UNIVERSITY OF CALIFORNIA SAN FRANCISCO LIBRARY Pra. A NE Recommendet College Hi Univer. A HAND] MEDK Assistar Univer: ton Co] Pr " I have e systematic, ai son, Jr., M.. "It is wit! tioners, as a compendium Allen, Rush "After du convinced of Yale College. " I have € take pleasure in the hands Medicine, Ai "I have r adapted for s be known."- "I shall i Surgeons, ar Lynch, Bait " It is unsi dium for students preparing for examination, fully up to the times." — The Clinic. " Our opinion of it is one of almost unqualified praise. The style is clear, and the amount of useful and, indeed, indispensable information which it con- tains is marvelous. We heartily recommend it to students, teachers, and prac- titioners." — Boston Medical and Surgical Journal. " That Dr. Roberts' book is admirably fitted to supply the want of a good handbook of medicine, so much felt by every medical student, does not admit of a question." — Students' Journal and Hospital Gazette. I shall be put ■:tice of p well ant to IS and hn S. mpen- It is thoroughly practical, and P. BLAKISTOK", SON & CO., Publishers and BookseUew, 1012 WALNUT STREET, PHILADELPHIA. BYFORD'S Diseases of Women. THIRD ENLARGED EDITION. Recommended as a 'lext-book at Rusk Medical College, Chicago ; Woman'i Medical College, Chicago; National Medical College, Washington, D. C, and other Medical Schools. THE PRACTICE OF MEDICINE AND SURGERY, APPLIED TO THE DISEASES AND ACCIDENTS INCIDENT TO WOMEN. By Wm. H. Byford, a.m., M.D., author of "A Treatise on the Chronic Inflammation and Displacement of the Unimpregnated Uterus," and Pro- fessor of Obstetrics and Diseases of Women and Children in the Chicago Medical College, and in the Woman's Medi- cal College, Chicago. Third Edition, Revised. In One Volume. Octavo. 164 Illustrations. Price, Cloth, $S.OO; Leather, $6.00. BBOOMMXNDATIOITB. " I have read with pleasure your book on Diseases of Women ; it gratifies me to indorse its teachings." — Prof. H. P. C. Wilson, Jr., Baltimore. " I am well acquainted with the author, and regard him an excellent practi- tioner and teacher." — Dr. J. A. Ireland, Professor of Obstetrics and Gyne- cology, Louisville Medical College. *' It is much improved and is still more what it always was, a valuable practi- cal assistant to the practitioner." — Prof Henry G. Landis, Starling Medical College, Columbus. " I find, from its being so well brought up to the present state of the science it treats of, that it is particularly adapted to the requirements of the medical student." — J. Fred Prioleau, M. D., Professor of Gyncecology, Medical College of South Carolina, Charleston. " The author has presented to the profession a concise and comprehensive treatise on the subject of diseases of females. We congratulate Dr. Byford upon his success, and feel satisfied that the effort will be duly appreciated by those whom the work is intended to instruct. It is one of the best treatises on the subject ever submitted to the American profession, and will early be acknowledged as such. It is well written, and where necessary, is appropri- ately illustrated." — Medical and Surgical Reporter, Philadelphia. "The present work being particularly of use where questions of etiology and general treatment are concerned, -h- -s^- * This volume, hence, will commend itself both to those who possess former editions and to those who do not. It cannot fail to be useful to many, and will certainly prove interest- ing to all. ' ' — The American Journal of Obstetrics. " These important topics are all handled vigorously and practically. The work cannot fail to be in great demand, and to exert a material influence on clinical practice." — New York Medical jfournal. P. BI^AKISTON, SOir ft CO.. FubUshers and BooksaUera, 1012 WALNUT STREET, PHILADELPHIA. GILLIAM'S ESSENTIALS OF PATHOLOGY. JUST PUBLISHED. Tlie object of this book is to explain to the student, in a plain, practical way, the fundamentals of Pathology, as an introduction to larger books. THE ESSENTIALS OF PATHOLOGY. By D. Tod Gilliam, m.d., Professor of Physiology, Starling Medical College, formerly Professor of General Pathology, Columbus Medical College, Columbus, Ohio. i2mo. 296 pages. 47 Illustrations. Price, Cloth, $2.00. RECOMMENDATIONS. A Review, by G. A. Piersol, m.d., Demonstrator of Normal Histology in the Medical De- partment of the University of Pennsylvania, at Philadelphia. Published in the Western Medical Reporter, September, 1883. " Of no study of the medical student of to-day is a clear conception of fundamental prin- ciples more necessary than of pathology ; yet how many are the first-course men who turn the last page of Wagner or Rindfleisch without having thoroughly comprehended a tithe of the broad and important generalizations without a clear perception of which elaborate detail and minutia: are meaningless. With this fact fully appreciated by the author, the little volume before us was conceived; 'not intended to supplant more pretentious works by allaying, but rather to lead up to them by kindling, a thirst for pathological investigation.' * * * " The pages before us will be found to present an excellent epitome of the generally accepted pathological doctrines, with a keen appreciation of the broader and more comprehensive and logical views of to-day. "The arrangement of the matter is well adapted to present the subject in a clear and attractive manner. * * * * We recommend every first-course student to make himself thoroughly familiar with the contents of Dr. Gilliam's book." From the Southern Clinic. " We will venture to say, that both student and practitioner will be likely to use this in preference to other more pretentious but less valuable works." CLEVELAND'S Pocket Medical Lexicon. THIRTIETH EDITION. The compact size, convenience of arrangement, and the extraneous information which it contains, make it a valuable companion to the student. THE PRONOUNCING POCKET MEDICAL LEXICON, containing the correct Pronunciation and Definition of terms used in Medicine and the Collateral Sciences, with Addenda containing Abbreviations used in Pre- scriptions, and List of Poisons and Their Antidotes. By C. H. Cleve- land, m.d. Thirtieth Edition. Very small 64nio. Price, Cloth, Red Edges, 75 cents; Tucks, with Pocket, $1.00. P. BLAKISTON, SON & CO., Medical Publishers and Booksellers, 1012 WALNUT STREET, PHILADELPHIA. BENRVI.ILEISSia Digitized by the Internet Arciiive in 2007 witii funding from . IVIicrosoft Corporation http://www.arcliive.org/details/compendhumanatoOOpottrich CoMPEND OF Anatomy. POTTER. ?QUIZ COMPENDS.? A NEW SERIES OF BOOKS FOR STUDENTS' USE IN QUIZ-CLASS AND EXAMINATION BOOMS. flS* These Compends are based on the most popular text-books, and the lectures of prominent professors. >e®=- The Authors have had large experience as Quiz Masters and attaches of colleges, and are well acquainted with the wants of students. it^ They are arranged in the most approved form, thorough and concise, with illustrations whenever they can be used to advantage. >8®=" Can be used by students of any college. 4®=" They contain information nowhere else collected in such a condensed, practical shape. iC®* Size is such that they may be easily carried in the pocket, and the price is low. 4®=-They will be found very serviceable to physicians, as remembrancers. LIST OF VOLUMES. No. I. ANATOMY. By Samuel O. L. Potter, m.d. 63 Illustra- tions. Now ready. No. 2. PRACTICE, Part I. By Dan'l E.Hughes, m.d., Demon- strator of Clinical Medicine, Jefferson College, Philadelphia. Nov) ready. No. 3, PRACTICE, Part II. Same author. Ncnv ready. No. 4. PHYSIOLOGY. By A. P. Brubaker, m.d.. Demonstrator of Physiology, Jefferson College, Philadelphia. Noiv ready. No. 5. OBSTETRICS. By Henry G. Landis, m.d.. Professor of Obstetrics and Diseases of Women and Children, Starling Medical College, Columbus, Ohio. Illustrated. No7v ready. No. 6. MATERIA MEDICA. By Samuel O, L. Potter, m.d. Now Ready. No. 7. INORGANIC CHEMISTRY. By G. Mason Ward, m.d.. Demonstrator of Chemistry, Jefferson College, Philadelphia, Now ready. No. 8. VISCERAL ANATOMY. By Samuel O. L. Potter, m.d. With illustrations. Now ready. No. g. SURGERY. By Orville Horwitz, b.s., m.d. With nu- merous Illustrations. No%v ready. No. 10. ORGANIC CHEMISTRY. Including Medical Chemistry, Urine Analysis and the Analysis of Water, Air and Food. By Henry Leffmann, m.d.. Professor of Clinical Chemistry and Hy- giene in the Philadelphia Polyclinic. Others in preparation. Price, each, in Cloth, $1.00. Interleaved Edition, for taking Notes, $1.25. P. BLAKISTON, SON & CO., Publishers, 1012 WALNUT ST., PHILADELPHIA. J8^ Complete stock of Medical, Dental, Pharmaceutical and Sdentific Books. Catalogues free. /^S:^ HENRV I. FLKISSia ?QUIZ-COMPENDS? No. 1. A COMPEND OF Human Anatomy. BY SAMUEL O. L. [potter, M.A., M.D., LATE A. A. SURGEON, U. S. ARMY. Author of " An Index of Comparative Therapeutics," " A Compend of Materia Medica," *' A Compend of Visceral Anatomy," and of the Lea Prize Essay of Jefferson Medical College, on " Dyslalia, A Study of Speech and its Defects." QHXb THIRD EDITION, REVISED. WITH SIXTY-THREE ILLUSTRATIONS. PHILADELPHIA: P. BLAKISTON, SON & CO. IOI2 Walnut Street. 1884. Copyright, 1883, By p. Blakiston, Son & Co. PREFACE. 'T^HIS little book contains a series of questions and answers, comprising a concise description of the bones, articulations, muscles, arteries, veins, absorbents, and nerves of the human body, including the heart and brain as essential parts of the circulatory and nervous systems respectively. Intended especially for the use of the medical student in preparing for the exercises of the quiz-room and for final examination, it includes the essential points of the structures named above, arranged in such a manner as to facilitate their acquirement in the shortest possible time. With this object I have omitted all superfluous description, and have confined the matter to those points which must be known in order to pass. In the general descriptions I have closely followed Gray, and have retained the Latin names so universally used by anatomists, believing that in both these respects my course would be that most acceptable to the student. For many of the special arrangements I am indebted to the lectures of Professor W. H. Pancoast, of Jefferson Medical College, and to the quizzes of Dr. Henry Morris, Assistant to the Chair of Anatomy in the same Institution. Philadelphia, 1882. The exhaustion of the first edition of this Compend within three months after its appearance, manifests an appreciation thereof on the part of students which is extremely gratifying to the author. The text has been carefully revised, and all typographical and other errors found are corrected in this edition. U. S. Army, February, 1883. A few additions have been made in this edition and the arrangement im- proved in several places. The continued favor shown the book is fully appreciated by the author. Salt Lake City, Utah, January i, 1884. S. O. L. P. TABLE OF CONTENTS. PAGE OSTEOLOGY 9 BONES OF THE HEAD 12 The Orbits 29 The FosSiE 31 The Sutures and Fontanelles 33 The Wormian Bones 33 The Hyoid Bone 33 Table of the Foramina at the Base of the Skull 34 BONES OF THE TRUNK 36 The Vertebral Column 36 The Thorax 38 The Sternum 38 The Ribs 38 THE PELVIS 40 BONES OF THE UPPER EXTREMITY 43 The Shoulder 43 The Arm 45 The Forearm 47 The Hand 48 BONES OF THE LOWER EXTREMITY 50 The Thigh 50 The Leg 51 The Foot 53 ARTICULATIONS 55 MUSCLES AND FASCI.E OF The Head 68 The Ear 71 The Neck 71 The Larynx and Epiglottis 75 The Back 76 vii VUl CONTENTS. PAGE The Abdomen 80 The Thorax < 82 The Perineum 83 The Shoulder and Arm 85 The Forearm 87 The Hand 90 The Hip and Thigh 91 The Leg 95 The Foot 97 THE HEART 99 ARTERIES 102 THE CIRCLE OF WILLIS 106 ARTERIAL ANASTOMOSES 114 VEINS 115 ABSORBENTS 119 NERVOUS SYSTEM 120 THE BRAIN 120 THE SPINAL CORD 129 THE CRANIAL NERVES 129 THE SPINAL NERVES 133 THE SYMPATHETIC NERVE 136 lAh^ COMPEND OF ANATOMY. i Define the term Anatomy. Derived from the Greek dva ana, through, and TEiiveiu iemnein, to cut, it strictly means dissection, but is technically applied to that science which treats of the structure of organized bodies. What are the divisions of Descriptive Human Anatomy ? They are, — Osteology, the anatomy of the bones; Syndesmology , of the joints; Myology, of the muscles ; Angiology, of the vessels ; Neurology, of the nerves ; Splanch- nology, of the internal viscera ; Adenology, of the glands ; Dermatology, of the skin ; Genesiology, of the generative organs. State the number of Bones in the Adult Human Skeleton. It is variously stated by different anatomists. Excluding the teeth, the Wormian and sesa- moid bones, and the ossicles of the middle ear, the whole number would be 200; excluding also the 2 patellae, and the hyoid bone, would leave in the skeleton proper 197 bones. Describe the Long Bones. They number 90, act as supports, or levers, and are known by having a medullary canal in the centre of each, a shaft {diaphysis), and two extremities. They are developed by osseous deposit in cartilage. Describe the Short Bones. Numbering 30, they are found where strength is required, but limited motion. They also are developed by osseous deposit in cartilage. Describe the Flat Bones. They number 38, protect the viscera by forming walls around them, and afford extensive attachment for muscles. They are developed by osseous deposit in membranes, and consists of 2 dense layers, separated by a cellular or cancellated osseous tissue, the diploe. What are the Irregular Bones ? They are 39 in number, and include the vertebrae, sacrum, coccyx, the temporal, ethmoid, and sphenoid bones, and the bones of the face, except the nasal, lachrymal, and vomer, 9 10 ANATOMY. Name the Bones of the Head. They number 22, and comprise the — Cranial Bones (8) — the frontal, 2 parietal, occipital, 2 temporal, the sphenoid and the ethmoid bones. Facial Bones (14) — 2 superior maxillary, 2 malar, 2 nasal, 2 lachrymal, 2 palate, 2 inferior turbinated, vomer and inferior maxillary. Name the Bones of the Trunk. They number 53, as follows, viz. — Vertebrce (24) — 7 cervical, 12 dorsal, and 5 lumbar vertebrae. Thorax (25) — 7 pairs of true ribs, 3 pairs of false ribs, 2 pairs of floating ribs, and the sternum, articulating vi^ith the bodies of the dorsal vertebrae. Pelvis (4) — the sacrum, the coccyx, and 2 ossa innominata; each os innomi- natum consisting of 3, — the ilium, ischium, and pubes. Name the Bones of each Upper Extremity. They number 32, as fol- lows : — Shoulder (2) — the clavicle and scapula. Arm (i) — the humerus. Forearm (2) — the radius and ulna. Hand (27) — 8 carpal bones, — the scaphoid, semilunar, cuneiform, pisiform, trapezium, trapezoid, os magnum, and unciform, — 5 metacarpal, and 14 phalanges. Name the Bones of each Lower Extremity. They number 29, viz. — Thigh (i) — the femur. Leg (2) — the tibia and fibula. Foot (26) — 7 tarsal bones, — the astragalus, os calcis, scaphoid, cuboid, external middle and internal cuneiform, — 5 metatarsal, 14 phalanges. Name the Unclassified Bones. They are the — PatellcB (2), which are sesamoid bones, each developed in the tendon of the quadriceps extensor femoris muscle. Hyoid Bone (i) — the tongue-bone, not articulated to the skeleton. Malleus, Incus, Stapes (3 pairs) — the bones of the middle ear. Sesajnoid Bones, of variable number, situated in the tendons of the gastrocne- mius and peroneus longus muscles, and in the flexor tendons of the great toe and the thumb. Wormian Bones (ossa triqueta), sometimes found in the cranial sutures, are not constant in number or size. Name the principal Eminences on Bones. Heads, are convex and smooth, for articulation in movable joints. Condyles, are irregularly shaped heads. Trochanters, when for turning the bone. Tuberosities, are broad, uneven prominences. Tubercles, are small tuberosities. Spines, or Spinous processes, when sharp and slender. Apophysis, is a process which has been an BONES. 11 Epiphysis, or separated from the shaft by cartilage, but has become united thereto by ossification. What other names are given to Bony Prominences ? There are sev- eral adjectives applied to them from their fancied resemblances, such as — - Azygos, without a fellow ; Clinoid, like a bed ; Coracoid, like a crow's beak ; Coronoid, like a crown ; Hamular, hook-like; Malleolar, like a mallet; Mas- toid, like a nipple; Odontoid, tooth-like; Pterygoid, wing-like; Rostrum, a beak ; Spinous, thorn-like ; Styloid, pen-like ; Squamous, scaly ; Vaginal, en- sheathing, etc. Name the Cavities of Bones. Articular cavities are called Cotyloid, cup- like ; Glenoid, shallow ; Trochlear, pulley-like ; Facet, if smooth ; Alveolar, or Alveoli, when socket-like. Non-articular cavities are named fossae, sinuses, aqueducts, foramina, canals, fissures, notches, cells, grooves, depressions, etc. What is the Composition of Bone ? Organic or animal matter, about i^, consisting of gelatin, vessels and fat. Inorganic, or mineral, about ^, con- sisting of phosphate and carbonate of calcium (621^ per cent.), with fluoride of calcium, phosphates of magnesium, sodium, and chloride of sodium (41^ percent.). Heaty^'xW remove the organic matter and leave the inorganic; dilute Nitric or Hydrochloric acid will remove the inorganic, and leave the organic. In old age the inorganic constituents predominate, and the bones are brittle ; in youth the organic predominate, and epiphyseal dislocation is more common than fracture, especially in the long bones of the extremities. (Describe the Structure of Bone. Bone is composed of an outer compact layer, and an inner cellular or spongy structure. It is surrounded, except at the articular cartilages, by a vascular fibrous membrane, the Periosteum, which receives the insertions of all tendons, ligaments, etc. ; and the central cavity of long bones is lined by a similar structure, the Endosteum. A transverse section of bone, examined microscopically, shows — Haversian Canals, diameter -^^^ inch, for the passage of vessels. Canaliculi, diameter x^^^ij inch, radiating from the canals, and connecting them with the lacunae. Lacunce, arranged circularly around the canals, and contain the bone- cells, appearing as irregular dark spaces. Haversian Spaces, connect the canals with the medullary spaces, and divide one Haversian system from another. An Haversian System comprises an Haversian canal with its lamellae, lacunae, and canaliculi. Concentric Lamellce of bone tissue, around the canals. Circumferential Lamellce, are bone layers binding the canals together. Interstitial Lamellce, woven in between the concentric lamellae. 12 ANATOMY. What is the Marrow of Bone ? In young bones a tenacious, transparent fluid, free from fat. In adult bones of a yellow color, consisting of fat in vary- ing proportion and extractive matters. It is found in the medullary canal, the cancellous texture, and the large Haversian spaces. What Vessels are found in Bones ? Arteries, veins, and some say lym- phatics. The Arteries are, — the nutrient, entering at the nutrient foramen; the articular, nourishing the cancellous structure ; and the periosteal, which supply the periosteum and the compact structure. The Veins emerge from the ends, the shaft, and from the nutrient foramen. Describe the process of Ossification. The site of bone is first occupied by a mucoid substance, which becomes temporary cartilage {blastema) in the second month of foetal life. The young bone-cells {osteo-blasts) are then de- posited in the cartilage at certain points, and their deposition and subsequent pressure cause the absorption of the cartilage. In most of the bones of the head and face, ossification is intra-membranous instead of intra-cartilaginous. The first bones in which ossification appears are the clavicle and inferior max- illary (5th to 7th foetal week); the last is the pisiform bone (12th year). Epiphyses ossify after birth and begin uniting to the bone from the age of pu- berty, and in the inverse order to that in which their ossification began, except the lower end of the fibula, which ossifies and is joined to the shaft earlier than its upper end. THE BONES OF THE HEAD. THE FRONTAL BONE. Describe the points on its vertical portion. They are as follows: — Externally, — Frontal Eminences, one on each side of the median line. Depression, marking the site of the frontal suture before obliteration. Superciliary Ridges, behind which are the frontal sinuses. Supraorbital Notches or Foramina, in the supraorbital arches, at about their inner third, for the supraorbital vessels and nerves. Nasal Eminence, at lower end of the frontal depression. External Angular Processes, articulate with the malar bones and form the anterior part of the temporal ridges. Internal Angular Processes, articulate with the lachrymal bones. Nasal Spine and Notch, between the internal angular processes. Internally, — Groove, for superior longitudinal sinus and the falx cerebri. Frontal Crest, for attachment of the falx cerebri. Foramen Ccecum, for a small vein to the longitudinal sinus. Depressions and Elevations, for convolutions of the brain. THE PARIETAL BONES. 13 Between the two tables of the vertical portion in the adult are the — Frontal Sinuses, two spaces at the anterior inferior part of the bone, which are lined with mucous membrane, and open into the middle meatus of the nose by means of an Infundibuhwi for each. Describe its horizontal portion, or orbital plates. They each present the following points, viz. — Fossa, for the lachrymal gland, near the external angular process. Depression, at the nasal margin for the pulley of the superior oblique muscle. Ethmoidal Notch, having the following foramina on its margin. Anterior Ethmoidal Foramen, for anterior ethmoidal vessels and the nasal branch of the ophthalmic nerve. Posterior Ethmoidal Foramen, for posterior ethmoidal vessels. Grooves, on the cranial surface, for branches of the anterior and middle meningeal arteries. Describe its articulations, development, and muscles. The frontal articulates with 12 bones, — the sphenoid, ethmoid, 2 parietal, 2 nasal, 2 supe- rior maxillary, 2 lachrymal, and 2 malar. It is developed by 2 centres in mem- brane, I for each lateral half. The muscles attached to it are 3 pairs, — the temporal, corrugator supercilii, and orbicularis palpebrarum. THE PARIETAL BONES. Describe their general characteristics. They are 2 quadrilaterally-shaped bones situated at the superior and lateral regions of the cranium. The supe- rior border of each joins the other by the Sagittal Suture ; the anterior border joins the frontal bone by part of the Coronal Suture ; the posterior border articulates with the occipital, forming the Lambdoidal Suture ; the inferior border with the sphenoid and temporal bones. Forming the lateral walls of the skull they are named parietal, from paries, a wall. Describe the points on each Parietal bone. Externally the bone is con- vex and presents for examination, — Temporal Ridge, continuous with the same on the frontal bone. Parietal Eminence, the point where ossification commenced. Parietal Foramen, close to the upper border, transmits a vein to the superior longitudinal sinus. Is not constant. Internally, the bone is concave, and marked by — Depressions for the Pacchionian bodies, and for the cerebral convolutions. Furrows, for branches of the middle meningeal artery. Groove, for the lateral sinus, at the posterior inferior angle. Half -groove, along the upper border, for the superior longitudinal sinus of the dura mater. 