the imclial lifiamenl.
[The trunk 1MU-. ul.ilur, I- .1. liv..) !'"'n ih. Inii.U i..\ i-ie. ..f ih. embrv.. ,,n.l i- . ie.irU .hvi>ible ini.i nv. |...rti..n..:
, , 1 ih. .l.>i.al irunlv nm^Huialur, , ,1, tixe.l In.n, ilu- ,|.M-..i i...ru..n- ■■f ihe inyMtn. . .....I -u|.plie.l b;. the .lor-al ■ p -u ii,.n
bran, he- ..f tlie -puial tierxe , .in.l i .• i lb. v.niral Iruiik nui- iii.eu.. , .lei. I..pi <l ir.im ihe v.-nlral p..rti..n. ..f ib, trunk
tin..|i.mi-^ ami -uppli. .1 b. ihi \' mr.il briii. h. . ..f lb. ~piii.il n.r\.'-.
\Vh. n ...p-i.l. r. .1 fn.n. ihi- Man.l|«..nl. .h.- itm-. 1. - -f ih. 1.,|. k a- ati.,..* .. ab..i.' . i. ,.r!v f. .nil .i -...n. nhal h. i.r..
i'.ne..ii- KP.iip !!..■ I1..1 imi-l.- ar,' f-.r the ni..-l pan -iippii..l bi %■ niral bran, he, ..I ihe ,piii.,l ii.rve-. ..i. i.i llie
,,,.,. ..( llu lr.UK.-ni-. b-, .1 .rani.il ner^.■, .. (.el «hi.h .a ..me .li,iin^.ibb.-s ih.in l-.,iii lie |.,i,- an.l -h..rt nuiM le-
t.t!.,!,,. vulh the-pl.nii.v.hi. 1, (...e, ih,- Iru. .l..r-..! n.n-. uial.in- T he «iaj..ri!v ,.f ll... Hal le.,-, I, - ,,re in r, alit v nue,. 1. s
■ if ih, up|Kt lin.b ,,n,l Ih,- iraiK/iu- i- primarily part .1 lb. . lanial nui- ul.ituri-. lh.> "ill b. ...ii-ei- i.'l Lit.-- in ...n
lli.!i..n iMIh Ihi ..Itl. r Mill- l.» "t lili ir ur..!!].-
.-,, (,,r .1- ih.- ini.- .I..1 -..1 imi-. ul.iiure i- . -.ni .rne.l. . - .n!parativ.-anal..Mn ha- -h..vi n thai il i-. ..inp..-i-.l ..f i • .. p.ir.ill. 1
ljr.„ip« ..i nm-.l,-, ., I.u. i.il ..n.. «hi.h ...n-i-N of nui-, I.- priniarilv pa^^ing fr...ii Ih. lei.wv.rM pr...e-e.< i.. Ihi- rib-,
.111.1 h, n. . i- l.rn.i.l Ih. /r.,u.rrr.... ..-/.,/ ,vr,.,./.. an.l a ni..r. Mi..li.iii ..ne, uh..-. niu,. 1. . j.a-- fr..ni the Iraii^-v. rM !•. ih.-
Crfmasifr..^
Reflectfd inguinal lig.
Intrrcrural fihm
' Subcutantoiib
inguinal ring.
^permstif CCd
)
11
Huperior pillar, tundiform lig- of prm's
Fig. 245.
Infnior piltur.
i-^L
,j
if
_.-.\-J;_
XriK ABDOMINAL MUSCI.KS. ^57
as IKCM UTmo.1 Uu- lr.nn:rrso..f,iw,l Er.mp. Tlu- .onsliluiion ..i ilw two gr.mp-, i. ■>>
spinous processes, and wliiih li
follows: 1 ..I ■
Transvers..-.oslal;-^^^m»p/.^///,^■, /V/W«M/n. /."^w>.,m.^<, an.l 5/./<-",».<-
and obliqmis cupitis iiijfri,<r. - 1 .n]
THE ABDOMINAL MUSCLES.
The abdominal muscles (Ki.^'s. .45 t" 2.0) form thr anurior, th. laKml, an.l a ,«rli.>n of
..ostcrioralxlominal wall, an.l cxt.n.l from .hc low.r mar,,in of ih. thorax ,.. llu. u,,pc.r ma-^m
■ ,dvis Thc.v aro sul..livi.U.<l into tho anteri.u- abdominal, of whi. h thrcr ■ v Hat muscles
,0 a strai-hl muscle, and the i.osterior abdominal, the .|uadrams knnhorum.
THE ANTERIOR ABDOMINAL MUSCLES.
THE KLAT ABDOMINAL MUSCLES.
The Hat alxiominal muscles (Im,s. .4^ l" ^>o, include the ohlu^uu^ r.Urnus. ,he .W^"'-
aMomwis i„lrnn,s, an.l th.. Inwsv.rsn. Mominis; thev are arran,.d m thne avers an.
IL the lateral an.l a porti..n of the anterior alnL-nunal .all. Acconhn, ,0 .h.. ,re. ,.on . f
the.r hber., the two ol.li.|ue muscles may Ix' r.uar.le.l as th.. .lirect .-ontnnKU.on. ol the inhr
cstales, the obli.iuus interna, in particular, heiuK .lirectly .onuntun,. .ith the lou.r mter..Mal
"""' The obliquus abdominis extemus < Ki^s. . ^.i" ^ to) is a broa.l Hat nmsck which i. a,,..neu
roti. anteriorlv an.l n.arke.lly .> in its anterior inferior p.,r,ion. I, )^ situa.e.l u, the la.end
IKr.oral. the hyp-K h.,n.lriac, ih ■pii^a.stri., the meM.p.Mric .lateral .dKlonunal an.l umh.h.aL,
an.l the hviK)ua>tri. I inguinal an.' pubic) re.ui.)n-.
U arises l.v ei.ht llcshv serr 1 .ns from ,h. . i.h, .f.fth „. lu.lf.h) low. r rd. Uu- upp.r hu-
.,n-a,ions inlenli.ilalin^ uhh tlu .w. r on. s „f the M.rra;us ant.rior, .he l..u.r three wth th..se
,„■ ,lK. latissintus .l.nsi. The mai..ri,y ..f .he lib. -. of .he musd. , like those ol .In umMvostales
..Mcrni. .-un from above .l.nvnwar.' Mi.l fn.n, uid,..u, inwar.l; ih.- sup.iMM- 1,1k rs, ho^.x.r, ,,as>
M.m.A...al h.H-i/,nntahv, uhile the ,. feri.M- ...us app.-..a. h a veru. al .Inv. ...m.
Tlu. hb.r, ...nin.. In>m the ower ribs Iunc an .vt.n.ne ll.shy .nMnnn, ,n,.. .lu .uU. r
,;„ „r ,h,^ ,n~l of th.. ilium, eMen.li.tK an.eri..rh ... .!>.■ ar,., ri..r su,..ri..r ^.n,. and p..s.ei-,n,U
Jnt..s. ... .lu -..r nK>r,in of the bussinu.s .lor^i. Tlu ...main.l. r .,f .h. nw r.,on ,s ap..n..,r..ti.
,n,l ,,,.... ,„ ,he ,nuui,tal ,|-..upan's, liKam.nl, .he U-valer p.,.-.ion ..I wh,. h ,~ lorm.. bs th.
^,,,,in..us fasu.uh of ,lu. n,us.le .sc.. pa,e ,(.,.. an.l .0 .h.. :o,„ , mr laxer „. m, sh.a.h oMh.
rectus, bv m. an, of . hu h ,, is . ..nnnu..! m .h. Inu ,. ..Iba. \lmo-. .lu ■ n.n-. an-eruu- ab. .m.nal
surface is . ..n...,uen,ly ap..neur.,.i. . esp.. iallv in .lu lou> r ab,i..nunal r..,i..n .h.. mus. le hlH.s
i.mimeiue .luit.' at ih.. sidi.. , , ■ , s
.... ,.. , 1 ,..;,.: ......_ ;. , . ,-..l,i;,», Mii.rri.irh v.i.h .lu ilKlomiiud p.H-li.>n ol
,lH. ,.ec...r,dis mai,.r, .Memallv wi.h the s. rralus anteru.r, p..s.en. eM.rnally u„h .h. la.,ssM„us
,i„r'i. vsi.h uhi.h' i. f.mns the hnubar >I'elil's) triangle (see page i^V- ami mteru.rly u.lh -c
X58
ATLAS AND TEXT-BOOK OF HU.MAN ANATOMY.
Flc. 247. — The su[)crficial lavtr of the aluJomiiuil musilcs and llic serrutus anlcior >ci.'n from the left
Till' pirtorali.^ iiKij<ir and minnr ami the innir porticm of the clavicle have Ix/cn rcmiivcd ami tlie arm has licen
'Iraun Ikh k\\ai«I.
iliac crest opposite to the f;luta:us niedius. In the rcj^ion of the symphysis pubis the tendinous
libers uf the ajioneurosis form an openini; by bridsjini; <)\er the space between the pubic spine
(the insertion of the ini^uinal ligament) and the ujiper margin of the symj)hysis. In this manner
(V)Uquus iihilnmiii!^ rxlrrniis
Miisflr siirjiirc . I pmicuritsix
f.iiici iilh.i
hitir,r :■-,!! fihrrs
.Su!>rri,ir i-illar
Sttht itl'iiii-owi int^uiiiiil
lil]iriiir piliir [iitl^uithl I
.XiUrrior stt furrier
sffitic vj ilium
hi^uhml /ii^'int' nf
.Icil'thulum
V Symphysis pubis
I ti;. : t" -Iii.iKr.iiii .f ihi- >ul« ul.mii'ii^ inguinal riiip. On tlte rinlil only ,1 |Kirllun m' ihi- .i|Hini-urci-is nf ihr olilirjuurt
.ilMliiMiinis is riprrsented.
ihrrc is t'orni((l a iriangK', the outer angle of \\liich i-; direcled upward and outward, ami which
((>n>tiluiis tile siihi uliiiuotis iiif^uituil {iwlirnal abdominal] rim^ (l''ig>. 245 and ?4'>). 'I'he
margins of tiic ring arc formed by the ajioneurosis of the obli(|uiis abdoiuinis externus, and
are known a-, llu sii f'triar (riis or pillar and the nijtrwr trus or pillar ol ihc ring.
The upper and outer angle of lhi> ..iangular >lit in the apoiuunois of the external obli(|ue
muscle is rounded off by lilxrs which arise from the region of the inguinal ligament and arc
^^v^V', .w-f-i^-^^^J'
Clavicle .<
Omohyoid
Scnleniis medius
Sternohyoid
+ Sternothyreoid
Scalenus anterior -
Pectoralis minor
Pedoralis major/
Fig. 247.
ill
: it
.V^:\.^;-,^!„^:v,Vv^' ^-V ..: :r>:P^ jYM^m
Hi
-L
^f^lgj^g^.. ... .., :W-^^m^ . :^;-C'',.;y;:<a^..: Wmm.^
THE ABnOMINAL MUSCLES.
I5Q
situated superficially and in front of the aponeurosis itself. They arc known as llie iitlrrrrural
I inlcrcoltimnar)fihirs or ihc anterior cms or pillar (Vl'^s. 24^ and 24(}). The inner angle is similarly
rounded otT by fibers of variai)le development whieli originate at the attaeh.ment of thi' inguinal
ligament to the jjiibic sjiine and jiass toward the linea allxi beneath the ajioneurosis. These
fibers are known as the rr/Urlnl iiii^uinal {triangular) tii^amcnt, or sometimes as the lii;amrnt
Slicalli I j rri/iii dhji'tiiinis . I /»>i!f«r.i.w> »/ Afioiiniriisis I'J
((inlcrior layer) ohliquus ,ihdomiin\ rxirrinis ohliquus .ilxtomim^ inleriius
1 (IHiquiia
\ rxlrnius
I
} nilcrni'S
I r<tns-
it rstis
Fir.. 2.4s.— Tr;in-vir~f ^nlinii.if thr .-intrrinr :itK|iimin:il \v:iU .ilnmt a h.ind'^ hriv'.illh :ili'ivr llii- iimliilit u> |ili.it;r.un-
niatii !.
Sliciiili «j rriiuf .ihliiminh [anterior layi-r)
A/MinruriiuK nj dliliijiiu^ .iMomiiih iiiirriui^
Apont'uriisii; oj obliijuus aMi'iriiins fxlrrntfi
'. I >lHi(jlllt.S
ti!fir:nts
/ r,nn-
I'll;. 24'). 'I'raii-vc r-r M dion of ilu' aiitiiicir Ml"l'>min.il w.ill miilw.iy 1h Iw.-i n tin- iimhilii lis ami llu- -Mti|ili\ -i^ pulii-.
i<liaKrani!ii.ili( ).
oj Colics or the posterior cms (Tigs. 24^ and 24(1). .\s a nsull of the iiresenc c of the tibers and
the ligament, the .ing biionus irregularly ijuadrangular in >liape.
It is tile antirior extremity of a laiiat, the inguinal (anal, whidi passes obli(|uely thnnigli
the abdominal walls, and transmits the spermatie eord in the niaii , and the round ligament ol the
uterus in the female.
' i|
il-nr a mnrr ilii.iili'H .-iiTount of ihi' inguiniil < anal tin rcadir i.. nfirnil to ti\i li<i.ik~ ami allasi-. of to;iiigrapliii
anutomy ami lo the ^idion upon ■.plani linologv . i
^e
160
ATLAS AND TEXTBOOK OF HUMAN ANATOMY.
Fig. 250.— The deeper layers of the abdominal muscles.
On the loft side thi- anterior laver of the slu-ath of the rectus alxlominis and the obhciuus abdominis exlernus
have been removed; on the riRht side, in addition, the reetus abdominis, the pyramidalis, and the obli<iui's abdomuns
internus. The cNternal intereostal ligaments have l)een removed im the left side.
1
I
The obliquus abdominis internus (Fi,a;s. 245, 248 to 250), like the cxtcrnus, is a decidedly
flat mustk. With the e.xeeplion of tile ;ill area in the lumbar triangle it is eompletely covered
by the obli(iuus externus. It arises from almost the intire len-^th of the middle lip of the crest
of the ilium, extending anteriorly as far as the anterior superior sjiine, from the junction of the
two layers of the lun bodorsal fascia (.see page 156), and from the outer two thirds of the inguinal
ligament. The direttion of the I'lbcrs of the u])i)er yxirtion of the muscle is similar to that of the
intercostales interni (from without inward anfl from below upward); the middle fibers are less
ol)li.lue, and the lower ones are horizontal, those of the lower third even passing slightly from
without inward and from ab'ne downward, like those of the obli(iuus externus.
The i)osterior fibers u g from the lumbar fascia have fleshy insertions into the lower
t)orders oi the three lower ribs. The long fibers < oming from the iliac crest, as well a.s the hori-
zontal and descending fasciculi from the inguinal ligament, i)ass into the sheath of the rectus,
the two lavers of which are formed by the aponeurosis of the obli(|UUs internus (Fig. 248).
The muscular i)orti<iii of the obliquus internus is broader than that of the externus and
conse(iuentl} ipjiroaches muth more closely to the sheath of the rectus in the anterior alxlominal
wall, especially in its lower jioriion (Fig. 24.)). .\ variable number of the inferior libers of the
obliquus internus actompanv the sitermatic cord, as the rrnua.slrr (Figs. 245 and 250), as far as
the testicle, and conse(|uently pass through the external abdominal ring as flat isolated fasciculi,
and in the female a few fibers of the muscle are similarly continued upon the round ligament of
the uterus.
The transversus abdominis *Figs. 24S to 2501 is a flat, rather thin, and largely ai>oneurotie
muscle which is completely covered hv \hv obli<iuus internus. It arises by flat mus( ular serrations
from the inner -urfate of ihe six lowtr libs and from the cartilages of the seventh to the tenth,
interdigitating with th. m rrations of origin <d" ihi diaphragm (see page i()4i. It also arises by an
ajxineurosis from the entire kngth of llie jundion of llie two layers of the lumix.dors.il fascia,
from the iniernalli]) of the cri-i of the ilium, and from the outer third of the inguinal ligament. The
fii)ers jKiss almost transversely and are altadud lo the aponeurotic insertion in a curved Ime.
the sniiiliiiutr line iliur oj .S/j/i,', //;/ > ■ T'ig. 2^01, in su< h a manner that the uppermost libers
coming from the ribs alnio-t apprtnuh rath other in the median line, the middle ones become
aponiurotii at ((uite a dislantc from thi- loialioii. and the inferior fasiitiili rtmain muscular
for a somewhat greater distance. The upper uvo thirds of iht aponeuro-is of the trans\ersus,
tog.ther witli that of ilu inlernus, form the ])ostirior layt r <d' the >heath of \hv rulu- (Fig. 2,48);
the lower third together with the aixineuroses of the obliiiuus internus and externus, forms the
anterior l:;vcr of the ^heatb (Fig, ?]■■}''■.
i
External intercostal ligts.
Obliquui abdominis
intfrnus :■:
Cremaster
Interrostale- iiiterni
Sirratus anterior
Internstales externi
Oblitfiiiis abdo-
minis externus x
Cremaster
m
FifT. 250.
Is \
^
THK AIJDOMINAI, MISCI.KS.
I6l
THE STRAIGHT ABDOMINAL MUSCLE. RECTUS ABDOMINIS.
The rectus abdominis (Fi^s. 248 to 250) is a tlat, broad, and rather thick mu?clc. It
arises (Fij,'. 250) l):-oadlv by Hat imis< uiar serrations from the cartila.tres of the tlflli l.i the seventh
ribs and from the xiphoid imx-ess, and its libers ]iass almost vertieally downward iu>t to eidier
side of the median Sine. The muscle becomes somewhat narrower as it descends .md is inserted
by a much narrower tendon into the ujjper border of the i>ubis between the pubic luliercle and
the symphysis, a portion of the tendinous fasciculi of the muscles of the two >ides inlerlacinu m
front of the ptibic syn-'physis.
The rectus is '-haiacteri/.ed by possessing several narrow, transverse, sli.i;htly curve<l or
dentate tendinous intersections, the tendinous inscriptions ^transverse lines) (V'v^. 2;pi, which
traverse a jjorlion or the entire width of the muscle, but do not usually cMenil throu.uhout its
thickness. 'Fhe number varies between three and lour. The uppermost one lie- immediately
below the orii;in of the muscle in the re,i,'ion of the costal arch and is sometimes develop.'.l onlv in
the inner half of the muscle; ih.e third is situated at the levil of the unibilu us or Mimc'what above
it; and the second is about midway between the first and the third. .\ ourili intersection is
inconstant, but, when present, Is below the umbilicus and usually tra-.ersts only ilie oute" half
of the muscle. In the vicinity of the tendinou> inler>e( lions the muscle i- a llurenl to the anterior
laver of its .-.heath.
Instead of beinj^ surrounded be fascia, the re( tus is inclosed by the aponeurotic layers of
its sheath (Fi-^s. 245, 247 to 2;oi, which loiisists of an anterior and a poslcTior la\cr. Only the
anterior layer covers the mu.scle throu.-jhout: the posterior layer forms a sheath for only the ui)i)er
two-thirds of the muscle (Fifis. 24S and 24(1). .\t the juncti<Mi of tiie middle with the lower third
of the leu.ulh of the muscle (or even somewhat hii,'her> the posterior layer of the rectus sheath
abru])tly ceas' in the shape of a slightly curved line', the semieireular line {line oj Ihiii^las) ( Vvj,.
250), and below this line, the muscle is in immediate relaticm jiosleriorly with the transversidis
fascia (see page i(),^).
The layers of the sheath are formed from the Hat abdominal muscli's (Figs. 24S and 240 1 in
such a way that the ajKmeurosis of the obliquus internus splits into two layers in the upi)er two-
thirds of :he sheath, one of which forms the anterior layer and the other the jio^icrior; in the- lower
third of the rectus, h;iwever, the aponeurosis of the ol)lic|uus internus forniN only the anterior
layer. The ai)oneurosis of the oblicpius externus ji.-i.ssc^s into the anterior layer; the upjier two
thirds of that of the transversus goes to the posterior layer, and the lower third to the anterior
layer.
M the inner margin of the rectus the two layers of the sheath unite with eac h other and with
the corresiicmding lavers of the opjjosilc side u> form a thick tendinous strip, the ///;'(( <//.'"' (Fig.
245), which extends be'.v.een the xiphoid jiroces- and the sternum.
Th. linea alba ustially ])ossesses a spec ial tensor mu- ' in the shai)e ol the inconstant pyra-
midalis 'Fig. 2-0;. Thi- is a
.r;.^„,,r,,i;,,- iTjrf.rle .'.risin'' broadlv fnjm the tenclon of insertion of
the rectus alxlominis and passing obli(,uely inwarci to be inserted into the lower jwrlicm of the
linea alba.
\e
m
Mi I
162
ATLAS AND TKXT-BOOK OF HIMAN ANATOMY.
The rectus an<l pyrami.Uiiis. like the other museles of the anterior aliiloniinul wall, are innervate.l by hranrhes of
the lower iptereostal inrve^; the Hat alKiomina! muscles also receive branches from thi- iliohypoKastri. anil the ilio-
inguinal nerves fVoni ihe lumbar pleNUs, The . remaster mus, U- i> supjihcd by the cNternal spermatic nerve (the genital
branch of the genitoi rural nerve).
When all the aiUi rior abdominal muscles ad together their function is to diminish the si/e of the alRlominal cavity
and to compress the abdominal < .niienis, the inc reased intra-abdominal tension aidins; in the ev.,. uaticm of the contents of
the intestine -, of the- uleru>, and p.is>ibly aUo of the urinary bladdc-r. W ith the exception of the transversus abdominis,
lhe>e muscles also draw the thorax downward, the rectus directly downward, and the ol.li.|ui, when .acting scjearately,
toward the side of the c ontrac tinj; mu^le. Whc-n the thorax is l.sc-d, the anterior abdominal mus, l,s and particularly
the rectus, raise' the pi Ivis.
THE POSTERIOR ABDOMINAL MUSCLE.
The' quadratus lumborum (Fi^s. 251 and -'54) i^ '^ llaik-ned, rather tliirk, and apjiroxi-
niatilv (luadrilak'ral muscle which forms a jiortion of the ])<)sterior abduniiiial wall. It extends
Thordck vrriihrd .\ 1 1
Lumbar verttbra I
;i;timcnt
T: -tilh rib
Lumbar vertebra V
Iliitlumbar il^-iiiu'U
Fig. 251. — The ipi.iclratus lumborum seen from the sicle anci somewhat from behind idi.iRran:matir).
between the (rest of the ilium and the iwelflii rib, and consists of two incompleK-ly sepanited layers,
a posterior and an anterior. The [x'slrrior portion 1 Fig. 251 ) arises by ajKjneiirotic libers from
THE ABDOMTNAI. MrSCI.I S.
thi' jiustv-rior ]);irt of llu- intu r lip of tlu' crc-t of ihi' ilium and from tlu' .liolumhai ' i;amfnl anil
;; . lo ihu inner half of thi' lower bonier oi ihc tui'lfth rib and lo Ik trans-ersc procoM-- of
the iij)]ier four lumbar \i'rtebra'. The diUcrior portion of the muMli arise-- from tlu' transverse
proeesses of the loWiT and middle lumbar wrtebra', tlie fibiT^ iiilimali l_\' iii' ilacint; with ihnse of
the ])()sterior portion, and inserts into ihe lrans\erse proeess nl ilu' fir-t lumbar \ ' rtebra and into
the inner lialf of the last rib.
The inner half of the <|uadratus kmiboriim is pLiced beneath (po^iirior '.■ ■ ihe p~oas major,
and it is situated in front of tin anterior layer of the lumbodorsal fas( ia. « hi. h sejiarales i' from
the sacrospinalis. The lateral limiboeostal anh leMi rnal annate liu'ameni of the diaphragm
bridges over the insertion of I'le musele into the twilfili rib. To the outer sidi of ihe mu^i le then
is visible ; he aponeurotie origin of the transvi-rsus abdominis from the i'.inibodorsal fa^iia, and
at the crest of the ilium it bo ' : on the iliaeus.
n
Tlir >!U.i(lratus lu?iil«iruni is sup]ilic'il liv musi ul:ir liranc tic< from tin' lumbar plrNu^. It ilraw-. '1:. la-i ril- Inwn-
ward ant! iK-nii.s llio vrlihral mlunui Imvaril tin- ^iilc.
THE ABDOMINAL FASCIA.
The superlk'ial layer of the llat abdominal museles is rovi-red only by iht- i^ciurdl siipfr:u i,il
ja.scid (Fips. 248 and 240), which i>, however, well de\elo])i(l iii the lower portion .4' the abdomen
in the refjion of the subcutaneous inguinal rinf^, where it forms what is known as Srarpii's jasrio.
From this situation it extends downward upon the thigh and also envelops tin- spermatii cord as
the cnmaslerk jascid. The sheath of the rectus musele serves as its I'asc ia.
The inner surface of the alxlominal musculature, i.e., tlie inner ^urfaie of the transxersus
alxlominis and the posterior surface of the jiosterior layer of the sheath of the rectus, i- lined by
the Ininsvirsalis lusciu, which also covers the anterior surface of the ([uadratus limi)M)nini :in<l is
especially strong over that mu.scle. It is rallier llrmly adherent to ihe aponeurosis .4' die iiinis
versus and to the posterior layer of the sheath of the rectus; lielow the semic irctil.ir lim ii is
fre(|uently very thin and forms tlu inly posterior cowring of the rectus alxlominis isd.' ijage idi
and Fig. :}4()). .\bo\e the symplivsis, it is connected with th( -o-called iidmininilum Ihuir
alha- isee below), and at the inguinal (I'oupart's) ligament, with the posterior surt'aci' of whi. h
it is adherent, it becomes continuous with the iliac fascia (see page 2,^1). Supt'riorly the fascia
gradually (lisap])ears upon the lowi r surface of the ciiaphragni.
The liiua alba (Figs. 245 and 248) is formed by the union of the aponeuroses of the llat
alnlominal muscles in the median line of the abdomen. It i> broader alnne than below the
umbilicus and, at the umbilicus iuelf, ii i- adh<Tent to the integument. At its insertion ii:!;; the
upper margin of the symphyseal cartilage, its jiosierior surface is reinforci'd by a triangular fibrous
expansion, Mimetimes containing muscle fibers, which passe u]jwar(l from the sujaTior jiubi.
ligament ,iiid is k^:0^.■n as tin- iidminii itlitiii lii-nr alhcr.
Tlu iiif^uimil lii^iuuiii/ . I'oupart's lii:;ami)u ' 1 1'ig.s. 208 to j 10 i^ also formed bv the a[)onni-
ro.ses and fas( i.e of <he alxlonien. It extend- as a strong tenilinou- band from thi' anterior
SU|)erior -pine (4' the ilium to the spine of the |)ubi.-,. some of its libers radiating at its insertii'ii
to the inner exlremiiy i4' the crest of the jiubis and funning an almost hori/.ontal triangular
vn
^^i^^a
J-i^^r4
'T
m
164
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig 2C2 -The diaphragm ami the muscles of the posterior abdominal wall.
The interior Abdominal ..II an!. >h. ahao.ina. v,s..ra have bec-n removed; the thorax has been bent back.ani
so that the lumbar vertebne are stronnly convex forward.
I|!
ligament, the lanuu.r li,a,nn,t (Gimbernars ligament) (Figs. 212 and 21,,) which is also con-
n ccd w'ith radiating f.hcrs of the fascia of the thigh ,sec page 2,.). The n//.. <</ u^,u,nal
" Ln, Urnn.„.larli,.n„cnn (Fig. 24.. is also formed by radiating filx-rs from the mgumal
i ament whi.h pass to ,he posterior surface of the anterior layer of the sheath of the rectus ,sec
pa e ; '). The'inguinal .i ament gives origin n.>t only to the Hat alxlominal muscles, but U also
lurnishl attachment to the fascix of the alxlomen and thigh (see page 231), and the deeper
layers of the integument are also adherent to it.
rrh> ventral ,,or.io,. of ,he trunk mvotonu. during their development undergo a eo-^uWrable -'"""' "f'";'-
1 '"> \wiii.ii I ..i. „,,,,,,,ni.. 1 i>..rtiiin < 1 ut off whieh eomes to lif ventral to
,,,n-iitute uhal i> known as ih.' oblique group of nuisdi's.
•n„. alHlominal mvw. le< aie r, 1. rable to thoe group-^ as follows:
UyiKiskelelal; /N.'./< '«.',/'"• and pso.is mi<wr f-^v p. -M0>.
ObUMue <V./;,„„. .,1.1 i..is .:.',..,. ,Hi„ .Mo„un. n..rnu.s. .ran.rr >,,o„u,ns. and ,u„^r.U.s
^ ';:;: ,,.. ,.„,,.„U. ,ha, ,he ..,W.„nv.M„n, /.,..„/,•. „, ,he luml. .ion are pro,.rlv referable to th.- obli,,ue
t;roiip
-V.i>,|
THE DIAPHRAGM.
•Ihe ,naphra„n .Fig. 2,2^ is :. singl. independent muscle, whit^ from a ,opognt,Oncal
.tandpt.int. is IkM ...nsi.lered with the abdnnnn.tl muscles. l,s shape .l.lTers from ,ha. o a 1 he
. Ir skele al ntusdes. in iha. i, is a ,hin and n,arkedly donw sitaped musde, u u h ,s stretched
, OS. the infeiior ape,U,n of the thor^.x in sut h a wav tha, i. is convex t.nvanl he horax an.
;;;,,,.. ,„.,,d Ihe Ul-men. I, tonsi-.s of a .tniral tendintnis portion, the ,nUr.l inulou, and
of a I ierii)herial muscular portion. . • • . .1.,
•Itc mustular fas.i.tdi of ,lu. diaphragm are s,i!.,!ivi.le.l according .0 the.r or.gm m.o thret^
,,.r.. .l.i.h are .lesi.nate.l the s„nuH portu.u .he a.,ol porUo,,. and the lu,nhar parUon and o.
llHM the lumbar ,K,rtion is the strong. M an.l tlte st. rnal p..r.ion by far the weakest. I he IdnTs
„f ail three iH,rli..ns are inserted into the margins. d- Ihe Mtttral tendon.
T,,, Lu,l poruon .Figs. 252 an.l 2.3) arises fn-n the ,K,s,en..r surfa... .,. the Mph.„.l
-.rocess an.l ...nsisis .d' but a few slender fasticuli. . . , ■
■n,. „..M/ por,i Figs. 2,^ an.l 2,,,) arise, by br.,a.l tUshv serrat,..ns fr.-m the mner s r. ace
' ' , .. .• ! ,-•. 1 if.V. rllvu lu inn :iUi. atta.hed to liie
,,f Ihi >i\ low(r..>staiiariiiagesarid iromtneeie-.viiin.jTiM - ■
,umlK.c..stal liganunt in this situati.m. interdigita.ing wi.it the tran.sversus alKl..nun.s and w.th
ansvt r.,s th.,nu i. f..il.nving the curvature ..f tlu .iome of the tiiaphragm and passing ...the
U 1 ,en.lon. Tlu hbers of this .K.rl.on. alth.-ugh weaker than those of .he lumbar portion.
L^S^:<^\:
Opening for the vena ca
^^ Otsonhageal opening Oesophagus ^
Internal liimbo-
costal arch
External lumho-
roslal arch
Fig. 25J
1
1^
■,!f: ,
« - 1
I i
u
■■■ 1
s 1
J t
■■ i
I i
t !
f
THK AHDOMINAI. MI'SCIKS.
I^S
cover a much larf^cr area and form the main iiortion of the dome of the (Hajihrasim. rutween
the individual serrations of origin there are sometimes Unear intervals whieh eoiilaiii no museular
tissue.
"T^he greater part of llie liimlnir porlioii i Fig. 252) comes from tlie l)o<he> ol th.- himhar
vertebrx. " Ujion either side tiiere ay l)e distinguished three crura, or pillars, the <rii< malialr,
iHlcrmrdiiim, and klvrak. The iiuur < r»n;, sometimes termed simply the crura, are l.y far llu-
wrongest parts. They arise Ijy lemhnnus fibers from the anterior surface.- of the third and fourth
lumbar vertebra- ami from the' anterior longiludiiial ligament and the inlervcrleimd libnn arlila-c
between the two vertebra', ami their outer margins s(K)n become muscular while the inner .^nes
remain tendinous. Thev may arise ..! different levels on tlu two -ides, and when this is the
case, it is the ri-ht cr . which is always the longer of the two. The imur t. ndinou- margins unite
at the level of the twilflh thora. ic vertebra or at thai of llu' eleventh inler\c rlebral fi!>rocarlilage
to form a i.ointed ar. h with tendinous margins, w ..k h is converted into a short canal l.y the anterior
surfaces of the last thoracic and the lirst lumbar vertebra. The opening so formed gives pa>sige
to the aorta and i-^ c.m->e«|uently <lesignaled the iinrlir ofiniiiii^ iFig. 2-^2).
The filHTs of the entire lumbar portion, and especially those of the inner crura, pas> at lir>l
almost verticallv ^ wanl in front of the lumbar column, but juM l.efon' their insertion into the
central tendon iliev follow tlie curvaluiv of the diai.hragm, and in thi> situation they inclose a
sc.nd opening in the diaphragm, which is elliptical, the long axis luing vertically i>lace(l. The
margins of the foramen are purely mu-cular and, as it gives passage to the es,,phagus, it is
known as the esophageal opening. In its formation there usually occurs a decussation of the
libers of the two inner crura.
The iiii.lill,' <riira are considerably weaker and more slender tli:in the iimer ones. 'I hey
arise bv short tendon- from the lalend surfaces of the bo,ly <,f the s.'i ond lumbar vert, bra and are
at first' sei-arated from the inner .rura by narn.w slits but belme their insertion into the .entral
tendon thev Iwcome closel> appri>\imated to the miisi ular tissue of tin m.
The otiuririiy^i practicalh arise from the luo tendinous hanibocosial an lies, the inlirwil ,.ih1
vxurual lumbon,./,,! „r.lus „/'/•-/;, ^ ,<l lhil!,r^. Tlu' inimuil linnh,„osl„l ,inh uiWru.il .mti.U.
li^^amntn passes from the Ix-ly of the lirsi lumbar Vi-rtebra to the ti). of the transverse pro. ess ol
ih,^ s.nne Ix.ne, crossing over the psoas major, while the ,xl,rn.:l hiwho, osl,il ,inh nxhni.il
arnuil, lii^.iwnih e\t. n,ls from the transvers, pro,.- ..f the lirsI lumbar veil.bra to the tvv. lllh
rib an.l bri.lg. s ov.r tiu' ,|ua.lr.iins lumlK-ruin. Tlu- sl.ii.U r Ob.rs ,.| the lateral lumbar |«.riion
Hi the diaphragm ari^.' chi.lb from .'.w int. rnal luml,... ..s|,d an h .wA also fr..m tlu- tiatisv.is,.
pr....'ss,,nd lal.ral margin. illlu body uf tlu m-t lumbar v. rl.bia. ( mlv a f, w lilufs ari-.' Ir..m
the .Mernal lumb... ..st.d ar. h an.l this.- m,,) \»- . lUirely abs. 1,1 ; lli.v r. pr.s. nt the c.mi.-.ti.m
Utu.rn th.- lumlur and the ...si.tl porti.ms of the diaphragm. Tlu las. i. uli .■! ilu- .nit. r . rnra
an- .orisl,K i.iblv -li,.rl.r lli.m iho.. of llu- inner aii'l mi.!. 11.- on.-s.
111. ,.(//)-.(/ I,iui,>ii li-iu. .'s-M i- a librous lay.r vvlii.h inav be .illi. r n nif..rm .'r sh.ip.d lik.-
a ,|o\,r l,al*an.lit-faMi,uli uml.rg.. manifol.l .1.-. iissati.ms, Tlu . ..nv. \ siirfa. .-of llu- ..ntial
.,.n,|,,n i- -itu,!!.-.! ani.-riorlv; th. molt- nuirk.il ..m.avitv i- ■ • . .•(! posteri.irlv . In it llu n- mav
Ik- i,...gni/.e.l a mi.l.'le almost plane or but sii..hil\ <urved port .n, whi.h issitu.iU.I b.Uv.en tlu
♦ llu iluMt li.ll (.Till i> jiri-Miil wh. 11 the ti-nlriil t.-n.l.m i-.\l. nL-. li.w.ir.l lli. M. 01, il (...lUuii
1
If't
iti'
w
m^
l55 ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
ivvo domes of the diaphragm, and two Icatlcts which are directed posteriorly. The left leaflet is
the smaller and forms the left dome of the diai)hragm; the right is larger and forms the right
dome. \\. the base of the right leallet near its iK)sterior margin is situated a large irregular
rounded opening, completely within the central tendon, which gius passage to the inferior vena
ca-c. and is designated the opniiiii; jor the vcm cava (qiiadrilaleral joramcii).
The curvature of the (liai)hragm is not uniform, but there is a middle lower portion and two
lateral domes which project mar!;edly toward the thoracic cavity. The right dome is more capa-
cious and exten.ls to a hi-her level than the left; its highest point corresponds to the fourth, that
of the left to the fifth intercostal si.ace. I'osleriorly the dia].hragm ( the lumbar portion) extends
much lower than it iloes anteriorly. Its transverse is considerably larger than its .sagittal
diameter. ... r
The diai)hragm po.sses.ses a series of foramina and spaces which give passage to vessels or
nerves These are: ( : ) The aortic Ppcnhif;, which is only partly formed by the diaphragm: (2)
the csophasealopciH,^, purelv muscular and formed entirely by th.^ (liaj.hragm: ^^) the opening
jor the vena cava, situated entirely within the ten.iinous j.ortion of the muscle; and (4) the slit like
.paces Ix'tween the inner and mi.ldle crura and between the mi.l.Ue and external crura. 1 he
later spaces give passage to the vena a/vgos, to the vena hemiazygos, and to the sympa-
thetic antl the splanchnic nerves, whic>- an' arrange<l in a variable manner. In addition to the
aorta, the aortic opening also transmits the thoracic duct.
Thimui,.rmT^.of Ih, .li,i|.hr,,Kn, i~lh,-,,hr,ni, niru fr.m. lli.'..rvkal,,lcxus. , , ,■ .
... drawn .loLw.nl an.l ,1,. .os.al ,H,r,i.,ns ar. ,lrawn away fn.n .nn.a,, wi,h <lu. ,l,..ra, i. wall. s„ that .h.- thoracc
lavilvi-iiniTiaM.l in >i.;i'iin'llhial«lMmiiial lavilyisdiminisliid.
"(Tlu- .liai.hrasn,. from ll„- .Irv. l„;mH.nlal s.an.l,».inl, LdonRS to tho ..rvi, ,,1 n>UM ulatur.-. th,- m..^, lUar t.ssuf whuh
i. .on.ain. l..inK .hriv,-.! from th. fot.rth (an.l to a ..rtain . xt.nt from tlu- third an.l CfthU .-ni, al nnotonus, th,- .-nfr.-
:,ru.,un- Ivin^ at „„.■ ,..ri.«l of ,1 ,.v..l,.pn,..nt in th.. .r.vi.al r.-gi.m an-l lat.T nd^ratin^ .l..wnwar.l ,.. ..s final ,«...-
,Ln U ,w,-, „ th. thora. an.! „b.l..m.n. Il.n. ,- it is th,„ it is suppli.-i U th.- phr.-ni. nom-, wht.h ar,s.s from th.. fourth
ilhir.l to fif.hl . . rv i. .,1 n.rv... an.l .lon^at- m |,roi»,r.,on a, th.' .li,.|.hr..Km r.ced.s t.,war.l its final ,K.s,t,. n. --Kl. ]
THE THORAQC MUSCLES.
The muM 1. > of the thorax i Figs. , ^-^, 247. 25,,, an.l 2Mt '>r'' cmposed of two main groups:
, , ) Those whi. h arise Ifoin ihc th.-ra. i. skeleton and insert ^ m. llie skeleton of the up].er extrem
itv; tlu M- are, ,unse.|Uently. -eally muscles of the extremity . and ..^1 the a.tual muscles of the
thoracic wall, whiih are known a- llie intercostales.
Th,- first group i> arran-ed in lime layers vhi. h are not exa.tiv superimp.oe.l. The lirst
hiyer is formetl by the pr.tnrali^ major, the second bv the pdoralis minor and the suhclavius, and
the thinl by the scrraliis aiUrrior.
THE THORAaC MUSCLES OF THE UPPER EXTREMITY.
The Firit Layer. The Pectorahs Major.
The pectoralis major . Fig. 24s' '> a large. Hat, thi. k must le whi. h is situated in th. sternal,
inlrulaviMiln. m.immary. axillarv. and inframammarv' regions, its out r iH.nler forming the
THK THORACIC MUSCLES.
■ 67
anterior boundary of the axilla. The muscle is ai)i)roximately triangular in shai)e, since its orisin
is very extensive and its insertion ([uile limited.
It arises by three more or less separated portions, which are designated as ihe tlnvkular, the
sternocostal, and the abdomiml portions. The clavicular portion comes from the sternal half of
the clavicle, the sternocostal portion from the anterior surface of the manubrium and tlie IxkIv of
the sternum, with accessory digitations from the cartilages of the second to the >i\lh or seventh rib,
while the alxlominal portion, which is by far the smallest i)orticin of the origin of the muscle, is
a tlat bundle which is attached to the lower margin of the sternoiostal portion and arises by an
aponeurosis from the anterior layer of the sluath of the rectus alxlominis.
Toward its insertion, the ])ectoralis major becomes consideral)ly narrower but corresjiond-
inglv thicker. Only the filxTS of the chivicular piortion and the upper libers of the -termuo-ial
portion jtursue their original course, the greater number of the lil)ers of the >terno(()stal and
alxtominal ])orlions ;)assing from the anterior surface of the muscle toward the posterior surface
of the tendon of insertion, m) that an extensive twisting of 'he muscular fasciculi occurs in the
outer ;)()rtion of ilie muscle.
The .endon is inserted (Fig. 2()()l into the entire lengtli of the greater tubepular (anterior
bicipital) ridge of the humerus. It (onsists of a weaker jMisterior a])oneurolic layer and of a
stronger anterior layer which becomes tendinous inmiedialely Ix'fore its actual insertion, iiolh
layers are adherent Ix'low; the anterior is formed by the davicular and by the ujjper part of the
sternocostal jjortion, the lower by tlu bulk of the sternocostal and alxlominal portions.
Tendinous fasciculi from the insertion of the pectorali> major not infn'(|Uently bridge over
the intertubercular (bicipital) gr(K)\f and jiass to the latis^imu-. Thoe tiber> s'lmetinus contain
muscle fibers the miisdr oj iMiii^cr).
The two i)eclorales arise from llie anterior >urface of the sternum in -ui h a way that an area
is left in the middle of the Umv, narrow above and somewhat broader below, wiiicli tontaiiis no
muscular tissue and in which is exposed tile sternal meml)rane. In thi> situation the sternal
headof thesleriKHleidoniastoid ( Kig. :?55) (seepage 171) 1 Herders inimeiliateiy upon the pectoraiiv.
and at the daviile the origin of the pectoralis is situate. i exailly opposiii- to the davicular head
of the sternocleidomastoid. The anterior margin o'" iheddidid usually l)()nlirs immediatdv upon
the U])i)er convex margin of the ])ecliirali-- maje, , ;i cDiisiderabie s|ia(f lietween ihi two nnis< its,
known at llie ddtoidiOpalonil Iriaiit^li , usually existing only inunidi^ili i\ l)i low the < la\ i( le, and
the npliali( vein 1 Fiir. ii)i> usually runs in the groo\c between the two miisi Ks. At its lower
margin the pettoralis major is (onlinuous with the aponeurosis oi the .il.iominal muscles dlu'
sheath of the redusi, ;rid itsouter margin bordiTs anteriorly iijion tla oblii|ims MlMJoniinis e\ter
nus and ])osleriorly upon dli' serratus anterior. Tlutendolio' 'Msertiou is situated between the
deltoid U|)on one side and the short hi id of the binjis ,md tlu , nrai obrat hinlis ujion the other,
in this situation it is si])arated from the l.itissiiuus by the inierluben ular 'biupii.di groove.
An I mhiUiikU iiu ml imisi li . ihi W/um/m, i, i|iiiii' r.m Is luiinil u|iim ihi |in Inr.iii- iii,ii"> ll ni.iy l« I'M-rnl
ii|Kiii niir iir Imtli .si(U>. i- i lonKulrd, tiiulinuus ,ii ii~ i \lrrmitii ~. ,inc| is u-.u.illy i ■mim Uc| \miIi Ihr 1. inlmi n( ih. -irrii.i
I |i'|ilMni:|.^'..{i| :im! (Iir «lli;lth nt I 111; n rlll« :li well .,» uilll I hi In i Ir.r.lli^ ni.liiir .Uul ll->ll.lllv niili srlMs .1 |||-I|>I .llcll jKirtllin
lit llir laUir miisilc.
'Ihr |H( tiiralis iPiijiir is supiilinl liv llir aiiti rior iIkt.k It ihtm - 'I'lim ihrr «iih lln- l.ilissiiiiu», il .uliiii. N llu- .inn,
nnil "hen it ails .ili.pr. ll ilra"s ihc arm anii ticirlv iiinl tun.ml I Iir i lirsi ami. al llir sanir liiiu . r..|.iti - il inlriii,i!l\
m
I : -!■■
i Is !• i
It
i68
ATLAS AND TEXT-BOOK OF HUMAX ANATOMY.
The Second Layer. The Pectoralis Minor and the Subclavios.
Tlu' pectoralis minor (FIk- 24O is a flat trianjiular muscle which is comi.lclcly concealed
bv the i-ectoraHs major and, at its insertion, also by tlu- <leltoi<l. It arises by thin tendmous slips,
fr'eciuentlv indistinctly separated, from the costochondral articulations of the seconrl or third to
the fifth nl)s; it passes upwanl and outward and becomes markedly narrower toward its sh..rt
tendinous insertion into the ti|) of the coracoid i)rocess.
It coxers the upjier portion of the serratus anterior and brid-es over the axillary vessels and
the brachial jilexus.
-n,.. ,H-..orali, ,nin„r. lik. llu- major, i. .u,,|.li. .1 l.y .hr anfrior ,l,„ra, i, n,rv, ,. I. .lra«. ,1„«„ ,lu. s, apula, „r.
if llu- Maimla 1..- Mm.! ■. i.vaK ■; the rih~, an.l il . an al>o ai.l in tixiiiK tlu- siajmla.
The subclavius (Fi-s. 24; and 26.,) i> a small, elongated, somewhat flattened muscle whi, li
■irises bv a ten.lon from the first costal (artila-e alongside of the costoclavicular ligament, and is
'insene.1 into ih.- umier surfa.e of the' acromial end of the .lavicie iK'tween the two portions ol
Ihe c.racociaxicular ligament (see page .20.. In this situation there is usually a shallow groove
in the iMine.
Tlu nerve ^ui.i.lviMKlh.nu ■ i. ilir Mil., lavian from llu- l.ra, hial i-l.-xus. . „ ■ ,- ,
Th,. L.. ].■. l.y ii. , ontra, uon, tiw, th.- , lavi. l. in ihc M.-rno. iavi, uiar join,, an,l when .h,- .howM.r «,r.ll.. ,- U..i
the iTUi-ili- il. vatf^ till lir-i ril..
•-''•
The Third Layer. The Serratus Anterior.
The serratus anterior isrmiius „ur^ni,s, (Fig^. 247. -\soi is covere<l in its uj.per i^ortion
bv l..lh pectoral .hum k- i;> lower portion i, >iuiate.l in the lateral pectoral region an.l. immedi-
aielv 1k4ow the i.ectorali- major, i^ covere.l only by the inlegumint and tax .a, the m.,M mfenor
poitiop .,f llu' muM K-. howevn-. being pla.ed beneath the anterior margin ol the lan»imus.
Tlu' nuiMle i^ Hat thnmghout. irregularly .|ua<lrilateral in shape, an.l its muMIe i.orlion i<
verv liiin; it forms a muMular plate whirl, i- adapt.<l to tlv -urvetl surface of the thorax. It
ari'r. from the lifM to the ninth ril- bv mean, of individual serralion>, the lower live ol which
are di-liiu-iv M-aratid and inlerdiuitale with the serrations of the origin of the obliMUUs exter-
num alHloniiiiis. In tin- bp>,,,l mu>. le sluet formed h^ ihe uninn t.f the >errations, three pt.r-
tions disiin.tiv din.t-en'.iated bv thr .linvlioi. of their libers, may be recognized. 'Ihe libers
,,f the upiKT and Inv.rr pnrliuns eonverg.- mward tln^ inMTlion of the nuiMle. while those ol the
middle seumuin i.a^s in tlu s:,n,r .liivcli.-n bal in a diveiging manmr. Thr noper ■ onvergmg
,,,,riion ,Fig. 2-,S, ariM-s as a rather strung inuseular mas, trum the lirst an<l McomI ribs an.l
fr.m aninlrrvt-ningl.iidinousarch; it ins, Hs into the superi..r angle of tin- >capula: the mul.lle
.!ix,T..ingi.<,rti,.n is bv far the thinm-st and Nv,-akesi part of ilu' mus.K- an.l it aris,> fr.^m the
,,-, on.l * .1,1,1 Ihinl :il)s and .liv.rg, s marke.liy to b,- inserl.d in-., ih-' .ntire l.-ngth ol the vertebral
iH.nl.r of thes.ai,ula; an.l the lov.er cnvenging porti.,,,. which is du- slron.gest part ..ftlie enllfe
muMle. arises from tin- fifth t.-lh,' ninth ribs ami i,ass,s 1,, tlie inh-n.,r au'^de .,1 tin m apnia. 1 !,.•
fibers „f tin L.wer p.>rti.,n aiv il„- h.ngest an.l those ol tile upjier porli.,n ,,iv ihe short, si. 1 he
* I'),,' s, ,..n<l 1,1. ,o„-ci|i,.„,;. iM - o:iiiin ,0 ,wo SI I, a, 10,,..,
THE THORACIC MUSCI.KS.
160
muscle is tlcshy ihrouRhout, ^vilh the exception of the insertion of the mid.lle portion, ultieh is
Mimetimes ;i|)oneurotic. . ,
In order to reach the vertebral border uf the scapula, the serratus antenor must ,.ass back-
^vard for quite a distance alon, the thoracic wall, to which i, is attached by oose connective
tissue When the muscle reaches the axillary border of tlte xaptda >t passes belund the sub-
scapularis as far as the vertebral border of the bone and is separated front th.s muscle by a xery
l(H,se onneclive tissue. Throughout its course it fornix the mner Nvall of tlie axtUa.
ihoMTrat,Ham.-riurHsiii,,,lhcll,vthrlonKtli"r:,,i, mrvofromth.-l,r.,hi.,l|.U'vu,
::t=i::i;';;;:r;:;:;i::;r";;r;;.;r«=t;r::;,: :f t: - .;...„
levat„r s.apuk-V tlu- serratus .an al., .Uval,- tlu- rih. an,l a, t a. an accessory nni>, Ic ,.[ rc~,„ra.>..n.
THE MUSCLES OF THE THORAaC WALLS.
The muscles of the thoracic walls are the iutmoslalcs, tlte IruUons cosUnun,. the suhroslah's,
and the Iraiisvirsus Ihormis.
The intercostales (Figs. 247, 250, 25;,. an<l 251) occupy the eleven uUercostal spaces and are
.omposed of two lavers, an external, the iuUra.sluIrs c.v/cr;,/, and an intcTnai, the n,l<rrosl.,l,s
nU,nu. The h.lrnoslalcs cxUrui (Figs. 24.. 2 ,7, 250, an.l 254) pa- fron, above downward and
from witiiout inward l>etween the bonlersof adjacent ribs; they are ^hort Hat nmscles winch fre-
nuentlv contain numerous tcndin.ms tiberx They commence posteri- iv in the region ot the costal
tulx'rcles and ex end ant.riorlv as far a^ the ci.sto. hondral articulations, leavmg the spacrs
Ix.tween the co>tal cartilages free. In these spaces a,v found tendincn^s slips «h.ch run m ttf
same clinrtion as tlte liber> of tlu' intercostales c xterni and extend to the' margnt ol thc^ Mc rmmt;
Ihev are called the r.\l,riuil inknn'-lcl li-oimnls di^nmnUa n>rus, ,iiUi,i).
■ The inlrnosl„lrs ;»/,r»/ ( Fi->. 2^0, 25;,, 254I run from alxnv downward and from wuhin out
xvard between the l..rder. of adjacent rib>, and they ari.e fron, ihc^ lower l..rd> r ol llu. upper r,b
c.f each intercostal ^pacr in -uch a manner that the co-tai groove, i. .i.ualed belwe.'n the two
muscular lavers. Thev cross ,he intercostales extern! at right angles an-l arc c-ov.T.-d by ih.^m
cxeept in the spaces b,iw.en the' costal cartilages. They . xtc^nd ante riorlv lo \\n- sic rmmi or to
,!,, anterior exlrendli. s of the crlilages of the f.dse- ribs and end posh riorlv a. .I,e costal angles.
|„ ,1,, n.'ion of the costal cartilages thev lie behi.ul the. external intercc.slal hgananls and those
ncrtions of then occ urring in these situations atv also terntecl the in>,rn,rlihK<'»n. He Iw.c ., the-
posterior ex.rcntities of the ribs t!tey arc replaced by tendi.x.us structures win. h are. called the.
iiilirihil iiihirv^hil lii'jiiih »/..■.
•i'h,. inlrnosl.il.^ rxl.nr are covered almosl throughout their entire. exU'iil by the- ihorac ir .
•dnlonunal an.l -lorsal mu^ .pectoralis maje.r an-l minor, serratus anterior, obliquus alHlonunis
externus, I'alissimus, s, 'i ,,.,slc.riorcs, rhomUmieii. uilh the excepti. - e.t a sn,all area U.lue..n
the irape/.iiis and tlie l.ii.ssimus i|.'ig. 2^S). ^ ^
The levatores COStarum iFig. :\:.>. in>ni cite coiose e,f iheir ii'ncr., ':ele;ng U- t.ie (•-!! ;-';a,
inte-rc u .tal nuisclcs. Thev ar,. siluatc-.l :n th.' dorsal thorac ic region imme.liai.iy beside the deeper
h.vers of the long muscles of the back, a.e covered by the sucrospinalis (particularly by the
V:tl
!' ff
i
II
J i
t V
170
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig. 253.— The sternum, sternal ends of the clavicles and the rihs, with the intercostales, and the
transversus thoracis, seen from behind.
Fig. 254.— The fifth to the twelfth thoracic vertebnu and the vertebral extremities of the corres|)onding
ribs, with the intercostales and subcostales, seen from in front.
On the left silk- the intercostal ligaments have tx-en remuved.
iliocostali.s), and are <li\ idcd into tlie In-alores costariim brnrs and lon^i. The Icvatorcs costarum
breves iVvT,. 24?) arise from the transverse jjrocesses of the seventh cervical to the eleventh thoracic
vertebric and insert into the rib next below between the tubercle and the angle. The Inuilorrs
costarum longi (Fig. 243) are found chietly on the lower ribs and are distinguished from the
breves in that they pass over one rib and in.serl into the second below near its costal angle. The
levatores costarum become markedly broader toward their insertion and usually jjossess aponeu-
roses.
The subcostales (Fig. 254) are flat muscles which are not always present and vary greatly
in their develojjment. PVoni the direction of their fibers they are to be grouped with '.he internal
intercostal muscles, with the ])oslerior portion of which they are continuous. 'I'hey are found
chietly in the lower ihorai ic region and bridge over one or two ribs. Thev are usually i)artly
tendinous Ijoth at their origin and at their in.serti(m.
The transversus thoracis {trianguhiris slcnii) (Fig. 25,^) is a very thin Hat muscle, the
greater ])ortion of whidi is tendinous, which arises by a broad aponeurosis from the posterior
surfaces of the Ixnly and xiphoid jtrocess of the sternum and inserts by short broad tendinous
slips into the inner surfaces of the cartilages of the second or third to the sixth ribs. The muscle
is constant but very \arial)le in its development.
All ihe niusiles of ihe ititireostal siries are supplieil tiy the iiiten o...tal nerved «hiih pa^-., ioj;ith<r with the vasa
intereostalia, between the intiTnal and the external inleuostal nuiM le-.
The intereostal musi lesare im|Mirtanl must les of respiration. The great majoril) .if iheni ,ire niiisi lis of inspiration,
hut the transversus thoraiis and the subcostales probalily play .some part in e.\piralion.
THE PECTORAL FASQA.
The fxrlonil jasrin lies upon the |)eci(iralis major and the lower ])orlion of the scrralus ante-
rior. The toraiiHlavuuliir jtisda iroslocoraco/i/ ninnhninc} is a mucii more iironouncfd lavcr which
is situated Ix-nealii tiie jiectoralis major and upon ihe ])ee toralis minor, covering the stibdavius
and the axillary vessels. It is particularlv firm where it lies upon the subc la\ ius and inserts into
the lower surface of tiie i lavidc. Inlernally it is in.sertcd into the u|)per costal cartilages; exter-
nally it is continuous with the axillary fascia.
[ \s was 111.- I ase in the dorsal ri'Kion, all the nui.si ies referred to the horaiie region in the aliove deseription do
not striitly iH-lont; to the lliorai ii nuisuiiature, but Ulon).' in part to the niu.si ulalure of the ujiper extreiuiiv. This is
true with reRard to the mu.sc les of the lirst three layers, only those desi riln-ii as the- muse les of the thorai ii walls l-einn
trunk musi lis.
These may lie i lassHied similarly to llie alidonunal nni^i ii s, but oulng to the presenie of .1 stirnuin in ihe ihorai ie
region and to the lesseneil mobility of the ihorai ii |Kirtion of the spinal luhitnii due to the pre.senie of fullv di-veloped
ril», no representatives of either the riitusor hy|K>skeletal gri aps ckc ur in this region. The ilassititalion is 1 onsi'C|Uently
as fuhows:
M'm
in
i t '
in. I
I
M^mmmmsmii^:
THE MUSCLES OF THE NECK.
171
Hyposkrlctal : wantir.f;;
Rectus: wanting;
Oblique- Inlrnoshilesexlerni, intccoslaks bilcrni, uiWosUile^. /r,ji.urrji,< Ihoracis, and lcv,Wm-. ,ml,trii»,.
In a.l.liti.,.,, two muscles descrilH-l as t,el«nKinK to the muscles of the hack are prohahlv numl.ers of the thorauc
ol)lii|ue Kroup, namely, the sirralus fmslerior supcrwr ami the serralus posterior injcrtor — I'.D.]
THE MUSCLES OF THE NECK.
The muscles of the neck (Figs. 256 to 259 an.l 2(.7i incKulc the i.latysnip, the sternocleido-
mastoi.i, the hvoid muscles, and the deep cervical muscles. The hyoi.l muscles are sulKJivided
into the suprahyoid and the infrahyoid ^roap; the dee]) cervical muse U > are comi)osed of an outer
group, the scaleni, and of an inner grou]), the ]>revertehral muscles.
The platysma im. suhniUimus colli) (Figs. 260 and 20; ) is a thin, tlat, (luadrilaleral muscle
which is situated in the sulxutaneous connective tissue in the neck, the upper portion of the chest
and the lower j.ortif.n of the face. It arises (Fig. 207) from the fascia over the pectoralis major
and the deltoid at the level of the first or second rib, by sej)arate fast iculi which are fre<iuently
separated bv interspaces. .\t the level of the clavicle these fasciculi unite to form a broad, thin,
compact muscular layer, which leaves uncovered tlie anterior cervical region but covers more or
k>s extensively the lateral cervical, the sternocleidomastoid, the carotid, and submaxillary
regions, and toward the chin the margins of the two muscles convi r-e and m. > 1 cacli other in the
mental region, freciuently interlacing.
Some of the fibers of the platysma are attached to the lower i)order of the mandiltle. while
the rest pass over the mandible ami ai)i)ear u-pon the face, graflually disai)pearing i)aitly upon the
par )tideo- masseteric fascia, and parllv by intermingling with the risorius and triangularis by
wnich they reach the angle of the mouth.
The [ilatvsma is .ufphe-l I'v the c<T\ical branch of the fa. ial nerve. 1> ^^rinkl.s the skin i.^ ih,- cervi, a! and upper
thoracic regions and ... Is upon the angle of the mouth with the facial nmsi k s. H . an also i,» re.ise th. u nsion of ih.-
fasi ia iir the fai ial, cervi. .il, an.l th.ira.i. ri'gi.ms.
The sternocleidomastoideus (Figs. 2;,S, 25;, 256, 260, and 2(121 is a strong, broad, and
thick muscle which is situated in the sternocleidnmastoid region. It arixs Ir. two heads, a
strong, thick, tendinou.s, sternal head from tlie anterior surfaie of the manubrium, and a -hort,
tendinous, clavicular head fr.im the sternal end of liu- tlavicle.
The sternal head |)asses over the sternoclavicular arliculalion and forms a muscular inter-
space of varving si/e, the Ir.ssrr sii pnuhivkular jnssd, by uniting with the clavicular licid. It
becomes much wider as it iiasses ujiwanl to a»i-t in fnrming the tiiick belly ol the nniscle and
]iartly conceals l!ie (la\icular portion.
The sternoclei.i.. mastoid is inserted into the outer surlaie of the mastoid process of the tern
]>oral bone and into the outer half of the superior nuchal line , the anterior [Kirtion of the insertion
being c tlected by a sh.irt, the jiosierior iioriie:, by a long leiuion.
The musck passes obli(|uely throug me neck from below upward and from within outward.
At its insertion it borders upon the trapezius (see page 145)> with the anterior margin of which
V t
172 ATI A'; ANr> T1..XT-1 .OK OF HUMAN ANATOMY.
Fig. 255.— Sufc rficial i . < r < f the musde> of the neck, seen from in front.
On Ihi- riKht si.ii- ihe stc-r-.uhyoid- n-i • .i . 1 x <)/ tH. iliKiiMri. , and llir -submaxillary glan.l hav. ln'cn nmovid.
Fig. 25().— Superficial layer m ihe muscles of the nc( k, seen from the left side.
* =■ Kxtcrnal carotid artiry.
it forms a irianijle in which arc siluaud die splenitis capitis, the levator scapiiLc, the scaleni,
and the inferior belly of the uniohyoi.i. The anterior man.,'in of the mu.sclc Ijorder- ujio: the
infrahyoid muscles, Inninds the carotid fossa (a deep muscui ir inters _.ace c :itainin:. the '.<rnii
vessels of the neck, /. < ., the common caroti.! art. ry and the internal jugular .in, and the xa.mi-.
nerve), and crosses over and cone ■- al~ the pi-tcrior bdlv of the digastric and stylohyoid. The
ujjper part of its anterior margin is a!.o in relation with ihe paroud gland.
Th.- sl,rnocl(ii!nni;i5l.iiil i'>K' 'her Ai'.h Iho trapezius i.^ supplii-il liy t!'- ain-ssory n. rv,.
When lK>tli slirn(Kk'i.lnmasti)ids ait tonith.r, Ih. y <lraw thi' li.-ad li ^wnwanl an.) i..rK,,r i, ulu-n ..-u- niu*.:. a<t~
alum-, it turns tin- luad ohliqmly so that the f.uc Kx^'k- upward aivi mward the <)i.|.<.sin- ^idc.
THE HYOID MUSCXES.
The Infrahyoid Muscles.