2 14 ANATOMY. Describe their articulations, development, and muscles. Each parietal bone articulates with 5 bones, — the frontal, occipital, sphenoid, temporal, and opposite parietal. It is developed from I centre in membrane. The only muscle attached to it is the temporal. THE OCCIPITAL BONE. Describe its general features and surfaces. It is trapezoidal in form, curved upon itself, and placed at the posterior and inferior region of the cranium. Externally its surface is convex and presents for examination the following, viz. — External Occipital Protuberance, and Crest, for the attachment of the liga- mentum nuchse. Superior and Inferior Curved Lines, extending outwards on each side of the external occipital crest. Foramen Magnum, transmitting the medulla oblongata and its membranes, the vertebral arteries, and the spinal accessory nerves. Condyles, 2 in number, for articulation with the atlas vertebra. Tubercles, I on each condyle, for the check ligaments. Anterior Condyloid Foramina, 2, for the hypoglossal nerves. Posterior Condyloid Foramina, 2, (often absent) for veins. Jugular Processes, 2, each helping to form the foramen lacerum posterius basis cranii. Internally, the surface is concave, showing — Fossce, 4, for the cerebellar and posterior cerebral lobes. hiternal Occipital Protuberance, where 6 cranial sinuses meet to form the torcular (wine-press) Herophili. Crucial Ridge, the vertical portion for the falx cerebri and falx cerebelli ; the transverse portion for the tentorium cerebelli, having also a groove for the lateral sinus. Groove, for the lateral sinus, and the inferior petrosal sinus, along the postero-Iateral border. Internal Openings of the foramina described above. Describe the Basilar Process of the Occipital. It lies in front of the foramen magnum, articulates with the body of the sphenoid bone, smooth and grooved internally for the medulla oblongata and pons varolii, which lie upon it; rough inferiorly for the attachment of muscles, and presenting the — Pharyngeal Spine, for the attachment of the superior constrictor muscle of the pharynx and its tendinous raphe. Describe its articulations and development. The occipital articulates with 6 bones, — the 2 parietal, 2 temporal, sphenoid, and atlas. It is developed by 4 centres, i each for the posterior part, the basilar process. THE TEMPORAL BONES. 16 and the 2 condyles; its ossification being completed about the 6th year of age. What muscles are attached to the Occipital Bone? There are 12 muscles attached on each side to the following portions, viz. — Superior Curved Line 3 — the occipito-frontalis, trapezius, and sterno-cleido- mastoid. space between the curved lines 2 — the complexus and splenius. Space below the inferior curved line 3 — the obliquus capitis superior, rectus capitis posticus major and minor. Basilar Process 3 — the superior constrictor of the pharynx, rectus capitis anticus major and minor. Jugular Process i — the rectus capitis lateralis. THE TEMPORAL BONES. Describe their situation and divisions. They are situated at the inferior lateral portions of the skull, and contain the organs of hearing. Each bone is divided into 3 parts, the Squamous'^ (scale-like). Mastoid^ (nipple-like), and Petrous c (hard); and it is named from being the site of the first gray hairs [tempus, time). Describe the Squamous Portion. It is a semicircular plate, smooth ex- ternally, and grooved internally for the middle meningeal artery, vi^ith de- pressions for the cerebral convolutions. Externally are seen the — Zygomatic Process, d or zygoma. Fig. i. arising by 3 roots, and extend- ing forwards to articulate with the malar bone. Zygomatic Tubercle e at the base of the process, for the exter- nal lateral ligament of the lower jaw. Eminentia Artictclaris, formed by the anteriofroot of the zygoma. Glenoid Possa,£: between the ante- rior and middle roots of the zygo- ma ; its anterior part receives the condyle of the lower jaw, and is covered with cartilage ; its posterior part lodges the parotid gland. Glasserian Fissure, divides the glenoid fossa; it transmits the laxator tympani muscle, the tympanic artery, and the processus gracilis of the malleus. 16 ANATOMY. Opening of the Canal of Hugier, lies in the angle between the squamous and petrous portions of the bone; and transmits the chorda tympani nerve. Temporal Kidge,/ in part. Describe the Mastoid Portion. It projects like a nipple from the inferior portion of the bone posteriorly. Internally it is grooved for the lateral sinus \^ externally are seen the — Mastoid Foratnen^h. the largest of several foramina, for a vein. Mastoid Process, at the tip, for the sterno-cleido-mastoid, splenius, and trachelo mastoid muscles. Digastric FossaJ for the posterior belly of the digastric muscle. Occipital Groove^ for the occipital artery. Mastoid Cells, in the interior of the mastoid process, open on the posterior vs^all of the middle ear, and are lined with mucous membrane. Describe the Petrous Portion. It is very hard, pyramidal in form, con- tains the internal and middle ear, projects inwards and forwards, and presents a base, an apex, three surfaces, and three borders. On the Base are seen, the — Fig. 2. Meatus Auditorius Externus,i the external opening of the ear. Auditory Process, a bony ring for the external cartilage of the ear. Apex lies internally, at the base of the skull, forming the outer boundary of the foramen lacerum medium, and contains the internal carotid canal. Anterior Surface, presents from within, outwards — Opening of the Carotid Canal, ^'^ for the internal carotid artery and plexus. Depression, for the Gasserian ganglion of the 5th pair of cranial nerves. Biatus Fallopii, for great petrosal nerve and an artery. Foramen, for small petrosal nerve. Ffuinence, over the superior semicircular canal of the ear. Depression, over the tympanum. Posterior Surface, presents — Meatus Auditorius Internus}^ transmits the 7th and 8th pairs of cranial nerves and the auditory artery, and lodges a process of dura mater. Opening of the Aqueductus Vestibuli^^ transmits to the vestibule a small artery and vein, and lodges a process of dura mater. THE TEMPORAL BONES. 17 Inferior surface, presents from within outwards — Rough Quadrilateral Surface,^^ for the origin of the tensor tympani and levator palati muscles. Opening of the Carotid Canal, transmitting the internal carotid artery, and the carotid pleficus of the sympathetic nerve. Aquedudus Cochlea, transmitting a vein from the cochlea. Jugular Fossa, a depression for the sinus of the internal jugular vein, form- ing with the occipital bone the foramen lacerum posterius, which trans- mits that vein and the 8th pair of cranial nerves, etc. i^See page 35.) Foramen for Jacobsoft's Nerve (tympanic branch of the glosso-pharyngeal), in the ridge between the jugular fossa and the carotid canal. Forafuen for Arnold's Nerve (auricular branch of the pneumogastric), in the outer wall of the jugular fossa. Jugular Surface, for articulation with the jugular process of the occipital bone. Vaginal Process,^ ensheathing the root of the styloid process. Styloid Process}^ a long projection for the stylo-pharyngeus, stylo-hyoid, and stylo-glossus muscles (3); and the stylo-hyoid and stylo-maxillary ligaments (2), which are attached thereto. Stylo-mastoid Foramen}^ between the styloid and mastoid processes, for the exit of the facial nerve, and the entrance of the stylo-mastoid artery. Auricular Fissure^ for the exit of Arnold's nerve. In the angle between the petrous and squamous portions, are seen the — Septum Tubes, a lamina separating the following canals. Its inner end pro- jects into the tympanum, and is called the Processus cochleari formis. Opening of the canal for the tensor tympani muscle. Osseous Opening oi \.\\e Eustachian tul)e« inferiorly. The Anterior Border articulates partly with the spinous process of the sphe- noid bone. The Posterior Border assists in forming the jugular foramen, and is grooved for the inferior petrosal sinus. The Superior Border separates the anterior fossa of the skull from the middle fossa ; to it is attached the tentorium cerebelli, and it is grooved for the su- perior petrosal sinus. '^ Describe its articulations and development. The temporal articulates with 5 bones, — the occipital, parietal, sphenoid, malar, and inferior maxillary. It is developed by 4 centres, one each for the squamous portion, styloid pro- cess, and auditory process, and one for the petrous and mastoid portions. Its ossification is completed about the 2d or 3d year. What muscles are attached to it ? There are 14 muscles attached to the following-named portions. To the — Squamous Portion 2, — ^the temporal and masseter. B 2* 18 ANATOMY. Mastoid Portion 6, — the occipito-frontalis, sterno-cleido-mastoid, splenius capitis, trachelo-mastoid, digastric, and retrahens aurem. Petrous Portion 3, — the tensor tympani, levator palati, and stapedius. Styloid Process 3, — the stylo-glossus, stylo-hyoid, and stylo-pharyngeus. THE SPHENOID BONE. Describe its Position and Form. Wedged in between the bones of the skull anteriorly, it resembles a bat with out-stretched wings. It is named from the Greek word a^/jf sphane, a wedge, enters into the formation of 5 cavities, 4 fossse, 3 fissures, and has — A Body. 2 Pterygoid Processes, 12 Foramina. 2 Greater Wings.^ 2 Styloid Processes. 12 pairs of Muscles. 2 Lesser Wings. ^ 6 Clinoid Processes. 12 Articulations. 10 Points of Ossification. 3 Lesser Processes. Describe the Body of the Sphenoid Bone. Placed in the median line, cuboid in shape, it presents on its Upper Surface from before backwards, the following points, viz. — Y^^ - Ethmoidal Spine^ ar- ticulating with the ethmoid bone. A Smooth Surface, grooved for the ol- factory nerves. Optic Groove, support- ing the commissure of the optic nerves. Olivary Process, an olive - shaped emi- nence behind the optic groove. Middle Clinoid Processes, bounding the sella Turcica in front. Sella Turcica^^ (Turkish saddle), lodges the pituitary body and the circular sinus of the brain. Dorsum Sella (back of the saddle), grooved for the 6th nerves. Posterior Clinoid Processes,^ for attachment of the tentorium cerebelli. Grooves, laterally, for the cavernous sinus and internal carotid artery. The posterior surface is rough and quadrilateral '}^ it articulates with the basilar process of the occipital bone, ossification being completed from the 1 8th to the 20th year. THE SPHENOID BONE. 19 The anterior surface is nearly vertical, and presents the — Lamella, in the median line, articulating with the perpendicular plate of the ethmoid bone, and forming part of the nasal septum. Opening of the Sphenoidal Sinuses,^ or cavities in the body of the bone which exist in adults, not in children. Sphenoidal Tui'binated Bones (pyramids of Wistar), which partially close the sinuses, and articulate with the ethmoid and palate bones. The inferior surface helps to form the nasal fossae, and presents the — Rest mm yd which articulates with a groove on the vomer. Vaginal Processes, I on each side of the rostrum. Piery go-palatine Grooves, which, with the sphenoidal processes of the palate bones, form the pterygo-palatine canals, for the transmission of the pterygo- palatine arteries and nerves. Describe the Greater Wings of the Sphenoid. Each vising, on its superior surface, presents the following points, viz. — Foramen Rotun- dum^ for the superior max- illary division of the 5th, Foraj?ien Ovale? for the inferior maxillary divi- sion of the 5th n erve , the small petrosal nerve, and the small men- ingeal artery. Foramen Vesalii, transmitting a small vein. Foramen Spinosum}^ transmitting the middle meningeal artery. The anterior surface assists in forming the external wall of the orbit, the spheno-maxillary and sphenoidal fissures. It articulates with the frontal and malar bones, and presents a — Notch, transmitting a branch of the ophthalmic arteiy. Spine, for part of the lower head of the external rectus muscle. External Orbital Foramina, transmitting arterial branches. The external surface presents the following points, — Pterygoid Ridge, dividing the temporal fossa from the zygomatic. Spine of the Sphenoid}^ to which are attached the internal laternal ligament of the lower jaw, and the laxator tympani muscle. 20 ANATOMY, The circumference is partly serrated for articulation with the temporal and frontal bones, and partly smooth for the anterior margin of the foramen lacerum medium and the inferior margin of the sphenoidal fissure, which margins it assists in forming. Describe the Lesser Wings^of the Sphenoid. Called also the Pro- cesses of Ingrassias,« they terminate internally in the Anterior C linoi J Pro- cesses ;^ iheir dLiiiQuox horHtxs articulate with the orbital plate of the frontal bone, the posterior are free, dividing the anterior cerebral fossa from the middle. Connected intimately with each of these wings are the — Optic Foramen,^ formed by the separation of its roots, and transmitting the optic nerve and the ophthalmic artery. Sphenoidal Fissure^ or foramen lacerum anterius,^ is bounded above by the lesser wing, below by the greater wing, and transmits the 3d, 4th, ophthalmic division of the 5th, and the 6th nerves, the ophthalmic vein, branches of the lachrymal and middle meningeal arteries, some filaments of the sympathetic nerve, and a process of the dura mater. Describe the Pterygoid Processes of the Sphenoid. The wing-like processes descend, i on each side of the body, and divide each into 2 thin, bony plates,^''« connected together anteriorly, and presenting — Pterygoid Fossa, between the plates posteriorly, the origin of the external pterygoid muscle. Scaphoid Fossa, at the base of the internal plate, serves as the origin of the tensor palati muscle. Hamular Process, a hook-like projection at the apex of the internal plate, around which plays the tendon of the tensor palati muscle. Vidian Canal^^ at the root of the process, for the Vidian nerve and vessels. Triangular Notch, at the end of the process, articulates with the pterygoid process of the palate bone. With what bones does the Sphenoid articulate? With 12, the other 7 bones of the cranium and 5 of the face, — the vomer, 2 malar, and 2 palate. How is the Sphenoid developed ? By 10 centres, as follows. — 2 for the greater wings, 2 for the lesser wings and anterior part of the body, 2 for the posterior part of the body, 2 for the pterygoid processes, and 2 for the sphe- noidal turbinated processes. Ossification begins in the 2d fcetal month, and is completed about the iith year, by the union of the turbinated processes with the body. What muscles are attached to the Sphenoid bone? There are 12 pairs, as follows, viz. — Orbital muscles, 6 — all except the inferior oblique of the eye. THE ETHMOID BONE. 21 Muscles of Mastication, 3 — the temporal, external and internal pterygoids. Superior constrictor, tensor palati, and laxator tympani, 3. THE ETHMOID BONE. Describe its General Characteristics. It is a spongy, light bone, de- pending from the ethmoidal notch of tlie frontal, and from between its orbital plates. It consists of a body and 2 lateral masses, and is named from the Greek word ^^//oc, aythvios, a sieve. What are the Points on its Body ? The body<5 consists of a horizontal or cribriform plate, and a perpendicular plate, and presents the — Crista Galli,c or cock's comb, projecting up- wards, for the attachment of the anterior end of the falx cerebri. Cribriform PlatCyd on each side of the crista galli. It is concave for the olfactory bulbs,z and perforated for the transmission of the olfactory nerves, the nasal branch of the ophthalmic nerve, and numerous small vessels. Perpendicular Plate,"' assists to form the nasal septum, is usually inclined to one side, grooved for filaments of the olfactory nerves, and has attached to it the cartilage of the nose. Describe the Lateral Masses. They consist of a number of cellular cavities, and each one presents the following points, viz. — Ethmoid Cells, the anterior opening by the infundibulum into the middle meatus of the nose, the posterior into the superior meatus. Os Planum,^ or orbital plate, helps to form the inner wall of the orbit, and is notched superiorly to form with the frontal bone the two ethmoidal foramina. Uncifor7n Process, descends to articulate with the inferior turbinated, and forms part of the inner wall of the antrum. Superior Turbinated Process,/ cvlvwqs downwards and outwards. Middle Turbinated Process, g is larger and more curved than the superior. These processes bound the superior meatus of the nose, and are often called the superior and middle turbinated bones. Describe its articulations, development, and muscles. The ethmoid articulates with 13 bones, viz. — all those of the face except the malar, and the frontal and sphenoid of the cranium. It is developed by 3 centres, I for each lateral mass, and j for the body, ossification being completed about the 6th year. There are no muscles attached to it. 22 ANATOMY. THE NASAL BONES. Describe them. They are 2 small bones forming the bridge of the nose by articulation with each other in the median line. They are convex exter- nally, concave internally, and grooved for the external branch of the nasal nerve and for small arteries. They each articulate with 4 bones, — the frontal, ethmoid, superior maxillary, and the opposite nasal ; are each developed by one centre of ossification, and have no muscles attached to them. THE SUPERIOR MAXILLARY BONES. Describe them. They are 2 hollow bones, together forming the upper jaw. Each bone consists of 4 processes, and a body which possesses a large cavity, the antrum of Highmore. Describe the Antrum of Highmore. It is a pyramidal cavity in the body of the bone, and opens into the middle meatus of the nose by an aperture which is very small in the recent subject, admitting only a small probe. Its walls are veiy thin, and are covered internally by a mucous membrane. It presents the — Aperture, partly closed by the articulation of the unciform process of the ethmoid with the ethmoidal process of the inferior turbinated ; and that of the maxillary process of the palate with a fissure in the superior maxil- lary; also by the maxillary process of the inferior turbinated which hooks over the lower edge of the orifice. Posterior Dental Canals, on the posterior wall of the cavity. Processes in its floor, formed by the alveoli of the ist and 2d molar teeth, the roots of which occasionally perforate it. What other points are presented by the body? The body has 4 surfaces, the facial externally, the zygomatic posteriorly, the orbital superiorly, and an internal surface forming part of the outer wall of the nose and the cavity of the mouth. It presents the — Incisive Possa,^ on the facial surface, above the incisor sockets, for the origin of the depressor alse nasi muscle. Canine Possa} more externally, for the levator anguli oris. Infraorbital Poramen^ above the ca- nine fossa, transmitting the infraor- bital vessels and nerve, from the in- fraorbital canal in the orbital surface of the bone. Fig. 6. THE SUPERIOR MAXILLARY BONES. 23 Maxillary Tuberosity, articulates with the tuberosity of the palate bone. Turbinated Crests, inferior and superior, on the inner surface, bounding horizontal grooves which correspond to the meati of the nose. Vertical Grooves, on the inner surface, one assisting to form the nasal duct, the other to form the posterior palatine canal. Rough Su7-face, for articulation with the palate bone. Orbital Surface, articulating with the lachiymal, ethmoid, and palate bones interiorly, partly bounding the spheno-maxillary fissure exteriorly, and forming the lower margin of the orbit anteriorly. Infraorbital Groove, along the orbital surface, ending in the infraorbital canal and foramen. (See ante.) Depression, for the origin of the inferior oblique muscle of the eye. Describe its Processes. They number 4, as follows. — Malar Process,* is triangular, looks outwards from the body, and is rough for articulation with the malar bone. Nasal Process,^ is thin anteriorly and serrated superiorly for articulation with the nasal bone; posteriorly it is smooth and articulates with the lachiy- mal. It presents the — Turbinated Crests, superior and inferior, the former articulating with the middle turbinated process of the ethmoid bone. Outer Surface, gives origin to the orbicularis palpebrarum and levator labii superioris alaeque nasi muscles, and the tendo oculi. Groove on the posterior border, helping to form the nasal duct. Alveolar Process, forms the curved line of the teeth, and presents — Alveoli, or sockets, for 8 teeth in the adult, 5 in the child. Palate Process, forms part of the floor of the nasal cavity, and the roof of the mouth. It articulates with the vomer, the palate bone, and with its fellow process, and presents the — Incisive Foramen, or foramen of Stenson, leading into the anterior palatine canal, for the anterior palatine vessels. Foramina of Scarpa, 2, transmitting the naso-palatine nerves. Groove on the under surface, for the protection of the vessels and nerves. Orifice of the posterior palatine canal, at the posterior end. Nasal Crest, at the articulation of the two processes with the vomer. Anterior A^asal Spine, the anterior extremity of the nasal crest. Describe its articulations and development. The superior maxillary articulates with 9 bones, — the fiontal,^^ ethmoid,^* vomer,^^ nasal,^^ lachrymal, malar, palate, inferior turbinated, and opposite superior maxillary. ^<> It is de- veloped probably by 4 centres, — i for the facial and nasal parts, another for the orbital and malar, a 3d for the incisive, and a 4th for the palate portion. 24 ANATOMY. V7hat muscles are attached to it? There are ii, viz. — the orbicularis palpebrarum, and levator anguli oris alaeque nasi, 2, to the nasal process ; — the levator labii superioris, levator anguli oris, compressor naris, depressor alae nasi, orbicularis oris, and inferior oblique of the eye, 6, to the body ; — the buc- cinator, I, to the alveolar process ; — the masseter, i, to the malar process ; — and the external pterygoid, i, to the tuberosity. THE LACHRYMAL BONES. Describe them. They are 2 small quadrilateral-shaped bones, situated in the anterior part of the inner wall of the orbit. Each presents a — Groove, on the external surface, forming part of the nasal duct. Ridge, also externally, for attachment of the tensor tarsi muscle. Furrow, internally, corresponding to the ridge on the external surface. Hai7iular Process, projecting downwards to articulate with the lachrymal process of the inferior turbinated bone. Internal Surface, closes the anterior ethmoidal cells. Describe its articulations, development, and muscles. The lachry- mal articulates with 4 bones, — the frontal, ethmoid, superior maxillary, and inferior turbinated. It is developed irova i centre, and has but i muscle attached to it, the tensor tarsi, or Horner's muscle. THE MALAR BONES. Describe them. The cheek bones are situated at the outer and upper part of the face, aiding to form the cavities of the orbits and the temporal and zyg- omatic fossK. Each presents an — External Surface, convex, for attachment of the zygomatic muscles. Foramen, externally, for the malar branch of the temporo-malar nerve. Foramen,<: internally, for the temporal branch of the same nerve. Frontal Process,'^ articulates with the external angular process of the frontal. Orbital Process,^ projecting backwards, forming part of the floor and outer wall of the orbit, as well as part of the temporal fossa, and bounds the spheno-maxillary fissure anteriorly. Zygomatic Process,/ projecting backwards to articulate with the zygomatic process of the temporal bone by a serrated edge. Upper Border, b forms the outer and inferior margin of the orbit. Lower Border, thick and rough, for the origin of the nias- 1^ seter muscle. Anterior Border,'^ articulates with the superior maxillary bone. Posterior Border, terminates the temporal fossa below. THE PALATE BONES. 25 Name its articulations, centres, and muscles. The malar articulates with 4 bones, — the frontal, sphenoid, temporal, and superior maxillary. It is developed by one centre of ossification, and has 5 muscles attached to it, — the levator labii superioris, zygomaticus major and minor, masseter and temporal. THE PALATE BONES. Describe them. They are 2 irregularly-shaped bones, situated poste- riorly in the nares. Each bone assists in forming the floor and outer wall of the nose, the roof of the mouth, the floor of the orbit, the inner wall of the antrum, the zygomatic, spheno-maxillary, and pterygoid fossae, and presents the following points. — Horizontal plate, '^ completes the nasal floor and hard palate ; has a — Ridge, on the inferior surface, for the tensor palati aponeurosis. Groove, assisting to form the posterior palatine canal. Foramina, transmitting the anterior and posterior Fig. 8. palatine nerves. Anterior Border^ is serrated, and joins the superior maxillary bones. Posterior Border, is free and concave, for the attach- ment of the soft palate. Inner Border, d is thick, and articulates with its fel- low, forming a groove for the reception of the vomer. Its posterior extremity is the — Posterior A^asal Spine, for the origin of the azygos uvulae muscle. Vertical plate/ a broad and thick lamella, presents the following : — Superior Turbinated Crest, on the inner surface. Below it is the — Inferior Turbinated Crest, s: dividing the middle meatus of the nose from the inferior, and articulating with the inferior turbinated bone. Posterior Border, articulates with the pterygoid process of the sphenoid. Groove, on the external surface, helping to form the posterior palatine canal. Tivo Smooth Surfaces, externally, one forming the inner wall of the zygo- matic fossa; the other, part of the inner wall of the antrum. Two Rough Surfaces, also externally, one for articulation with the superior maxillary ; the other with the pterygoid process of the sphenoid. Deep N^otch, which by articulation with the sphenoid bone, forms the spheno-palatine forame7i,h for the spheno-palatine nerves. Pterygoid process,^ is wedged into the notch between the plates of the ptery- goid process of the sphenoid, with which it articulates laterally. In it are the — Palatine Foramina, for the external and posterior palatine nerves. Posterior Surface, aids in forming the pterygoid fossa. 3 26 ANATOMY. Orbital process,^ triangular in shape, large and hollow. It has — l^hree Articular Surfaces, for the sup. maxillary, sphenoid, and ethmoid. Two Free Surfaces, the orbital forming part of the floor of the orbit, the external aiding to form the zygomatic fossa. Rounded Border, forms a part of the spheno-maxillary fissure. Sphenoidal process,/ projects backwards, articulates superiorly with the body of the sphenoid, and externally with the pterygoid process of the sphenoid. On its upper surface is a — Groove, which assists in forming the pterygo-palatine canal. Inner Suiface, forms part of the outer wall of the nasal fossa. Describe its articulations, development, and muscles. The palate articulates with 6 bones, — the sphenoid, ethmoid, vomer, superior maxillary, inferior turbinated, and its fellow palate bone. It is developed by one centre at the junction of the two plates. There are 5 muscles attached to it, — the azygos uvulce, internal and external pterygoids, superior constrictor, and tensor palati. THE INFERIOR TURBINATED BONES. Describe them. They are 2 thin curved osseous plates situated in the nasal fossae, their convex surfaces presenting inwardly. Each bone is attached above to the inferior turbinated crests of the superior maxillaiy and palate bones, and presents the following, viz. — Lachrymal Process,^ aiding to form the nasal duct, by articulation with the lachrymal and superior maxillary bones. Ethmoidal Process,^ articulating with the unci- form process of the ethmoid, thus helping to partially close the aperture of the antrum. Maxillary Process,^ also helps to partially close the aperture of the antrum, by hooking^ over the lower edge of that orifice. Free Border,^ below, coming to about ^2 ii^ch above the floor of the nose. Name its articulations, centres, and muscles. The inferior turbinated articulates with 4 bones, the ethmoid, lachrymal, palate, and superior max- illary. It is developed by one centre, and has no muscles attached to it. THE VOMER. Describe it. The vomer (plough-share) forms the postero-inferior pari Fig. 10. of the nasal septum, but is usually bent to one side. Its — ^ Superior Border} '^ has a groove and two ala; or wings, for articulation with the rostrum — JT^ — i^ ^^^ vaginal processes of the sphenoid bone. THE INFERIOR MAXILLARY BONE. 27 Anterior Border^ is grooved for the ethmoidal plate and the nasal cartilage. Inferior Border,^ the longest, articulates with the nasal crest of the superior maxillary and palate bones. Posterior Border^ is free and presents towards the pharynx. _^ Naso-palatine Grooves, laterally, for the naso-palatine nerves. Furrows, on the lateral surfaces,^ for vessels and nerve-filaments. Name its articulations, centres, and muscles. The vomer articulates with 6 bones, — the sphenoid, ethmoid, 2 superior maxillary, and 2 palate bones. It is developed by one centre. Which appears about the 6th foetal week in cartilage between two laminae which coalesce after puberty. It has no muscles attached to it. THE INFERIOR MAXILLARY BONE. Describe its general characteristics. The inferior maxillary bone forms the lower jaw, receives the inferior teeth, and is the second bone of the body in which ossification appears, the clavicle being the first. It consists of a body and two rami. Describe the Body of the bone. It is shaped somewhat like a horse- shoe, and presents for examination the following: viz. — Alveolar Portion, above the oblique line, containing on its upper border alveoli for 16 teeth in the adult, for lo in the child. Symphysis, a vertical ridge on the median line, marking the junction of the two symmetrical portions of which the bone originally consisted. Mental Process, a prominent triangular eminence, forming the chin. Externally on each side from the symphysis backwards, are the — Incisive Fossa, above the chin, for the origin of the levator menti. Mental Foramen, below the 2d bicuspid alveolus, transmitting the mental artery and nerve. External Oblique Line, for the origins of the depressor labii inferioris and depressor anguli oris muscles from its anterior half Groove, near the angle, for the facial artery. Internally, on each side from the median depression backwards, are the — Genial Tubercles, the superior for the genio-hyo-glossus muscle ; the inferior for the genio hyoid. Mylo-hyoid Ridge, obliquely backwards, for the mylohyoid muscle. Fig. II. 28 ANATOMY. Sublingual Fossa, near the genial tubercles, for the sublingual gland. Fossa, below the sublingual, for the anterior belly of the digastric muscle. Submaxillary Fossa, below the ridge, for the submaxillary gland. Describe the Rami of the Inferior Maxillary. The rami, or ascending portions of the bone, are 2 in number, and each present the — Coronoid Process, anteriorly, for the insertion of the temporal muscle. Condyloid Process, posteriorly. Its condyle articulates with the glenoid fossa of the temporal bone, its neck receives the insertion of the external pterygoid muscle, its tubercle has attached to it the external lateral liga- ment of the lower jaw. Sigmoid Notch, a deep depression separating the above-named processes from each other, and crossed by the masseteric vessels and nerve. Groove, on the coronoid process internally, and prolonged downwards upon the body, for the attachment of the buccinator muscle. Ridges, on the external surface, for the insertion of the masseter. Spine, a projection on the internal surface, for the attachment of the internal lateral ligament of the jaw. Inferior Dental Canal, opening behind the spine, lies within the ramus and body of the bone for the inferior dental vessels and nerve. It communi- cates with each alveolus and with the mental foramen. Mylohyoid Groove, below the spine, for the mylo-hyoid vessels and nerve. Rough Surface, behind the groove, for the internal pteiygoid muscle. Angle of the Jaw, at the junction of the posterior body of the ramus with the inferior border of the body, for the insertion of the masseter and in- ternal pterygoid muscles, and the stylo-maxillary ligament. Describe the Articulations and Development of the Inferior Max- illary bone. It articulates with one pair of bones, — the temporal. It is the earliest formed bone in the body except the clavicle, and is probably developed by 2 centres, one for each lateral half, the two halves coalescing at the symphysis about the ist year of age. In adult life the ramus arises almost vertically from the body, and the dental canal lies about the middle of the body. In old age the ramus extends obliquely backwards, the angle becoming very obtuse ; and the alveolar portion being absorbed, the dental canal is near the superior border. What Muscles are attached to the Inferior Maxillary? They number 15 pairs, — the masseter, internal and external pterygoids and temporal, 4, to the ramus ; — the genio-hyo-glossus, genio-hyoid, mylo-hyoid, digastric, and superior constrictor, 5, to the internal surface oi the body ; — the depressor labii inferioris, depressor anguli oris, levator menti, orbicularis oris, platysma myoides, and buccinator, 6, to the external surface of the body. THE ORBITS. 29 Fig 12 THE ORBITS. Describe the Orbital Cavities. The orbits are 2 conoidal cavities, situated between the forehead and the face, their bases outwards, their apices pointing backwards, the lines of axial prolongation meeting at the sella turcica of the sphenoid bone. They contain the organs of vision with their appendages, and are each formed by 7 bones, — the frontal,^ ethmoid,^ sphe- noid,^ * s lachryma],^ superior maxillary,^ palate,® and malar,^ of which the first three are common to both orbits. Each orbit communicates with i cavity and 4 fossae, as follows, viz. — Cavity of the cranium, by the optic foramen ^^ and sphenoidal fissure. •*' Fossa; (4) — the nasal, temporal, zygomatic, and spheno maxillary, — by the nasal duct^^ and the spheno-maxillary fissure.^' What Foramina communicate with each orbit ? Nine, — the optic foramen,^^ sphenoidal fissure,^^ anterior ^^ and posterior ■^2 ethmoidal foramina, supraorbital,^* infraorbital ,^5 and malar foramina,'^ the nasal duct,'^ and the spheno-maxillary fissure.^-^ Describe the Roof of the Orbit. Formed by the orbital plate of the frontal bone anteriorly,^ and the lesser wing of the sphenoid* pos- teriorly, it is concave, and presents the— Lachrymal Fossa,^'' at its outer angle,for the lachrymal gland. Depression}^ at the inner angle, for the pulley of the superior oblique. Describe the Floor of the Orbit. Formed by the orbital surface of the superior maxillary bone,'' and the orbital process of the malar 9 and palate bones,® it is nearly flat and presents the — Palato-maxillary Suture poste- riorly. Infraorbital Canal, and a De- pression for the superior oblique muscle of the eye, anteriorly. Infraorbital Groove}^ poste- riorly. 30 ANATOMY. Describe the Inner Wall of the Orbit. Formed by the nasal process of the superior maxillaiy bone,^^ the lachrymal ,« the os planum of the ethmoicl,^ and the body of the sphenoid,3 it presents — A GrooT'e, for the lachrymal sac, and the Lachrymal Crest, anteriorly. 2 Sutures, — the ethmo- lachrymal, and the elhmo-sphenoidal. Describe the Outer Wall of the Orbit. Formed by the orbital pro- cess of the malar bone,^ and the greater wing of the sphenoid,^ it presents the Orijices^^ of the malar canals, and the Spheno-nialar Suture. Describe the Angles of the Orbit. They present the following points. In the superior external angle. Sphenoidal Fissure}^ or foramen lacerum anterius, transmits the 3d, 4th, ophthalmic division of the 5th, and the 6th nerves, the ophthalmic vein, branches of the lachrymal and middle meningeal arteries, filaments of the sympathetic nerve, and a process of the dura mater. Articulations, — the fronto-malar, and fronto-sphenoidal. In the superior internal angle. Suture, — the lachrymo-ethmo-frontal, in which are the following foramina. Anterior Ethmoidal Foramen,"^^ transmitting the anterior ethmoidal artery and the nasal nerve. Posterior Ethmoidal Foramen^ transmitting the posterior ethmoidal artery and vein. In the inferior external angle. Spheno-maxillary Fissure^^ (described under the Zygomatic P'ossa). In the inferior internal angle. A Suture, the ethmo-maxillo-palato-lachrymal. What other points are connected with the Orbit? Two, the supra- orbital notch, and the optic foramen, as follows, viz, — Supraorbital A^otch or Foramen}^ at the junction of the inner and middle thirds of the upper circumference, transmitting the supraorbital artery, veins, and nerve. A line prolonged from this notch through the interval between the bicuspid teeth of either jaw, will cross both the infraorbital and mental foramina, and the canine fossa of the superior maxillary bone. Optic Foramen}"^ at the apex, is formed by the 2 roots of the lesser wing of the sphenoid, and transmits the optic nerve and the ophthalmic artery. From around its margin arises a tendinous ring, the common origin of the 4 recti muscles of the eye. What Muscles arise within the Orbit ? The 4 recti and 2 oblique of the eye, the levator palpebral, and the tensor tarsi (8 in all). THE FOSS^. 31 THE FOSSiE. Describe the Nasal Fossae. Together they form the cavity of the nose, being separated from each other by the Septmn Nasi}^ They open in front by the anterior nares, behind by the posterior nares ; and extend from the palate processes of the superior maxillary and palate bones,^^ upwards to the l\ise of the cranium. They are formed by 14 bones, — the ethmoid, sphenoid, frontal, vomer, 2 nasal, 2 superior maxillary, 2 lachrymal, 2 palate, and 2 inferior turbinated. Describe the Septum Nasi.^^ It forms the inner wall of each nasal fossa, and is formed chiefly by the perpendicular plate of the ethmoid bone, the vomer, and the triangular cartilage of the septum ; to a less extent by 5 other bones, — ^the rostrum of the sphenoid, the nasal spine of the frontal, and the crests of the nasal, palate, and superior maxillary bones. Describe the points presented by each Nasal Fossa. They are — On the roof. Openings, posteriorly, into the sphenoidal sinuses. Olfactory Foramina, and the Nasal Slity in the cribriform plate of the eth- moid bone. On the floor. Orifice, of the anterior palatine canal. Suture, between the bones forming the hard palate. Nasal Spines, anterior and posterior, and the Ridge connecting them. On the outer wall, from above downwards. Superior Turbinated process of Fig. 13. the ethmoid. Superior Meatus of the nose, into which open 3 orifices, — those of the posterior ethmoidal and the sphenoidal sinuses, and the spheno-palatine foramen. Middle Turbinated"^ process of the ethmoid. Middle Meatus of the nose, into which open 2 orifices, — those of the antrum^* and infundib- ulum, — the latter draining the anterior ethmoidal cells,^ and the frontal sinus. Inferior Turbinated Bone}^ below which is the— 32 ANATOMY. Inferior Meatus of the nose, the largest ; into it open 2 orifices, — those of the lachrymal, and anterior palatine canals. To these may be added the anterior and posterior nares. Describe the Temporal Fossa. Situated on each side of the cranium, it is shallow above and behind, but deep in front and below ; and is formed by parts of 5 bones, — the frontal, sphenoid, temporal, parietal, and malar. It is bounded above and behind by the temporal ridge, in front by the malar frontal and sphenoid bones, and below by the zygoma and the pterygoid ridge on the greater wing of the sphenoid. It is traversed by 6 sutures, — the spheno-malar, spheno-frontal, spheno-parietal, spheno-temporal, fronto-parietal, and teniporo-parietal. It opens below into the zygomatic fossa ; and lodges the temporal muscle, and the deep temporal vessels. Describe the Zygomatic Fossa. Extending downwards from the tem- poral fossa, it is thus bounded, — In front, by the tuberosity of the superior maxillary bone. Externally, by the zygoma, and the ramus of the inf. maxillaiy. Internally, by the external plate of the pterygoid process. Above, by the temporal fossa, the squamous portion of the temporal bone, and the greater wing of the sphenoid. Beloiv, by the alveolar border of the inferior maxillary bone. What Fissures open into the Zygomatic Fossa. Two, the — Spheno-maxillary Fisstire, between the greater wing of the sphenoid externally, and the superior maxillary and palate bones internally. It connects the orbit with the zygomatic, temporal, and spheno-maxillary fossae ; and trans- mits the infraorbital artery, the superior maxillary nerve and its orbital branches, and the ascending branches of Meckel's ganglion. Ptery go-maxillary Fissure, between the tuberosity of the superior maxillary bone and the pterygoid process of the sphenoid. It transmits branches of the internal maxillary artery, and connects the zygomatic fossa with the spheno-maxillary. Describe the Spheno-Maxillary Fossa. It is a triangular cavity be- tween the pterygoid process of the sphenoid bone and the tuberosity of the superior maxillary, and is situated at the junction of the spheno-maxillary, pterygo-maxillary, and sphenoidal fissures. Into it open — J Fossce, — the orbital, zygomatic, and nasal. 2 Cavities, — the cranial, and buccal. ^ Foramina, — the Vidian and pterygo-palatine canals, and the foramen rotundum, posteriorly; the spheno-palatine foramen on the inner wall; and the posterior palatine canal inferiorlyj — occasionally also the acces- sory palatine canals. THE SUTURES AND FONTANELLKS. 33 THE SUTURES AND FONTANELLES. Name the Sutures of the skull. There are 17. At the Vertex of the skull are 5, the — Sagittal, or interparietal. 2 Coronal, or fronto-parietal. 2 Lambdoid, or occipito-parietal. At the Sides of the skull are 4, the — 2 Spheno-parietal. 2 Temporo-parietal. At the Base of the skull are 5, the — 2 Temporo-occipital. Basilar, in the central line of the base. 2 Temporo-sphenoidal, In the Mesial line, besides the sagittal and basilar, are 3, the — vSpheno-ethmoidal, Spheno-frontal. Ethmo- frontal. Describe the Facial Suttires. The most important are the following, but the sutures of the face are very numerous. Zygomatic Suture, at the temporo-malar articulation. Transverse Suture, extending from one external angular process of the frontal bone across to the other, and connecting that bone with the malar, sphenoid, ethmoid, lachrymal, superior maxillary, and nasal bones. Symphysis of the Chin, the site of a foetal suture. How are the Sutures formed ? By dentations of the external tables in- terdigitating with each other, the adjacent edges of the internal tables lying in unjoined proximity. The sutures are not formed until a long time after the formation of the skull, probably to permit of the marginal growth of the bones. What are the Fontanelles ? They are 6 membranous intervals in the in- fant's skull, corresponding in situation with the angles of the two parietal bones. They are as follows, viz. — Anterior, at the junction of the sagittal and coronal intervals. Posteriory at the junction of the sagittal and lambdoid intervals. Lateral Fontanelles, 4, two at the anterior inferior angles, and two at the posterior inferior angles of the parietal bones. Describe the Wormian Eones. They are supernumerary small pieces of bone, irregularly shaped, and developed by special centres in unclosed por- tions of the cranial sutures and fontanelles, being more frequent in the lamb- doid suture. They are also called "ossa triqueta" from their triangular form. Describe the Hjroid Bone. It is shaped like a horse-shoe, has no articu- lation with the skeleton, but supports the tongue. It consists of a Body^ two greater, and two lesser Cornua or horns. On the body is a Crucial Ridge, with a Tubercle at the centre. It is developed h-^ 5 centres, — one for the body and one for each horn. Attached to it are lo muscles, 3 ligaments, and I membrane, as follows, viz. — c • ANATOMY. To the Body, — the genio-, mylo-, stylo-, slcrno-, thyro-, omo-hyoid, the genio- hyoglossus, and the hyo-glossus muscles; also the pulley of the digas- tric, the hyo-epiglottic ligament, and the thyro-hyoid membrane. To the Greater Cornu, — the hyo-glossus, middle constrictor muscles, and part of the thyro-hyoid ; — also the thyro-hyoid ligament. To the Lesser Cormt, — the stylo-hyoid ligament. TABLE OF THE FORAMINA AT THE BASE OF THE SKULL, with the various structures transmitted by each. Anterior Fossa contains i single foramen and 5 in pairs, viz. — Foramen Ccecutu, — lodges a fold of dura mater, and transmits a vein to the longitudinal sinus from the nose, sometimes one from the frontal sinus. Ethmoidal Fissure, — the nasal nerve, and the anterior ethmoidal artery. Olfactory, — olfactory nerves, and nasal branches of the ethmoidal arteries. Anterior Ethmoidal, — anterior ethmoidal artery and the nasal nerve. Posterior Ethmoidal, — posterior ethmoidal artery and vein. Optic Foramen, — optic nerve and ophthalmic artery. Middle Fossae contain 8 pairs, viz. — Foramen Lacerum Anterius, or Sphenoidal Fissure, P — the 3d, 4th, oph- thalmic division of the 5th. and the 6th cranial nerves, and filaments of Yic^ 1^. the sympathetic ; ophthalmic vein, a branch of the lachrymal artery, orbital branches of the middle meningeal artery, and a process of dura mater. Foramen Rottindum, — superior max- illary division of the 5th cranial nerve. Foramen Vesalii, — a small vein. This foramen is often absent. Foramen Ovale, t — inferior max- illary division of the 5th nerve, lesser petrosal nerve, and the small meningeal branch of the internal maxillary artery. Foramen Spinosum, '« — middle men- ingeal artery, meningeal veins, and sympathetic filaments from the cavernous plexus. THE CRANIAL FORAMINA. 36 Foramen Locerum Mediuni,q — internal carotid artery, carotid plexus, large petrosal nerve, and a branch from the ascending pharyngeal artery. Small Foramen, — lesser petrosal nerve. Hiatus Fallopii, — large petrosal nerve, branch of middle meningeal artery. Posterior Fossa contains 6 pairs and i single, viz. — Aleatus Auditorhis Iniernits, — facial and auditory nerves, auditory artery. Aqueducttis Vestibuli, — small artery and vein, process of dura mater. Foramen Lacerum Fosierius,^ — glosso-phaiyngeal, pneumo- gastric, and spinal accessory nerves, internal jugular vein, meningeal branches of the ascend- ing phaiyngeal and occipital arteries. Mastoid Foramen (often absent), — small vein, occasionally the mastoid artery. Anterior Condyloid Foramen, — hypoglossal nerve, meningeal branch from the ascending pharyngeal artery. Posterior Cojidyloid Forameni» (often absent), posterior condyloid vein. Foramen ATagnum,^^ — medulla ol)longata and its membranes, the vertebral arteries, and the spinal accessory nerves. Externally, at the base of the skull are lo pairs, viz. — Opening of the Eustachian Tube, — air to the middle ear. Opening of Tensor Ty?npani Canal, — the tensor tympani muscle. Orifice of the Vidian Canal, — the Vidian nerve, and vessels. Glasserian Fissure,n — laxator tympani muscle, tympanic artery, processus gracilis of the malleus. Orifice of the Canal of Tlugier, — chorda tympani nerve. Forajjieti for Jacobson's Nej-ve, — tympanic branch of glosso-pharyngeal. Foravien for Arnold' s Nerve, — auricular branch of pneumogastric. Opening of the Aqueductus Cochlea, — vein to the cochlea. Stylo-mastoid Foramen, t — facial nerve, stylo-mastoid artery. Auricular Fissure, — exit of Arnold's nerve. Face presents 3 pairs, viz. — Supraorbital Foramen or Notch, — supraorbital artery, vein, and nerve. Infraorbital Foramen, — infraorbital artery and nerve. Mental Foramen, — mental artery and nerve. Palate presents, on each side at least 6 pairs, viz. — Incisive Foramina^ (one or two), — nerves and vessels to the incisor teeth. 