The infrahywid muscles (Figs. 2;:. ;?,'''. and 2^Si are situated betv.
the upper margin nf the thorax, chi( :ly in the anterior cervical region
ation of the rectu- alxlomiiii- ir.to ihr ne( k, being the remains of an
Some
!u'--e nvu--.
laver liich i- !!iterru]ilrd in the thoracic n-gion.
retained indiiaiions ^. 'heir original ^-gmental tendinous intersectiins.
tin ;;; :ie am)
lepreseni continu
1 , 11 >inglr mu^- lar
lik> the rectus, have
The group till ludes
the slirnoliv'iitltus, the ^Irr}^ •ihyr-o'uhii':., the ihyn;
The stemohyoideus Uig^- - - 1. \v^> -.'"• •"
which i- -imaled in th. suprasternal, lliyroid, la-
(I*'ig. 2;4l from the iiil'.rnal surfan of the lirsl co
the manubrium ,.nd llie cai. stile of the slernoclavi-
bv the .sternal end of t' ■ i( le anil the stem
ujiwanl at a sliglr distai ■;! Jl'c median lii
into tile body of the IumkI bone. It not in"
inscription.
The sternothyreoideu Fiu-. ;,, 25-;, -'^o.
origin is similar iiit n.ure duply : l,i d iImi.'. 2-
second costal cartilage. T' e lov., r ■rlioii of \;
and die sleriKH kidomastoi i, but -- ■ '')' tile sti
])roje(l biyond the Litter muscle, an. its nii.ldlf ai w':-
benea''! the ui'per Ik ' . of the < .nioh;, "idelis. ll ir
lil\reoiii gi.imi, | las.si - .iniillV U,..'. aiM, s,-. \r,\\\ r.w.y ::
betAcen tin two must k s ,,f opposite ■ 'des, ami is inset"
canilage. .i''>r additioii .1 details - "Si. he hnologx
must ll - is situated a tiorli' of the lar\ n\, ti tiyreoidgla
oidciis, and the miioii
'^.Si i- a tlat, long, an.
eal, subiiyoid, am;
eartil; ;e and froni
;r artii n' iiion, '
of lie stern - ii
,;!g somcwhn nar
e.xh)i)i a fi- ' "■■
r n.! niuscle
■Su in ""{.ses
III- ol
.ritiin
.is.ses
tied
tendinous
-onii
.1U.S( i
■lV<il-
lh:i lyoid. lis
t; (1. .Is I'ar as the
on: manvibriiim
uier . aner margins
; ■ rtioii ..;e also situated
miisi le which covers the
■. ]^■([ in !h.- !i!r.!l:o- lini'
;.li(iue line of the thyreoid
ic spai e between the two
i, ai liie irai Ilea.
iL
f
.a
I
■■■■
' ■ V
Hi
THE inJSCLES OF THE NECK.
173
The thyreohyoideus (Figs. 255, 256, and 258) appears to be a .lireet continuation o the
sternothvreoid. It is a flat musele, the greater iK)rtion of which is concealed by the upper belly
of the omohvoi.1, an.l it passes fn.m the oblic,ue line of the thyreoid cartilage to the hyo.d Ixme,
where it is inserted fei.le the sternohyoid into the lateral portion of the U.dy an.l into the base-
,.f the greater cornu. A fasciculus sometimes passes from this muscle to the thyreoid isthmus
and is known as the Innilor f^latulidfc lliyrcoidccr.
The omohyoideus (Figs. 2vS, 256, and 258) is a long, flat, narrow muscle which is com
posed of two distinctly separated beUies. The injcrior hdly arises from the upper iH.nkr of the
Utnii'li yngldss i {il ivided)
H'imtis I'l miiiiilihir
isrf/i.'ii)
drrtilir ciirnu
Vx,.. :!S7 Till- Mivliihyni.l ami jjmiuhyi.iil imiMk-. .-i<n ffmi al".ve.
scapula iKtween the inner angle and the notch, >ometimes luing alx. attache.l to tlv transvers.
ligmient It i^ ai first cov.red bv the tiape/iu^ an.l tlu' davi. le an.l ihen IxTomes suimtIu lal m
the greater supra, lavi.ular fossa a> it passes t.. the po>tenor margin of llu- M.rnocl. i<loma>to..l. us
Henealh the latter it f..rms a flat interm..liate tend..n which i^ a.ilierent lo the cerM.al fas. la an.l
,„ the sheath of the great vessels of the neck. The sHf>rrior brily ...innun, . s at ih.' .nterme.liate
ten.lon, appears at the anteri..r margin of the slerno. lei.i.Mnast..i.l, partly ...n..ai.d bv ill. M.rno
lhyre..i.l an.l il,yre..hyoi<l, an.l is inserte.l imme.liately alongsi.ie ..f the slern..hy..Hl int.. the
j.^^.^,. !^,r,!,..- (.f thi' lateral iwrtlon of the hyoid Ixme in front .)f the thyri-ohyoid.
•l-h- m(.al.v..i.l nu.„U-. »r.. ,u,,l,li..l fn-m tli.- u,.,"r ..-rvi.al nrrvr, tl,r.m«h .1,, ..M..lk.l nn>a 1.v,h,r
thvr.-..lnoi,1 r.-,.iv.-. a .(.r. ...1 t.ra.v I. Ir-m (h. -...»■ n.rvs, «hi. 1. a. . ..n,|.anH s ihr l,>l..«l."Hal.
Ihr
I'
i 11
174
ATLAS AND TEXTBOOK OF HUMAN ANATOMY.
Fig. 258.— Deep layer of the muscles of the rck, seen from the left side.
The anterior Ix'lly of the iliRastric [ the niylohyoirl, thi> stcrnoclcidomastoiil, ami ilit- sternal end of the clavicle have
been removed.
Fig. 259. — The deep mu'Jes of the neck, seen from in front.
On the ri^ht side the longus capitis has U-en drawn outward.
The infrahyoid muscles depress the hyoiil Inmi , the stemothvreoiil draws down the larynx, and the thyreohyoid
approximates the hvoid Ume to -he larynx. They also act a.s ai cessory musi l<-s of ilcKlutilion, an<l, hy its attachment to
the sheath of the great vessc'ls, the omohyoiti fai ililates the return of blood through the internal jugular vein.
'.J»'
i.ii.
11
The Suprahyoid Muscles.
The suprahyt>i(i muscles (Fij>s. 255 to 258) lie between the hyoid bone at-'i 'he mandible.
Thev are the ili)^tislricus, the slyloliyoidfus, the myhhyouicus, and the gciiialiyoiihus.
The digastricus {bivcntcr mandibula) (Figs. 255, 25b, and 258) is a ty])i(al two-lxllied
muscle wit'i a distinct cylindrical intermediate tendon which is attached to the hyoid Ixtne. The
two bellies form an obtuse angle, oi)cn above, in which is situated the sui)maxillary s;ilivary };land.
The anterior Ix-lly is a fairly thici. muscle which pas.ses from the intermediate tendon, frwiuently
rec 'iv inji a fi w tendinous IiIkts directly from the hyoid !)one, to the diga.stric fo.ssa of the mandible,
wheic it is inserted by a short tendon. The ^fterior htlly is longer but somewhat weaker than
the ai terior one. It arises from the mastoid notch of the tcmi)<)ral Ijone and passers with the
stylohyoidiiis to the hyoid region, where it iKfomes continuous with the intermediate tendon.
The anterior Ixlly of the digastric lies in the submental and mental regions, Ix'twwn the skin
and the mvlohvoid; the posterior iK-lly is omjiletely concealed at its origin by the stemcK leido-
mastoid, and further anteriorly it seiuirates the submaxillary region from the carotid fossa.
When iIk' hvoid iH.nc i.. fixed, the anti nor 1.1 .'epn-s.M-» the l.iwcT jaw and opens the mcvulh, ih. posterior iM'lly
draws the hvoid l»ine bai kw.ird anri upward and. u. net her with the stylohyoiil and the infrahyoiil mus< les. fixes the hyoid
Umr The |Histi .-ior In llv is • upplied by the fa< iai nerve, the anterior Ully by tin niyjoliyoii! nerve twin the third division
ipf thi' trigeminus.
The stylohyoideus iFigs. 2;^, 2;^, atui 2;8) arises by a tendon Irom the styloid process of
the temporal Ixine and run^ ;i> the hyoicl txiiie as a tlai rounded muse Ic- aU)\f and almost parallel
to the posterior Ik'IIv of the digastric before its insertion into tin lioi-r it almost always divides
into two slips, iK-tween which ll;.' intermediate tendon of the diga'^^lric jiasses. These slips have
muscular attachments to the base of the greater cornu and ic the posterior extremity of the IhhIv
of the hyoid lK)ne.
'lh<' ailion ..f iheniusileis similar to that of the |(osicrior Ully of ihe illgasln. and ii e. aKi. supplied by the
fa( iai nerve
Hetweeti llie infrahvoid musdc^ .ind ilu- anterior Uirder of the sterniM leiiloinastoid there n mains a <leep »pai e
Niunden above bv the inwierior IhIIv of the cligastrii us, iliis is 'lie ,,in>liil /m<.i.<, und il i ontains the ((real vessels
and nerve of the neck (llie i oitimon i amlid arlerv, the interna! jugular v. in. and the \agus mrvel The lateral wall
Ihe mylobyoideus (Figs. 2^6 to 258 and 2f)?) is a (ifculiar broad, llat muscle which is
situateii in the submental and submaxillary regions .mil is partly covi red oy the anterior ImIIv of
i
HI
i'i
n
■ i
It '
'll
. *.
H f
THE MUSCLES OF THE NECK.
175
the digastric. The two muscles of opposite sides unite in the median line in a slightly tendinous
mvlohyoid raphe, and form a muscular layer which extends across the mandibular arch and
constitutes the floor of the mouth.
Each muscle arises (Fig. 257) hy a short tendon from the mylohyoid line of the mandible,
and the majority of the fibers nm ot)iiquely to tlie median raphe, some of them, however, passing
to the upper border of the IkkIv of the hyoid bone.
Tho musrU' i< supplird hv tin' mvloludid m-rvt' fnmi the thinl division iif thi' trincminus. DuriiiK drglutilion it
oli-vatcs itif t-nlirr llixir i-f thi- mouth, togothi-r with tlir tonKUi ; itu- hyoid lionr i^ al^o drawn upward Iiy the filiirs in^rrti><l
into it, and whi-n the hyoid bom- is liwd, the musi Ir di|iriSMS ilu- lower jaw, a^sistinR the digastrii .
The geniohyoideus (Figs. 257, 258, and 265) is a rather strong, slightly flattened muscle
which is situated between the muscles of the ttmiiue proper and the mylohyoid, the inner margins
of the muscles of the two sides being in immediate t ontact. Eaih muscle has a tendinous origin
from the m. ntal spine of the mandible (Fig. 257), and becoming considerably broader as it ])asses
backwanl, has a fleshy insertion into the anterior border and upper .surface of the Ixxly of the
hyoid hone.
Thv gi-niohvoid i^ supplied liy IiImts from the first and scrond rcrx-iral nerves, whirh aeeomp i ■• llie hypoglossal
n<r\e. It draws the hvoid hor- forward, or, when the hyoid l)one is fiNed, it (U'lirisses the lower j.i . Together with
the infrahvoicl and the jiosli rim si-pr.diyoid mus. les. it fixes the hyoid lione.
THE DEEP MUSCLES OF THE NECK.
The Group of the Scaleni.
The scaleni (Figs. 244, 247, 25S. and 2;,()i are t()m]iosed of three (rarely four) muscles which
iia.ss from the transverse jirocessi'S of the cerviial \titebra' In tin first and Mcond ril)s. Their
origins are concealed by the sternocleidomastoid, but they are partly situated immediately beneath
the skin in the lateral iirvical region.
The scalenus anterior (Figs. 247, 258, and 2;()! is a long nuiscle which is almost wholly
covered by tlu' sternocleidomastoid an<i luirtly so by tile inferior 1h liy of the omohyoid. It arises
by tendinous slijis from the anterior tulHrcle> of llie transverse proiisses of the fourlli to the sixth
cervical vertebra-, and jtasses downward and forwarii to the lirst rib, becoming narrow ami tendin-
ous at its insertion into the scalene tiilunlf. The anttrior surfaie of the must le just alxi\-e the
» insertion is provided with an aiioneiirosis.
The scalenus medius d'igs, 258 and 251)) is longer and usually strong! r than the anterior,
with which it is closely relateii by it- short iiridons of origin. It arises fmm the anterior tuberiles
of all of the cervical vertebra' and is situated to the outer side of and ]iartly iKiiealh the scali mis
anterior. It is insertid bv a broad short tendon into the outer surface of the first rib alK)Ut a
fmgerbreaillh to the outer side of tlu si alenus anterior.
Hetweei> the insertions of the scalenus .interior and medius into tin first rib there is a space
which gives pass;ige to tl.e sulnlav ian arti ry and to tlie gnater part of tin brat hial plexus.
The scalenus posterior (l*ig>. vu aiii -sifi i^ tlie smallesl oi tin- siuKiu, and is ininunily
adherent to the medius, from which i| i- di--tingui hable onlv by its separate insertion. It arises
fmm the transverse pr<H'es.ses of the iifih to the st enih >trvical vertebra', is situated Ixtween the
[ill-
H
i|!
iiN'
' iii %
■ i s
176
ATLAS AND TEXT-BCOK OF HtJMAN ANATOilY.
scalenus mcdius and the levator scapula-, and is inserted by a short tendon into the upper border
of the second rib. Its insertion is covered by the upper digitations of the serratus anterior.
There is occasionallv present a small independent muscular fasciculus situated Ix-tween the
scalenus anterior and mwlius. It is known as the scahnus minimus, and is inserted into the f^rst
rib and also into the di-me of the pleura.
The s.al.ni r.> .iv ,l,oir ncrv..u,,,,ly ,,ar,ly fn,m the ..-rvi...! plexus a„.l partly Che scalenus posteHor, fr.,m small
spe. ial t.ran> hes of the brachial plexus. They elevate the tw„ up|.,T r.bs.
ii! I
ii
THE PREVERTEBRAL CERVICAL MUSaES.
The muscles of the prevertebral group (Figs. 258 and 250) are situated to the inner side
tnd ah.ve the scaleni, from which they are separated by the transverse pnxesses of the cervical
vertebra- Thev are the /<;h?«.v colli, the hmi^us capitis, l, ul the rectus capitis uutcrwr.
The longus colli ( Fig. 2^.,) is a rather thin Hat muscle which is situate.1 between the cervica
viscera and tlv bo<lies .,f ihe'upper thoracic and of all of the cervical vertebra-. Its upper ant
outer portion is cverctl bv the longus capitis, and between the two muscles and It, either side (.f
the metlia., li.ie thert i> a's,,ate, the width t.f the little fmger, in which may be seen the anterior
l„ngilu<linal ligam.m of the vvrtebral column. The muscle has the form of a very obtuse-angled
triangle, the obtuse r.ngle being placetl at the transverse prt.ce.,s of tiie sixth cerMcal vertebra.
1, i, composed of llirte portions, each of which c.mstitutes a side of the inangle. 1 he mner
portion is the longer, an.l t xtend. from the btnly of the thinl thoracic vertel)ra to the axis It
arises bv tentlinot,. slips from the l^nlies of the upper thoracic an.l the lower cervical vertebra-
,n<l insc'rls, nartlv bv muscular an<l juirtly by tendinous tissue, into the botlies of the upper cervical
vertebre The »/>^r an,i o.tcr portion arises by Hat tendinous tligitati.ms fr.m the anterior
,t,l,ercles of the transverse processes ..f the upper tervical vertebra antl is inserte.l into the antenor
tubercle of the atlas, this ,.ortion being sometimes termetl the lou^us allantis, and also mlo the
l.Klies of the im.lerlvi.ig . . rvit al ^t■rtebra■ in common with the inner segment ot the muscle I he
/.v,r"and outer portion ..ises from the lateral surfaces t,f the Uxlies of the-^ upi>er thoracic
vertebra- an-i is inserte.l by tiie tt n.iinous slips into the transverse prt.cessc-s of the lower cervical
''' '-riH' longus capitis (rectus capitis anterior major) (Figs. 258 an.l 25.)! is a rather broail Hat
muscle the upper p.,nion .,f ^^hi. h is somewhat timkene.i. It lies t.. the outer si.le of the It.ngus
colli an.l ...vers its upper ami outer segment, an.l arises by .listinctly separatetl ten.hnous
tlig.tations in.m the anterior lulxrcl. s ..f the transverse proces- s .,f the th.nl t.. the sixth
eervital urlebrav Fn.m these origins it passes upwanl ami slightly inwar.l, ami is inserted
i„l„ the lowtr surfa.e ..f the basilar iK.rtion of the occipital iH.ne. There .s a .l.stnul aponeu-
...,.;. .,....., .1 ,tt.r;,,r tnrf.ur i.f the muscle somewhat al>ove its mifl.lle.
The lonuu. ,..lli an.l .he longus , api.., are ,uppli.-l bv N"< i^'l '-""'h- ■•' <h.- ..Tvi.al plexu. Th.-y In-nd the
„.n.i, e tlal ,..lu,„n a,.,e ', an,:! ^h.n thev a,, u .Tallv. „ he he. wan. the ...e „( ' ' •'•n-'-^
ntuvle, In the .urr,in« movement, the l.,n«u .i» «n,l the upper an.l outer s.„men, o, the lonRU h a,, .oguh.r.
THE MUSCT.F.S OF THE HEAP.
T77
The rectus capitis anterior (minor) (Imr. 250) is a small n^usclc i>assin^ hcUvei-n the atlas
and the occipiuil bone and is almost entirely concealed by the longus capitis. It arises from the
base of the atlas and passes upward and inward behind tb.e insertion of the lon-us ea„.>is. to l)e
inserted into the under surface of the basilar process of the occipital l)one.
B,>th .he funriion ami ih. inn.-rvalion ..f ihis musclo an- intimat.ly .onn.TU-.l with thoso of th. ,,ro>.-,lmK onrs,
THE FASaiE OF THE NECK.
In the neck two fasclic mav be distinguished: the rrn'iai! jasria an<l the prr.rrUhral jasda .
The cervical fascia is further sulxiivided into a superficial stronf^er and a deeper weaker layer.
The supvrfuial layer of the cen'ieal jascia covers /.le sternohyoid, the sternothyreoid , the
thvreohvoid, the anterior surface of the sterncKlei.lomastoid, the inferior belly of the omohyoid,
the posterior Mlv of the.lit^astric, the stylohyoid, the submaxillary -lan.l,and the carotid foss;i; it
is itself conceale.i bv the pUuvsma. This superficial layer is connected alx.ve with the narotideo-
masseteric fascia, and also covers in the space between the ,.osterior iK.rder of the si. ii.Hleido-
mastoid and the anterior Ixirder of the trapezius.
The deep hnrr oj the eercieal jascia unites with the superficial layer at the anterior Ix.rder of
the sternocleidomastoid, so that in the mi.UUeof the neck but a sin-le lay.r <.f fascia covers the
larvnx and the upper portion of the trachc'a. It covers the iK)sterior surface of the sterno<le.<lo
mastoid, which is conseriuentlvensheathal Ix-tween the two layers, the posterior surface of the
posterior M\\ of the diRastrie and of the stylohyoid, the tl<«.r of the caroti.l fossa and the sealeni.
It is intimatelv adherent to the intermediate tendon of the omohyoid and l)ehin<l the manubrium
of the sternum it extemls .lownuanl to the first rib, while posteriorly it is continuous wnh the
nuchal fascia. .11
The preverlehrnl jasria is a rather dense layer of fascia which < overs the i.revertel)ral muscles
and the anterior surfaces of the cervical an<l of the ui)per thoracic vertebrx. It is separated from
the cervical viscera by l<K)se connective tiisue.
1 1„ ,1„. . ..rvi. al r>Kio" ^'«."n th. ,u|M,Kra,,hi. al r.-la,i.m> of .1,.. mus. U-s arr far fn,m a«nrinK will, ,h.-ir .l.-v.lnpm.mal
rclaliuns, n,anv ..f llu- mu.s, l.s ,lrs.rilH.l al».v.-, su, h a, Uk' plaly.ma, ll,.- ...-rn.K Ui,|o,r ■ ...a.l, a„. all ih. supralnnwl
mus, l,s will, tlic fNcoptinn ..f thr Kcninhyoi-I, iKlonRinR U tl.r ■ ranial mus, uialur.- 11., tru.- . ,rv.. al nuis, ks, ,. , , .!>,.„■
(U rived friMii tile eervi, al my,Homes. may l)e i lassifieil as fi>ll,ms:
Hyi>,isk,l,lal: lmii;iis inlli. Iiin!;iis ■.J/>///<. and rrr/id ni/>i/n ,inwrwr-
Re<tus: steriwhywlcu^, ^l.-riiollivrniideiis. IhvnnliyoiJnis. au<l imwhyoidnix.
Ohli.iue: tnitfiu (and prohalilv als,i th,' iiilirlr,iiinTr'..irii .nilrriorrs).
As has alr,.a,lv In-en |M,int,'d ,ml, ihe mus, ulature ,.f .1.,- ,liai,l,raRm is also .lerive.l (nm. ih,' . ,rvi, al mv„t,.nu-s an.i
is |)r,il)at)ly tu be regardeil as d iMirtiim ,it the .iMiiiue Rroup.— Ku]
THE MUSCLES OF THE HEAD
The muscles of the head are composed of two larRe and completely independent groups: (0
The cutaneous mus.le. of ihe head, i. c. mu:.cl,s which ari-e d:re<!!y "r i»dimtly from the
cephalic skelet-m but which are inserted into the skin of the fac.' or scalp or are situated in the skin
of the face; and ( 2 ) the muscles of mastication, which are typical skeletal muscles in every resinrt.
178
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fig. 260. — The superficial layer of ttie facial muscles and the neighboring muscles of the neck seen
from the side and siightly from in front.
Fic. 261. — The orbicularis oculi seen from behind.
The musric together with the integument has l«;en removed; the lachrjmal portion is represented in connection
with the inner margin of the orbit.
THE MUSCLES OF THE FACE AND OF THE SCALP.
The cutaneous muscles of the face exhibit manifold peculiarities by which they arc more or
less differentiated from the ordinary skeletal muscles. They jwsscss no fascia', they exhibit but
a slight degree of indcjiendcnce, and many of them are so combined and their fibers interlace to
such an extent that it is often purely a matter of choice whether individual fasciculi arc regarded as
sjiecial muscles or as the heads of a larger muscle. The arrangement of the facial muscles into
sphincters or muscles of ckxsure is also characteristic. The group includes the epicranius as
well as the muscles of the face jiropcr.
THE EPICRANIUS.
The epicranius (Figs. 260, 262, and 264) consists of a middle aponeurosis which cnvelojis
the cranium, the galea aponciirotica, and of muscles which arise in the frontal and occipital regions
and are inserted into the galea. This is thi- k. st in the occipital region, becomes thinner toward
the forehead and ]iarticularly toward the temjiles, and gradually loses its ajioneurolii.- character
(especially in the temjioral region). It is connected to the skin bv fibrous connective- tissue
fasciculi and sejiarated from the cranial periosteum by l(X)se .T'^olar l' •
The frontalis is a very thin, broad, and Hat muscle wj- is intiri; 'ely adherent to the skin
of the eyebrows. '; has a broad origin above the supraorbital margin, ■ xtendsover the vertical
jiortion of the frontal l)one, and is inserted into the galea aiioiieurolica in the upper ])ortion ol the
forehead. It has also a slender origin, which \aries in si/.e, from the l-Miy bridge of the nnse;
when strongly developed, it i- known as llu- frorrnis ( pyramidal is) nasi, but it is always
immediatelv connected with the frontalis. The two frontales are separated in the median line
by a narrow area containing no muscidar tissue.
The occipitalis is also a Hal, broad, and an apiiroximalely (luadrilateral must le wliii h atises
on each side by short tendinous fibers from the highest nuchal line; il passes upward, and after
a comparatively short course is inserted into the galea aponeurotita in the occipital region. The
width of the muscle is much greater than its height, in contrast to the opposite condition in the
frontalis.
Like all the fa( iai nius. Ii -,, the frontalis and ihe iki ipitalis are supplied by the fai ial nervi-.
Both musdes are tePMirs of the galea aponi-urotii a. They pull the si alp forward or baikw.ird, and the fr italis
wrinkle^ the skin of the fonhiad.
,\ portion of the aurirularis is also related to the galea ajwneurotica. This muscle jiresents
three portions, an auriiuUiri-. anterior, superior, and posterior, and like almost all the facial muscles
they arc subject to great individual variations in 'he degree of their develo]iment.
Lilr palpehrale iiinHale
Procerus
I Angular
head
In/ra-
orhital
tahii head
super.
Zygo-
matic
head
Trunsvcr^iis 7<
Occipitalis
Fig. 260.
I roiitni hnitr
t.achrymal portion
Lachiy^^ii! -oc-
f'ossa /or
luihryr'iii! sar
'
Fig. 261.
'■
li i I
M«
t
1 i; :
N
iiill
THK MUSn.KS OF THE FACF. AND OF THF SCALP.
179
The auricularis anterior {attriihens aurktihr] (¥{%. 2f)o) has a very thin and usually
quite a small origin from tlu suiKTtuial temi)()ral fascia (see juige 184); whin well develojied,
the muscle extends lo the frontalis. It is inserted by a short tendon into the cartilage of the
auricle and into the eartilagino\i> external auditory meatus.
The auricularis superior (attollcns auricuhr) (Fig. 2f)o) is u>ually the strongest portion of
the auricularis. It arises broadly from the galea aponeurotica abow the tem])oral region and
becomes markedlv narrower as it descends to be inserted by a tendon into the upper margin of
the root of the auricle.
The auricularis posterior inlraliciis auricula-) (Fig. 264) consists of one or more flat slender
fa.M iciili which arise over the' tendon of the sternocleidoma.stoid and are atlac bed to the posterior
e.xtiemity of the root of the auricle. The Irnusvirsus nurJi<r (see jiage 14O) which is not inlre-
quently present pcjssibly al>o belongs to the auricularis |)osterior.
Till' film li- 'IIS of ihf imlividual |Hirti>ns "f tin- Miirii iilaris an' tii movr llif aurii It- in l)n' (liriilioii of ih,- nius. ular
MIkts. Thi inri' . ation i< frowi tlu- fai ial lUTvc.
THE PROPER MUSCLES OF THE FACE.
The remaining muscles of the face pro])er are composed of three groups: the pulpthral
musch'S, those surrounding the orbital orifice; the oral musdi.s, those situated about the mouth:
and the itasai nnisclcs, those >i!uated upon the nose.
THE PALPEBRAJ. MUSCLES.
The palpebral musculature forms the orbicularis oculi {palpebrarum) (Figs. 260 and 261 1.
This is a flat muscie, situated < hielly in the ori)ital region, which forms a broad ring about the
entrance to the orbit, and is comjjosed of three ]iortions, the orhilal, the palpi hral, and the ladiry-
mal portion. Onlv the last ]K)rtion possesses a certain degree of independence; tiie orbital and
paljvjbral portions ar- directly i cintinuou> with each other.
The orbital portion forms the broader external circumference of the mu^cidar ring, and lies
U]X)n the margin of the orbit inmiediaii iy beneath the >kin. Its broad fasciculi arisi' from the
frcmtal process of the maxilla and the adjacent ]iortion of the frontal l«in. . and pass in a wide
curve alK)Ut the ' ntrance of ihr orbit to return almost to their -tarling jioini at the inner canthus.
The muscle is connected witii many of its neighbors, i)articularly with the frontalis, and til)ers
which radiate into the skin of th< eyebrow constitute what is ti-rmed ilic (orrut^al'tr siipcrrUii
(Figs. 262 and 2(>4), while others w hich pass to the cheeks are known as the walar portion ol the
muscle.
The palpebral portion is the more posterior portion of the muscular ring, and is that jiart
of the muscle wiiich is situated within t'ne eyelids. The fibers ol the muscles of Ixnh the ujiper
and the lower lid ari-e at the inner canthus from a short hori/onial tendinous band, the inlirual
palpebral lifiniiient, and pass as line fasciculi in an arched manner to the outer canthus, where they
are partiaiiv inlerlan d and foim die ,\lerndi pdip,hral rapiic. [Vv.r a further dcss nplion ol the
relations of the I'iIkts in the eyelid itself, see "Atlas and I'.pitome of Histology," Sobotta Huber.)
The laelirymal portion, also known as Horner's musili (Fig. 2(11 ), is a deeply situated portion
of the muscle, which is connected with the ]ialiiel>ral portion. It arises from the jiosterior k'c hry-
m^
,^:^-
I
Hr
ilk':' S
J (
' i
:M!
^g
1 80
ATI.AS ANI> TKXT-BOOK OF HI MAN ANATOMY.
Yu. ^0^.— Tho (Icencr laver the farial mustics , ■ , ,
The „.a,...u . lalni supcriori:, ;,,„„K,,i. u. ,nL«u,ans, „ Ira.us lahii i.Uri.n. tlu- „an,„.U.o-n,assc.on, fa. M.
tho parotid i;l.inii.
t a iHirtion of .h.- -^uiHTrii iai layi-r of the li-ni
,|Miral fa~( ia have been renlovcl.
Fi( 2()( —The oral musculalurc seen from bchiiul.
The mus, le. ,.,KeU,er w„h .h: ime,u.nent, have bee. separaU-l fn,„, .he hones a,vl .h.. mu.nus nu-.^hrane e„ver,n^
the mu^iles ha^ been n muveil.
n.al ri.l.'c of Uu- lachrvmal Ix.n. and the fibers i>ass hori.t.ntally acn.s the lachrymal sat to tl.
I^ar "nCof the litis, whert : -^ v clecus.ate antl tlisappear ia the fibers t,f the palpebral port.on. < \
more tlelailetl tlest riplion uii! !« f'>uml in the seetitm upon - Fhe K>e. )
The ,.,.u,ans „et„. h.e au ,. the ^^f----;^;:^-;-;:, ^ ::::';:::" z^^i':: r:ntrat,„ .. .he
^.j::::::::::i::^X;::::u^^^^^ -^
the [..rehead -.vrinkle the -km in th. m- legion^.
THE ORAL MUSCLES.
The nntsdes of the oral regit.n consist of the buahuUor, of the circttlar m.trs situau..! ab.mt
the mouth which form the orbicularis oris, t,f the mu.cles t.f the upper hp, o, the njuscles of le
: lip, of muscles which are situate.l upon the sUin. and of muscles wh.ch -hate ,m., e
anis tlf the mt.uth. The ^reat majority of these muscles are .nfm.tely connectetl ..th each
""''"•rhe quadratus labii superioris <Fi,.. 260 and .62) is situate.l in the upper lip in the
nasal infraorbital, malar, buccal, antl superior labial regions. , , , r ,,
U ha- in general a triangular shape antl arises by three heads: the a„,uor ua.l rom the
bt,nv hritlge t-f the nose in conne.tion with the frontalis antl the orbicularts otuh; the n,,raorual
hZ< arising broa.llv from the infraorbital margin antl coveretl by the orbua! porUon o he
o^bi^ulari^^culi; antl the cv„.»„//, lu.nl, a slen.ler fasciculus fn.n the malar surface ot the
zv-omali. bone, which i- usuallv a.lherent to the lateral ra.liati.ms of the orbicularis ocuh.
■ " The an,ul„r hcul .Icvalor lahii suprrioris aUcquc nasi) is compost-l of two pt.rtions, an inner
one passin.Mo the ala of the nose ilcvator al.r .u.uU an-l a stronger outer one whith unites .,th
Z uvo otl^r heatU of the t.ua.lratus antl passes ,0 the musculature t,f the upper hp near he innt:r
idc of the angle of the n..uth. The iujraorlnlal haul .Irvator lahu suprrnms^ is he broa.le t,
^ the s,>me^d.tt intonsiant cyt:.mt,//c /.c,./ ,.v,,.m.//n. ./..n tlK. U
At the insertion of the .,ua.lratus labii superioris into the upper hp Us muscular fibers interlate
with those of the orbicularis oris.
The zygomaticus i,.,om,tirus maior^ (Fig. .<.o) is an elongatetl, rather strong, antl eas.l
ist,la,cd mu^le which is shuatetl in the malar, buccal, an.l t.ral regions. t has an in.lepentlent
r g in from the malar surface of the malar bt.ne, close besitle the zygomatic hea, of the t.uadrat^
Z^\ superior., an.l rtins to the angle of the mouth, where it fuses with the orbicularis oris and
the neiirhl>oring mustles. . , • 1
The risorius or "smiling" muscle (ligs. 360 and .6;) is a thin, approximately triangular
mustle of variable tlevelopment which is situate.l chielly in the par.iti.leo-massctenc anc buccal
"gi<!,r!s. It arises frt,m the partuitleo-masseteric fascia (see page .84), st>metimes exten.l.ng
Cormgator supt'riilii
Quadratus \ Angular head
labii \ Zygomatic head "
superioris \j„fraorbital head
Zygomaticus x
Quadratus lahii infer.
Trapezius
'Spleniiis capitis
ill
Depressor sepli Inciwus labii superioris
Hi
■f* Buccinator
Triangularis
fig. 203.
ill
lll
!f
THE MUSCLES OF THE FACE AM) OF THH SCAM'.
l8l
upward as far as the zv^oma and covcrinK the radiating: fitxTs of the j)hitysnia in this situation.
The lower portion of the mu.seie is eonnetted with the platysma and fre(|uenlly apjiears to he a
direet eontinuation of some of the individual fas.ieuli of the latter muscle ( Fij,'. -'(.7 i. It is
inserle.l into the laijial musculature at the ang'e of the mouth immediately l.elow the /y-o-
maticus major.
The triangularis >ntiii;ul,iris hibii injcriorh or </</)rc.v.s«r ,i)ii;i<li oris) (Imk. 2601 forms the
superfuial laver of the musculature of the lower lip. It is a Hal trian-ular muscle, situated in
the tnural, mental, and inferior labial regions, and arises broadly from the anterior extremity
of the lower Ix.rder of the body of the jaw. Its libers are inMTled into the laliial musculature of
the lower li]) near the angle of the mouth, some of its >^uperfn ial fasciculi j.assing to the opjxisite
side in an arche.1 manner [n f(,rm a single subcutaneous nuisde which i- known as the :r,iiisv,rsus
lUiiili (Fig. 2(k)). . .
The (|uadratiis labii superiori>, the /.ygomaticu>, the ri^oriu>, and llie lriangulari> lorm the
superficial layer of llie oral mus. les and con(eal tiie greatir nunil)er of tluoe wiiidi are now
to be des( ril)ed.
The caninus ari,nii;iil,iris l.ihii suprrioris or Irr.ilor ,iit,^iili oris] iFigs. j(.o, j()j, and -'(141
arises from the canine fossa of the n axilla and passes into tile mus.ulature of ill. lip above the
/.ygomaticii-. It is a ilaltened elongatid mus. le and i- iilmost entirely (..ncealed by ih, over
Iving i|uadratus hibii siqierioris and /ygomaliius.
The quadratus labii inferioris k/, />r. xv.-r hihii ii:j,rioris 1 1 Figs. j(.o. .■(•-•. and .-o 1 > i- a ilai
(|uadrangular nuivlr. the posterior portion of which i> lov.ivd by tiie triangulaiis. it arises
from the :inlerior cMremiiy .'f tin- lower iM.rder of the jaw and passe, to the orbi.ularis oris in
Ihe lo\u r lip.
rii( incisivi </dl>ii siipcrioris ,1 injrrioris] .Fig. .■'vv ^ire small slimier nuisdes which arise
from the alveolar juga of the superior and inferi.>r l.il.ral incisois and jiass dire.tly into the
musculature of ihe orbit iilaris oris.
The orbicularis oris ../-///m/.r ,t/m (Figs, joj ai;.l .'Oy is the mus. le which surroun<ls the
mouth and f..rnis ihe ,,n.p-r nnis, ulalure of ihe bps. The fas, i. uli of the mus, le run in .|iiit,-
,lir!Vr,nt , lire, lions and. at the angles ,,f ihe ni.uilh ;.n,l 111 Ih.iIi llu- upper Mii.l lower lips, ;,,,•
inlimauly ,onn,-,U<l v, i:!i llie iilie.soi l.,,ih .piaibali, llie iriangul.iris, llu ,aiiinus, ih.- risorius,
Ihe /ygomali, us, ami the buxin.ilor, s,,ni,- of \\w lili. is ,,f ili.-,- nuis, l,s |>.,,sinu' in ill. sanu-
,|ir.'cli."^.n a- ill.' fas, Villi .>f th.'orbi. ularis.,ris. In a.l.lili.m lo ilu lil ris ^^Wu h . n. in I.- ih.' inonih.
,|„, ,,,|,i, Iilaris ,,ri- al-o |,osm->ms ..^.in.il an.l x.rli.;-! I,is, i. uli' llu lall.r loiiu a siu.ill ~l. lul. r
mus, le, situal..! al..n-si,U. of llu- nu-.lian liiu' ..lilie npp. r lip, uin, '> ' ■ iiis.n.'.l inio llu- . an il.iL'iii
..Us nasal s,-|,ium and is knoA- as die ,1, pnysiir w /-// w/./wi 1 i'ig. .•(.,;'■
'I'll, mentaliiS /.;.//."■ -■,»;// ..r h :ol,>r l.ihii injiriori^ 1 l-igs. ..(..■ lo .(.| i 1 s|„,ri mus. I.
silual.-d in llu- in.iilal r. gion, vnIiuIi aiiMs (n-m llu- l.m. 1 jau n.-,ir \\u .ib.-l..i iat'uni ..| llu
me.liaii in, is,>r. S.nu- ..f llu .ir, liini; IiIh rs uniu- wilh tlu.s, ,,| ilu nii.s. |. ,.| ih, opp.. ii. -Id..
but th; gnaU-i iiiinil'.r an iii~.il,-.l mio ilu ml. -uni. nl o| ili, . Iiiii. Ih. .origin .•! b.'lh
menlali-s is ,,.\i nd b\ llu <|ti,i.li.ilus kibii inf. riori-.
The buccinator d-i-s. ..(,,., -i). an.l .'OM i- a llal nn;s,l.. .M. luiin- Ul«..n ill. upi . 1
an.l III. lower j..u. an.l siiual.,1 inim. .li.il. I\ Iniualh ill. bii. .al niii..Mis nu iiibran. . « liilv llu
l83
ATLAS- AXD TKAT HOOK OF HUMAN ANATOMY.
Flc. 264. —The (ici|H">l layer of the fiu ial mus( les and liu' temporalis.
Till' ianinu>, tin />x.iiiialir an li, .i |iMrtinn of ihi- zyKomatic lioiir wiih the urigin .if iln- mkissi-Iit .in'l ihc tcmpur.il
Flc. 265. — The tui) |)tervK"iilei --een from the inner surface.
The- anti-rior |Kinnin .if ihr ^kul! h.i^ hen .iiviilnl 111 lli.' ^axiiLiI plaiu, .uul llii- t<m|).iral Imiih' in an iil)li(|Uc i.lanc;
the !'>n){ue anil siifl pal. 11. • h.ivr U'lri iiiiiov.il.
i I
i
antcrini tx)nl(r of ilie must le 1 shixtIk i.il, ]);i>-iiii,' into ihe orljii ularis oris and the other
muscles of the nioiitli. It is the slronnest imiscle in the oral region.
It arises from the buccinator ridge of the niandihle, from the ]«)sterior extremity of the alveo-
lar process of the maxilla, and from liie i)teryg<)niandil)ular raphe. The pterygomandibular
raphe (pterygomaxillary ligament : is emlx-dded in tlu' iHiccojiharyngeal fascia (see ])age 184) and
e\i<nds from the hamulus of tile inu rnal pterygoid ijl.iie to the jioslerior Iwrder of the alveolar
]K>riion of the mandible. It separate- the inu inator from the constrictor ])haryngis .suixrior
(see••S])lan^hnolog\ '). .\t the angles of the mouth the lil)ers()f the Inu cinalor muscles are directly
<()nt:niious wiih tho.se of the orbicularis oris, whili the jiost* rior surfaces Ijorder immediately uiion
the oral muious membrane. The .interior portion of eat h muMle is covered ])y the risorius, the
triangularis, the zygonialicus, and the canihus, while the |K>stt rior ])ortion is situated Ixneath
the massc-ter (see jjage i8.<i, from which it is .separated by a mass of fat, (he Inttial jal mass
(Hii hat's fat mass).
Till buicinalor i> j.erforai. • by the parotid dud, and the small bunal gl.md- rest
directly ijjon the mu.sile.
THE NASAL r^USCLES.
I'iie musilc of the n.-. are muih less imjH)rtant than those of the inouih. The feebly
develo|«fl nasalis < l-'igs. 2<>j. -•'.(. and j()()i i^ ( oniiK)sed of a transirrs, portion and an ali:r par
tioii. The Iraitsvirsi portion i- .1 llat .ind \ery thin nuisile i\liich uri-ns from tin up]>er jaw .ind
i- adherent to the angular head of tin i|uadratu- l.diii Mi|HrioriN u]Kin lh( bridgi of the nn^v, it
is united with its ft How i,f;hi <ip|.osii, -iije b\ nuati-of a thin ajHmeun. .dernie.l the (■(iw/>r.A.w<r
narium. llu i,'/<(f portion .onus from tlu al\if>l,!r jngiim of the iippir tanine tiMHh and goe^ to
lilt ..iriilagi 111 llu al,i of llu in >m: ii^ gii .Her |Mir!ion i- i mered by tlu i|iiailr,itiis labii superi
ori-. .dthoiigh ,1 --mall portion is .lUo 1 ont t .ded b\ tin mbuul.iriN ori-. {"hi .ila of the nose
ij-o reteives tor, I nily tin inM-rtion.if a [Hirtion of the .ingular lu.iil of the ijuadralus labii
NUperiori-.
,\!l III 111. tr.ii.. 1. . i.f ;(ii fan i.r.i|irr.in -upiili. .1 In ili. I.i, .al ii.rvr. Thiir fun. ti-m i< i.i pr.nlu, .- ilic mutenii iilx
..f ix[.t.>-i..ii. 1 1....U1. ..I 111. III. mill, nil iM nil in- . .| ili. Ii|... .in.j . .niiprt ,M.in .i| llir miiunl-. ..( the nmulh i ,is, in IiIuhihk,
till liih . m.il.in.
THE MI.ISCLES OF MASTICATION.
I hi nuiMlts of inasijia;' ;i are tom|M>-td of four -inmg Mparale muscles which an dnidtil
inio iwi. iiroiip^ iht iir^t K^'i^l' i-~' foriiud In llu niasulir ami tlu timpoiali^. the sen.nii by the
ivMi jll, t ,1'oitil I.
Ihi masseter Fig. :(>}) U a ihiik, >lrong, .uul apjiroximately i|u,idrilalt ral mustle whit h
(-Orrugator ,
Procrrus
QuadmtttS
labii sup. X
Zygomatiais -
Trianguiaris
frapmiis
:^plenius capitis
l'tcrvf<oitifiis extfrniis
y Slyhliyoiiieus.
j^ '^hli'pft'in'igfii^
stvloiil />ioir\s
^nloftiiiiiilihu/iir lif^.
.Am. I'flii"
fig. 2t)'i
i
THF. MrSCLF.S OF THE FACF, AMI OF TlfK. SCAI.P.
183
is situaU'd chicllv in the paroikko-massc-ric and partly also in the zygomat.c region. Its super-
ficial iH,rtion arises bv a broad aponeurosis from the lo.er border of the an.enor and n.uldle
thirds of the zygoma', while the d.ep ,)ortion take> a short muscular or.gm Irom the lower
border and the' inner surface of the ,,osterior part of the zygomatic arch. I.> < hut mserfon ,s
into the angle of the jaw and into the adjacent portion^ of the l..dy .nd ot the ramus, the deep
portion being inserted into the ramus alH.vr the superUcial portion, wli.ch conceals n
The aponeurosis cover> more than half of the length of the muscle an.l usually ,,enetrales
its interior in the >hape of individual serrations.
The masscter is covere.l I.ehin.l hv the i.arotid gland, whose <luct passes transversely across
the muscle, and in front bv the paroti.leo-masseteri. fascia. Its anterior portion is also in
relation with the uppermost portion of the ri>orius. which i. still more superhcal than the
naroli,lc..-masseteric fascia, with the /.ygomaticus, and ,>artly with the zygomatic licul of the
I.uadratus labii superiorly. Onlvth. lower portion of the muscle is situated immediately
beneath the fascia, the aponeurosis being usually covered l.y a layer of fatty tissue. It covers
the inserti.-n of the temporalis an.l i^ .eparate.l from the buccinator by the ft;/r,-.// /.;/ »u,ss (s.r
page liS.'i.
Th.. massrl.T is suppli.-l l.v th.- „K,s«-„Ti, l.ran. h ,.f tl,.. .hint .livi.ion ..f ,1,,. Iri^wninu. 1. . los.-, tlu- ,nnu,i, by
bririKinK thi- Lw.t jaw 1,1 ..mlact willi tli>- ui>|mt.
The temporalis i rig. 204) i> a i.n.ad -f nig mu>cl.', rather 'lal in ii> '.tpper porli,.n, whi.h
covers the plamim t.mpurale an.l th.. t.inp..,.! f.>ssa. In the temporal regi.>n it is almost sub-
cutamous, and lakes a muscular origin fr.-m the entire M.rfa.e ..f the planum temiH.rale Ixlow
the inferior temporal line, partiv fn.m the anterior i.orti..n of th. temporal to>sa. an.l als.>
fr.>.r .i« -.verlving .k-M' I^'V.t ..I th,. tem|.or:il fascia. Th.' wi.l.. la.cicuh ol th.. nius.l.. .-on-
vcr,«r ym-ar.l the ...r..n..i.l pr..c.>s of the niau.libU. ..n.l in .l-'ing >- beu.m.^ marke.lly lendi
nous upon th. out.r surfa.e. Th. y .nibrace the entire ape.v of the process and upon its inner
surfan' extend dowinvar.l as far a> llie base.
■I ,„. „„,., 1. ■■ -u,.,.li. •! I'V >'"• ■!■ -I' '■ "'l-ral l.ran, l>,s (r.„„ ,1„. n,o,„r ,.,r.i.,n ,.f ,1,.- .l>iM 'l.v -i-n of ,1„. ,ri«,n,im„.
1,- „„„ 1I..M U ... . I.-.' .!..■ moulh, ■.„..;;,«. UW llu- ,„.>.>. Ur, llu- |..u, , muar.l tlw u|.|K.r jau
Th. pterygoideus externus .Figs. ,.,- an.l -'(-'.i i- a triangular, fairly stn.ng muscle
vUiich is siuat. lin til. i„frat.nip..ral tnssa U^tween ih.' i.mp.-ralis an.l the pl.Tv^ouleiis mt.T
nu- It arises bv iwo more ..r l.ss .listin.ilv M-parau.l h.a.ls: th.. larg. r an.l int.ii...- tn.m ili.
„ul.r snrf.i.e .-I'lhe .mt.r |.lat.- ..f the pt.-yg..i.l pr..ce~s, from ill.' pvranu.l.d l.nuvss ..I the
,,,1,,, |„„u. an.l troMi the tuber.Mtv .,f the maxilla; th.' sniaii,-, .u,.l sup.ri..r ..„.■ fn.m th.'
infral,mp..ral crest an.l s„vfa.,' ..I llu givai.r uin« ..t th. sph.n.-i.i 1....... I h. tw.. h.a.ls
unii.' ih.' pu.scle l»...m.^ n.ark.'.llv nar...wci, an.l is in^.rh.l bv a sh,,r, t.n.l.-n nito t ,,■
ptcryg....i lo-a ..f tlu h.a.L.f ilu^ man.libl.. som.' td..Ts passing a!s,,i..tlu articular .lis, ..f the
li-miioroni-i\illar\ arli. tllalion.
I'hr pterygoideus internus i Kius. .^(,-, a.nl ."." is ^n.ng.r than th. .M.nr.-s, ^^lll,h ...n
,v.ls its ...iu'In, an.l its fasciculi cn.ss those ^.l du latter nn.s.l... It lak. s a t.ir.K t.n.hn.-us
origin fn. n the i-lervgoi.! fossa of the spiv. n..i.l iK.ne an.l passes h. the iiuur surta..' .•! ih. angle
m If ^
1 !'
184
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
Fk; 266.— The ilccp hivcrs uf the faci;il muscles, the buccinator, and the ptervRouls, seen from the side.
' Till- lowir puriiun of I'hr nm|».ralis loKflhtr with the (onmoid pnxrss of the mandible has U'l-n rcmovod; the whole
of the masseier i^ also removed and the parotid duet has Ix-en severed near its entrance into the buccinator.
Fig. 267. -The left platysma, seen from the side.
' 1
1
:,
1
": i
II
of the jaw, where it is inserted exactly opposite to the masscter. The outer surface of the muscle
is usually ajioneurotic.
(The ptervRoideus inlernus is an elevator <.t the mandible, assisting the temporalis and m.issotcr. The ptcrygoidcus
cxtcrnus ilraws the eondvie of the man.lil.le and the artiiular disc forward uiM.n the articular eminence; when th. muscle
of on.' sUle acts alone, it <iraws forward the mandibular .ondyle to whi. h it is attache.l, the other one pivojng
in the mandibular f.>s.sa. and the result Ining an api-arintly la!< ,.d m.ivement of the mandible.— Eo ]
The musdes are supplied by the external and i.iternal i.lerygoid nerves from the third division of the trigcmuius.
THE FASaiE OF THE HEAD.
The p,irotUlfo-ma<iSflirk jascia (Fig. 260) is the layer of fascia which passes over the
j.aroli(i gland and the masseter muscle. .\t the zygoma it is (onneded with the temiKirul fascia,
at the anterior margin of the ma.sseter with the l)Uccopharyiigeai fascia, and at the angle of
the jaw with the cervical fascia.
The tcmpor.il j^isciti (Figs. 2O0 and M)J 1 is th.' stronge-l lasria in the head and in ii^ lower
]K.rtion divides into two 'ayer-. the suprrfii ial and llu -.'../), whit h are se]iarate(i hy fatty n-sue.
The interspace between the twt, layers beconii s larger a. they (Uscen<l. the sui-erficial layer
inserting into th<' anterior, the deep iiit" the posterior l)order of the zygoma. The upi)er rir
cumference of the l.ni]".ral f.i-< ia i^ (onnectr.! with the galea aponinrnlM .1.
The anterior i>ortion of ihi- hu^'Opliaryiiiirii/ jum in lies upon il.e buo inab.r and is conn, rted
with the parotide., ni.i-el.ric fascia; tlic ifMcri-.r portion is stronger, more i.ndinofo. .iml
(overs the inner >urfa<e .d' the pl.ryg.-i.ku> ini.rnn.. In ilii^ !,oM,i-i.,r p<.rli..n are . mU-tMui ih.
pt.ryf^onwiiilihul.ir raplu , pt.rxi^nm.ixilhiry lii^uninil- an.t the slyl,wu„ulihul,ir sty'oiiuixillarvi
lifi.niKitl (se. ' ag. I iHi. In this Hiuali..n the fax ia form- the poster., lateral «all of the oral
cavit'' anii ih> lateral wait of the pharynx.
jTh. .r..n...i m,... uUlure, .onsi.l.nd f,-..., il., d. u i..pm. m.il .t.mdi.o.nl . in. hide, Mveral m .- le- in a.j.lili.m lo
thos,. «l.„l. ..r, ...MKI1.-.I toth.' h.ad ii, th. ..I.,v.' d.-. option -i... .■ it .- proj.rly to U- r,Kar.l..l as , on.i^tinK of all the
,„.i.. 1. -.ippl.. d l.v ih. , runial fi. n. ■. \moni; ll.ev ... rvr- ih.t,- , vi,i m..tor hln-r^ ..( H.. .bit. r.1,1 .,.Mhties 1 1 1 lateral
„„„„r r...tv v>l„.M-n,..l.i.f ...iain ,na , I-' re«.,.d,-d a- .« . u,.^ in« .. ,-.-.ti.... ...I. r..i.-.|ial.- b.tw.,.. th. <c^-.r^ ..... I.i ati.l
, ,) th.- .... .Ii..n nv.t..r r...tv vvl.i, h ...r.. ^|..ii.t in all th. ir e...-nl.aK t.. !!..■ ...it. rior r.„I- ..f th.- S'.»..l . ...'I 1 h. i.il.ral
m..|... r..' "li. H ■"'■... 1" ...nn.-.tion »vnh ll..- I.flh, MV.-mh, ninth. I. mil. an.j ,1, v...ili rv.,. ..r, .li-.i ilnit. .1 (.. the
,„u«a ...i.<l .viihth. .mbrv.n.. br.i.i. hul ar. h. s. while the ......b.,.. .....I... .....l- .... ., |.r, -. Ml. .Ma llu thiol.
(ourtH, M*.h, anil l«. Ifth m rv.-^ and supple th,' mu^ilrs a-«» ial..! «.ll he .v. '.iH aii.l tone..^
Inai...r.l,.n..- wilh ihiMlilT. r. m. ..I .n.i.rv.itlu... «hi, h i, o( gr. al i!...rph..l..ui, al in.i.irlan. ih.' . ranial m'l-. iila
,„„.,„,. ;.-,|..„i,,l ..tioovo Rr..m.. i.i lli.- iHV...H,vi, ,,,u-. I. s -..pph.-.l !■> im-.lian moP.r r...t^. and { ;l ih.- /.r.<"./i.
.m,rr:, n,u~lt- -iippi,..! l-v lal.-ral ..■..'••r r.-.l- The mii'« I. •• l..l..n«i.tK !.. ill. form, r ijn.up a- >v.ll a. .<i!a.. ..I lho.-.e
1. l..n«ina t..lh. bran, hi i. «ri.ui.. -u. h a* I... mux, I. , „f the lympamim. |s-.l..l. . pha. v .. v and larvnv. w ill U- .1, m ril»-.l
in.l fiK.."-d in ...nm.ti..n with ih. -. «.o.is L. whi, h .li.v U L.ntf. but f.r ;h.- ~..k. -t • .......l.ten. .- .l..v w.ll
(, i„. l„.l,.l i-t th. .l.-.t....l....i .h.U foll..«^ In .he.la«-if...,li...iof Ih. lu-. I. « .-f .a.:. r""M' H"- in.bM.hial nirvt-
^•ipf.ty may i<.»m ihr ...i»is.
m
I j 1 1.
THE MUSCI.KS OF THI. Xl'PKR KXTRF.MTTY.
18 =
I. MvOMKUic- Musci r.s.
(„) The oculomou.r mu^v K ,: .rtwA.r /.„//-..V,f s„<>eri„ris. rntu, u.fcrior, rectus mnl,„lis. rn lus n,,,rior. .,,,,1 ohliquu.
inleriitr.
(b) The troililciris musi lis; ohliquus sut^rriur,
(() The alKhiirn.-. muscles: rrciiia liilcr.ila
(d) The hy|Kigli)ssus musiles. frHWc'"""'- hy^l-"^"^, slyhqlossiis. and liiixu.di':.
2. likANCMIOV.KKIC M I'SCl.IiS.
{,•) The trigeminus museles: m„.wfrr, lcmpor,:li>, phryaoidn,^ ,x„r„us. !,lrryx„i.l,;..<: Uuenv,^. myhl „■ ' . >. .' ■
Iricus (anterior Ik'IIvI, Innnr p.ihi'.i, an<l Ifiisor lymp.ini. ^
(h) The facialis museUs: \iylohy,>idf,i^. dig.islnnis (i»,sUTi..r lu llv\ >.l„pnl,i,-<, t.l.ilysni.i, ,pi,ra:u. < ,„. ;.•■
auricular, i.alpeliral, iiral, and nasal nnisclis as classilud alii.c.
(c) The vagc-accessorius muscles: „yl.'pl,.,rv„nn.^. /--v/mr v,li p.ilalm.e. mus.: ,r.:,l,<: p.,l.„.n:l„.su-. ;w/„/,./,/,„rv»-
geus, constriclori-s pharynsn, the larNriReul nius( les. trapezius, an.l sl,rm,deid„m„slo,dni^.-\:D\
THE MUSCLES OF THE UPPER EXTREMITY.
The muscles of the ujiiar ixlrtiiiily arc comixistd of four cliiif ,i;rouiis;
I. The muscles of the shoulder, /. -., nuisdcs which ari^' from the .shoultkr-^irdk',
pass throui,'h the refjion of the slioulder. an<l are inserted into the si<eleton of the free ui)per
extremity in the viiinity of the -lioulder joint. Tliis ,c;roui. inihides tiie ,l< !loii!nis, the si<l>r,i-
spinalHS, the injrnspiiuitus, the tma minor, ilie siiku.i pulnris, and llir i.ns worn.
II. The muscles of the upper arm, ;. <■., nni-iU- tlie ,i,'reater j-ortion of wiii. h ;ire Miuaii-d
in the upijer arm. 'I'his .'.^roup is subdivided into: i i ' Tlu' miisvl.'s of the llexor ~urt:e,e: u)
the muscles of the extensor surhK e.
('.rou]) II, I, is ■■onij.Msrd of liie hi<--h: br,i,l:it. tile lonimhr.n In.ilis. and ih. hra,hi<ili^:
grou]) II, 2, is forme<l l>y die Iri,, ps hrmliii coul 'lie •iiKdiini^':.
III. The muscles of the firearm, ;. <■., liio-e of wliiih the .i^reater iioriion- -re -iiu.iud
in the forearm. .\c cord in;; !(■ their arranu'ennnl .md jiosilion iluy irc' cuiii-OMci oi tliro suh
divisions: (i) tlie miisele^ of :he Ik \or surlac'; I -'• the niustic- of ih.' radi.d H'ir; (?; ihi'
museks of die (Aiiiisor suu.m.
The nii;.-.k- .d' llu ik \or Mirfaee are arranged in t"o l.iyers. Tlu- sninrluial iner i
foriiitd iiy tlie pronator /.t. v, ih, p.ilmoris loii,Ktis, llu /. vor .nrpi niili<ili\ ilie ,A ^or .lii^iionim
siihl::ni>, and llir y/'.vo;- ,,irpi uhutris. The dee]. la\cr I- .omiioscd of th'- jU\or ,li:'Horiiin pro
jitni/-'i, tlu ;l(.\i'r poll.ii-. loiii^ii^. and the pronalor ,ji<.,idriUu^.
The 'adial '.rroir. (on-i>ts of llir br,u liiora'li.ili^, tlu i xU nu-r lorl'i raili.il:^ l,nr^i<\ and
ihe I vtiii^oi- iiirpi roiliiil:^ hri'!'^.
In tlie iniisi le> nf llu ext.ii- r ;,roui) tin ■.iipinotor luiM- a soec i.d posiliiM.. The remaii>
ill!,' nr:sii.-saiv ,n,ni>osed, of ihr... -uLdiv i^.m-. on A -.uperli. i.d lavrr, form, d 1,\ ilu rMnisor
,lii^ilon<iii noMiiiiin;^, li,. - \/.;/ ,'r /.•■'<//.' I proprins, an-! 'Ju- ' <!■ ii'^or <.irpi iiliiorls. i /o a .h-ej.
ot,ii,|u- l;p^ I. io :,i.il .y iIm- ■I'.iu ' ly /»■'", .■. ' '".c»v and the r\:', i:--or p:'lli,h hr^ . i ■
del |)
s!rai:.;ht lav. r, .oinpu^ed of llu . ylnt^r.r polli, .^ lon'^^iis and tlu- . \l< in.'r iiidois propriu-
W . The musc'es of the hnvA, i. -., iho-i wliiih . ^'l nd h. iwim \<i\<-\- "i t!u -ki l. H'li "i
i'le IviP.d. The-. -vji-.ele- are su':di\ide.' it'.o tiin «■ inoiip:-: (il The niusele> < I tlu- thenar
m^i^
*^*J«Bfel^ii*i*«$ '
iZLJf'
jj,6 ATLAS AND TEXTBOOK OF HUMAN .\NATOMY.
F:r .68 ^Thc n^usdcs „f the p...orior surfac of ,he left sc.pula an.l .he neighboring portion of the
TZ^^^:'::^:T::t':::;::^i^^:oi the .ft ..^.a a„.l tl. ne.h,.oring ^.tion of .he
vt 1 11:1;
2 ■
11
M .ho muscles of th. hviK.ihcnar eminence; and (3) the lumbricales (four)
(four) and the inhrossci volarcs (ihrerV
THE MUSCLES OF THE SHOULDER.
Th . deltoideus Jmrs. -(,8 and .70) is a thick, triangular, markedly c.rvcd muscle .hich
wmmmmmm
tascia (sLc iM^i -"/I. > muscle rau d v diniuushis in si/.e as
uiiiuT siirfice "t lit inseiiion is mn-cular, inc m^h '^ '
ui)l)tr sur!ai.(. ui siibd. I„, bursa (Im-. 26h;.
th.. fascia of which partlv cvers ,.. under surface, and ,hc in ,r ,„. .r
Uk. ,rape.iu>. It. .nser,io„ i. emhrace-l by the orig.n of the brach.ali>.
Th. supraspinatus .Kig. .oS, is a triangular, moderately -7^;-;;';;;;: \f tr'!:
;:;r;:-:zr!zr::;r;;;r:rn^^^^^
Acromio-clavi
rulur tig.
DeltoUU'its >
Subdeltoid hiir.^ii
I cvinor sritniiltic
h'/ii'.">l:iniic:is minor <
fh'li'-ii'!- ■
l(/i,^in-ii>idi-i:, I'Kijor
Pectcriilii, major
<iiM':vi:!S
Conuoid /irii'YS--
i'litjni'i.i ii:iiiiif
'•■■•^.-/isnlis
Srrratn
ant. \
llhvns ■7ri,.-; itvd)
t.
m
4
4«<
I
I
I :.l
;:| fcr
thp: Mt'sri.r.s of tiik. snori.DKR. i.Sy
immcrliiitc'Iv ht-ncath the skin in liu' scajmlar region (sic pa.m' 14(1). Tlu' mus( k- arises from tlu'
entire surface of tlie infrasjnnatus fossa and from the markedly a])()neiirolic enveloi)in,i; infrasjiin-
atus fascia. The fibers are jiraetically hori/onlal, and as they loineri^e loward tlie insertion
fre(|uently form a kind of intermediate tendon. Tlie terminal tendon is a llat stroni; tt'ndon,
and, like that of the sui)ra.spinatus, is adherent to the articular cajisule of the shouliler joint; it
is inserted into the middle facet of the greater tubenle of the humerus.
Tin- .suiinis|iitialiis :iii>l the infr.ispin.nus .in' suppliiil hy llu- .~ii|ir,i-.i apiil.ir iutm. 'I'h. v r.it.iir llir arm ..itw.ird
(baikuaril).
The teres minor is an elongated (|uadrangu]ar nniscK-, situated immediately below the
infraspinatus, to which it is more or less adherent. It is covered by the inlras]iinatus fascia,
from which it takes a ])artial origin, and in its outer third ii is also covered by the ileltoideus.
It arises from the lower ])art of" the infrasiiinatus fossa and from tin' middle portion of the
a.xillary lx)rder of the scajmla. The tendon of the muscle is but slightly narrowed and is inserte<l
into the lowermost facet of the greater tubercle, being, like the tendons of the i)receding muscles,
also adherent to the articular ca])sule of the shoulder joint.
Till- tiTi's niinnr is .'.iipiilird l>y iIk- axillary (i irmnillc* ) nirvi- an. I i, an ■•Mirnal Mlatnr liki- ill.' '.ui.ra?|.iTialii-i and
ihc infraspinaui^.
The teres major (Figs. 268 and ^(k)) is stronger and longer than the teres minor. Its
origin is covereil by the latissimus, luing situated between this musde and the teres minor, and
it lies along the axillary Ixirder of the scapula somewhat nearer tr the dorsal surface. It arises
from the dorsal surface of the lower third of the axillary border of the sca]>ida, ixtending iloun
ward as far as the inferior angle, and, (Tossing the long Inad of the triceps, it terniinatis in a
broad thick tendon which is situated in front of that of the latissinuis and i^ inserted with it into
the entire length of the lesser tubercular ridge (sec jiage 1.401.