2 Anterior Palatine, — anterior palatine vessels, nasopalatine nerves. Posterior Palatine, — posterior palatine vessels, anterior palatine nerve. Accessoiy Palatine Foramina (one or two), — posterior palatine nerves. Pte7-ygo-palatine Foramen, — pterygo-palatine vessels. Fig. is. THE BONES OF THE TRUNK. THE VERTEBRAL COLUMN. What Characteristics are Common to the Vertebrae ? Each vertebra consists of a body and an arch, the latter being formed by 2 pedicles and 2 laminae, which support 7 processes. Body^ is thick and spongy, convex in front '^ from side to side, concave verti- cally, and on the upper and lower surfaces, which are surrounded by a bony rim. Anteriorly are small foramina for nutrient vessels, posteriorly a large foramen for the exit of the ven«; basis vertebrarum. Pedicles, project backwards from the body, inclining outwards. They are notched above and below, thus forming, with the adjacent notches, the Intervertebral Foramina for the entrance of vessels and the exit of the spinal nerves. Lamina:^ are 2 broad plates, meeting in the spinous process behind, and rough on their upper and lower borders for the attachment of the liga- mentum subflava. Transverse Processes,^ one on each side, projecting outwards. Articular Processes, two on each side, superior' and inferior,* project from the junction of the lamince and pedicles, and articu- lating above and below with the articular pro- cesses of the adjacent vertebrse. Their superior facets look upwards in the cervical region, out- wards in the dorsal, and inwards in the lumbar. Spinous Process} projects backwards from the junc- tion of the laminse with each other, sometimes very obliquely. Spinal Foramen^ is the space enclosed by the body, pedicles, and laminse ; and which, when the vertebrse are articulated, forms part of the spinal canal. r^ THE VERTEBRAL COLUMN. 37 How are the Vertebrae distinguished? As cervical (7), dorsal (12), and lumbar (5), Each of these divisions has several peculiar features, but their especial characteristics are as follows. TAe Cervical Vertebrcz are pierced at the bases of their transverse processes by the vertebral foramina, which transmit the vertebral artery, vein, and plexus. The Dorsal Vertebra have facets and demifacets on their bodies, for articula- tion with the heads of the ribs. The Lumbar VertebrcB are marked by the absence of the foramina and facets which distinguish the other two classes. What are the Peculiar Vertebrae? They are 9 in number, — the atlas or 1st cervical, the axis or 2d cervical, the vertebra prominens or 7th cervical, the 1st, 9th, loth, nth, and 12th dorsal, and the 5th lumbar. The Atlas is a bony ring supporting the head. A bony arch takes the place of a body, and its spinous process is a mere tubercle. Its Lateral Masses form its chief bulk, supporting large Articular Processes which all look inwards, the superior articulating with the condyles of the occipital bone. The Axis is marked by its Odontoid Process projecting upwards from the body into the anterior part of the spinal foramen of the atlas, where it articulates with the anterior arch, and receives the occipito-axoid and the check ligaments. The Vertebra Prominens has a long and prominent spinous process which ends in a tubercle for the ligamentum nuchae. The Dorsal Vertebra. The ist has one facet and a demifacet. The 9th has a demifacet only. The loth has but one facet on the body and one on the transverse process. The nth and 12th have each but one facet on the body, and none on the transverse processes. The 12th resembles a lumbar vertebra in size and shape. The jth Lumbar is much deeper in front than behind ; its spinous process is small, but its transverse processes are large and thick, and point slightly upwards. What important Relations have Certain Vertebrae? The 3d CVrz'zV^/ corresponds to — the bifurcation of the common carotid artery, and the superior cervical ganglion. The^th Cervical, to — the junctions of the larynx with the trachea, and the phar- ynx with the oesophagus, and the middle cervical ganglion of the sympathetic. The 2d Lumbar, to — the junction of the duodenum with the jejunum, the commencement of the thoracic duct and the portal vein, the origin of the superior mesenteric artery, the lower margin of the pancreas, the opening of the ductus communis chol^dochus, the lower end of the spinal cord, and the crura of the diaphragm. [The false vertebrae are described as bones of the pelvis.] 4 38 ANATOMY. THE THORAX. What is the Thorax ? An osseo-cartilaginous cage formed by the bodies of the dorsal vertebrae posteriorly, the ribs and costal cartilages laterally, and the sternum in front. Its shape is conical, the axis inclined forwards, the base below and closed by the diaphragm. What Structxires pass through its Apex? The trachea, oesophagus, large vessels of the neck, pneumogastric, phrenic and sympathetic nerves, thoracic duct, and in inspiration the apex of the lung. What Structures are contained in its Cavity? The trachea, bronchi and lungs, the heart and great vessels, internal mammary arteries, azygos and bronchial veins, pneumogastric, phrenic, and splanchnic nerves, oesophagus, thoracic duct, lymphatic vessels, and glands. THE STERNUM. The sternum, or breast-bone, consists of 3 parts, — the manu- b num,^ or h an dle ; the gl adiolus,^ or sword; and the ensi- form or xiphoid appendpc^ It presents the — Interclavicular Notch, on ils superior border. Ma7iubriut7i,<^ articulates with the clavicle,'^ 1st costal cartilage,* and a part of the lA.f Gladiolus, articulates with the costal cartilages from the 3d to the 6th inclusive, and partly with the 2d and 7th. Ensiform Appendix (the tip), articulates with the carti- lage of the false ribs, and in part with the 7th costal cartilage./ Describe its development and muscles. The ster- num is dezieloped by 6 centres, I each for the manubrium and ensiform appendix, and 4 for the gladiolus. The mus- cles attached to it are 9 pairs and one single muscle, — the sternorcleido-mastoid, sterno-hyoid, and sterno-thyroid, 3, to its upper part ; — the rectus abdominis, external and internal oblique, trans- versalis, and the diaphragm, 5, to its lower part; — the pectoralis major, i, an- teriorly ; — and the triangularis sterni, i, posteriorly. THE RIBS. Describe them. There are 12 ribs on each side, of which 7 are "true ribs," being each connected to the sternum by a separate cartilage , — and 5 are " false ribs." Three of the latter are connected by their cartilages to the carti- lage of the 7th rib, while two are called " floating ribs," having each one ex- tremity free, •^^ What are the Characteristics Common to most of the Ribs ? They each \ consist of a head, neck, and shaft, and present the following points, viz. — Fig Head,a. is divided by a ridge into 2 facets, which articulate with the facets on the bodies of the dorsal vertebrae ; the ridge giving attachment to the in- terarticular ligament. Neck, about an inch long, having attached to its upper border the anterior costo-transverse ligament, to its posterior surface the middle costo-trans- verse ligament ; its anterior surface is smooth. Tuber osity,^ at the junc- tion of the neck with the shaft, has a facet for articula- t io n with ^ the trans- verse pro- cess of the next lower vertebra, and a rough surface for the posterior costo-transverse ligament. Shaft, twisted on itself, is concave internally, convex externally, its upper border round and smooth, its lower border grooved«^ for the intercostal vessels and nerves. At its external extremity^^ is an oval depression for the insertion of the costal cartilage. Angle,e just in front of the tuberosity, is marked by a rough line, to which are attached the muscles of the deep layer of the back. How are they developed? Each rib has 3 centres, one each for the head, shaft, and tuberosity. The last 2 ribs, having no tuberosity, are devel- oped each by 2 centres. Describe the Peculiar Ribs. They are the ist, 2d, loth, nth, and 12th. They respectively present the following peculiarities, viz. — fst Rib, is broad, short, not twisted, has no angle, only one facet on the head ;« but on its upper surface are seen two grooves for the subclavian ar- tery^ and vein,^ and between them a tubercleg for the scale- nus anticus muscle. 2(1 Rib, is not twisted, its tuber- osity and angle are veiy close together, and its upper surface presents rough surfaces for the serratus magnus and scalenus posticus muscles. Fig. 18 40 ANATOxMY. f < 1 0th Rib, has but one facet on its head. ///// Rib, has no neck, no tuberosity, and but one facet on its head. J2th Rib, has neither neck, angle, tuberosity nor groove, and but one facet. THE PELVIS. Describe the Pelvis. It is formed by the sacrum, coccyx, and two ossa innominata, and is divided into, — i\ic false pelvis, comprising the upper and expanded portion, — and the tnie pelvis, below the ilio-pectineal line. The false pelvis corresponds to the iliac fossae, and is marked by its walls being deficient anteriorly between the iliac borders, and posteriorly between the sacrum and the posterior iliac spines. The true pelvis has a — Brim, or inlet, bounded in front by the crest and spine of the pubes, behind by the promontory of the sacrum, laterally by the ilio-pectineal line. Its axis corresponds to a line from the umbilicus to the middle of the coccyx. Its average diameters in the female are, — 4 inches antero-posteriorly,* over 5 inches transversely,' under 5 inches obliquely.^ In the male each of these measurements is about ^'*'- ^9- yi an inch less. Cavity, is a short curved canal, connecting the brim with the outlet. In front its depth is about i|^ inch, posteriorly 4 to 4^ inches in the female, 4^ to 5^ inches in the male. Its diameter is about 4|^ inches in the female, 4^ inches in the male, all around. Outlet, is bounded by the pubic arch above, the tip of the coccyx behind, and the tuberosities of the ischii laterally. Its axis, if prolonged, would touch the promontory of the sacrum. Its diameters in the female are each about 4^ inches, in the male about 3^ inches. State the chief differences between the male and female pelves. The male pelvis is marked by strength of the bones, prominence of the muscular impres- sions, a deep and narrow cavity, and large obturator foramina. Tht female pel- vishzis lighter bones, broader iliac fossse, the spines being further apart, greater diameters at every point, the sacrum less curved, and the pubic arch wider. Describe the Sacrum. The "sacred bone" is triangular, curved, with its convexity backwards, and is situated base upwards between the ossa innominata, forming with the coccyx the posterior wall of the pelvis. The bone is formed by the coalescence of 5 vertebrae, and presents the following points, viz — THE PELVIS. 41 Fig. 20. 4 Ridges,^ transversely across both surfaces, mark the union of its original segments. 8 Anterior Sacral Foramina, for the anterior sacral nerves. 8 Grooves,^ shallow and broad, for the aforesaid nerves. Promontory, at its junction with the last lumbar vertebrge. 8 Posterior Sacral Foramina, for the posterior sacral nerves. Tubercles, representing the spinous processes of the segments. Groove, posteriorly, on each side of the spinous tubercles. 2 Comua, at the posterior inferior portion of the bone. Auricular Surface^ on each side, articulates with the ilium. Notch, laterally and inferiorly, for the 5th sacral nerve. Base^ has all the characteristics of the lumbar vertebras, with the last of which it articulates. Apex}^ has an oval surface for articulation with the coccyx. Sacral Canal, the continuation of the spinal, is incomplete posteriorly at its lower end. It transmits the Cauda Equina ; into it open the sacral fora- mina laterally. / Describe the Cocc5rx. It consists of 4 or 5 rudimentaiy vertebrae coalesced y^: into a triangular bone, the base^ of which articulates with the apex of the - ffk sacrum. Its posterior surface is rough for muscles and liga- ments, its anterior surface is smooth and marked by ridges at the junction of its constituent vertebrae. It presents the fol- lowing points. — 2 Cornua^ superiorly, articulating with the sacral comua to form foramina for the 5th sacral nerves. Apex, is sometimes bifid and turned to one side. Describe the Ossa Innominata. The unnamed bones are placed one on each side of the osseous pelvis, and are each formed by the union, about puberty, of 3 bones,— the ilium, ischium, and pubes. The innominate bone as a whole presents the following points, viz. — Acetabulum, or cotyloid cavity, receives the head of the femur. It is situ- ated at the junction of the 3 bones, the ilium and ischium each forming about two-fifths, and the pubes one-fifth of it. A depression in its centre lodges a mass of fat containing vessels for the nourishment of the synovial 42 ANATOMY. Fig. 22. membrane. The Cotyloid Notch is a deficiency in its lower anterior margin, transmitiing nutrient vessels to the joint ; to the edges of the notch are attached the ligamentum teres, and it is bridged over by the transverse ligament, a continuation of the cotyloid ligament which surmounts the brim of the acetabulum. Obturator^ or Thyroid Foramen^ on the anterior surface between the pubes and ischium, large and oval in the male, small and triangular in the female ; is closed by the obturator membrane, except above where the obturator nerves and vessels pass through it. Describe the Ilium. It is the superior part of the innominate bone, and presents the following points, viz. — Crest^ along its upper borcer, having an outer and inner lip for muscular attachment, and ending in the superior spines. Anterior Superior Spine, ^ to which is attached the sartorius and tensor vaginoe femoris mus- cles, and Poupart's ligament. Anterior Inferior Spine ^ for the straight tendon of the rectus femoris. Notchy between the above-named spines, trans- mitting the external cutaneous nerve, and lodging some fibres of the sartorius. Posterior Superior Spine }^ for the attachment of the erector spinas muscle, and the oblique part of the sacro-sciatic ligament. Posterior Inferior Spine^"^ for the great sacro- sciatic ligament. Great Sacro-sciatic Notch}^ below the last-named spine, transmits the great sciatic, superior gluteal, and pudic nerves, the pyriformis muscle, and the sciatic, pudic, and gluteal vessels, and a nerve supplying the obturator externus muscle. Curved Lines,^^ superior middle and inferior, on the outer surface of the bone, from the spaces between which arise the glutei muscles. Groove, above the acetabulum, for the reflected tendon of the rectus femoris muscle. Linea Ilio-pectinea, in part ; on the inner surface, above which is a smooth surface, the Venter of the Ilium. Auricular Surface}^ rough, articulates with the sacrum. Describe the Ischium. It is the lowermost portion of the innominate bone, and presents the following points, viz. — Body^ forms two-fifths of the acetabulum, and the external margin of the BONES OF THE SHOULDER. 43 obturator foramen ; on it is a broad groove for the tendon of the obturator externus muscle. Its posterior margin assists in forming the great sacro- sciatic notch. Spine}^ for the gemellus superior, coccygeus, and levator ani muscles, and the lesser sacro-sciatic ligament. Lesser Sacro-sciatic Notch^^ below the spine, transmits the obturator muscle, its nerve, and the pudic vessels and nerve as they re-enter the pelvis, hav- ing crossed the spine of the ischium. The sacro-sciatic notches are con- verted into foramina by the sacro-sciatic ligaments ; the greater notch by the lesser ligament, the lesser notch by the greater ligament. Tuberosity ^'^ the lowest and most prominent part, gives attachment to the greater sacro-sciatic ligament, and to several muscles. On it one rests when sitting. Ascending Ramus, bounds the obturator foramen inferiorly, articulates with the descending ramus of the pubes, and gives attachment to the obturator membrane and several muscles. Describe the Pubes. The pubic or pectineal bone forms the anterior portion of the innominate. It presents the following, viz. — Body, lies between the rami, with its fellow forms the Symphysis, giving origin to several muscles and ligaments. Crest^ in the upper part of the body, terminates externally in the Spine, and internally in the Angle. Spine, affords attachment to one end of Poupart's ligament. Linea Ilio-pectinea, in part; gives attachment to the conjoined tendon, Gim- bernat's ligament, and the triangular ligament. Horizontal Ramus, forms part of the brim of the pelvis, of the margin of the obturator foramen, and of the acetabulum. On its under surface is a groove for the obturator vessels and nerve. Pectineal Emitience^ gives attachment to the psoas parvus muscle. Descending Ramus^^ flat and thin, joins the ascending ramus of the ischium, and bounds the obturator foramen internally. What Muscles are attached to the Os Innominatum ? 36, comprising those of the abdomen, thigh, perineum, floor of the pelvis, and rotators of the hip-joint. BONES OF THE UPPER EXTREMITY. THE SHOULDER. What Bones form the Shoulder? The clavicle and scapula connecting the arm with the trunk, and in this respect homologous to the innominate bone in the lower part of the body. 44 ANATOMY. Describe the Clavicle. The collar- or key-bone, is a short bone by struct- ure, having no medullary canal; and is curved like the letter f, its inner two-thirds being cylindrical, and convex anteriorly ; its outer third flattened, and concave anteriorly. It is placed horizontally between the sternum and the scapula, and is the most elastic bone in the body. It presents, from within outwards, the following points, viz, — Facets, for articulation with the sternum and the cartilage of the 1st rib, at its sternal end. Impression for the rhomboid, or costo-clavicular ligament. Groove, on the lower surface, for the subclavius muscle. Tubercle, for the conoid part of the costo-clavicular ligament. Oblique Line, for the trapezoid part of the same ligament. Facet, on the acromial end, for articulation with the scapula. Nutrient Foramen, in the subclavian groove. Describe the Scapula. The shoulder-blade is a large, flat, and triangular bone, situated on the posterior and lateral portion of the thorax, from the 2d rib to the 7th, inclusive. The Venter, or anterior surface, presents from within outwards, — Ridges, giving attachment to the subscapularis muscle. Marginal Surface, along the inner border, for the attachment of the serratus magnus muscle. Subscapular Fossa, and Angle, for the subscapularis muscle. The Dorsum, or posterior surface, presents the following, viz. — Spine, a bony ridge, which affords attachment to the trapezius and deltoid muscles, and ends in the acromion process. Supraspinous Fossa, above the spine, for the supraspinatus muscle. Infraspinous Fossa, below the spine, larger than the supraspinous, convex at its centre, lodges the infraspinatus muscle, and the nutrient foramen. Marginal Surface, along the external border, to which are attached the teres minor muscle above, the teres major below, and sometimes a few fibres of the latissimus dorsi at the lower angle. Giwove crossing the margin, for the dorsalis scapulae vessels. Smooth Surface, behind the root of the spine, over which the trapezius muscle glides. The Acromion process, or " summit of the shoulder," extends from the spine, and projects over the glenoid cavity, articulating with the clavicle by an oval facet. It affords attachment to the deltoid and trapezius muscles, and by its apex to the coraco-acromial ligament. The Coracoid process, or " crow's beak," projects from the upper border and neck of the bone over the inner and upper part of the glenoid cavity. BONES OF THE ARM. 45 Into it is inserted l muscle, the pectoralis minor; the coraco-brachialis, and the short head of the biceps arise from it by a common tendon ; and 3 ligaments are attached to it, — the conoid, trapezoid, and coraco-acromial. The Superior Border presents the — Suprascapular Notch, converted into a foramen for the suprascapular nerve by the transverse ligament, over which passes the suprascapular artery. The omo-hyoid muscle is attached to the border just internal to the notch. The Axillary Border is the thickest, and presents a — Rough Surface, for the long head of the triceps muscle, just below the glenoid cavity. Groove, the origin of a part of the subscapularis muscle. The Vertebral Border is the longest, and presents an — Anterior Lip, for the attachment of the serratus magnus. Posterior Lip, for the supra- and infra-spinatus muscles. Interspace, between the lips, for the levator anguli scapulae, the rhomboideus minor, and the fibrous arch of the rhomboideus major muscles. Other points of interest on the bone are the — Superior Angle, affords attachment to part of the serratus magnus, levator anguli scapulae, and supra-spinatus muscles. Inferior Angle, affords attachment to part of the serratus magnus and teres major muscles, and occasionally to a few fibres of the latissimus dorsi. Glenoid Cavity, at the external angle or head of the bone, a shallow cavity for the reception of the head of the humerus. It is deepened by the glenoid ligament which is attached around its margin ; and at its upper part gives origin to the long head of the biceps flexor cubiti muscle. Neck, is the contracted part of the bone behind the glenoid cavity ; from it arises the anteiior root of the coracoid process. THE ARM. Describe the Humerus. It is the only bone in the arm, and articulates with the scapula above, and with the ulna and radius below. It presents the following points, viz. — Head,b is nearly hemispherical, and smooth for articulation with a gle- noid cavity of the scapula. Anatomical A^eck,c is a constriction in the bone, just below the head, for the attachment of the capsular ligament. Greater Tuberosity ,d. has 3 small facets for the insertions of the supra- spinatus, infraspinatus, and teres minor muscles. 46 ANATOMY. Fig. 23. Lesser Tuberosity e on the inner side of the bone, gives insertion to the subscapularis muscle. Bicipital Groove,/ lies vertically between the tuberosities for the upper third of the bone, and lodges the tendon of the long head of the biceps flexor cubiti. Into its inner or posterior lip ^ are inserted the teres major and latissimus dorsi muscles, while its outer or anterior lip^ receives the in- sertion of the tendon of the pectoralis major, which covers the groove. Surgical Neck, is situated immediately below the tuberosi- ties, and is a slight constriction in the upper part of the shaft. Shaft,^ is cylindrical above, prismatic and flattened below. Rough Surface,i for the insertion of the deltoid muscle, about the middle of the external surface of the shaft. Musculo- spij'al Groove, lodging the musculo-spiral nerve, and the superior profunda artery, is situated on the pos- terior surface of the shaft, separating the origins of the outer and inner heads of the triceps muscle. 7|^ Orifice j of the nutrient canal, about the middle of the i-y shaft. Condyloid Ridgesop internal and external, arising from i| the respective condyles, extending upwards along the jilt shaft. External Condyle,^n gives attachment to the external lateral ligament and the extensor and supinator group of muscles. Internal Condyle,^ lower and more prominent than the other, gives attachment to the internal lateral ligament and the flexor and pronator group of muscles of the fore-arm. Radial Head,k forms the external part of the inferior articular surface ; for articulation with the radius. Trochlear Surface,l articulates with the greater sigmoid cavity of the ulna; is a deep depression between two borders, and extends from the anterior , to the posterior surface of the bone. Coronoid Fossa,q in front of the trochlea, receives the coronoid process of the ulna when the fore-arm is flexed. Olecranon Fossa, behind the trochlea, receives the tip of the olecranon pro- cess, when the fore-arm is extended. BONES OF THE FORE-ARM. 47 THE FORE-ARM. Describe the Ulna. The elbow-bone is the internal bone of the fore-arm. It is larger and longer than the radius, forming the greater portion of the articulation with the humerus. It does not enter into the formation of the wrist-joint, being excluded therefrom by an interarticular fibro-cartilage. It presents the following, viz. — Olecranon Process,^ at the upper extremity, forming the elbow. It is curved forwards, its apex being received into the olecranon fossa of the humerus when the fore arm is extended. Its posterior surface gives insertion to the tendon of the triceps. In its function and structure it resembles the patella. Coronoid Process,^ below the olecranon, projects forwards, its apex being received into the coronoid fossa of the humerus when the fore-arm is flexed. Its upper surface is concave for articulation with the humerus, its lower surface rough for the insertion of the brachialis anticus muscle. Its inner surface has a margin for the internal lateral ligament, a tubercle for the flexor sublimis digitorum, and a ridge for the pronator radii teres. Greater Sigmoid Cavity, i lies between the processes, and is divided by a vertical ridge into two unequal parts. It articulates with the trochlear surface of the humerus. Fig. 24. Lesser Sigmoid Cavity c lies external to the coronoid process ; is oval and concave, articulating with the head of the radius, and giving attachment to the orbicular ligament. Shaft,a large and prismatic above, smaller and rounded below, has the A'utrient Foramen/ on its anterior sur- face, and a prominent margins externally, to which is attached the interosseous membrane. The shaft gives attachment to 9 of the 12 muscles of the fore- anii. Headh at the carpal end, articulates with the lesser sigmoid cavity of the radius, and the fibro-cartilage of the wrist-joint. Styloid ProcesSyi projecting from the head internally and posteriorly, its apex gives attachment to the in- ternal lateral ligament, and a depression at its root to the fibro-cartilage of the joint. Groove, for the tendon of the extensor carpi ulnaris muscle. { V 48 ANATOMY. Describe the Radius. The radius lies externally to the ulna when the fore arm is in supination ; it is prismatic in form with the base below where it articulates with the carpus. The bone is curved outwards and is shorter than the ulna, by the length of the olecranon. It presents the following points from above downwards, viz. — Headk cylindrical and cup-shaped, articulating with the radial head of the humerus, and the -lesser sigmoid cavity of the ulna, and playing within the orbicular ligament. Neckfl the constricted part below the head. Tuberosity, *n rough behind for the insertion of the biceps, and smooth in front where it is covered by a bursa. Shaft,j prismoid in form, presents a sharp border internally for the attach- ment of the interosseous membrane, the Nutrient Forainen is on its an- terior surface. It gives attachment to 8 of the 12 muscles of the fore-arm. Sigmoid Cavity, at the internal side of the carpal end, is shallow, and artic- ulates with the head of the ulna. Articular Surf ace, o is divided by a ridge into 2 facets for articulation with the semilunar and scaphoid bones of the carpus. Styloid Process, P externally, gives attachment by its apex to the external lateral ligament, and by its base to the supinator longus muscle. Grooves, on the posterior and external surfaces of the lower extremity, for the tendons of the 8 extensor muscles of the thumb, and those of the radial side of the wrist, and fingers. THE HAND. How are the Bones of the Hand divided? Into the carpus (8), the meta- FiG. 25. carpus (5), and the phalanges (14). Total, 27 bones. Name the Bones of the Carpus. They are placed in 2 rows, one row in front of the other, with 4 bones in each row, as follows, — the left hand being in supination, naming from without inwards, viz. — ist, or Proximal Raiv, — Scaphoid,^ Semi- lunar,^ Cuneiform, C Pisiform.-f '^^^^^^^'''■^^S^I^B^^ ^^> o'f' Distal Row, — Trapezium, T' Trape- zoid,^ Os-magnum,-^ Unciform.^ State the number of Articulations in the Carpus. 34, as follows, — the number after each bone representing the number of its articulations, viz. — BONES OF THE HAND. 49 Scaphoid, 5. Semilunar, 5. Cuneiform, 3. Pisiform, i. Trapezium, 4. Trapezoid, 4. Os-magnum, 7. Unciform, 5. "What peculiarities have the Carpal bones ? The first three enter into the formation of the wrist-joint; the pisiform does not, but is wholly without it, and may be considered a mere appendage of the carpus. When the hand is in pronation — The Scaphoid, or boat-shaped bone, has a tuberosity on its outer side, its largest auricular facet is uppermost, and a transverse groove crosses its posterior surface. The Semilunar Bone has a crescentic facet externally, and a convex facet superiorly. The Cuneiform Bone is wedge-shaped, its convex surface above, and has an isolated facet for the pisiform articulation. The Pisiform Bone is the smallest, and has but one facet, which lies poste- riorly when the bone is in position. The Trapezium has a deep groove for the tendon of the flexor carpi radialis, and a saddle-shaped facet, inferiorly. The Trapezoid is small and quadrilateral, bent on itself, with a saddle-shaped facet looking downwards. The Os-magnum has a head looking upwards, a neck, and a body ; is the largest bone of the carpus, and has a tubercle on the inner side of the base. The Unciform Bone is triangular, with a concavity which lies to the outer side ; and the unciform process, long and curved, projecting from its palmar surface. Describe the Metacarpus. The 5 metacarpal bones are placed between the carpus and the phalanges, are long bones, and each has a head, shaft, and base. Their heads articulate with the respective phalanges. isi Metacarpal Bone,d articulates with the trapezium, is shorter than the others by one-third, and its base has but i articular facet. This bone is classed among the phalanges by Professor W. H. Pancoast. 2d Metacarpal Bone,e articulates with 3 bones of the carpus, — the trape- zium, trapezoid, and os-magnum ; its base is large, and has 4 articular facets. jd Metacarpal Bone,-f articulates with i bone of the carpus, — the os-mag- num ; its base has a projecting process on the radial side, and 2 small facets on the opposite side. 4th Metacarpal Bone^ articulates with 2 bones of the carpus and with the adjacent metacarpal bones; its base is small, and has 2 circular facets, i on each side. ^th Metacarpal Bone,^ articulates with I carpal bone, — the unciform; its base has i lateral articular facet. 5 D 50 Describe the Phalanges. The finger-bones are 14 in numljer (15 accord- ing to Pancoast), 3 to each finger, and 2 to the thumb. They are long bones, and each has a base, a shaft, and a digital extremity. The Bases of the first row articulate with the heads of the metacarpal bones. The Digital Extremities of the first and second rows have each 2 small lateral condyles, while in the terminal row they are rough, for the attachment of the sensitive pulp of the fingers. BONES OF THE LOWER EXTREMITY. THE THIGH. Describe the Femur. The thigh-bone is nearly cylindrical, and is the longest, largest, and strongest bone in the body. In the ver- tical position of the skeleton it forms one side of a triangle, of which the base is the breadth of the pelvis, and the apex at the knee-joints. The base of this triangle is longest in the female, and consequently that sex is usually knock-kneed. Head,b articulates with the acetabulum, forms about two- fifths of a sphere, and has an oval depression^ below its centre for the attachment of the ligaraentum teres. Neck,c connects the head with the shaft, is pyramidal and flattened ; its obliquity varies with age, being less before puberty, about 1 20 to 125 degrees in the adult, and nearly horizontal to the shaft in old or debilitated subjects. Great Trochanter,^ a broad, rough, quadrilateral process directed outwards and backwards from the summit of the shaft to within three-fourths of an inch of the level of the head. On its outer surface the tendon of the gluteus maximus plays over a bursa. It gives insertion to the obturator internus, two gemelli, pyriformis, and gluteus minimus and medius muscles. Digital Fossa, on the inner surface of the great trochanter, gives insertion to the obturator externus muscle. Lesser Trochanter,^ at the inferior root of the neck pos- teriorly, is small and conical, and affords insertion to the tendon of the psoas magnus muscle, the tendon of the iliacus being inserted immediately below it. Inter-trochanteric Zz«^j, anterior and posterior, the latter the most prominent ; to the anterior is attached the capsular ligament of the hip-joint. Linea Quadrati, extends from the middle of the posterior inter-trochanteric line about 2 inches down the shaft, and gives attachment to the quadratus femoris muscle. BONES OF THE LEG. 51 Shafts is slightly curved forwards, broad and cylindrical at each end, and narrow and triangular in the centre. Its nutrient foramen perforates its posterior surface below the centre. From its anterior surface arise the crureus and sub-crureus muscles. Lima AsperaySS a crest lying along the central third of the shaft posteriorly; bifurcating above towards each trochanter, also below towards the 2 con- dyles. To its outer lip is attached the vastus externus, to its inner lip, the vastus internus ; and between them, the pectineus, adductor brevis, and gluteus maximus above the short head of the biceps below, and the ad- ductors longus and magnus along the greater portion of the space. Groove, crossing the internal condyloid ridge, and lodging the femoral artery. Popliteal Space h triangular and smooth, lying between the condyloid ridges, for the popliteal artery. External Condyle i broader and shorter than the internal, so as to form a horizontal articulation, the bone being inclined towards the median line. It gives attachment to the external lateral ligament, and the popliteus and gastrocnemius muscles. Internal Condyhyl the longest by half an inch; it gives attachment to the internal lateral ligament and the gastrocnemius muscle. Inter-condyloid Notch,k lodges the crucial ligaments. In front the condyles are continuous with each other, forming a concave depression or trochlea for the patella. Otiter Tube?-osity, on the external condyle, for the attachment of the exter- nal lateral ligament. Groove, below the outer tuberosity, for the tendon of the popliteus muscle, terminating in a depression whence the muscle takes its origin. Inner Tuberosity, on the internal condyle, for the attachment of the internal lateral ligament. Tubercle, above the inner tuberosity, for the insertion of the tendon of the adductor magnus muscle. Depression, behind the tubercle, for the tendon of the inner head of the gastrocnemius. THE LEG. Describe the Tibia. The shin-bone ranks next to the femur in respect to size and length. Its form is prismoidal, the upper extremity being much larger than the lower. Head, expands into 2 lateral tuberositieSj-^*? which articulate with the con- dyles of the femur. Spine,d projects vertically between the 2 articular surfaces, is bifid, affording attachment to the semilunar fibro-cartilages, and by depressions in front and behind its base to the crucial ligaments of the joint. 52 ANATOMY, Tubercle, e anteriorly on the head, between the tuberosities, for the insertion of the ligamentum patellce. Popliteal Notch, posteriorly between the tuberosities, affords attachment to the posterior crucial ligament. Groove, on the inner tuberosity posteriorly, for the insertion of the tendon of the semi-membranosus muscle. Facet, on the outer tuberosity posteriorly and looking 7- downwards, for articulation with the head of the fibula. Popliteal Line, obliquely across the upper part of the shaft posteriorly, affords attachment to the fascia of the popliteus, and parts of the soleus, flexor longus digitorum, and tibialis posticus muscles. Nutrient Canal, the largest in the skeleton, opens just below the popliteal line, its orifice looking upwards. Skaft,a has 3 sharp ridges, — i in front, the Crest or Shin,/ and I on either side, to the external of which is'^ttached the interosseous membrane. Lower Extremity,s is smaller than the upper, grooved posteriorly for the tendon of the flexor longus pol- licis ; externally has a rough triangular depression for articulation with the fibula, and for the attach- ment of the inferior interosseous ligament. Its in- ferior surface is concave and smooth for articulation with the upper surface of the astragalus. Lnternal Malleolus,^ projects downwards from the in- ternal side of the lower extremity. It articulates with the astragalus, is grooved posteriorly for the tendons of the tibialis posticus and flexor longus digitorum muscles, and affords attachment to the in- ternal lateral ligament. Describe the Fibula. It is a long slender bone, placed nearly parallel with the tibia on the outer side of the leg. It is also called the peroneous, or peroneal bone. Head,J articulates with the external tuberosity of the tibia by a flat facet. Externally it has a prominence for the attachment of the long external lateral ligament of the knee-joint. Styloid Process, projects upwards from the head posteriorly, and gives inser- tion to the tendon of the biceps muscle, and the short external lateral ligament of the knee-joint. Shaft i is triangular and twisted on itself, having 3 marked ridges, the BONES OF THE FOOT. 53 innermost of which is sharp for the attachment of the interosseus mem- brane. The shaft arches backwards, and gives attachment to 8 of the 12 muscles of the leg. Nutrient Canal, opens about the centre of the shaft posteriorly, its orifice looking downwards. External Malleolus Ji is the lower extremity of the bone. It is larger and longer than the internal, articulates with the astragalus by a triangular facet, and is grooved posteriorly for the tendons of the peroneus longus and brevis muscles. Its edge affords attachment to the external lateral ligament of the ankle-joint. \ ! THE FOOT. How are the bones of the Foot divided? Into the tarsus (7), meta- tarsus (5), and phalanges (14). Total, 26 bones. Name the bones of the Tarsus. They are placed in 2 rows side by side, 2 bones in the external row, 5 in ihe internal, as follows, viz. — Internally,— Astragalus.^ Scaphoid.'^ 3 Cuneiform. €/& Externally, — Os calcis.'^ Cuboid.^ How many Articulations are in the Tarsus ? 28, each bone articulating with 4 others, except the os calcis, which articulates with 2, and the external cuneiform with 6 bones. What Peculiarities have the Tarsal Bones ? They may be divided transversely at the astragalo- scaphoid-calcaneo-cuboid articulation, the site of Chopart's operation. The Astragalus,*^ has a rounded head, a convex surface on which is a broad articular facet, and on its inferior surface a deep groove between 2 articular facets. The Os Calcis,c is a large bone, having on its upper surface a deep groove for the interosseous liga- ment, between 2 articular surfaces; anteriorly a large irregular portion, the head; and pos- teriorly an elongated portion forming the Heel. On its internal surface is a projection, the Susten- taculum Tali, which supports the internal articu- lating surface ; below which process the bone is deeply grooved for the plantar vessels and nerves and the flexor tendons. To the os calcis are at- tached 8 muscles and the plantar fascia. 5* 54 ANATOMY. The Scaphoid Bone,d is boat-shaped, has 3 facets anteriorly for the cunei- form bonts, a concave surface posteriorly for the astragalus, and a facet externally for the cuboid bone. A tubercle is situated on the lower sur- face internally, for the insertion of the tibialis posticus muscle. The Cuboid Bone J^ has 3 articular surfaces, and a groove inferiorly for the tendon of the peroneus longus. The Internal Cuneiform Bone^e the largest of the 3, has a tubercle on its plantar surface for the insertion of parts of the tendons of the tibialis anticus and tibialis posticus muscles. The Middle Cuneiform Bone,/ is small and wedge-shaped with the narrow end downwards. Its anterior surface is considerably behind the line of the tarso-meiatarsal articulation, thus forming a recess into which the base of the second metatarsal bone fits. The External Cuneiform Bone,g is also wedge-shaped, but longer than the middle one; and affords origin to i muscle, the flexor brevis pollicis. Describe the Metatarsus. The metatarsal bones i are 5 in number, are long bones, having each a shaft and 2 extremities. Their bases articulate with the tarsal bones and with each other ; their heads with the first row of phalanges. jst Metatarsal, is large but shorter than the others, and forms the inner border of the foot, articulating with the internal cuneiform. 2d Metatarsal, is the longest ; its base has 3 facets for articulation with the 3 cuneiform bones in the recess formed by the shortness of the middle cuneiform. ^d Metatarsal, has 2 facets on the inner side of its base, besides the facets for the internal cuneiform and the 4th metatarsal bone. ^th Metatarsal, articulates with the cuboid bone, and also with the internal cuneiform. ^th Metatarsal, articulates obliquely with the cuboid bone, and has a tuber- cular projection on the outer surface of its base, which forms the guide to Hey's operation. Describe the Phalanges of the Foot. They number 14 as in the hand, the great toe having 2, the other toes 3 each. They are long bones, each having a base, a shaft, and an anterior extremity. They are convex above, concave below, and articulate by the bases of the first row with the bones of the metatarsus. The anterior extremities of the distal phalanges>i',« are expanded into surfaces for the support of the nails and pulp of the toes. THE ARTICULATIONS. 55 THE ARTICULATIONS. Into what Classes are the Articulations divided? Into 3, — i. Synarthro'sis, immovable; 2. Amphiarthro'sis, Synchondrosis, or Symphysis, having limited motion; 3. Z>mr//^r^^j'w, having free motion. How are the Synarthroses subdivided? Into 3 divisions, — Sutura, by indentations; Schindylesis , by a plate of bone into a cleft in another; and Gompho^sis, by a conical process into a socket. The Sutura are again sub- divided into — S. Dentata, having tooth-like processes; S. Serrata, with ser- rated edges; S. Limbosa, having beveled margins and dentated processes; S. Squamosa, y^\i\\\\\\Ti beveled margins overlapping each other; ^. Harmonia, contiguous rough surfaces opposed to each other. The first 3 are also named Sutura Vera (true sutures) having indented borders ; the last 2 Sutura Notha (false sutures) being formed by rough surfaces. How are the Diarthroses divided ? Into 4 divisions, — Arthrodia, gliding joint; i5'«(3;r//z7w?>, ball-and-socket joint ; 6'm^/r/w/^, hinge-joint; and Z>2ar- throsis Rotatorius, a ring surrounding a pivot. Give an Example of each of the above-named articulatiDns. Synarthro'sis, — bones of cranium and face, except the lower jaw. Sutura Dentata, — the inter-parietal suture. Sutura Serrata, — the inter-frontal suture. Sutura Limbosa, — the fronto-parietal suture. Sutura Squamosa, — the tempora-parietal suture. Sutura Harmonia, — the intermaxillary symphysis. Schindylesis, — rostrum of sphenoid with the vomer. Gompho'sis, — the teeth in their alveoli. Amphiarthro'sis, — the bodies of the vertebrae, the sacro-iliac, and pubic sym- physes. Diarthro'ses, — Arthrodia, — sterno-clavicular articulation. Enarthrosis, — hip-joint, shoulder-joint. Ginglymus, — elbow-joint, ankle-joint, knee joint. Diarthrosis Rotatorius, — the superior radio-ulnar, and atlo-axoid articula- tions. Name the Varieties of motion in joints ? There are 7 varieties, viz. — flexion, extension, adduction, abduction, rotation, circumduction, and gliding movement. What Structures enter into ths formation of joints? There are 5, viz. — the articular lamella of bone, ligaments, cartilage, fibro- cartilage, and synovial membrane. 56 ANATOMY. Articular Lamella of bone differs from ordinary bone tissue in being more dense, containing no Haversian canals nor canaliculi, and having larger lacunae. Ligaments are bands of vv^hite fibrous tissue, except the ligamentum sub- flava and the ligamentum nuchse, which are both composed purely of yellow elastic tissue. Cartilage is temporary or permanent. The first forms the original frame- work of the skeleton, and becomes ossified. Permanent cartilage is not prone to ossification, and is divided into 3 varieties, — Artiadar, covering the ends of bones in joints; Costal, forming part of the skeleton ; Reticular^ arranged in lamellae or plates to maintain the shape of certain parts. Fibro-cartilage is Interarticular (menisci), separating the bones of a joint ; Connecting, binding bones together; Circumferential, deepening cavities; Stratiform, lining grooves. Synovial Membranes secrete the synovia, a viscid, glairy fluid, and resemble the serous membranes in structure. They are Articular, lubricating joints ; Bursal, forming closed sacs (bursae) ; Vaginal, ensheathing tendons. Describe the Vertebral Articulations. They are formed by the adjacent surfaces of the bodies of the vertebrae, and their articular processes, and are connected by the following ligaments, etc. — (See FiG. 31.) Lntervertebral Fibro-cartilages, between the bodies of all true vertebrae, ex- cept the axis and atlas. Anterior Common Ligament} along fronts of the bodies. Posterior Common Ligament, along backs of the bodies. Ligamenta Subflava, connect the laminae of adjacent vertebrae. Capsular,^ surround the articular processes, and are lined by synovial mem- brane. Supraspinous and Inter-spinous, connect the spinous processes. Inter-transverse,^ connect the transverse processes. Describe the Occipito-atloid Articulation. It is a double arthrodia formed by the condyles of the occipital bone with the superior articular surfaces of the atlas, and has 7 ligaments, viz. — 2 Anterior Occipito-atloid,^ from the an- terior margin of the foramen magnum to the anterior arch of the atlas. Posterior Occipito-atloid, from the posterior margin of the foramen magnum to the posterior arch of the atlas. It is per- forated by the vertebral arteries and sub- occipital nerves. Fig. 29. THE ARTICUIATIONS, 57 2 Lateral, from the jugular processes of the occipital bone to the bases of the transverse processes of the atlas. 2 Capstdar,d around the articular surfaces, lined by synovial membrane. Describe the Occipito-axoid Articulation. Formed by the occipital bone and the odontoid process of the axis, which do not articulate with each other strictly, but are connected by 4 ligaments. Occipito-axoid'^ {^Apparatus Ligamentosus Colli), a continuation of the posterior common spinal ligament to the basilar process of the occipital bone. 2 Lateral Occipito-odontoid^ ( Check Ligaments), from the head of the odontoid process to the sides of the occipital condyles. Vej'tical Occipito-odontoid [Ligamentum Suspensoriuni), from the anterior margin of the foramen magnum to the odontoid apex. Describe the Atlo-axoid Articulation. It is a double arthrodia between the articular processes, a double diarthrosis rotatorius between the atlas and the odontoid process, and has 6 ligaments, and 4 synovial membranes. 2 Anterior and i Posterior Atlo-axoid, continuations of the anterior and pos- terior common spinal ligaments. 