Iktween the teres major and minor then' is a Iriangidar a])erlure whiih is sulxlivided by
the long head of the triceps into an inner triangular and an outer (|uadrangular space. The
triangular sjiace gives jiassage to the lircimillix scapular artery, while the (|uadrangidar space
transmits the axillary nerve and the i)osterior lirmmllex arter\ of the humerus.
Tin- Iin^ Tiiajnr i- ^upplird liy lllf .--uIim aprllar ihtv.".. ll i^ an inlirnd rntalMr of ilu arm, a^-i^liiiK tin- lali-.-imiis.
'l"he subscapularis iFig. 2(h)) is a broad, llat, triangular nniMle whi. h completely lilb the
subscap'dar fossa. The nnisilc with its fast ia i^ in (ontatt with the serralus anterior b\ its
entire w.Mih, with the origin of the ^hort head of the biceps an<l the lorat obrachialis by its inser-
tion, and with the teri's major and the origin of the long heacl of the triteps by its lower l)order.
The upper border of the nniscle is adjacent to the origin n\ the onioliMiid.
It arises from the subscapular fossa an<i from the nuisndar line> ihiri'on. Its f;(sriiuli
converge to a numlHT of intermuscular sepia, and the stri>ng broad t ■Md"n o( ins( riion pa--Ms
over the anterior surface of the artiiiilar (a])sule of the shoulder joiiii, lo uhi(li ii is lirndy
adheren', and is attached to the lesser tulKrile of the hunttrus and lo the mighltoring portion
of the Icssi r tubtreular ridge.
< <l
0'
I
..-.Mf-
■\m
n I
1 88
ATLAS AND TKXT-BOOK OF HUMAN ANATOMY.
Fig. 270.— The deltoid and muscles of the upper arm seen from the side.
Fic. 271.— The muscles of the upper arm seen from the side and from liehind.
Tin- iiart i.| \hv ;intih™ hial f.is. iu whirh lov.rs the an<i>ncus has lifin rfmovt-ii and thi- ouUr h.ad of Uu- Iriiciw
has lirin stviri-d and turned aside in either direilinn.
Flc. 272.— The muscles of the flexor surface of the up[)er arm, superficial layer.
The deltoid has Uen removed.
Fu;. 273.— The muscles of the tle.xor surface of the upper arm, deep layer.
The deltoid and hiieps have l)een removed.
Immediately below the coracoid jiroccss, and on the under surface of the suhscapularis
near its insertion, ihere is a constant bursa which is a diverticuhim of the synovial membrane of
the shoulder- joii- and is known as the suhscapiilnr bursa (see page 121).
e suhseapularis i- sui-plied l.y the subscaimlar nerves from the brachial plexus. It is an internal rotatornf
The sul)scai
the arm.
THE MUSCLES OF THE UPPER ARM.
THE MUSCLES OF THE FLEXOR SURFACE.
Ujion either side of the lower \wn\on oi the arm there is a distinct intermuscular srplurt
(Figs. 270 to 27,^) Vtween the mus( ' s of the llexor and tho.se of the extensor surface. The
internal intvrmusnitar st jilum is the stronoer of the two and ends ; • the internal ei)icondyle,
the external intermuscular septum is weaker antl extends downward as far as the external epicon-
dvle. These -ejna give oiit^in to muscles of boiii groujis, the external seiitum fumisiiing attach-
ment also foi lie radial tiruup.
'\'hv biceps iFigs. 272 and 27;,! is a lonij, larj,'e, si)indle shaped muscle which is situated
immedialelv l)eneath tiie brachial fast ia in (he anterior braihial and cubital re:.iioiis, and ari.ses
hy two distinct heads, the loni; head and the siiorl head. The long head arises from liie sujiragle-
noi.lal tulRTosiiv of llie s, ajmla by means <>l a loiiir «ylindri.al tendon, whi. li jiasses through
the cavitv of the siioidd.r joint isec page 121 1 and thrniigii the inttTtubercular groow, Ining
enviloi)ed in llie latter siui.-njon by the inlerliil" niilar muioiis sludtli 1 F ig. 27.O. 'I"he irndon
of liie short head is -horl. ilai, and adherent !<> that <d" ihc , oracobradiialis; it (oines from the
coracoiil jinKiss of tile scapul.i.
Kaili hea.i of the bitcps forms a ( vlindrical miisctdar ixHv iihe sji,,,-! iicn! ainK-t i.i;medi
alely afur its oiigini and tiie Iw" Ixilirs may remain sepiiaied for <|uilc a di-lame. t' ''Mgli in
immediale (onUict will) one another, lait always unite alH.ve the ell)ow joint (n.ver before uath-
ing the niiildle of the arm 1 to form a single muscle. The widest part of this muscle is at the
middle of ihe arm; and m either side of il a disiiiul gr(M,\e may be recogni/.ed, t!ie iiiirrnal
and external lueipilal i^roon^. .\s ii passes downward, ihe mus<ie becomes narrower, and in
the region of the ellxiw joint il passes into a lendoii of inst rtion whith i.msists (f two ]K.rlion-,
I .1., .- . I...- 1 .. ii,;.. .,i,,,.kI",, ; i1 i.i>rti,.ii l.niiun tis lUi' liKirliis iiliriiMis iFiu-.
a >'i.-ep, il.:i . -t:--:-^ n:;M--Ti ^i-jm,. •■■.•• -■;« ;
2-2, 2"^ 27,}, a .d 2()i ). I'lie latttr i> (i)m)K).sed of superiiiial nidiating lil)t rs from the lendfii
Trapezius
.'i Hxlernal
epiconriyle
(ilfrran?n
Outer
head ■
t.xtfrniti intrr-
Braehioraiiiiilis
ixten^or carpi
radtalis loriffus
I xtermil
e/iirondyle
t.xtinscr turpi
rudialis hrei'is
t.
Fig. 270.
nf>. 271.
Oniohyoideus x
Coracoid
process.
Internal
intermuscular
septum
%
Lmfrtiis V*'
/ihrostts
Antibrachiat
fascia
Deltoideus
Supra-
spinatus
Coracobrachialis
Tendon of long
head of bleeps
ifiursa of Idtisslmus
Tendon of latissimus
Tendon of
xioralls major
Coraco-
brachialls
htleriiid
inif-niiseular
septum
Internal
epieondyle
lendon if bleeps
braehii
Coracoctavi-
'r-"^ ndarltg.
Coraco-acro-
mleil llg-
Intertnhereutar
miieons sheath
lenUin of hice:)S
(lonii lieod)
Tendon of
■torahs major
oni; head
of biceps ■
I aeerlns
llieipilii-radlal
tnirsti
I eiidon
bleeps
fig. 272.
H^. 271.
F II
i. I:=
i^
THE miSCI.KS OF THT-. TU'PKR ARM.
iS()
i i
of the biceps, which pass obliquely across the antecubital fossa toward the ulnar suU uvl
fade away n \hv antibrachial fascia covering the supertkial llexors ol the lorearm.
mi tendon of the biceps .uscle passes deep down bc^een the .lexo^and U,e r. uU
croups of muscles an<l inserts into the tuberosity of the rad.us (P,,s. .7,^ -".1 ,0. lUt u n
r til of insertion and the radius there is place.l a bursa, the l>,at>.>or,ui.al bursa ,!•,«.
,vith .h.- su,.inu,or bn-vis). an.l iP..r.as,.s ihc- .cn.,,., o, .lu- :uu,l,r., h , 1 f.,- A h,„l
i. ,,rc.s.nt in ran- instanus; i. aris.-s from .ho hun.-n,. u, , ..n,m.,n w,.H .„ hr,„ h.,.,,.
The coracobrachialis (Fis. 273) is a Ion, and rather Hat muscle, which i. placed alon.si.l..
of th short head of the biceps and is almost entirely conceale.l by th,s structure. 1 > >lor
tencU n f origin, arisin, from the tip of the coracoid process, is adherent to jh. short head o
TZ.,s an^ overs ^e insertion of the subscapularis and the ten on> o, the la„sMmus an.
te re n ajor shortlv before their insertion. It is inserted into th. antenor and m ernal
uHaces ,f the humerus at about its mi.Uile, below the lesser tubercu ar rul.e, and m he
internal intermuscular septum. The muscle possesses a Ion, slit wh.ch g.ves passage to the
musculocutanious nerve.
Tin- . ora. ol,ra< hi.ilisi> Miiiplio'l ''X tlu- musi ul.KUlam-.ms n.TW,
II cl^'vati's tin- upiKT arm. as>islinK the ck-llimlius.
The brachialis (Fi,s. 273 to 27?) is a stron,, broad, rather Hat, elongated muscle, almost
cntirelv concealed bv .he biceps, whi, h is situate.l in the lower two th.rds o, the tlexor surlace
of the' arm. It arises from the antero-internal surface ot .e humerus, somewhat abo... the
middle of the b<,ne and, embracing the insertion of the -leltoid, take. on,u, al., Irom the an ero-
internal and antero-ex.ernal surfaces of the lower portion . f the .halt o, the hun,eru. and f n
he internal and external intermuscular septa, the origin from .he .nternahn.ernu>scular scp urn
extending .lownward aln.ost to the internal condyle. The amerior surfac. o the nu.cle .
distinctlv hollowed to accommodate the overlyin, bice,,s, and m .Ije lower ,.ornon of .he .rn
app..ars ,0 either .ide of .ha. muscle. ( )n .he ou.er side i. is in rela.-on wuh .he ou.er head of
he triceps and with .he brachiora.iialis; on .he intter side, it isespecially d.s.u.ct and ,s „, relat.on
with the inner head of .he triceps. 1. is inserted into the tulxTosity o, .he- ulna by mean, of a
strong .en<lon which is especially well d.velope.l upon the anter.or surface ot the muse e. 1.
iLnion is concealed by .lie .endon of .he biceps and also by the superhc.al ilexors of the forearm
arising from the internal condyle.
Tlu- l,ra,!uaUs is supplicl by ,he musculoru.an.ou. nor^•>. and usually also by tbc ra.lial. It i, a pure flow of .Ik-
forearm.
THE MUSCLES OF THE EXTENSOR St^FACE.
The triceps (Figs. 268 and 270 .0 27.^) is a larg.. elonu I muscl, wl
hich ]iossesses .liree
hcad^ T^^h,>:-hr-u! 'anamrus h'K^us) (Figs. 268 and 27. .0 27.^) is a somewhat roun.lal
muscle which arises bv a short tendon from .he infraglenoi.lal tuberosi.v of he ^_';M'ula. It
passes iK'lween the teres major and minor, that is to .say, in fron. of .he lere. mn.or an-l beh.nd the
IQO
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
■'I
teres major (sec page 187), and becomes aponeurotic u])on its inner surface. It is frequently
connected with the latissimus dorsi by a tendinous slip.
The oulcr head (anconeus lateralis) (Figs. 270 and 271) arises from the iMistero-external
surfac I 01" the humerus, commencing immediately below the greater tubercle, and from the upper
half c ■ the upper two-th-'nls of the external intermuscular sejitum. The origin of this outer
head is librou^ above but fleshy below; its libers run downward and inward to the common
tendon of the tricejjs.
The inner head (anconeus medial is) (Figs. 271 to 2;;,) arises more deeply than the outer one,
and its fibers are shorter and extend further downward; a:, a rule, however, it is not as strong
as the outer head. It arises fro.ii the entire length of the internal intermuscular s'jptum, opposite
to the brachialis and i)artly covered by the biceps, from the posterior surface of the humerus
below the groove fo • radial nerve, and from th. i-xternal intermuscular septum as low down
as the external epicondy le. The j)ortion of it which jomes from the internal intermuscular septum
and which is not concealed by the biceps, lies immediately beneath the brachial fascia, as does
also that portion arising from the external intermuscular septum, which is not covered by the outer
head. A large i«rt of the inner liead is concealed by the outer one, and between the origins of
the inner and outer heads the radial nerve runs in its groove.
The fibers of the inner and outer heads unite with those of the long head and pass into the
common extensor tendon, which commences upon the j)osterior surface of the muscle at about
the middle of the arm and is inserted chicly into the olecranon pr. ,ess of the ulna. The insertion
not only completely surrounds the olecranon, but also radiates to the ulna and the a..tibrachial
fascia.
The triceps occu])ies the entire extensor surface of 'he arm l)etueen the intermuscular >epta,
and is conse(|uently situated in the po.stenxAternal and [)ostero-internal irachia' regions. The
relations of the long head have already been described (-ee page 1871. The inner head is in
relation with the brachialis at the internal intermuscular septum, and at the internal epicondyle
its fil)ers are C(mtinued directly into the anconeus; the outer head, at the external intermuscular
septum, is in relation successixely with the brachialis, the brachioradialis, and sometimes also
with the extensor carpi radiali^ longus.
Till- triccp- i^ v(i|i|,li,.,l l.y the ni<iial lurvi-. Il i-\ti'nil- ihr f"rcarm.
I'rom a functional and toj^ographic standpoint the triceps is associated with the anconeus
(anconeus quarlus) (Figs. 271, 278, and 2S0), which is situated in the up])er jjar' of the forearm,
and is a llat triangular muscle lying l-mcath but not adherent to l\w antibrachial fascia. The
lower angle of the muscle is jjlaced tx'tween the tleXi)r carjii ulnaris and the suinrlicial grouj) of
extensors. It arises 1 , ■> -hort tendon from the external epicondyle, passes over the articular
capsule of the ellK)w joint, to uhii h il is adherent, and is inserted into the upper portion of the
posterior surface of the ulna immediately below the olecranon. The ujjjjcr libers of the muscle
are usually directly continuous with the lower ])onion of the inner head of the trice
Tlu' ancum-iis has a funiticm ami innervation Mniilar to that of the Iric'ii^, an. I in ad.lilion it m. rcasi-s the tension
■it the artirular eapsnle .if the ell),)w-ioint. Th.n- is f,r,|„enlly a small rnnsrular fas, i, iilus passing between the internal
epicondyle and the olecranon over the iiln.ir nerve; il i- known as the epilroihlco-aiiconcus.
THK MUSCLES OH TlIK FOREARM.
191
!i
THE MUSCLES OF THE FOREARM.
THE MUSCLES OF THE FLEXOR SURFACE
THE SUPERFICIAL LAYER.
The superficial layer of the flexor firoup (FiK- 274) consists of a muscle complex which
arises by a common tendon from the internal e])iconflyle. All of the muscles of this grouj) with
the exception of the jjronator teres pas.; beyond the wrist joint and become tendinous at a varying
distance alxne this articulation, and they occupy the ulnar side of the volar surface of
the forearm. In the u per portion of the forearm they are all adherent to the antibrachial
fascia, with the excejition of the Ikxor digitorum sublimis, and conceal the insertii)n of
the brachialis. They are sepii- itid from the radial grou]) of muscles by a deep groove
through which the tendon of tht .lu ^ passes to its insertion (see page 188), and in contrail
to the muscles of the dei 'n.r tlu y ;n :>e cli 'ly in the upper arm and, with the e.xce-plion of the
ilations.
he (' termost of the grou]), is an elongated quad-
rhe hmmral head is the stronger and comes from
u nor head x-. more deei)ly ])laced, coming from the
Ihen he tendon of the brachialis. The
'lan lUTM.
ions of the bice])s and su])in:' ■ and ])asses
ariace of the radius, \>here - attached to
! \'<)
pronator teres, consequ tly |)ass 1
The pronator teics (Figs. 2; , and
rai gular muscle which arises by tw.- b.i ad
the common tendon of origii^; the ni-..
ct)ronoid pnKess of the ulna, and is la-tp
s])ace between the two hea is gU'es passa;.
The Ix'Uy of the i)r')nator tea- covei
below the latter musile to the middle of i.
the bone by a short tendon (Fig. 2S0).
This musi If. liki' tlu- majority of \\u- -luuii, i- -uinii:
the foaarni, and it lan also assi-t ih.- brai hiahs in ll.-' ■ H"
Usually gives a |Mrii;,l origin lo the tmisiU'.
The flexor carpi radialis irmlialis im mi,
the distal half of which is ien<linoas. It is tlie
radial to the ulnar side, and arises like il-. fell"
anliljrachial fascia. In the middle of the forearm
a special .-heath (see ])age 205) benealli the trans\
multangulum majus to the lia-e of the .second, and son
ih.
~uii|ilii'(l by llu' nu'clian lurvr. T.igillur with ti;
ill cMensi'-s il i.iu-i'S r.iiiial llr^imi i radial aluh
The mil-.. 1
it ails with the i.-
The palmaris longus (Fig. 274) is the -mallest :i
layer, and is w.ak, freipiently absent, and tendinou-
origin is adherent to those of its neighbors and is from
fascia. The long tendon becomes markedly flatten* <!
situated immediately beneath the fascia; it pa.sses o
it is partly adherent, and radiates into the i)almar ai
This m
usili- ail- ihiilly as a tensor of the |..ilmar and .)( the .mliiira.
tn.di.in mrve. \- indirateil liy its name, it pronatrs
,, int. Il a >uiiraiundyloi(l proeess W present, it
Spindle-shaped muscle,
group pas.^ing from the
' lend'm an'! from the
. vhich pa.s-i - through
the gi'^ve n! the
iird nulai ,;r])al bone.
'-oduiis vol \ion ; \\hen
,il muscl. of 'he enlire
f il- t o! rsc. Its
he aniil)r:n hial
10 rearm (I is
:;;,riienl, to uhich
lan al>o assist in
pleolii
li. ■■■r {hv
le trai - erse i .
urosis (se ]iagi
flexing the forearm. It is -upi'lied liy the median nerve.
192
ATI.AS AND TEXT HOOK OF IIIMAN .\NATOMY.
Fi(.. 274. —The superficial layer of the museles of the llexor -urface o the ' Airm together with the
liraehioradialis, seen from in fnirit.
Flc. 275.— The superficial liver of the tnu-cies of the llex<ir surface of the forearm after removal of the
palmaris loi'igus and the tlexor carpi railialis, seen from in 'Vont and >iightly from
the radial side.
Thi- hrachiurailiulis is drawn oulwuril to show the su|iinalur ami llif insertion of tin- len.,.m of the tjicrps.
lUl
m--
The flexor digitorum sublimis 1 Im^s. 274 to 276) is tonceakd at its oriirin by the ],alm;tris
longusand the tk'xor cari.i radialis, and ihc greater portion of its ulnar lx)i(kT is c'()'erj(i by the
flexor caq)i ulnaris. The main origin of the muscle, the humeral head, forms the deei)est ])ortion
of the common tendon arising from the internal e])icon(lyle, while the second heat, he radial
head, arises by a llat ti idon from the volar surface an<l Ixirder of the radius below the in.sertion
of the supinator. The two heads ate connected by a tendinous arch beneath which jiasse.- uie
median nerve, and unite to form a broad and strong muscular belly which is usually com '-*o
of two distinct portions, a superficial and a decj). The deep ])orli()n receives t'-r oblicpie • ' ci-,
from the radius and soon gives olT the tendons forthc index and little fingers, \vl, 'le ten(i;>n: 1 <r
the middle and ring fingers proceed from the sujierf 1 jiortion. The four lendons, which
frequently do not become independent until near the wrist-joint, run through a synovial sheath
together with the tendons of the deep tkxor and i)ass beneath the transverse carjjal ligament
to the middle ])halanges of the second to the fifth lingers (see page 203).
Thr ill \cir iliKiloruni svililin;!
{our lin^iT-..
i- ("cilusiviiy sup|ilir(l l.y tlic nii'ili.m ncrvr. It lUvvrs tin- miciillc [ihalanm ■; of tlir
The flexor carpi ulnaris mhiaris iiilcruii.s] (Fiixs. 274 and 276) is the innermost and the
most ])Osterior muscle of the group. Its jxisterior border is in relation with the an(Oneus and
the su])erlicial extensors, being sejuirated from the latter by the dorsal border of the ulna. In
addition to a humiral head liie muscle also posses- s an ulnar head from the anterior ..rface
of the olecranon, the ulnar nerve ]MSsing between the two heads. .\n additional origin is
furnished by the a itibracliial fascia, which is adherent to the ujijier two-thirds of the ulnar
border of the muscle and in means of which the muscle arises from the volar Ijorder of the ulna.
The muscle is distinctly semipenniform in structure, since a tendon is formed in its inner Ijorder
at the middle of the forearm, into which muscular fibers radiate almost as far down as the
wrist joint. This tendon is inserted into the ])isiform IxJiie and the insertion is thence jirolonged
to the metacar])us by the ligaments of the |)isiform bone (see ])age 125).
The miisrlr i- >iiii;'lii<l liy thi ulnar ncrvi. Wlirn a< lin^ with the llexor carpi ratliali- it ctTcils volar flexion,
togclhrr with the cNtmsor < arpi ulnaris it prmluii'^ vilnar flexion.
THE DEEP LAYER.
The deep layer of the muscles of the tlexor surface -insists of the two dee]) flexors of the
diL'its and of the pronator ouadratus. It is almost entirely concealed by ilie suiierticiid hiver.
The flexor digitorum profundus (Figs. 273 and 277) is a broad, strong, thick muscle
which arises from the volar surface of the ulna from the coionoid process to ti.e junction of the
iceps (inner head)
Initrnal
intermiiscu-
hir septum
Intenidl epirondyle ...!j
Olecranon
scla
laidon pf
bittps
Pivihiror l^res
l.ii rrtiis
nbro^i":
Interna I
ipicoi'dyle
fnlrnan^
iXi:
lirnchio-
rodi'iiUi
f'xtrnsor carpi
(idiiii'is lonf^is
firffiHi of biap.
Hinptio-riiJiiil
blirs/l
l-f^M
ri.vnr mr}\
iilniins
l(adius
t'texor digito--
ntm sublimis
Fig. 274.
Flexor pollicis
longus
Tendon of
brachioradialis
Pronator
i/uadratus
I
lendon of '■' f
palmaris lo.,gust
■ Flexor digitorum
pro/undu.-<
Flexor pollicis
longits
Radin<.
Abductor pollicis
longus
Tendon of hrnrliio-
radialis
f'rotiiitor
i qiiailralii-.
lendon of flexor
carpi radialis
A
s. ,
Fig. 275.
flOi
I
ih
fU
I
m
iii
i^Bji
THE MUSCLICS OF THE lOREAP"
193
Internal cpimndylc '
Humeral head tij flexor sublimis
dif^itorum
hlexxr curl" iilnari
Vliuir hr.id nj pmnnl'tr lere% X
Tendon oj lorcp-: X
SiipiniUor
lirncliior.idiolis
K.idiol hind oj fhwir suhlimis
dif^ilorum
!■!• .\,'r f'oUiii^ loneus
I
. ,. ,, ; ...li .ii_ .)„ n:ilni.iri- l..lli!U«. .Itlcl 111' l'l"I l'"r
FlO. J7fi.— 'Ihi lii'ior suiiiiim^ ilinii'uuni .ill. ; 1. ;r..-.vr.: t^ tnt .r t :•• ■■
13
1W\
194
ATLAS AND TKXT-BOOK OF HUMAN ANATOMY.
Flc. 277. — The deep Kiyer of the muscles of the llexor surface of the forearm after removal of the
suj)erticial layer, seen from in front.
Fli;. 278,— The muscles of the forearm seen from the radial side.
rniddle and lower thirds of the Ixme, and fiom the adjacent jxirtion of the interosseous membrane.
1 r parallel tendons are soon jjiven off, the one situated nearest to the radial side coming from
a separate muscular belly composed of the libers proceeding from the interosseous membrane.
These tendons run in the sanu synovial sheath as do those of the tlexor sublimis and i)ass Ivneath
the trans\er:e carpal ligament (the anterior annular ligament) to terminate upon the ungual
phalanges of the second to the fifth lingers (see l)age 205).
Thr ulrvir h.ilf of till- mu^ili- i> .sujii>lii'(l In iln- ulnar niTvi-, the radial li.ilf )iy iho median nrrvc. It ttvxvs llu-
li-rminal plialaiiK^s .if tlii four Iuikits.
The flexor pollicis longus (Figs. 275 to 277) is a spindli shajied muscle placed imme-
diatelv alongside of the ilcxor digilorum profundis; it is penniform above and semipenniform
Ixlo" . It ariMs from ihc volar surface of the radius between tl'.e ins.rlion of the supinator
and the upper border of the pronator (luadratus. It also usually receives a >lender fasciculus,
fre(|uentlv a]>onein'otii , from the coronoid process and from the internal condyle; this origin,
howev( ', whi( h. is known a> tin- Itlinuriil luail. does not come direcllx Horn the boiv but from the
muscul mass of the superlnial tiexors. Tlu nuiscle bi'comi's tendinous almo,~l imnudialely
Ix'low i;- origin, the upjier portion receixing the muscular libers from either ^idi'. the lower portion
from ilie radial ^ide only, and the tendon run> in il-- own tendon -<heatli iMiicaih the lrans\-erse
carjial liganienl and pa-M's between tin- two heads of the llc\or pollicis bri\i> to the ungual
])halanx of the thumb.
Ihr
'1 In- ihr nu-dian rn'r\r. h tlrxt^ tin' trr!iiinal |'liaian\ of thi ihurut'
The pronator quadratus .(■'igs. 277 aid 2S11 i> :i ll.-it (juadrilateral niu-rle wliidi i- con-
cealed b\ all ill, t. iidon^ id' the lliAor mu>i Ks and lie^ r.pon llie volar surfair^ id' bolh bone> o|
the forearm inward llu ir di-lal exlrrmitii^. It arises from llu volar border of llie ulna and
is inserted into llir volar sindai e ami Imrdt; of the radium, ImiIi ii> (uigiii and insertion being
Usual!;. b\ short ,i] • neuroses.
Till' niusi il i- -ii]i|iliid ii\ ih.' 11;. dijn lurvi
id pronali - ilii' foriarm.
i
THE RADIAL GROUP OF THE MUSCLES OF THE FOREARM.
'I"he ihrir musi II s of the radial group are jilaied at the radial -ide of the forearm and of
llir loner |Mirlion id llu' .11111 in llu' so (ailed r.nli.il teuinii. belvvetii liii (li Vuis ,uiil llu evteiisors.
The brai hioradialis belongs more to the llexor surfaic, but the other ivvo must les are upon the
extensor side of ihe fort arm, and vvhilt the supenk iai la\t rs of bolh tlexor and extenx r must les are
ii: ! lii-riiU li! ll'.i- fjisti.i of lilt' forearm, ihe extensor ■. art.! radialis lirevis is the oidv p.lusi le i>f the
radial group in vvhiih a similar nlalion obtains.
The brachioradialis iuipniiilor li'ii^^its) <Fig>. 270, 271, and 27 j to :->)) is a very long tlat
Palmaris longus
Pronator teres
(humeral head) +
Flexor carpi radialis
Ulnar head'
of pronator teres
Tendon of biceps '
Humeral head of -'
flexor longus polticis
Brachioradialis
Bicipito-radial bursa
Fendon of fit
carpi ii/nans
Tendons of flex. dig. suhlimn'^
I'ronatoi teres
liraihioradialis
Interosseous membrane
I'enu'on of bnicbii'tadinlis
u
\hducl0:
lendonofeu.-nsor pMcis lonpis
' earpi mdial. i"nnus FMcn.wr pnllicis
hrevis
fendon
I endon onlexor "/■ '>^trns. ,. .. , .
r.irni nidi il>y f"'r' '"«<'• '<^"g:- t>ars„f / rnrpom
mamh
1 Fxternal
epirondyle g
• Olecranon
I \tensor dig. V
propr.
1,1
l.ndi'U of extens.
<//(;. comm.
tendon of extensor
,/;tf. t' propr.
lei'.don of extens
I lit pi iilnaris
t iiiii
tendon of palmaris lonpus
lit; 277.
tindoii of extens.
carpi rnd. i>r
teniioit I
h/i:. 27H.
\len\ ;iidieis prorr
s
VZi
THK MT'SCI.KS OF THE FORF,AR^r.
K):
muscle which is in immediate relation in the forearm with the sui'orticial layer of the tlexor
surface (see jjai^e iQi)-
T arises fro:n the es.ernal intermuscular sei)tum of the uj.per arm, where it is in mimediate
relation with the outer portion of the brachialis on the one >ide an<l with the ouier head (or inner
head, see page i.,o) of the triceps on the other (Fi-s. J70 and -'71). The ori-in ends some
distance above the external epicondyle. In the forearm the brachiora.liaiis becomes somewhat
narrower, covers the supinator and the insertion of the pronator teres (Fi-s. 274 and 275), and,
in the middle of the forearm, terminates in a llat tendon which nms ovi r liie insertion of the
pronator <|u;>.iratus to be attached to the uii!>er end of the styloi.l proce-s of the radiu.,.
The radial nerve passes between the outer portion of llu brachialis and the braci.ioradiali-.
The musilris ^upi'lii'l I'v lli.' ra.li.il m-rvr. ll i> prarlically ., Iloxor ..f th,- fnr.arni, an.l tl.r n.inir, Mi|.inal..r
lonnus, foriiicrlv '- niic' i it, iW< net iDrrrilly state its fi'mti.>n.
T'.ie txtensor carpi radialis longus (riuli,i/is i:\iiriius loutiiis] (Fi>;-. 270, 271, and 278>
is a long llat muM le resemblin.i,' the brachinradialis. Ii arisen as a direct t dntinuation c die
origin of the latter muscle, from the lowr end of the exlern.il ml. rmuscular septum of llie upin r
arm and from the e\trrnal epicondyle opposite to tlie lowermost (lorlion of the inner head of lite
triceiis (Fig>. 270 and 271) (see page i<)0(, and terminates above llie middle of tin- fonarm in
a somewhat llatlened tendon. It lie-, immediately adjaicni m the brae nioradial,-. (iiiion its
ulnar md somewhat jjosteriorly 1, covers ihe vi.lar and iatirai Mirfaccs of tht- rathiis, pa-ses
heneai dor>al carjuil ligaiuent, ai; 1 insert- into the dorsal >urfaie of the base of the xtond
metacar]al i)oni- (see also ]iage 20\\.
The extensor carpi radialis brevis (nnliiilis rxirnins hnils) iFig-. 270. 271, and 278!
lies immediately bcMde the Immuu--. It ari^s jus: lulow the lall.r must Ir from the exit rnal
epicnndvie, the aiitibrachial laxia, and the articular tap ule of tin- .Ibnw joii,,; i( cMwr- .hr
lateial -iirlaie of tlie nidiiis and lieiomes tmiliinui- sonu v, ;al IuI.av ilir middle of llic lonant'.
The tlatteneil liiitlon is longer th n that of thf loiigil-, wiih whii h it passes beneath tin- dorsal
carpal ligament, and i- inserted into tlu- ba-c of llic third mdaiarp.d buni'.
Both I'Xtensdir- tarpi '-adiali- are stio]'lir(l b\ llu- r.idial tier\> . TdL'rd'.i r with the rxler-.>r
cari>i idnari> thev produtv dorsd llexion; and wilh ihr lit \or tarpi radi.ili- ihr> cited radial
(lexion (radial abduction). Their temlon- are ii-(i"td in ihr Inr.arm l.\ ih.- e\lin-or polli. 1-
bv(,\i.., and the abdu'lor pollit i- longu-. and tlu ir iiiserlion- are iio-ed by llu- I. ii<lon ol llu-
exu-iisor pollii is lon.Ms.
THE MUSCLES OF THE EXTENSOR SURFACE.
Willi lii( exifpli'in of llu- .si'pinalois, lilt- ixtinMii> ,ir. .-iuialtd to ihe ulnar >idc ot llu-
radi.d gKiup.
Tlu- supinator suipiuaUn- hi;-,-ist 1 Fi;:-. 275 lo 27- and 2S0! i- a llal iiuim K wlii. li (i:r\(-
1 , .1 _ ... ,_ :... . ; ll... »..,i;,,^ ..,,,1 ;. ;., i-..l.ii L.m « ii!i 1:1 mhv nf llu- niu-i Ics <il the liiri
arm. lis origin is concealed by ihe anion' Ms, its midtlle portion by the siipirii, lal e\t(-n--i>r-,
anil its anterior ivojari portion by ihe radial group and the pronator teres. The insertion ot the
196
ATLAS AND TEXT-BOOK "F HUM, X ANATOMY.
Fk;. 279. — Tlic suitcrlkial layer of muscles of the ..-xtensor surface of the forearm.
Fig. 2S0. — The (leej) laver of muscles of the e.\tensor surface of the forearm.
The superficial lavir i)f thi- <xu-nsi')rs has Ix-cn rcmovid, thr cavities of the <lor?al cariial ligamoni have been opened
and the tendons of t'.e superficial muscles removed.
muscle is in immediate relation with the insertion of the tendon of the biceps and with the bicipito-
radial bursa.
It arises from the e.xternal epicondylc of the humerus, from the radial lateral and annular
ligaments of the ellxnv- joint, and from the supinator rid{rp of the ulna. It is tendinous at its
orifiin and usually exhibits a su])crficial aponeurosis in the middle cf its course. Some of the
fibers run almost horizontally and some of them obliquely forward a .d downward, paFsing to
the upper, outer, and lower portion of the tuberosity of the radius and to the voiar surface and
border, the outer surface, the dorsal surface and Iwrder of the same bone. The fibers passing
to the volar tx)rder terminate immediately alxive the insertion of the pronator ( radii ) teres.
The muscle usually consists of a suiierficial and of a deep jiortion which are not sharjily
differentiated, and between the two portions the deep (])Osterior interosseous) branch of the radial
nerve passes.
The supinator is supplied hv the radial nerve. .\s its name indicates, it supinates the forearm.
THE SUPERFICIAL LAYER OF THE EXTENSORS.
This layer consists of three muscles, adherent to each, other at their origins, m lich are partly
in (ommon with the extensor carjii radiali^ brevis from the external epicondylc of the humerus
and the antibrachial fascia, and tliey terminate in tendons whii h are distin- 'ly directed toward
the ulnar side and pass beneath the dor.s;il carjial ligament to llu back ot hand. They are
situated in the dorsal region of the forearm, chietly upon the dorsal surface of the ulna (and upon
the supinator al)ovei, and are in relation externally with the extensor car])i radialis brevis, inter-
nallv wiih the anconeus and l)elow with ihi tlexor car])i ulnaris.
The extensor digitonim communis (Figs. 27S, sjc), and 2S()) is a l)road, flat, strong
muscle which arises from the external epiiondyle of the humerus and the antibrachial
fascia; it is intimately adherent to the extensor digili V and partly to the exten.sor carpi radialis
brevis. Somewhat beiow the middle of the foicarni it divides into three (or four) bellies
(Fig. 27()) which terminate in round tendor.s the ulnar one gives olT tendons for lK)th the ring
and little fingers when "uly three belliis arc iiresent. The tendons pass beneath the dorsal
caq)al ligament !<> the back of the hand (Fig. 2«()l, where those for the ulnar tuigers are
connected by slender transverse or olilitpie tendinous fascitiili. the iniirliira loidiiiiim. In the
fingers, these tendons form the main portion i>f the dorsal a])oneurosis.
The extensor digiti V proprius iFigs. 270 and 28()) is a thin slender musde which is so
closely connected with the extensor digitorum communis that it seems to Ix' a part of it. Its
slender tendon passes through a se!)arate compartment in the dorsal carjtal ligament to the
dorsal aponeurosis of the little finger (Fig. 281) and is sometimes double, taking the place oi the
tendon of the extensor communis to the little finger, whith may be poorly developed or even
absent 1 Fig. 28(>i.
Ute
Brachialis-
W
Radial lateral ligament-
Annular tigan- it
I m
Pronator teres x / K
Flexor carpi ulnaris
Abductor iiollicis long.—
Extensor potlicis brtvis
Temions of exten- .
sores carpi radial-
Extensor pollim'-^j^rr^r,! carpal iigcmr.
long.
Fig. 27Q
> Extensor dig. V
proprius
Extensor indicts pr
Win
^y Dorsal carpal
ligament x
,' Tendon ofextensoris carpi radial, brtvis
Tendon ofextensoris carpi radial- longi
Fig. 280.
npm
vm-m
TUl. MUSt:i.I.S OF THK FORKARM.
197
Roth muscles an- supplied from tin- r.,lial mrvr. Tlu-y .NUnd llu- luur ulnar linp-r. .sp,-, iaily ll'air ,,ruxi,ua-
phalanges
The extensor carpi ulnaris (iihuiris exlmius) (Fi.us. 270 and 28()) arisis t()<;ctlur with the
two other muscles of this Kroup from the external epieondyle of the hunieni>, and also from the
articular ca])sule of the elbow-joinl and (luite extensively from the antil.rarhial fascia, vvitli xvhu ii
the muscle is adherent for almost half of its emire lenRth. It is in relation above wuh the anco
neus and lower down ' separated from the llexor caq.i ulnaris l,y the dorsal bortler of the ulna.
It pas.ses over the dorsal .surface of the ulna, becomes tendinous in the lower third uf the forearm,
runs beneath the dor>al caq.al li-ament, and inserts into the base of the fifth nuta. ar,,al l)one.
Tlu- exu-usor , arpi ulnaris i. M,ppli,.l from th,- radial n, rv, . Win n a.li.,..,' vilh th- ,vu n^orr, , arpi ra.liaU- it
procUuc- dorsal llexion, anil loi-etluT witl, the ll. xor ,arpi ulnari- it , If. . K ulnar ll.xion (ulnar ahdmllonl.
THE DEEP OBLIQUE GROUP OF EXTENSORS
This layer is differentiated from the deep strai-ht i^roup by the fact that only the ori-in>
of the muscles comprising it are conceale.l by the superfuial extensors. The muscle^ b.rome
superficial below and cross the tendons of botli extensores can)i radiales in the lower third o\ tlie
forearm, l-ike the muscks of the deei) Hexor tirou]), they pass over only the wrist joint.
The abductor pollicis longus (ixlntsi>r o.ssis miUuarpi polluis) (Im^s. nyt), ->So. and 2K()i,
the outermost of the group, is a tlal strong muscle, the origin of which is comiiletely concealed liy
the .superficial group of extensors. It has a long pointe.l origin from the dorsal surface ol the
ulna and also arises from the interosseous membrane and from the tiorsal surtace ot the radiu^
below the insertion of the supinator. In the lower third of the forearm il t rosses, together with
the extensor pollicis brevis, the tendons of the extensores carpi nidiales at an acute angle a ,d
terminates in a tendon (or two tendons) which passes beneath I'.e dorsal carpal ligament lo be
inserted chietlv into the l)ase .d' the metacarpal bone of the thumi). Tendinous fibers usually
.idiate also to the greater multangular bone and to the abductor pollicis brevis (see i)age iqt)).
•n,.. „u,s, k i. .u,.pli>d iron, tl- radial .rerv. . Il a!,du,l. ll„- thun.l. and al- a-.i,., in th- , stcuMon ..f tlu. .I,«il
The extensor pollicis brevis (Figs. 270, 280, and 28QI is situated more t.. ihe ulnar side
and is bv far the weakest muscle of the group. It is a slender muscle, situated immediately
alongside!' of the abductor, and arises from the interosseous membrane and from the dorsal surface
.,; the radius. It crosses the ten.lons of the extensores carjii radiales and its slender tendon
passes through the same compartment as the abductor (Fig. 28()l and is in.serted into the dorsal
aponeurosis of the first phalanx of the thuml).
It i, ,u!)plicd Ir.un i!« radial mrvv. It .-M.nd. and ahdu.t. th.' tir.t phalanx ..f tlu ihinnh.
THE DEEP STRAIGHT GROUP OF F.XTENSORS.
The muscles of this group lie immediately to the ulnar side of the preceding, but they are
deeply placed in the forearm and are completely concealed l)v the sui)erlitial extensors.
Th. extensor pollicis longus (Figs. 27c), 280, and 28t,) is stronger than the brevi-. It
aris. ■ from the dorsal surface of ,he ulna and from the interosseous membrane and lorm- a
198 ATLAS AXn TEXT-BOOK OF HVMAN ANATOMY.
Fir.. 2S1.— Tcn(ions and musrlcs (intcrossei dorsales) of the (K)rsum f)f the hand.
The iliir^al <ar|);il ligament H rctainrc!, the rest of the dorsal fuseia tx-in}; n-movnl.
Vu,. 282. — The ))almar a|)o?ieurosis and the palmaris brevis.
The thenar am! hypothenar nniseles are shi>wn eovored !«• the fasiia.
long, slcndiT, muscular belly which ]iasscs (lo\vn\\ar(l to the wrisl-jtiint beside the extensor
(ligiiorum communis. Just before reachinjj; the wrist it terminates in a tendon which passes
throuj^h a S]>ecial com]>artnHnt in the dorsal carpal ligament (Fig. 2Si)i, crosses* the In Ions
of the e.xlensores carpi radiales imim-diately before their insertion, and is attached to the ungual
jihalanx of the thumb, being partly adherent to the tendon of the extensor ])ollicis brevis.
'Ihi^nui^i K' IsaKosupi'lie.] from the radial nervi . I, extend- the ungual ph.il -sx of the lluuiih and assists the action
of ihe alidui lor.
The extensor indicis proprius (the iiulicalor) (Figs. 2-q, 280, and 281)1 is a long blender
muscle situated to the ulnar side of the extensor poliicis longus. It arises chiclly from the dorsal
surface of the ulna, receiving adfliiional libers from the interosseous nietnhrane, is com])letely
concealed l)v the extensor digitorum commu'^'s, and passes ihrough the dorsal cari)al liga-
ment in the same compartment wit' the latter n.uscle i Fig. j8i)i. Just above the wrist-joint
it terminates in a tendon which runs on the dorsuf'' of the hand alongside of the tendon ol the
communis for the index-finger and forms with this tindon the dorsal a])oneurosis of that finger.
Il is ^up|llied from ihe railial nerve. Il aid~ in ihe e\len-.ion of liie iiidex-fmger.
THE MUSCLES OF THE HAND.
Tile tlienar and hyjiotlienar eir.itKiices o(xupy r>-spectively the radial and ulnar bor-
ders of the hand, l)ut the 'lexor tendons and lunihricales, running in tile middle of the ]ialm. are
cowivd hv a strong aponeurosis which is u>ually a direct radiation of the tendon of the palmaris
longus i-ee page !(Ki and is isnown as the palmar aponciirvxh 1 Fig. 284; (the palmar fascial.
This aponeurosis is alw:iys ronneded with the lran-\erse (arjial liganu'Ut and g.-' (les
awav u])on eitlur side into the fascia of the thenar and hyiiotlicnar eminenco. i. iw at
tile tran-verse cari)al ligament and becomes broader a- il pa>M's downward lowani . ..• lingers,
anil il> longitudinal faM-iculi. which gradually disappear in i!k' integument over the Ijases of the
proximal |ilialangcs of the -cmnd to tlie fifth lingers, arc united in the distal i)ortion (-f the ])altTi
i)v transverse fasciculi, wliiih i lose in the interspaces lying helwcen the longitudinal fasciculi
])assing to the individual finger-. Tlu-e spaces gi\e pa>>agc to the vessels and nerves for the
marL'ins of the finders, and henealh them are >iiuated the lumliricales.
The ulnar margin of the denser central ]'onion of tiie palmar aponeuro-i- and the transvirse
cari)al ligament give origin to a muhde which passes over the muscles of ihi' hyiiothenar emi-
nence ,ind llu- ulnar ve->el- to the integument at the ulnar border of llie hand. This muscle is
situated cntirelv within the suiiorhcial lascia ol the palm, vaiies in it- development in dilTerent
individuals, and is termed the palmaris brevis 1 1-'ig. 282).
* This iro^-ing oei in- « it bin llu dor-.il . arpal Imainenl, -o il.at the tmdon -heaths al>o ■ ro>s eai h other (-ei' the
deseri|ition oi the tendon -hiaih~of tin- hand, )Mg<- joj!.
-!
' ^.-z .-
■IH— P-~~»"
m
ilUi
^
199
"•""""^^"'"T-^....-^ "-'
u „f 'oil" t.irv,- ana i^
,...uppUe..y.he.upeH..a>vo.aH.aneH..
of the hand.
,„H »SC.^ or THE THENAR ^^ , „. „ ., o,
phalanx of thclhumb. U >^ "
longus (sec vaj^c iQ?)-
„,1 -ibdM. t^ lb.- tln'ml'-
. ^,^^ n.o<kra,.ly >u-on, nmsdc
«^ '8_i ana-^<)0)i>;i'^'il'i^'^^ ,' from tho lulHTosiiy
The opponenspolUcis.^..- -^v -J^; ,^ ^„,,,,„ ,..vi. U --^.^^ ,\.^,,,,„ .,ul
-r:::r;:ri;-7? :rr::-^^^^^^ ^ -
tens bv oblique, partly U.n<hn..u.i>bcr
carpal bone oHbe thumb.
;:;-T•-':S■':;:n;;^^:-'^^-^;?'"' ■■•■''■ ™
... ,, ,s, ami 2,r^^ is situau-a ui 'l^^.'':'"' , ,„ ,he lum-
The adductor pou-s ^^;^;--;;;^;, :,,,.,. .. u. «-"-'';::::-;:;■ z;:!, .hieh have
ma^J^^
200
ATLAS AND TEXT-ROOK OF HUMAN' .V^ATO^^V■.
Fir.. 28-,.— Tlic palmar mu>clcs after removal of the palmar ai>oneurosir;.
The tcnilon-li.alli .if thr nii.l.l!.- lMij;,r h;i.-. iRcn split l,■n^•lll^vl^<■.
Fic. ^8a -The deep laver of the jjalmar musilcs. . , , it,.!
have bfcn iiartly removed ami |>arlly drawn aside.
the bott<.m <,f the carpal canal from the i^almar surfaces of llie lesser nn,hanf,'ular .trapezouli
and capitate (os niasnum) Ixmes, hut the greater numlnr ari^e from liu- ,,al>nar surface ol the
sh.ft of the I'.ird tnetacaqial bone, and pass almost hori/.ontally toward the narrow tendon ot
insertion which i> attached to the basal phalanx of the thumb by means ol the ulnar .se.samoi<l
Iwne.
The muscle i, supplied i.v ,he ,.ln,>r rurve^ It adduets the .huntl., i. r., approvmale. the thumb and imlev-l-m;,.-,.
THE MUSCLES OF THE HYPOTHENAR EMINENCE.
The abductor digiti quinti ( Fi'Js. 285 and 200) i-^ the .tron-est and innermo-t muscle of the
unnip. Il ari-e. from the j, inform bone, sometimes also from the transverse carpal li-ameni,
and is inserte.l into the idnar l)onkr of the dorsal aponeiiroM- of the little fin.ger.
U i, -upplied 1. the uii.ar „erve, ;,„d abdu. .- the little l„e;er, /. ... separate, the liitl,. in.n, the rin^; nns.T.
The flexor digiti quinti brevis ( Mj^s. j8^ antl j86i arises from ilu- transverse (arpal li-a-
menl anti fn-m the hamulus of the hamate (unciform 1 iHtne. it i^ a small slen.ler muscle situated
t.tthcra.lial M.le of ihe alHlticIor and mav be entirely absent, or ftiM.I «ilh ihe opponent. In
short te.ul.mof insertion isaltaehe-l besi.le that of the alHl.i. fr inf. the ba.s.l phalanx of the little
lin.i^er.
Il i, -uiM'lied bv the ulnar nerxe It l1e\e- th.- fir>i phalanx ..f ihr llttl,- Ihiixer.
The opponens digiti quinti (Fi-s. .;8;v 28.,, am! j.»oi ari-es lo^ndher with the precedin-
muscle aii.l runs to the ulnar border .d the nieta. arpal U-iie <d' the little linger.
It also is .supplied l.s the ulnar nerxe and ..p|.~ , the httl. line, i
THE INTEROSSEI AND THE I.UMBRICALES.
The interossei .<.m],leleK Till Uie interspaces between the metacaqtal Ivmes. Those mus
(les situateti nearer lo the .lorsd surfac. are known .is ihe nilmissri ,/<.rv<;/cv, those nearer the
])alm,ir surfaie as the /H/rrnxM'/ ri'/.j/. >.
Ihe ftuir interossei dorsales I Figs. j8i. jS;. anil jS.)i are l.uaied in the dorsal jMirtions
(,f ih. four interovM'oii- sp.i. es, the largist being tile interossevis .iorsali:- primti-, which is situated
Ixtween the metacarpal Ix.nes of tht thumb antl index finger. They arise by two heads from
the oppo-ile surfaces of the conliguou- inela. arpal lH>nes and art the only muscles which are partly
vi-JMe h:rva !■■.• f.i-cia ufjn tlf l>ai k of th.' hand. Near the heails of the metacarpal Iwnes
1
1
1 ^
I ^
--•§
i 1
l2 *
^■5
1 s-
^ i:
^^2
>J
11
i
g
•a 5r ^
5 ^ -tS
i
;*
Mi
f:-ff
THE MTISn.KS OF THE HAND.
20 1
they terminate in short tendons which ra.liale into the dorsal aponeuroses of the l)asal j-halan^-es
(see pa<?e 20;) [Vvj,. jSh), the middle linger receiving; the tendons of llu- second and tbird
jscles? while the lendon of the first passes to the radial side of the indeN-tinL'rr, and
niusci
that of the laM I0 the ulnar >ide of the rini;-fin,L'i'r.
The interossei volares (,Fi-s. .'8i ami jS-ji are three in number and arc deej.ly [.laced ni
yii//T./.(irii.? ij/if «,.'.'/( /.'
/i(i*'T,i*.s( H^ (Jor^ liJS I
tal'im
Ti'iiii'xfs '<; lumliriialfS
ln!rro\';nis i/.<ri,;,';\ ///
liitirnssfus d'irsilis IV
I fiiiii'ii', ■•■ jii/cr.n«-i ; lAjr.
Km. JS5 -ni.ianm iif llu- ,l(ir^.il ,iixin. up.-i ■ ..f ih. fmRi-r- in.l ..I lln iriUn.,,, i ilor-^jlcs.
the palm, the tvo ulnar muscles (th. .econ.i and third) i).in^: sit.iate.l In-id. ih, ahdu-ior pnllin.
and Ih.' first or ladial one beneath th.' latt. r miiM le. They ari>e by a sj„.u. l„,,d, the lir>i one
comin-,' from the ulnar l«>rd.r of the metacarpal l^-ne of the index fin ire r and the . < <.nd and ihinl
fnmi the radial sides of the fourth and lifth metacarT)al Ixmes. Kach mas( h i> iiiM rted into thr
extensor lendon of the fingiT from the metacarpal Ijone of whi. h it taU,- it^ origin. Ih.
ir.dex fincer (onsenucntiv receives the tendon of an interosseus dorsalb uj-on il. radial sidi- and
k
202
ATLAS AND TK.XT-BOOK OF HI ■^^A^• ANATOMY.
Trttilim of
txtnisi>r tliy/ifonim ciiniiu.
Tnidnii oj
inlcrnssciis Tciidmi ni Inmliriiiilis
Tcnil.nl ,•■ ;h-x,:r .li.JU'rum fillil,"! oj ;hxi:r Jl^iturum silblimis
pro/:iiliitis
Ik. vM,.-I)iai;r.Lm -li.."iiim'i..-nl.ilinii.>f ihc uml..iu ..f ihr iiil.r.i.-., i ami lunil.ri, :il<;^ to tlir <ior.-al ai»ii:. ur,..-is .,f
the liiii;' r^ and tli. arranffnii nt .'f ihr lon(; lli xor t.nil.;n ..1 ilu' liiiKi r-.
Tnnlmis «l
;h\vr ,//.,■/-
/ mm pro-
fundus
Lnnihri' lUis
IV
I.u'v'r:. ,/,,
III
Trml.on oj ■h\or
dicjforunt fro;un-
dny '<
t\>:. .'H; — I)Mi;ram ..f ttii- inl. nw^i i vo!.iris.
l-'lii. jS-v. l)i.ii;tam "I tli' kmilirii .ilcs.
i^a^' '^^^m^^im^^mimmi
Till-; AIVSCMS OK TTIK HANP.
20;
the tendon of an intcrosscus volaris uj.on it> ulnar >\i\v; the middle Im^'er has iw.. ml iovmi
dorsales; the ring-lmj^'er has a volar tendon uiK.n its radial, and a dorsal tend.ni upon its ulnar
side; and the link' linger received a sin!,de tendon, that of the third inlerosseus volaris, upon its
radial side. The interossei dorsali s re posterior an<l the inlero-s. i volares anterior to the trans
verse caiiitular li-aments (see page i27>, xvhieh conswiuently sej^aiaie the tuo .^nnips of interossei
in the region of their insertions.
[ V, .f.u-.l al.uvr, i, i~ . u>t..marv .0 r,-, n^;ni/.■ but ihr.v int. f.^M^i vnl;,rr., A l..nnli i-, h..^^^^.■r prrM„t in tl.r i,.>->ii
of ,,n ,-N.v,.,linKlv hmWr nn,- 1.- wlii.i, .i,-i>.'> frun, th, InM ,n,..„,,i,ul ..n.l i~ in-, rtr.l n,... .!..■ nln.n -..!,■ .4 th.- I..,..'
„f th. l-.r.-t ,,h.lanv „f In. ihuniL ;,IonK witl, th.- ulnar lua.l ,,f tlv -Lx,,,- hn^i. ,,.,lli. i-. ui-h ^^hi, 1, nu,-, I. n ,. (,.■.,», nlly
nion- .ir li-^s I'McnsiviIy fused.- i:ri.] ., ,
Ml ,,: llu- i>U,T,.->.-i ar.- wsiullv sui.|.ii..l l.v ih.- nln.,,- u.■r^,. Th. v . ilb.T al»|... 1 ..r ...l.lu, t th.- In.«. . -, , h, nn,,,!!.-
nnmr mnv b.- P,..v,-<1 unvanl eith.-r tin- in,l.A.hnt;,T .,r rint; hnt;. r by th.- ... li.in .,f i;- int. n,.-. . .|..,-.,l. th.- n. n n,i, r-
.,-s™. .l..i^^.ais ,,ulls th.- it,.l.-x-lin^;,r l,m-.,ni tit.- thutttb; th,- la,t .,n.- .Iraw. th,- rinu hntt.r t.a.var.l th.- bill. hn^;. .. I h.^
,n-,t v.,iari. ,mll. th.- i.i.l.-x f.war.l th.- mi.l-li.- hnt;,-r; th.- -,.-,...1.1 .Ir.tw- tb.- rinu t....ar.l th. nn.l.ll.- tin,-, r; ,,n,l tlu thii.l
adducts th- httU- t,.war.l th,- rint;fmn,r. Th.- int.-r.,.ssi-i aK., ;- - IM th,- a,ti,.n .-f th. bnnbii, ai,~ .- . 1 . l,.« 1.
The fciur himhriailis , Fi-^. 2.^,^ 2,S(., 2.S.S, and ->()0i are lon.t;, narrow, wtirni like niustles
whieh ariM- .leep in the palm frt.m the f.mr tendons of the llexor .li..iib-rum profunilus. Th, two
radial lauseli-s arisi- hv a single lu-atl from thi- radial borders of the two ra<lial tendons, v.iiile
tlK- uvn uln.ir must ks' usually arise- by two ht-ads from the adjarenl border- -if th.- ihrt-t- uhuir
tendons. Near the ba-al phalangi-s of th.- lingers they i,-rminate in v. ly -1. n<k r t.n.l.ms whi. h
art- in-erte.l, from the radial -i-le, intn the .'.orsal aiioneur.tses „f tit, fuiLM- in ..>nini,.n \sith ihe
interossei.
Th.- t-.v,, ra.i;..l lumliricali-s ar,- u.ualK- ,,-i.|.li.-.l by th. ni.-han n.-iv.-, th.- tw<. ulnar by tb.- ubia: ->, rv.-. 'l b, y ll.-x
th, ba>:ii l.halani.', < ..f th.- litli!,-rs all.l , \t,n.l tb,- ■■ • -.ml -in.l tibr.l lilialani;, -.
THE RELATIONS OF THE EXTENSOR TENDONS AND THEIR SHEATHS BENEATH THE
DORSAL CARPAL LIGAMENTS.
A- the teiidnns of the- .-Mens.n- .d du- hand an.l ..f the lingers jiass M\er ilu- wiiM joint (Mgs
280. 283, a.i.l 2.S,,) lluv are . n, I ,-d in th,- ■.vno^ial sh.alhs an.l h, Id in tit- l'vo.im- uj.on lib-
.l.trsal slirfa..s of ih,- ra,h,. miuI uln.i liy a tlii, k, n.d p.irtion of tlu- air 'na, hial la- ia. ih, ^lon„l
,arf>al > posUno, ,i,nn,!.ir, liL'.im.-nl. ■I'lu- iii.livi.lual -ymnial -lualb n -ilual,,! in .lili.i.nl
.omiiartnu ,,1 iln ligam, la, -in..- thi- -trmtuiv i-aiia, h..l m the l.ingilu.hnal lidg,- upon ih.-
boiie-- .ind ,-peiially 1" ; 11— ,- .if th,- ladm-.
■I'l,.-M-,,.inpartni, 111 ..ill b.- .1,-^, 1 ibe.l in ill.- .ml.T in v.hi. h ih. \ ,in- , m ot: it, ml in i,i--ing
iHim th,- radial to th.- ulnar .-i.le <if tin- wri-i 1 Fi-s. j.So ami J.S., Ih, hnd..n-..l ilu , M, ii-or
inlli.isbr.-si-an.lab.lu.l.irpolli(i-lont'u>pa-lhrotu;ha,oinun .ompartin, nt an,l lo a ,.rlain
.■M.tii are in\.Me.l bv a ..Mnmoti -\ ;io\ iaUh.ath. T!u-s.-.on.l , ..m^.a-ini. iii fiN.- pa-;i-.'.- to th,
I.lid.in- .if th, .-M.tiMir ..tri ,,|i,ili- loni^u- .tnd brev i-, wlii, b u-ualb, po-, - ■ -' niu.il
svno\ial -1uaih-. The thi;-'l . .nniiarimenl i- -niu fiii iallv pla...l in.l i- noi lon;^ib,...ii.il but
..bli.|ue; il .fo-e-llu- tendons an.l -ynovi.il di, ath- ,.f ih, iti.ir. .l.-,p!v -itualt.l -,.on,l .omoar!
m.nt at an a. tite angk and lont.iin- tlu- len.l.m an.l -ynoxial -h.-alh of th. , M. n-or imiIIi, 1-
l.MiL'us. NeM follows the larg.-t of all the < .mipar- uent-; il .ontain- 111 .. (.imnion di.aih ilu
204
ATLAS AND TF.XT-HOOK OF HUMAN ANATOMY.
four tendons of the extensor digitoru i communis and that of the extensor indicis proi)rius. The
fifth eomiKirtment contains the slencK." tendon of the extensor digiti X" j-roprius and is superficially
situated. The Mxlh and last compartment gives passage to the tendon of the extensor carpi
' The syno\'al sheaths are considirahlv longer than the width of tlv dorsal carpal ligament;
those of the extensores communis, indicis, and digiti X' may extend to the middle of the meta-
carpus.
Tendons nj f.v/cin.ir Jii^il.'nim
Jtiihliir r tniilinuin '-'
/ . ,1,1, III -\h ■ nil •', rxtntsor - '
l\ii,i.ni-sli,-i:l! .■/ i-MeiiSiir'
( irpi it'll ir;^
I, i:\,,r (//i;.; 'mm ,liui :.\t(i:-
.si'r iihli, i\
IiUir,is^,iis il'irs.ilis !
1 riuliiU'^h'-ilh i>i 'Xtin'or n.illici'i
f,rr:'is
'\ I n:,l -l\lie,llh oj ,lh.l li, t.ir piilliiis
l<nii;lts
I ,'n,l„it-'hi-Uh I'i I sunwr fiuliu /.! /."^'Hi
/ ft»ii„n-sh,:ilii iij rxinifiir ,'irpi r.iiliUit Ami,'K(
Trii,l,iil-.Jl,-irll 11/ ,\lnn,ir ,,irlii rhii, ill's iirrris
It.;. .'S.) -Tin .i",miirnii'i\l "( t
!„■ iiiulon^ ..f tiK I vtin-.r im.-. 1,~ aiv^ Tnilnn-.hr.alis hfiualh llir tl.irs,il ..irial
Im.iminl .iinl in tin li.i'i'l i -oniruh.it - -natic ).
THE EXTENSOR TENDONS OF THE FINGERS.
The extensor ten<lon> or dor.al apuneuroM. nl the fingers i ligs. 2,Si , 'SO, and -'8(), are < iiiefiy
romoosed ..f the ten.ion. of llu' extensoirs digilorum, hut al-c. receive fibers from the tendons
of the inlero>>ei and lumldnales.
THi: MLSCLKS OF THl". 1IAM>.
.^O!
The tendon of the extensor or those of .h> t^vo extensors* which pass to a fmger, beconu-
flattened in the region of the metacarpo-phalanseal joint an<l <livide int.. a stron-' long.tud.na
fasciculus, which continues onward in the same direction as the main ten<lon, iK.ssmg to the head
of" the first i.halanx and to the articular capsule between the first and secoml i-halanges, an.l mto
weaker obli.iuc fasciculi whidi unite with the tendons of the interossei. , , • .
These form llat expansions .ver the basal phalanges, which pass to the lateral margins of
the extensor tendon (Fig. 286) and are also continued to the middle phalanges, um.mg with the
oblique fasciculi of the extensor tendon an.l with the ten<lin..us expansi..ns ol the hm.br.cales
proc cling from the ra.lial si.les of the finger. These lateral fasciculi of the d.^rsal aponeun.Ms
come from Ixnh mar.ins o' the finger, unite at the capsular ligament Ix.tween the secon.l an.l
third phalanges, and are inserted together int., the base .,f the latter Ixme
The direct continuation of the extens..r tendon consef.uently termmates at the hia.l ol tlu
^"""^Thetol ap<.neur.>ses are "rmly attache.l t.. the onvex surfaces of th.- phalanges an.l are
intimately connected w^'H the articular caj-sules of the interphalangeal j..mts.
THE TENDONS AND SYNOVIAL SHEATHS OF THE FLEXOR TENDONS IN THE PALM.
]„st as the exteuM.r ten.l.ms run in synovial sheaths upon the back ..f the han.l, s., wc- find
the tendons of the llexores digit<,rum, and those of the llexor pollicis L.ngus an.l tlexor c.rp. ra,h-
alis .urroun.le,l bv svn.nial sheath^ an.l passing beneath the Irausv.rsr carpal U,, mm ,n the
carpal canal (Figs. .8,, 285, an.l 2 p). The llexo;- carpi ulnari. has n.. synovial sheath. I he
outermost synovial shea.h in the ca.pal canal ,Fig. 282) is that of the tl.xor carp, ra.hahs, whuh
extends t.. near th. inserti..n ..f the ten.l.,n an.l is alm.,st enli.vly .-onceale.l by tin. ..r.gnis ..1 the
thenar mus.les. \, xt this sheath is the l.-ng narr..w ..ne f.,r the tlex..r p..ll.. >s l.mgus, wh.ch
extemls fn.rn ,h.^ .p'-" '"^"-Si" "^ "^^' ^^'"--■^^^' ''''^'''^ "«=^"^^"^ '" "^'' "'?'T I/'^^''^'"". '" ' ^'
thumb. Next in .n-der. passing towar.l the ulnar si.le. is th.. large sh.alh wh,ch eontams the
eight len.ions .,f the llexor .ligit..rum sublimit an.l pr.>fun.lus; it cmmences al)..v.. the transvet-se
carpal ligament and exten.ls t.. about -he mi.l.Ue ..f the palm. Only tiu^ svn.-vrd slnath t.>r th..
tendons .)f the little finmr i- . ontinued dire.tly int.. the tmger itsell.