2 Capsular, surrounding the articular surfaces, each lined by a synovial membrane. Transverse, or Cruciform Ligament, divides the spinal foramen of the atlas into two portions, stretching across between the tubercles on the inner sides of the articular processes. It holds the odontoid process in place, having a synovial membrane interposed. Another synovial membrane is situated between the process and the anterior arch. The transverse liga- ment sends two vertical slips, one upwards, the other downwards, from which it is named the Cruciform Ligament. Describe the Temporo-maxillary Articulation. A double arthrodia between the condyle of the lower jaw and the anterior part of the glenoid cavity of the temporal bone. It has 2 synovial membranes with an inter-articular hbro- cartilage between them, and 4 ligaments, viz. — External Lateral, from the tubercle of the zygoma to the outer side of the neck of the condyle of the lower jaw. ^^^- 3°- Lnternal Lateral,erse. Describe the Costo-stemal Articulations. One a synarthrodia!, 6 are ar- throdial articulations, between the costal cartilages and the margin of the sternum. The first has no synovial membrane, the second only has an inter- articular fibro-cartilage. Each has 3 ligaments, — the Anterior and Posterior Costo-stemal, and a Capsular. The Costo-xiphoid Ligament connects the xiphoid appendix to the cartilage of the 6th or 7th rib. How are the Costal Cartilages connected with the ribs and with each other ? With the ribs by a depression on the end of each rib, strengthened by the blending together of the periosteum and the perichondrium. The carti- lages of the lower ribs, sometimes from the 5th to the loth inclusive, articu- late with each other by their borders and for each a capsular and an intercostal ligament, with 3 synovial membranes for the 3 articulations between the 6th and the 9th cartilages. What are the Ligaments of the St?mum ? An anterior sternal and a posterior sternal ligament, with a layer of cartilage between the manubrium and the gladiolus. THE ARTICULATIONS. 59 Fig. 32. Describe the Sacro-vertebral Articulation. It is similar to the other ver- tebral articulations, but has 2 additional ligaments on each side, viz. — Lumbosacral, from the transvei-se processes of the 5th lumbar vertebra to the base of the sacrum laterally and anteriorly. Lumbo-iliac, from the apices of the transverse processes of the 5th lumbar vertebra to the crest of the ilium. Dascribe the Sacro-coccygeal Articulation. It is an amphiarthrodial joint, and has 3 ligaments, viz. — Anterior Sacro-coccygeal. Posterior Sacro-coccygeal. Interarticular Fibro-cartilage, in the joint. Describe the Sacro-iliac Articulation. It is an amphiarthrodial joint, formed by the auricular surfaces of the sacrum and ilium. Its ligaments on each side are as follows, viz. — Anterior Sacro-iliac. Posterior Sacro-iliac^ Oblique Sacro-iliac. Describe the Sacro-isch'atic Articulation. Its ligaments convert the sacro-sciatic notches into foramina, the greater notch by the lesser ligament, the lesser notch by the greater ligament. These foramina are described under the ilium and is- chium l)ones. Great Sacro sciatic Ligament, ^^ i* from the posterior inferior spine of the ilium and the posterior sur- faces and margins of the sacrum and coc- cyx, to the inner margin of the tuber- osity and the ascend- ing ramus of the ischium. Lesser Sacro-sciatic TAgament}^ ^^ from the margins of the sacrum and coccyx, into the spine of the ischium. Describe the Pubic Articulation. It is an amphiarthrodial joint, formed by the 2 pubic bones. It has an interarticular fibro-cartilage and 4 ligaments, viz. — Anterior Pubic. Posterior Pubic. Supra-pubic. Sub-pubic, forming a fibrous arch between the rami. 60 ANATOMY. Fig. 33. Describe the Stemo-clavicular Articulation. It is an arthrodial joint, formed by the sternal end of the clavicle with the sternum and the cartilage of the 1st rib. It has an interarticular fibro-cartilage, 2 synovial membranes, and 4 ligaments, viz. — Anterior Stemo-clavicular. Interclavicular. Posterior Stemo-clavicular. Costo- clavicular or Rhomboid. Describe the Scapu!o-clavicular Articulation. It is an arthrodial joint, formed by the outer extremity of the clavicle and the acromion process of the scapula. It frequently has an interarticular fibro-cartilage and 2 synovial membranes; usually but I synovial membrane is present, and 3 ligaments, viz. — Superior Acromio clavicular."^ Coraco clavicular"^ j Trapezoid, externally. Inferior Acromio-clavicular. divided into — I Conoid, internally. What are the proper ligaments of the Scapula ? They are 2, the coraco- acromial, and the transverse, as follovirs. — Coraco-acromial,^ completes the vault par- tially formed by the 2 processes over the head of the humerus. Transverse,^ from the base of the coracoid process to the margin of the suprascapular notch, converting it into a foramen, for the supra-scapular nerve. Describe the Shoulder-joint. It is an enarthrodial joint, formed by the head of the humerus and the glenoid cavity of the scapula. It has a Synovial Afembrajte which is reflected upon the tendons of the biceps, subscapularis, and infraspinatus muscles, and communicates with bursse beneath the 2 latter tendons. Its Arteries are derived from the anterior and posterior circumflex and the suprascapular; its Nerves from the circumflex and the supra- scapular. It has 3 ligaments, viz. — Capsular^ from the margin of the glenoid cavity to the anatomical neck of the humerus : has 3 openings for the reflexions of the synovial membrane over the tendons. Coraco-humeral^ intimately united with the capsular, extends from the cora- coid process to the greater tuberosity. Glenoid, a fibro-cartilaginous ring, continuous above with the tendon of the THE ARTICULATIONS. 61 long head of the biceps,'' and attached around the mar- Fig. 34. gin of the glenoid cavity in order to deepen the articu- lar surface. Describe the Elbow-joint. It is a ginglymus articulation, formed by the lower end of the humerus with the greater sigmoid cavity of the ulna and the head of the radius. Its Synovial Membrane is reflected over the ligaments, and dips down between the surfaces of the superior radio-ulnar articu- lation. Its Arteries are derived from the anastomotica magna, radial ulnar, and interosseous recurrent, superior and inferior profunda arteries. Its Nerves are branches of the ulnar and the musculo-cutaneous. It has 4 ligaments.' — Anterior^ from the inner condyle and anterior sutface of the humerus to the orbicular ligament of the radius and the coronoid process of the ulna. Posterior^ from the posterior surface of the humerus to the olecranon process of the ulna. External Lateral,^ from the external condyle of the hu- merus to the orbicular ligament of the radius. Internal Lateral, from the internal condyle of the humerus to the coronoid and olecranon processes of the ulna. Describe the Radio-ulnar Articulations. They are 3 in number, as follows, viz. — Superior radio-ulnar articulation is a lateral ginglymoid joint, formed by the head of the radius and the lesser sigmoid cavity of the ulna. Its synovial membrane is a continuation of that in the elbow-joint. It has I ligament, the — Orbicular Ligament,^ forms four- fifths of a circle and surrounds the neck of the radius. It is attached to the margins of the lesser sigmoid cavity of the ulna, and to the external lateral ligament of the elbow-joint. Middle radio-ulnar articulation is formed by the shafts of the radius and ulna, which do not touch each other, but are connected by 2 ligaments, as follows, viz. — Oblique Ligament, from the tubercle at the base of the coronoid process of the ulna to the shaft of the radius. Interosseous Membrane^ obliquely downwards from the interosseous ridge on the radius to that on the ulna. Through the interval between its upper border and the oblique ligament, the posterior interosseous vessels pass. Inferior radio-ulnar articulation is a lateral ginglymoid joint, formed by the head of the ulna and the sigmoid cavity of the radius. Its Synovial Membrane (membrana sacciformis) is very loose, and sometimes communicates 6 62 ANATOMY, with that of the wrist joint through an opening in the triangular fibro-cartilage which separates the head of the ulna from the wrist-joint, and acts as one of the ligaments of this articulation, which are 3, viz. — Anterior Radio- ulnar. Posterior Radio-ulnar. Triangular Interarticular Fibro- cartilage. Describe the Wrist-joint. It is chiefly an enarthrodial articulation, though incapable of rotation, and is formed by the lower end of the radi^us and the tri- angular fibro-cartilage, with the scaphoid semilunar and cuneiform bones of the carpus. Its Arteries are the anterior and posterior carpal from both the radial and ulnar, the anterior and posterior interosseous and ascending branches from the deep palmar arch. Its Nerves are derived from the ulnar; it is lined by a synovial membrane, and has 4 ligaments, viz. — External Lateral (radio-carpal). Anterior. Internal Lateral (ulno-carpal). Posterior. Describe the Carpal Articulations. They are in 3 sets, (i) between the bones of the first row, (2) between the bones of the second row, (3) between the 2 rows of bones. (i) The scaphoid, semilunar, and cuneiform bones are connected together by 2 Dorsal, 2 Palmar, and 2 Interosseous Ligaments. The pisiform bone has a separate capsular ligament and synovial membrane and 2 fasciculi connecting it with the unciform and the 5th metacarpal. (2) The 4 bones of the second row are connected together by j Dorsal, j Palmar, and j Interosseous Ligaments. (3) The 2 rows of bones are united by a Dorsal, a Palmar, and 2 Lateral Ligaments, the last named being continuous with the lateral ligaments of the wrist-joint. Describe the Carpo-metacarpal Articulations. That of the thumb with the trapezium is an enarthrodial joint, having a Capsular Ligament and a separate synovial membrane. The 4 inner metacarpal bones form 4 arthrodial joints with the adjacent carpal bones by 6 Dorsal, 8 Palmar, and 2 Interosseous Liga- ments, irregularly disposed. Describe the Synovial Membranes of the Wrist. They number 5, and are situated as follows, viz. — The First, or Membrana Sacciformis, between the head of the ulna, the sig- moid cavity of the radius, and the triangular interarticular fibro-cartilage. The Second, between the lower end of the radius, the triangular fibro-carti- lage, and the scaphoid, semilunar, and cuneiform bones of the carpus. The Third, between all the carpal bones except the pisiform, and between the bases of the inner 4 metacarpal bones ; but it extends only halfway into the 2 intervals between the 3 proximal bones of the carpus. THE ARTICULATIONS. 63 The Fourth, between the trapezium and the metacarpal hone of the thumb. The Fifthy between the cuneiform and pisiform bones. Describe the Metacarpo-metacarpal Articulations. The 4 inner meta- carpal bones are connected together at their bases by Dorsal, Palmar, and Interosseous Ligaments; and at their digital extremities by th^ Transverse Ligament. Describe the remaining Articulations of the Hand. The metacarpo- phalangeal and the phalangeal articulations are all ginglymoid joints, and each has an Anterior and 2 Lateral Ligaments, the former being lined each with a synovial membrane. There are no posterior ligaments to these articulations, the extensor tendons of the hand supplying their places. Describe the Hip-joint. It is a true enarthrodial articulation, formed by the head of the femur with the acetabulum of the os innominatum. Its Syno- vial Membrane is extensive, investing most of the head and neck of the femur, the capsular cotyloid and teres ligaments, and the cavity of the acetabulum. Its Arteries are derived from the obturator, sciatic, internal circumflex, and gluteal. Its Nerves are branches from the sacral plexus, great sciatic, obtu- rator, and accessory obturator. It has 5 ligaments, as follows, viz. — Capsular, from the margin of the acetabulum and the transverse ligament, into the base of the neck of the femur above, the anterior inter-trochan- teric line in front, and to the middle of the neck of the bone, behind. Iliofemoral or Y-ligament, from the anterior inferior spine of the ilium, into the anterior inter- trochanteric line by two fasciculi. It is a dissected por- tion of the capsular ligament which is very strong anteriorly. Ligamentum Teres, from a depression on the head of the femur into the margins of the cotyloid notch of the acetabulum and into the transverse ligament, by two fasciculi. Cotyloid, a fibro-cartilaginous band surrounding the margin of the acetab- ulum in order to deepen its cavity. Transverse, that part of the cotyloid ligament which crosses over the coty- loid notch converting it into a foramen. Describe the Knee-joint. It is a ginglymus articulation, formed by the condyles of the femur with the head of the tibia, and the patella in front. Its Synovial Alembrane is the largest in the body, being reflected for 2 or 3 inches over the anterior surface of the femur, where it is supported by the sub- crureus muscle, also over its condyles, the patella, semilunar cartilages, crucial ligaments, and head of the tibia ; and is prolonged through an opening in the capsular ligament beneath the tendon of the popliteus. Its Arteries are derived from the anastomotica magna, the 5 articular branches of the popliteal, and the recurrent branch of the anterior tibial. Its Nerves are branches of the 64 ANATOMY, obturator, anterior crurul, external and internal popliteal. It has 14 ligaments, of which 6 are external and 8 internal, as follows : — Anterior, or Ligojfiejitum Patella, is a continuation of the tendon of the Fig. 35. rectus femoris muscle, extending from the apex of the patella to the lower part of the tubercle of the tibia. Posterior, or Ligamentum Winslowii} from the inner tuberosity of the tibia to the external condyle of the femur, being partly derived from the tendon of the semimembranosus muscle. ^ Internal Lateral^ from the internal condyle of the femur to the internal surface of the tibia and semi- lunar cartilage. 2 External Lateral^ from the external condyle of the femur to the head of the fibula. These ligaments are a Long anteriorly and a Short posteriorly, separated by the tendon of the biceps. Capsular, is only present where intervals are left by the preceding ligaments. It is thin but very strong. The Internal ligaments are as follows: — Anterior Crucial^ from the depression in front of the spine of the tibia to the inner side of the outer condyle of the femur. Posterior Crucial^ from the same depression, to the outer side of the inner condyle. [To remember the positions and insertions of these crucial liga- ments, let the student cross his index fingers over each knee in succession; when over the right knee placing the right finger in front, when over the left knee the left finger in front. The positions of the fingers will then in each case correspond with those of the respective crucial ligaments,] Fig. 36. 2 Semilunar Fibro- cartilages^ external and internal, are situated between the articular surfaces, and attached to the depressions in front and behind the spine of the tibia. Transverse,^ is a connecting slip between the semilunar fibro-cartilages anteriorly. Coronary^ are short bands connecting the outer margins of the fibro-cartilages to the tibia and the adjacent lig- aments. Ligamentum Mticostim, is a triangular fold of the syn ovial membrane which at the lower border of the patella is given off to the intercondyloid notch of the femur. Ligamenta Alaria, are fringes on the sides of the liga- mentum mucosum, and are attached to the sides of the patella. THF, ARTICULATIONS, 65 Bursce in the vicinity of this joint are 5, viz. — I under the ligamentum patellce," I between the patella and the skin; I betw^een the internal lateral ligament and the tendons crossing it ; sometimes i replacingthe synovial pouch on the anterior surface of the femur; and occasionally i in the popliteal space re- placing the synovial pouch usually situated therein. Describe the Tibio-fibular Articulations. They are 3 in number, as follows, viz. — Superior tibio-fibular articulation, is an arthrodial joint, formed by the contiguous surfaces of the bones. It has a Synovial Membrane which is sometimes continuous with that of the knee-joint, and 2 ligaments, the — Anterior and Posterior Superior Tibio-fibular^^ which connect the head of the fibula with the outer tuberosity of the tibia. Middle' tibio-fibular articulation. The shafts of these bones do not touch each other, but are connected by the Interosseous Membrane extending between their contiguous borders, and perforated, above for the anterior tibial artery, below for the anterior peroneal vessels. Inferior tibio-fibular articulation, is an amphi-arthrodial joint, formed by the contiguous rough surfaces on the bones. Its Synovial Mem- brane is derived from that of the ankle-joint, and it has 4 ligaments, viz. — Inferior Interosseous, continuous with the interosseous membrane. Anterior and Posterior Inferior Fibio fibular, from the margins of the ex- ternal malleolus to the front and back of the tibia. Transverse, posteriorly between the 2 malleoli. Describe the Ankle-joint. It is a ginglymoid articulation, formed by the lower ends of the tibia and fibula and their malleoli, with the astragalus. Its Synovial Membrane is prolonged upwards between the tibia and fibula for a short distance. Its arteries are derived from the malleolar branches of the anterior tibial and peroneal arteries ; and its Nerves from the anterior tibial nerve. It has 3 ligaments, viz. — Anterior, connecting the margins of the tibia and astragalus. Internal Late?'al, or Deltoid Ligament, from the internal malleolus to the 3 adjacent tarsal bones. External Lateral, by anterior posterior and middle fasciculi, from the ex- ternal malleolus to the astragalus and os calcis. Describe the Tarsal Articulations. They are in 3 sets, (i) between the bones of the first row, (2) between the bones of the second row, (3) between the 2 rows of bones. (l.) The astragalus and os calcis are united by 3 ligaments. External Calcaneo-astragaloid. Interosseous. Posterior Calcaneo-astragaloid, 6* E (2.) The scaphoid, cuboid, and three cuneiform bones are united by an ir- regular number of U>orsa/ and Plantar and 4 Interosseus ligaments, which latter are arranged transversely. (3.) The 2rrows of bones are united by 7 ligaments viz, — Superior Astragalo scaphoid. Inferior Calcaneo-scaphoid. Superior Calcaneo-cuboid. Short Calcaneo-cuboid. Superior Calcaneo-scaphoid. Long Calcaneo-cuboid. Interosseous.^ or Internal Calcaneo-cuboid. Describe the Tarso-meta tarsal Articulations. They are 5 arthrodial joints formed by the bases of the metatarsal bones with the adjacent bones of the tarsus, the 2d metatarsal bone articulating with all 3 cuneiform in the recess formed by the shortness of the second cuneiform. They are united by Dorsal y Plantar, and 3 Interosseous Ligaments. The 2d metatarsal bone has 3 dorsal ligaments, i from each cuneiform bone. The interosseous ligaments pass from the 2d and 3d metatarsal bones to the internal and ex- ternal cuneiform. Describe the Synovial Membranss of the Tarsus and Metatarsus. They are 6 in number, and are situated as follows, viz. — The First, between the os calcis and the astragalus, behind the interosseous ligament. The Second, between the same bones in front of the interosseous ligament, also between the astragalus and the scaphoid. The Third, between the os calcis and the cuboid. The Fourth, between the scaphoid and the 3 cuneiform bones, running backwards between the scaphoid and the cuboid, forwards between the cuneiform bones, between the external cuneiform and the cuboid, between the middle and external cuneiform and the bases of the 2d and 3d metatarsal, passing also between the bases of these bones and the 4th metatarsal. The Fifth, between the cuboid and the 4th and 5th metatarsal bones, also running forwards between their bases. The Sixth, between the internal cuneiform and the base of the ist meta- tarsal bone. Describe the Metatarso-metatarsal Articulations. The metatarsal bones are connected together, except the first, at their bases by Dorsal, Plantar, and Interosseous Ligaments ; and all 5 are connected at their digital extremities by the Transverse Metatarsal Ligament. Describe the remaining ArticulatiDns of the Foot. The metatarso- phalangeal and the phalangeal articulations are similar to those in the hand, each having an Interior or Plantar, and 2 Lateral Ligaments. The extensor tendons of the foot supply the places of posterior ligaments. THE MUSCLES AND FASCIA. 67 THE MUSCLES AND FASCIA. What are the Muscles? They are the active organs of locomotion, formed of bundles of reddish fibres endowed with the property of shortening themselves upon irritation, which is called muscular contractility, and chemically consisting of syntonin, or muscular fibrin. How are the Muscles divided ? Into 2 great classes, ( i ) Voluntary, Striped^ or Muscles of animal life, comprise those which are under the control of the will. (2) Involuntary, Unstriped, or Muscles of organic life, are those which are not under the control of the will. Voluntary Muscular Fibre consists of fasciculi about ^1^ inch in diameter, each surrounded by a tubular membranous sheath, the perimysium; and marked by fine striae passing around them in curved parallel lines about yy^^o i^^ch apart. These fasciculi are formed oi fibrillce, each about j^^^^y inch thick, also striated, presenting the appearance of a row of minute particles, the "sarcous elements" of Bowman, and surrounded by cellular tissue, the sarco- lemma. Involuntary Muscular Fibre consists of flattened fusiform or spindle-shaped fibres, averaging about y^VcT '"^^ ^^ breadth, consisting of elongated cells, and bound together in bundles by areolar tissue. These fibres are found in the alimentary canal, in the posterior wall of the trachea, in the bronchi, the ducts of certain glands, in the ureters, bladders, urethra, genitalia of both sexes, walls of all arteries and most veins and lymphatics, in the iris and ciliary muscle, and in the skin. What are Tendons and Aponeuroses ? Tendons are white, glistening cords or bands formed of white fibrous tissue almost entirely, have few vessels and no nerves, and serve to connect the muscles with the structures on which they are. Aponeuroses are fibrous membranes, of similar structure and appearance, and serve the same purpose. What are Fasciae? They are laminae of variable thickness which invest [fascia, a bandage) the softer structures. The superficial fascia is composed of fibro-areolar tissue, and is found beneath the skin almost over the whole body. The deep fascia is of aponeurotic structure, dense, inelastic, and fibrous, ensheathing the muscles and affording some of them attachment, also the vessels and nerves, and binding down the whole into a shapely mass. To what Structures are Muscles attached ? To the periosteum and peri- chondrium of bone and cartilage, to the subcutaneous areolar tissue, and to ligaments. In the latter case only are their tendons in direct contact with the tissue on which they are to act. How many Muscles are Double-bellied ? Five, — the occipito-frontalis, biventer cervicis, digastric, omo-hyoid, and the diaphragm. Describe each Muscle of the Body, giving its Origin, Insertion, Action, and Nervous supply. MUSCLES OF THE HEAD. Occipito-fTontalis,« fro7}i the external two-thirds of the superior curved line of the occipital bone and the mastoid process of the temporal ; also from the pyramidalis nasi, corrugator supercilii, and orbicularis palpebrarum fibres, — into an aponeurosis or "galea capitis," which covers the vertex of the skull. Action, chiefly as a muscle of facial expression. Nerves, facial, supraorbital, small occipital. AttoUens Aurem, from the occipito-frontalis aponeurosis, — into the pinna of the ear superiorly. Action, to raise the pinna. Nerve, small occipital branch of the cervical plexus. Attrahens Aurem, from the lateral cranial aponeurosis, — into the helix of the ear anteriorly. Action, to draw the pinna forwards. Nerves, facial, and auriculo temporal branch of the inferior maxillary. Retrahens Aurem, from the mastoid process of the temporal bone, — into the concha. Action, to retract the pinna. Nerve, facial. Orbicularis Palpebrarum, y>'c?w the internal angular process of the frontal bone, the nasal process of the superior maxillary, and the borders of the tendo oculi, — thto the skin of the eyelids, forehead, temple, and cheek, blending with the occipito-frontalis and the corrugator supercilii. Action, to close the eyelids. Nerve, facial. Corrugator Supercilii, froDi the inner end of the superciliary ridge of the frontal bone, — into the orbicularis palpebrarum. Action, to draw eyebrow downwards and inwards. Nerve, facial. Tensor Tarsi (Homer's \a\x%Q\€), from the crest of the lachrymal bone, — into the tarsal cartilages by two slips. Action, to compress the puncta lachry- malia against the globe of the eye, and to compress the lachrymal sac. N'erve, facial. Levator Palpebrae Swpexioxis, from the lesser wing of the sphenoid, — into the upper tarsal cartilage. Action, to lift the upper lid. Nerve, 3d cranial, or motor oculi. Rectus Superior, from the upper margin of the optic foramen and the sheath of the optic nerve, — into the sclerotic coat. Action, to rotate the eyeball upwards. Nerve, 3d cranial. Rectus Inferior, from the ligament of Zinn, — into the sclerotic coat. Action, rotates the eyeball downwards. Nerve, 3d cranial. Rectus Intemus, froju the ligament of Zinn, — into the sclerotic coat. Action, rotates the eyeball inwards. Nerve, 3d cranial. MUSCLES OF THE HEAD. 69 Rectus Extemus, by 2 heads, the upper from the outer margin of the optic foramen, the lower from the ligament of Zinn and a bony process at lower margin of the sphenoidal fissure, — intc the sclerotic coat. Action^ to rotate the eyetiall outwards. Nerve, 6th cranial, or abducens. Between the 2 heads of the external rectus pass the 3d, nasal branch of the 5th, and the 6th cranial nerves, and the ophthalmic vein. Obliquus Suj)erior, from about a line above the inner margin of the optic foramen, its tendon passing through a " pulley " near the internal angular process of the frontal bone and thence beneath the rectus superior, — into the sclerotic coat at right angles to the insertion of the rectus superior. Action, to rotate the eyeball on its antero-posterior axis. Nerve, 4th cranial, or patheticus. Obliquus Inferior, /re-;/; the orbital plate of the superior maxillary, — into the sclerotic coat below the insertion of the external rectus and at right angles thereto. Action, to rotate the eye on its antero-posterior axis. Nerve, 3d cranial. Pyramidalis Nasi,'^ from the occipito-frontalis, — into the compressor naris. Action, to depress the eyebrow. Nerve, facial. Levi|tor Labii Superioris Alseque Nasi,^ from the nasal process of the superior maxillary bone, — hito the cartilage of the ala of the nose and into the upper lip. Action, to elevate the upper lip, and dilate the nostril. Nerve, facial. Dilator Naris Anterior, /rd?w the cartilage of the ala, — into the border of its integument. Action, to dilate the nostril. Nerve, facial. Dilator Naris Posterior, /r(?/;z the nasal notch of the superior maxillary and the sesamoid cartilages, — into the in- tegument at the margin of the nostril. Action, to dilate the nostril. Nerve^ facial. Compressor Naris,^ from the superior maxillary above the incisive fossa, — into the fibro-cartilage of the nose, being continuous with its fellow and the pyramidalis nasi aponeurosis. Ac- tion, to dilate the nostril. Nerve, facial. Compressor Narium Minor, from the alar cartilage, — into the skin at the end of the nose. Action, to dilate the nostril. Nerve^ facial. Fig. 37. 70 ANATOMY. Depressor Alae Nasi, from the incisive fossa of the superior maxillary, — mtc the septum and ala of the nose. Action, to contract the nostril. Nerve, facial. Levator Labii Superions,//rfw the lower margin of the oxhMy^— into the upper lip. Action, to elevate the lip. Nerve, facial. Levator Anguli Ot\s,o from the canine fossa of the superior maxillary, — into the angle of the mouth. Actioti, as named. Nerve, facial. Zygomaticus Major/^ fro77i the malar bone, — into the angle of the mouth. Action, to raise the lip outwards. Nerve, facial. Zygomaticus Minor,^ from the malar bone anteriorly, — into the angle of the mouth, blending with the levator labii superioris. Action, to raise the lip outwards. Nerve, facial. Levator Labii Inferioris'« (Levator Menti),/r^w the incisive fossa of the in- ferior maxillary bone, — into the integument of the lower lip. Action, as named. Nerve, facial. . Depressor Labii Inferioris^ (Quadratus Menti),yr^z;z the external oblique line of the inferior maxillary bone, — into the lower lip. Action, as named. Nerve, facial. Depressor Anguli Oris« (Triangularis Menti),/;w;/ the external oblique'^line of the inferior maxillary, — into the angle of the mouth. Action, as named. Nerve, facial. Orbicularis Oris,-^ by accessory fibres (accessorii orbicularis superioris and in- ferioris, and naso-labialis)yr^/;^ the nasal septum and the superior and in- ferior maxillary borders, — into the buccinator and other adjacent muscles, forming the sphincter of the mouth. Action, to close the mouth. Nerve, facial. Buccinator,/ from the posterior alveolar processes of both the maxillary bones and the ptery go-maxillary ligament, — into the orbicularis oris. Ac- tion, to compress the cheeks. Nerves, facial, and the buccal branch of the inferior maxillary. Risorius, from the fascia over the masseter muscle, — itito the angle of the mouth. Action, the laughing muscle. Nerve, facial. Masseter,2 froi7i the anterior two-thirds and the inner surface of the zygoma and the malar process of the superior maxillary, — into the angle, ramus, and coronoid process of the lower jaw. Action, to raise the back part of the lower jaw ; a muscle of mastication. Nerve, inferior maxillary. Temporal, from the temporal fossa and temporal fascia, — into the coronoid process of the inferior maxillary. Action, to bring the incisor teeth together; the biting muscle. Nerve, inferior maxillary. MUSCLES OF THE EAR AND NECK. 71 Internal Pterygoidj from the pterygoid fossa of the sphenoid bone, and the tuberosity of the palate, — in/o the angle and inner surface of the ramus of the jaw, as high as the dental foramen. Action, raises and draws for- ward the lower jaw ; a triturating muscle of mastication. Nerve, inferior maxillary. External Pterygoid, by 2 heads, the upper, from the pterygoid ridge on the greater wing of the sphenoid, the lower from the external pterygoid plate, and the tuberosities of the palate and superior maxillary bones, — into a depression in front of the condyle of the inferior maxillary, and the inter- articular fibro-cartilage. Action, to draw the jaw forwards; a triturating muscle of mastication. Nerve, inferior maxillary. Between the two heads of the external pterygoid muscle passes the internal maxillary artery. MUSCLES OF THE EAR. Tensor Tympani, from the under surface of the petrous portion of the tem- poral bone, the cartilaginous Eustachian tube, and its own osseous canal, — into the handle of the malleus. Action, to draw the membrana tympani tense. Nerve, branch from otic ganglion. Laxator Tympani Major, from the spinous process of the sphenoid and the cartilaginous Eustachian tube, — through the Glasserian fissure to the neck of the malleus just above the processus gracilis. Action, to relax the mem- brana tympani. Nerve, tympanic branch of the facial. Laxator Tympani Mx!\ox,from the back of the external meatus, — ^passes be- tween the layers of the membrana tympani into the handle of the malleus and processus brevis. Action, to relax the membrana tympani. Considered a ligament by many anatomists (the lig. mallei posticum). Stapedius, /r^w the interior of the pyramid, — through the orifice at its apex into the neck of the stapes. Action, to depress the base of the stapes. Nerve, filament from the facial. MUSCLES OF THE NECK. Platysma "^yoxdits, from the clavicle, the acromion, and the fascia covering the pectoral, deltoid, and trapezius muscles, — into the lower jaw, the angle of the mouth, and the cellular tissue of the face. Action, to wrinkle the skin, and depress the mouth. Nerves, facial and superficial cervical. Sterno-cleido-mastoid,'^ by two heads from the sternum ^^^ and the clav- icle^' at its inner third, — into the mastoid process of the temporal bone, and the superior curved line of the occipital. Action, to depress and rotate the head. Nerves^ spinal accessory, and branches of the cervical plexus. 72 ^^^^^ ^^ F^G. 38. Between the sternal and clavicular origins is a fossa, the fonticulus gtdturis, which rises and falls during la- bored breathing. Sterno-hyoid, 1* from the posterior surface of the sternum and the sternal end of the clavicle, — into the body of the hyoid bone. Action, to de- press the hyoid bone. Nerve, a branch from the communicating loop between the de- -^ scendens and com- municans noni. Stemo-thyroid,'^/rt7/;z the posterior surface of the sternum and the cartilage of the 1st rihy— into the oblique line on the ala of the thyroid cartilage. Action, to depress the larynx. Nerve, a branch from the communicating loop between the descendens and communicans noni. Thyro-hyoid,'^ from the oblique line on the thyroid cartilage, — into the body and greater comu of the hyoid bone. Action, to elevate the larynx. Nerve, hypoglossal. Omo-hyoid,^' '^ f-om the upper border of the scapula and the transverse ligament, — into the body of the hyoid bone. It has a tendon in its centre which is bound down to the cartilage of the 1st rib by a loop of the deep cervical fascia. Action, to depress the hyoid bone, and draw it backwards. Nerve, branch from the communicating loop between the descendens and communicans noni. Digastric, by 2 bellies, the posterior ane"^ from the digastric groove of the mastoid process of the temporal bone; the anterior^ from a fossa on the inner surface of the inferior maxillary, near its symphysis, — into a central tendon' which perforates the stylo-hyoid muscle, and is bound down to the body of the hyoid bone by an aponeurotic loop. Action, to raise the hyoid bone and tongue. Nerves, facial, and mylo-hyoid branch of the inferior dental. Stylo-hyoid,* from, the styloid process of the temporal bone near its base, — into the body of the hyoid Iwne. Action, to elevate and retract the hyoid bone. Nerve, facial. This muscle is perforated by the digastric. MUSCLES OF THE NECK. 73 Mylo-hyoid,5 from the mylo-hyoid ridge of the lower jaw, — into the body of the hyoid bone and a fibrous raphe in the median line running from the hyoid bone to the chin. Action^ elevates the hyoid bone and draws it forwards, also forms the floor of the mouth. Nerve, mylo-hyoid branch of inferior dental. Genio-hyoid,^ from the inferior genial tubercle of the inferior maxillary, — into the body of the hyoid borie. Action, same as the mylo hyoid. Nerve, hypoglossal. Genio-hyo-glossus, from the superior genial tubercle of the inferior maxillary, — into the body of the hyoid bone, the side of the pharynx, and the whole length of the under surface of the tongue, forming a fan-like muscle. Action, to retract and protrude the tongue. Nerve, hypoglossal. Hyo-glossus^ (the basio-kerato-chondro-glossus), from the body of the hyoid bone, its lesser cornu, and the whole length of its greater cornu, — into the side of the tongue. Action, to draw down the side of the tongue. Nerve, hypoglossal. Stylo-glossus,^ from the styloid process and the stylo-maxillary ligament, — into the side of the tongue and the hyo-glossus muscle. Action, to elevate and retract the tongue. Nerve, hypoglossal. Lingualis, lies between the hyo-glossus and the genio-hyo-glossus, from the base to the tip of the tongue, along its under surface ; some of its fibres being attached to the hyoid bone. Action, to elevate the centre of the tongue. Nerve, chorda tympani. Inferior Constrictor, from the sides of the cricoid and thyroid cartilages, — into the fibrous raphe of the pharynx. Action, to contract the pharyngeal calibre. Nerves, glosso-pharyngeal, pharyngeal plexus, and external laryn- geal. Middle Constrictor, from the cornua of the hyoid bone and the stylo-hyoid ligament, — into the pharyngeal raph6. Action, to constrict the pharynx. Nerves, glosso-pharyngeal, pharyngeal plexus. Superior Constrictor, from the lower third of the margin of the internal pterygoid plate and its hamular process, the contiguous part of the palate bone, the tendon of the tensor palati, the pterygo-maxillary ligament, part of the alveolar process of the lower jaw and the side of the tongue, — into the pharyngeal raph6 and the pharyngeal spine of the occipital bone. Action, to constrict the pharynx. Nerves, glosso-pharyngeal, pharyngeal plexus. Stylo- phsuyngeus,'** from the inner side of the base of the styloid process, — into the constrictor and palato-pharyngeus muscles, and the thyroid car- 7 74 ANATOMY. tilage. Action, to elevate the pharynx. Nerves, glossopharyngeal, pharyn- geal plexus. The former nerve crosses this muscle in passing to the tongue. Levator Palati, front the under surface of the apex of the petrous portion of the temporal bone and from the Eustachian tube, — into the posterior surface of the soft palate. Action, to elevate the soft palate. Nerve, facial, through the Vidian and petrosal. Tensor Palati, from the scaphoid fossa of the sphenoid bone and the Eusta- chian tube, — reflected around the hamular process, — into the anterior surface of the soft palate, and the horizontal portion of the palate bone. Action, to tense the palate. Nerve, a branch from the otic ganglion. Azygos Uvulae, from the posterior nasal spine of the palate bone, and from the soft palate, — into the uvula. Action, possibly to raise the uvula. Nerve, facial, through the Vidian and petrosal. This muscle is wrongly named, as it is double. Palato-glossus (anterior pillar of the fauces), from the anterior surface of the soft palate laterally, — into the side and dorsum of the tongue. Action, con- strictor isthmi faucium. Nene, anterior crural. Fascia Lata, the deep fascia of the thigh, extends from Poupart's ligament to the prominent points around the knee-joint, and from the margin of the sacrum and coccyx around the limb to the pubic arch and pectineal line. It sends two strong intermuscular septa down to the linea aspera, and con- tains the Saphenous Opening, which is fonned by the reflected margins of its pubic and iliac portions. Pouparf s Ligament is made by the knife, and is only the line of junction between the aponeurosis of the external oblique 92 ANATOMY. Fig. 47. "i muscle and the fascia lata ; extending from the anterior superior spine of the ilium to the spin^ of the pubic bone. Tensor V aginse Femoris,* /fom the anterior part of the outer lip of tlie iliac crest, and the anterior superior spinous process, — into the fascia lata later- ally, for one-fourth down the thigh. Action, a tensor of the fascia lata. Nerve, superior gluteal. Sartorius,* from the anterior superior spine of the ilium 2 and half of the notch below it, — into the upper internal surface of the shaft of the tibia. Action, to flex and cross the legs. Nerve, anterior crural. Quadriceps Extensor, includes the rectus, vastus internus and externus, and the crureus muscles. Its tendon contains the patella. lectus Femoris,^ by two tendons, the Straight from the anterior inferior spine of the ilium, the Reflected from a groove above the brim of the acetabulum, — into the tuberosity of the tibia by the tendon * common to this and the next 3 muscles. Action, to extend the leg. Nerve, anterior crural. Vastus Externus,'^ front the anterior border of the great trochanter and the whole length of the linea aspera, — into the tuberosity of the tibia, by the common tendon. Vastus Internus ^ and Crureus are one muscle, arising from the inner lip of the linea aspera and nearly the whole of the shaft of the femur in front and laterally from the trochanters down to within the lower one-fourth of the bone, — into the tuberosity of the tibia by the common extensor tendon. Action, to extend the leg. Nerve, anterior crural. Subcrureus, from the lower part of the femur anteriorly, — into the synovial pouch behind the patella. Action, to draw up the synovial sac. Nerve, anterior crural. Qir2SiTX\'&}^ from the inner margin of the rami of the pubes and ischium, — into the inner surface of the shaft of the tibia below the tuberosity. Action, to flex and adduct the leg. Nerve, obturator. Pectineus,i2 from the ilio-pectineal line, and the bone in front thereof, also from an expansion of Gimbernat's ligament, — into the rough line extending f ^f^ if |X,.^;^^^hi. 5 ^^^^ / \ .'X\SS- \^> ,ua^^ \ ^\^ MUSCLES OF THE HIP AND THIGH. 93 from the trochanter minor to the linea aspera. Action, to flex the thigh and rotate it outwards. Nerves^ obturator, accessory obturator, and anterior crural. Adductor Longus,^^/)-^/^/ the front of the pubes, — into the middle third of the linea aspera. Action, to adduct the thigh and flex it. Nerve, obturator. Adductor Brevis, front the descending ramus of the pubes, — into the upper part of the linea aspera. Action, to adduct and flex the thigh. Nerve, obturator. Adductor Magnus,^* from the rami of the pubes and ischium, and the outer margin and under surface of the tuberosity of the ischium, — into the rough line leading from the great trochanter to the linea aspera, the whole length of the linea aspera, and by a tendon into the tubercle above the inner con- FlG. 48. dyle of the femur. Action, to adduct the thigh and rotate it outwards. A^ei-ves, obturator and great sciatic. This muscle is pierced by 4 aper- tures for the 3 superior perforating and the profunda arteries, and about the lower one-third of its insertion an angular interval is left therein, the lower opening of Hunter's canal, for the passage of the femoral vessels into the popliteal space. Gluteus Maximus,^ from the superior curved line of the ilium, the crest behind it, the last piece of the sacrum, the side of the coccyx and the great and posterior sacro-sciatic ligaments, — into the fascia lata and the rough line leading from the great trochanter to the linea aspera. Action, to extend and abduct the thigh and rotate it out- wards, also to maintain the trunk erect. Nerves, inferior gluteal and a branch from the sacral plexus. Gluteus Medius,« from the ilium between the su- perior and middle curved lines, the crest between them and the fascia of the part, — into the oblique lines on the great trochanter. Action, its posterior fibres rotate the thigh outwards, its anterior fibres rotate inwards. It also abducts the thigh and draws it forwards, and assists to maintain the trunk erect. Nerve, superior gluteal. Gluteus Minimus,^ from the ilium between the middle and inferior curved lines, and the margin of the great sacro-sciatic notch, — into the anterior 94 border of the great trochanter. Aciion, to rotate the thigh inwards, also to abduct and draw it forwards, and to maintain the trunk erect. Nerve, superior gUiteal. Pyriformis,^ by 3 digitations from the front of the sacrum, from the margin of the great sacro-sciatic foramen and the great sacro-sciatic ligament, — into the upper border of the great trochanter,'' having passed through the great sacro-sciatic foramen. Aciion, an external rotator of the thigh. Nerves, branches from the sacral plexus. Obturator Intemus,^^ from the posterior bony margin of the obturator foramen and the inner surface of the obturator membrane, — into the great tro- chanter,'' passing through the lesser sacro-sciatic notch. Action, an external rotator of the thigh. Nerves, branches from the sacral plexus. Gemellus Superior ,^° fr-om the outer surface of the spine of the ischium, — into the great trochanter, being blended with the tendon of the obturator intemus. Action, an external rotator of the thigh. Nerves, branches from the sacral plexus. Gemellus Inferior,^''* from the tuberosity of the ischium, — i7ito the tendon of the obturator internus and the great trochanter. Action, an external rotator of the thigh. Nerves, branches from the sacral plexus. Obturator Extemus, from the anterior inner bony margin of the obturator fora- men, and the inner two-thirds of the anterior surface of the obturator mem- brane, — into the digital fossa of the femur at the inner base of the great trochanter. Action, an external rotator of the thigh. N'erve, obturator. Quadratus Femoris,^' frojn the tuberosity of the ischium, — into the upper part of the linea quadrati on the trochanter major posteriorly. Action, an external rotator of the thigh. Nerves, branches from the sacral plexus. Biceps,^^ by 2 heads, the Long Head divides Buccal, to the bucci- into Incisor and Mental. nator muscle. Describe the Internal Carotid Artery. It ascends in front of the transverse processes of the three upper cervical vertebrae, and close to the tonsil, traverses the carotid canal in the temporal bone, and after piercing the dura mater by the anterior clinoid process, divides into its terminal branches. Its branches are the Tympanic, enters the tympanum from the carotid canal, and anastomoses on the membrana tympani with the tympanic branch of the internal max- illary, the stylo-mastoid, and the Vidian arteries. Af'teria Peceptaculi, numerous small vessels going to the walls of the sinuses, the Gasserian ganglion and the pituitary body ; one of them, to the dura mater, is called the Anterior Meningeal. Ophthalmic, arises from the cavernous portion, enters the orbit through the optic foramen, terminating at the inner angle of the eye into the frontal and nasal branches. It gives off, — Lachrymal. Short Ciliary. Anterior Ethmoidal. Arteria Centralis Retinae. Anterior Ciliary. Palpebral. Muscular Branches. Supraorbital. Nasal. Long Ciliary. Posterior Ethmoidal. Frontal. Anterior Cerebral, joined to its fellow by the anterior communicating branch, about 2 lines long. 106 Fig. 57. Middle Cerebral, in the fissure of Sylvius ; divides into 3 branches, anterior, median, and posterior. Anterior Choroid, to the choroid plexus, corpus fimbriatum, etc. Posterior Communicating, anastomoses with the posterior cerebral, a branch of the basilar. What is the Circle of Willis? An anastomosis at the base of the brain, between the branches of the internal carotid and vertebral arteries, to equalize the cerebral circulation. The 2 Vertebral arteries join to form the Basilar, which ends in 2 Posterior Cerebral. These are connected with the Internal Carotid by the 2 Posterior Commztnicating. The circle is completed by the connection of the 2 Anterior Cerebral branches of the internal carotid through the short Anterior Communicating artery. Describe the Subclavian. It arises on the right side from the innominate, on the left side from the arch of the aorta, and is divided into 3 portions by the scalenus anticus, which crosses it just ex- ternal to the origin of the thyroid axis, viz. — the parts internal, behind, and ex- ternal to that muscle. At the outer border of the 1st rib, the subclavian becomes the axillaiy artery. Its upper border is a little above the clavicle, and it is separated from the subclavian vein by the scalenus anticus at its origin from the first rib. Its branches are all given oft' from its first portion, ex- cept the Superior Intercostal, which on the right side arises from the second por- tion. Vertebral^ passing up the neck, through the foramina in the transverse pro- cesses of six cervical vertebrae, and enters the skull by the foramen magnum, where it joins its fellow to form the Basilar Artery, Its branches are — Lateral Spinal Branches. Anterior Spinal. Muscular Branches. Posterior Spinal. Posterior Meningeal. Inferior Cerebellar. The Basilar, formed by the junction of the vertebrals, gives off" on each side a transverse, anterior, and superior cerebellar, and ends in the two posterior cerebral. (See Circle of Willis, above.) THE ARTERIES. 