The fingers p..ssess >.parate svn.nial sheaths (Fig. 2.p>, ...mm.n.hig at th.. m.ta. (,rp.>^
,,halan.-eal pints an.l exten.ling to the !....■> of tl^e t.rminal phalang... wlti.h a,v .um.un.le.l
bv fibrni. structures kn.nvn a. the vaginal ligaments , Fig. 28.. In tlte -li-tai port,.,,, ot tlu-
lingers th..^.. sheaths became thinner a.i.l (ct frcpiently int..rn!pte.l, an.l a. .■..-.hng as t.. wh..th..r
thc'r fas.iculi cross ea.h .uher ..r are arra,ige,l circularly i,t this Mtuati..n. n-unal a,„l annular
lii'am..nts mav be .listingui<he.l.
Ov.r the meta.arpal b.nns tli.. t..,i.l.ms ..f the n..x"r s,iblimi> ,tM i,nm,.,ha,. ly up.,n^thnM.
„f ,lH. pn.fundus within the teml..n-slu-alhs. but at th.' mi.M', ..i tl,e firM phaiang.. ihev „.ule,
forminl: >lits whi.h give passage to the t.n.Ums .f the pn.lOn.lus. In lhi> Mfuaf.m the ,t..r
,,n.l.u.s bec.me s..mewhat broa.l.r, exhibit an i.vlistin.t nu-.lian l^ngitu.itnai n.snr... a,,. a,v
eveniualiv attached t.. the bases of the ungual phalang.'s. Th.e tu.. shps ,.| .a. h snbhnu.
^Th. i:^.::
uliins.
k^j^:
206
ATLAS AND TEXT-BOOK OK HU.M/VN .VNATOM\.
'I riuioii-slltdl}i I'j :l(.\ •!■ ■
Ahiwii'r pi'lli'i-. ''rr:i
O/it""!! "■' ,''■■/''■' " I. •'"'■"'
inij. 'II ,•, rxuiis. urp: r,itii-u l^nir
TflM'H-sh.f-ill' !'■ :l''y'f thiili'l-. I,nii;lis
l)ii;il'i! \li,;illis of
tfitdoiis
■ C'lnmu'ii ttiid'"!-
slir.llll 11; jh-.wrcs
dK,:.
Opp'iifiis di-^iii V
Trin'i-rrsr r.irii'il lii^itmnil
■J'liid.iii «: iliwr i.irfn iilinris
T r.ia.m ^::ri:i: ■■; ;::
;, ._ JJ;iiM\ ,111,1 n't :hx,:r
,/,■„■. firnjimdln
ri,., j,,o.— Tlu'.irr.mn.ni.nt ..( th, trn.l..ii-sli> .uh-, ■ 't 1
h, l.mi; llr\.,r~.i il"! ih.- |K'\. .r ...rpi r.i.ii.ili- 1 M,in.« h.ii .1
THE FASCIA OF THK UPPER EXTREMITY. -°7
tendon pass beneath that of the profundus and are attaehed to th. f ^-^' --"--^;;;;;-;';^
1 . .,, flv.t th,. tendons of the Ikxor sul)limis are tonsc.iuently pcrloratc-d In tho.c .-1 the
:;:::::" irl »,:'.■«*.>,. ■>... ...n,. m, i„s„„.„ ;,„„ ,i, -n.. ...... .1.. ......
proiunuusiuL , , ' , ry, ,, tindons are im rcetlv eonneelc-d with thr IkimI
t'l rlll't^:^- t^ <.f ::w;."l. ^"n.e of .h.h ar. thr.ad-li.e .n.ifonn,.
£:X '^ ,:^ uh;^Xse in the noddle phalanx, are triangular. Tiu, n-U onl^- c.,nneet
:;!: tenil^"ol the sublhnis and profundus to the hasal phalan..s, but al.o those of the pr..-
fundus to the middle iihalanf^es.
•l-HE FASCLE OF THE UPPER EXTREMITY.
The muscular masses of ,hc upper extremity are enveloped by a o.mmon faseia (H^s. ..,,
and ' ) -hieh is particularlv w.ll dcvdope.l in the arm and .otvarm at.l whteh ha> ,....1
d^.;cm names in iilTetvnt re.,ions. M the shoulder the.,v are r.o.nt.ed at, -:.y/ ..v, a «/^
, an n,jr„s,>ina,us. and a .suksn,pular /„,./„.• in the arm. the l.raJn.l ,,snu, ,n the
o "a m' t^ Jlil'rM /— and in the hand, the .loru.l l„sn,. and the ^1.,,,. ,, t>...,.ros,s
X v///„n. /„./„ , Ki,. ., . i> a thin lau. wl,iei> elo.es in the ax.Ua,. eav.ty. I. ts dt.-eti
continls below^with the mueh s.rott.er brachi.d faseia, i. perf,.ntUj by a ---;;•
vessels, ami contains .several strong, fasciculi .sometimes mu.cular) v,hu h p.i>.. lion, tli. ia„.
" ^"^n;!;;/.-.. ;-'■/.' -vers the supraspinatus an.l is partly u.dinoi. in '_'-;;-; ;
The n,n,s hu,l„s /„./„ ,Fi,. .,8- i> a very elense. ten.hnou. .ase ,a wh . 1, . o.eis th n.t
spinll:. the teL mi.or, aiul the te-res majo,., .ivin. partial ori,i„ ,o the Ur. two mu.le.^ and
also to the eleltoideus, beneath which muse le it ' uluaily .l.>ap,.ear>.
The.v,r^vn//>,</./r/.'.v'Mislhinandcenerstl> ■.capulans nu.>cle- Hn„ f , , i..
The l,nukial jJia , Vl^. .... an.l :o. > is .he immeeliate e,.„„nua,u,n „, th.. preevehn, f, >< ,
.„., ^ .i.^. thin i.ve the insertion of the deltotde-u. 1, cot.i.^ . lu-ly o, n---; -' ' '
and u,l it^ ante-rior H.rfaev ,1,.. ivlie 1 ,.f .he. hie.ps may be .iiMmctly ,ve.„n..e d. to . . u , Md
" V e uateel the . v.r,,,,/ .uul inl.n,.,l lun pUal ,ro.nrs. In tii,. lo..r par, o. the- an,,
lt:':i nese.U the t.o i..n,u..„!„r . ,„ .Inch pa. to tlu- bo,, be-tweeii le ,.o nm. u ..
^,-oup> of thi. region, the inlrnul inUnnu.ul.r . punn exten.hu,. .L-nuaiel „> ,1,. nncn.d
cicon.lvK' a,i.l the cxUnud on.- to the extei-nal epie .'ti.lyle.
' The a,;uri.,r surta. .■ of .he fa. ,a e-xhibit. orilieo ,..r th.. pa.a.e .„ nUan.... n. ...^ an.l
veins, do,- further <le,aii sev se. ti.-ns upon ■■X..un.io.v" .,nd ■•.\nK,..l..^v. ,
Th .,.///.-.„/..,//.<-/.: :Fi.. ...1. -»^' i..li,v.,ly ..H„i„u.u,.w„h dubnuiuailas. a ,n
,vp., .. the- eii.nv i.,ui, ati.l, . ,.h ,he .-xe ..,.,i,.n ..f one :v,i..n, ,. c..ns,.le ,-ably .,.„„. r .a,, h.
fatia. I, i^ parti, eliariv .ietise Ivlow the ,-e-,ion of ,h.- eih.,.. .o,-m,n, an ap-me-u,...^ uh h -
.Iheren, ,o ,he supe-rlicial laver.. of the llexor an.l e-x,e-n.or mu. 1. . ,.-e |.a„ ,.M >. an.hl,.- /./-•,
, ,^ . . f ,h,- l-icep. t.-ud.,n .e-e pa,.- iSS^ i. ,-e-aliv form.-,l bv this fa.ia. 1, ,. . i.nne. ,n
L cubital f..>.. an.i ove,- the l.a. hiora.liali. an.l exten.-r ea.pi ra.liah. i.,n,u. unh ulu.l, „
'^Td:-';:::::-,po,-,,..noftl,ef..r.-a,-mthea,n,b,.a.h,a,fa.ia.. T .lee-per lav.,^ .h,. li
..nelos.. the in.liu.lnal mu.el.s an.l ten.l..,,.. ■lo.a.d tlie .,i.~.Ju,nt the ^olar and eiot.ai
y^
if^^
M.^!m
208
ATLAS AND TEXT-BOOK OF HUiLVN .VNATOMY.
Fig 2gi -The fascia of the left arm seen from the volar surface.
Fig. 292.-The fascia of the left arm seen fn.m the dorsal surface.
surftce. arc reinforced bv strong circular fibers, forming the volar carpal ';^--""j!«; J^J^j
S!ch is situated above the .rist-joinl and over the flexor tendons and is continuous bv its distal
..^hichpasse^J.^
t^ :r Ih ti^^ uti>-l a4,artn.ents for the extensor tendon, .see page .03).
T^ie W / 1 : ./ ,k. Mnd commences at the distal margin of the dorsal carpal hgament
.s it^ V ervthii, .he line of demarcation is much more noticeable than is ^^e one bcu - ^
Hgament and the an.ibrachial fascia. The palmar aponcnros. (see page 198) .s .ell dc^eloped
and is by far the strongest of the fascia; of the upper extremity.
THE MOST IMPORTANT BURS^ OF THE UPPER EXTREMITY.
,. The sulnuro,nial hursa is situated beneath the acromion and above the insertion of the
tendon of the supraspinatus.
of the humerus.
I. s: ;r:;'::r ,:x:^ .: '.^^ir" n„„„ ,„ ,„.. ».,. .« ..
greater tubercular ridge.
- The hiirsa oj tlir latissiimis dors, (see pat ■ '4^))-
S' The sul.J„ro,.s oUcranal hursa .Fig. = -> between the olecranon an.l the .k n.
I The 'suluuiancous rpianuiylar burs. unUrnal an<l ..■/,..„/., over the epuon-lMe. of the
'"":rThe nuralauUnous and subU;uUnous olrn;nu,l l.rs. siuuUed respectively .i.hin and
upon the insertion of the temlon of the triceps linconstant).
II The bidpitoradial bursa (see page i8()) il'igs. 273 and 2,, I.
'• T cuL n„rrossrous burs., between the uppcr extremnas o. '•- -<■- ; "^ ;^
: The bur., oj tin- r.lrusor carpi radialis br.vis. a. .he base ol the thud nKta.arpal be nu
,;■ \tdL!sub,u„n,.ous .,Lcarpopl,alan,ral burs., inconstant subctUaneous burs,
unon the dorsal aspect of the joints ..f the same name. ^ ^ _ _^^ _^_ _^_^ ^.^^_ ^_^ ^^^^^
' IV The dors.il subculamous dii^itai bursa; svilKUtaiuou^^ duis.l uyr :, ,,
proximal interplialangeal joints. ,- ,1,,. ,L.v„- ,-in)i ulnaris to the
^ ,6. The bursa o] the jUxnr unpi ulnarh, at the attachment ..1 the Ih xo. carp.
idjiform bone.
/,V
mL^itmk'
V -6*1 ■
Axillitrv fast'iiT
Crphatir
I' fin .
[I
In tf inn I
intermuscular
sff'tiim
txtfrniil
internutsailiV'
sertnrrj
[?■
/ lurriii^
tihmsii-^
/r/
\%
Siifiiiil.i'if'':!
,'iririt ml
V
i4
['oiiir tiiivul hiitinnnr
Il."^,ll ,<l>/»ll i/<J.I/'l' r.t
/if;. 21)1.
Hi.'. 202.
i^ii
7*V;;^v!J?^'^;jurgn^fflr,y^-i.>-_,.^^j ,.y^^'Wr
THK MT-Sn.KS OF THK I.OWKR KXT U'.MITV.
209
>8. The inl.rmrlacarpophah,i>Kcal bursa; s.tuatc.l at tlu m uu.iqx [
posterior to tlu- lapitular li^..;-'"ts.
■ , . vinmitv ,,„ .-arli.-st ililT.T,miatinnnl,M'n;it.UM<M M-iurationuf
[In tlu- ,k-v<-lo,.num nl tlK- nnwU> "I llu- u,,,.>-i- ; ^^^ ^^^ ^.^^^^^ ^^^^^^ ^,^^^j ^^,,i,,, |„,^ „|„„, ,h,- ,,..l.-n..r
the musrU- sh.-,-t xvhi. !, U.- vip-n tlu- |.oM>T,ur or ,M.n>,, - . ,„„un„r ,.r, a- tlu v „., |,r. UrM.lv l,n,u-.l.
p„s,-u.u,l mu.,l.s. a.ul a s, end ,r.,t,i. -t ,n.^a.,..l ->- '' ' ^^ ^ ;^"^,„.^ „„. ,^,,,,i.,„„,,„ „f tlu- cnls ,.f ,1,. '.ra, l.ial
that tlK- fornu-r, in so far as ,lu-y ar. su.M- u-. '--^^^'^^ ,,.,, „;, ,„,^„ ,,.. ,,,,,H..,1 l,v .Urivam.- of tlu- . .-i-r
plexus, mcixr tlu-ir ittnm-atum through t.-. po^Uru.r .oni,
(;•. c, the imiiT anil out.-rW'ords. , ,- , ,„„,nt~ ,- uivcii al»A., mavllu r, fore !..■ -.'I'liK tiu ■ tr.|
The elassilVation of the limb muscles aeconhnK ""!>'■ ''"''• - *^"" "'- ''^ ^'"
l,v dlvi.li,tR each set imo a ,.ost-axial an,l a l'^'^-^';':'' »^;";';; "l"^;,,, ,,,1 „,, ,,,„„, ,„u., les a.ul the -u,.er.u i.,! -nu-, les
■ 1. Thk MfS.-i.KS OF Tin: S11(H1.I>1,K (to whuh ^ho.il.i I.. a,l I
of the l.ac k with the eN.epti...! of the tra|.e/.iu>l. ^,^^^^,,,^. ,„„,,„„, ,/,/,„„/,-»,s. w,,-..;-
,„) ,..,s.-axial muscles: ln:.U>r so,^-, rl'o'ohouUu. «u.,.r. / . ' '"'
,/,> I-re-axial museles: /.,-,/»r„/» -»„;«r, /-er/»^./^< - .w,M,„ <»., an
II. Tin: Misci.Ks or iiiK vpi-kk aum-
(„^ I'ost-asial nuisiles; (r/.r/n. .l>ini/H-H.v.
(M l're-axialniu>^le^: I'i.rp^. hr.uhuUis.
III. Tilt: Mtsci.is or thi, ioki ahm. _,^ ., ■ ,.,„,„„;, ,„,;.,-,, ,,v/,-„s„.
(.n I^.s.-a^ial nu.s.les: / ■''"-"■"-'-"■";;.;;':/'„:';, r.,,,,,.,,,,,-, „/„/„.... ,-//- /-.<-■ '— ^
,:„„, „r..is, r.,..s,:r ^f-;^'";-;;;^ :";,-;:: ::;-:Z.. ,<U..r. l.n,.s. ,:..r .,r,i :,.,.,ri. //--^ ■//./-""'
ih\ Pre-'i\ial nius( es- prinhii'>r i'.'^. ,.(.\'' ■ /
suh/inus. lt,'Xor ,Ii,qilori,m pr,<iumtu,, jUxor p.'hu ,s lo„,^ir , a, /
IV. The Mi-sfLKS or riir. u\ni>.
,„) r,st-axi.ll museles: wanting; „..,„„-», /,-,///,;../;«- hr,vi^ pollUh. alnhu :.>r
(M m-axial muscles: A""'"-. -X;..!: ' ; i.t/, /.-..^Wo,,^ ,.-/,/«./- ^.//'-. '"— ^-^--- ' "'
dorsales. — !'•"]
THE MUSCLES OF THE LOWER EXTREMITY.
t::'^T:::rz^:r:z.f2:L ,.„. , -»".-- ;- - -^
M.l.
tl;
;,;;:;,:'::?;,::'„;:;;i:n:;::-":;:,»:-';; -4-;:;:;:;:;:", ;;:,;:;:,::
ini,nus. an.! tlu- ,./.,'»r„/,.- ,.v/,r;,».s.- .v.A ihos. nl iiu- i)o
niiundb
,.1 il... V, iiw'i)). mln-iiniisu<
i:;,: w .IU-.V > , i„.n.i..i .:..■ ---; < ";- '7::':::'!;;"";:":;:;;:
?m-?^.
■' I Li;
210
ATI.AS AND TT.XT BOOK OF IIIMAN ANATOMY.
f .,r . .,rrin.'.<l in two lavtTS, the supcrlKial one Ixinf.' formed by the iri-
ri -u, ... ,i,.. ..<..-.>■ ..>■ '"t,;:! :,:.;:.;. -.-«.' '■'■••■" "»
ami the /«/.r,»..r/ are al.o situated in the sole of the foot.
THE MUSCLES O^ THE HIP.
THE INTERNAL MUSCLES OF THE HIP, THE ILIOPSOAS.
.,n,l ^noi i> (omix.-i'l of 111" A^.i.v mnior and the
The iliopsoas ,Fi,^. .;., .0, ^07. .... and -^ '^ ^^,^ J ,,^,^ ,,,,,.1 .^ „,,!,
,//.,. ».,wl,i.h are eompletely se,arated ,n the ui^per poUmn o,
i,,.„,.n. This n.u.le fre,,uen,lv al.o ineh.de. ';;-;;;';-;.. ^,^ ^, ^^,,,,, , „„,,, „, .He
•nu. psoas major ,- a ion,. >.ron, mus.le, tin ^ •'^'''^f ^,,^,, „„,.,.,. .f,!,, twelfth
posterior aUlonnnai .all. 1. arises from the upper and ''; ^ ^ p'^' ^ ,^,^^.,. ,„, f,„„ „te
i'->'- -'■ - ":■ ^-;-!'; ' -;,;.\'r ::,: :;;;;,; ,;; : ;i:;: :;'.: ^lii^^ ..n.u. mmhar ver,e^
''::;: e':n:;:::-;^^^.'i;'•"n:.a;ed ,. „„ ...rs proeeedm. f,..n the vertebral l.d.es.
:,;;,;:;.::: ^..-nin, .. ...u. p... pa. ,., ;•-;;';;--:;;::;;::;;;,, ,., ,„,
,„„.,,,K ;„„1 |,.l,,u uiih the inner nKU-.n ol ihe iluuu^ I h. inn.r mar^
■'"■ 'n"~ "';.'.m'.;,.! iii....... !■:.".- 1™™"' '•""i"'-> !«»"■■" """"«" "■" "',":"'" '■"""■'
THK MUSCLICS OF THK HIP.
211
j,,,t th.a. is a bur., whi.h not infrequently n,n,nu.nica,.s.i,h tlu- ania,hu- >avi,v, ,1,. i!iof.r.
tiiual hiirsii (Fig. 2i)S). , i i,- ; .,n , ^ li 1., ■! llat
V psoas minor (Fig. 2,8) is present in sonu.vhat more than hall ol all .a>c . It is a at
thin'mtle. Ivin, upon the psoas ntajor an.l aris,n, Hon, the l.o.lv o, the la. , ..nuae o the
tZ Zl a vJne Jand from the in,ervertel>ral .lise between the two. 1 he nu,. le soon passes
!;:; !; ;;!: Ldon whieh Ix^onK. continuous wuh the iliac fas. ia eoverin. the thopsoas ,sec pa.e
2;, I) and i> inserted with thi^ fas. ia in the re-L.n of
the iliopectineal .■minence.
'Ilu- ilin|,s,,.,~ is supiilira fnmi lb. lu.'ilur iiles...^. H A'""'^
,h,- llnKh an.l al>., rnlal, . il slinhuy inuar.l. -fh,- [.s-as .mn„r
is a unsor of ihc ili.u fast ia.
■0
THE GLUTEAL MUSCLES.
The glutaeus maximus di.u's. 2.),^ and 204^ '^
a large slron- muscle, particularly thi. k* in its lower
porti.m, and is situate.l in the ghit.al re-i.m im
mediatelv Ik neath the skin. It is covere.l hy a thni
layer of fascia and by lite layer of sub. utan.-.ui^ lat
which is very well <U'v.l.)p.e.l in this MUialion.
The mus.l.- arises from ihe e\t. rnal -urfa.e of
the ilium (Fig. 2.),,) bit ween the 1.0-terior gluteal
line and the jiosterior portion of the ilia. . r.-t, from
the i)osteri..r surfa.c .>f ihe sa. rum and ...i.w i.md
fiom the posteri.>r sa.r.nlia. liganunt in thi> Mlua
tion), and from die >a.ro lubenno ligament. Its
hlnrs iia^s fmni aUive dowiiwanl and from widiin
outward. The faM i. uli ar.' vuuisually thi. k an.l -lis
tin.tly >eparate<l fr.mi .a. h ..th.r by penetrating septa
of fas.ia and fat; tlu' l.)w.r (imuri fa-, ieuli are the
l.Mige-t.an.i thi- I'orlion "\ th.' muM 1, is tui..' as
thick as the Ujipir (.niter) srgm.nt.
The superluial fibers .-f the nuis.l., espe.i.dly .,.-,• 1 , 1 ,,1,
thoseof tlu upper weaker half, pas- over the greater tro. hanter ,., th.. iho.d.ialhan.l o, h
t-a lltl .see' page 2,.. -h.. .leeper .d.ers, particularly .1... l..g. r inf.,„.r •. a,.- r,..!
'""■ -n;.^n :;;;' :!::;:;■; margm ,. ,>. gU.,a.us nta.mus is m re,a.ion with ,h.. p..s„.,ior la..
.,f ,H Untd..,.. .rsal fa'lia. .her.^ this s.ru.ture gives origin ,., the lat, tt. the -'- n. evt. d
,lni..n is in ivladon with the glutaus me.lu.s a„,l the glut.al 1... ,,, uhi, h .in.lops 1 ut r
, t, „ run -th.. tub..n.sity .,f the i. hium an.l the ..rigius o, tlu ,lev..r group o. . . -^
; MS, tluse latt. r making tlu ir app. arance beneath tl... fas. ia below ,h. mneran.l 1 1
i^\ '/: .,....-70
wtf
^■.fAAJ'
W.y .,ll;:lll- "1 111. Ill" ' l^l"''' ' "1"'" ''"
,|,.l iiin .il 111. ihan.
Ih. rl.lH.il III..-. 11. ..fti. nt..lliV 111. .I..U..I lill'--
I 1.;
♦ 1 111 i;lill.lll- m.lXiiil.l-
i.m "1 Ui. liiii Ml III
212
ATIAS AN1> TEXT-BOOK OF HUMAN ANATOMY.
Tl>. Rluui-us maxi.nu. has'lH-cn .li^i<lo<^ an.l rcflecU-.l.
"^ • . Thr insertion conceals the tendinous ori-in of the vastus lalcr-
n,ar,in of the «'"----; ^ ![ X: ;„,,,,,, i. separated fro. the great trochanter
alis from the trochanter major 1 he icnc. i^ , ..^^...^ ,,.hi,h there is usuallv one or two a.idi-
,,..Utr.ehurs.t,the/.>c/...cn./,»«. a.,,^ ,.K xncaU..^ ^^^^^^ ^^^ ^^^. ^^^_^^^^^ ^^^^.^^^
uonal burs^e. the ,/«/../""-''' '"'-" ^ ^ '! ^'-,; .,, f,n.oris. and the adductor mint-
the nirif..rmis, the obturator mternus and semelh, the
mus are c..vere<l bv the i-duta'us maxm^us.
™" ■ a .xu-n.ls tlu. thigh ana i. ih. anlaRon.st of On
. ^,u,aus maximus > -u,,,>lKa l,y th.- inf.ricr gUUcal n.rv.
"'"''^""~ .. , ■ on- , is lis,, 1 strong, flat, thick muscle, part of Nvhich is
Th. glutaeus mediUS ,1 .«s. .<xs, 3.).. • 1 -^ ^ ;-"';,,;being situated in the upper ;-h.
^,„,^,,,,,d by the ,luln-us max.mus. "-; 7-^'.'"' ^"^ ^ , I ^//Xrent U arises fron. the outer
teal region .Hrectly ..neath the gluteal ^--^ ^^ ^ ' ^H '^,,uteal line, the iliac crest, ami
,,,faee of the ilium (Fig. ...-, -n tl.e -^ '^ ^ '\;; ; ,,^,:., ^.e muscle converge t.nvanl
the p.,s,erior gluteal line, and trom he J^^ ;;;,.,, ^s independent and passing obli.,uely
the greater trmhanter, the posterior tase.a.h bem;. m-m J _ anterior ones down-
■"T""' '::™i:;';;:r;:;!:;;::;:^3r::r::;;^-,t:;:::;i-> - <> ^- .»- '
ward and inuaid. 1 lu slioit ano 1 f.,. ns ihe tin of this pnK-ess.
,,urv, the />.'>" ^/<'^ /'"rva »/ ///. f^luKrus malms . !• .g. ^o. K
, , , „, ha,., t,,h..lhiKh; thclawr anterior ,K,m.,n ,,!-.. uls as
,,„, „„,.U ,. .u,,,,li.a 1.V >;u. ->„.,n.,r gU.,,.! - ; , ^J ' " ,^ .., i,:'.,f i„„„,.aiat. t..na.,n ana l.y a .l.mKm
,„,„...-n,ar..ta,or,th, ,«.>t.rior,K,rt (n .,>., n,lv . h,>r,., t, n/, . 1
;,„,,,j„„„f„,r,lurO.,Koasan.-M.TnalroC,l..
,- ,o ,oi and '0^1 i- a Hal, broa.l. fan-like muscle whi.nhcs
The gluteus mm.mus il.tr^. -m, .,o., an i ■ °- „f „,^. .^lieula. tap
""- r, "T'^ •"• r" H :;s;^^;r::;h"::;s:n!.; :-:• ^"^ .- >" '--- ";■ ---' :-•
::;::;;:^n;::'i;;;t::;v:,::r--^^^ -"^•■— ^
,,„g,u,a.-,„in,nn,-,hU.h, ,u,., .-..,,..„ a ,o , .' •' " "'
( iliamtioni , , . 1 •
1 • t .!!.. ..>-.;■' t!'.'.:-: !; >.vn!'-!l IS
..■ u ..il ,r«-\ Ui jn 1 ) i^ a uivitie*''** ;w::u.u ■ " •*
£ 2 B
<3
•■r,
O
■A-
" ■'^^' ' *^^.'^''''''
THF. MX-SCLKS OF TTIK IllP.
21,^
covered by the gluteus melius and minimus, the midcile .,r main ,...rt.nn of ,he muscle .s d.rec- ly
beneath the sh.ta'us maximus, an.l the origin i> situated wi.hin the pelvic c avUv. 1. ar,-. s In.m he
pelvic surface of the sacrum a. the maruin. of the anUrior sacral foranv.na II lo 1\ - tre.|ucn.lv also
from between the foramina or concealin,- ihem ., and !,om ,he mar.nn ..f .iu- ,n-, ,,.cr . u„u no,, h.
\fter leavinfi its Hat and broad ..ri.i-in, the muscle l,ecomes M.nuwiu,, narrower, pa-M-. ihrou^^h
'the middle of the greater sciatic foramen, beneath ,he uluta u> maxima. becon,c. lendmou. rather
abrupllv. and is inserted bv a slen<ler nmnded Undon into the tip of the greanr iroc hanter.
The piriformis <loes not till die greater sciatic foramen l)Ul divide^ it i.V.o two .„mpanmcnts
which transmit both ^e..els and nerves, the sciatic nerve being one of .evcral structure^ uhal,
leave the pelvic cavity through the lowt r con •tnunl.
Th.. ,,inf„rmi> i- u.ullv M„,,liul !n .lir.-. , ...uW^ fmn, -lu- -, i.,... ,t. vu- 1. i- an , v., rn.l ..,ca.„. „ , .■
lim, - |Krf..niUil l.y ,. |,.,rUi.n ..f tin m iali. n. i \. .
The Obturator internus (Fig^. 20-. and ;,oo to :,02), like the pirifomti^. aii.o in the true
pelvi., but U ,,as.es to the gluteal region through the lo.er m iatic foratnen. 1 he tm.sclc ar,-..
Irom the obturator membrane atid the a.lja.ent surface, of tlu pul.i. and ,Mh,u,., and, ,0 a .cr
,,in exten. from the obturator fa. ia. 1- i> very broad at it, origin, bu, become, n.arkc.lly nar
rower as its tlbers converge toward the lesser .iatic foramen, in passing through winch the muscle
bends at aimo., a right angle anmn.l the tnargin of the lesser sa. ro.. iatic notch, the Mirlacc duvcted
,.,,,,1 UK- bone being ten.linou., and reaches th,- gh.teal region, .here ,, .o„n t.-tnunates u, a
slighllv naltencl tendon which passe, directly to the trochanteri. lo.s., where ,t ,. ntM-rtcl.
Vfter pasMug through the lesser viatic foramen a,>d rea.lung the poMetaor M,r a.e ol he
pelvis the inu.le receive- two accc^orv head, in the for,, of the .lender ,.null, he ,n„rllus
luprrior ari.es from the spine of the ischium, the .n.llns ,n,nor front the- tMlnai ubcros, y.
Tlev are inserted into the ten.lon of the obturator internus ahno., tltroughon, ,h, ,r en.ue K ng h,
so that thev together with the t.ndon form a kittd of pennitonn nn..,l.. XMutv th. obtura or
iniernt.s l.nd: about the margin of the leer .ciati. notch th.re ,. c^nMantlv .ttuated a
bursa, the 6»rs., ./ the oblunilor iul<rnu>, attd upott the tnu- I lu . the tin, k .c.tta nerve.
,,„. .,,„„,„, ;„„„„„. ,„^„„„. .„,. ,!„■ ..n,.ni. i- u.ull. .u,,,l,.,l t. .!,.„ ..„„.,„.. „ ,1,. -n --i fi-u-
l.ikr ill. pirif..Mni,. it i . .in . xl. rn.il ...i.c.or ol llu- ilii^li.
Th,- quadratus femoris d- ig>. ..,. and ,o. li. a Hat, thi, k. r.itangular mu.. k- .ituat.d in
(,..„, f „u. glu.a-u,. tnaxinn... I- an.c frotn the out.-r b,„d. r of the tub. ,o.,.y o, the wihunn
^,d in.crt. L a .ho,-, tendon into the inte-t,-o. hanteric tidg. . The upp.r tnargtu ,. the nu.. -
i, in nntncdiate relation wi,h ,h,- .. tnellu. mt.-rio,-. and the k.w r n,a,-.,n u„h tin- „ddu. ,,. n n
nu,.. r.ually betuath the .,uad,,atu., or in the grouv,- betuien tt and th,- mntellu. ,nl,-M,„ . ,u,,.
die obturator extcrnu., upor, whi, h li,. th,- s> iati, mvw.
■llu .|,l.nll --I- I'
,,1,. ,ll„ i!„. Mi.iii, n. r>> ll i- an.M'-rn,,! i..i. i lii.-ihu'li
The tensor fasci« lat« -I-'ig.. .., ami ...o, i. a tl.it ,lo-u:at,,l nm.,1. , nart-,iw ab,.,- atul
,, . .1 I... ..,■ ,l„. r,,. ;., Inlil i.,-,' D.IL',- J ; 'I in tiu U],p, I
broad iieiow. "in, h I- .Mu,.i, ! ll,;-*, - • ■■'.'.■ , ,i , , ,, i,,„ i-,.,,m
,,„„,,, „..,.han„-ri,, an-l .-M.rnal femoral r.-.ion. I, aii.,. bv .. ^hort an.l .kit nndon bo,n
^ .
214
ATI.AS AND TKXT «OOK OF Ul MAN ANATOMY.
rC .;.,1 1 ,v..r of mu-^clvs „f Ihc anterior surface of the li.ish.
I- IG. 207-- ril- m"^^ '^^ :;.,,,, i„^,,i„,, |iK.,„..,U h... als.. be.-,. r>move<l.
,1 ,,.rv,- 10 in> K.iM' tlu- I. iisi.m uf the fascia lata.
).()
Till.- mu
«l^^^u,.,.l..al>^•th,■^u,.,■ri.,r^luu,am■rv,■ami
THE MUSCLES OF THE THIGH.
THE SARTORIUS.
.„H.ri..r surface of fhe thi^h. ttt.i is U. -n.. ;— ^ ^ t' ^ ^-^ "^ ^'^^^ '''''' "^"^^'^'
superior ^,,ine of tlu. iliu.11 m co.iimon ^^ tth he U ">"■ '^^ ' j,^^^ ^^^,, ^.,,1 ...vnwar.l
U^omes eonsiclerahlv i.roader for a short thst.UK. ; ^ ^^^ ^J ^,,^.^^^ ,,, „,,,,, ,..,.,..
U-low the iliopsoas ami u,>ou th. upper portton ' ' _„.,, ,„, ,,,hes
U.. va.us tn.,ia,ts ami the ad.lu. --- ^^ '^'t ^ ^.a.iou \. gradually U.eo..es
,H. lower ,.rtiou of the -'-V ^ 't^^ras anterior in the upper portion of the thi«h
narrower and ts ,w ts ed . ^ ' ^^^ \,.,^i„„ ,,„,u. the outer (anterior, niar.ni o, the ,ra-
n,nv iKeonus nnernal. It tlu ti laKCs up a ^^^^.^ ^^^^^^ ^^^ ^^^^,^, ,,, „,^. ^^^^,,..
"",. ■ ":,'■- "■" "■■•" ""°'""'"'
THE MUSCLES OF THE ANTERIOR SURFACE.
THE HUSCLna ur ir... ~
•.1„. quadriceps femoris iKis* =*>.' --'A .l"' •'"■^^^^^^
T,,, rectus fcmorls ,1..^>. •* ■" -'*' '";."':;.;„,,,, ,„,, ■i„„„„li,mly I,. .,,,,.1, .1..-
t':,;;;;:;;;. .is::;;;::::,,,; 1.™ a,,,, «.» ...^ --^ "™ »- "- ^^ ■""-
*riii' ,,irliiriii> a
.lv,|«.-,s,'- ,lh.-l.>iW-t MUl
iM iilar (a^iUuli in lli'- I""')'
Anterior super,
spine of iliu;n
Tensor _ „.
fasciae latae
llicitibial '
baud of fascia
lata
-^ Prontontory
Unrtorius
Tensor fasciae
Piriformi<i InUie ■
Olutaeus
Inguinal media'-
ligament.
Tnhcrosity of tibia
— Adduaoi magniis
•i- Graciii'-
I 'aslas laterali
Tendon of sarlorias
Tendon of gracilis
Tendon of
semitendino^us
Sartorius
Svm/ihyseal
surface
of pubis
Adductor
magnus
Adductor
conal
(femoral
vessels )
Gracilis
Fig. 2Q6.
Fig. 297.
■jr
a
""'-Jf^V
■.?^K
THE MUSCLES OF THE THIGH.
-M^
itself while the other proceed, from the up^er margin of ihe aeetaln.hnn an<l ,o,ns the on„n lr(,n,
the anterior inferior spine at a right or obtu.e angle, the two together b. .ng eon,.nue,l . ownwar.l
a, an aponeurosis upon the anterior surfaee of ,l,e nn.sele. The I'.ber. o, the n.Useie -io not run
lon^Mtu'linallv, hut diverge downwanl and haek.ard touard ,he in>er,>on iron, a .end,nou> s,r,,,
in ;lu. mi.ldk'of ,he nn»ele. The Hat ten.ion <,l in>eni..n .onu.Hnees up'-n the anterior a.peel
of the museular belly a few eentimeters above the i>a,ella and uniu.> wuh tl^e rc.nanung head. ,o
pass to the ujiiier margin of this l)one. , ■, , i
The vastus medians unUmus. .Fig^. ...(. to ..S. i^ a large, llat. dn. k mu.. le Mtua.ed
the anterior and internal femoral r.gion>. h. origin is from the inner lip o, du- hnea a., . ra o
the fenu,r where i, i> adherent to V . insertions of the addue.or. hs , k,. run downuani and
fonvanh .ome of them being inserle.l into the upper n^argin of the patella v.d, the eonuu<.n ,en
,l„n and some of them passing in.lepen.lendy to the inner margin of .h,s bone. I he greater por-
tion of the musele is situated in the lower thi-d of the femur; its outer uu.rgn, r. tuse.i wuh .he
vastus intermedius. . n . i
The vastus lateralis irxlcmu. . , F'g^. .<;<- --' ^-.S. ^oi , and ,,o. ) » an unusually strong, large.
,lat mu.sele, whieh forms the ehief bulk of the museula.ure of the external lemoral o.non. 1. ,.
stn>nger than the medialis and do., no, exten.l as far .lownward as ,h,s nu.sele, ...ng h uated
chielW in the upper and nud.lle thirds of d,e llugn. I. arises from the outer hp o. d,e hnea as,.,a
as far' upward '.s the great trochanter and ,o a eer.ain extent Iron, the ou-r pon.on o d,e ia„e
prominenee, and its libers run <,ui.e obliquely from behind forward and Iron, aUne downward.
the direction of the upper fasciculi apjiroaciiing the vertical.
The entire -xternal surface of the m.r.cle is covered by a broa.l aponeuro.,.; ,N inner mar
gin conceals the greater portion of the vastus intermedius. wid, win. h i, w inseparably connec,..,
an<l it is inserted bv means of the common tendon into die upper an.l outer margm^ .)l die patella
The vastus intermedius icrurrus^ iFig. .„S. i^ a Hat muscle, the ant.nor surlace o w n, h
is tendinous and distinctlv excavated ,o a.rommo.late the overlving rectu. lemons. 1. ,- ,l,e leaM
independent of all the heads of the Muadriceps. since 'ts lateral margins are inseparably co.n.rol
.ith the other two vasti. It arises fn.m almost the entire length o, the anterior sur.ac o, die
shaft of the fennir. and its libers pa., from behind downward and forward mto die anlerioi- ,en
dinous surface of the mu.cle and .ubscMuendy in.o the .ommon tendon ol die ,|uadriceps. 1 he
lower fasciculi of the vastus intermedius pass to die join, an.l a,v known a. ihe m. .ri,.ul„r,s
rhe ...mmon lend.ni ..f insenion ,.f ,he four lua.ls of ,!,.■ MUa.lri.vps ari>.s imm.-.lia,. v ab.,ve
the pa,ella bv ,he union of du' ten.lon ..f ,he rectus wi,h ,ll..se of ,lie vas,i. I, embra. .•. ,!,.• entire
upper an.l ,lie la,..ral margins .,f ,lie pa,ella. ,he la„er s,ru. ,u,v simply serv ing a- a ..■samo.,1 bone
f.'r the ten.lon which i. c,.ii,inu...l ,o ,he ,ulHn.si,v of ,li.. ,ibia a. die i-au^llar hganu-n, (..r pag.^
,,,5). The actual point of insertion ..f the .lua.lricep. i. c.,nse.,uen,ly d>i. rough.n.-l pro..... ot
the tibia.
•I-l„. ,,„,„lri,,.,.s i^ >u,,pli..l 1./ tl-- l."-.'l — '" -'-■"'l"-« "" l''^ *' '■''""- ""■ I''"'"'
I:
ATLAS AND TEXT-ROOK OF HT'MAN ANATOMY.
Fig -oS.-Tlie .icq. lavtr of musdcs of iho ^interior surface of the thigh.
Th. iii,,,Las, sartoriu. r.aus f.moris ,,.-.n.KU.. ad.lu.l.r lon«us, an<; graul.s have been rcmov.-,!.
Fir -GO -The insertion of the iliopsoas and the origin of the ol.turator externus.
Th. a-Ulll^U.;'";... t.!^ "ivi,Ud an., r..,,,.,.,, ' ,.,. f.nu.r ha. W,n .a.v„ ,hr„u.n ... ,w th. tr.nha.U.rs, and ,.
sHchtlv Ik'Xiil anil rcitateii outwanl.
Fig. 300.— The origin> of the piriformis and th. ohuirator internus.
Thi- pelvis h.i.s livvn diviik-il in llu- mc'<lian l.nc.
THE INTERNAL OR ADDUCTOR GROUP.
Tho muscles of this ^roup ari^e from the pul.i> ar 1 ischium in such a way tha, ,hev forn. a
series of rin<^s ahou, the ol„uraU.r foramen. The outermost ring is forme<l by ,h. ol,tun,'>,
exnrnus, the'middle l.y the. M,aor /-nr/.v an.l mhw.us. and the inner by the !>,rlnuvs, the Mu-
tor hn^m, the ,i,'n" ///.v, and the nddiuWr mapius. , • . 1 , ,„.,., „
tL pectineus .Figs. .oO and ..;, is a llat, -trong. .t^drangular muscle suuated between
the iliopsoas and the a.lductor L.ngus in the subinguinal and anlerior femoral reg.ons. and form-
in., to.'ether with the iliopsoas, , he iliopeCineal h.sa. h arises from the ., est o. the pubis a. Ki."
fc;.vard as the pul,ic tubercle, passes ..bliquely fron, above dovvnwanl and t,-om within outw.ird,
.,nd i. in.erte.l bv a short len.lon int., ihe pectineal line of the femur. 1 he i.tser lion ,s parH,
conceale.1 bv the iliopsoas, covei's the obturator externus and the upper pan of the ad.iuctor bn Cs,
and passes over the inner siirface of the articular capsule ot the hip-Joint
TlK. ,„., ,in, u. addua. .he ,hi«h and als„ a.i-t- iL xi-.n. 1. i^ -upi'li. ■! '- '1- ..'--t,,,- and fen,oral nerves.
T-he adductor longUS ^Mgs. ,^u and .07. i> a thick. Hat, almost triangular truscle, situate.!
,..,ween .he pectineus ait,! the gracilis, it ar,.-. bv a rather naiTow In. .hor. ami strong te,.do.
1, ,he sup rior puwic ramu. between the origin, of the pectinetis and gracilis b^conjes decidedb
" uler as t passes downward, an.l i^ i,i. rU..i by a ^hor, icn.L.n in-o the mi.l.Ue ihinl . .he inner
he lin a a.p..ra. The hb.is ,d .he mu.le pursue a direc,i..n siiiular ,0 .h.^sc- o. the pe. „
s though th V run m.„-e ,lii-e. .ly .l-wnwai-.l. If ,he muscle i> w.ll de. op.-d ii. upper mar^
;; i; imm..dia,..i; ..,n.i,ti,otis w„h ,he lower margin of .he p,c,i,t.u. a,t,l wl, e i, .s .,uaU.d
b...we..n .he p. e.ineu^ a.t.l .h.. g-'a. ills ab.ne. i.~ L .wer p,.i-ti..n I.es up..n .he a.l.lu. .- magm,>.
1 ic is exp.le.l between .h.. a.l.iu.„.r longi,. aivl ihe gra. ili. Tl,e upper p.,r,,.,n o the i, due -
„„. longtis lovers the a.l.lu.tor bn vi. .he lower .he addu..,..- n.agnu. u- .en, on .- in--e : J^
,„nceale.l bv the sir...riiis an.l i^ a.ih.T.n. .0 ,lu- ...gins .d .!,.■ Nas.u> mciah^ (se. ,.ig. -is>,
;:;X ut 'h- -.^.1,0 sar...riii. an.l ,h.. iiiguinal ligam..,., .he ntuscle forms a .rtangle, the le.oral
tr'miii^^k (triangle .'f Scari.ai.
The a.ldu, .0,^ luni:u. i^ sunphed l.v ih,- ul,u,r.„.,r nvrv. , ii addua- the .h,uh.
The mcili. .Fi.'. ..,71 i^ a long, thin, slemler mu.de, .i.ua,.-.l i.pon .he inner aspe.l of .he
1 lie gracilis. I.,. - ;, ^ - ^^ ^ ^_ ^_ ;.,,•,.,.;.„. r.,nu ,,i ihe nubi- near .he svm-
|hi"h. It ari-e- i)\ a ilai . .11, i"n ironi .iie :U|Tt.. :■.!■,:, •,, ,, i „ ;,„•„,
Hv^i, be.„m,.. -m.vhii. bn.a,l.r a. .k>., but s.,.,n narrow- a.i.l. ,u>t ab„v.. the k,ue ,o u ..
: ■s.-Jinio a long, r.,und. .l..n.U.r .en.l.nt which runs t., the inn.r bonier ,d ,h,. .ubercl.. o. .he
liljia and radiates inf.. the />, v anscrinn. as .he secon.l .eii.ion .d .ha. Mru.ture.
Sartoriiis
I lio pectineal bursa
Iliopsoas <
^-^ Siicrotuhrrous ligament
* Adductor tpn^iis
Obturator externiis
Addiictiir brevis
Adductor opening.
Tendon of adductor
magnus
- Semimembranosus
Obturator canal.
Internal intermuscular
septum
Tendon of sartorms_ _
/ endon ofgradlis ■
Tendon of semitendinosus
Pes anserinus
Sartorial bursa
.-\nserine bursa
Fiff-. 299.
Adductor
longus ■
A^ymphyseat
lift surface
I I ; 1 (>/' pubis
Piriformis
Coccvgeiii
Sacrotuberous
ligament
Promontory
Si'cral canal.
Sacrotuberous ligament
fifr. 300.
rig. 20S.
■■^'■1
T^
i
i
1
1
;
\
s!
11
THE MUSCLES OF THE THIflTI.
21'
TK musck- is Mn.plicd hythc obturator m-rv,-. \Vh,n ih. kn. i- rsl.n.l, ,1. il a,l,lu.t- hv tliiL'h ,,.,.1 ..-i--.- <n i!u
flexion ,f 'he kill'-' !.. int. and, wlun thi- knn- i> fli'xcil, tkv.iU- iIu '-t; lUA.iril
The adductor brevis (Fig. pqS) is a long, broad, rathrr tbic k muscK' which i> uiuur.l m
the midd-- lavir of the adchictors (t,chind the i» rtineu-. ami addiulnr lon-n-, Imi in In.m -; ilu-
adductor inauniis). Ii i^ longer than the pctineu.-. >horter than ih, addiutor longvi-. .'.vA i~
usualK .omi'.letulv .oncealod by these two ntu^ele.. It ari-.e> from 'u >ti,.enor ramus .A thr
I)ubi>,' nean . ihc'obturai- - foramen thnr the ad.ltutor l(.ngu>. an.' ,t- libera imr^iie a c...,u>.
similar to those of the lai r mti~- k; but nni m. nbli(|ue, t.. the ui-ik r third ..| the inner lip ^ i the
line;! aspera of the femur.
•[•|„. ,„ rvi— up|.lv .incl the fund:, i. an- i.^.-. iliusr . \hr .ul.l . l<.r liini."i-
The adductor magnu? .Figs. 2<)(^ to 2()S, ,^oi, and ;,02) is ■;'- stnnv. est of the addtuK.rs.
It forms the deei.e.-t layei .nd i- Mluate.i most ;.o>terior!v, arisi-i- from tli,- inf. r ,r ,.ubic amu^
and from the km. r bo'rd. r of ' 'e luSenoiiy .,1 the i- am. In np|-. r liber^ ;.a» bi,' dighliy
downward, the middle ,ire more oblique, and the lower an.i anermnq liber- pursu. m alm..^
vertical direction: the upper and middle libers i.as.-, behin.! the a<l.t utor l.-igus and brevi> l,. a
muscular or short t.ndinou- insertion int.. .e upper t\\M tl.ir.l-^of ■ • iiuur hp of ti;. linra a-pera .
the lower. alm...t xerli.al liber^. l,owe\, :, pas> mlo a round ^1^ .ler ten.l.m whu h run^ lo th.
lowest portion ..t the linea aspe. and t.. 'he int. nal ej.i. ..n.lyle nl the lemur. .\l aN.ut the lower
third ui the Ihigii this insertion eoni,.in> an el..n..;ated orilae. kno'.vn a> \hr l,n,Inwii^ <uUlw lor
opcnin- (Fig. 298), which ha> ten<iinous boundaries ;ind give.- passej. I'l 1' lem. d vesseK.
Between the tendin.uis origin of th. va-tus m(.Hali~ .■..! th. aort i adinou- inserliu.., ,,f
the adductor brevis, longus, tml ma.rnus. acre i.-- a deej) ur.-ove .Ahich i- ..nvert..J into a .mal.
the</(/(/»rtor iHlinUr-^) nmal, In die sarl..riu-. li coniain- th. femoral -.es.eb, .uid the len<li
nous libers of tjoih group- of mu-. les are interw.,\en in ihis situation !■■ form > liiirou- va,-. idar
sheath. .
While the gre:.-.T porti.m of the anterior -urfa,, f the ...l.luct..: magn-- is .(.\. r.il 1,\ ihe
adductorl.mgusandbrevis. it-i-o-ierior-arla.. liesup. nth. ll.A.,r .nusc 1. -, a) i it is . ..n-e.|Uently
-iluated between these tw,, -, ts of mils, i, s. Hie m i.itic nerve li.> upon it- p..-teri..r -urta.e.
The adductor minimus il'igs. 2.>;. .^oi, .^02) 1- a small, llal, approximat, K quadrangular
muscle, which fre.iu. :niy appear- to be -imi)ly '.la up; • . p..nion ni ■he .. huL.. nagn :>, with
which il i-alwavsdir.-.tiy ...nlinuous. It ari-<- from iii.- inf. a.r pe-a r,mus.,i in.m ili. juiu
tion of the infer!.. r rami of ;h.- pnbi- an.! i-. itium, il- upjicr liber- 1.. in' Im.. hori/...Mial, ,inil
running below ,di-tali ami i>arail.l ■ . ihe .|uar!ratu- Umori- ...v. aigin : u'u; ..rm.iM ^il..!;. .,f
the adductor magnus from behin.l . to be insert.d int.. ihe upper . a.l .)f i f.aii r bel..u 'i'. -real
trochanter ami be-i.le the glui.a! liib.r..-ilv. It- k.,ver liber- nn; oblLiuely .|..wnwant .1 are
in.serte.1, t.igether with th..-.> ■•i the a.lductor maL'nu-. ii.io the pper Mremi' ..f the raier lip
of the linea aspera. The sciali. nerve lie- also upon th. ,.lduct..r miiuinu- (-it .M-e 21;.
I'll.' a.l.lu.ti.r ni.innv;- ili.i
Thtir .itUi)n is -imil.ir t.. lli.it >>i
i!iiu> ai' . .Ill in -..pe
iitllcr ail.l.-Hl.il'--.
:,;ur;K r nvr\v .lit-:
Th.' obturator externus . igs. 2^,S ami 2 ,■ belongs to the ad.huM- -;roup .mly ..n acmni
£-iM^-''
i
i^\:.
m
2j8 atlas and tkxt-book of human anatomy.
F,o. 30.. -The d.ep^layer^_of the posterior hi,. n,u.dcs and the su,.cr«c1al layer of the Oexor. of the
•nu. «luu.us .SSr^llnH-lius an,l ,1... „...ura,„r ''^^^■'';''' '^;;r ]CaZuL of the rtexors of the thigh
F,G. 302. -The .lee,, layer of the posterior h.p muscle, and the .kt,. l.ucr
region. , ■ ,1, i„ni, !„■ 1,1 ..f thi' hiirus, ami thu srmiti-mlinosus haw
Th>- Rluta-us maVimus an,l nH-.li.>, ih. .,ua.lrau,s f.muns, ,lu- lon^ h. a.l 1 •
b«n rinioviil.
.„,, ischium »,1 is .,™,,k,dy ■,.vm-.l l.y , .■ 1" ;""'- 'j' ' ^ ""\i . ,„„„ ,h, i,,„i„„,,
, ,„,„, ,„ .--;;»;*»;„„ : — r^rn.:^:;:":;;! -„. ,„ ... ....
chanter, and i.asse> n\cr and i.c n.nd ur ,.„v(.red hv the latter muscle, to the
^xr^:rr*:;:t;i::s.t:;:Jr^ -"
dinous a short distance before its insertion.
The „„U..U.,r >..U.n,u- i, sup.li,-.. i,v -h,- ,„„ura,.,r n.rv,.. I. a- ,. as an eternal ...a...
THE POSTERIOR GROUP. THE FLEXORS.
,, , 1 th,. />;,, fts ;Vm(>r/v the .'"■m//()i(//»<>';i/v, and the srm/-
-i:s;i:;;::r;rpri:';;t:;:«^^
hulf'.f the outer lij. of the iineaas]Kra. ,.,,.:, ,h,. ,K,sterior surface of the lon«
„ ,^:^;:r;:i,;i;';;:::^^^^^^^^^^^^ - '-
„„. ,:■ ;:;;;::;;;';«;;.r'n;:i: ,;':,l;:i,; „; -.,.. < - -■
lH.]ilileal fossa (see page 2.-0..
„„,„n,hea„.,t.he ,.„.,, i .,..,....,. ,h,0.„.„ , .he .„.Oh,a,M. ,.„.,.,. a,,„ne.
S,icroti:herous lig.
Sacrospinous lig-
Obturator internus x /
fiiirsa of obturator int.
Tendon of
■ifmitfiidinoiiU'^
Trndon of
si-mimemhranosiis
I rndv'i '''' i^iiljra-
tor iiitirnns
MiilJIr '^iutM'i
hui v( >'
jlntaeii s incdiiis
Hiiv/i'i fi'iioris
(short heiiit)
Irrtdon of
Iticrps
Itndon 0) ^
simimtm-
branosus
Oemellus superior
Gemellus inferior
aiutaeus
medius -
Qiuidratas
fimoris ■
llinii:i femons
Inni' head)
n, m
lie WJ.
.T>
^iH
mijj-:L^r^;,khs.
S.:^i£<ji
THK MTSn.F.S OF TTIF. I.FC.
21Q
head Of the biceps, although its tcrdon ^s sonn.vhal sho,,c.r. and .ts muscle porfon rcquenth
exhibit Ttendinou intersection. In the l-.ver fourth of the thi.h U ,,as>. . .n,o a c yhndrual ten^
don which is insenci into the inner surface of the tubercle of the ..l.a and .orm^ tl,. .o..nK,st
tendon of the pes anserinus (^iS- 2q8)- ,,n.i,en.lino.u> form!,,, the
The three tendinous i-xi.ansions ot the sartonus, i^iaciii.. i ,•,,.,,
uesans rinus(Fi,. ..,8. are peculiar in that they form fan hke ra.hat.ons Intween whul are
Su2rt^nu.mbranes. The broa.l ten.iinous surface of the pes anseru.. ,> separated .rom
ttlX:Z^^ns.rn,c l...rsa ,Ki«. .,<S,. In a.l.li.ion to it> attachment to the t.b.a, the pe>
anserinus is also intimately connected ^vith the crural fascia.
Th.. .■,.....n.l.n..us i, >u,,,,iu.a l.v .h.- til,i„, n.rv.. 1, IVm< -i.- W, and r.,,.,,. „ ,n.anl
The semimembranosus (Fi,. ^on i> a v.ry pe.uli.r mu.le. Its up,.r ^^^jf^'uiZ-
sistsof a Hat membranous tendon, then follow, a tla. but wry .huk muscular belly whu h Ima
aim nates at its insertion in a llalt.ned round tendon. The ma.k- ar,... Irom the ube-oM' ,
"r hi m in front of the Ion, hea.l of the biceps an.l the s.mi,end>noM.-, by a .b, tendon
: '; ^Z.:..n the posterior surface of the adductor ma,nu. and .i'-^".-!;;;-;" o tl. s.n.
lcn<linosus; upon the outer side it extends .lounward a. far a> the nuddle ol ,lu tin^h. uh.k
sZwh t i.rter upon hs inn.r aspect. Fron, .his undon ar. ,uen .... muscular tascuuh
l^ri^ from alH.u. downward and from witltou, inward, and Ikcohu. ..nnmun. .„ a
^ rlded t..ndon .tuated t.pon ,h. inner ..l. of the •"-^'--V''';;:";;;!; ".':.:: 1 r
„f „,, thi.h. Thi-^ tendon of in.r.ion passes to the n,ternal tuber, le of the tib.a ,. >nudl p. ,
.' a i^aes into the obli„ue popliteal li.amen, ..e ,.a,. ,,.,, an,l .; ..be. ^''^ '- •--
orh to the inner n,ar.in of the tibia. Heneath the ten.l.M. .., the s..mu.u ,nb,an..sU. tin,. ..
Z!ue!l a bursa which communiea,e> with tlu knee-j..int. the l.rs. o, ,l,r s. ,un,u,„l.r.u.s,.s .see
'"'Viule the upper portion of the >emimembrano>t,. i. M-uat..! in fnu,, .,f -h. -->-'''--;;
„., L lon« head of 'h.^ bicep>. in the lower ,hir 1 -f the ,h„h. , .- nu., 1. h.-. m,..rnal t.. the
biceps. t..«ether with winch it f.-rms the u,,per Ix.un.lary ..f liie !„>ph..al .o-s, ,mv IkIo.v ..
,-,„. n,.rv. .„.,U ..,,.. ,h, fun, „ I -l. -. nun,, ,nl,MM,„u. an ..n„l„ ■•, .1..- .m n,| ■„ an,l i, a...
.„u as a t,ais.,r ,.f lllr tai.-ular li«anu nl ..I llv t-n. . I„.m
THE MUSCLES OF THE LEG.
THE MUSCLES OF THE POSTERIOR SURFACE. THE CALF MUSCLES.
The muscles of the po>teri..r asp.c, of the le« , Fi,. ^o^ .o ,o;, a-"""i"; '''";;;;; '^^ ^;;
a superl-uial laver forme<i bv du. /nV, /n su.r, and ,. deeper lav.r. n.n>...m« .. in /../■/""- •'
,„,lo( tin- libiali. po.Urinr:,hx,.r l,.,l.,ui. hw„<^, and //rv.r .//,■'""•"'" /"".^'"^ ^u^. .
THE SUPERFICIAL LAYER. THE TRICL 'S SURAR.
.- :.i i: ._.;. ..I.,- ,M,I l.liiiiilal iKirtion. till' i,"'*''"'"
The triceps sure »"ii-i--,- "• a ii.rni.n -r..-.:-
mm/«v, and .'f a d.TiHT m.mariiMilar p.)rtion, liu' M'/c/(^. ... .
The gastrocnemius , Fi«. ,o.V i> a .lat, . I..n..ate.l. .lis.inctly bi, ipUal an-l verv Mron, nuH. le.
"s^^mmtm^^ms:. vts^^.
i \
t !
2 20
ATLAS AND TEXT-BOOK OF HUMAN .\NATOMY.
Yic 30^.— The superricial muscles of ■.'tc calf of the- leg.
Fic 504 -The second laver of the calf muscles. The gastrocnemius has been removed.
P,(, ' _xhe deep musculature of the calf, seen from behind and from the inner side.
Thi.' iriups sur:i- has luin rcmi.vi-cl.
which is situate! upon the ].(.stcri<.r aspect of the knee and leg; its muscular belly ,s s.tuated
chietlv in the sural region, ^^hile its tendinous portion is located in the po.stenor crural region.
The two heads the inner hnul .^aslroawnuus miJu.lls) and the oulcr head (aastrocnamus laler-
alh) arise bv tendons from the upper extremities of the epicon.lyles of the femur and exhibit
aponeuroses ujK.n their internal and external surfaces, extending <lownw.- d almost to the muldle
of the muscle. Beneath the somewhat stronger inner head is >ituate(l a bursa which communi-
cates with the interior of the knee-joint, the inmr ^i^.islrocncmial bursa (Fig. 304) (see also page
n6) Both heads of the muscle pass immediately over the ].osterior surface of the knee-joint
furmin-r the inferior Ix.undarv of the popliteal fossa, and below the articulation they become
broader ami are united in such a manner that their line of union is indicated by a median groove
which extends almost to their insertion into the common tendon. Somewhat below the middle
of the leg, the muscular tissue terminates rather suddenly in a broad tendon which becomes nar-
rower and fuses with that of the sulcus.
The soleus J'ig. ^04) is a Hat, verv broad, ami rather thick muscle, the upper portion of
which is covered bv Uu- gastrocnemius, the lower porticm be ing situated immediatelv beneath the
deep fascia to either .ide of the gastrocnemius tendon. The- nu.scl.. arisen Irom the- capitulum,
,K.sterior surface, ami outer Ix-nler of the fibula fr.mi the poi-Hleal line .id the surface immedi-
atelv belcjw it upcm the posterior surface- of the tibia, and from a tendinous arch pasMng over the
popliteal vessels between the tibia and fibula. Hie tendinous ar,h 0] the sohus. Shortly after Us
I,ri.nn the muM Ic- become-, broader, and e dlibit^ upon il> ] osterior aspect an aponeurosis which
ismMinuousNvilhatcidon ^^hich fu>c-. with that of the ga>tro. nemius and also receives the
inse.rtions ,• lower Iving lateral mUM ular fa>ciculi. Thi> Ic-.tdon of the triceps .ura-, broad at hrsl
and becoming narr.mc r and thic ker a. it pa»c-s downward, is km.wn as the uiUaneal Inuhn itnuh
ArhiUh . it i. tin- strongest tendon in the entire Ix.dyand is in>erte.I into the ui.per margin
of the tube rosiiv of the calcanc-us. , . . 11.
The triceps Mine also in, hides ih, plantaris (iMg. ;,04i,;i small muscle wit a very short but
rather strong b. liv and a verv long -lender tendon. It aris, s fn,m the- external enicondyle- ol tlie
femur to the inner -ide of and s.,mewhat alH.ve the- outer h, ad of the gastro. m-mn,s, « hie h partlv
covers' i! :,nd the- short muMuler b.lK i- dim tc-d ol.li,|Uc-U .mtw.rd and downward betwc-en the
uastrcKnemiu. and sole c,s. Tlu slen.le r tendon lies up.m the- inn. r si,le of the soleus, runs d.mn
ward along ihe i.m, r margin -f the tendo Achillis, and fadc-> auas partly into .his structure ami
j)artlv into the dceji fasi ia of the leg.
Tl„ ,n,,ps -ur- I. s„p|.l.-l '.y .K- „. . ,1 n, ,., , I. ,.r. 1... • ,.!.en,.,r ll, vi ( ilv- f..,.,. Th,..,.l,emaris a. .s as a
(cllsnl- i.f llle- letl'l" \' I'llll'.
THE POPLITEVIS.
The- popliieus I-igs. ^0 1 ,ind ^o-.) i> a Hat triangular musde which is in a class by iisc-lf. It
i. .iu.atce! in til, s.,nu- lav.-r as the soleus. with vvhieh it is dire. Iv related by its U.nmt ami outer
IniiiT head of Gaslrocn
InH'^i- hriid :}fpv^l-orneiin,
Tendon
of !
semiten- I
diiwsus
Crura'.fascia
(deep layer)
/'.'iintarii ■
lute.- hi'd
Ciisfroni
A ■citatr
Pmmaeus I
peronacus I
(iilranea
* I tfmiim
^ii/i ptron
nlittflCllI
rir irt'>
Fig. 3U3.
fig i(i4.
p
THE MUSCLKS OF THK IKC.
221
margin, and is covered by the gastrocnemius; it runs immediately over the iK.Men..r .urta.e of
The knee-joint. It arises (inserts) by a tendon from the external epieondyle of the fenu.r and ron,
the arcuate popliteal ligament and inserts (arises) in the trian.uhr area alx.ve the poph.eal hne
upon the posterior surface of the tibia. The lower portion of tlu. muscle .s covere.l by a la>aa,
aponeurotic in character, which a'so gi^c. .H,in to muscular tibers. lU.neath the tendon of or„„.
(insertion) is situated the poplil.ai hnrsa <.ee pajje ,3"'. ^vhich communicates wUh the knee-
joint.
The ..opHtous U .upplu-d by .hc .it>i.. n^rvc. I, a.-.s as a ..nsor „f .lu- ar.i.ular , ap...,- of .h. W.H.-ioi,,. an,l
hdps to rotate the tibia inward (when the knee i> rleNedl
THE DEEP LAYER.
The muscles of this laver (Fifi. .^o?) .the ,.osition of which has been previot.sly described)
have experienced a peculiar' displacement with reference to those of the antenor ^roup smce the
S^ 1" o erior is pushed awa uc.n the :ibia and situated in the middle, w .le the .^.or . .,
c!rum lies a.a.nst the tibia; the llexor halhu i> conse.,uently lies upon the hbula a,K there.ore
to the outer and not to the inner side of the llexor di.itorum. as nn^ht Ik expected. The correct
relation is restored bv a crossing of the nn,>clcs. that of the tib.ahs posterior .k curr.n, .n the Ic,
,vhile the tendons of 'the .lexer hailucis and of the flexor di.itorum do not cro.. unul .h.y reach
'"' te ^Llau/^^^terior (Fi«s. ,0. and ,. . i. a Ion., , ather Hat, di... tlv , c-nniform mu. Ic
(llu. lower ,.,r,ion is onlv semipenniform ., which arise, l.a short -cndon from ,hc. upp^T 1""'-
>f Ute postlrior surface of the tibia, from the interosseous ntcn.b.ane. and .rom the -- scjr.acv
of the ibula beside the .lexer diKiton.m, which frec.uentty , ar.ly cover. U. Imincc ha el b.low
this origin a verv stron, tendon appears in the mi.hlle of the mu.cic vc-r^n, «radua ly .0 U. nmc.
rder, and parses l.hind the internal nudleolus to the sole of .he foot I he .e.don ,s >n.e,te.
dtie.lv nto tl tulKrosity of the navi.u.ir bone (Fi.. ,..). son,e fascuuh be.n, ouvctly prol...^d
to thJ internal cuneiform and others radia.in, al>o .0 the remannn, cuned ,rm l,ones and extend
inc as far as the (ul)oid. , .
M.ove the malleolus, ,hc. tibiali> posterior cros... be.ea.h tlic Hexor .l„Uoa.m, .0 , ha, U.
tendcm assumes a position internal U. that of the latter ,.ascle. Heltind the malleolus U . ..ua-ed
within a tendon-.healh in the huini,llr /(..,/mr;,/ l:ee i)a-e -\^il.
Il prochi'
, pl.un.n 11, AioM'of I'l.- fool .m\ ,iUn
, I he
inn.r iiiarj-ir, oi ihe .v.le i .u|.M.,,iiMU-
The flexor digitorum longus (Ki^s. ,,0.; a-^d ,;m r.sembk- .he tibialis pn-t,.!,,,- in i.s
external appearance . 1. i^ p. uniform above , scntipenniform belou , and he. a, l,rM „pon ,he nl,.a
an 1 1 wer .ourd, of the U., be, ween ,1k tii,ialis poMeri-v and d.c .lexor hallu. ,>. .he .ormer
n^ Kin, crossed bv i, a. a sh.h.ly higher level. The mu. ic- ari.. .rom .h, pe.Menc.r M,rfae .^
rimerosions crest of the tibia, and i.. .endon.like ,ha, ,-. ,],.■ .ib.al. p..„;nor. . deveiope^
, . ., , >.^.,.,... „f ,1, ..h. Thi. tendon is sitnal.el .0 ,lu outer sulc- o. .ha, ol ,he
Eir^Ilr'and ntns lH.nea,h ,he lacinia.e ii.a.nen. ,o.he s,.i,..,f ,h „., ,l,.. ..n, when.
, ,,ivid s in.o four .ettdon. for ,he outer four ten.. These perfot.Ce ,h.. tendo.s o. .!.■ ll. xo.
^m'-
:^m'^j^^:^
^
in si
i
J i
222
ATLAS AND TEXTBOOK OF HUMAN ANATOMY.
Fig. 306.-The muscles of the anterior surface of tl„ lower leg and of the dorsum of the foot. The
transverse crural ligament has been removed.
Pic 307. -The muscles of the lower leg and of the dorsum of the f<x)t, seen from the side.
diRitorum brevLs and pass to the ungual phalanges. (Further details as to the relations of the
tendons are given on page 231.)
The muM k- is suppli..! by the tibial nerve and flexes the second to the fifth toes (especially the ungual ,,l>alanges).
The flexor hallucis longus (Figs. 30^ and 311) resembles the other two muscles in -his group,
but it is somewhat shorter and stronger and, at the same time, distinctly penniform. It is the
most external muscle of the group and preserves this relatitm throughout the leg. It arises by a
short tendon from the posterior surface and outer border of the fibula, Ix^low the origin of the
soleus / e from the lower two-thirds of the Ijone, extending downward to just above the malle-
olus ' \ thick tendon which is situated in the center of the broad muscle, commences m the middle
of the leg and passes through the outer compartment of the laciniate ligament to the sole of the
foot (Fig. ,v 1 ), where it crosses the tendon of the Hexor digitorum and runs to the ungual i)halanx
of the great toe and indirectly also to the other toes.
The mu« le is supplied from the tibial nerve. It flexes ,he great toe and indirectly also the four lesser to,.s.
THE MUSCLES OF THE OUTER SIDE OF THE LEG. THE PERONJEL
The posterior iH.rd.rs of Ix.th of these muscles are in relation with the soleus and with the deep
flexor group, while their anterior margins are in relation with the muscles of the extensor group,
from which thev are separale.l in the lower third of the leg by the lower portion of the shaft of the
fibula and the external malleolus. Tiny are situated in the external crtiral region.
The peroneeus longus (Figs. ;,ot. an-i 307) is a very long, distinctly semipenmform muscle,
which ariMs l,v indistinctiv separated anterior and posterior heads. The anteri.-r head is a short
tendon from the head of the fibula, the contiguous portion of the external e.mdyle of the tibia and
the .rural fascia; the p.slerior springs from the upper two-thirds of the outer surface and outer
border of the fibula. .\t the junction of the middle and upper thirds of the leg, In.th heads
pass into a slightlv llaltene.l tendon upon ihe anterior surface of the muscle, which broadens as
it descends and passes beneath the nthianil.i prromorum (Fig. ;,07) (see page 230) in the gr.H.ve
behind the external malleolus, to the outer sid.^ of the sole of the fool. Deep down in the sole
the 'end.m lie~ in the groove of the culxml (Figs. ,^1 and ,;i2),is provided with a thick sesamoid
cartilage or sesamoid bone, and passes L- the UiIh rosity of the metatarsal bone .^f the great Icks
s,,m.. filKTs being prc.l.mgc.ll.. the internal .•ut>eif..rm and to the base of Ihe second metatarsal bone.
The peronanis longus almost entirely conceals lite origin of the perona'us brevis; in the lower
(. ,, . .1, I.,... r -eiv he --e" i>oib i" fn..ii of and behind the maruinsof the perona'US
I. .'in 01 ine le^ iile LiiuT mt\\ oi ..t.. .,< . .
longus or iis tendon.
The i-ronau. longus i. M.ppli'-I f-n, ,he peroneal nerve. I. abdu, .s the f,«„, assi.,. in produ. ing plantar flexion,
and ilevates the outer margin of the sole (pronation).
Tendon of biceps
Tibia
(Inner surfnce)
Pes anserinus
Tuberosity of tibia
Plantaris
Soieus
F.xtensor digitorum
longtis
Extensor Crural fascia
hailuds longus (Deep layer)
Extensor digitorum-
brevis
Cruciate lig.
I xtensor
Httllucis brex'i-i
Calcaneal
tendon
Tendon
of peronaeus HI \l\\^ \\1 \\\
Tendon of ext.
hiiU. long.
^Patellar lig.
Capiiulitm of fibuin
Tuberosity of libui
Tendon of peronaeus lent;
\--^ Peronaeus brevis
Super pfronaeal
rrtinacttlum
Inf. peronaeal
retinandum
Tendon of peronaeus long.
Fig. 306.
Tendon of peronaeus brev. jendon of peronaeus III
Fig. 307.
^'~;^ ^-^i^^m^r '^4^S^ ^
4--.;"l=S:
1
I ' i:^
■■*»*r
if
t:
W'^^^'^' W^^^^'^WM^: ... p.;
THE MUSCLES OF THE l.EC.
223
1 .^■.■ ch„vi..r ihin the lontnis, which il markedly
The peron^us brevis (Fi^s. ,oO, ,08, ^p\^^^Zn..^^uri... an.l anterior
resembles, and by whieh U >s largely eoneeak^^ ,'\;";.,r margin of the external malleolus.
,^.1.. of the lower half of t e 1; ^ J ^ ;:^:;;^ ^^^'the muscle and then passes to the
The tendon commences m the middle of the upper pc .^^ ^^^^^^^ ^^^ ^1^^.
:::=;v:r=rr^^;"----^^^^^^ --'>
1„„K,,I inlJ tht .k.rsa ui«.r,™r.»is of llu' l.uW l-c.
,-,. , „ ,. »„.».,. ." - — ■' ■"■'" '"' ' ■ '"
dorsal iVxinn anil pron.m.m.
THE ANTERIOR GROUP. THE EXTENSORS.
The outer margin of this grcup is in relation with the„er...e^ ^:''-:Z:::::;t
isolated, since its inner margin is boun.led by the .nner sur.aee of the t>b,a.
group are situate.l i,, tl.e -^J-'- --;; "-^f;;;^; ^^ ,„„„ „„,,,, ,,hi,h is broa.l alx.ve and narrow
The tibiahs anterior il-gs. ^^ -^ ; .;^ f^,„, „^, .„,,, ,,Hace of th. libia as far
below. It is the strongest muscle ot tlu gnap anl „,,.„,,,r,n. The upper ihinl of the
,p.vard as the external condyle an. from the "-;- ^ ^ '^ ; ;^, ,,,,,,, \l „,,.„.. of ihe
nUle is marl<edly adherent to the deep fasna ol ^'^ y^, ; ' "^^^^^^^.^ ^^^ , ,,,.end. This
,., a develops a llat, broad tendon whtch ^--^^'^^ ,,:,..,„ ...he foot, and upon
-:;:;: ..nnto the inner border of t,,ei,a. of t...n.tmet.a^ _^^^^^^
i.ini-rnMr«innfth.-f....t(>.n!i"iatiun>.
.- 1 .,,,1 U 1 riiluT weak -einipennilorni muscle
The extensor hallucis longus (l-gs. ,06 and _;;';';, ^.^,^,,^^„^ j.^,,.,,,, tIu..
K,.g to the outer .de of the libiah, ^-^^-^^^^^^^Z ^^^^ -1,. origin of the ext.nsor
two muscles, partaulariy the latter, .-ncea ^ ; ' ^ ^ ^ ^^.,.,,^ ,„ ,,^. ,■,,,„ ,,, f,.,,. th.
hallucis, which is from th, n,ner surhu^o, ,h. ^ ^ ^,,^„. ,^ .,H„i,, . undon
„,j,,,,„ portion of tltc. in,.ro.>eous men,brane. ^ ^ -^ ' ^ , ,.^..,,,,, „,,,,,,,
is |ornu.<l which is .tuat.d ,n dte an.er.or and -- > ' .....out inward and passes
r,b,rs which are .lirected obliquely Irom ahov. dov^nwa d .m-l r .,
itLh the <ruciau. ligan.en, .. th. d..rsal .urface o, the great ,o..
Th . extensor digttorum , communis, longus .l.g.. ,.o(> an<l ;..) i^ dte -'--;;;;-!;;;;
The extensor aigii"'" ,„. iv.lln.is which t otlurw we re-eml)les. i ni
^,c ^,,^. .„,,,.„ ..nd. is ^ironger than tlie extenso. hallu, . . ^^^
;^;-,; j„ „. ,„>- 7'-- »-,;r;:r,:::;;.;;:i:»: -.h:^'-": ,"•;;;., .,..
IM
AII.AS .Xn TEXT HOOl OF HVMAN AN ^^M^
Fig. ^o8.— The mu.-d. uf o (lorsum of the l
T'herompanim-msoftluirmiuti-liK'amcm liHv U-vn .ru-a ami th.' undon ,ih.|,,: i^'iisors .
tjcfiirc tlifir in^tTtiuns,
Fk.. 309. — Th ]vlant;>^ .'.(x! :rosis.
Fig. 310. -T!' uperti< ial 1 r nf tli. pL. Uarrri-, les.
The plantar (as(i., has Iwri largely " '."ifnmi th( - r ucoflh. ll.-\ r (iigiu.ru i brevi,.
.iT shortly
brane. The u,.i.er imnion <.. :!;<■ musck i- adh. rcn! -) tnc origin of the til)ialis anu-nur and
to'the'duci) fascia of the leg. 1;k- tenrlon i- situated 1 the anterior margin of the muse! and
re. lives the mi.ldie and inferior liln: vhich pursi. ., rour,. similar to those of the extci.sor
hallueis. During ii> I'^'-'^'i?^''-' '*"'"'t,'h ■■ -niriai ligament <^ just a -n-c it, the U ' >n sub-
divides into four ilat, rather ^^.■ak lendons, uliuh n t., Uiv lorsal a oncuroscs of 1; sec i
to thi' lll'lll toes,
■nu perotiaeus -rtius Mgs. 306 and ,31, sLvms to h. , part 01 'n' extensor digiiori
It irises Ip 'hose xv ne lati' ' muscle wni. h come p the In-. portion ..f the hue
hs !lat tend. runs tjcneath ih. crucial 'iganuT- uth thus. tl; nsor dig-orum . d
inserted hv cans of it tefiinous ■ •.• ansion to lite dors 1 suiiai. of the I met
bone.
TI1.
:he fiHlt.
_;iti)ruM! len'
- are s^^vilje.
Mtrr UK
, ijrae
^lus assist, in jiroii -:-mt;
.ft!-.
Ur 'ik.
\tensi
Tl ex
■ lich . -••
isi in
.,[
1:, :-sal !,■
1,. eat!
THE MUSCLE' F IHE FOOT.
THE MUSCLE- OF THE DO^' M-
hand, the di'" -^..
lecl of
Kit i.s providei
. brevis (Figs. - ;(>, ; s, and ^15 a ■
uic .iorsal surface ol the >nes, joints, nid II
the exien.s<)r digitonim brexi-. with whii h it is au
lat. 1 ascle
;s of s. It
rent, from ilie dorsal
.», passes forward and inwa'd, and in tile region of the base 01 the lirst
ines continuous with a tlat narrow tendon which nn ~ over the metatarsal
ulon of the extensor longus, the two tendons togeth forming tiii' d.irsal
..'Xtensoi digitorum brevis ( Figs. ,;;o6, ,;;o,^ ! ,:;i .s) ari.ses togetl' • He preceding
,0111 the dorsal surfac e and the adjacent p.^ 1 of the lateral surta.e oi ilie calcaneus,
livides into three 1 rarely four) muscular bell.^ which terminate in very slender tendons
. . .u 1 Ov-'i -"'I fonrih Iocs apd fusinc with the tendons of the extensor digi-
•.-; tie, -T^'-ifi, .,fi)... . -- . -.1- .
longus to form dorsal ajioneuroses.
Both mt.s.le, u,K,n the .lnr<uT,. ul the i,>„t are futiplie-l 1.) tlte ,1.-1. peroneal nerve. They .xtoml llie toes, .\
teni|..n for the Intl.' 1ih' is r.irelv pr.'sent.
1^. :rv
^
IC
I'.: {
^'U
THE MUSCLES OF THE FOOT.
225
THE MUSCLES OF THE SOLE OF THE FOOT.
The muscles of the sole dilTer materially from those of the palm, since in addition to the
frroups for the ^nat and little toes there is also a central muscular mass. This central group
is formed by the flexor digitorum hrevis and the fiuadratus planta-, an accessory hea.l of the
flexor digitorum lonRUS which arises in the f.x.t. The superficial muscles of the sole are cvere.l
by the plantar aiK)neurosis (plantar fascia) (Fi.i?. :,o<)) (see page 233), wuh vvhuh they are partly
adherent.
THE MUSCLES OF THE MIDDLE OF THE SOLE OF THE FOOT.
The flexor digitorum brevis (Fig. ;,io) is a thick elongated muscle entirely covered by
the plantar fascia, and forms the middk pUwtar cmimm,' (see page a;,;,! (••"'K- :^°<')- '^ ""'^^■■^
by a short tendon from the inner tulxnle of the calcaneus an.l from the j.lanlar fascia, with
which the entire pro.ximal half of the muscle is adherent. Just in front of the mui.lle of the
sole it sulxlivides into four bellies, terminating in four flat l.ndons, whuh beluive m exactly
the s;ime manner as do those- of the flexor digiton.m >ublimis in the hand, /. . ., ihey are per-
forated by the tend.ms of the flexor longus in the region of the i.roximal phalange^ an.l are
inserted chieflv into the second i)halanges.
Tlie posterior jK.rlion of the flexor digitorum brevis is in immediate relation with the two
alxluctors (hallucisaml digili V) which form the middle an,' .xternal plantar eminen.es (I'lg.
.o.,^ and the origin ..f the muscle is especially adherent t.. the aUiu. tor halUicis. Us anterior
portion covers the tendons of the flexor .ligitonim l.mgus .,nd the lunibri, ales an.l is in r.lation
on either side with the short musdes ..f the great anrl little toes.
Thf musili- i> >upplir'l I'v llv inti rn.il |.l.inl.ir turvr.
The quadratus plantse, aUo termed the jhxor mssorius an.l th.' <'iro quadrala Sylrii
(Fig. Vi). niav be regar.le.l as a plantar hea.l of the flex..r .ligitorutn l.Higus. It is situated
upon the ilorsal surfa.e of the flex..r brevis an.l is entir.ly (.nere.l by tlu' latter muscle. It
takes origin bv mean- of two hea.ls, ..f wlii.h th. inner is usually ill.' stronger, fr.im the plant.u
surface of the calcaneus an.l fr.im the l.mg plantar ligament, an.l the flat ami approximately
nuadran-'ular muscle inserts int.. the outer margin ..f th.. t.n.L.n ..f tiu' flexor longus .ligitorum
•IS it passes obli.|uelv across the s,.le of • f.n.t fn.m within .mtvvai.l an.l In.m Inhiml forvv.n.l.
Th.' insertion .Kcurs l.fore the iVxor ;us ten.L.n h.is sulnlivi.!..! int.. its f..u, .ligilal shps
■ind after it has . rosse.i th,- ten.lon ..f llu fleN..r halhuis. .\l the .rossing ..f these t.n.L.ns they
assume their proper positions (see page 22^) an-l are always ...nne.te.l bv anasionu.ti. IiIkts.
While the ten.i..n of the flexor hallu.is runs in the long axis of the t..e, an.l . ..ns, .pu ntly in th.
axis „f tra.tion, those of th.' flexor digitorum pursue an oblLpie (ourse as alnne .lescnln.! an.l
deviate from the axis of tra( tion by about to degrees.
Till- .|U.i(lr.itu- pl.inl..- i- Mi|.|.li. .1 l.v tlir iM..n..l [.l.im.ir mnr
|,.Milun> 111 111. Itixi.r iiJKil..riiiii !■ itfu- ihi.. .1 -ii.iijjhi ,.r.i .imi in; ir.i-'- 1
.; 1... i.....l..n.
«s
226
ATLAS AND TEXT-BOOK OF HUMAN ANATOifV.
Fir. III.— The miiicUe la ver of plantar musdcs.
Th.- flexor .ligitorum brcvis. ,ho ib.iuc.or hallucis. an.i .'he ab,lu.,.,r digi.i .,uinli hav. In-.-n r.-,m.v.„; the ..-n.lon-
shfath.^ of the- .limits and of the pi-ronxus lon^us have Ihto opetu-cl.
Vu: ji2.—T^e(leq)lav(Tcif plantar musrles.
The tendon, of the flexor .iiKm<.run, lon«us. the llevor hallu. is lon^us, and the ..uadratu. p)anta. have Ix-en renu.ved.
i iici
I I
THE MUSCLES OF THE BALL OF THE GREAT TOE.
The muscles of the hall of the groat tcK' (lilT.r from those of the thenar eminence not only
in their numlxT but also in the fact that one of them arises from the posterx.r extrem.t) ol the
calcaneus an.l the other two from the anterior portion of the tarsus. The ball of the great toe
eonse.,uentlv contains one long an.l Uu, .h.,rt muscles, ^vhile all four muscles of the thenar
eminence ai^c practically of the same length, on account of the shortness of the carpus.
The abductor hallucis (Kig. :,.o) is a long, triangular, ,Hnniform muscle which occupies
the entire inner margin of the f.n.t and whose origin is situate.l imme.hately alongside of that
of the flexor digitorum. It forms th.. internal ,.lantar eminence (Fig. ,;o„) and arises from
the inner tutx-rcle ..f the calcaneus from the a.lja.ent ,K,rti..n ..f the inner surfa.e of that l..ne,
from the laciniate ligament, an.l also from the plantar a,Hmeur..sis. which ...vers the mus.le
completelv bv the ra.liations ..f its mi.l.lle p.rtion. S.,on after its ..rigin, a flat strong ten.lon
.levelops in the mi.ldle of the muscle, which is inserte.l by m.a.ts .,f the int..mal sesam.,..! l.>ne
into the first phalanx ..f the great to., an.l into its .lors.l ap..neur.,M,. The .lex..r hallucis brev.s
is siiuate.1 Ntween th.. ten.lon ■ of the alKluclor hallu. i< and tl.xor hallu. i^ longus.
The
, I,, i, .„|,,.l.ed l,v ihe ,„.. rn.a |.l,,n.,,r n. rx ■ . It^ ■ !>., 1 fum lion i- .he ..l.du. li,.,, .,f the «rea. toe.*
The flexor hallucis brevis ,Figs. ,;,, an.' .;>-m is mu.h ~lto,„r titan th.. ab,luc:or. t
arisc-s turttv fn.m the plantar surfa..-^ of the mi.i.lle an.l external . i.n..if..rm iK-ne. an.l ,.art y
from th.. ten.lin..us pr..l..ngati..ns of the l.,ng ,.lantar ligament whi. L f..rm .he ~h ath ot the
.Krona.us longus. Like the lU.x..r polii.i^ brevis, llie inser.i.m of the -nus.le .im, es into lw.,
'lips. lH.tween which PUS.SC-S the tend..n ..f the flexor hallu. is longus. The inner shp, t.-g-tur
with the addu.tor hallucis, passes int.. the t. tuL.n of the internal sesanu.i.l b..n..: th.. ..uter shp,
,„f;ether with the a.l.lucf.r hallucis, passes t.. the evt.mal sesanu.i.l l^.n.'. I h. ,.ut. r margin
of the muscle is in relation with ih.. alKlu.tor. the inner with th. ...l.iu.lor hallu. iv
The „n.. le .1. xes , l,e ,u M U, and , .,1-' l'.-'^ ''^ >'" ^ '"■' I''""" """ ■""' '"'"'^ '" ''" '"'"'•'' '''"" ■"
ntrvr.
The adductor hallucis (Fig. vj) is a .lislinctK bi.ii-ital muscle an.l the tu.. hea.ls .lo
no. unit, until th.v alm..M rea. h th.. ins..r.ion. Th.. .-W/./m li,.ul is a n.un.i, strong, elongate,
mus.le ariMng fn.m th,- plantar ^urfa.. ..f the . xt. mal . .m.iform l..ne, in ...mmon wuh an.i
partly a.lh. ren" to .he t!. x..r hallu. i.. fron, th. bas... ..f the ■.r...n.l an.l thir.l m...a;ars.-,i iK.nes.
.The m.rked .levelo,,M,e.,. of mo., -,( the ,m.M 1. - ..1 the «na, and i.,ne .,.v o, ,,.,!. -i ih. iimmd
r..„«e o notio o. ,h... di«i,- wiO he .,M.,d .overtnu. ol the f,.. alt .he .on. tu.on tha, ,h,.,e mu«l.., n..
.T,:.. . ...s. ,„„ tha, thev ,dav an in.,..r,an. o.te in ,u,.,H,r,in« .... ar, h o, ,h.. f,... ...,.., .allvMn.e the a
.,^„ V ,i,.., no. . ,..M th. t.H a. all, 'm, .. .n-ert, d in, ■ pra.ti.allv nnmovahle l.fth n,..,a,ar.al !.«,..
fcii '
I
THE MUSCLES OF THE FOOT.
227
and especially from the anterior extremity of the long plantar liganiint (see ])agc 141). The
broad muscular belly is at first situated in the middle of the sole, covering the i)lantar interossei,
and it then passes inward toward the external sesamoid bone of the great toe, and in this situation
unites with the weaker Iraitsvcrsc licail. This arises by a puriiy niuM ular origin from the jilantar
aspect of the tarsometatarsal joints of the second to the liflh toes; it remain> muscular until
its insertion, while the obti(iue head usually exhibits an aponeurosis before reaching this point.
Both heads are inserted together into the first ])halanx of the great toe, tile tendon of insertion
containing the external sesamoid t)one.
Thi' aililiHlcir li.illuc i^ i- svi|)pliiil liv ilu' cxtiTn.il ulanlar nerve. lis . hi, f funnioii i-. ad.hu ii..ii uf ilu- fiUM tin-.
THE MUSCLES OF THE BALL OF THE LITTLE TOE.
The muscles of tin's group lorrespond to thoM- of tlie hyiiollunar eminence botli in numb(r
and in function, but the alKluctor is mucii longer than the otlier two muscles.
The abductor digiti quinti (Kig. .^10) nsembles the abductor haiUuis not only in its posi
tion but in many other respects. It forms tiic external jilantar eminence, and is tiiic k and broad
t)ehind and narrow tid tendinous in front. It ari-es by a >horl tendon from the outer tulnTcle
of the calcaneus be -nle the tlexor digitorum brexis, and also (piite extensively from llie plantar
ajH-neurosis, which covers the greater jiorlion of the muscle. The insertion is jiartly into the
tui)erosilv of the fifth metatarsal bone and partly into the outer liorder of tlu' lirsl phalanx of
the little toe. The inner margin of the al)du( tor digiti \' is in relation with the Hexor digitorum
bre\is behind and with the llexor digiti \' b!c\i> in front.
It is su|i]ilii'il l>v till- cxtrmal plMnl.ir jutm-. lis ^jiei i.il fum li.Mi i> .il)ilmiioti >,i iW iillli- (oc.
The flexor digiti quinti brevis (Figs. ,^10 and ,:;iii is a --mall elongated iiiumK which
arises chiellv from the anlerior portion of the long jitanlar ligament (see page i(i) and is
inserted bv a short tendon into the first phalanx of tile little toe. Il is in relation eMernally
with tile third jilantar interosseous musci ■.
The opponens digiti quinti (Fig. u 1 > is smaller but somewhat b-- ider lii.in tlu tlexor
bre\is, the two muscles lia\ing a tonnnon origin. It inserts into tlu' oult r liorder of the anterior
portion of the fifth metatarsal bone, extending forward almost a.s far as the lu.id. Ilie musi le
is almost entirely comtimI by the abdm lor digiti \'.
THc flivT .iii'l .i|i|»ininsainiti \' aiv "iipi'lii'l In 'ln' ' Mirn.il pl.inl.ir n.rve. Tlu ir . Iiii f lunuiuns ,iii- iiiili. .ilrH I'V
th, ir n.inii-si.
THE INTEROSSEI PEDIS.
There are, as in the hand, fov.r dorsal and three plantar interossei (Fi^s. ;i.> i<i ^ijl;
the former arise by two heads, the lalter by one. The dilTerente betwieii the hand and the
f.Mit consists in the f;i<l that not the middle but the seiimd toe receives the tendons o| iwo ilorsa!
/■/(/(•rovNc/ (the first and the seiond), while the third anil ih.' fourlh pass from the outer side into
the extensor tendons of the third and fourth toes (Fig. .;i,<). Ihe inner In ad ol the lirsi dorsal
interosseous is |HM)rly deviloiHil; il arises only from lb base of the first milatarsil Imiuc and
from the ligaments of the tarsometatarsal joint, not fro," the sh.ift of the Ikiuc.
228 ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
The planlar intcrossei (FIr. 314) arc stronger than the dorsal. They arise from the outer
borders of the three outer metatarsal bones and pass to the same borders of the correspondmg
♦oes.
Th. in,..n,ss..i .k.Us arc .upplW by the ext.-rnal plan.ar none. Thdr (unctions are the same as th.«e of the palmar
interoii, with certain mo.lifualions de.Kndent upon the di.Terence in the.r ,K«,t..,n (see page .o,,).
THE LUMBRICALES.
The lumbricales (Fig. 311) "f fn- foot arise from the tendons of the flexor digitorumlongus;
the first lumbricaUs has a single origin from the inner margin of the first tendon an.l the other
Fig. ,?m
f.i,.. (,»,! iv.. , ,4. -DiaBtam of the plantar intcro.vsd. if the foot.
Uranwf dorsal inttrossci 111 the !'««. ri'. .,)■•*■ "">b i
three havf a bicipital origin. In the vicinity of the metatarsophalangeal joints, they pass from
11;; inner side inio the dorsal a,K,neun>ses of the toes. At their insert.ons are usually s.tuate.l
small bursa-, the //("i/ir/n;/ /ii/rw. , , , ,„ 1
These must ks are supplied in a variable manner partly by the external plantar nerve ami
partly by the irt.ernal ,.laniar nerve. Their functions .re similar to the corresiKmdmg muscles
in the hatid (see page 203).
THE MUSCLES OF THE FOOT.
229
THE SYNOVIAL SHEATHS OF THE FOOT.
Like the tendons of tb'; muscles of the forearm, the muscles of the leg nm in synovial sheaths
as they pass into the foot. The rctinacula of these synovial sheaths are formed parth by rein-
forcements of the deep fascia and jjartly by processes of the ligaments of the fool.
Upon the dorsum of the foot (Fig. 315) arc situated three synovial sheaths: one for the
tibialis anterior, one for the extensor hallucis longus, and a common one for the tendons of the
Extrnsor dii^itorttm
lonaiis + I'cronaus III lixlcnsor hallucis loiif^us
Fibula
m. jirroturus
brevis
Tendon-shealh 0/ cxiriisor dicilnrum li'iif;us and l>rri>'i,rus III
Tninon anil Inidoii-shralh
()j fxlfiisiir halliii'i^ Inni^us
/ \ iti. rxlnmnr hallucis brevis
Superior
prrinirat
retinaculum
Injcrior fiiruncal rctiiuu iiluin
I'rmlan sheath lendan ,i> fcro- ":■ exi.iiynr ,ii,i. Tciidani aj cxieniar
oj In-ronaus Tendon and n,i us I'l 1 Irrum l.n.is' dieitorum lari^us
lonKus ■rndim'Shealh oj
'tfon.rus hrevis
Vic. 315. 'rtir tinilnp. -Iiiatli^ ami riliiiaiula '^f liiii.^uai ami cxliTiial virfau- ni ilu' Imii (•;uini "I: 1 diaKiammatiiJ.
extensor digitorum longus and jieronanis tirlius. They commence in the U:' ird cn c .id for
ii variable 'isliMKc uiion the dorsum of llie fool. Their retiii.uulum i> ihiellx idriuiii by a rein
forcement of liie dorsal fascia nf the fool, llie iritiiitlc {untcriiir aitmdiir) lii^'iiiitiil, wliii h arises
from the outer surface of ihi' cdcaneus, whcri it i. adherent to the intirosseous talot alcaneal
ligament, and di\ides into a (ii>tal and a proximal band wiiich form almost a right angle with
each other (Fig. ^of)). The proximal band runs lo the internal malleolus, the distal to 1 u dorsal
surfaces of the navicular and internal (unciform l)ones, and when tiic lallir band is prolonged
23°
ATLAS AND TEXT-BOOK OF HUMAN ANATOMY.
to the external malleolus, as sometimes occurs, the ligament jjresents a cruciform appearance.
The outer undivided half of the ligament is connected at its origin with the inferior peroneal
retinaculum and the ligament contains three compartments separated by fibrous partitions, for
the three synovial sheatlis.
At the outer side of the ankle-joint the two jjcroneal muscles (longus and brevis) have a
common synovial sheath (Fig. 31 0, the upper and Umer j.ortions of which are usually sub-
divided for a short distance. This sheath is held in place by two retinacula which are frequently
indistinctly separated. The superior peroneal retinaculum (Figs. 307 and 315) passes from
Tendnti shii}lh ni lihiiiUs niitrriiv-
I eiiddii-shriilli ii/ rxlensur hnlluin hiiixiis
-Temhni-shralh oj
tibialis ftoilrrior
'Tcndnn-shalh n/
flfxor ilii^ilontm
Tt'iiilon-slw'itli '
' cxlfiisnr hill, .s
loili^US
'C'tlranC'il tendon
- I.iii iiiiiilr lif;.
'I'liui"!! o; ;lf.\"r h.illtii i
lull:.
I ' >td<<n-^ii'-!lii
iij ,'lixiir di'^i-
I iiidi'nsliiftlli
nj tihiiilis
tni\Iiri"r
I Ainiuttor iidlliuts
l-ltxiir difiil. hrrvis X
l-'Ii.
•,!(,. -Tlu l,ml..ii-.lii-alh- ;i M r.lin.n:!,! of llu' inUrii.il l...nl.i ul ihr f.,.,t ,,onir«h;il .lusrammaliO.
ihe po^uriur border of tiie inuTnai pnlKolu:, to \h,- upper extremity of tiie tuberosity of the
calcaneu>, an.! i> alx) conneiud ■■•iih the ueej) fascia of the leg. The iiijmor prroiuv! rclnuifU-
lum iFig>. 307 ami 31.:;) tMen<l> from tiie outer exinmity of the i ruciale ligamenl to the outer
Mirfaie of the < aitaneu^ anil its iroi iiltar process.
\. .1, ; _ ;,i,. ..r iK, I 1. ;,,;.,! 1 J'i.r ;iA> ilu'fe an- three synovial heaths for the tiliialis
posterior, liie llexor digilorum longUN and liie Uxor h.illucis longli>. The sheath for the tibialis
po>leriui- i- liie shortest and exteniU <'u\^ i- tile inner border of the fool. The two remaining
Nhealii- are K.nliiiued into tile M,le of the fool and extend as far as the deeussatioii of the ten.ions.
Wk
THE FASCLE OF THE LOW ER EXTREMITV .
231
These sheaths are held in place by the laciniak linlrrnal annular) li^amnil (Figs. 305 and t,i6),
a wide, ])o<)rly defined band which commences at the internal malleolus and jjasses partly to the
inner and upper Iwrder of the calcaneus and partly to the plantar surface of the f(H)t as far for-
ward as the navicular lx)ne. It contains three distinctly sei)arated comi)artments for the three
synovial sheaths.
In the sole of the fiK)t, in addition to the continuations of the synovial sheallis of the llexor
hallucis longus and digitorum longus, there i> situated the sjjccial synovial sliealli oj llw pinmiriis
lonf^us, which surrounds the tendon of this muscle in its i)assage ac ross the sole within the groove
of the cuktid (Figs. ;,ii, 312, and 316) and almost to the point of its insertion.* This >heath
is at first shuated aljove (dorsal to) the tlexor digitorum brevis and the tendon of the longus,
and its retinaculum is furnished by a prolongation of some of the fibers of the long iilanlar liga-
ment which i)ass Ix^yond the cutx)id to the base of the metatarsal tH)nes (see page 141)-
The tlexor tendons of the toes ;dso jiossess syno\ial sheaths which reseinble those in tile
lingers, although they are corresi)on(ling!y >iiorler and smaller. The longest sheath is usually
that for the tendon of the tlexor pollii is longus. The retinacula for these sheaths are the Vdt^iiuil
lifiamrnls, which are analogous to the similar structures in the lingers (see i)age jo;).
Within the >vnovial sheaths of the second to the tilth toes exactly the s;inie relation^ obtain
which we have previously observed in the lingirs. since tin wiak t( ndons of the llixor digitorum
brevis are jierforated by the much stronger tendons of the tlexor digitorum longus (>ee page J07I.
THE FASCIiE OF THE LOWER EXTREMITY,
The lower I'Xtremily is envelojjed in a very strong fasi ia ( Fig>. 317 to 3-'0' Nvliith i> iuni>-
ualiy thick in certain situations. In the different region- ..f ihe extremitv tiii> la-i ia rc(en(s
corresiionding names, and wi- conse(|uently sjieak of the iliac fascia the fa^ia lata, the crural
fascia, the doi>al fax ia of the tool, and the plantar aponeurosis.
THE ILIAC FASCIA.
The iliiK j,is(i,i cov( he anterior surface of the ilioii.Mias al)Ovi' the inguinal ligament.
.\l the inner margin of th ,.,.oa> major this fax ia i- ituitinuous wiili the ju'lvic I'aM-ia; at the
outer margin it iia>se- into the thigh with the iliojisoas and joins the jieitineal ta-iia to torm
the iliopirthual j,isn,i, a ])ortic)n of the fascia lata (see pagi' -'3-'i. In doing tlii> llu lax la i>
attached to the anterior sujierior sjiine of the ilium, to the inguinal ligament, and to the iliopei
tineal eminence (tin- iliopcilhual H;^<imciih and divides the .sjuue beneath the inguinal ligameiii
into two compartment-, an outer i()mi)artment t'or the iliopsoa- and the fi-moral ner\e, the l<u uiui
miisnilornm, and an inner one for the femoral vessels, the hiniiui vasoiniii. Tlie iiiai la-oa 1-
directlv lonlinuou- with the iran-versalis fascia (see i)age i()3). The lacuna \a-orum i- rounded
oil" and bounded inlernallv by tile lacunar idimbernat'.-) ligament (see j'age Hqi, and lorm-
tlie internal femoral rim,' '.-ee pagi' -'331-
THE FASaA OF THE THIGH. FASQA LATA.
The jasrid lata (Fig-. 317 and 318) (onsi-ts of two layer- whidi are separated only in urtam
situations, and its difl'erent ixirtion- vary greatly in thickne-. It i- compo-ed of lonu'itudiiial
*\Villiiii Ihi- Oil, 111) 111. im.l.ir. ..f llir piruiKiu- |i>iitfiis il.v.jnp, .1 m -aiiiui.l I".m.' (.t ,,umI,ii!i 1.
'' if"'
1
vy
232
ATLAS AND TEXT-BOOK OF HITMAN ANATOMY.
Fig. 317.— The fascia of the thigh seen from in front.
Fig. 318.— The fa^iia of the thigh seen from behind.
Fig, 3ig. — The fa>iia of the lower leg seen from liehind.
Fig. ^20. — The fascia of the lower leg. seen from in fr. '. and the dorsal fascia of the foot.
and transverse fasciculi which are so arranj^efl that sometimes one set and sometimes the other
i)reponderates, or both mayoccur together. In a general way the [losterior jjortion of the fa.scia
lat.i is stronger than the anterior and the external p<jrlion is decidedly thicker than the internal.
U])On the jjosterior surface of the thigh the very thin sujxrtkial layer of the fascia lata covers
the gluta.'us ma.ximus, while the deep layer jjasses beneath th'.' muscle, and over that portion
of the gluta'us medius which is not coxered by the maximu,-. the fa.scia assumes a markedly
tendinous or ajioneurotic character and is termed the glulcul jascia (Figs. 2,:i8, 240, and 241).
Tn the glutvul siiUits fF'ig. ,^iS), o\er liie lower ])ortion of the glula'iis m.iximus, the fa.scia con-
tains numerous strong transverse fasciculi, and over the llexor muscles ii i.- of average thickness
and is composed ( hiellv of transverse fasciculi which are esi)ecially will marked in the ])opliteal
region, where tile superlicial layer i>l the fa.scia lata covers ui the jiofjliteal spare and its con-
tents, the dee]) layer envelo])ing iis muscular ntargins.
The strongest portion of the fa.scia lata is situated u].on the outer -ide of the thigh and is
known as the iliotibial lor Maissiat's) htiud (Figs. jcjO and ,?iS). This Land is composed cliielly
of strong tendinous longitudinal fasciculi and receives the insertion of the tcn-or fascia' lata'*
and of a portion of the glula'us maximus (see page 2ri). lis lower extremity i> attached to
the external lubero.sity of the tibia, and l)eneath it is situated the va.stus iaii ;ali> with its large
ajioneurosis. In the lower portion of the thiu'li the fascia lata givo olT a .sejilum u|K)n lillier
side, and these ])ass l)etween the fi'moral muscles to the lips of the linea aspera, forming
the internal and cxlcrnal inlcrmusculiir .sepia. Just below the inguinal ligament the fascia lata
i> com])osed of two layers. The supert'ic ial layer ])a.s.ses over the anterior surface of the sar-
lorius and the great femoral xcssels: llie posterior goes behind the sartoriii> and covers in the
ilio])ectineal fossii (sec ])age 2101 and the groove between the vasiu- nu-dialis and the adductors.
Over the adductor muscle the fascia i> \iry thin and transparent. The 'ortion of it mxering
the ]ieilineus is also called the pcctimal jastia: it tuiites wiih the lower extremity of ilic iliac
jasi'ia to form the iliopci lineal jaseia coxcring ihi l1(X)r of the ilioi)ectineal fossa.
Immediately l)elo\\ the inguinal ligament the .su|)erricial layer of the f.iscia lata exhibit> a
free internal margin, the jahijorm marii^in (Fig. S'TK which, together with the pectineal fa.scia.
bounds a round or o\al depression in the fascia lata, \hr mal jossa (saphenous opening). Tin
inferior portion of tile fall iforni margin, which i)asses almost imperceptibly into the pectineal fa.scia.
is called the injerior eornii, while the su])erior portion, extending ujiward <■•< the lacunar ligament,
is termed the superior eornn. The opening of the o\al foss;i is coxered \<\ a portion of the
sutierticial laver. the erihri ior^f! ^astiii. whicii contaiti^ a '.onsideral)le (luan'.itx' of lat and
<|uile a number of foramina, the largest of whicii gives jjas.sage to the ,i;n<t/ saphenous vein (the
internal saphenous vein 1. 'I'hi- x-ein comes from the foot and I ';. runs upon the fascia lata and
* TW ..urf.ii c of th<' li n-iir fu-i i:i- l.ini- i^ iil-n < iimti'iI !■ i xrrv lliiii l.ivi-r of llii- fasi iii l.ila.
1
t lllt'Cill ttl^flil
falciform rmi'X'n
Suhi-utiiruou-'
f etnonil viin
I'fi-tintid JiUiia
Suhaitaniou
/'ii/iiitt'l/itr bur>a ' "
I
^/ihaitanfoii.
rtitf/i'iir t'lU'iii
Cirrat siifihcinniS
Gluunl
sii/ais
i,iy<iiif totnel
I\^»i,tfiil h>y^u
Fig. 317.
f-i<'. lis.
■f- !
Iw ■ wll ~
^ ^.>:-:'^£-- m^^mm
TmM^m
f'ofUirrnl fossa
i'ti/iiinmf tnuion
m
^
intrafftiu'llar hnr-ii
I rtOf'Vi I ■>»■ mi ml /it;.
( riitiiiti- li<<iiitiftif
f'i,ir. 3t9.
Oorsai fastin
of foot
KK-~.-
L.
r I!:
.filBf
THE RURS^ OF THE LOWER EXTREXHTY.
23^
empties into the femoral vein, which is situated in the region of the oval fossa. The oval fossa ( the
saphenous opening) is the external or subcutaneous femoral rin}^ and the external orifice of the
femoral canal. (For a more detailed description the reader is referred to the text lKM)ks and
atla.ses of topographic anatomy.)
THE FASCIA OF THE LEG. FASQA CRURIS.
The jascia cruris (Figs. 311) and 320) envelops the muscles of the leg, hut is wanting
iiver the inner surface of the tibia; it is nickest anteriorly IkIow the knee, where it
is adherent to the extensors, the perona-i, and the tendons of the pes ans'Tinus. It
give-J (>iT the anli-rior iiihrmuscuhir septum, which i)asses Intween the extensors and tlic
])eron;ei to tlie anterior l)()rder of the libula, and the posit rior inlrr»iiis< nlar sipliim,
which passes in'tween the perona'i and the flexors to the jiosterior l)<>rdir of the fibula,
and itsui)|Kr and inner portion is adiierent to the»pes anserinus (see page 210)- Upon the
posterior aspect vi the leg it divides into a superficial and a <leep layer, the former cover
ing the triceps sura , the latter the deep group of flexors; tUf tricei)s sura' and it^ tendon, the
tendo .\chillis,ari <()nse(|iiently completely invested l)y this fascia. In addition to the previously
descril«(l ntinatula (see page 2.^0) the fax ia cruris is especially riinfon cd liy the Irnnsvrrsr
(rural lii^timiiil, which is loinposed of trasisverse fao( iculi passing from the tibia t" the tiliula uIhim
the ankle. I; is situa.edto the proximal side of the cruiiale ligament, with whidt it graduailv
tjc'iomes (onliniu>u>.
THE FASa^ OF THE FOOT.
While tile d0rs.1l fuM ia I if the foot ( I''ig. ^jo I is an exceedingly thin iayer, iIk nl.iniar apoiu iiro-i-
(Fig. ;»)) is the thicke-i iiortion ol the entire fasi ia of llu' leg. In the middle of tile ^oj, ii (on-i^ts
of a Ncry thick a|KMieurolii iaver, (iimpo-id cliiell\ n< lungiludinal I'a-cii uli with -nnie IiImt-- ■\hi( h
passobli(|Uelv toward the Literal margins of the loot. Tlu proxiinai portion of 1 he, i|.nneuro--i>.i :, •«
from tile inner and outer lubenles of tlu- calca.neiis an<i i- i IomI> aijlun nl lo tin Ioi.l; mu-ilis
of the fiKit which lake their origin- from the same Imnv |oint^; ii i- toi-ideraliK iliiik^ r ill. in
the broader d'stal port,, n. iiie aponeun»i- together willi llu long niu It ^ lorni^ die inni'
pUinl<ir iinimuos \inlir\uiL iitidiih . and ryiiriuil: M-ejiat-'eN •.•> lo .-j;!. It> lap r:d p<ii-lioii^ .ne
mutli weaker than the ic ntral jKirtion, aii<l I lie lliiikeM |iarl of the laui.d porlioT, i.. Minaled over
the origin of the alniuilor digili \'. Numerous slender fa^iimli pa-- f-om 'he eiiiin margin 01
the a|K)neuro-.i- lo the ^kin, and low.ird the loe- llie aponeun>-i~ di > ule^ iiilo four ~lip~. • orre>-piinil
ing to tile four outer to< -, wliiili art Ixniml logethe'- by traiisvcrM liUr-, llu /r./i/w.rw j^i^iii.ili.
I'lMin thv ttM~ the .i|«iiieurovi- gratluallv ilisijipears in tin ionmtii\e tis>ue la\ir^ of llie ^kin.
llolli lilt f.i-t i,i I.Ua .mil lilt laM i.i 1 niri-, like llu l,i-t i,i o| iht upper i xirt iniiv , imm p.i--ai;e
|o \ivmK ,inil nt r\(^.
THE MOST IMPORTANT BURS^ OF THE LOWER EXTREMITY.
I. Tlu ui'ii iili^iiiniiy Inn lidiitirii hiir^ii. iht t hit t Imrsi upon tlu gii.il Irot li.inli r.
:. The Irm hiiiilirt, I'ur^'i oj llu t^lui.iif m,i\iiuii^ iset page jt-'. Fig. .'n^K
i,. Tlu i;luli(>, miir,it hiirui (set |>.ig( .• 1 J. Fig. .'>)><. inioii-tant.
II
r
234
.\TLAS .VXD TF.XT HOOK OF III MAX ANATOMY
4-
The
sciatic bursa oj the j^lulcrus mnvinius, Ixtwicn the- tulxTositv
of the
isehium and the
Uluta-us
maximus.
tendo
IS of the glulieus
5-
The (!«/' rior ( /roflnnilirii ! hiirsd oj Ilu- i^iuin us imdius. ljc'l\Men tht
nudiu.s
incl
na.\inni>.
().
The
■ pos/trior {Irochautrrii ] bur ii n; Ilu i;/iiltiits nudiiis, bttwun Uu
leiuluns of ihe
i;lulncus
nuii
us and ihc jiiriformis i.si'i' |iagf .^1.".
-.
The
trociiant'rii bursa oj llic f^liila lis niininim. a! Uu- inM-rli<in uf
the nnisdc of the same |
nanif inid ilu ^Trai Iroi lianur.
8.
The
pirijorm bursa, al Uu- iiisc-rlion of ilu inuxk- of Uu- >ani
- iiatn(
- iiilo Uu- <;r(-at
Irochant
(T.
U-
riu-
i'ursa oj ihr obturalorius iiiUritus (see ])agi- Ji.;, l-'i^. ioi -.
10.
Tllr
/);(;•'./ ('/ the rictus j, moris. al Uu origin of the nui-i 1( of Uu
same
iianu- from Uu-
margin uf ilu
aei lahuiiini.
1 1.
■Vhi-
i/iopci liiii .it bursa oei- pafzi- 2ii,l-'i^. jijM onasioiially lonnnunii aUs wiili Uu- |
Iiipj'oint
I.'.
Tin-
siibli iiiUhoiis iliac bursa, al Uu in.-erlion of ihr iiiop.Mias iiilo Uu li
-s.-i r Iroi liaiili V.
'.V
The
pectineal bursa, al Uu inst nion of the iiiii^t Ic of Uu- same n.
me.
14.
Ilu
^upirior bicipital bursa, al Uu- oriL-in of ilu loiii; lu-ad of Uu
)i(l-[).s.
'v
The
injcrior bicipital bursa, iK-iunn Uu u inlon of ins(-rtioii of 1
u- liin
[IS aiu! ihi- ioni;
( Mirnal
lalcral lijianuiii dl'hi- ktui' joint.
If).
The
suhcutaiunus prcpalillar biir^a i-vv pa^i 1 \i>. 1m,!.;>. ,u 7 aiul ,,
JO).
17-
Ilu-
subjasiial prcpalillar bur\ii isd- |>af;i i,;')i.
iS.
Ihe
subtcmliiuaiy pnpalillar bur^a t-n- pa^i- 1 ;'o.
•
II). 'I'lu su prapatitlar bursa ii< pagi- i;;) (omnumiiaii- alnui^i alw.iv^ wiili liii kiin
joint.
.•o. Ilu subiutatunwi iiijrapatillar bur^^a. in front of Uu- upiur '-Mrrmiiy t.f Uu- li^anu iiiiiin
piilella -^ri |iaU( 1 i'l, \\j~ :i, and ;.-c .
.?!. 'I III iticp iii.rii pa/iil.ii lair^ii 1 --i i |>am- 1;; .
->->. Till •■iibi Hl.i'i- I'us l>nr a Of Ihi liilh rosity oj tin ///)/.;, a -^lllH^il.ln( oii> biir^.i omt llii tvdicnK-
of liu- liliia.
2;. I hi sartorial bur^a (■-(-( |iaui- .m |, l-i::. Jo8i.
.'|. Ilu aii^irnii bursa i>n' pat;r :u). \'\m. ji).'^'.
-■;. Tlu poplii, at bursa i^.i paui ^ i;'iand j.'ii i onimunii air^ wiUi Uu kiui- ioini.
j'). Tlu- iitlcnhil i;a\lri>i lit iiiia! buci ' -> 1 pa^i-^ 1 ;(i and j.?o, l-'ii;. ;o ; 1 al-o < onnnunii ,iii s
uiih till kni-i joint.
_•;. Tlu ^iiiiiiiinnlir.iiioiis hur-a 1 -. 1 pau;< - i.;f) and : {<) ) nia\ lomniiiiikati- \wih tlu kiui
joint.
.'S. I'hi ^iib< Ulan- oil. ,\t,riial iihilhoiar l<iif-a. Mil« utann.ii- liiir-a om r Uu iMirnal
malli-olu-.
.'<). rill ^iilii ulaihou. inliriuil iiialiiobtr I'ur^a. -\ilii nlam 011- Inir^.i ovir Uii inUfnal in.d-
leoju-.
io. 'Ilu buisii (i: ill, •rlH^ III '/. in Uu- mn-ro-Mouv livMimnt in tlu --iniiN i.ir-i iHtwi-in the
THE m'RS.*: OF IHE I.fAVER ftXIKl.MITY.
2.S5
talocrural and talonavicular articulations, may communicair with the arti(ular ca\iiy f>f ihc
lalocalcani'ona\i( ular articulation.
,^i. The siihlcnitiiioiis hiirsa oj llir lihiali antirior, at ilu- insertion of llic liiidoii nt \\\v tihiaiis
antorior.
7,2. The suhtcndinoiis hursu oj Ilu lihliill^ fxi.slinor, at the insertion uf tlie tenilon nt liie
tibialis |)osterior.
_^?. The sulk Ilia nrous lahnniiil hiirsii. a -iihi utaneoiis bursa l)inealh the lulxr ( aieanei.
.^4. Tile hitrsd (ij the (lilt ii mill lituloii. at the insi-rtion of tile tendo Aeliiilis.
^^5. Tile inlrniii liiliir.sof)luiliiii;;<nl hiir\n-, (orrispoiidini^ to tile inlernietaiar|)0|ilial:ni,i;eal
bursa'.
!,(>. Tile liniihrii al hnr\ir (see Jiai^i' jjSi.
I \~ in 1I1,' 1 ,i-',- of ill,- ii|>|H r cvm-niily, -o em in ilu- jow.r a 1 l.i^^iii. ,iii..n cil ilu nui^i li'^ of 1 ,1. Ii nf llir ^;IllU|l^ i. . cm
ni/f(l alMivc into />.»^^</.v^// a fit! pn ii.\i<il ^i-N , .m Im- ni.t'ii . < 'v\in^, iiowrsi r, t't a rnialioii wlii. li tin- lowt r limit ut!.iir-
KtK's (turillj^ il^ <h vi Inpnunt. .in iint r^i(in of iu >url;t, i -, a^ - "Hiitar, (I with lllo>r i.f ihr ii|tiHr limit. ■» < ur>, so lli.il ihr
|><ist..i\ial liiii'.i I.-, of ih. lliijih. Iin, .iii'l looi .,rr ^im.ilitl Mil ilu .ilih rior >nrl'a. .■ ,iiiil tlu- |in- a\i,il niii>, h , mi llir |io hiici
surfatt. turthcriiior. , ilu it i^ not, in tlu lit r\t |jIi \il^i - <il tlu low- r linili. that tiiJinilr ^r|i.ir.iliMn of ill- tilu r^ ol ilu
|iri' a vial anil |«t^l a\i.il mi|..i li ^ into ili-liiu 1 . onl , -in ll .i~ .in fomul in tlu hr.u hial |ilr\ii~, I nit tlu |ii. axial ,iiul |to>l
axial lilnr-. ilu iioi 1 oiii|ili ir ilu 11 v,|i.ir.iiion. a riiU , iinlil ilu \ li.m- n .u linl ilic low. r thin I of thr thi|.;h. ilu iliiivioii
of thr ^riMI s( i.iiii iutm' into tlu liiii.il an'l |m r.,iu-.il ncr\r- 'H i urrini; ,it a I mill thai li-ii-l,
Uf.irin^ tlu M- f.it u in nainl. .' moriiliolniiii .it . Liy^itu .ition of tlu- !nii..( K-s of tlu low. r linili liia\ !..■ m.i.l.- a . follow ^
I I 111 Misn I s 01 1 HI Ilii'.
f'M I'.i-t axi.il lulls, h-s; rfittifif^ ni'txiniit^. -/»/..f(^ mriijtt^. i^/tit-'ifi miiii'itity, an. I /. 'm-t ;.i\n,i I'l,'.!
(/'I Vu- .ivi.it iiui.i lis; ilt'itit\, l*iri;^irmi\ ''liirtilor twtiriuty, tt'>,iir<it<ir ii!!<rtut\, i^rtth/i!. .in. I iiii<iJr<ilit\ ;tin<ti\.
1 1. 'I'ln M I -. 1 I - 1.1 nil Int. II
(■M p. 1^1 axi.ii nni^. 1. -: ^■trwriin. iflui-lrii ri>^ ;, iiuin^, an. I ''/- 'f> ;< nuiri\ 1 -li. .rl. r la I'i i.*
\h) I'n i\ial liiiK, l,-^' fut ttiii'li\. i;riliii!\, ilildluh'r lni:.'li\. ihljtnfiir lirf,'i\, iiii<ittih-r niili'Hli\, ./././.'i. /..r a;,'!?,',»«\,
srmiiftfHthr'iih'^iiy. ■■* nntriiiiiihi^ii^ alul hiitp'- ;<}tuiri\ ( ioiii* lif.i.|>.
Ill I ill Ml s, 1 I , 1,1,..
f.Jl t'.i^t i\i..l mils. 1. s f\!ti!\tti lin^iltflini /*ilt,"/n. fnr^nhi rhm. t\;itt\nr ihilhiii\ l<tir^u\. fll'i-ih^ >li:'iriitr^
pfroih' Wi ti'fltiii^. alul fhr'>n,tn\ hni /.
I'm I*rr a\i.li iini^.r.s, (;,n/r..f ».»i;/o, f'iiiitifi^, yn/,iix. I'ttflH-t ii\, ;h\i*r iln^ittitttni /a.n;/(\. Ithu>!i\ tit\iir:.ir^ jfrvitr
Ihiltiiii- /iiiii,'»\, an.l ./H.i./i.i/;(> f'l iiih, t
1\ till Ml .. I I . .ii I 111 I'. 1111.
(.O I'iKt axi.il iihuiIi-n; rv/fHTfir iliiiilnrum hmiy an.l tilininr h>l'itt>i\ /irr/«
CI I'r, -.ivi.il imiM li ■>: //i vr ilii^iinrum hn , /•. ,i><Jii, 1 ir Ii.iUmi i\, ,/> !.•>• hr,: i\ li,iltu, (.. ./W.i. !.ir ih^ih i/iiinli .i^r>.>
», iM ttt\:itt tfti:>tri, tuniUrifiit^. iitUiui ti'r It tit lit /., ;U v.t htt-i;^ lii^iti >juitlti . .in. I i>itiri''^i 1. I 1> )
* Tlu l.i. . p-. f. !n..Ms I. .lilv I. ). lis. Ill 1 Ao iniiM h ^ Willi iniiiou iiivt rl 1. .n . it ■ lontj lu .i.| i a |'l» ;. vi.il n ih. It
an.l it" -h.trt li. i.| It. Im^s |iriiii,i,il\ l.t ih. KJutt .il ^.1 ..I inii^ 1. -
t "I lu .|ii.i.li.iiu |.l iiil.i . .illlutiiuh ^ilii.ilt.l in Ihr f....t. i. lita. rtluli.a iii.ir).h..|..m. .ilh ..n. ..fllu mu-. 1. - ..I Ilu I, tf,
Itiiiin .1 .!• lii.ilivi ..f Ilu ■,imi nui-( 1. in i-s w In. li «im ■, n , i., ih, il. x.tr I.hiuik li.illu. i. ..n.l ili. iiln ih. |t. tO. n. ,r
J
■1 ,v*;
^1
^H. I J" V IHil^*
INDEX
Abdomina:, fascix, i6^
musclfs, 157
anuriiir, 157
ilcvflopnicm. 164
dcvi'liipnicnl, 1^)4
flat, 157
(ii-\('loi)mtnt, 164
jH»sttTi(tr, i6j
(U'vclopmont, 104
straight, idi
ilfvrli)|mn'nt, 164
|M)rtiiin of |iritoralis major musdi',
167
ril)s, 128
rinn. fxtfrnal, ijS
AUluctor iligiti iiuinli musric, 220,
227
function 'if, 200, 227
nt-rvo supply of, 200, 227
lirivis must If, 18(1. 210
hallutis mustle, 2 to, 226
fum lien iif, 22^1
ncrvi' siipplv uf, 22fi
|K)iiicis hrcvis niu-itli-, iSfi, ig<>
function of :,ji)
iicrvr iiipt^' . of, oii|
longus nniwii', 185, 11)7
funition of. 107
inTvc sup!»ly of, 1^7
At I (■s,w>rv I'Kaiinnl-,, io>i
of foot. I (0
plantar liganiml. 1 v;
pr'Mfss. 28
sril.tr liiiann-nt''. 1 27
At ti.iiiul.ir fo>-.i. t>6
noli li, o'l
At ctahuhini, oi. •*'»
ticvclojinn lit , o't
Aironii.il I'viniiiiiy of ilaviilc, 81;
AcroniiiK la\ii ular ,irti< ul.ilion, 1 .mi
liRanifnt. 120
.\i roiiiioii prtHc— .. 8 I
,\iMuctor liri-vi^ imi-^i It*, ?o^^ 2iti, 217
funition of. 217
niT'.f ■■•upply of. 217
canal, 217
hallu<i« imiM Ic. ji.i, .'^'i
fuiKiioii of. 227
ncr\c "^uppK of. 227
lont!u-, ifiiM Ic. jcx). 2i'i
function of. Ji'.
nerve >uppU- ol, 2il>
niaijTv.i'i niu^t Ir. 20<), ji'». 217
funition of. 217
ncrM- >upplv of, "1 7
tnininiU' nuisi It- .hmj. .'.<>. 217
Ad'luctor minimu.s must Ic, tunctitm
of, 217
nt'rv<* t\ipply t)f. 21 7
muscles of tliivifi. 2iti
tipeiiing, tentlinous. 2 1 7
jKiIlit is must le. iSfi. it>t)
function of. 200
nerve suppl)' of^ 200
.Vlitus orliila'. 7 (
.VIminiculum line.e alli.e, 165
.\l.i' of ethmtiiil. fij
of ilium, t)^, 1)4
Nurfat t's t)f, ()4, tj5
vomer:'., ;\(t, 65
.Mar ftiKIs of knee, i^j
liKaiuerts, 1 15
IKiriion tif na^^ilis must le, 182
processes. 6;
AUt'oIar Ijonler of mandible, 71
(anais. '17
foramina. (17
)"«•'. 7>
ptirtit.n of iiKinilililf, 7 ,
pron-ss, ^7
of suj>erior maxilhir\-. 6fi. fiS
.Mveoli ft)r teetli, 68, 71
Amphiartlirtisis, 108
Anatoniit al net 1: o( humerus. .S5
.Vnaitiiiu . tieliiiition. r 7
tlesi riptide, tit rmition, i 7
Kcneriil, ili liniiioii, 17
sjM't i.it, tlt-tinitittn, 17
system. (lit , tlermition. t 7
If>lK>i;rapliit . tletinition. 17
Ant. mills l.iitr.ili, mus, le. i,)o
It, nulls must le. I St,
nietlitilis must If, ii|0
niu-(le. i'^>. hio
fum lion of, ii)o
ner\e sujiply of, mo
qUiirtus musile, it)o
funition 'if. I 10
iiervf ^uppK tif, ii>o
AnKioloyy. tl'-linition. 17
Vimle. I Mcrnal. of si.tpul.i. 84
inferior, of st .ipul.i, 8)
infrasternal. <;
intern. il. of s, .ipui.i. H4
m.isioi, I. n
of l.ollis. t }
of parietal iHine. fionl.il. S')
masioiil, ^i|
i«iipit.il, So
sphenoidal. ?i(
of rilis. i.-
of St apulii, e\lirii.d. 8 t
ipi.itlralus l.diii su-
i.So
.Angle nf sra[i'.ila, inferior, 85
internal, 8(
su|)erior, 85, 84
of sternuni, ^4
parietal, 50
puhic, lit
sphenoidal, 36
suh.ostal, ?5
\ngul,ir heail tif
perioris n^ust le,
.Xn^ulus iierni, ^4
.\nkle-ioiiit, 1^7
ligaments o' 1 V)
.\nnular li^imenl, 122
toiierior, 127. 2.11)
internal, 2?i
of palm, 205
Imsierior, 20V 208
Aiinulus tvnipanit us, ^8
\nserine liursa, 2 nj
\niagoni-l mustles. 1 j \
\nterior alKloniinal must les, 157
tie\elt)pniem, 1(14
annular ligament, 127, 221)
arih of atlas, 25
of verlelir.i, 22
articular f.it ei of talia-ieus, 10
<- t;ilH'>. 10
atlanto'ii t ipii.il tne'
U'lly of tligaslrit ,
iti|iitular lii^.imenl,
ilinoid priHt'ss, 41,
itintlyloiil t anal, 40, . ^
(oronoiti protest of ni.nalilile. 7.'
(osioirans\,rse ligamcm, iH)
1 rani.il ftfs.i. (i
crest of liliitl.i. i.-si
irui i.il tig.imi ni. i ^ t
irtis of stilit ui.inttiii^ inguin.il ring,
1 so
elhmoitl.il f.ir.iniin, Oi. 7>
f'lnlaneitf. Si
gluteal line, f||
inferior spine of ilium, ij)
intt rt oniKloitl fo».i, tut
inliTniust ultir septum. 2 t i
intt'riH I ipittit ,-\ ni hontlrosis, 47
inlertr.iiisvt rs.iriii-^ mii^t le. 15s
inlraot 1 ipilal svnt liomlrti^is, ,>(i
t.H hr\'mal 1 re>t. '17
l.iver of lumUnl.iiv.il f,i-,t ia. 150
ligament of eMerii.il m.tlleoliis, I 57
lonifitiitlin.il liiijiaint of \ertel)t.il
1 ttUinm, 1 1 1
musi les t>( leg. •.' t
nares, 66, 76
.hrane
■'Uisi le
, ,(i
10
238
INDEX.
Anterior nasal spini-, j;, 68
obturator nu'iribrant', 115
tulnri li', 05
pi'lvif surface, t)U
pillar of . subcutaneous int^uinal rin^,
'5')
portion of ■luiilraliis Uiniboruni
niusi le, I (15
:.aeral foramina. :!.S
.sai HM oei ypeal ligament, 11 i
saeroiliae ligament, i jj)
superior spine of ilium, 04
surface of su|)eri()r maxillary, <)(>
of thi^h, muscles of, ^[4
of ulna, S7
taloialcaneal articulation, i ^.S
li^ami-nt, 140
talot'ibular lii^anu-nt, 1 ;o
talotibial lin.jnienl, i ;'i
troihanterie bursa of ^'utjcus me-
(lius, ^54
AnlenKxteriial surface of humerus,
S(,
Anteroipternal .surface of humerus,
Sft
Anlibrailii.ll fasc ia, ;oy
■Anlrum of ir.;hniore, (iD
tympanic. 5.,. 5H
Aortit optiiifm of tli.ijihrai^m. i(f>.
itil.
.\|KTtura piriformi-, ;;. (>^. (<(<. -(>
.-\}M.'rturt of at|ua'(iuuas vestiliuli, e\-
lern.il. 51;
of peKi>, inferior. 1 ;i
-upcrior. I (.~
ofi\nipanic i.m.iiii ulu-. -upcrior,
\pe\ of tiblil.l, 101
'if p.itella. 'Ill
if pvr.tmiil "f timjH)r.ii b..nt. -: ;
\|iii.il inlonliiirl lin.imenl. 1 1 ;
\i«meurosis, 14^
palmar, I'j.S. J07, ioS
\|niph\ses. :!o
\pjieiulie 111;!! >kileliin. -•-»
\t|u:iiluciu^ iiMhiea/. iiriliie .if. ^f>
vestibuli. api rturi of. cxp rn.ii. ^ ;
\rih. losi.il. j)
lunili«>ii»^l.il. i\ti Mi.il, 1(1^
intern'!. ,0;
of llallir, lbs
of v.li u , .'."O
of \ertebra'. -'.', .' ;
ligaru nls betueen, 1 1 ,'
pubi< . I ti
>u|R'fi ilian . (lij
lemllnoiis, I i <
/\(.jomatif . t."^, io. 40
.\ri 11. lie eminent e 5 1
Mltan.ent. 1 -•>*
iMirnal, 1 io iii^
ini'rn.'i. I'l^
line. 1)1;
|<iplili .il liKnini lit. 1 ;:;
\rni. l«i les <if. .^^
uptK-r, fitensof tnf.o e ..!, inu-- t- -
of, i!o
tU'Xor ■ urfat t of. nnisi i, s of , is.
] .\ini, upper, mu.--, les of, 1S5, i.S.*!
i lassification, 201)
.\rlery, vertebral, .15
canal for, .;(>
Vrthrixlia, 1 10
Articular capsules, lo.S
of hip-joint, i%2
of phalanges of foot, 137
of hanil, 127
cartilages, ji, 108
circumference of radius, .S8
of ulna, 88
crest of .sacrum, 21)
discs, 108, 1 i.S
of elbows, I 1 ^
emineiue, of (»ci ipital Ume, 40
c*f tenitioral Uiiie, 5^
j margins. 108, ich)
i proit-sses, 20
of sacrum, superior Jo
().' vertebra-, : \
surfaces of calcaneus. 103
of patella. t>ij
of rac|iu.>, carpal. .So
1 of tibia, inferior, 100
su|>erior, c)t)
\rticulari- genu muscle, .'15
subc rureus niuscle. J15
Vnii Illations, 107. loS
.11 ••onie M 1.1 vii ut.ir. 1 2C
iinkle. 1 >7
■111. into, iviil. 1 1 ! i I ^
.iti.into. pi^iropliii , 1 1 i
allantoo, 1 ipiial, 1 1 ;. 1 :',
ball-.ind -01 ket, 1 \o
biaxi.il. I 10
iiiioc ul.ir, loS
■ .lit .ineoi nboicl. I .^7 I ;.*<
c .irpometac .irp.i' ■ ■ :
1 .'s
of lluiiiib, l.'4. 1 .s
( hoparts, 1 (8
t 01 hit <ir. to*)
t tiniiioun.l, loc^
t ondeioid. 1 10
lostoti m^versi
t oval. I 51
t line oiiav it ul.i!
digit. il. 138, 1 ;
c-tlip-oiili '. 1 to
gliding. 1 10
ll'ilgi-, lO)
hip. I (I
humeroradial, 122
hunit rouln.ir. t .'-»
intiTi .11 pal, I .' 1
interihoniir.il, 1 1;
int* rmt i.ii.ir-.d. i 17. i m
il.Ielph.iUtUft :i:, 1 .i.-^. I ^-. 1 \'l
intiTl.irsil, I 57
intrrviTti bral. : i 1
I.i.fraiii ■>. I (I)
iiicta..iriieipn.d.ingeal. \ jy
of t'lumb. I J7
n\ii.'ia> i,.li.ilangi ,1! 1 57. i to
III .I'liaK.tliis, 1 (7
of at lav, ir (
of axi-., 1 1 (
I I'l
I ;7. 1 C*
1 i<>
Articulations of carpu.s, 124
of costal cartilages, 117
of elbow, I2J
of fibula, 136
of fingers, 127
of first and seconl cervical verte-
bra', 1 13
of fcHit, I.!7
of hand, I2\
of hea'l, 117
of knee, T 51
of pelvic girdle, 128
of jihalanges of fcKit, 137
of h.ind, 1^7
of pi>iftirm JHine, 124, 1 -s
of ribs with sternum, iiO. 117
with vertebral colunen, 2<t, 116,
'■■
of .sacrum, 1 13
of shoulder, I .! 1
of sternum with ribs, iid, 117
of talus, I 57
t)f tibia, I 5(1
of toe-, i;,7
of upjier extremitv. im
of vertebral 1 olumn, 1 10
with ribs, 2(1, I I
(),
>>7
of uri>t. 1-' i
pelvic, Ij8
pivot, IOC)
|>olya\ial. i to
radioi arpal, i 2 t
Milioulnar. .li,-M!, 12
i
proxiin.il. 1.2
v.ie roili ic, 1 .'.S
s.idc!le, 1 10
simple, ici;
-.plieroid, 1 10
iiir.il. IOC)
-tfPviclinii ular. 1 ic)
-.le nioc cista!, 1 1 7
t.el " .ileuneal, 1 57 1
(S
t.ilot atcaneonavic ular,
,17. ' •i'<
lalcjrrural. 157
t.Uim.i'. icular, i,(S
lar^l, 1 .■;, 1 58
t.irwMni". .i.irv.d 1 57
1
t<l
lemijoinmandii iilir.
1
•S
libiolilieii ir. 150
trinsv" ? .1 , of t.irsus.
1,
■-<
trochoi'i lOQ
iriie, '08
uniaxial, mi
with iongiiiidmal
IX
S, IC'I
with tran-\-r-4' axis.
IW)
uniliH ukir, ! ,%
\-traeabis. loj. See-
iK
: Titlw-
Atlantci.i\!.il .irti. ul.iti'
it-
t 1 5, 11;
\llantiK-\ii-in.phit arti
1,1
ttiolis, 1 1 5
,\tl,inlo<K 1 ipit.il .irlii ui
ition, 1 1,1, 1 11;
memliranr, 1 1 i
anieiior, 1 15
jKi-iO-rior. 1 15
Alia-, .M. 'i;
.irtic ul.i" .11- of. 1 i I
develop '11 til of. 51
1 ■nil maicsc's of, 2^
iran-verso li){ainen'.
.f.
II I
nmm
INDEX.
-'39
Attoilt-ns auriruI.T muscle, i-,()
Attraiu-ns auricula? musLlc, 179
Auditory canal, internal, 55
foramen, internal, 55
meatii.^, external, 3S, 40
internal, 4;^
Auricular surface of ilium, cj^
of sai rum, 20
Auricularis anterior mu.-n le, i 7S,
muscle, 1 7.S
funtticpns of, 1 7*)
nerve supply of, \~(}
(Misterior muscle, 17S, 171)
superior must !e, i 7S, 17.)
Axial skeleton, 22
Axillary Umler of s<ai.u!.i, S;
faM ia. 207
fossa, 147
margin of stajiula. S^
Axis, ijt, 2=;
artii ulations of, i 1 ^
(lens of, 25
ile\clnpnient f)f, '
iHlontoid priHcs'^ nf, j^
HA'-K. fas, \r of. 156
nnistles of, i ^4
(!»'Ve!npnicni rjf, 1 ;h
Hat. I 1^
'Ifvili'pnieiil, I ;fi
lonu. 140
tlevelnpnn III, i ^f»
•>hiirt, 1^4
• ie\(lopment. i'.i>
It.tll of ^jrcal I«K', mu-mIi-^ i i, .-.'O
of liiile lot-, nin^< le> of. .-^7
li.ill-an'l-'^fH kci joint. ' 10
hasal li^aminl-s. dor-al, i.'7. i|i
itit' ro>*rou ;. I -'7
n-,1 tatat-ai, 141
planta- 141
vohii. I, '7
Ha-^i of maniiililf, 71
of nietaiarpai Umh •-. fi!
of .net iitrsal 't )n( -, ic>
of p.itil!.'. 00
of ph.il.inirr- . of lirit:( r-. 'j.'
of i-H ^. 10^
of Mapul... S^
Ha^ilar portion of o»iipii.il l-o'n-.
\>
Ila-ripliarvngi.it . .ui.d, 4;»
Ha•^l•^ I r.inii i Mirn.i, i,i)
H.-llv ol -MiMlr. .1:
lii.irtii ui.ir nuiM Ic. r jj
Itiaxial if'int^. 1 10
lU. < p-. Kra-hii mn-. !r, iS^. jSS
funi (i.tn of. iK)
Mt r\e ■ nppiv of, iNf
Ii-ntlon of lonK 111 .m! ot, i . r
frmoris Ui\\>t le. 20*). 21S
full) tioti of 2 |S
rurxc siippU of, .' iS
Hit li.il''* fitt nia^^. \Xj. iSt
|iu ipilai It'irsa, infitiof _■ < j
-utHrior. .•;!
f;roovr, rvTrrnal. 'S"^ .'-17
Bicipital groove, internal, iS.S, 207
of humerus, 85
ridges, 86
Kiciimoradial bursa, iSg
Hifur<ate liijament, 140
Hilocular joints, loS
Hipenniform muscles, 142
Hipinnate must les, 142
Jlivenler itrviiis nius( le. 152
niandiluil.e niuscie, 174
muscle. 142
R!iHxlve^.->i Is of Ikhu-, 21
Hone-cartilage, 20
Hone-marrow, 21
Hones, m
l»l^lod\t>•^^ K i»f, 2 r
Kruid, K)
calt inetl. 20
f oni(«isiiitm ot, 20
dtvclopmnu of, .-r
flat. U)
hl-iuls of, JO
iiioruam'i npn^iiiiK-n'-- of. 20
irrij;ular, 20
ionp, K). >^ce aU() Lorn^ I'onts-.
macerated, 20
nu-ni!)ranous, 21 , 22
Till k of. 20
IUT% C-. Ill, 2 1
lunririi! t arials of. 20
orjf.init t on^titiitnt> of, _>o
jrieaniatii, 10
ii.---tii- of, 20
tulMil.tr. i»>
xi^rral, 22
Hony loikini; mi 4 h.tnisni-, icS, io<)
|>|-1VK, Hi,
ti--i]e. ."o
Itra. Iii.d TiMi,!. 2-7
Hrai hi.di> miumIc. 1S5, iSij
funi tion of. I s.,
nerve -uppiv of. i.Si,
Brai hioradiali- nui-( If, iS;;, k,)
tutu tion of, Kj;
nerv«' injOy 'il, m^
Hrant hioriHTK nui~t h •-. i>(. 1^;
Hrra>t iM.ne. 2-', ^.\. Sy\ also .V/ci--
rft tt
11 road Uoni -. ]<)
liuii al f.tl nia^N. 1S2. iJ<\
Hill 1 ifiatiir i revj, 7 ^
Hm- t ophar\nneal I\i~. i.i. i.S |
Muitiii^ \i-iia- iuv'ulati> vuprrior ;m
lUir'-.r. ari^rrinr, .■ 10. 2 i i
I'i. ipit.d. infi rior. 2; j
Mi|.rrior. .'u
lii ipitor.-idiit, t^i)
'.il',int\d. -u'h ulaneou^. 2^1;
-■■i.uohi.i.hial. 208
■ tiliila! ml<rov-*t-tr >i, 208
diitital. ilor-al ->ul'« ut.meou-. 20S
e.i-lriu ru ndal.inh-rnal. 1 ^0, :jxi, 2\ |
ututf*iftteor[d, 2r 2. .* ; {
liiopi-i tiiical. I n. 2U
infrap.M- ll.ir, dn-p i ;■;
>ul" uliricou . I ;'i 2 ! i
Burs;c, infraspinatus, 308
inlerniv.i irpoj luilanReal, 200
intermet ilarsophalangeal. 2^5
intralendinous olecranal, 208
latis>irmis. 140
!und)rical, 22!^
malleolar. >u1k utane<)us external,
internal, 2 ^4
nietacarpo|)lialani;eal, dtirs.il -,.{,-
I utaneou-'. 20S
mm ous, 14^
of » alcane.d tendon, 2_;5
iif iMiriMir t arj.i radialis bnvi-;, 20S
of llexoriarpi radialis. 2c<)
uin.iris 20S
<if glula-us maxitnu^, Mi.itic, 2\\
tPK hanteri) , 21 2. 2,^5
medius, anleric}r Irtu h.in erii , 2 ^ \
IMoii-rior. 21 2
trochanteric, 212. 2 ?(
minimus. tnM h.mtrrii , 2(|
of !ati----imu' dorsi, 1 4'i
I if lo\MT (■\tremil\ . 2 !, \
of oliitiralor internus, 21 ;
of olituratorius intcrnu-, 21^, 2\\
of rci tus feniori^, 2 ^ (
of M-miincnibrano-^us nui-'* le, 210
of '-inus tarsi. 2^ j
of lere> major. 20S
of tibialis ant»-rior >ilil<ndin«ius,
po--i( rifT -ulitrndinou-', 2^;
of tulHTo^ity of liii.i, -idu ulani-ou-.
of lippcT e\trcmil\ , 208
iilcirana', 2ot>
|tr( tltn.d y;i
piriform. 2\ i
Itoplilcal. I ;;<. 2^0, 22] . _ ; •
prepatellar, -.ijb iit.rirou-, 1 ,0, 2U
-ul.faMJ.d. 1^0
iditiiidinoiis. I ;f»
sartorial. :i \. 2^\
St iatit . of i;iula'u> ;ii.i\inuis, .' ^i
si-niinu inliranou-'. 1 .;''. 210. •,»
'-uUh romi.d. 20S
suIk utaneta'-^ ( pit orith !,ir, 208
otrn..n.d. 2^-8
NlllKlflto'rl, iSO, T S
-uhs* apular. 121, iSS
■^iditmdinous iiiai . ;4
olfit.in.d, 20S
' I'pnipatellar. 1 ;; .• ^4
-yn >\ial. i.)S
( otJUJiunii it aiy 108
tP» li.intrrit , 2 \ :
anterior, of glulau-- midiu->, 2U
of |^U:',tMi ndnii-iii - ; (
maxiirui'. .' r • 2 , ,
|>»tsfirior, uf liluiani- niei.'ti-.. 212.
'U
^ul1l utaneous. 2 \ {
(' vi» \\( \i Imr^a. -uIm ulanrou-,
trndon-. 22.'
Inir-a of, .> j^
240
Caliancocuboi'". articulation, i,?7, i^S
ligament, -it
l-lantar, I4r
Ca:' -m-ofi' ular ligament, 140
Caicunconaviiular liganu-nl, 141
dorsal, 140
plantar, 141
C'akani-otibial ligament, i3<)
Calcaneus, 103, 10^
articular surfaces of, 10 j
Ixxly of, 10;
<levelo)mienl, 106
facets of, 103
j^riMiVO of, 10,^
surfaces of, 10^
CaU muscles, ji<»
Calvaria, inner a<|ie( t of, 44
Canal, aililuclor, 317
alveolar, 67
auiliti>rv, imirn.il. S!;
basi|)har>nReal, 40
lurotitl, 5>. 5'^
extern, il oriliu- of, 40
conilyloi'l. 4°- 4s
anterior. 40. 45
IMislerior. 40
ilenlal, inferior, 7J
faiial, 50, 57
m'ni< nluni of. ^7
for verteliral artery, j'>
\ein. 2(1
Hunter's, :;[7
hy|ionlos-al. to. 45
infraorhit.il, ''7
en'r.iiu I 'f. 7^
inKuin.il, ISO
tn;.n<lit>ulai . 7-'
muMuloluliar. ;;. ^H
nas..l. 7s
nasi, 1. 11 lirym.ii. 04, (■-. ;,
nutrient, of .1; :\ .s;
Mf l»)ne-.. .-..
of radiu-. .s>.>
i,f temiKiral 1 -'ne. ;7
|i,il.itnu-, ^(>
I'h irvpiie.i!, to. t; i
ii.er\ i^oid. 50, ;>^
]iier> ^upalatint . si. ''-.}
sairal. -M)
>|)inii. ;i
verteltral. '. 1
vidian. -
< ,.ii ilii uli, ' .iriitiiiilcmiMnii. ; ■-
C.oi.iliiulu- ihnrda- tMii|'..ni. 57
,.., hle.e. ..rliM i.f. s'>
mastoid. s>t
tympani" , ?>!
Cinidis vertelirali-, )i
('.mine foss.i 'lO
v'anir.us nuisi It . i'"*!
Capitular li^i.iineni. .ititerior, i ;''
(iiMeiior. ! i<'
tiansverse. ot f'mt. I \i
ol li.oi.l. i-'7
Capituluin "' liiii"' ni^, So
i.f ulna. ,VS
('.apsides, .irtit lll.ir. ! os
of hip ioini, 1 1;;
INDEX.
Capsules, articular, of ph,ilanges of
foot, 137
of hand, 127
Caro i|uadrata Sylvii muscle, 325
Caroticotympanic canaliculi, 5''. 5**
Carotid canal, 55. 58
external oritice of, 40
foramen, external, $h
internal, 55
fossa. 172, 174
groove, 41, 48
tulHTcle, 3(>
("arpal articular surface of radius, 81)
hones. 8:. .^v)
anil ulations of, i J4
central, iji
development, o>
supernumerary, ij
surf.ices of, 00, 01
eminenc e, radi.il, go
ulnar, go
<^r(K)Ve. ()0
ligaments, I3fi
dorsal, 303, 20H
extensor tendon slieaths Ih'-
neath. 20\
radiati', 137
tr.insverse, 127. J05
volar. 20.S
CariMmiet iiarpal artii ulation, tom-
mon. i>|, Us
of ilumdi. 1J4. i-'S
litjament. dorsal. i.'7
viil.ir I. '7
of, ,.M
108
Carpus. 80
a.liculalion
liganunls nf
Cartila«(s. .'i
artii ular. ji
Imne, 20
,o-tal. ,.?
I'rnlations -if,
iiilei.iriii ular. 108
^t 111 oiiia"-, i,?t
I, im lions nf. 1 ;'
Cavities, gl.noid. ."it.
na.al 7;.
iiral, •.11.' of. 7^
oriiital. ; i
pt Imi . I t:?
(Ml;., eti-.tni.iil.il. i'\.
frontal, ''!
lachryni.d. '■
in:istoid. s i
iii.,\ill.i! . '1
palatini ' ;,
sphenoid. i
Ceni, rs •■!
'M
'S
(I-
Cent, li
.-,i|,.
lal li.
01
.1 ilia|"iragm, I'l). 10^
tendon
Cerebral Ljga. i
of -iihenoid imnr. '0
siirfati . of f-tjii.ai li-'iu
of orhiia' iw.i!es, (■
.if p.iriet:; fume, sn
of s|,heni.id ti'ine. 4.'
of ti mpiii d Uille. ^.'
(.'er\ii ,il f.i .1 i.i, I 77
Cervical muscles, prevertebral, i -()
ribs, 35
vAlehra', 2.V See also ]'erlel>rcr,
cervical.
Ccrvicalis asccmlcns muscle, 141)
t?hassaignac's tubercle, 2I1
Check ligaments. loS
Chiasma of tendons, 207
Choana-, 30 "(>
Chopart's joint, I,v8
Chorda dorsalis, 1 10, 1 15
tvmpani, S7
Clavicle, 83, 85
iMxly of, 85
development. 85
e.xtremities of, 8^
Clavicular notches, ;^^
jionion of pectoralis major mu.scle,
i(>7
Clinold pro. ess, anterior, 41, 40
middle, 48
jKisterior, 48
Clivus, 4,'v 4S. |8
Coccygeal (ornua, ,10
Cmcyx, 30
development of, ,^1
joints of, 1 1,;
movements of, 1 1?
(■(Hhlear ioint. io<)
Colla'- bone. 85. See also Clavicle.
Cilles' ligament, 150
Common i arpometacarpal joint, 12|,
'-S
UM-atvis i)f nosi', 77
Ciimnuiniiaiing synovia' bursa-, 108
Complexus minor muscle. 151
nuisi le, I s2
Compound joinf^. loi)
Compressor n.iriuni. 182
Coniha nasalis inferior, (14. f)7, 77
Com ha' nasales, 77
nii'dia. '>!
superior. <^\
sphenoidale ., (8
Conihal crest. (17, 61)
Conduction I'gaments, 108
Condyle^. 20
femoral. 1(8. 1 ;i
of (M I ipil.d Imtie. 4s
if tibia fvtern.d. oo
inn rnai ij*i
I Conilyioi I • .inal. to. ,5
[ .interim, f-i. t<
I p..-l<r'or. 40
I fuss 1 . 4 s
, joint, I o
) jMirtioris of
proi es.,'^. 200
of m.mdibU. -1 , 7 ;
pi, icrio;. 7J
of skull. ',8
''omii I liga' leni, 1 >n
Coral 0.11 romi.il lii'amen'. 1
Cor.iiiibrai lii.il burs.i, <r.'-^
C.irai obraihi.ilis rue. ie, : -
film lion of. i'"',
iier\ e ,.up',ilv ot. I s.;
Cor.iuHlavii ul.ir lasiij, 17:
I Ipil.d b,ine. 4<
is^i
INDEX.
24 1
CoracoclaWcular ligament, 120
Coracohuincral liganiont, 121
C'oraroid proross (if scapula, 84
lulxTfJsity, S^
Cornua <»f fascia l:ita, 232
of hyoid htmc, grouter, 7^^
ksscr, 73
Ommal suture, 36, ^7, 7*)
C'oronoid fossa, S6
[)r(Mess (if cranium, ^S, 72
of mandihle, 71, 73
of ulna, 87
CnrniKiitor '-u|)ercilii muscle. 170
Costa', 32. Set- also Rihs.
Costal arch, 33
cartilages, 33
articulations of, 1 17
gr(K)ve, 32
jKirtion of (lia|ihraRni, 164
process, 24
surface of scapula, S3
tulwrcle, ligament of, 116
luhrrosily (if t l.ivide, S^
Co-^tfK lavic ular ligament, iif)
CosliKoracoid membrane, 170
Costotransverse articulations, 116
foramen, 1 1 7
ligament, anV'ri.ir, 116
middle, t 16
(K)sterior, i lO
superior, i lO
Cotvl*iiii liganunt. 131
note h, i)(t
Coxal tM>ne, 93
development. <)6
ioint, 131
Cranial iMtne^, 44. 45
fossa*, 41-43
anterior, p
middle, t >
|>ost<Tior. |r. 43
'.auh. inner a■^p^'^■t of. 44
Cranium. 36. St-f also SkuU,
I crrliralc, 44. m
visccrale. 44
Crt*n>a--ter niu-.. It , \()o
^^uiutions of, i6j
n'TVi suppU 'if, )/».'
Crem;'Steri< fasiia. I'l^
Cre-.t. JO
Inn < in.H'n, 7^
cont Iial, *')7, 'kj
> th?nnidid, f>7, (»;
foi rectus (apiii- |Kistiiu- mai<:
inuM If, 47
frf^nt.d, 41. (m
infratem|M(ral. 30. ; ■
lai hrynial. .intiii'ii. (17
posterior, 0:;
na-^al, ftK, fuj
o( t ipiiiil. ' \{iTn,iI. 4''
inn tpal, 41. jf>
of ni.ul... 101
of lu.id of ril)'.. 32
of ilium. 04
lips of, <; \
nf n<-< Iv of rill ^j
of puliis, 0;
'. Crest of sacrum, 29
of tibia, 100
orbital, of sphenoidal Ixme, 50
sphenoidal, 48
j Cribriform fossa, 232
plate of ethmoid Ixme, 41, 61, 62
j r,,-' . ■ 41,62
i »-"r: ' ,, . >.w ■... .■, 43, 46
\ itw'.i r- r , ,4
j rf p;; -' . -.
I ;"'-^i' '■ ■' > ■ ,
j '' .' . ■'■ ■ ■'.•'< r' I [ ^, 22()
.' : ■'.iieni i'-^iisverse, 2;^j^
i ( n. -. a.. '. <■, "f iiaphragm, 165
inurmediu!,! of diaphragm, 165
lateralo of dia|)hr;igm, if>s
mediale of diaphragin, 1^15
of subcutaneous inguinal ring, an-
terior, I ^0
I inferior. 1 5S
jKistcrior 1 5()
superior. 1 5S
Cubiial interosseous bursa, 20S
t'ulxiid [nine of foot, K 2. iO|
(ieveldpnu-nt. lof>
Culxiideonavicul ir ligament, dorsal,
[ '"*'
plantar. 141
j Cuc\illaris mu-.c le. i 15
functions of, 146
I nerve sujiply of. ! |0
I Cuneifori:; liones. evternal. 104
first, 104
j internal. 104
middle, loj
j *>f fiKit. 102, ic;
i d ■vr|(,pment, lo^
j w' Ictnd. >(;. (JO. ()i
I sei iind, Tot
I fliird. 10 i
j ligaments, na\ii 1:' M '■ Txal. \ \]
I Ci:n(-o< uboid Iig;.'ii' 11 , r>iil, ip
inieio^Mous, 1 [ 1
j piant.ir, 141
Cuntttmetafitrs.il ligimt vu, ir.ter-
I *('. 'COUS, i X t
Cuneon.'p-ii >!.■.! .irlii LiLnu-f, : i- ■ -s
In IP Ih.m' ,.; n,-\or i-.iii. is bn\.,
ime-i It . I 'J')
infrajialell.i; b'ir-,i. ! 'v=^
l.iycr of I ,df nius( les, J2i
of I er\ii ai f.isi i.i. i ;;
of e\tensi»ts of fnrcarni. obliiju< ,
107
'Straight. ot7
of flt'xi.r inusi '<s of f.iir.iMii. ojj
nuis, !r^ Mf tie. Is, I ;;
|Mtstrrior ^.11 ro» o* * vgcal iig.i'VMnt.
I ' \
leni|M.i.d fit 1,1. iS(
Oehnid liuainini. 1 Vi
tub' [..^ity. S^^
Delloideopeiti-r.il triangle. i(.;
DehoideUs niUM I. iS: i .Mi
Deltoideus muscle, function of, iSf<
nerve supply of. 1S6
Uens epistrop.'iei, ^5, 2ti, 114
of axis, 2-;
Dental canal, inferior, 72
foramen, inferior, 72
Dejiressfir anguli oris mus< U-. \<i
labii inferiori-i muscle, i.'si
scpti nasi must le. iSi
Descriptive anatomy, defmition. 1 ?-
Designations of jMisiiions, 17, iS
Diameters of pelvis, 131
Diapl'-agm, i/'j
crura of. 1^5
d' . loptnent, i()()
foramina of, 166
functions (»!, j6(t
nerve supply of, i6fi
hiai^iiyslal (enter of ossifhaii n, 21
lliapbysi.s. ]<>
Uiarthioses, 107. loS. See als<» Ir/n .
ulalionx.
Digastjit foss.i, 40, ~:
mus( le, I 4.', 174
Tunctions of, i 7 )
nerve supplv of, 1 7 j
Digital artii ulations, i 'S. 1^7, m.j
bursa-, doisal suIh ulaneou-. Jo^
fossa. 07
Digitate iir.pressir.n>. 4-
of sphenoiil U>ne, 50
Diploi", 11)
Disarticulated skuii. \h
Disis, arlM nlar, 108, 1 iS
of elbow. I :3
Distal radioulnar articul.uion. tj;
Dorsal an h of virtibra. 22
basal hg.irnenl'-. i .>7, 1 1 1
Ihirder of meia<arpal Ume-,, ,,i
of radiw; SS
of ulna. .H7
cairaneona\ii ui.ir lig.inient, i^o
<arpal iigamenis, 2o\, »o^
exten-'or tenrlon shr.uh-. be
ne.nh. .'03
I ar]Mimria( arpal lig.nneni. ]j~
( uUiideonavii ular liganieiit. 1 1 1
< utu-'H ulmicl ligament, i 1 1
f.is(ia of li.md, 207. 2C.S
itUenarp.iI ligament, i ,7
iritert uiieiforru lig.imeiit . i { \
interosset nuisi les, 117
ligaments of fi.ot. 1 p
ii.ivit ulari I uru'ifi rm ligament*, i 1 1
radio*. irpal tig.itnc tit, 1 :ft
-ubeutaneou^ digital bur~ i . .'oS
metaiariMiphai.ingv.il burs.i-. .>oS
surfate of r.idius. HS
of s. .ipula, S^
of uln.i. Sj
t.ilonax i* ular lig.tment. 1 ( >
l.tisai lig.tmenis, 1 \ ^
Iar-.oMiet.il,ir--al linann nt-. 1 (i
I "irsum. tnust 'n ~ of. 2 .; \
^ell.r. p. iS
Douglas' line, im
Dui (Us entloluuph.ui- w-. ^s
\^M'
.MMl
242
1 i.HOw, arlicular disc of, u^
articulatii'Ti of, 122
Klljow -joint, 122
movciiR'nts of, 1 23
Kllipsoidal joint, no
Kmbryology, (Icfinition, 17
Kmint'nt v, art uatr, 54
artirular, of tfnijM)ral })i)Uc, 40, ^^
carpal, radial, (;o
ulnar, go
' r'lii iai, 4^, ^6
frotual, (io
'■;|><ithenar. iijS
must k'^ of, joo
ilitipcitineal. C15
intiTiondyloiil. of tibia, ()()
olivary. 41, 4S
parietal, ;()
|)lanlar, i-.vlcriial, ?<
intfrnal, 2;^
miildli-. 215. i^j
pyramidal. 57
thenar, kjS
nuisi li-s of, it>()
I"-narthro^i^. 1 lo, i;^r
Epitoiul>lcs. JO
of fr.-nur. L-xlcrnal, (j-^
inti-rrial, o>i
of hiinirrus, SO
Kpiiraniu-s musile. i 7S
Kpi|)ltyscs, II)
l^liijihysial rintirs r,| ossifu ation, .m
line, 21
f-'-pisternal hones, ^0
i;pi>triipheii>, .'!, .>5
I'-pilrut liletKinconetH must le. lo-'^
!%rer;or spinie nnist le, 14')
I'.-ophap'al openin;; uf i!!aplirat;m,
K),, 166
I'.tlli :..i'l iKine, 6.'
ala' of, fi;
(riV)riforni jilale of, 41. (o, '.j
deVelopnietU of, (i)
" ,ewl«]rn, (14, ,Si
' tcral masses ef. t)2, hj^
p( rpendii ul:'. , ' 11 of, (>.», u^
I'.!limi>ii!:il 1p"'1 ., ')
ivIK, (M.
erest, 67. "
depression . ci
foranun. 0^
anP licir, Oi. 7^
[H.,.1. rj.ir. (.,, 7-
i;nHJi<', ()>
l,il»\rinlhs, t'j, fi;
n..l,|i, Oi
pro<i>s of infiri.. ■ uilti.i.tU'i l-me.
spine, t ' . t'^
'iirfae" o' l.;i hrynta! bone, t>5
I'".t!imiiideuma\ill.tij sutun, .So
ru.sl.K hi.m tube, I artila^itions iHirli.in
of, St
semi<an.d for, sS
Kxtensor rarpi r.tdialis brevis nui-,i Ir.
iSs, 1 -.
Itinmis miisi le, I.S:;, tt)^
iiinaris nuist le, 1S5, 107
INDEX.
Extensor earpi ulnaris mu.scle, function
of, 107
nerve supjily of, 107
di);ili V proprius muscle, 1S5, U)(>
function of, 107
nerve supply of, ic)7
dij{ilorum brevis miisi !,■, 210, 224
communis niusde, i.S^. n^o
fuTK tion of, i()7
nerve supply of, 107
longus nuNcle, 210, 22^^
funition of, 224
nervt- >upply ()f, 224
halkuis brevis mustle, 210, 224
function of, 221
nerve supply of, 224
longus must le, 210, 22^
funttitin t)f, 22 ^
nerve supply of, 22 ^
indii is |iropriu.s must le, 1.S5, jij.S
funi lion of, it)S
ner\e supply 'if, iij.S
of leg, 22?
ossis nietat.-irpi pollit is nuistle, H17
ptillit is brevis must le, 1.S5, !()7
functif>n t>f. r(j7
nerve supply of, 107
Itingus must le, iSq. [97
fcnction of, njS
nerve supply of, |.;.S
I surfatc of forearn,. nuist les of. ms
I tif upper arm, nui-t le of, i.Stj
I tentions of Imgers, 20 i
ttf hand, 20J,
■heaths ,,f, 20^
Il\tern,d alKl.iminal ring, 1 s.S
tirif^'e of s, apula, s^. S|
angular proi ess of fnHii,il Ihiuc, \u
.iperture of ai|uaibii Ills vcsiibuli, ;;
art u,ite liganu-nl, i ;0, if)^
,iuililory nii,[ius, ^s, 40
bicipital grotAf, i,**s. 107
iHirtler .>i imiiii us, Sd
i,iro;!ii I'l ranu 11, ^o
I onil\ !•■ of lemur, i>S
of libi.i. If)
t rest tif libul.i. I ni
• jneiioini 111. He- ..f fcK.i 102, lo)
i epitondylcs 1 ' f,Mi:ur, i.s
tif humerus. St)
'm i.ondyloiil luiien le c f li!,;,,, ,,,,
iti'ert osl.d li'Mnients i^xj
il '• riosl;ile, musi le,. '.<•■,
inierniust ul.ir sei-i.t of .irni. 207
of ii.i«h. ,,;.
l.itrml Iii;;im(iii nl ;in'!. i • :
of h.-.i.l, \iS
of kr.t'f. 1 ;;
lunl!^lK.t^Ial ;irt h, td.;
i;i.»llf«(i.ir lnir^.u ^-uln utJtit'oU'. .• ; |
'-urf.u f of lalu'^. IC-'
in;iilrolu-., 101
■ Iit;anicnis i.f, anlirinr, i i;
)Misurif)r. (5[7
in;in;in of -.(aimi.i. S^
nuni-(us n{ knr<- I tint, i \i,
in I ipii.i! I riM. (f)
[tmt iilirraTK f, \\. \(\
External palpebral raphe, 170
liatellar ptinacukim 135
plantar enii ■tntc, j^j
pHKL'Ss of talcantus, 10,5
of talus, 102
ptery^ioid plate, 40, 50
rcctu> mustle, 'ipine for, 76
semilunar rarlilaftc, 133
sulHutanei)US t-pimndvlar l)ur>a,
su|)erior articular surface of tibia. «,()
surfate of shaft of tibia, 100
talo( all am-al li^anu-nt, 140
IuIkTi Ir of talus, lOJ
Kxtremities, lower, Inirsa' of, 2_^^
fasci;e of. 2.:ji
free, skeleton of, 07
tnust"k-s of, 2o<)
elu^situation. 2_j,^
skeleton of, S», cj^
of lon^ IkmU's, ii>
skclelctn of, 2J, Sj, S^
upper, artieulation?- of, i n)
bursa' of. 20S
fascia' of, 207
frte, skeleton of, S:;
ligaments of, 1 i<)
museles of. 185
flevi lopment, 201)
-skeleton of. S_>. K^
thora* ir riiu-« le^ of, 166
V\(V, bon^■•^ of, ( I
must les of, I 7S
funttioti^ of. iS_'
nerve ■^uppl\■ of, iSj
proper. i;.j
i .!(ial eanal, 5'>, >7
f^enieuluni of. 57
surface of malar hone. 71
1 all itorm marj;in of fasi i,i lata, 2^2
process, i2t)
I'al^e j)elvis, i ^o
rib>, I J,
vertebra-, 22, 2X
Ka-.. ia-. r j^
ai"!oniinaI. i^;
aiiiibrai hia!, J07
axillary, 207
braeliial. J07
buetojtharyni'e.il, iS.;
terviial. 1 77
» orat ot i.ivit ular, i 70
I rema>t( rii . i '• (
(ruri>. 2 {-^
^iul.Ml. 21,2
iliai . 2 \\ . : \2
iliope) tineal, 2 \i. j^*
infra^pinatu-^, -'07
lata, 2i,\
himlMxIorsal. i i<i, 1 ^C)
iunhal, i;'>
of i)ai k. I ;f)
of f.«.i, ..(^
of hand, dorsal, 20";, .-•oS
of lirad, 1S4
of leg, 2,.?
INDEX.
243
Fascia; of lower txtrcmity, 231
of nt'ik. 177
of tliij^h, 2^1
of iipiKT rxtrmiity. J07
[Kiroti'ironiasst'Urii , 1S4
JH'ttilU .ll. 2_J,2
piTtor.il. t ;o
jiri-viTiihnil, 177
Scarpa's, ih^
suhsv apular. J07
^upt•r^nial. ^t-iura!, i6^
supras|)in.itus, .'07
ltin(M)ral. 1S4
iransviT^aiis. U»t
Kaxituli, transvtTsi', jri?
l-at tnas^, Iliihat\, iSj, i8^
hut cal. iSj?, iS;
Finiali' iH-Ivis. 1 :;i
i'Viiioral lotnUI -, 155
Irianiilr, .'ifi
I'Vinur. Sj, 07
tcnniyk's of, gS
<i(\(-!i»pinfm. i)A
rpi,..MtivIi-. of, (,S
fXtnniitM- of. ()-. <)H
lu-aii <.f. 07
m-t k of. 07
^hafl nf. .,7, i).S
^urfa< I-' nf, 1)7, ()S
surfai*^ *ti. ()7
triK h.inliTs <if. {)7
I'Vnt-'lra < ali--. >;
vr<uliuh, ;;
Kt-nrstration of ril^, i(»
KilKTs of suIh utamous infruinal rinj;,
ISO
I-ilinM artilam-, inttT)>ulii< . loS, ijS
intcrvirti hral. loS, 1 ro
na\iiiilar, 141
Kihrous l.iytr of ariii ular (apsiiU-, loS
rin^ of iMttr\<rltliral lit)ro<artilau< ,
I JO
riiiula. Sj, loi
and til)ia, rcl.iiion^, lOi
apex, to I
ar!iruiation< of, i ^h
iH)riitT-- of. ioi
I M sis of, 101
dcvrlopim-n'. 101
r\iM-inili(s of. loi
hfai! of. roi
inlcro-.M'ou-' nu niliranc
sh;ifl ..f m,
surfai is of. IOI
liliular Litt lai li|ianu'nt,
noil ii. ion
I'inmi ioinis. I. '7
I-inKiT'-. hone-- of, i}2
fxitiisor Uinion-. of, ?04
?iit»\fmtnl-. of. 1 .•7
synovial -Inalli'- of. .>c!:;
I-'irst (iiiiriforni l>onr of fiM,). 10 i
Kis.sura iMiroiympanit a. 10. > ?. 5
I■i^^^lrt■, (it.iM-rian, \o. 5 ^ ;7
infitior orliital. 17. VK '•''. 7'. 7
infundilM'hr. t*\
,Miroo, » ij)ii;il. 40. n. 51, ,Si ■
|»( lros<(iiam(»^al. ; ^, 54
M. i.V'. ".*;
'.M. i.vS
Fissure, petrotymiiai'i. 40. 51. 57
s])ht'noi<lal, ^7. 42. 41) 74. 75
sphenomaxillary, ^7. _^o, 71, 74. 75
sjihtniMwripitai, 4=1
s[>ht'nojK'lrosai, ^k 1'='. 4-- > *• ^s-
.Si
superior orhital, 37, 4*. 40. 71, 7i
tyupanomastni;!. 51. 57
tynipanos(|uainosaI. ^j
Fixation lii^anuni^. loS
Flat .lUloniinal nui"! Irs, [:;7
(ie\ flopiiictit. i*)^
iMme--. J
must I. > of h,i( k, 145
(levclopnu-nl, 15O
l-'lexiori vrt" lira-. 2 ^
Flexor ae(essi.rius niU'i le, 2.'-'5
hrevis iji^ili \' niusi )e. 21 .•
larpi ratliati-. imum le. iN^. imi
funi tion 'if. itji
nerve siipjily of. !-)[
u.nari^ musi le, iS;, i()>
funetion of, i<)j
neive --upply of. \u2
dit^ili quiiili hrevis nm-- le. iSo, :oo,
- - 1
fuin 'ion of. .^ -.o. 2.^7
ner\e ^t;p|'t\ , .'oo, j.'7
ilit;iloruni hre\ i - niu-t le. _■ tc. 2.'^
nerve sajiply of, 22^
lon^u-' inusile. Jio, 2i(), 22\
funi lion of. .'.• >
nerve supptv of. 222
profundus nui-t le. iS-;. oji
fnm lion of. loi
ner\.- --uppl) ol. m j
■-uhlinii'^ niu^* le, |.S>, I f).'
lurn lion of. ro-'
ner\ \ --upph of. m j
liallui i-- hre\ i^ inu-t le j 10, jjO
funi lion of. 220
ner\e -upply of. 22U
l<»n^us nui--i le. 2\o. 210. 222
fuiM tion of, 222
)rCiMi\v for, to^
nerv*' -upplv "f. :?--•
nf liiiph. 21S
|Hillii is hre\i^ nui->t le. 1 S^, \m)
funi tion of. ii}<t
nerve -uppiv' of. 100
lonj^u- nui-» le. r >^;. lo^
fnm lion of, i., j
nerve -u|'ply of. nj 1
surfaie nt (oreann. must les uf. iiji
ol upp' r arm, 1 lu-i les of, iSS
tendons of p. dm, 205
llo.iiiuLi rih- . ^
l-'onlantiU'. s !
mlerior. Si
fr.intal. Si
m,a-toii|. S»
o( ( ipiial. Si
jHMerior. Si
sphenoidal, S2
I'ontii nli. Si
l\nii. .iriii ul.ition-^ of. 1^7
U.ni's of. 101
eaUaneus of, loj, 10^
Foot, lulxud Umt* of, 102, 104
euneiform iMines ol, IC2, 104
fast i;e of, 2i,_\
ligaments of, 1^7*
auessorv. \ \f}
inlerossenus, 141
hmdirit lies must les of. 22S
niiiatars.it fmii'-^ of. 10^
nuisi le*- of. 224
t la->irii .ition, 2 iS
navii ular Uine of, 102. o\
phaiam^es 4»f, S2, ic;
se-an.oi»! hones of, S2, lofi
skeleton of, 101, io('
sole nf, l-;iJ.|^( Irs of, 2 J ;
syaovi.ii -heath- of, 22t)
talus of. 1.^2
tarsal hones of, 102
xaj^inal ii;.^anient~ of, 2;i
I'oramina, 20
alvmlar. U-
anterior -.h ral, .:-
auililnry. internal. 55
( ai um. 41. ^M . So
( aroiid. exiernal. ;/»
intirn.d. ;;
I n-ioir.in-\er^t .117
dental, inferior. 72
ethiimirlal. 6;
anterior, (>i . 75
I«i-lerior. 'm . -:;
front. d. f)'". 7-;, ;'»
ini i--i\ e, ;o, ''S
infraori'ital, ^7, ('H. (17
interverlehial. 2 \. \\
iuj^ular, 11. 1 ^ \(i
Lif eruin, ;(). j-i. (.-. n, 5^
ma^nuhi, 40. ( \. 1^
itLUidiindar. 72
in.iMo'.!, ,0 ;;. Si. 51
mental. ^7. , 2
na-ai, ''5
miirien', 20
of hn„r. -n
of lilii.t. 100
.►f ulna. S7
ohiur.ilor, o;. o'l
of di.iplu:igm. U'')
<A na-al i .i\ity. 7,
>i -ji rum, iiiK t verl( hial, 20
of -i< mum. \f'
ol xii-hoid pro< I -s. ;()
o|.tii . (f. )S. :^
ovale. ;.;, 4:. 10. so
p.liatine, L'leatel , 40. (n)
I'-'-'vel , j.i, 70
)uri< t,d, \\. 50
<|u.idri'aiera!. i(tO
mtmidum, \2. to. 50, 7S
sairal. 2S. 20
interxerli hr.d. 2n
^Ai ro>i i.idc . I \''-
-I iatii . ^ncil. I \o
le--ser. I ^o
-pheno|>aIatine. 7c, 7H
sliinal, 2 ^
spino-um. \ii. \2. 10. 50
stvloma-loiil, \v. ;fi
-,*,-T-
ii
T-''<*
244
Foramina, su;>raorbiial, 60, 75. 7ft
transvtTsarium, 24
vertehrak', 2^
zyKiimatii-ofarial. yt
zyg()inatinM)rl>ital, y •. . 75
/yg<>m.iiitotfmjK>ral, 71
Forearm, extensor surfare of, mus< Ir^
of, ii)S
flexiir surface of, niiiseles of, igi
muscles of, 1S5, i(>i
classification, 20()
radial musilcs of. i()i
Foreheail. Uiny, ^l>
Fossx, 20
acetabular. ()6
anterior « ranial, 41
axillary, 147
canine, dd
carotid. 172. 174
condyhiid, 45
coronoid. .S6
cranial, 41-4?
anterior. 41
niddlc, 41
IK)sterior. 11. 4.5
cribriform. .',^.'
di^ia.stric, 40. 72
.IJKiial. (17
for lailirvnial nl-""'> 7*
■-ai , 7''i
Ulenoiil. ,?S, yt
liypo(;lo-.s.il, 4S
hy|«o|il>y^c,il, 41
iliai , 115
iliopei lineal. 210
infras]iinalou-i, of siapula, H)
infratemporal. 7()
intercondyloid, ()8
anterior. ()<)
postirinr. i|i)
juKular, in. |(i. 50
niandibul.ir. ^.S, |o. 55. iiS
niastoiil. ;i
tniddle t r.oii.il. p
• mipilal, inferior. 4 (. 40
superior. 4'i
olecranon, S7
oval, -vt-'
pelrusil, 5'>
|io^n rior cranial, 41, 41
pler\4ioit!. 40, 5 1
ptervxo|i.ilalin. . 40. ^o. 7,S
radiiil. S7
.s( aplioul. 51
!«|ilteiiom.i\ill.ir\ . 4'i. 50. 7.S
nulKiri uali . s;
sulisiapul.ir. .■<(
.siiprai l.ivii uf.ir. lesser, 171
Hupraspinalou^. "»f s(apul.i, Ht
temiioral. i-'^i ^J
triK hant* m . 07
/.VKomatii . 71)
FoMM. ..n
arti< nl.iri^ dentin, :^
I-o\iH(I.e yr.imilires. ^^, i)o
Free lo«el < MreniilV. --kel'Mon of. 07
Ujiper e\trelillt\. skeielon of. is.,
F'rons, 4(1
INDEX.
Frontal angle of parietal Iwne, 51)
bon. , ^<), 60
Ixirders of. ()o
cerebral surfaces of, 41
development of, 62
frontal [jortion of, 60
ill ne\ ')orn, 62, 81
nasal portion of, Ao, 61
orbital plates of, 61
surfaces of, 61
suit i arteriosi of, 61
surfaces of, 60
zygomatic jirocess of, 60
iHinler of parietal bone, 5()
of sphenoid bone, 41)
cells, (\\
crest, 41, ft I
eminences, fto
fontanelle. Si
foramen, fio. 75, 76
notch. 60, 75
plane, 17
|«)rtion 01* frontal iMine, 60
process of maxilla. ,^7
of sujierior maxillary, 6^, 67
sinu'., 61
development, f)2
sjiine, ft I
surface of frontal l«ine, (to
suture, (to, .Hi
Fronlali* mus. li'. 17.H
functions of, 1 7.S
nerve supply of, 1 7S
FrontiKthnviidal suture. 41, (it, .So
Frontol.idirymal suture, (7, .So
Frontoin.ixiilary suture, ,?7, i'o
Frontosphinoiiial process, 57, 71
Fusiform mu-cle, 142
G.M.K.x a|«>neurotiia, 17.S
(rasirocnemial burs.t. inner, 220
nilernal, 1 ^ft. 220. 2(4
(lasirocnemius lateralis niusile, 220
nieilialis muscle. 220
niu--! le. 211)
(lenielli mii^i les, 201). .' 1 i
(iemellus inferior nuisi !e, 214
su|HTior nnisili'. 21 \
(leneral .m.ilomy, delinilion. 17
su|K'rfii i.d fa-iia. ift)
Cieniculum of f.n i.d caii.d. ^7
(ienioliV'iidcus niu^i le. 171, 17;
fum lion^ of. 17s
nerve su|.|ilv 111, 17:;
Ciimlx'rnat's li(tameiil. iti. I'n, lOj,
-Ml
llinnlvmoaiiliri»lia. 127. i to
CilnKlvinus. 100
later. il. io<)
Cfinlle. pelvic. ()(
anil ulalioii, of. 12H
lipianieni- of, i 2S
shoulder, .s^
C.lalM'lla. fv.i
I'lladiohi^ of -lemuiii, \4
to.ind, i.HfMvnt.ti, [o„,.,i I«tr, 7n
(ikseriun lissurr, 40. 5,A, 57
Glenoid cavity, 84, 121
fossa, 38, 55
ligament, 121
Glenoidal lip, 108, io<), 121
of hip, 131
Gliding joints, 1 10
Glut.Tus masimus muscle, 200, 211
function of, 21 2
nerve supply of, 212
medius musile. 20<), 212
function of, 21 2
nerve sujtply of, 212
minimus muscle, 20<), 212
fun( tion of, 212
nerve suppiv' of, 212
Gluteal fascia. 2_^2
line, anterior, ()4
inferior, 1)4
middle, ((4
jiosterior, ()4
superior, ()4
muscles, 21 1
sulcus, 2,^2
tulKTOsity, q8
Gluteofemoral burs,T, 212, 2,5?
domphosis, 107
Gracilis muscle, 2tx), 2i()
funition of, 217
nerve supply of, 2 1 7
Great sacrosciatic ligament, I 2((
saphi'nous vein, ;,u
sci.itic foramen. 1,^0
nop h. 1)4. ()(>
UK-, ball of. muscles of, 226
Greater icirnua of hyoiil iKjnc, 7.5
multangular Imne, .S<), r)o
palatine foramen, 40, (»>
pelvis, 1^0
sigmoid notch of ulna, S7
troihanter, (17
tulierile )f humerus, 85
tubircular ridge, 8ft
wings of s|.henoi<l iMine, 47, 41)
Groove, 111' ipital. external, 188, 207
internal. i.S.S. 207
of liunienis. 85
(arotid, 41, 48
carp.il, 00
• osial. 42
.■Ihinoidal (i,
for ll( xor h.ilUiiis longus, lo.?
for nius« ulospiral nerve-, 86
for i.idial nerve, 8ft
haimll.ir. 51
infraorliilal. (>ft, 7ft
imerlulH-n ular, of humerus, 85
lai hryni.il. <i7
miisculo^piral, 80
mylohyoiil, 72
obturator, (15
of calt aneus, 104
of prtimontorv, 58
of i.ilus, 102
oiHii. ti, 48
p.alaline. ItS
paraglenoiilal, o?
prr.inca:. ic,;. i"}
(K'lriwal, inferior, 4t. 45, SS
INDEX.
245
Gnmvc, j)etrosal, superior, 43, 55
ptiTyRop;ilatinc, 51, 67, 69
pulmonary, 35
sagittal, 44, 46, 60, 61
sij;moi(l, 43, 40, 53, 60
sulx'lavian, 33
transviTSf, 43, 46
tympanii, 57
Hai.i.f.r's arches-, 1(15
Hainatf Ixinc, 8<), (|0
Hamatonuiacarpal liganicnl, 127
Hamular gro<jVL', 51
])ro(i'ss, 4c, 5t
Hamulus lai rimalis, 65
pro'.i'ss, ()0
ptcryBoidi us, 40. 51
llami, artiiulatioTis of. 124
Ininrs of, S()
carpal l)o ics of, Sij
extensor tt ndons of, 203
sheath- of, 203
ligaments of, 124
metacarpal <M)r.es of, i)I
movements of, 12O
must les of, 185, i(>S
ciassiluation, 201J
palm of, tendons cif. 205
phalanges of, 82. ()2. See also /'/;,/
iiiflt^rs 11} hiiful.
sesamoid hones of, 82, i|2. .Sec .iNo
Sesamoid hours oj Intmi.
skeU'ton of, ()2
Il.inl palate, 3.). t<H, 7S
in newlM>rn, 'hj
tulHTOsily of. 40
[farmoni( suture, 107
Head. arti( ulalions of, 1 17
fas(ia' of, 1H4
ligar'U'nls of, 1 17
independent, i iS
mus{ les ()f, 177
of I Mines. 20
of femur, 07
of hliula, 101
of humcru'-, Xs
of melam.pal Ixmes, 01, 02
of nn-tatarsal iKines, 10s
of must le, 142
of radius, 88
of rilis, ^1
of scapula, 8)
of lalus, 102. T03
skeleton of, i:. 3()
Ili.ilu-, 20
lan.ili^ faiialis, 4;, s»
Kallopii. 43. 54
seniilunari-, (14, 7S
Hinge joint, icxi
Hip. must les of. 210
, lassilu atitin. J i,\
internal. 210
Hip joint, 131
anil ul.ir ia|)sule of, 132
glenoid.d lip of. I <i
Horizontal plane. 17
Horizontal plates of palate 1hv.ii (x)
lK)rtion of hani palate, 30
of sijuamous jMjrtion of teni|mral
l)one, 52
Homer's muscle, 170
Humertl head of flexor car]ii ulnaris
muscle, 102
digiliirum sulilimis muscle, 102
jHillii is liingus musi le, t()4
of pronator teres muscle, iiji
Humeroradial articulations, 122
llumeroulnar articulation, 122
Ilumertis, 82, 85
anatomical net k of, 85
iHpnlcrs of, 8(1
development, 87
extremities of, S^
head of, 85
neck of, anatiilllical, 85
surgic al. 80
shaft of. 85
surfaces of, 80
surgiial neck of. 86
tulxTcles of. 85
Hunter's laii.ii. 21 7
Ilyoid hone. 73
Ixuly of. 73
(levelopnienl. 73
ligaments of. 1 it)
mvisi Ic-s, 172
llv|Miglossal tanal. 40. 4S
•foss... 48
lit popliNscal fossa. 41
ily|Kiphysis. j8
Hy|Kiskcletal muse li s, i(i|
lly|pothen,ir eminence, ic),S
mustlfs ol, 200
! Ii.lM- liiirs,!, sulilc ndinous, 234
I fascia, 231, 2,11
I ft>s.sa, QS
' Hiatus mustle. 210
Ilioi -tstalis ccrvicis muscle, 14C1
ilorsi muse It . 1 |cj
lumlK>runi muse Ic-, 1 10
must le, 1 41)
functions of. i;t
nerve suppiv of, 1 SI
lliofi iiior.il lig.imcnl. 1 ii
IlioluMili.ir lig.imeni. 121)
Iliopct lineal Imrsa. 133, 211, 2(4
eminent e, t);
fascia, 331, ii,!
fossa. 210
ligament, 231
line, OS
Illiipso.is ntustle, 200. 210
funttion of, 21 1
nerve supply of, 21 1
llioiiliial hand. .•}-•
Ilium, CJ3, o)
ala of, 1)3, 01
surfaies of, 04, c)S
IkxIv of, lis
crest of. 1)4
lips ..f. ..4
ileMlo)iment. c)6
Iliun), spines of. 04
tulierosiiy tif, c)S
Incisive f,)ramen, 31), 68
must les, 181
r iih. <>8
s 'urc. t>i). 8t
Int isor teeth in fclus. (x)
Incisura. 20
mastoidea. 40
Independent ligaments of he.itl, 118
Incliiator muse le, li)8
Inferior .ingle of st.ipul.i, 83, 8(
aperture if pelvis, 131
artitular surfat cs of tihia, 100
helly of omohyoideus must le, 171
liitipilal hursa. 234
tornu of fasc i.i I.Ua. 232
t rus of siilic uianeous inguin.il ring,
158
tienlal tanal. 72
foramen. 72
extremity of femur, 07, cjS
surfac-es of, t).S
of lilnila. 101
of humerus, 85
of radius, 81)
• if lihia, 00
of ulna, 87, 88
glute,ll line, lit
inlerverteliral notch, 2;
maxillary, 71. See aKo
meatus of nose, 77
nut hal line, 41, 40
01c ipiial foss,i, 4 1, |0
orliiial lissure. 37. 30, 'Ki. 7
perime.il retin.ii ulum. 230
petrosal groove. 43, 45. ss,
pill.n of sulii uianeous inguinal ring,
158
prcH c-ss of icnipiiral hone, 57
puhii* ligameiU, I 28
ramus of ist hium. cjj
of puhis. 03, c)(i
temporal line. S')
thoratic aperliire. tS
transverse ligament, 121
turhinateil Inine. 64. 67, 77
ilevelopincni, (14
\ertehral nolc hc-s. 2 {
infr.iglenoiil.il margin of tihia, mo
lul«rosiiv, 8|
Infrahvoiil mii^c li s. 172
fum lions C.I. 1 7 I
nerve supply of. 173
Infr.iiirliil.il i.inal.
1 nirance of. 7v
for.imcn. 37, '»6, 67
grcKixe. ''/). 76
ni.irgin. 7s
siilure. '18, 81
Infr ip. o ll.ir hursa. dc-ep. 1 ;s
siilii iii.iniiiiH, 136, 231
Infraspinatus hursa. 20H
f.isi la. 207
fossa of siapul.i. H;
must le, 1 8s. ISO
fun' lion "1. 17
nerve --uppl' "I, i>7
M.imlMr.
71. 7s
246
InfrasUTnal angle, 35
Infratrniporal crest, ,{(), 50
fossa, "(>
surface of sphenoid iMjne, 50
of superior niaxillary, 66
Infundibular fissure, 64
Inguinal canal, r5(>
ligament, 131. it\^
reficcted, I5(). 164
ring, sul)cu'.';neous, 1 58
Inner 1 rura of diaphragm, 165
ga^lnHnemial bursa, 220
head of gastrocnemius muscle, 220
of triceps muscle, iijo
lip of tinea aspera, ()7
portion of longus colli muscle, 17O
vitreous table of flat bones, 19
Innominate bone, (13
development, 06
Inscriptions, tendinous, 143
of rectus abdominis, 161
Insertion of muscle, 142
Interalveolar septa, 68
Interarticular cartilages, los
ligament, ir6, 117
Intercarpal articulations, 124
ligament, dorsal, 127
volar, 127
Intercartilaginei ligaments, i6q
Interchondral joints, 117
Inten lavi<uh)r ligament, iii)
not(h of manubrium, 14
Iniercolumnar libers of suIm utaneous
inguinal ring, 15c)
Intercondyloid eminence t>f tibia, ijc)
fossa. oH
ant*'rior, (j<>
lK>sterior, gt;
line, i)H
tuln-rt le, external, tut
internal, i)()
Intercostal ligaments, 117
external, ifx/
internal, i(«)
spa-e^, ;;
Inli-r(o-,i.ilc> extern! niu^iles, 161)
interni nuistles, i(x)
muscles, !<>(), I'm
functions of, I 70
nerve >uppl.v of. 170
Intercrur.-d tit>ers of ^ubi ul.ineous in-
guinal ring. 150
Interi unciform ligament, dor-.il. 141
iaten»sseous, 141
plantar, 141
Intcrnuixiilar)' Iwtnc. fxj
suture. 17, ,So
Intermetlial crus of di.tphragm. 105
In: -met.-H arpoplial.mge.il bur^a', 200
Inlermclatar'i.il anil 111. iiions, 1(7, 1 ^i)
Inlermel.itar^oph.dangc.d burs.i. 2^5
I.ilerttui--< ular sept.i. 1 ^ \
anterior, of leu. .•((
external, of arm. 207
of thigh 2^1
internal, of arm. iSH. 207
of thigh, 2\2
of .If Ml-,. 18S. 20;
INDEX.
Intermuscular septa, posterior, of leg.
Internal angle of scapula, 83, 84
annular ligament, 231
arcuate ligament, 165
auditory cani>l 53
foramen. 55
meatus, 43
bicipital grcMive, 188, 207
border of humerus, 86
of tibia, 100
rarotiil foramen, 55
cerebral surface of frontal lx>ne, 60
condyle of femur, g8
(ii tibia, (>()
crest of libula, 10:
cuneiform bones ot fo<it, 102, 104
cpicondyle of femur, qS
of humerus. 86
gastrocnemial bursa, 136, 220, 234
intercondvloid tubenle of tibia, 170
intercostal ligaments, 169
intercostales muscles, i(x)
intermuscular septum of arm, 1.S8,
207
of thigh, 232
lateral ligament of knee, i u
of radius, 122
lumlxwostal arch, 16:;
mallef)lar bursa, sulKutaneous, 234
surface of talus, 102
malleolus, too
margin of scapula. S^
meniscus of knee-joint, 133
musiles of hip, 210
of thigh, 216
occijiital crest. 44. 46
protuberance, 44, 46
pal|R'bral ligament, 171)
patellar retinaculum, I.VS
plantar emineni e. 233
prtK-ess of calianeu^. 10^
pterygoid plate, 40, 50
semilunar cartilage, 133
sulMUtaneous epicondvlar bursa,
20S
suiH'rior articular surf.uc of tibi.i,
surf.ue of shaft of tibia, 100
of ta!u->'. 102
of uln.i, H7
tal<HaKaneal lig.iment. 140
tubercle of talus. 102
Iniernasal suture, 37. 6^, 80
InleriKi ipilal >ynihonilrose-., 47
Interossei itor'^ales muscles, 1H6, 200
fum lions of. 20 (
nerve supply of, 2C\
ntusi les of f«Mt|, 210, 227
of hand. iHli, 200
[M'dis mu-.! les. 227
dorsid. 227
fniH lions iif, 22S
nerve -apply of. 228
plant. ir. 227, 228
volares muscle-, 186, 200, 201
function of, 303
nerve sup|»iv of, 203
Interosseous basal ligahunts, 127
metatarsal ligaments, 141
bursa, cubital, 208
cuneoculxiid ligament, 141
cuneometatarsal ligaments, 141
intercuneiform ligament, 141
ligaments of f(M)t, 141
of neck, 1 16
membran'' of ra<lius and ulna, I2j
of tibial and fibula, 136, 137
ridges of tibula, loi
of radius, 88
of tibia, TOO
of ulna, 87
sacroiliac ligament, r20
spaces of metacarpal bones, 02
tai(H\alcaneal ligament, 140
Interphalangeal articulations of foot,
',??■ '3')
of hand, 128
Interpubic fibrocartilage, 108, 12S
Intersphenoi<lal synchondrosis, 51, 81
Intcrspinalcs muscles, 154
functions of. 155
nerve supply of, 155
Intcrspinous ligaments, 1 1 2
Intertarsal articulations, 137
Interlransversarii anterior muscles,
laterales muscles, 155
mcdiales muscles, 155
muscles, 154, 155
functions of, 155
nerve sufiply of, 155
[HKteriores muscles, 155
Intertransverse ligaments of vertebral
itilumn, 1 1 2
Intertrochanteric line, 97
ridge. 97
IrnertulMTcuIar gnxive of ) -lerus, 85
mucous sheath of biiep>, . ji, 188
Intervertebral discs, 30
fibrocartilages, 108, no
foramen, 23, 31
c)f sacrum, 20
joints, 1 1 1
Intrajugular pfxess, 46, 55
IntraiKt ii'ital svni hondrosis, anterior,
81
posterior, 81
Inlratendinous olei ran.il bursa, 208
Irregular l>ones, 20
Isthiocapsular ligament, 132
Isihiuin, 03, ()6
de\'elopment, 96
Jaws. Sei' Mamlihle and M.ixilUr.
Joint. See ArtUutiiliimi.
lu-hions. 108, itx)
Juga alveolaria, 68
Jugular foramen, 40, 41, 4(
fossa, 40, 46. s6
nod li of manubrium, 34
of ti-mporal Innie, 55
prixess. 43, 46
tul«'ri le-., 43, 46
Jugum sphenoidale, 41, 48
Juucluro; lenduiuin, 196
INDEX.
24/
Knee-cap, gg. Sec also Patella.
Knee-joint, 1,53
menisci of, 133
funrtions of, 13''
movements, 136
semilunar cartilages of, 133, 136
transverse ligament of, 134
Lacertus fibrosus, iXH, 207
Lachrymal bone, 37, 64
development. 65
surfaces of, 65
cells, 63, 65
crest, anterior, 67
posterior, 65
gland, fossa for, 76
grtxjve, 67
notch, 67
portion of orbicularis txuli muscle.
pnx'ess ftf inferior turbinated, /)4
sac, fossa for, 7(1
Lachrymoconchal suture. 80
Lachrymoethmoidal suture, .So
Lachrymoma.xillarv suture, 80
Laciniate liganu-nt, 231, 231
Lacuna musculorum. 231
vasorum, 231
Lacunar ligament, 131, if>3, 164, 231
Lambdoid border of occipital bone, 46
suture, 38, 7q
Lamina papyracea, 6?
Langer's muscle, 1(17
Lateral crest of s.t rum, 2(,
crus of diaphragm, 1(15
ginglymus, loq
i..tertransversarius muscle, 155
ligament, external, of arm, 122
of head, 1 18
of knee. 13S
fibular, 134, 135
internal, of arm, 122
of knee, 134
of lingers, 127
of f(M)t, I3()
radial. 12O
tibial, 134
ulnar. 12')
masses of atlas. 25
of ethmoid, ')2, (13
of sacrum, 21)
jtortions c)f (Hcipit,!! fionr, 40. 4.,
sacr(hi>c( yge.il liganii-nts, 11 \
surfaii' <ii railui^, 88, H.j
Latissimus bur-.,i, 141)
dorsi muM le. 140
function-, of. 147
niTvi' supply of, 147
Leg. antcri'T niuHile-. of. 223
extensor-, of, 223
fast ue 1 il, i^},
must les of. 211)
tLtssiliiation, 235
tiuter mustles tif. 222
IM»steriur niustlfs of, 2n>
LcT.-tT c:irn-da of hytjiri Inint-. 73
multangular (xine, 8<), i>o
Lesser palatine foramen, 40, 70
pelvis, 130
sacrosciatic ligament. I2(;, 130
sciatic foramen, 130
notch. 1)6
sigmt>itl ntitth tif ulna, 87
sui)raclavicular ft)ssa, 171
trochanter. t)7
tubercle of humerus, 85
tubercular ridge, 86
wings of sphi-nt)i(! Ixme, 47, 40
Levator ala' nasi mustle, 180
anguli oris muscle, 181
glandul.1' thyreoitlea' muscle, 173
labii ir.ferioris muscle. 181
superioris ala'quc nasi muscle. i.So
mustle. iSo
menti mustle. 181
scapuKx* mustle. 147
functit)ns t)f. 147
nerve supply of, 147
Levatores costarum breves muscles,
170
Itmgi mustles, 170
muscles, li-n)
Ligamenta mruscantia, 169
Hava, 112
Ligaments, 108
accessory. 108
acromitH lavicular, 120
alar, 1 15
annular, 122
anterior, 127, 221)
internal, 231
of palm, 205
[HKterior, 203. 208
a|iical iKlontoiil, 115
arcuate, 128
external, 156, 165
internal, 165
1H>pliteal, 135
basal dorsal, 127. 141
intertis.seous, 127
metatarsal, interosseous, 141
plantar, 141
volar. 127
bifuriate, 140
caltaneiHulxiiil, 141
plantar, 141
ialcanet)libul.ir. 140
lalcaneonaviiular, 141
dorsil, 140
plantar. 141
I .iltaneiiiibi.il. 131)
1 ipilular. ,in , , lor. "36
|)Oslirii r (()
transvcr>. , tf ftKH, 1 3tj
larpal, 126
titjrsal, 203. 20S
extci.s.ir leniltm sheaths In-
neath. 203
railialf. 127
transverse, i 27. 20^
--lar. 208
carpmielai iirpal. ttorsal, 127
vtilar, 127
check. i=H
Colles', 151)
Ligaments, conoiil, 120
ctirattiacrtimial, 120
coracoclavicular, 1 20
ct)ract)humeral, 121
costocIa\icular, i it)
costotransverse, anterior, 116
miilille. 1 16
posterittr. 1 16
superitir, 116
iDtyloitI, 131
trucial, 134
anterior, 134
of palm, 205
posterior, 134
cruciate, 1 15, 220
crural, transverse, 23^
cuboidet)navicular. tltjrsal, 141
plantar, 141
cunetKuboiil, tlt)rsal, 141
intert>sseous, 141
plantar, 141
cuneometatarsal, interosseous, 1 41
deltoiti, I 30
dtjrsal, t)f ftK... 140
Gimlx'rnat's. 131. 163, 1(14, 231
glentiiil, 121
hamatomelacarpal, 127
iliofemoral, 132
iliolumbar, i2t>
iliopettineal, 231
inguinal, 131, 163
rtfletHil, 151), 164
interanitular, 110, 117
intertarpal iltirsal, 127
vt>lar, 127
inlercartilaginei. i6<)
inten lavit uiar, 111)
interttjsial, 1 17
external, 161)
internal, ifx)
intert uneiftirm, dorsal, 141
intertjsset)us, 141
plantar, 141
intert>sseous, 1 16
basal, 127
metalars;il. i \y
cunetM"ulM)itl, ■ • 1
I unettni,'talars.il. 141
intercvmeiftirni, 141
t)f ft>ttt. 141
sacroiliac. 12()
taltnaltancal. 140
intersi ntuis. 1 1 •
inltrtransvt rsc, •>{ vcrlebral loluinr
1 12
isi hiiH.ip-.ular, 132
lat\ii,ite, 2.1, 231
lat un.ir, 131, 163. 164, 231
lateral, exit rnal, tif arm, I2J
tif head, 122
of knee. 13s
'1, i.iS
lit ar, 134, I3S
internal, of head, 122
tif knee, 134
of fingers, 127
of f'Jot, I ;:j
radial, 122, I2fi
248
INDEX.
if
Ligaments, lateral, tibial, 134
ulnar, 122. 126
lumlxKostal, 156
navicular tnneiform, tlorsal, 141
plantar, 141
oblique, 123
JHipliteal, 135
«lontoi(l apiral, 115
of ankle-joint. 130
of confluction, loH
of costal tubenle. 116
of external malleolus, anterior, i,:
posterior, 137
of fixation. toS
of fiH)t, 137
accessor)', 13Q
of hanil, 124
of head, 1 17
inflependeni, i iS
of hyoiil l«)ne, 1 jij
of lower extrcmilies, 12S
of neck . 116
of pelvii ginlle. 12S
of scapula, i 20
of upper eMreniities, 1 U)
of vertebral column, 1 1 1
orbicular, 1^2
pal|iebral, internal, I7g
patellar, 135
pelvic, 128
inilepenileni, I2()
pisohamale, 125
pisometacarpal, 12;
plantar accessory, i,^c)
lonj;, 141
of fiHil. 140
tarsal, 141
]K)pliteal, arcu.ite, 135
oblique, I IS
Poupart's, lii. if)?
ptervRomaxillary, 184
pteryg<)spinous, i if)
pubi( . inffrior, 12H
s^pcior, I 28
pulxxap-ular. 132
radial lateral, 122, 126
radiate, 11 0, 117
raditwarpal, dorsal, 126
volar. I .''t
reinforiinv;. 108
rliomlKiid. I U)
round, i.;2. 13^
satrodKcy^eal. ant*'rior, 113
lateral. 1 1 ?
posierioi, I n
s.u roiiiai , anterior, I2<^
iniero>^n.us, 1 2t)
|«i^Ierior. 121)
sacrosi iaiii , ^reat, 121)
lesser I 2(), 130
sacrospi us, 120. 130
sacroiul- 'Us, 121)
sjilienon ilibular, i iH
stellate, ; ^•.117
■-tcrntK iii\ 11 ular, 1 ic)
slvlohyoid, I II)
-IviolM.liidlbui.il, I I.N, i.';4
stylonuixillary, 184
140
•Vi
Ligaments, supraspinous, 112
talocalcanea!, anterior, 140
external, 140
internal, 140
interosseous, 140
]tosterior, 140
talofibular, anterio
|M)steri<ir, 140
talotibial, anterior,
jx>sterior, 130
tarsal, 13Q
d()rsal, 140
tarsometatarsal, dorsal, 14T
plantar, 141
lemiH)n')mandibuIar, ;iS
tibitmavicular, I3(), 140
*ransverse, tapit'ilar, 127
inferior, 121
of a:'.is, 1 14
of hip, 13T
of knee. 134
.superior, 1 20
tra|)ezoid, 120
triangular, 150, 1O4
ulnar, lateral, 122, 126
vaginal, 143
of foot, 23:
\' Jar, accessory, i 27
Ligamentum nuch.r, 113
teres. 132
Limbus alveolaris, ')8
Linea alba, 161, 1O3
aspera, 1)7, q8
musi ularis. S3
suprema, 40
termin.dis, 2()
Lingula. 48, 73
Li(is, glenoidal, loS, icx) I2r
of hip, 131
of crest of ili'im, 1)4
Lisfranc's joint, 1 31)
tutxTcle, -^2
Little toe, ball of, niusdes of, 227
l^iocking mechanisms, l)ony, 108,
Long lM>nes, ig
diaphyses of, n)
epiphyses of, II)
extremities of, K)
neck of, 20
shaft of. 1,,
head of triceps mus< Ir-, 180
must les of bat k. 14*)
tlevclopmenl, 1 s'>
plantar ligament, 141
|K>slerior sat roiliac ligament, 1.
Ltingissimus tapitis niustle, 150,
terviiis musile, 150. 151
ilorsi must If, 1 10, 150
musile, 141), 150
funttions of. 154
nerve supplv of, m
LongilutHnal ligaments tif verti
t oiumn, 1 1 1
Ltingus .itlanlis niustle, 176
( .ipiti> ; lusi le, 176
funttions of, 17(1
nerve suppi> of. 1 jf,
ttilli niustle, 176
l.ral
Longus colli muscle, functions of,
176
nerve supply t)f, 1 76
L,>uis' angle, 34
Lower extremity, bursa- of, 233
fascia? of, 231
free, skelettin of, t)7
muscles t)f, 2og
classification, 235
skeleton tif, 82, ()3
jaw, 37. Sec also Mandible.
portion t>f longus colli muscle, 176
Lumbar jxirtion of diaphragm, 164,
165
rite, 28, 35
triangle, 147
vertebrae, 27
LumlKKtistal arch, external, 165
internal, 165
'igament, 13b
Lumlnxltirsal fastia, 146, 156
Lumbtjsacral vertebra, 30, 36
Lumbricales bursx, 228
muscles t>f ftHit, 210, 228
of hami, 200, 203
functions of, 203
nerve su|i|ily of, 203
Lunate Ijtme, 8t), tjo
Maissiat's baml, 232
Malar \nmv, 3b, 70. Sec also Zygn-
matic hour.
jHirlion t)f orbicularis ,« \ili muscle,
170
surface t)f malar ln)ne, 71
Male [k'vis, 131
Malleolar bursa, subt utanetjus exter-
nal, 234
intern.d, 234
surfates c,f lalus. 102
Malleolus, external, 101
ligaments of, anterior, 137
fMisterior, 137
internal, 100
Mammillar\' pi<Kes.s, 28
Mandible, 37, 71
IkkK' of, 71
lM:rtlers tif, 71
developmeni, 73
in nt'w-lKirn, 73, 8t
noil h of, 71
prot esses tjf. 71
ramus of, 37. 71 72
Manilibular 1 anal, 72
foramen, 72
fossa, j8, 40, S3, 1 18
M.iniilirium of sternum, 34
Marri w. iMine. 21
Masseter niusi le, iS>
functions ol, i8^
nerve sufifily of, 183
M.is-.eterii iuliero>i'y, 72
M.istoid angle, 4,, 50
Utnler t>f oi(i[)ital lM>ne, 4ft
tanaliiulus, 56, 5S
tells, S3
fonlanelles, 8j
INDEX.
249
Mastoid foramen, 40, 43, 53, 54
fossa, 54
jKirtion of temporal bone, ,^8, 40, 52,
53
process, 38, 40, 5.?, 54
Maxilla*, 37, 66
Ixxly of, 66
developmem, 6q
frontal j)r(H-esses of, 37
in ni'\vlK)rn, 6<), 81
nasal prcKi-sses of, 37
processes of, 37, 66
surfaces of, 66
Maxillary cells, 63, 67
process of inferior turbinatexJ, 64
sinus, 66
orifice of, 67
surfa'e o." ])alate Ixine, tx)
Meatus acusticus externus. 38
auditorius externus, 40
nasopharyngeal, 77
of nose, 77
common, 77
inferior. 77
middle, 64. 77
suiwrior, 64, 77
Medial crus of diai)hraRm. 165
inlertransversariuM niustle, 15s
Mi-dian palatine suture, ^tj, 81
plane, 1 7
Me<lullary cavity, k)
Membrane, aUanHKx i i[>itai, 115
(posterior, 1 15
cosl(Koracoi(i, 170
interosseous, of ra^lius and ulna, ij ,
of tibia and fibi:la, 136, 137
ol)tuiittor, 1 11;, i2t)
anterior, 1 15
|K)Sterior, 1 15
sternal, 117
•-ynoviiit, 108
tectorial, 111, 115
Membrane. us Ixjnes, 21, 22
MtTiiscu^, 108
of knee idint, 133
funtti'-n of. 136
Mental f<ii;unen, 37, 72
protubt \uue, ' .
si)ine, "^2
tulwrrlc 72
Mentaiis nuisi le. iSi
Metiuarpal lM)ne*^, H2, 01
base of, (ji
lK)rders of. (>i
development, 92
llCild 111, If., t)2
shaft of. gi
su»"faces of, gi
MetacariM)pha!:inKial artit ulalitm^,
127
<tf ihuml), 127
Imr-^a-, <ior-^al sulu (il;im*ous, 208
Metaiarpus, i»i
Metatarsal ljoni*s, 82, 105
Ihisc of, 105
df'-r!'r|>men!, 106
head of, 10^
Metatarsi] liones, shaft of, 105
ligaments, basal intenwseous, 141
Metatarsophalangeal aliculation.s,
137. i.W
Metatarsus. 105
Nietopic suture. 60. 62, 81
Middle articular facet of calcaneus,
of talus, 103
clinoid pnnesses, 48
costotransverse ligament, it6
cranial fossa, 41
•Tura of diaphragm, 163
cuneif( rm Inmes of f<ni|, 102. 104
gluteal line. ()4
ni -alus of nose, (., 77
j ()lantar eminence, 2^, 2Ti^
\ tur))inated bone. i(>3
' Monaniculiir mu.si U"^, 142
Mucous bursa', 1 43
{ Nheath, intertuben ular, 121, 188
I Multangulai •Mine, greater, .iij. (jo
I lesser, ik), i;:>
Mult'*ulus cervicis niustU, 152
dorsi must le, [52
lundKirum mii>t le, i ^2
must le. 152
function^ of, ■ 5 1
nerve supply of. :54
Mu-'cles, 142
alxlominal, 157
antagonistii , 14^
belly of, 142
li'articular. 42
biceps. 142
bipenniform, i \2
bipinniile, 142
bivrnter, 142
cervical, prevertebr.d, 176
development, 1 ,s
digastric, 142
fusif<jrm, 142
gluteal, 21 1
head of. ^42
hyoic . 172
infrahyoid, 172
insertion of. 142
monarticular, 142
nasal. 17). 1S2
of anterior surface of thigh, :i4
(►f back, 144
tlat. r45
long. 40
short. 154
of e.\tens«tr surfii e of fore:ir'n. ms
of upper ami, iS<>
of face, 178
of fle.vor surf.ice tti f»>re;irm, l<)l
of upper ;irni, i ^S
of fiMU. 224
of forearm, 185. iiji
of hiind. 1^5, U)S
of hfiid, 177
of hip, 210
of hyiM>then:ir eminent e, 200
of 'eg, 310
o. it7-,vrr r-'itremiti . 2Ci}
of niiistiiaiion. 182
I Muscles of ne(k, 171
(tf scalp, 178
()f shoulder, 185, \Ah
of thenar eminen<e, kk)
of thigh. 214
j of thoracic walls, Ki«)
j of trunk, 144
of ujiper arm, 185. i,S8
[ extremity. 185
oral, I 7-.J, .So
I orb ir, 1 42
orig..of. 142
alpebral, 170
iiniform, 142
j-innate, 142
prevertebral tcrvital, 176
(juadriieps, 142
I short, 142
sphincter. 142
: >pindle-shaped, 142
supraiiyoid, 174
synergistic. 143
thoracic, 166
! triceps, 142
lypital, 142
Mus( ulospiral gro4»ve. 86
nerve, groove for. 86
Mux ulotubar < anal. 5^, 5S
Mylohyi-id groove, 72
line, 72
r; 'he. i 75
Mylohyoideu-^ muscle, 174
futK lions nf, 17:;
ner\e -ui>l)Iv of, 175
M, ■;,,«>, ,4. •
detinitio.i, I 7
general, 142
spei iai, 14.'
Myonierlc niu-dcN, 1S4, 185
N.ARF.s. anterior, 66, 76
]>o-,terior, 3(>
\a"«al Uine-i, 37, 65
development , 65
in nt \v-1mtii. 65
iMinh r ot' front*.. !?'«ne, 61
I an;ii, 75
ravi.y, 7'.
f tramina of, 77
I ttncha'. 37
crest, 68, (x)
foramina, 65, 77
must les. I 70, 1S2
nott h, 68
IM)rti<»n of frontal Uine, 60. 61
proiess of maxilla, 37, 6ft. 67
>eptim, 3; 76, 77
•^pin« , anterior, 37, 68
posterior, v). ^x)
surface tif palatt l«ine. 6«)
of s\iperior i.iaxill,ir\ . 66. fi7
Nasalis nui-;* le, r S2
Nasofrontal suture. 37. d^. 80
NaMilai hrvtnal i an;d, 64. 67, 7^
N iM>fnaxiltarv suture, 37, 6:^. 80
N Tsojihnryngcai meatus. 77
Nusoph 'r\ii\, 77
250
INDEX.
Navicular Ixmc of foot, 102, 103
dcvdopmenl, 106
of hand, 8<), 90
fibrocartilagf, 141
Naviculari-cunciform ligaments, dor-
sal, 141
plantar, 141
N'crk, fascia- of, 177
ligaments of, 116
muscles of, 171
deep, 175
short, 155
development, 156
of femur, 97
of humerus, anatomical, 85
surgical, H(i
of long bones, 20
of radius, 88
of ribs, ,^2
of scapula, 84
of talus, 102, 10^
Nerves of b<ines, 2 1
Neurolog>, definition, 17
Nose, meatus of, 77
common, 77
inferior, 77
laiddle, 64, 77
superittr 64. 77
"jchal fascia, 15<>
1, e, inferior, 41, 4f)
superior, 41, 4(1
surface of occipital bone, 4ft
Nutrient canal of arm, 87, 81)
of tM>nes, 20
of radius, 87, 89
foramen, 20
of tibia, 100
of ulna, 87
Oblique head of adductor halluci^
muscle, 226
ligament, 12,^
line of mandible, 72
of tibia, too
muscles, 164
IHipliteal ligaments, I,VS
Obliquus aUlominis exlemus mus-
cle, 157
functions of. 162
nerve supi)ly of. 1A2
internus muscle. IS", 't>o
functions of, I'lj
nerve supply of, 162
capitis inferior muscle. 155
functions of. 155
nerve supply of. 155
superior muscle. 155
functions of. 1 55
nerve supply of. ilj
Obturator i-xternus muscle. 2011, .'•ift,
-'"
functions of. .-iS
nerve sujiply of. 21.H
for.\nien, 0?. o'l
pr:..v.. o:
intemus musile. 20<), 21.5
functions of. 21,;
Obturator internus muscle, nerve sup-
ply of, 2 1 3
membrane, 115, 129
anterior, 1 1 5
posterior, 115
ridge, 95
tubercle, anterior, 05
posterior, 95
Occipital angle of parietal bone, 59
bone, 38, 40, 45
b:tsilar jKirtion of, 40, 45
Ixirders of, 4ft
condyles of, 45
condyloid portions of, 45
development of, 47
in ne\v-lx)rn, 47, 81
lamtxI'Mil iKirder of, 46
lateral [Hmioiis of, 40, 45
mastoid border of, 46
nuchal surface of, 4 1 , 46
relations of, 38, 40
squamous ixjrtion of, 38, 45, 46
border of parietal bone, 59
condyles, 40
cest, external, 46
internal, 44, 46
fontanelle, 81
fossa, inferior, 44, 46
superior, 26
protuberance, external, 41. 46
internal, 43, 46
Occipitalis muscle, 1 78
functions of, 178
nerve sufiply of, 1 78
Occipitomastoid suture, 38, 40, 43, 53,
TO
Occiput, articulation of first and sec-
ond vertebra- with, 113
Odontoid ligament, apical, 1 15
process, 25, 26
Olecranal bursa-, 208
Olecranon, 87
fossa, 87
Olivary eminence. 4t, 48
Omohyoideus muscle, 172, 173
Opponens digili (|uinti musele, 200,
227
funciii.n of. 200. 227
i\tT\e supjtly of. 200. 227
V muscle of fi»)t, 186, 210
[M)llicis muscle, 18A. 109
functi(^n of. 199
nerve supply of, 199
Optic foramen. 41, 48, 75
gro<)ve, 41. 48
Oral cavity, riMif of. 78
muscles. 179, 180
Orbicular ligament. 132
muscles, 142
Orbicularis oculi muscle, 179
functions of, i.So
tierve supj)ly of. 180
oris muscle. 180, 181
Orbit, margins of. 7^
walls of, 73. 74
de^'i'loprncnl . ':fl
Orbital lavil'.es. 37. 73
cri-sl of -phenoidal Ixinc, 50
Orbital fissure, inferior, 37, 39, 66,
7'. 74, 7,i
superior, 37, 42, 49, 74. 7.'i
pLites, 61
surfaces of, 61
portion of orbicularis muli muscle,
I7Q
process of palate bone, 70
surface of lachrymal l>one, 65
of malar bone. 71
of orbital plates, 6 1
of sphenoid lione, 49, go
of superior maxillary, W)
wings of sphenoid bone. 47. 49
Orifice of aquaductus cochlea', 56
of canaliculus cochlea-. 56
of maxillary sinus, 67
Origin of muscle, 142
Os basilare, 47, 51
capitatum, 8g, 90
inca;, 47
incisivum, 69
interparietale, 47
magnum, 8g, 90
nasoturbinale, 64
planum. 63
trigonum. 103
Ossa Bcrtini, 48
suturarum, 83
Ossification, 21
centers, 21
Osteology, 19
definition, 17
general, 19
special, 22
Outer crura of diaphragm, 165
head of gastrocnemius muscle, 220
of triceps muscle, 190
leg muscles, 222
lip of '.inea aspt-ra, 97, 98
|Kirtion of longus colli muscle, 176
vitreous table of flat Imnes, 19
Outgrowths, 20
Oval fossa, 232
P.\CCHIONIAN depressions, 44, 60
Palate bone. 611
development, 70
horizontal plates of. (tq
in newborn, 70
perpendicul.tr [)late of. 6<)
processes of. 70
surfaces of. U)
hanl, 39, 68, 78
in newlKirn. 68
tuberosit\' of. 40
Palatine ( anals, fn)
cells, 63, 70
foramen, greater, 40, (x)
lesser, 40, 70
gr(K>ves, 68
prftcess, 31), 66, 68
sjiines, 68
suture, metlian, 39, 81
transverse. 39. 81
PalatiK'thmotdal suture, 80
Palatomaxillary suture, 80
INDEX.
251
Palm, tendons of, 205
flexor, 205
Palmar a[)oneurosis, ii)8, 207, 208
Palmaris brcvis muscle, 186, ig8
function of, i(^
nerve supply of, I'W
longus muscle, 185, i()i
function of, igi
nerve supply *)f, IQI
Palpebral ligament, internal, 171;
muscles, I7g
jjortion of orbicularis oculi muscle,
rqphc, external, 171)
Par-glenoidal groove, ()5
Parietal angle, 50
bo.ic, ^(1, 5()
angles of, 5g
borders of, 5q
development of, 50, 60
in new-Uirn, 60
sulci of, 5(>
surfaces of, 59
bor^ r of frontal bone, 60
emporal bone, 52
cn.i ence, 59
foramen, 44, 50
notch, 52
surface of parietal fxine, 50
Parietomastoid suture, 38, j.v 7<)
Parotidcomasseteric fasda, 184
Patella, 09
aiH'X of, Ql)
base of, gg
development, gg
surfaces of, gg
Patellar ligament, 1,15
retinaculum, external, 135
internal, 135
surface of femur, g8
synovial fold, 135
Pectineal bursa, 234
fascia, 232
line, g8
Pectineus muscle, 20<), 216
function of, 2if>
nerve supply of, 216
I'ectoral fascia, 170
Pectoralis major muscle, 166
functions of, 1(17
nerve supply of, 167
minor muscle, if)(), if)8
functions of, 168
nerve supply of, i68
Pellicles of vertel)ra', 2\
Pelvic contraction, plane of, 130
diarthroses, 1 2S
expar ion, plane of, 130
ginlK ,)3
articulations of, 128
ligaments of, 1 28
inlet, 130
ligaments, 12S
independent, i 2g
oulli'l, 131
svnarthrosLcs, 128
Pelvis, 128, 130
a|)erture of, inferior. 131
Pelvis, a[)erlure oi, superior, 130
bony, g3
cavity of, 1 30
diameters of, 131
false, 130
female, 131
greater, 130
lesser, 130
ligaments <if, 1 2g
male, 131
true, 130
Penniftjrni musdes. 142
Perichondrium, 21
Periosteum, 21
Perona'us hrevis muscle, 210, 223
functions of. 2 2^^
nerve supply of, 223
longus muscle, 210, 222
function of, 222
nerve supply of. 222
sheath of, 231
tertius muscle, 210, 224
function of, 224
nerve supply of. 224
Peroneal gnxtve, 103, 104
process, 103
retinaculum, inferior.
'.^o
superior, 230
PoriK-ndicular plate of ethmoid Ixme,
62, 63
of palate Ixmc, (»)
Pes anserinus, 214. 216
Pctit's triangle. 147
Petrooccipital fissure, 40. 43, 54, 81
synchondrosis, 81, 1 18
Petrosal Ixirder of sphenoidal Ixmc
50
fossa, 1,6
gRMive, inferior. 43, 45, 55
superior, 43. 55
Petros<|uainosai I'lssure, 53, 54
suture, 81
Petrotympanic fissure, 53, 57
Petrous jKirtion of tcin(K)ral bone, 40,
52. 54
apex of, 55
Phalanges of fiMit, 82. 105
development, loO
of hand, 82, <)2
articular lapsuK's of, 127
articul.itions of, 127
Ixiniers of. 02
developmenl, ()2
movements of. 127
shaft of, 02
surfaces of, g2
troihlea of, g2
ungual, 02
Pharyngeal canal, 411, 51
lulK-rcle, 45
Pill.ir of sulxulaneous inguinal ring,
anterior, 150
inferior, 158
posterior. 150
superior, |i;8
Pinnate muM les, 142
Pintorni bursa, 234
Piriformis muscle, 20<), 212
Piriformis muscle, function of, 213
nerve supply of. 213
Pisifcirm lM)ne, .Scj. c)o
articulation of. 124. 125
Pisohamate ligament, 125
Pisc)meiacar|)ai ligament, 123
Pituitary Ixicly, 48
I*ivot joint, ICH)
Plane of pelvic contraction, i ^o
expansion, 130
Plantar basal liganients. 141
lalcaneoculiiiid ligament, 141
calcaneonavicular ligament. 141
c* *ioiclectna\ic uiar ligament, 141
lecK'ulMticI ligament, 141
t. 'nence. external, 2^^t,
;ernal, 233
iniddle, 225. 233
intercuneiform ligaments. 141
interossei muscles, 227. 228
ligament, accessory. 131)
long. 141
of fcKit, 140
naviculari^ unciform ligaments, 141
surfac-e, 18
tarsal ligaments. 141
tarsometatarsal ligaments, 141
Planlaris muscle, 220
Planum nuchale, 41, 41/
cK'ci|)itale. 41, 46
.sternale. 34
temporale, 38. 50. 52, ,>i). 60
Matysma muse le, 1 71
functions c:f. 1 71
nerve supply of, 171
Pneumatic Umes, k)
Polyaxial joints, 1 10
Po[ili.,al bursa. 136, 221, 234
ligament, arc uate, 135
obliciue, 135
line, 100
space. c)8
Popliteus muscle, 210, 21c), 220
funclion of, 221
nerve supply of, 221
Porus ac usticus inlernus. 43
Positions, designations of, 17, 18
Postaxial muse Ic-s of lower extremity
2.<s
of upper extremily, 20c)
Posterior alKlominal muscle. it)2
developtnent, rt)4
annular lig.inicnt, 20^, 20.S
arch of vertebra. 22
articular facet of ealiaiicu-. 10 ;
of lain-, 102
atlanlo-oeeipilal membrane-. 115
l«'lly of elig.ustrieus nuisc Ic. 174
bursa of ghiueus ine<iiu>, 212
capimlar ligame-nt, 1 1''
e iinoid processes, 4-8
conclvloiei e ,in;ii. 40
process of manelible. 72
lostotransverse ligameni, 11')
cranial fewsa, 41, 43
crucial ligament. 134
crus ol sui)cutaneous inguinal ring,
l.SO
■^A^-;**!ifc\filr\"
n
252
Posterior ethmoidal foramen, 'ii, 75
fontanellc, 81 '
("luteal line, Q4
inferior spine of ilium, q4
inlerconilyloid fossa, qq
intermuscular septum, 2.?,?
intenxeipital synehonilrosis, 47
intertransversarius muscle, 15s
inlraocrijiilal synchondrosis, ,Si
huhrymal i rest, (15
layer of lumlxKlorsal fascia, i.s()
ligament of external mallei>lus, 1,^7
lonRituilinal lipiment of verteliTn
(olumn, II I
muscles of thigh, 218
nares, 30 |
nasal spine, .w, 60 I
obturator memlirane, 115 j
tubercle, 05 ■
pelvic surface, <|(>
pillar of subcutane<ius inguinal rinj;,
jKirtioii of cjuaclratus lumburuni
muscle, 162
jiriHCss of talus, 102 j
sacral foramina. 2()
sacrococ ( ygeal lisaments, 113
sarroiliac'lii^ament, 129
surfaie of tibul.i, loi
of humerus, .S(>
of legs, muscles of, 211)
of tiVna, 100
of ulna, 87
of zvprniatir Ixme. ;i
taloiaicaneal ligament, 140
talolibular ligament, 140
talotibial ligament, i.V)
trochant.Tic bursa of gluta-us me-
diu-,. .'I 2. 2,u
Pouparl'- ligament, 1,^1, if'.i
Preaxial muscles of lower extremity,
of upper extremity, 20<)
Prepatellar bursa, subcutaneous, 136,
subfascial, i^h
subtenilinous. 136
Prevertebral c ervical muscles, i 76
fascia, 177
—S
rriHcnis nasi muse le,
Proces'-c's, 20
accessory, 28
at romion, 84
nlar, (1?
alveolar, 37. ''''• '^^
articular, 20
of vertebra-, 23
c'.inoid, anterior, 41, 4<)
middle, 48
posterior, 48
rondyloid. 20, 38, 71, 72, 7?
coracoid, 84
Kironoid, of m.indibli', ,?8, 71, 73
anterior, 72
..i uina. '-7
costal, 24 , . ,
ethmoidal, of inferior lurbmaled,
64
IN HEX.
Processes, external angular, 3O !
of calca us, 103
of talus, 102
falciform, 12()
frontal, of maxilla, 37, fi6, <'7
frontosjjhenoidal, 37, 71
hamular, 4°, S'' '1°
inferior, of temporal bone, ^J
internal, of calcaneus, 103
intrajugular, 46, 55
iugular, 43, 4b , . ,
lachrvmal, of inferior turbinated,
mammillary, 28
mastoid, 38, 40, 53, 54 .
maxillarv, of inferior turbinated,
f)4
n.asal, of maxilla, ,7, W), f)7
cKlontoid, 25, 2()
of sacrum, sui>erior articular, 2C)
of vertebra-, 23
orbital, 70
jialatine, 30, 6(>, 68
peroneal, 103
posterior, of talus, !C2
]ilerygoici, 3(1, 47- 5°
|iterygospinous, 51
]iyramidal, 40
of palate bone, 70
sphenoi'l,il. of palate bone, 70
s]iinous, of tibia, i)c)
of vt-telira', 23
styloid, c)f metacariial lion,', 0'
'of radius, 8(i
of tem|ioral bone, 40, ,S')
of ulna, 88
supracond vliiid, 87
tcTOporal, of ulnar Ume, 71
transverse, of vertebre, 23
troi hlcar, of calcaneus, 103
un< iform, tyo
uncinate, (14
vaginal, of jiterygoid processes. 4<),
51
of temporal Ixme. 5'', 57
xiphoid. 34
foramen of, 3'>
zygomatic, of frontal li
' of maxilla. M. 67
of temjioral bime, 3ft, 3S, 30, S2
Processus civinini, 51
costarius, 24
mastoideus, 40
pvramidalis. 40
Promontory, groove of, 58
of vcrti bral ccilumn, ,]o
Prcmation, 12 (
Pronator ciuadratus nuisde, 185, I<J4
function of, n)t
nerve supply cif. i')4
ITS muscle, 185, IC(I
j function of. i')i
ncTve sujiply of, loi
Protuberance, mental. 71
Prc'ximal r.idionlnar articulation. 122
I'^cias major muse le, 210
minor must le, 210, 211
Pterygoiil ctmtd, 50, 78
. 60
Pterygoid depression, 73
fo,s.sa. 40, 51
notch, 51
plate, xternal. 40, 5°
internal, 40. ;3
process, 3C1, 47 50
tul)erosity, 72
Pterygoidei mu^ les, 182, 183
functitins ol, 184
nerve supply of, 184
Ptervgoideus externus muscle, 183
internus muscle, 183
I'lervgomtimlibular r.iphe, 182, 1S4
I'ter'vgomaxillary ligament, 184
Pterygopalatine canal, ji, (*)
fossa, 50, 78
groove, 51, 67. 'x)
Ptervgospinous ligament, 1 19
process, 51
Pubic angle, 131
arch, 131
ligaments, inferior, 128
superior, 128
Pubis, c)3, 05
ilevelopment, cjf)
ramus of, c;;, 0''
Pul>ocapsular ligament, 132
Pulleys, 143
I'ulmcmarv groove, 35
Pulpy nut leus tif intervertebral fibro
cartilage-, 1 10
PvramicI of temporal bone, 52, 54
apex of. 5S
i Pvramitlal emiiunce. 57
'prticess t)f ptilate iKine, 40, 70
Pvramiilalis muscle, 1(11
i ' funclicms of. ih2
nerve sujiply of, 162
n.a.si muscle, 178
QCAUKATUS femoris muscle, 20c), 213
function of, 213
nerve supply of, 213
labii inferioris muscle, 181
superioris muscle, 180
lumborum muscle, 162
functions of, ih?
nerve supply of, i'>3
]>lanta' muscle, 210, 225
functitm of, 225
nerve sui)ply of, 225
Qutidritep^ femoris muscle, 20c), 214
function of, 21:;
nerve suppiv of, 215
muscle, 142
Qjaclrilateral foramen, r6f>
R,\DI.\L carpal eminc-nc", i)o
fossa, 87
he.ad of flextir digitorum
-.ttuscle, ic)2
lateral ligament, 122, I2(>
mu^t Ic-s of forearm, ic)4
lit 1 ^c-, gloo\c fi.: , .-'O
notch of ulna, 87
Radiate carpal ligament. 127
lublimis
i6i
Radiate liganirnts, Ii6, n"
Railiorarpal artiiulaliims, 124
ligament, dorsal, 12I'
volar, I2h
Radioulnar artii ulalion, distal, w^
proximal, i.'2
Radius, H2, SS
and ulna, relations. Si)
articular rinumferenie of, 88
borilcrs of, 88
development, S()
extremities of. 88
hea.l of, 88
inteross'-ous ri(ls<' "'. ""
ner i of, 88
nutrient canal of, 81)
shaft c', 88
si-rfac-'S of, 88
tuberosity of 88
Ra.-iX arcus vertebra-. 23
R; nus of isdiium, ()4
of mandible, .^7, 71.7^
of pubis, 1).?, ')$■ ')'!
Rectus alj<lomiriis muscle
development, 1^4
func*.it>ns of, i'>2
nerve supply of, 162
capitis anterior major muscle, 17
minor muscle, 177
functions of, 177
nerve supi)ly of, 177
lateralis muscle, 155
functions .'f. I55
nerve supply of. '55
posterior major r-.uscle, 155
ere ; ' 47
fun( ti s .if, 155
nerve supply of, 155
minor muscle, 155
functions of, 155
nerve sujiply of, .5.S
femoris muscle, 214
muscles, if)4
external, spine for, 76
Red boiu'-marrow, 21
Rellected iiiKuinal ligament, I5r),
ReirforcinK liK.imeiils, 108
Retinacula perona'orum, :'22, 230
Reti.iaculum of arc uatc' lij;ament,
patellar, external, ;.^5
internal, i ?5
peroneal, inferior, 2,?o
superior, 230
tendon, 142, 14 i
Ri'lralien* auricula- muscle, 171)
Rliachischi'-is, j(i
RnomlMiid li|;anunl, 1 i<)
Rhomboideus major muscle. 147
func tions of. 1 17
nerve supply "f. ' 17
minor nuisiles. 1 17
functions of, 1 17
nerve supply ol, 147
Ribs, 22. ,v
alxlominal, 28
.:^nc;!e of. 12
artlculatic'ms oi, with sternum,
H7
I'M
INDEX.
Ribs, articulations of, with vertebral
column, 2b, 116, 117
IhxIv of, ,v
bony, 32, .^,5
cervical, 35
curvature of, v?
development of, ,^5
eleventh, 3.5
false, 33
fenestration of, 3'>
first, 32
lloating, 33
head of, 32
lenKth cjf, ,^,^
lumbar, 28, 35
movements of, 117
neck of, 32
sacral, 3'>
second, ^^
surface c urvature of, 33
torsion c urvature of, ^^J,
true, 33
twelfth, 33
tvpical. 32. 33
Ririn, alxlominal, external, 15S
inguinal, subc -ataneous, 158
Ridge. bici|>ilal, 8()
interosseous, of fibula, 101
I of radius, 88
I of tibia, 100
1 of ulna, 87
\ intertrochanteric, c)7
' obturator, ci;
sphe.iomaxillary. 50
■ supinator, 87
temporal, ^8
I tubercular, greater, 86
les-cr So
Risorius nuisc'e, 180
Rcof of oral cavity, 7S
RcK)t of MTUbra-. 23
Rostrum, sphenoidal, 4^. 4')
Rotary vertebra-. 23
Rc.tatoresbrevc-smu-.cle>, 152, 153
longi iiUiscU-!, 152, 153
iuuscli,-s, r;2, 153
functions of. 154
nerve sujiply c>f, 1 >t
Round ligaiiunt, 132. i3.(
i.VS
' S.^crl'l AR recess, 122, 123
Sacral can.il, 2c>
cornu. 2ij
foramina. 28. 21)
inti-rvcrtcl>ral, 2c)
J hiatus, j(|, 31
rib. 3'>
tuberosiiv. 21)
Sacroc.iicygeal ligament, anterior,
lateral, 1 13
posterior, 1 13
svmphvsi-, 1 13
Sacroiliac arlic ilation. 128
ligament, ai lerior. 121)
interos..cous, 1 --i)
,i(-,, p.ci.ri.ir, 12:;
Sacrosciatic foran ,, 130
-'53
Sacrosciatic liganvnl. greater, 1 21)
leaser, 1 2cj, 130
Sacrospinalis muscle, i4c|
'line tions of, 15 J
nerve supply of, I54
Sacrospinous ligament, I2ci, 130
Sacroluberous ligament, 12c)
Sac rum, 28
a[)ex of, 2A, 50
ba.se of, 28
canal of, 21)
crests of, 2c)
development of, 31
dorsal surface of, 2c;
female, 30
foramina of, 28, 2C)
intervertebral, 2e)
joints of, 1 1 i
male, 30
movements of, 1 1 3
pelvic- surface of, 28
prcM-esse-^ of, Nupcrior articular, 2
lulM-rosity cif, 21J
upper surface of, 21)
Saddle joint 1 10
Sagitt:il Imrdi-r of |iaric-tal iMinc, ,Vi
gro.,v . 4), 4''. '». '"
plane-, 17
suture, 71)
Saphenous opening of f.iscia lata, 23 j
vein, great, 2},2
Sartorial bursa, 214
Sarlorius muscle. 201), 21 1
function of, 214
nerve supply of. 214
Scalene tubercle, 32
Scaleni muse les. i 75
functions lel, 1 "')
nerve supplv ol, 1 7'>
Si alenus anterior mu-' le, 175
mc-dius muse le, 175
minimus muse le, i 70
posterior muse le-, 1 75
Scahi, muscles of. 178
Scaiihoiil bone- of foot, 102, 103
dc'vc-lopmc-nt, io()
of hand, .So, c)o
fossa, 51
Scapula. 83
angles of. .S3. 84
base- .if. 83
border- of, 83, S4
de^elopme-nl, 84
head of, 84
ligaments of, 120
margin-^ of, 83
neck of. S,
-pine of. Si, 84
surf.iees of, 83
Scapuleir iioti h. 84
Siarua's fa-cia, 1I13
Sciali. bursa of gUila-iis maximus, 2\\
foranic-n, great. 1 \o
le-sser, 130
notch, gre-at, Ol. 0"
li-sse-r. 1)0
Si.re.nil . ime-iform bone-, 104
Sella tunica, ti- 17- 4-'^
254
-8
i\ •■'■ ; -- ».
t... ■■-, ■■>.
Semiranal for Eustachian tub
for tensor tympani, 58
Sc-miririular lini-, if)i
Seniilun^ir bono, Sy, yo
cartilaps, I.V3
funition of, 136
lini', i(K)
note h of ulnar, 87
surfaii- of aictabulum, qd
Seminu-mbranous bursa, 136, 210, 2^4
musili'. 2CK), 2 1 8, 2iy
funi'ion of, 2i<)
niTVf su|>]ily of, 211)
Scmispinalis capitis musrlo, 151, 152
rcrvicis musilc, 152
(lorsi musi li-, 152
muscles, 152
functions ol. 154
nerve supply of. 154
Scmitenilinosus musde, 20Q, 218
(unction of. 21c)
nerve supply of, 210
Septum ■hoanaruni. 39, bb
inlermusiular, 143
anterior, of lej;, 233
external, of arm, 207
of tlii»;l>. 232
internal, of arm, iSS, 207
of thigh. 21,2
of arm. iSS, 207
of IcK, 233
of thi«h, 232
posterior, of Icr, 233
nasal, 37' 7^'* "7
Serrate suture. ro7
Serratus anterior muscle. ''lO, if)8
function- of, i(k)
nerve sui'ply "f. ''">
magnus mu-t Ic. i()8
functions o(, itx)
nerve supply of, ifx)
[Kisterior inferior musiK. 148, 171
fund ions of, 14^
nerve -upply of, 14S
superior mu-i le, 148, 171
functions of, 14**
nerve supply of, 148
Sesamoi<l Ijones, 143
of fiKit. 82. loO
of hand. 82, (12
Sheath, intertubtnular mucous, 121,
iSS
perc.iueus lonKus, 231
re us alnlomini-. I'li
synovial, of dors.il <ar]ial ligament
203
.if fmgers. 2C5
of llcxor lendons of p.ilm, 205
of fool, 2 2.)
Short Ikmus. i.)
extern.iUalcral ligament of knee, 13:
muscles. ]42
of back, 154
<!ivelopnu-nl, 156
of neck. 155
development, 156
posterior sacroiliac ligament, i2c)
Shoulder, articulations of, 121
INDEX.
Shoulder ginile, 83
muscles of, 185, 186
classification, 20Q
Shoulder-blade, 83. Sec also Scapula.
Shoulder-joint, 121
movements of, 121
Sigmoid groove, 43, 4''. 53. *'°
notch of mandible, 38, 71
of radius, 8()
of uln.i. greater, 87
lesser, 87
Simple joint, io<)
Sinus, frontal, 61
development, 62
maxillary, 66
(trifice of, 67
of tarsus, 102, 103
sphenoidal, 47
Skeleton, ai-pcnclicular, 22
axial, 22
divisions of, 22
of extremities, 22. 82
of foot, loi, 106
of free lower extremity, q-
upper extremity, 83
of hand, 02
of head, 22, 36
of lower extremities, 82, 03
of trunk, 22
v;Lriations if, .'.i
of uiMier evtren.nies, 82, 83
Skull, 36
anterior aspect of. 36
l)ase of. external surface of, 3c)
internal surface of, 41
iKmes of. 44
developmental cla.ssification 44
disarticulated. 36
external surface of base of, 3<)
inner aspect cif, 44
lateral aspc'it of, 37
of newlKirn, 81
-uperio; aspect of, 44
-utures of, 7c)
Smiling musdi . iSo
Sockets for teeth, 68
Sole of foot, muse lis of, 225
Solcus. arch of. 220
muscle. 2i(). 220
Special anatomy, definilion, 17
Sphenoethmoidal recess, 77
suture, 7c)
Sphenofronlal suture, 37. 4I> 4'). 7')
Sphenoid bone, 37, y), 47
body of. 47
iMirdcrs of, 4c). '50
ciTcbral juga of, 50
surface o', 42
development of. s;!
digitate imprc'ssions of, 50
greater wing of. 42
in newborn. 51. 81
lesser wings f, 41
orbital c rest of, 50
v.iii.cllon- in, 31
wings of. greater, 47, 49
surfaces of. 4c)
lesser, 47, 4<»
Sphenoid bone, wings of, orbital, 47,
4')
tem]K)ral, 47, 41)
spine of, 3c)
Sphenoidal angle, 36, 59
cells, 63
crest, 48
fissure, 37, 42. 49. 74. 75
fontanelles, 82
process of palat^ bone, 70
rostrum, 48, 41/
sinus, 47
spine, 56
turbinated Imnes. 48
Sphenomandibular ligament,
I Sphenomaxillary ' .sure, 37,
74. 75
I fossa, 41), 50, 78
1 ridge, 50
I surface of sphenoidal bone, 50
j suture. Si
1 Sphenooccipital fissure, 45
svnchondrosis, 41, 45, 47, 81
Sphenoorbilal sutu'c, ■;<)
Sphenofialatine foramen,
notch.
118
,39,
,78
nolcn, 70
Sphenoiiarietal suture, 37, 38, 4', 7c), 82
Sphenopetrosal fissure, 3g, 4°. 4^- 54.
synchondrosis, 81, it8
Splicnosciuamosal suture, 38, 39, 4-'.
4^, 52, .80
Spheno/.ygomatic suturc\ 77, 38, 50, 80
Sph;'rciici joints, no
Sphincter muscles, 142
oris muse le. 181
Spigelius' line. 160
Spina ree ti lateralis, 50
Spinal canal, 31 , , ,
column. 22. See also Vrrlchral mi-
ll 111 11.
Spinalis eapilis muscle, 151, 15-
cervicis muse te, 151
de.rsi muscle, 151
muscles. 14C1, 151
functions '>f. 154
nerve supply of. 154
Spindle-shaped muscles, 142
S]iine, 20
anterior nasal. 37
ethmoiihd. 41- 4^
for external rectus muscle, 76
frontal, 61
mental, 72
nasal anterior, 68
1 po-icrior, 6<)
j of ilium, anterior inferior, 94
superior. ei4
IMisterior inferior, 94
of ischium. ■/6
' of jiubis. ey5
of scapula. 83, 84
palatine. 68
sjihenoidal, 56
v.ipramealal, 5'
trochlear, 61
tympanic, greater, 57
lesser, 57
INDEX.
Spill"! ransvcrsali^ muMle, v
Spincius jiriKi-ss oi tibia, i)i)
<if viTtebnu, 2,;
Spiral joint, ico
SplanrbniiluKy, (ii'l'iiiiliDn, 17
SpU-nius lapiiis nuis( k-. 14**
fumtiiin'^ nf, U'**
nerve supply "f> 14!^
lerviiis muMle. 14**
funitions (if. I l^^
nerve ^upplv nf. 14?*
Squum.isal Inmler .if parietal Imne, 50
uf sjibenciiii limie, 50
suture, ^S, ),?. s-'. T'l
Simaniii-.imastoi.l suture, 5.t, 5.1M
S.iuam.iu^ purli.ins uf .i.ripual bune,
.V**. -t.v 4''
of temporal txine. .?■"*. 4°, 4.i, .s-
>ulure. 107
Slellate liijaments, 1 1(>, 117
Sternal eMri'iiiity of el.ivii le, >**5
menilirane. 1 17
jiortion of iliapliraKni, I'M
synchonilrosi'-. 1 17
Sternalis muM le, I'V
Sternoi l.ivieular artieulation, no
ligament, "')
Slern.K leiil. '.oideus inusele, 1 : i
funitions of. 17-'
nerve supply of. 17-'
Stcrnoeostal artieulations, 117
portion of peetoialis major imiM le
■'17
Sternobyoi.leus mu-i le. 17:1
Sternolbyreoiileus nm-i le. 17-'
Sternum. 2j. .; I
ansle of. ^4 • , -
artiiulalionsof rib- "itb. ii'i, ",
YuhW of. U
(levelopnieiit of. ,^5
foramen of. 3<>
srlailiolu^ of, ,^4
manubrium of, 34
not 's of, .u
Niphoill proiess of, ,u
Straight alKloiiiinal muscle, I'n
il.velopnieiii. i'i4
Sivlohyoid lit;anient. 1 n)
Stvlobyoideus mu-,! le, 171
funetions of. 174
nerve supply of, 174
Styloid liro. ess of metaearpal Imiie, ■
of railiu-. .'s(i
of temporal bone. 40. =.>'
of ulna. .-^.S
Stvlonian.libular ligament, n."*. I'^t
Si'vlonia-loid fora-iien. 40. |;ii
Styloinaxillary licameiit, i.'<4
Suliai romial bursa, 20S
Subareuale fossa, 55
Subelavian groove, v^
Subelavius musele, iW), i6,S
funetions of, I'lS
nerve supily of, I'lS
Subeostal angle. ^;
Subeostales mus. les. 1(10. 170
Subcutaneous bursa ..1 ;anercisiiy
tibia, J,U
Subcutanwus rakaneal bursa, 2,^
eolli musele, 171
digital bursa' dorsal, -'0>S
epieondvlar bursa-, 20S
external' malleol.ir bursa, -■ ; 1
infr.ipatellar burs.i, i,?<'. -',' : I
inguinal rini.'. 15,** I
internal malleolar bursa, -VU ,
metaiarjioph.il.iiigeal bursa-, dorsal,
oleeranal bursa, .'fS
prepaiell.ir burs,i. i,('>, J.?4 1
troibanteric bursa. 2,^.^ >
! SulKielloid bursa. iH(i, ;o,S 1
1 Sulifas.ial prepatellar bursa, I s<>
I SulHieeipit.d triangle. 15(1 ^ I
I Subseapul.ir bursa, i-m, iS.S |
I fasei -07
fossa, f .,
Subsiapularis mus( le. iS;.
I funetions of. 1-^*
nerve suppb ■'. i--*"^ .
Subtendin--.. '- ' "'"•'''- •'""■■
I rior, -•,,;, i
i |„,-tt-rior. ■ .^
,1, .- bur-a. o^,-
' -anal bursa, -"^ !
I i A|.alellar bursa, i.^n . !
I Sulius, 20
arteriosus, 4!. 44
of frontal bone, (u
of parietal iKine, 50 i
1 ,,t spbelloiil bone, 50 j
I ,,f Knip ir.il bone. 5,5
' ealeaneus, l-D-
ihiasmalis. 41, .|.S
gluteal. -',i-'^
, nervi spinalis, :i
i tali, 102
' venosiis. of pariet.d bone. 50
\ Superiiliarv arilu-s. (10
i Superli. iai fas. ia, general, id^
I head of tl,-xori.olliiisbrev.smus,le,
' too
laver of . ,01 niuseles. .-lo
'of cervii.d fascia. 177
of ,-\leiisors of forc-.uni. icjd
,,f |l,-\or muscles of fon-.irni. 101
l„,M,-ri"r sa.ro. oe.ygeal ligantent.
tc-niporal f.is, la. e^t
Suiieri.-r angle of s, upula. .S;. S4
aperture of p.-Kis. 1 ,!0
,,f tvm]iani. . analii uliis. ;;
articular proci-ssc-s of sacrum. -•.,
^i,rf,i.c-s of tibia, cjc)
bill-.- of onii hvoideus musi le, 17.?
biei'pll..l bursa, .\u
bordc-r of -, apul.i. .•-< I
,,,rnu of fas., lata. .',?-•
(■os(otransvc-rs.- ligament, i m
,rus .if sub. utani-ous inguinal ring
is.S
extremity ..f femu.- i)7
of I'diula. ici
,,f humerus, .'^i
„f ra-lK:-,-^'^
of tibia, .|.|
Miixili,r
iuperior extremity of ulna,
gluteal line-. .11
inti-rvcrlebt.il notch. .'.<
n-..irgin of scipula, ."<.<
niaxill.iry. ('('. Sn- .lis
mt-atus of nosi oj. 77
nuchal line-. 41. 4'i
cKcipital fossa-. 4(1
orbital lissurc-, .^7, 4-', 40- 74- 7.?
pi-r..m-al reiinacidum, -\!o
|,(trosal griH.ve. 4,^. S.s .
pill.ir.if sub. utani-ous inguinal ring,
pubic ligani. ' '. i-'S
ramus .if is.i .uni. .14
of pubis, c);. 1)5
surface- of t.ilus, lOJ
tcmp.ir.il line. 5,;
thora.i. apc-rture. ,Vs
transvc-rsc- ligam(-nt. i-'o
lurbinali-d bone, b?
vi-rlc-bral notch. s, 2?
Supernum.-rary b..ncs, ,~<J
Supii..ilion. 1 -4
Sui'inator brevis :nusc le, lOS
longus niu-c Ic-. 1.14
muscle. oSs. 11).;
funi4ion of. 11)''
nerve su|.ply of, i')()
ridge-, S7
Sui.raclavi. ui.ir fos-a, lesser. 1,1
Suprac.inihioi.i pro.iss, 87^
SupragU-n.'iidal tuberosity. .^4
Sujiralnoicl nnisc le-s, 17.1
Supran. •Iciiel ridge, ,s2
Siipramealal spine. ,.'
Supr.iorbiial b.,r.l.r ..f fn.ntal b.me,
(.0
f.iramen, <io. 75, 7'i
margin, 75
n.)t. h, ^10, 7s
Suprapat.l!.;- bursa, l.'-.^. 2U
Supraspinatus fascia. 2C7
f,,„a ..t s. apul.i. -'^1
mils. ic-. 1S5. iSd
function ol. 1^7
I,.- .e- supply of. i-'*7
Supras|.in.-us ligame iit, ' 1 -■
Surgical nc-e k of humerus, S(i
Suste-ntae uluni tali. IC ?
S u ira me-n.lo-a. 47, -"--i
Sulura- si-rr,iia-. 5.1
Suture-. 107
coronal. },t\ ,^7- 7''
cthmoidi-omaxill.iry
frontal, '10. ?<i
frontoetlinioiilal, 41-
I frontol.iehrvmal,
I fronlomaxiilarv.
i harmonic . t^7
' in. isivi-, Ihi. .^1
infra. erbital. '1,^, Si
I intermaxill.i'^ . .(7. ^o
internasal. ;;. ''s ^o
I laehrvmoeon. Iial. fvD ^
l.i.hrym. .ethmoidal, !^o
1 laelirvmoniaxill.iry. So
i lamlidoi.l, .v'^. 7'1
So
, (•!.
So
, So
Si
-■*^
256
Suture, mcflian palatine, 39, 81
mendosal, 47, 81
melopic, 60, 6j, 81
nasofrimtal, .^7, b.s. So
nasomaxillary, ,^7. '15, 80
oceipitomastdiil, 38, 40, 4,5, 53, 79
,if skull, 7<)
jialatine, median. 3(1, 81
transverse, 31), 81
palatiK'tlimoiclal, 80
palatomaxillary, 80
parictomastoiil, 38, 53, 79
j)etr()stiuanit)sal, 81
sagittal, 79
serrate, ^c), 107
sphenoethmciiilal, 7<)
sphenofnmtal. 37, 41. 4'>. 70
si)hen<imaxillary. 81
sphencKirliilal, 79
sphenoparietal. 37, 3**. 4-. 70. Si
splienos<iuam<)sal, 38, 3(), 42, 43, Si,
80
sphentwvKomatie. 37, 38, 50, 80
squamosal, 38, 43. 5^, 70, 107
squaint»somastoi<l. 53, s9. 81
transverse palatine, 31). 81
zVKomalirofronlal. 30, 37' ^
z'yKomatieoinaxillary, 37, 39, f>7, 80
/vHomalieo!eniporal, i,!^, 52, 80
Symphvsis, 107
pubis, 91;, Ii8
saeruicHiy^jeal. 1 13
Synarlhri'sis, 107
mixed, 107
pelvic, i.'.8
Synihnnilro-is, 107
epiphyseo~, ji
interiii lipilal, anterior. 47
|)osleriur. 17
inu-r-plunoidal, 51.81
inlr.ioKipilal. .interior. Si
posterior. 81
petrtHH < .pita!. St , 1 iS
splieniHui ipilal, |r. 4v 47' St
sphenopiiro~al. 81, 1 :S
sternal, 31. ' I7
Synde^niotogy. 107
ddniiiion. 17
jji-ner.d. 107
'-pel i.il. 1 10
Synde-mo-is. 107
libiolilailar. 1 t'l, 13"
I rue, 107
Syneri!i~l>, t 1 <
.^\no\i.t. i^S
Swiovial hur-a-. inS
lominiini'.ilMiu. 108
fold-. 108
patellar, i t;
laver of .irti. iilar 1 ap~ule,
inenibraiie. ioS
.-li.alli-ofd.ir-.di.irp.ilIiKaMienl..'^
I'f linfi* rs. 205
of lleyor lelidon. of palm, .'05
of fiuil,
INDEX.
Talocalcaneal articulation, 137, 138
.nterior, 138
ligament, anterior, 140
external, 140
internal. 140
interosseous, 140
posterior, 140
Talocalcaneonavicular arliculation.
1,^7. ',^S
Talocrural articulation, 137
Talofibular ligament, anterior, 140
posterior, 140
Talonavii ular articulation, 13S
ligani' nt. ilorsal. 140
Talotibial lieament, anterior, 139
[)Osler: r, 139
Talus, lOi
articular facets of. \o!
articulations of, 137
binly of, loi
(bvelopment, 106
gr(H)Ve of, 102
head of, 102, 103
neck of. 102, 103
surfaces of, 102
Tarsal iMines. i^2, 102
articulations of, 137, 138
development, 106
ligaments, 139
dorsal. 14°
plantar. 141
Tarsometatarsal artic ul.itions,
ligamenls, dorsal, 141
plantar, 141
Tarsus, 102
I articulations of. 137. 13S
ligaments of, 131)
sinus of, 102, 103
transverse artic illation of. 138
Tectorial mendirane. 111. 115
Teeth, alvc-oli tor. 08, 71
incisor, in fetus. («)
SOI kets of. fi8. 71
Tegmen tvnipani. 5;. 57
TciniMmd lionc-. 57. 38. !;i
artic ular eminence of, 53
canal- of 57
development of 58
in newborn, 58, 51). 81
108
i,?7
iriferictr procc-^
..f. 57
of iMTona ii-' longu-
ill! i/^K
-31
Systematic an.itoniy. cletinilion. 17
mantoid portion of. vH, |o. 5.'. s!
pctroii- piirlion cif. 40. 52, 51
ape \ of. -^
pyrai lid of, 5.'. 5 1
a|H'\ ol. ^^
scpianiou- potiioM of. (8. 40, It.
iMiipaiiii |iortioii ol, 38, 40, 5.',
' '!7
fascia. 18 1
fo^a. iS
line' 1 1. 'CO
inferior, 5c)
superior, ^'}0
priMi>- of /\goniaiic bone. 71
ridge. 38
surface of /ygoin.ilic i~.cic , Ji
Temiwral surface of sphcnoici bone,
49. 50 . , ,
of squamous [xirtion of temporal
bone, 52
wings of sphcnoici lione, 47. 41)
Tem[K)ralis muscle-, 182, 183
functions of, 1S3
nerve supplv of. 183
Temporomandibular articiilation. 118
ligament, 1 18
TemiKiromaxiilary articulalion, 1 1 ,
Tendinous adductor opening, 217
arches, 143
inscriptions, 143
of rectus alKlominis, I'li
Tendc) .\chillis, 220
Tenclons, 142
central, of .liaphragm, 1(14, 163
chiasma of, 207
flexor, of palm. 205
of fingers, i-xlensor, 204
of hand, I'xtensor, 203
of long head of biceps, 121
of palm, 205
retinae Ilia, 142, 143
vincula, 207
Tendon-sheaths, 143
Tensor fascia- lata- muscle, 200, 213
function of. 214
nerve supply of. 214
tvmpani, semicanal for, 58
Teres major muscle, 185, 187
function of. 187
nerve -upply of. 1S7
minor muscle-. 185. 187
func lion eif, 187
nerve sup] Iv of. 187
Terminal line- of ilium. 1)5
Thenar eminence--, ojS
muscles of. ie)9
Thigh, addiiifor musiles of, 2 if)
anteiior -.urfaee- of, muscles of, 214
fascia- of. 2U
flexors of, 218
intt-rnal muscles of. Jift
niusc Ic-s of. 21 4
( lassilie ,ition. 235
iwisterior muse le- of, 218
Third cuneiform bone-, 104
trcKhantcr, i)8
Thoracic mu-ile- I'l'i
velle-bl.'e. J'l
elevc-nlli, 2(), 27
lir,I. 26
walK, musilc-s of, I'n)
Thorax, 22, 35
ii]«Tture'- of, (5
iiuiMles of, ififi
w.ilU ol. mu-iles ..f, 1(1 1
Thumb, bone- of, 92
i.irpomilae.irpal joint of. 1 -' t i.-;
nnlacarpophal.ingicil.iriiiul.itionof.
I -'7
Thvreolivoiiliu- mu-c Ic-. 17.-. i:t
■ril.i.l, 82, <)e(
anil libul.l. rel.nioiis, ini
.irtieul.ir -iirfaces of, inferior, too
INDEX.
-.•)/
Tibia, articulations nf, i,?6
borders of, loo 1
condyles of, 99
crest of, 100
developmiiu, ici
extremities nf, go '
interosseous membrane of, 1.^6, 137 [
shaft of, W. 100 ,
surfaces of inferior extremity of, <)i) j
of shaft of, 100 ;
of >u|ieric)r extremity nf, i)0 |
lulxTosily of, subcutaneous bursa
of, 234 '
Tibial lateral liRamenl, i,u
Tibialis anti-rior nui>( le, !\o, 221, 1
function of, 221, j
nerve supi>ly of, :;:>^ '
]H>^terior niusi le. 210, 2ni, 221 ,
function of, 2^1 1
nerve supply of, 221
Tibiofil)ular articulation, 1 ^6 '
>ynclesmosi'i, i.^O, 1 57
Tibionavicular liKanurn, i,V). 14°
Tissue, bony, 20
TiK's, articulations (jf, 1 ^7
lH)nes of, 105
great, ball of. muscles of, 220
lif'r, ball of. muscles of, 2.'7
To] -graphic anatomy, (litinilmn, 17
Toru^ palatinus. 7S
Tracheloina^toid muscle, 151
Tran^ver^alis caiiitis muscle, 151
cervicis muscle, '.'i
fascia, 16,5
Transverse articulation of tar-u^, 1 ^S
capitular ligament of foot, i.t')
of h.inil, 127
c.up.il lipimcnt. 127. 205
1 rur.il ligament, 2 V4
fasciculi, 2.<.!
j;rcK)vc-, n, .((i
head of ,cdcluctor llallucl^ muscle.
227
ligament, inferior. 121
of .11 la^, 1 14
of hip. i,?i
cif knee, i ?4
superior, 120
lines cif re(lu-> aUlcimini-, idi
palatine sutuie. v(. f^i
plane, I 7
(Hirlion of nasalis mu-de, iXi
prcK esses of vertc bra . .' i
TransverscHostal mu>c lc->. is''- 1^,"
Tran-.versospinalis mu-c le, 1 ici, i^i,
">"
Transversu-> aUloimiti^ muscle, 157.
ifK)
(line lions of. |02
nerve -uppK cif. idj
nicnti muscle, iSi
luic lia'. 14(1. i/ci
Ihor.ic i^. I'"). 1 70
Trape/ium, .H«j. cjo
Trapc /ill niu'-c Ic, 14s
(unctions cif. 14I1
nerve supply ci(. 14(1
Trapc.-oiii, .-:j. t;c
»7
Trapezoid liRamcnt, 120
Triangle, deltoidcH)pectoral, ifi?
femoral, 216
lumbar, 147
of Petit, 147
suboccipital. I5t>
Triangular ligament, i.sc), 1114
Triangularis labii inferioris muscle,
i.Si
superioris muscle. iSi
muscle. iSi
sterni muscle. 170
Tricejcs brae hii muscle, 142, 1S5, iS<i
function of, ic)0
heads of, iS<). icjo
nerve suiiply of. 100
sura* muse le-, 210. 21c)
function of. 220
, nerve supiilv of, .'.-o
Trigeminal impression. i,(, .SS
I Tric|uetral Inme. .Sc). c)o
I TrcKhanteric bur^a, 212
of glula'us maxinius, 2,v?
I meclius, anterior, 2,v;
jMcsterior, 212. 2^4
i minimus. 234
. r-ubcutancejus, 27,\
} foss.i. ci7
TrcH hanlers, c)7
greater. c)7
lesser. c)7
third. e,S
TrcKhlc.-e. 14.!
cif phalanges of fool, 105
of hand, c)2
of lahi>, 102
rnxhiear area of humeru-, S'l
clepre-i-ion, 01. 70
prcKess of ealc anc u--, lo.i
spine, 61
Tr.ic hoid joint, loej
True joints, loS
jH'Ivis, I (O
rib>. .?.< ■
svndc-smosis. 107
vertebra', 22
Trunk, mu^c les of, 1 4)
ske Icton of. 22
\ari.iliiins in. ,(>
Tubcrc le. 'O
c .ircitid, jO
c cisi.d, ligament of, 1 1'l
intcrconclvli.id, extern, d c)c)
internal, cii)
jugul.ir, 4), 4''
nu-ntal, 72
.ilituralcir, anieiior, 115
IMisterior, nS
c'f ("hassaign.ic , 2(1
ii( hunienis, greater. «?
IC-SCT, S5
Cif Lisfranc . \!
eif neik cif rii)-, ^2
of pubis, 1,;
of talus, e\te rnil, 102
internal, u"
eif tni|K'fiuin, i)0
Tubercle, sc cilene, ,<2
Tubercular ridge, gre-ater. Sfi
lesser, Htt
TuUrculum c, erotic um, 20
sella', 41. 4'"^
TulR'rositas atlanti'^, 25
Tuberosities, 20
coracciicl, 85
e-ostal, Sc;
deltoid. SO
gluteal. e)S
infraglenciidal. S(
mas'^eteric, 72
of calcaneus, !o;
of fifth metatarsal bone. 101;
cif lirst mciatar-al bone, \r:%
of hard palate. 40
of ilium, c.s
cif isehiuni c)0
of maxilla. (17
of n.ivic ular Ixme, lo?
of palate bnne, 70
of r,idius, .SS
cif sc.ipliciicl Inine. io(
cif tilii.i. 100
subc ut.ilieeius bursa of. -\u
of uln.i. ><-
pterygoid, 72
sacral, 2c)
supraglenciiclal, S4
ungual. C12, 10^
Tubular bemcs. ic|
I Turbin.ilc'd Uines. ^7. 77
I inferior. <n. '17. 77
' develcipment. (14
middle , (M
sphc noichcl, 4S
superi'.' . ti^
Tympanic iiinulus. Si
antrum, s i. ,SS
e analie ulus, ^S
.1!" ruirc' of, su|,, ricir, 54
gMcve. ;;
notch. S7
|Hirtion ci( tcni|icir.il l«inc, jS. (o, s-'
.';7
spines, greater. ^7
lessee, ^7
Tvmpancim.isiciid lis-uo . s ;. ','
'l'ynipano-c|u,imcis.cl li -iirc , 57
liw, S. S7
and Kicliu-, lilaliicn-. S.)
Unilers cif, S7
devclcipmciil, 'SS
evtremitie- cif, S7, SS
shaft of, S7
siufac es cif. S7
Idii n c arpal inline nee, c)n
held of tlcM" ' o|'i nhi.iris im,
cif ptcin.ctur le re - nini le, Icil
later.il ligameiil, i-'-' 1 -•''
noh li. Si
I'nciform bcmc. Si,. i,n
prcH es,i, I,!.
I'minale pun c , (14
?s8
InRual phalanges, q2
tuberosity, O-J, 105
Uniaxial joints, loi)
I'nilocular joints, loS
U|)!HT am, fxtensor surface of, mus-
lU- of, i8q
flexor surface of, niusi les of, 188
muscles of, I^^5, 18S
cl.issificaticHi, jcx)
cxtn'inity, articulations of, 119
l)urs;e of, 208
fascia' of, 207
free, skeleton of, 85
ligaments of, in)
muscles of. 185
ilevelopnient, 2CX)
skeleton of. 82, 8?
tlioraiic niusdes of, 166
[wrtion of lon^us <olli niusde, 17(1
Vacin.*; nui'o-a'. if. I4.i
Va(?inal ligan" -11-, i4,i
of fool. 2,)I
prot ess, 4(). 51
of ti-m|ioral bone. 5(1. t;7
Vastus externum nm-i K . -'15
internu'ilius nni^i le. 21s
internu-> inu-i Ic, 215
laler.ilis nin~c le. 215
niedialis niu.i li-, 215
Vein, s.iplunou-. Kre.ii, 252
vertelir.il. lan.il for. 2(1
Vena lav.il opininKof cliapliragm, ifX)
Ventral an h of vertebra. 22
Verlebr.T. 22
arc he- of. 2:. 2,^
artii ul.ir pnne^^se-; of, 23
iHKlie- of, 22. 2.i
.onneiiioii-- ol. 1 10
laudale-. ',^
icrviial, 2 i
iharailer-. of, 24
hr-t. 2(. -S
anil M.on.l. .iriic ul.Ulon^, of,
I I i
(levelopnii nl. \l
set on< 1 . 2 t . 2 s
ilivelo]Mnenl, \i
INDEX.
Vcrtebraf, cervical, seventh, 24
third to sixth, 24
development, 31
false, 22, 28
fle.xion, 2,^
lumbar, 27
lumbosacral, .^0, 36
l)edicles of, 2,^
])rocesses of, 2,^
j)rominens, 25
root of, 23
rotatory, 23
spinous prcKC'iscs of, 2,i
supernumerary, 35
thoracic, 2b
hrsl. 2(>
twelfth. 26, 27
transverse prcscesses of, 23
true, 22
Vertebral arches, liRaments Inlwcen,
112
artery, 25
canal for, :(>
bonier of sc apuhl. 83
canal, 31
column. 22, ^o
articulation cif ribs with, 116,
117. -■<>i
I ur\,iiure of, 30
development, 31
intertransverse ligaments of. 1 12
joint- if, 1 10
liK.imc nls of. 1 1 1
movements of, 1 13
promontory of. 30
margin of scapula, 83
nouhes. 23
M-in, can.il for. 2b
Vertical i»irtioii of squanmu- porlim
of temporal Iwine, 52
Vidian c.inal. so
X'illi. synini:d, 108
X'incula. I t!
of lem'on. 207
Visceral iBines. 22
Vitreous t.dlles of 111! Umes, I,)
Volar ba-.ii liii.iin.iils. 127
JKirder of radiu-. .88
of uln.i. 87
Volar carpal ligament, 208
cariK)metac arpal ligament, 127
Intercarpal ligament, 17
ligaments, accessory, 127
radicK-arpal ligament, 126
surface, 18
of radius, 88
nf ulna, 87
Vomer, y). (15
ala- of. (15
develo|>ment, 66
W.Ml.s of thorax, muscles of, ific)
Wings of sphenoid iKine, 47, 4c|
Wormian lionc-, 82
Wrist -joint, 121
XiPHOili proces-, 34
foramen of, 3!)
Vl.I.l.O'.v bonc--marro\v, 21
Zona orbicularis. 132
Zygom.' 70
Zygoni anil. 38, 30, 40
' [Mine o. 70
dc \ .ipment. 7t
serial c-s of, 71
iKirder of sphenoid Ixine, 50
fossa, 711
head of i|uadratus labn su|HTioris
muscle, I. So
process of frontal iKine. 60
of maxilla. 66. 67
of teni|ioral iMine. 36, 38. 31). 52
/ygoniaticof.ici.il foramen, 71
Zvgomatiiofronlal sutun . 36. 37. 80
i Zygomatic oni.ixillary suture-. 37, .3ci.
'67,80
I Zygomaticoorbii.d for.imcn, 71, 7";
I Zvgomatiioiem|Hiral foramen, 71
' suture. 38. S2. '^o
Zvgomatii us maior muscle, ISO
ntinor muscle, 180
I muscles, i.So
I»^
^
r-i*.'
:.'■ :^ i--'!
SAUNDERS' BOOKS
-on-
SURGERY
and
ANATOMY
v;
r>. B SAUNDERS COMPANY
925 WALNUT STREET PHILADEf^HIA
9, HENRIETTA STREET COVENT GARDEN. U ON
SAUNDERS' REMARKABLE SUCCESS
^ATIC arc often asked t(i accDUiit (or <iur I'xtr.idiiliii.iry muhss
^ ' \Vc cm but point to nioticm i)U>iiHss methods, caiviully pir-
fLCtcd tiiisiiK'ss iiiai liiiu'iy, and uiiiivalli'd laiilitics ior (li--tril)utMin nf
books. I-Acry dc|)aitiiK'iU is sn uiLj.i'ii xd that ilic j;rcalist possible
amount of work is i)rodiiccd with tii' lca->t waste of encrf^y. The
n prcscntativts of tlic ftiin .iic tiicM \ i lifc-loni; i\pi;it lu c in the
s.do iif tiicdical hooks. ThLH, too, wc iiiu- imt nVL-rionk tliat in.ijor
force in the modern business world — advertising. Wc have a special
department ile.oied entirely tn tlu- pl.innin;.;, w lilini;, and i)!aiinj; of
advertising inatlcr; .\\m\ 've rni;_;ht mention tliat the nmnt y .mniially
spent in advertisini; nnw t.ir evcecds the entire .nnni.d tciii])!-- of tlu'
linuse during its e.iilier years. '1 li. •~e cNtiaoiilin.uy f.H ilitli ■ fur di-^-
pusin;.^' i>f l,irL;e e<litions en.ihte tis \.i devote a hiv^c ainonnt ol nmiuy
to the perfee^'ili; of every dri.iil in tlie ni.iniif u Mire of book-.
A Complett; Cat*lofu« of uur Publii alioni will be Sent upon Request
The price* of all books bound in sheep or half
morocco have been advanced FIFTY CENTS PER
VOLUME over the prices herein listed, excepting Keen's
Surgery and NothnagelV Practice
SA r\P /■: /fs' HOOKS (>
KeenV Surgery
AN tNABRIDOED TREATISE FOR THE SLROEON AND
THE UENERAL PRACTITIONER
W^
Surgery: Its Pkincii'I.ks anh I'kactick. Written by 66 eminent
siKcialists. Kditc.l by W. \V. K!;ks, M.l)., LL.D., H..N. F.R.C.S., Kng.
AM. Hi. IN., I'rofessor of the Principles of Sur^'ery and of Clinical Sur^'ery
at tlK Jefferson Medical Colle<;e, I'liiladelphia. Five large octavo vol-
iinio ct" about 950 \m\'^c-^ eacii, containing 1 500 tf'xt-illiistrations and 50
colored plates. Per volume : Cloth, S7.00 net ; Half Morocco, ;iil8.00 net.
IN FIVE VOLUMES- ISOO TEXT-CUTS AND SO COLORED PLATES
VOLUME I -JUST READY
THE EMINENT CONTRIBUTORS
Rnbtrt Ahlio, M.I).
I. ci. .\,l.imi, M.l I.
1:. WUl)- .\'i.lr.-«-. M.lt
<;. K. .\rin>lriini;, M I >.
rhijiii.li I.. llcniiLil, M.l>
A h. lie. MM, M.l).
W.irnn S. H.tkliaiii, M I )
lolin !• liimiiis M D
I'lforjjf K. lirevvcr. M.l>.
J. lilami Sutton, K.R"' S.
A r. CaUdt, M.n.
Il.irni'tnn !.. ("arson, Kv|
K A. I'c.lman, M I ).
\Vm li. r..!o-, \1.I).
M, I.. i..| lui, M.n.
I,,..,,;, \V. fill.-. M I)
ll,.rvi-v I'l'^iiiit;, M l>
I. Ch.ilmi.ri 1 ):;(■.,, I;:, Ml)
l<,lii> I'. ll.iC.la, ji . M 1 1
K. 1; Drnrli, M.I).
i . \ I M\uni, M.ii-
(i 1- ili-Sih«tinii/, M I).
Davi.l I.. KdNill, MI).
I). N Ki-cmlratli. Ml).
Win. I . K-t.s, Ml).
I. M r. l-iiimy, Ml)
l.ilii. A. lonlycc, Ml).
Clia-. II, lia/i.r. MI)
l,,,.iianl Irc.-nian. M.l).
1 u-.l,n>k II. Ccrr.ili, M.D
l..|in II. t".!!.!...!!, MI).
(K-orm- I iou^tiin. Ml).
I ulvic ll.klDcn, M.I).
drxiU,- Il<.r»iiz, M.I).
All,.'ii K-ilit-r, M.n.
K.iil I lu-i.iv I iiiiiaii'k'i. Ml)
llian>fiii(l l.ewi-. Ml).
K. W. I.ovitt, MI)
\V I.. MaiDonal.l. Ml).
i:.lv(,iil Martin, \l . I ).
Ku.l..li,li Matas, Ml).
Cli.is A Mayo, M.D.
Will, i. May.-, M I'.
Mai \Vallir 1 1 M>< aw
11. (1. A Mi>>nihan. l-.K.C.S.
I. (1 Munifor.l, Ml).
I„liu C. Munio, Ml).
John H. Murphy, M.D.
E. II. Nichols, M.l).
A. I. DdiMier, M U.
William Dskr, M D.
K.limincl Owen, K.K < .S
Jm„. Kansohott. M 1 ).
l;tii;. C.cn. K. M. ' )RiilIy
.\.lniiral I' M. Ki\cy,
John U. KohiTt-, M.n.
A.W . Mayo Kotison, K.K.l'.S
\V. 1. Koilnian, Ml)
r.uRcne A Smith, MI).
ll.irmon Smith, M D.
Wm i;. Spillct, M.I).
Wellcr Van IltMik, MI).
J. I'. Warlasse, M.D.
K. ( . Wood, M.n
{;...r;T.. W.«i!".ry. M.l).
Hugh II NiniiK, MI).
SlAo/t/iy AXn AXAIOMV.
Fowler's
Treatise on Surgery
IN TWO VOLUMES
A Treatise on Surgery. Hy Gk()i<(;k R. I'owlkk. M.D., Professor
of Surgery (Emeritus), New York I'olyrlinic . Sur^cim to the Metho-
dist Episcopal (Seney) Hospital, Brooklyn ; Surgeon-in- Chief to the
Brooklyn Hospital. Two imperial octavo volunus of 725 ]>a!:;es each,
containing S88 original text-illustration-^ and 4 colored plates. IV. set :
Cloth, ;gl 5.00 net ; 1 lalf Morocco. $17.00 net.
JUST READY
WITW 888 ORIGINAL ILLUSTRATIONS
This entifly r,. w w.irk preNCnts iho sc icnc ;inil art of Miri;tTy as it is prac-
tised to-day. i • irst part of the worlt ilc.ils wuh ^cner.il siirj^ery. aril eiiitirares
what is usually irn lulled under the head of print iplcs of surgery. Special .ilten-
tiiin is Kivpn tn the suhject of intl\iiini.ition from the surueon's point of vie.v.
due (-<msidcration heinK accorded the inlhicni cs of trauiiialisni and bacterial in-
fection as the predisposin},' ami e\( itinj; lanses of this < nndition Then follow
sections on the injuries and diseases of separ.itc tissues, ^^unslioi injuries, ai ule
wound diseases, diionii sur^iial infci lions (uu hiding' syphilis), tumors, surgical
operations in general. foreiK'n bodies, ,ind bandaijin!;. 'Iho se> 1 nd part of the
work is really the clinical portion, devond to re-ional smtjcry. Ilercin the
author cspci ially endeaiois to rmph.isi/e those ,n| iries and siirj^ii al diseases that
arc of the greatest import, in<e, not onlv bei ausi of their fiicpicm > , but .ilso
because of the dilVn ully of dia^;nosis and the spei iai (are demanded in then treat-
ment. The text is elabiuately illusliated with enti-ely new and on>;inal ilhistra-
Rudolph MalM, M. D.. rtvfu,<r of Sni\:,,v. Inlni.- r»i:, r</fy ,-^ / ,;,i.:.,fi,t.
'■.\IUi .. . a..:..: . \..ir.;il..I, ii 111" Ifii^ v^.l'L t .i;r. ..i.i : ■ : u;- r=i ;• t't ^-y' '--^ i..:!v - ..:
«»«uri»nLt- 1 rnltrtaiitra . 'llial tliis w.irlt wtuil.l pii.vt .t itM I Iv "I Iti^li .-i.trr ami <l<-.mi. t liif tit
••>ltndid v..|umfi (ully jtntify the re(mH' of ilinir aiitli"r Imi iriii»im-^s. lli..|.ii,!hii.«», aii.l Icarninu "
SAUA'DERS- BOOKS ON
Howard A. Kelly
and C. HURDON on the
Vermiform Appendix
RECENTLY ISSUED-AN AUTHORITATIVE WORK
The Vermiform Appendix and Its Diseases. By Howard A.
Kki.i.y, M. I)., Professor of (}ynecology in the Johns Hopkins Univer-
sity, Halliniorc ; and K. HuKUON, M. D.. Assistant in Gynecology in the
Johns Hopkins University, Baltimore. Haiulsome octavo volume of
827 pages, containing 399 superb original illustrations and 3 litho-
graphic plates. Cloth, .^lio.oo net ; Half Morocco, $1 i.oo net.
WITH 399 SUPERB ORIGINAL ILLUSTRATIONS
This work is one of the most niaRnifirent medical books ever published, con-
t...nmK some four hundred beautiful illustr.itions. in the preparat-on of which the
artists"of the Johns Hopkins Hospital have spent many years. IlarN beautifully and
.ir.uratelv portrays the condition represented, and together they form a magnifi-
cent collection unequaled by those in any other work on the subject ever placed
upon the market. \ large amount of original work has been done for the ana-
tomic chapter, f(,r which over one hundred original illustrati.ms have been le.
Afp.mlutlh naturally receives the fullest consideration. The pathology is not
only amply ind clearly dcscnbe.l. but it is beautifully illuminated with an abun-
dance of Illustrations depi. ting the pathologic conditions with rare fidelity. Diag-
nosis and treatment, by far the most important sections to the practitioner and
surgeon, are elaborately discussed and pr,.fusely illustrated. Special chapters are
devoted to the peculiarities of appcnduiti- in children, and to the characteristics
of the vermiform appendix in typhoid fever. A valuable chapter is that on the
mediiologal status i>f appendicitis.
Briliih Medicsl Journal
• h i.i..h.'5 till- liiKh.w.iIrr m.irk ..f n..'.|ir,,l m.mnKr.l|*. hmh in rrR.ir.l l.. in.- ,<-aoiMiB,
rrsMrrl,, .,„.» clinu-.il r,a.„„inK of ihc toxi. and in the .,u.,liiy of its illuMrUion.. IIr-so are
really maKnificont."
\ i
SURGEK y AND ASA TOM 1
Kelly and Noble's
Gynecology
and Abdominal Surgery
aynecology and Abdominal Surgery, lulited liy Hhwaki. A.
Kia.LY, M. 1)., I'rofcssor of Gynecology in Johns Hopkins UnivcrMty ;
and Chaklks P. Noble, M. D., Clinical Proft-ssor of Gynecology in the
Woman's Medical College, Philadelphia. Two imperial octavo volumes
of ipo pages each, containing 650 original illustrations, some in colors.
IN TWO VOLUMES- VOLUME I JUST READY
WITH 6S0 ILLUSTRATIONS BY *X BRODEL AND HERMANN BECKER
In view of the intimate as-sotiation of , neclojry with alnlominal surgery the
eait.)rs have combined these two important subjects in one work, for this reason
the work will be doubly vaUialile, fur not only the j;ynecolot;i.st and j^cncral prac-
titioner will tind it an exhaustive treatise, but the surgeon also «ill tind litre the
latest te hnic of the various al)do-iiinal operations. It poss. . s a nuudicr of
valuable features not to be f mnd in any othe; publication < ovenn- the s.iuk- li.lds.
It contains a chapter upon the bacterio^.^'y and one upon the |iatholo-y of >;>ne-
coloCT. dealin;; fully with the s. ieatific basis of f,'yne((ilot;v. In no other uork
can this information. pre|ared by specialists, be found as scpaial.- . hapters.
There is a large chapter devoted entuely to m,,/h;i/ .i,MV/rV,'/.!:r. written e>pe, i.dly
for the physician en-agcl in general pr.i. tice. lieremfore o,. gencr.d |ua(ti-
tioner was compelled to search through an entire work in order to obtain the in-
formation desired. . J/',/.w;;;.i/ w^/.v/t proper, a. distin. t from t;\ nei clogy. is
fully treated, embracing operations upcm the stoma, h, ujion the iniestmcs. uiion
the liver and bile-ducts, upon the pam reas and spleen, upon the kidn.vs, ureter.
bladder, and the peritoneum. Special atten* .n has b.-.-n guen to wo./.m
l.rhni, and illustrations of the very highest order h.ive been used to make clear
the various steps of the operations. Indeed the illustrations are Irulv mag-
nificent, being Ihe «..,k of Mr. Max liriiL: and >!■-. ,'/-'-«••.••••-■■■ /•• ' - ' ! the
Johns Hopkins Hospital.
SAi'XDEKS' UDOKS OX
Moynihan's
Abdominal Operations
b fi
Abdominal Operations. By B. G A. Moyniuan. M.S. (Lond.),
F.R.C.S., Senior Assi.stant Surgeon, Lewis General Infirmary, England.
Octavo, beautifully illustrated. Cloth, Sj-Oonet ; 1 lalf Morocco, .S8.00 net.
JUST ISSUED- NEW (2nd) EDITION
TWO LARGE EDITIONS IN ONE YEAR
It has Vjeen said nf Mr. Moynihan that in describin;,' det.iils of operations he
is at his best. I'he appearance of this, his latest work, therefore, will be widely
welcomed by the medical profession, ^'iv in<,', as it does, in most clear and exact
lan^'uane, not only the actual miu/iis op.iamii of the various abdon '.lal operations,
but also the preliminary technic of preparation and sterilization. Complications
and scquel.i; and after-treatment are presented in the same clear, ( lean-cut manner
as the operations themselves. The beautiful illustrations have been especially drawn.
Edward Martin, M. D.
I'r.'ftswr of Clinh.it Siit\',-ry. Vnr.frutv of I'fnn<ylv,v!i.i
•' It is ;i wonderfully Rood Look. II.- lias .u liii-vcd tompli'te suir<";s iii iniislraiiiiK, both
by words and pictures, the hesi le, I.mk ..f die alHloiiiiii.il oper.iiions no« eoninionly performed.
Moynihan on Gall-stones
Gall-stones and Their Surgical Treatment. By B. G. A. Moyni-
han, M.S. (LoNi).). F.R.C.S., Senior Assistant Surgeon, Leeds General
Infirmary, I'jigland. Octavo of .;38 pa^es, fully illustrated. Cloth.
$ 5.00 net ; Half Morocco, JS 6.00 net.
RECENTLY ISSUED— NEW 2d 1 EDITION
Mr. Moynihan, in revising; his book, has made many additions to the text, so
as to include the most re< ent advam t-s. i;s|M'cial attention has been K'^en to a
detailed description of the early symptoms in i holelithiasis, enablini; a diajjnosis
to lie made in the .ta-e in uhirh sursjical treatMcnt > an be most safely adopted.
Kvery phrase of >;all stone disease is dealt with, and is illustrated by a larRC
number of clinical records. The account of the operative treatment of all the
forms and < (implications of gall stone disease is full and accurate. A number of
the illustrations are in lolor.
Britiih Medical Journal
■ He expresses Ins views with admirable ele.irne55, ,ind he supp.irts llieni l.v a l.iri;e num-
ber ,.f ilinicd <.«Hn.ples. vvhieh will b- nuleh prue.l by iho.e wlm kllo^^ tl,e difficult problem.
and tasks which g.ill-sione surRerv not infreipienlly presents."
i:.J' ..H
srA'(;/:/n- a\o axatomv
Sc\idder*s
Treatment of Fractures
WITH NOTES ON DISLOCATIONS
The Treatment of Fractures: with N-.to^ on a few Comnmn
Dislocations. Hy Cmaklks L. Scui.ukk. M. D., Sup^ch to the Massa-
chusetts General Hospitil, Boston. Octavo volume of 562 pa-es
with 736 original illustrations. I'olished Huckrani. S500 net; Half
Morocco, !56.00 net.
RECENTLY ISSUED NEW (5th) EDITiON. ENLARGED
riVE LARGE EDITIONS IN LESS THAN FIVE YEARS
Five lar^e editions of this remarkable work have been < alic.l for in less than
nve years. Kor this new fifth e.lition Dr. Srudder ha. n.ado nun.evm.s .uM>t,un.
throuehont the text, and has ad.led s..n,e fifty new ilhist.a.ions, KnatK rnhanrmR
the value of the work. The articles on D.slo.at.ms, >ll.>str,,te.l in that pra.lu.-,!
manner which has made Dr. Scuddcrs work so useful, will l.e foun.l eMrenuly
valuable.
JoKVh D. B-yMit. M.D.. rro/..u„- of !'„■ r.mctl.s -m,/ /V,„y^,■ of Su,;,ry, Vnu.r.,,
and HfU,:u,- llo /■it.ll .U.,il,.l/ ('.'//^V''.
•■.\s .> praclK-.il ,U-nu)nstrat...,. ol ll,.- mpic a .s t-xclU-nl, an.l ... an >-xrin.|.l.- uf Iwuknuika.g
a Is higlily commemlable."
BickhamN Operative Surgjery
A Text-Book of Op •.. Surgery. Hy W akki n St.im; Uk kii.vm,
M.D. I'liAK. M., Visitino ^^urs,-e<m to Charity Hospital an.l to Touro
Hospital New Orleans. ( ktavo of lOOO pa-es. with y,<, he.u.tilui illus-
trations, nearly all ori-inal. Cloth, s6.oo net ; • ' 't Moroco., S7.00 net.
RECENTLY ISSUED. 2nd EDITION-TWO EDITIONS IN SIX MONTHS
This absolutely new w..rk completoly ...vers the sar^iral anatomy and ol«'-»
live technic involved in the operations of :^eniial surKe.y. I he pra. tirabilits of
the work is particularly emphasized m the 55., ma.nnilicenl dlustiations whi.h fon
a useful and strikini,' feature.
NicholM Senn. M. D.. /Vo/;-!),.,- of S„.x.n , A'/o* .I/.,/„,</ (■.•//..,•'■
•■,\.,„m-..v!Mlc.,r,-f..l.-x:..n,„Ml,„n of th,- l.M a,„l ,l:„Mr,,t,.,n. nf I .r Hi, kl,,„n\ l.n„k ,.n
()|„Ta(.v,- Si,rt;..rv has s,.li-li.Ml m,- of il. nuiit-. 1 l„- ..,,„k «ill n,.-.i »« ,. ■• <'.l i.... ..
ti-aclier-i, sludents. .inil iinctitiom r.. '
SAUNDERS' BOOKS ON
Gould's Operations on the
Intestines and Stomach
The Technic of Operations upon the Intestines and Stomach. By
Ai.FK'U) H. GouLi>, M. D., oi Boston. Large octavo, witli 19c original
illustrations, sonic in colors. Cloth, S5.00 net ; Half Morocco, sO.oo n^^^t.
JUST ISSUED
Dr. (loulds new work is the result nf exhaustive experiincntatiiin, the technic
of the operations descriheti beinj; simplilieJ as far as possible by experiments on
animals, thus leading; to the development of many new features. The te.vt is pur-
posely concise, the te( hnic bein;,' presented very clearly by the numerous practical
illustrations, all made from actual operations done either upon the animal or the
human bein^'. As the success of i;astro-intestinal surjjery depends upon an accur-
ate knowlidf,'e of the elementary stejis, a thorou;.,'h accoimt of repair is included,
followed by a full description of all the important stitches, knots, and instruments
used in intestinal suri^ery.
DaCosta's Modern Surgery
Modern Surgery — Gk.nkkai. and ( )i'i;KATivr.. By John C'jiai.mkks
UaCd.sia, M. 1). ^'rofcs.sor of the I'rinciplcs of Surgery and of Clinical
Surger> in the Jefferson Medic, il College, I'liiladelphia. ()ctavo of 1 283
pages, with 872 illustrations. Cloth, Si. 5') net; Half Morocco, Sf>.?o net.
JUST ISSUED— THE NEW 15th) EDITION
Kor this new fifth edition the work has been entirely rewritten and reset. One
hundred new practic .il lUuntiations have been addcil ; .intl the work has been en-
larged by the addition of two hundicd p.ijjes. lo keep the book of a si/e to handle
conveniently, a thinner but hi^jh grade paper has been used. DaCost.i's Surjfery
in this edition will moie than maintain the reputation already won.
The M«dical Record, New York
■ 1 !:-.■ '.\^Mk t!:!''Ui:h"'it U n.tt;»hlf f.ir its rnnris.'nr-;';, P*..lnn(Innc'' of t.mijuaut' and n:id-
din)j h.ivt* titen scrupuluuslv .ivoulrd, wliilf ;it Ihc ^www tinir it cont.iins .1 sufficit-nl am.nint oi
inforriuiiion to fulfil thf oli|iit aimiil :ii by its aullii>r— naim-.y, \ li-xt liook for tl '; use of the
student and the Ijusi pr.ici.uoner."
.S7 A't/AA'f ,L\7> AXATOMS
Schultze and Stewart's
Topographic Anatomy
Atlas and Text-Book o' Topojcraphic and Applied Anatomy. \\y
l*k()i'. l)u. C). Sciiui.i/i;, of Wiirzburi;. lAlitcil, with additions, hy
GKoK(iK 1). SiEWAKT, M.U., I'lofcssor of Anatomy and Clinical Sur-
gery, University and Ikllcvue Hospital Medic il Coile<:;e, N. Y, I^r^e
quarto of 189 passes, with 25 colored fi^Mr-s on 23 colored litho<.rraphic
plates, and Su text-cuts, Oo in colors. C -Ji, ^SS-jo net.
RECENTLY ISSUED
It was IVofessdr Schultze' s special aim, in preparing' this work, to produce a
Text-liook and .\tlas. not for the n.itomist aWme, but more partindarly for the
general practitioner. The value of the knowledge of toponraphii anatuniy in bed-
side diajjnosis is eniphasi/ed throujdiout the book. 1 he many colored lithoyiaphic
plates are exceptionally excellent.
Arthur Dean Bevan. M. D., /''.'A<""- >■/ Smxery in Ki,s>: M,,/i.,i! CMx'\ Chic^:
■■ I i.q.iiil Silr,ili/r iin.l Sliw.irl'< Tcipc.sjr.ipliic- ;iinl Appli< il .Xiuiloiiu .is a v<t) [i.lniir.ible
wurk, for MuJi'nIs e5p'".ially, ami 1 luiil llu- plales ami the tfxt ejicclk-ni."
Sobotta and McMurrich's
Human Anatomy
Atlas and Text-Book of Human Anatomy. In Three Volumes. H;,
J. Siiiioi r.\. M.D.. of Wlirzbur^. lulited, with additions, by J. I'i.avfaik
McMt'KKicii, A. M., I'll, n., Professor of Anatomy. I'niversity of Mich-
igan, Ann Arbor. Tliree larije ([uartos, each containing about 250
pages of text and over 300 illustrations, mostly in color'-. I'er volume:
Cloth, Sfvoci net.
JUST READY
The >Mcat advanta},'e of this over other similar works lies in the larK'e number
of maKnilic ent lithoKraphic plates which it contains, without ipie^tion the best that
have ever l)een produced in this lield. They are accurate .ind be.iutiful r.,, reduc-
tions of the \ariou5 anat'-mic part= reprrsrnted,
Edward Martin. M.D., /'r./.^vr .■/ Ohiiai/ S,i>x,iv, Imv/ydtv,! r,mivi.n,ij
I hi-, i-, .1 pi.c of ho.ikin.lUinK «liKh i^ IniU ..tlnui.ililc. willi |.i il. - in I t.M -o Ufll
chose" .itiil so il. ,r tint til.' \».Mk I- m..-! u- fiil lo lliu |,r.Kti^in^ surE:i-"n."
'■<'-
SArXD/:KS' h'OOA'S (^V
Eisendrath's
Surgical Diagnosis
A rext-B(K)k of Sureicai Diagnosis. Hy Damil N. Kisknorath,
Ml). Ailjmict rrofcssiir .)f Surgery and Clinical Sur^'try. Ci)liet^e of
riiysicians ;iiul Suri;eoiis, Chicago. Octavo of 600 pages, with 400 < 11-
iiniy new aiui orii^inai tcxt-iilu.strations ami sonic colored plates. Cloth,
SU.^o net ; Hair Morocco, ^S.oo net.
JUST READY
WITH 400 ORIGINAL ILLUSTRATIONS
()( first importance in every sur^'ic:il condition is .1 correct Jiaijnosis, for upon
this ileppnUs the treatment t<i he persued ; and the two— diagnosis and treatment-
constitute the most practical part of joictical surgery. Dr. Kisendrath takes up
each disease and injury amendahlc to sur^iical treatment, and sets fortli the means
of correct (lia<;nosis in a systematic mil comprehensive way. Dchnite directions
as to methods of examination are inesented clearly and concisely, providing for
all contin^jencies that mi-ht arise in any ^;iven case. The ma^inilicent illustr.itions,
some four hundred in number, arc all entirely new and ori;,'inal, havin;,' lieen
diawii (lire, lly under Dr. I'.isendrath's personal supervision. They are ni>l only
ex. client Irom an artistic stan.lpoinl. luit also from a pt.u ti. d point of view, for
eai h one indicates precisely how to diagnose the v.irious i onditions.
Eisendrath's Clinical Anatomy
A Text-Book of Clinical Anatomy. Hy 1),\mki. N F.isKNDRATri,
A H. M. I) , A'iiinut I'rofessur .if Snrgci^'and Clinu.il SiirRoiy, C.'ll<oc
ol I'hyski.ms ,in.l Surge. ms, (liic.ii;... ( )ct,ivo .il Si? pages, illustrated.
(.1 Ml, f,e,.oo net , Sheep or Il.ilf M.jrucco, jgii.oo net.
RECENTLY ISSUED
This new anal.imy discusses the mi1.|. ■ t from the . Imi. al standpoint. A por-
tion .if .M.h .hapler is <levoteil I., the e\.Miiinati..n ..fill.- Iuiuk' thr..uj;h palpati..n
an.l m..rkin>; ..f surla. c <M,lllne^ «l l.n.linaiks, vcvs.ls. nerves, thora. » an.l
al)d..Monal viscera. Ihe illustrations ar.' from new and ori>;in.il drawings an.l
photographs.
MmUoI Record, New York
,\ s,,,., ,1 ,,im.'n.tiu..n lur Ui.- tigurM is lh«i ilirv «rr m..-.llv .jr.>[.iial .ii..l wirr
1.1.1.1. I..r il..- i.iiri in vi.w 1 lif srclions of joiliK .in.l Ininkj «r» Ih.iw .»f f.>mi»Jllin«a
i:uij>'r« «nil .ir« unimiw.u ImIiL m .i.r.irmy '
;,?r^^
SUftGER Y AND AXA TOMY
International
Text-Book of Surgery
SECOND EDITION. THOHOVGHLY HEVISED A.!!* ENLARGED
The International Text-Hook of Surgery, In two \nluiius. By
American and Hritisli authors, lulitcd l)y J. Coi.i.iNS Wakkhn, M.l).,
LL.D., F.R.C.S. (Hon.). I'rofcssor of Surijcry. Harvard Mtilical
School ; anil A. I'e.xklk ("ioild, M.S., l'".R.C.S., of LcmkIoii, Kni^land. —
Vol. I. Gemral and Opinitivi- S/oxirv. Royal ort.ivo, 973 pai^'os,
461 illustrations, 9 full-pat^c colored plates. — Vol. 11. Sf<,;!,il or
Regional Siin^vry. Royal octavo, 1 122 p.ivjes, 499 iliii.strations, and
8 full-pa^e colorcil plates.
I'er volunK': Cloth, jSj.OO net; Half Morocco, ;S''>.oo net
ADOPTED BY THE V. S. AR.MY
In thii new cilitinii I he entire ImidU \\.\> 1»-cn < .-ircfiill\ icMscd. and s|ii' i.iIcIIimi
has boon niaiU- In liiinn tin' u..rl< il.nvn tii llic pirstnt ilav . I lu' .utiiU's <in the
<'IUm| iipfin tlu' liiinian l)nil\ ofiliu varlmis kinds cit Imlliis. ,ind the irMills nf mii-
jicrv in llie Cii'ld .in' li.iscd on the l.iti'sl ir|M.its d llir sm^^ci'Tis m llu- tiold
Americ&n
Text-Book of Surgery
American re.\t-li<H)k of Nursery. I'.dit. <1 1.\ W \V ki 1 \. \1 I • , I I I > ,
l|o\ l.k.t'.S., \^.\^.. wii I hiN , and | WiiiiWi Winih, .\1 I". I'm I>
(tila\<), 1 ;f>,? pa^es, ^5 1 li'M ( iits and v» ' ^ili"< <l ;niil hah lone pi. iu>. ( lodi.
J7.00 net ; llah Mokm 1 o. i,>^ 00 lu-l.
rOURTH EDITION. KKCENTUY ISSUtO OVER 42.000 COPIES
In lliis pii-srhl i-diti..n cwiA I liaplii li.i-. I.i'cn . xlrnsnclv nLulilu'd. ,ini1 iii.inv
(it llii in li.iw I Kin p.iin.dK . ind ■...nic < ntniK . ic'«iillrn '^i'" i-r\tii>U n< « . Ii.ip
Icis .ipp''-'i Ui,'i/,i)\ s/„,,,|, .\\i:;i/ ■-II',:, n\ /),/(..// .V/^',;.- ' r. / i .'».'"•(/'•""
,1/ M. /i'/.i.'./, Imiiiiiiiih. .ind Siiii^.iv ,>l l/i, /'iit,>,,i\
Edmund Owen. r.R.C.S.. .tA^/*-. fl.,,.r> /■ ^-n,, ,.. /■,.,.,/(-...7,v,./-'. ■ » . / ".
■ r. , ,.,, ,iK 1 I, nl.l n..| ni.n.l .1 I.. ii,v ■ 'il' 'I Th« !■ >l M-k i inst.v..| ..I A 1 rM It.^Lkl
t,,r t know .1 11.. iMi'l. \..liim. «liii li . i nliiiir ■- r. i.lilil. an.l . ,.inpl..|.- in n.. 1.11111 ul 'In
■-i irn. > ma irl .if siiti'.T\ :is t'li ilorv
\^f
■^■•*'. vy".^ '• ''>
sAr^'D/■:J!'^''^ hooks on
American Illustrated Dictionary New74th'Edition
The American Illustrated Medical Dictionary. With tables
of Arteries, Miis< les, Nerves, Veins, ett. ; of liai illi, Hai teria, et( . ;
Kiioiniuic Tables of Diseases, Operations. Stains, Tests, etc. By W. A.
NnvMAN DoKiANL", M.l). I jrgc o< tavo, 840 pages. Hexilile leather,
54.50 net ; with thnn;l) inilev, #5-oo net.
Howard A. Kelly. M.D., /'/■,/..,..<- ,/(,>«f<.V,,4-,'. /'A"' H.'piins I nivnsih: l<..lhm,Hf.
• III. l>..H.,ri.l-. .h. ii.inarv is aJmir.ilile. II is s,i well ^owv-a up iiiul of siuh con-
.1111111 ^\K. No trnirs have Ihtti I. .1111. 1 in iii> us
of It.
Golebiewski and Bailey's Accident Diseases
Atlas and Epitome of Diseases Caused by Accidents, liv 1»R.
Ku. (Ini 1 iiiKWhKi, of Merlin. Kdiled, with additions, by I'k.xkii- Uaiikv,
M.l). Consulting Neurologist to St. I.nke's Hospital, New Soik (ity.
With 71 (olored figures on 40 plates, 14.? text-cuts, and 549 l"t;e^ '^^
text Clolli, j;402 1"^'' ''" StiiDK/tri' J/,tn,/ A/An X/iis.
Helferich and Blood((ood on Fractures
Atlas and Epitome of Traumatic Fractures and Dislocations
liv I'Kiii. Hk. 11. Hi I 1 IKK H, of (ireifswuld, Prussia. I'.dUed, « itli ad-
ditions, by l.isKiH C. I'.i M- I>-, Assot iate in Surgery, l.)lins
Hopkins L'niversity, Itahiinore. .iifi .olored figures on 64 lithogniphu:
jilates, Kjot.xt . uts, and J5.} pages of text, (.'loth, #3 00 net. /'t -S.iioi-
d,-.
. tlUt!. Siiii-s
Sultan and Coley on Abdominal Hernias
Atlas and Epitome of Abdominal Hernias. I'.v I'k. Dr. (; Si 1,-
i\N, of ('..itlmgen r'.ditrd, with adtlitions, l.\ \V\i. I!. Cni.iA. M. D.,
(Iini<al i.e. Hirer and Instru. tor in Surgery. Coluinbia I niversity. New
York. I I.) ilhistratioiis. ,56 in ( olors, and ^77 pages of text. Cloth,
f,\ 00 net. /'/ S,iiiii,l<r\' /l,iii,/- lt/,ii Si'iis.
Warren's Surgical Pathology Edmon
5urKical PatholoKy and I herapeutics. Ity J. Coiiin^ W \KKhN.
Mil. I I, |i. I |< (S ' ll"N 1. I'rolessor of Surg.rv, Harvard Medi. al
Siluuil. O.lavn. .S;^ piges; \ \t> illustialions, \\ in lolois Cloth,
J(i;,oo 111 I ; llill MoroiKi. f,i>.oo iiel
Zuckjrkandl and DaCosta's Surgery Ed^^on
Atlas and lipitome of OiH-Tative Suritery. Il\ Dk <» /i.kkk
KVNi.i. ..I Vienna r.dile.l, with a.lditn.ns. bv | Ciiaimkks DaCo>ia,
M D. I'lof.-.sor of the I'nnnpl.s ..f S.iigerv air.l Clini- al Siirgerv, jeffer-
son Medi.al lolbt;.. I'hil.i 40 . olored plates. .7S text . uts. and 410
Kiu.s of t.'vl Cliiih, .<! so net. /'i S.iii'I.Ak' ,!//.;> .S,'/,>.
SrRCERY A\n ANATOMY
13
Lewis' Anatomy and Physiology for Nurses Just i»ued
Anatomy and Physiology for Nurses. V<s l.iRov Liwis, M. I)., Stiit;c.M
to and Lecturer on Anatomy and I'hysioloj;y for Nurses at the Lewis Hospital,
Bay City, Mii hijjan. I2nu>, 317 pages, with 146 illusirationb. t loih, •;i.75 net.
A dfm;ind for sued a work as this, IreatiHi^' thf iuhjeits from thf nurw' ^ r'"if ■ /" -■tC'''. '..la
lony i-xisted. Dr. Lewis h.is ti.iM-d tin* plan aiul sropi' t»f Itin Wi-rk "ii iti.- ni- thinh - ni ■
pU.yi'il by liim in liMcliinj; llirsi' lir.iiulif., making the It-xt unu^nallv sini|ilo .iml 1 liar.
Nunei Journal of the Pacific Co&it
'■ ll IS H(U in iiny srtiv nulimtntary , Inn i iiiiprthrnsive in its frcrttnn-nt i.f tin- sul-j" ts ni han'i,"
McClellan's Art Anatomy
Recently Iiiued
Anatomy in Its Relation to Art. Uy Ci -^k McCi.f.i.i.av. NLD.. Professor
of .Anatomy, Pennsylvania .■\<a(i<my of :,v r'ine .Arts, (Mi.iilo volmne, v In
12 '2 inches, with 338 original drayvin^s and photo>;raphs, and jf>o pa;;(s of
text. Dark bhie velUim, #10.00 net ; Half Russia, ■f.iz.cm net.
Howard Pyle, '" ''''■' I'hihi././p/iiti Mi.iu.il /,>iiin,il
" i hf I'MMk is nil.' Ml itn- lifst an.l l.H' ..msl ll iiyh tivt I ks >>f aiti- .iiiatnmv win- li it li.is \f \y
the wiitt-r •* Icrlune t.i lalt upun, and, as a trxl-bo.ik, » ..ukIu to make itt, way iiitu Iht lit-lil l-i wlmh
it in intrndeil."
Senn on Tumors
Second Reviled Edition
Patholofcy and Suriclcal Treatment of Tumors. L> Nn lifi \^ ^i n^
M.I)., I'li.l).. LL.I>,. I'nifessiir of Siir.nciy, Kush Medii .il ' flic;;"', < Ima-o.
Handsome tntavo, 71.S pi-cs. with 47H en-iaMn-s. int liidnv.; 1 -• lull pa-e
colored plates. Cloth, *5.(x) net ; Sheep or ll.ilf Moroxd, *6.<«i net.
Journal of the American Medical Auociation
■■111. IIMSI 1 vIl.lll.tiM- -r .IIIV 1 "I I k I" K|i„ll~tl I. II till
(li.nlill.ss i.niain as llic |iriii. ip.il iih.Mi.traiili ..n 111. sill j. ■ t (.«
Senn Practical Surgery
II illiiMiaU'l .Mi'l 1
Bated on Dr. Senn'i
2J Yean' Experience
l>ractical Surgery. A Work foi the 1 .tnetal T'r.n iitiim 1 liy Ni 1 \-
SlN-s, M. 1)., I'M. I)., LL. I)., I'tofessor if Siir}.;er\ in Kusli Medu .\I I illei;e.
( hii ano. (Vtavo of 1113 pajjes. with '150 illiisiiatinns. many m lolnis.
Cloth. *6, 00 ; Sheep or Half Moroi ro, 57.00 net. SM hy Siih'i, fif>li,>n.
■ It fi i)f value not onlv .is pn-vnlinj:' "niprfln'nsivrlv I'n- 1110 1 • ;> .in. ,d !• c 1 ini;- ■■(
iii.Mlirn sunjiTV in the siibjrcts wliiili il t.ikfs itp. hiit ;ils.i a n re. m •( tin- in itnml ..pm
ions .ind pratiicf "( .in an ninplisli.'il ami t-\p.ri. nifil siii^ion .1 • i/i / .s»<.4-».i-
Macdonald's Dia|(nosis and Treatment
A Clinical Text-Book of .Surgical UlngnosU and Treatment. I'v I W
MA( |H.\ VI 11, Mil. I dm , I.K.( .S. ^ l-din ). I'l.iffssii, I menliis t,t ilu- I'lai
tire of Siiri:>ty ami nf ' liniial Siir',^ery in llamlinc I niveisiis Minne.ipolis.
(Ktavo, 7((« paues, illtis. (loth, 55 ihi net ; Sheep or Hall M.t , *■<< 0,1 n.l
sjygaK^
M
s.tr.\7i/:A's' /.vu)A'.s- ox
Haynes' Anatomy
A Manual of Anatomy, liy Ikv-fnc; S. Havnes, M.D., Professor of Prac-
tical Anatomy, Cornell University Medical College. Octavo, 6So pages,
with 42 diagrams and 134 full page lialf tones. Cloth, Jti.so net.
" This txMik is the work uf a pt;n tiral instructor — one who knows bv expt'riftue tlif require-
ments of tlie averaKi- studeli- .iv! is ai)le to meet these requirements in a very satisfactory
way.'- 7A<- Medical Ketoul, .^Va■ Votk.
American Pocket Dictionary rourth S^vUeMtion
The American Pocket Medical Dictionary. I.>iit. il by \V. A. Newman
DoKl..\Ni), ,\.M., .M.D., Assist, lilt Obslrlriciaii, Hospital of the University of
Pennsylvania, etc. 566 pages. Kiill leather, limp, with gold edges, $1.00
net ; with patent tlmnil) index, J1.25 net.
" I am struck .it once with admiration at the compact size ami attractive exterior. I can reiom-
meml it to our students witlioiit reserve."- Jamks W H*ti iank. M.I)., t^ofeliot of Medtfal
C/iemnliy "rit J\rl irolm'v. Ml l/ir J.;^; ■ wn .1/. .IJ..1/ tcK.ic, /■lii:.iji/^''ii,i.
Beck's Fractures
Fractures, liy Cakl Ukck, Ml)., Professor of Surgery, New York Post-
giadnate Medic.il .School and Hospital. With an Appentlix on the Practical
Use of the Rijntgeii Rays. 3^5 pages, 170 ilhislralioiis. Clotli, $3.50 net.
■' The use of the ravs with itstechtiic is iully cxpl.iiiied, and I he practical [hiints are brought out
with a thoToURhiiess that ineiits hi«li praise. " T/if Mntuai AVcc*./, AVw Yofk.
Barton and Wells' Medical Thesaurus Recently inued
A Thesaurus of Medical Words and Phrases, lis Wii n<i n M IUkkin,
M. P.. .\sMsi,iiii 111 I'riifcs-r id" Matcri 1 Medica .ind I lierapt'iilirs. and l.ec-
lurcr iin I'haniiai v. 1 ;ccir>;<'tii» n 1 nivcrsltv. \\'asliin.L;tim, I >. C. ; and W M i IK
.\. Will.s. M.l>.. I iciiiiinstratir of Uir\ n.u;M|ii.4y, Cicid-elnwn Cnisersity.
W.tshln-ton. 11 C. 1 :iiiii uf 534 pa^e;,. Ilexihle le.ither. >2 50 net ; with
thiniili iiulcx, * vi""" net.
ra*i:
_ , t c> ^< • «i« t. • Recently liiued
Stoneys Surgical Tecnnic New (2d) Edition
BacterioloKy and Surgical I'echnic (or Nurses. Hv I mm \ M. A. Stum v,
Siipcnnloiidem at the t ainrv llusj.ii.d. Smith lioston. Mass. Revised hy
Vhi 111 Kic K. (.1(1111111. M. 1>.. Surgeon, of .New Voik. unio, 20(\ pa^cs.
iUustiatcd. »l-50 "»^'
" These subji-i ts ate lieali,i most ,t. t lirati U ■
which 1- %.■ "lien cinpl.o.d Nuisc
7't,Uft'-.l \lti S' and //■"/ If^lf A*. ;*..'
id in. lo d.itr. uith-iul lb. slipeltlu,ms leadinR
will liiid Ihis lK,ok ol ihe ,;leutest value."
Grant on Face, Mouth, and Jaws
A Text- Book ti( the Surgical Principles and Surgical Diseases of the
Face, Mouth, and Jaws. I ..i Denial .Stiidi iits. jiv II, Huu.v. 1 (.kant,
A.M., M.r>.. Professor oi Surgery and of Cliiinal Stirger\, Hospital College
of Medicine. Ocl.ivo of 2,v p.igi-, with (.,S illustrations, Clotli, |i so net.
" The latlKuace of the l»iok is oimplc and . Icai
whom II IS intended 1'hil.iJttfkia Mrdnjl Jtmintl.
We recommend the woik to thow; (or
Khm.'
SUKGF.R V AND ANATOMY
>5
Preiswerk and Warren's Dentistry just i»ued
Atlas and Bpitome of Dentistry. I!y I'kium;. I'ki iswi hk. ,,f i;,isil. I <|
itcd. with additions, by (;i;(>i«.K W. \V auri n.D.D.S.. I'n.fi-sor nf Opoialuf
Dentistry, Pennsylvania Collej^e iif 1 )cntal Siirj^cry, I'liil.iili i|)lii:i. With 44
hthosraphii: phites, 152 text < iits, aiul 343 pa-, > of text. Lh.lh, #3 50 net.
/« Siiutitiirs' Alias \ii,s.
" Nowheri" in ilental lilprallirc linvf \n- ivi r scrn illustralior. wliic l\ r m l"gin I.. ( nmiMrf
Willi thecMiuisite colored plati's proiluteil in Ihii volume." — Pcntul h'ezitw
Beck's Surgical Asepsis
A Manual of 5urKical AsepRis. !'■> l \ki Diik. M, |i. ' 1 p-'^:''^ > ''^
text-ilhistratiuns and 12 full-page plares. (, loiji, >i .-j Tin
"The tuM.k is well wiiui-n. The data are tli.uK ;uhI rnticisfly Rivi-ri. The facts ai,- well
arraiiKid. Il is well worth readinK to Ihe s.ud. 1,1. ihe phvsieian in general practiee, and the
surge* »n."—/>'c'j/fjif Aff-ttica/ ami Suiv:it:al JumnaL
Griffith's Hand-Book of Surgery
Recently Iiiued
A Manual of Surgery. Hy I- itian un K. ('.mil rrii, M. I> , Siirj,'eon to the
Hcllcviie Dispensary, New ^■()rk City. i,;ino of 57^ pa:.;es. with 4i7ilhis-
trations. Ilcxililc leather. »;;.oo net.
'* Well a'lapled to the needs ..t itii' stii'l'-ni .iii.i in the tie^y [ins miuiicf for a hasty review of iniiH-rtanl
points ill surjfery." — Aniii ;. UH ,1/r.//, iHi .
Senn's Syllabus of Surgery
A Syllabus of Lectures on the Practice 01 Surger-' Arranged in con-
formity with "American Text-llook of Surgery." I'.y Ni(;mol.\s Sicnn,
M.D., Ph.D., 1.I..D., Professor of -Siirijery, Rush Medii.il Collc>;e. Chicat;o.
Cloth, $1.50 net.
"The author Ii.is e\ ,(i, nil y v| 1.(1 td no pains in in.ikint; his S\tl.iliii-. Ihoion^hlv i ompiehenstve,
and has ailileii new inatloi and .ilhided to the most recent anlhui^ .lod oiu-iatmns. l-iiU leter-
ences an- also >iiveii to all lequistii itetailsof surgical anatomy and pathology." — Hulish Mrdv
cat Journal.
Keen's Addresses and Other Papers
Recently Ittued
Addressc-- and Other Papers. Drliwrnl '.\ Uiiiiwi \\ , Kmn, M. D ,
IIP. ■<. t. S. (llonV I'lnfessni it Ihe I'nni iplis of Ntn ir\ ,iiiil id'i Im
ical Surgery. Uilersun Medii.il t i'lle:,;c, I'hilaiklphi.i. iht.i-' M.lnnie of
441 |iaj;es, illtistiated.
Chilh,
Keen on the Surgery of TypKoid
The Surgical Complications and Set^uels of I'yphoid lever. Ily \\ m. \V.
Kkkn. M.D., IT.D,, K.R.C.S. (Hon.), Professor o<'lhe Principles. d■^lll^;cly
and of Clinical Smoery, Jefferson Meilical Collej.:e, I'hiladelphia, etc.
Octavo vohime of 386 pa^es, illiislralctl. Cloth, S3 <x> net.
" Kvei V siiii:i< .d ln< dent \^ htch can m 1 nr dnimg 01
hilly illnsliiied hy inses . , . Tile IkkiW will In 1
The I'laclitumt't , Lom4en.
Ill r l\phoitl lever is .iinptv disc nssed alld
eliit iKrth to Ihe suige»<n ,uul physician."^
m^i.
i6
SiRGERV AND ANATOMY
Moore's Orthopedic Surgery
A Manual of Orthopeclic Surgery. By James K. Moork, M.D.. Professor
of Clinical Surgery, University of Minnesota, College of Medicine and Surgery.
Octavo of 356 pages, handsomely illustrated. Cloth, $2.iiO net.
"Thtb(X)k iseniincnllv pradiial. It i- a safe cuidc iti the uii<Urslantlinc anH Ireatimiit ot
orthoiiedic cases. Sliuulcl be owned '..y every surKei.n ami pracliliuner."— .(»i>iu/s 0/ .VioiT^'O'-
Fowler's Operating Room
Juit Iiiued
The Operating Room and the Patient. Ky Ki ssi t.i. S. Iowiik, M. 1).
Surgeon to the (".erman Hospital. Brooklyn, New York. Octavo of 172
pages, illustrated. •- >"th, *2.oo net.
Dr. Fowler li.is wrilti-n his 1)1... k f.ir siirs;i-..iis. muse- .is^i-lin!; .it ,111 ..peralinn. interne>.
,111.1 ill ..ih. r- wli..-.e iliilies tjrini; them inl.i tl.i cpenitlTit i....iii It eontams explicit
ilir.-. lion- f..r tlie pi. p.iration cif in.iten.il. in~tniin.nl- n.i.leil, p..~iticm iif patieni.it.
all heautiftilly iliu.^tr.ite.l.
Recently lijued
Nancrede's Principles of Surgery Ne* (2d) Edition
Lectures on the Principles of Surgery. I!y Cii as. H. Nanckf.dr, M.U.,
I.1..I)., I'rofcssor of Surgery and of Clinical Surgery, University of Michigan,
Ann Arbor, fktr.vo, 407 pages, illustrated. Cloth, S2.50 net.
•■VVecan stn.iiKK rec.miiKiid this hii,,k to all Murlciiti; anil lh.se wh. m.uIiI see si.m.lhinB
of the scienlilic foundati1.11 .i|K)n which the art of smuerv is lunll."— (.'kui ' ly M.-ilniilJ^nn tuil,
ShiffiFld. l-.Mglaiid.
Nancrede's Essentials of Anatomy. ^""th'Edition
Essentials of Anatomy, including the .Anatomy of the X'iscera. ByCiiAS.
H, NaNihkhi;. M.U., Professor of Surgery and of Clinical Surgery, University
of Michigan, Ann Arbor. Crown octavo, 3K8 pages; 180 cuts. With an
Appendix containing over 60 illustrations of the osteology of the body. Based
on 0><m' t . ;»<f A>«n'. Cloth, Ji.iMnet. /ii S,ii()i,/,rs (Jii,sf/,>n Ci'mpi-n./s.
:\ concisely (;i\cn."--
" The nuestions ha\e lieeil « i.elv selected, anil the answers accuratel
t'niTrt sily Mi-diial Ma^itiztttc.
Martin's Essentials of Surgery.
Seventh Fldition
Revised
Essentials of Surgery. Containing also \ ciieieal Diseases, Surgical Land-
marks, Minor and 1 i()crati\e Surgery, and a complete description, with illus-
trations, of the ll.iudkcrchief and Koller liandages. Uy Kdwaki) M vktin,
A.M.. M.D., I'rnfessor of Clinical Surgery, University of Tcnnsylvania, etc.
Crown octavo. 338 pages, illustrated. With an Appendix im Antiscjiiic Sur-
gery, etc. Cloth, 51.00 net. /« S,iii;u/,rs' (Jiieslhn (i>inf<ctiiis.
"Wiitten to assist the student, it will he of ni. I.umecl value to the pra. litionei. .oritainiriK as il
does the essence of suiRiial «..rk."— /;..JA.»( .\/,'linil iiiuf Snificiit Joniniil.
Martin's Essentials of Minor Surgery, Band-
aging, and Venereal Diseases. *""£i|?;r'"''
H8.sentiais of Minor Surgery, Itandaging, and Venereal Diseases, lly
KiiwAUh Mmiiis, a.m., M.I)., I'mlcssur of Cliiic ,il Surgery, University of
Pennsylvania, etc Crown octavo, 1C16 pages, with 7S illustrations.
Cloth. < 1. 00 net. In S,vin,i,rs' Ou,slwn i'nn ' w-'v
"The hiM londensalion ..f tin siihieits
Tht Mt-Hxiat .%>« .1, I'hilaitflpkm,
of will, h it Heals >rt pl,lceil helorethe pT..lessio» '
MM
^