107 Thyroid Axis,^ at once divides into the three following branches: — Inferior Thyroid^ to the thyroid gland, giving off, — Laryngeal Branch. CEsophageal Branches. Tracheal Branches. Ascending Cervical." Transversalis Colli}^ divides beneath the margin of the trapezius into — Superficial Cervical. Posterior Scapular. Suprascapular y^ to the shoulder-joint and the dorsum of the scapula, anas- tomosing there with the posterior and subscapular. Internal Mammary}^ arises opposite the thyroid axis, descends upon the costal cartilages, and ends at the 6th interval, in the musculo-phrenic and superior epigastric, the latter anastomosing with the deep epigastric branch of the external iliac. Its branches are the — Comes Nervi Phrenici, Pericardiac. Perforating. or Superior Phrenic. Sternal. Musculo-phrenic. Mediastinal. Anterior Intercostal. Superior Epigastric. Superior Intercostal}^ gives ofif branches in the intercostal spaces to the posterior spinal muscles and to the spinal cord. Profunda Cervicis *® supplies the muscles of the back of the neck, and anastomoses with the arteria princeps cervicis of the occi- pital. Describe the Axillary .^ It is the continuation of the subclavian, extend- ing from the edge of the 1st rib to the lower margin of the armpit muscles, where it becomes the brachial. It has 7 branches, viz. — Superior Thoracic ^ to the pectoral muscles and walls of the thorax. Acro7nial Thoracic, branches are thoracic, acromial, descending. Thoracica Tonga, to the muscles of the chest and mammary gland. Thoracica Alaris, a small branch to the axillary glands. Subscapular, to the inferior dorsum of the scapula. Its branches anastomose with the supra- and posterior scapular, and are the — Subscapular. Dorsalis Scapulae. Median Branch. Posterior CircumJIex, to the deltoid muscle and the shoulder-joint. Anterior Circumjlex, to the joint and the head of the bone, anastomosing with the posterior circumflex and acromial thoracic. Describe the Brachial. It is the continuation of the axillary from the lower margin of the teres major tendon to its bifurcation into the radial and ulnar, which is usually about one-half inch below the bend of the elbow. The median nerve crosses it from the outside to the inside at its centre. Its branches are the — Superior Profunda, winds over the arm in the musculo-spiral groove, giving off the posterior articular to the elbow anastomosis. 108 ANATOMY. Nutrient Branch, enters the nutrient canal. Inferior Profunda, to the elbow-joint anastomosis. Anastoniotica Magna, anastomoses with the posterior articular, inferior pro- funda, anterior and posterior ulnar recurrent. Muscular Branches, to the muscles in the course of the artery. Describe the Radial. It extends from the bifurcation of the brachial to the deep palmar arch, and gives off the following branches respectively, in the fore- arm, the wrist, and the hand, viz. — Radial Recurrent. Posterior Carpal. Princeps Pollicis. Muscular. Metacarpal. Radialis Indicis. Superficialis Voice, Dorsalis Pollicis. Perforantes. Anterior Carpal. Dorsalis Indicis. InterossecE. Name the Branches of the Ulnar. It extends from the division of the brachial to the superficial palmar arch. It has 8 branches, viz. — Anterior Ulnar Recurrent. Muscular. Deep or Communicating Posterior Ulnar Recurrent. Anterior Carpal. Branch. Interosseous \ . ' Posterior Carpal. Digital. I Posterior. ^ ^ Describe the Palmar Arches. The Superficial Pahnar Arch is that part of the ulna artery lying in the palm of the hand, and anastomosing with the superficialis volse from the radial, and a branch from the radialis indicis, at the root of the thumb. It gives off 4 branches, the digital, to the sides of the fingers, except the inside of the index finger, which is supplied by the radialis indicis. The Deep Palmar Arch is formed by the palmar portion of the radial artery anastomosing with the deep or communicating branch of the ulna. It gives off the radialis indicis, palmar interossese, perforating and recurrent branches. Describe the Thoracic Aorta. It begins on the left of the spine, at the lower border of the 3d dorsal vetebra, and ends at the aortic opening in the diaphragm directly in front of the last dorsal vertebra. Its branches are as follows : — Pericardiac Branches, irregular in number and origin. Bronchial, also vary in number and origin ; generally one on the right side and two on the left. They nourish the lungs. CEsophageal, 4 or 5, anastomose on the oesophagus with branches of the in- ferior thyroid, phrenic, and gastric. Posterior Mediastinal, numerous small vessels. Intercostals, usually 10 on each side, each dividing into an anterior and a posterior branch. The anterior divides again into two along the adjacent borders of the ribs, supplying the intercostal muscles and anastomosing with THE ARTERIES, 109 branches of the internal mammary and axillary into a spinal branch going to the vertebrae and the spinal cord, and a muscular to the muscles of the back. Describe the Abdominal Aorta. It begins where the thoracic ends, and terminates at the 4th lumbar vertebra in the common iliacs. Its branches are as follows : — CCELIAC Axis,2 arises oppo- site the margin of the dia- phragm, runs forwards for half an inch and divides into the Gastric, Hepatic, and Splenic arteries, occa- sionally giving off one of the phrenics. Gastric^ supplies the stomach along its lesser curvature, anastomosing with the aortic, oesophageal, splenic, and he- patic branches. Hepatic,^ divides in the trans- verse fissure of the liver into the right and left branches, to the lobes of that organ ; also the — Pyloric. Cystic. The posterior divides Fig. 58. „ , J J ,. I Gastro-epiploica Dextra, Gastro-duodenali= ^ ■ ^ ^ lis/ Pancreatico-duodenalis. Splenic,^ the largest branch of the coeliac axis, passes by a very tortuous course to the spleen, giving off the following : — Pancreaticae Parvse. Gastric (vasa brevia). Pancreatica Magna. Gastro-epiploica Sinistra. Phrenic} one on each side, but usually only one arises from the aorta, the other springing from either the coeliac axis or the renal artery. They go to the under surface of the diaphragm, Superior Mesenteric,^ supplies the small intestine, caecum, ascending and 10 110 ANATOMY. transverse colon. Arising about one-fourth inch below the coeliac axis, it arches forwards, downwards, and to the left, giving off — Inferior Pancreatico duodenal. Ileo-colic. Vasa Inteslini Tenuis. Colica Dextra and Media. Inferior Mesenteric}^ supplies the descending colon, sigmoid flexure, and most of the rectum, giving off the following branches : — Colica Sinistra. Sigmoid. Superior Hemorrhoidal. Stipra-renal^ arise one on each side, opposite the origin of the superior mesenteric, passing to the supra-renal capsules. Renal} one from each side, just below the preceding, pass to the kidney, at the hilum having the middle place between the ureter behind and the renal vein in front. U. A. V. (you 'ave!) Spermatic}^ one on each side, in the male through the inguinal canal to the testes; in the female to the ovaries, uterus, and the skin of the labia and groins. Lumbar}^ usually 4 on each side, analogous to the intercostals. They each divide into two branches, the — Dorsal, giving off a spinal branch. Abdominal. . Middle Sacral}"^ arises just at the bifurcation of the aorta ; it descends along the sacrum and coccyx, giving off numerous branches. Describe the Common Iliac Arteries. They extend from the bifurcation of the aorta at the 4th lumbar vertebra to near the lumbo-sacral articulation, where they each divide into the external '^ and internal iliac, ^* They are about 2 inches in length, the right being a little longer than the left one, and each is crossed by the ureter, just before its bifurcation. Describe the Internal Iliac.'* It is about i^ inches long, and extends from the lumbo-sacral articulation to the great sacro-sciatic notch, where it divides into an anterior and a posterior trunk. From the anterior trunk are given off from above downwards, the — Superior Vesical, the remaining pervious part of the foetal hypogastric arteiy. It sends branches to the vas deferens and the ureter ; and one, the Middle Vesical, to the base of the bladder. Obturator, through the canal in the obturator foramen to the thigh, where it divides into an internal and external branch. Within the pelvis it gives off an iliac, vesical, and a pubic branch. In one out of 3j^ cases this artery arises from the epigastric. Inferior Vesical, to the bladder, prostate gland, and vesiculae seminales. In the female this artery is called the Vaginal. Middle Hemorrhoidal, to the rectum. Uterine, in the female, anastomosing with the ovarian. THE ARTERIES. Ill Internal Pudic, the smaller of the terminal branches of the anterior trunk, supplies the external generative organs. Its branches in the pelvis are numerous and small, in the perineum they are — Inferior Hemorrhoidal. Artery of the Bulb. Superficial Perineal. Artery of the Corpus Cavernosum. Transverse Perineal. Dorsal Artery of the Penis. Sciatic, the other terminal branch, supplies the muscles on the back of the pelvis. Its branches are as follows : — Muscular Branches. Coccygeal. Muscular, external Hemorrhoidal Branches, Inferior Gluteal. to the pelvis. Vesical Branches. Comes Nervi Ischiadic!. Articular Branches. The Posterior Trunk gives off the following : — Ilio-luinbar, dividing into lumbar and iliac branches. Lateral Sacral, superior and inferior on each side. Gluteal, the continuation of the posterior trunk, divides into a superficial and a deep branch, to the glutei muscles, the skin over the sacrum, and the hip joint. Before dividing, it gives a nutrient branch to the ilium, and some muscular branches. Describe the External Iliac. It extends to beneath the centre of Poupart's ligament, where it enters the thigh and becomes the Femoral Artery, lying be- tween the femoral vein on the inside and the anterior crural nerve on the out- side — V.A.N. Its branches are, small muscular and glandular, and — Epigastric, which usually arises a few lines above Poupart's ligament, passes between the peritoneum and the transversalis fascia, to the sheath of the rectus which it perforates, and ascends behind that muscle, to anastomose by numerous branches with the terminal branches of the internal mam- mary and inferior intercostal. It gives off — Cremasteric. Pubic. Muscular Branches. Circiuiiflex Iliac, arises opposite to the epigastric, passes along the crest of the ilium to anastomose with the ilio-lumbar, gluteal, lumbar, and epigas- tric arteries. Describe the Femoral Artery. It extends from Poupart's ligament to the opening in the adductor magnus, where it becomes the popliteal artery. Its course corresponds to a line drawn from a point midway between the anterior superior spine of the ilium and the symphysis pubis, to the inner side of the inner condyle of the femur. It lies in a strong fibrous sheath with the femoral vein, but divided from the latter by a. fibrous partition. It bisects Scarpa's triangle in the upper part of its course, where it is superficial, and rests 'on the inner margin of the psoas, which separates it from the capsule of the hip-joint. Its branches are as follows : — 112 ANATOMY. Fig. 59. Superficial EpigostHc,c to the superficial fascia of the abdomen. Superficial Circumflex Iliac^J to the skin over the iliac crest. Superficial External Pudic,d to the integu- ment of the lower abdomen, penis, and scrotum. Deep External Fudic,(i to the skin of the scrotum and perineum. Profunda Femoris,^ arises posteriorly about I or 2 inches below Poupart's liga- ment, and descends to the lower third of the back of the thigh, giving oft' the fol- lowing branches : — Ext. Circumflex. ;r Int. Circumflex. y 3 Perforating.-^ Muscular Branches, k to the sartorius and vastus internus. Anastomotic a Magna, arises from the femo- ral in Hunter's canal, and divides into a superficial and deep branch, the latter anastomosing around the knee-joint with the superior external and internal articu- lar arteries, and the recurrent tibia. Describe the Popliteal Artery. It extends from the opening in the adductor magnus to the lower border of the popliteus muscle, where, having passed behind the knee-joint, it divides into the anterior and posterior tibial arteries. Its branches are as follows : — Superior Muscular Branches. Inferior Muscular, or Sural. Cutaneous Branches. Superior External Articular. These are distributed around the knee-joint in a free anastomosis. The azygos branch perforates the posterior ligament of the joint to reach the internal ligaments and the synovial membrane. Describe the Anterior Tibial Artery. It extends from the bifurcation of the popliteal to the front of the ankle-joint, where it becomes the Dorsalis Pedis. It passes between the two heads of the tibialis posticus, over the upper edge of the interosseus membrane and along its anterior surface, resting on Superior Internal Articular.l Azygos Articular. Inferior External Artictilar. Inferior Internal Articular. THE ARTERIES. 113 the tibia for its lower one-third. It is accompanied by the anterior tibial nerve close to it externally, and is crossed below by the tendon of the extensor pro- prius pollicis. Its branches are — Recurrent Tibial. Muscular. External and Internal Malleolar. Describe the Dorsalis Pedis Artery. It is the continuation of the ante- rior tibial, extending from the front of the ankle-joint to the ist interosseous space, where it terminates in the Dorsalis Hallucis and the Communicating. The anterior tibial nerve lies close to its outer side. Its branches are as follows : — Tarsea, passing outwards along the tarsus. Metatarsea, giving off 3 interossese, and they 7 digital. DorsaWs Hallucis, to the great toe and the inner side of the second toe by its 3 digital branches. Communicating, which dips down into the sole of the foot in the 1st inter- osseous space of the metatarsus, to inosculate with the external plantar; and gives off 2 digital branches to the plantar surface of the great and second toes. Describe the Posterior Tibial Artery. It is a large vessel, extending from the bifurcation of the popliteal along the back of the tibia to the fossa below the inner malleolus, where it divides into the Internal and External Plantar. The posterior tibial nerve crosses it a short way below its origin and then lies close to its outer side for the rest of its course. Its branches are as follows : — Peroneal, along the fibular side, giving off the anterior peroneal, muscular branches, and the nutrient artery of the fibula. Nutrient of the Tibia, the largest nutrient artery of bone. Muscular Branches, to the posterior muscles of the leg. Communicating, a branch to the peroneal artery. Internal Calcanean Branches, to the heel and sole of the foot. Describe the Internal Plantar. This artery is the smallest of the termi- nating branches of the posterior tibial, and passes along the inner side of the foot and great toe. Describe the External Plantar Artery. It sweeps across the plantar aspect of the foot in a curve, the convexity of which is directed outwards and forwards; and at the interval between the bases of the ist and 2d metatarsal bones it inosculates with the communicating branch from the dorsalis pedis, forming the Plantar Arch, or the Stirrup Anastomosis. It gives off numerous muscular branches, and the — Posterior Perforating, 3 small branches passing through the 3 outer interos- seous spaces. 10* H 114 ANATOMY. Digital, 4 branches supplying the sides of the 3 outer toes and the outer side of the 2d toe ; its inner side, together with the great toe, being sup- ])lied by the Digital Branches of the Doisalis Pedis Communicating. Describ2 the Pulmonary Artery. It alone of the arteries carries venous blood, which it conveys from the right side of the heart to the lungs. It is only about 2 inches long, and nearly all within the pericardium ; arising from the right ventricle in front of the ascending aorta, passing upwards and back- wards to the under surface of the arch of the aorta, where it bifurcates, and is connected to the aorta by a fibrous cord, the remains of the ductus arteriosus of the foetus. Its terminal branches are the — Right and Left Pulmonary Arteries, the latter being the shorter of the two; pass horizontally outwards to the roots of their respective lungs, where each divides into two branches, which again and again subdivide to ramify through- out the lung tissue and end in the capillaries of those organs. ARTERIAL ANASTOMOSES. Describe the AnaEtomosis around th2 Shouldsr-joint. It is formed by the following 8 arteries, viz. — Posterior Scapular^ br. of transv. colli. Suprascapular, br. of thyroid axis. Subscapular, br, of axillary. Ant. Circumflex, br. of axillaiy. Dorsalis Scapula-, br. of subscapular. Post. Circumflex, br. of axillary. Infraspinous, br. of dorsalis scapulae. Acromial, br. of acromio-thoracic. "What Arteries Anastomose aroimd the Elbow-joint? The — Superior Profunda, br. of brachial. Radial Recurrent, br. of radial. Inferior Profunda, br. of brachial. Recurrent Interosseous, br. of posterior Anastomotica Magna, br. of brachial. interosseous. Posterior Articular^ br. of superior Anterior Ulnar Recurrent, br. of ulnar, profunda. Posterior Ulnar Recurrent, br. of ulnar. What Arteries Anastomose around the Hip-joint ? They are the Gluteal, Iliolumbar, and Circumflex Iliac, with the External Circumflex. Obturator and Sciatic, with the Internal Circumflex. Comes Nervt Ischiadici, with the Perforating branches of the Profunda. Name the Arteries Anastomosing around the Knee-joint. The — Descending, br. of ext. circumflex. Sup. Int. Artiatlar, br. of popliteal. Anastomotica Magna, br. of femoral. Inf. Ext, Articular, br. of popliteal. Inferior Perforating, br. of profunda. Inf. Int. Articular, br. of popliteal. Superior Ext. Articular, hx. of popliteal. Recurrent Tibial, br. of anterior tibial. How is the Collateral Circulation established after Ligature of the Carotid or Subclavian? By the following anastomoses, viz. — Superior Thyroid, br. of external carotid, with the Inferior Thyroid, br. of the thyroid axis, from the subclavian. THE VEINS. 115 Arteria Princeps Cervicis, ht. of occipital, from the external carotid, with the Vertebral, br. of subclavian, and the Profunda Cervicis, br. of the superior intercostal, from the subclavian. What is the Longest Anastomosis in the Body? That between the subclavian and the external iliac by the anastomosis of the Superior Epigastric, br. of the internal mammary, with the Deep Epigastric, br. of the external iliac. [The circle of Willis has been described on page io6 ; the palmar and plantar arches on pages io8 and 113 respectively; and the anastomosis on the mem- brana tympani on page 105.] THE VEINS. What are the Veins ? Vessels carrying blood towards the heart. Their walls are composed of 3 coats, an internal, serous ; a middle, muscular ; and an external, fibrous. They all carry carbonized or venous blood, except the pulmonary veins, which bring oxygenated blood to the left side of the heart. The deep veins accompany the arteries, generally jn the same sheath, and are given the same names. The secondary arteries, as the radial, ulnar, brachial, etc., have each two veins, called Venc£ Comites. The superficial veins are usually unaccompanied by arteries, and lie, as a rule, between the layers of the superficial fascia, terminating in the deep veins. Many veins are so irreg- ular in their origin that they cannot be accurately described; they all anasto- mose with each other much more freely than do the arteries. What are Sinuses ? They are venous channels, differing from veins in structure, but answering the same purpose. Those of the cranium are formed by the separation of the layers of the dura mater. How are the Veins divided ? Into the Pulmonary, Systemic, and Portal Systems ; the latter being an appendage of the systemic, its capillaries rami- fying in the liver. What Veins have no Valves? The venae cavce, hepatic, portal, renal, uterine, ovarian, cerebral, spinal, pulmonary, umbilical, and the very small veins. Name the principal Veins of the Head and Neck. They are the — (i.) Exterior veins. (2.) Veins of the diploe and cranium. Eacial. Veins of the Diploe. Transverse Sinus. Temporal. Cerebral and Cerebellar. Cavernous Sinus, htternal Maxillary, Superior Longitudinal Sinus. Occipital Sinus. Temporo-maxillary. Inferior Longitudinal Sinus. Superior Petrosal Sinus. Posterior Auricular. Straight Sinus. Inferior Petrosal Sinus. Occipital. Circular Sinus. Lateral Sinus. 116 ANATOMY. (3.) Veins of the neck draining the above-named. External yugtilar,^ terminating in the subclavian vein.* Posterior External Jugular, opens into the external jugular. Anterior Jugular^ enters the subclavian vein near the external jugular. Internal Jugular i" formed by the junction of the twro last-named sinuses at the jugular foramen, and uniting with the subclavian vein to form the innomi- nate, at the root of the neck. In its course it receives the facial, lingual, pharyngeal, superior and middle thyroid veins, and the occipital. Vertebral, descends the foramina in the transverse processes of the cervical vertebrae, and empties into the innominate vein. Name the Veins of the Upper Extremity. They are in two sets, super- ficial and deep. The deep follow the arteries, generally as vense comites, beginning in the hand as Digital, Interocseous, and Palmar veins, they unite in the Deep Radial and Ulnar which unite to form the Vence Comites of the brachial artery at the bend of the elbow. The superficial veins lie in the superficial fascia; they are as follows: — ^^^^'^^ • \ Median Cephalic. Cephalic. , . ^,_ ,„„ Median f f Ax llary 1 Anterior and Posterior Ulnar ^ Median Basilic. Basilic. ' ^^^• Name the principal Veins of the Thorax. They are as follows, viz. — Internal Mammary. Bronchial. Right Azygos [major). Inferior Thyroid. Mediastinal. left Lower Azygos {minor). Intercostal. Pericardiac. Left Upper Azygos {minimus). What are the Azygos Veins ? They supply the place of the vense cavse in the region where these trunks are deficient, being connected with the heart. 7^1? Right Azygos^'' begins by a branch from the right lumbar veins usually, passes through the aortic opening in the diaphragm, and ends in the superior vena cava, having drained 9 or lo right lower intercostals, the vena azygos minor, the right bronchial, oesophageal, mediastinal, and vertebral veins. The Left Lower Azygos^^ begins by a branch from the left lumbar or renal, passes the left crus of the diaphragm, crosses the vertebral column and ends in the right azygos, having drained 4 or 5 lower intercostals. The Left Upper Azygos drains 2 or 3 left intercostals and empties into either of the other two. It is often wanting, its place being filled by the left superior intercostal vein.^i Name the Spinal Veins. They may be arranged into 4 sets, as follows, viz. — Medulli-spinal, the veins of the spinal cord, which lie in plexus form between the pia mater and arachnoid. They unite into 2 or 3 small trunks near the base of the skull, which terminate in the inferior cerebellar veins or in the petrosal sinuses. THE VEINS. 117 Fig. 6o. Vena Basis Vertebrarum, empty into the anterior longitudinal. Longitudinal y in two plexuses, anterior and posterior, running the whole length of the spinal canal. The posterior join the dorsi- spinal veins, the anterior empty into the vertebral, intercostal, lumbar, and sacral veins in their various regions. Dorsi-spinal, form a plexus around the spines, processes, and laminae of all the vertebrae. They empty into the vertebral, intercostal, lumbar, and sacral veins in their respective regions. Describe the Subclavian Vein. It is the continuation of the axillary, extending from the outer margin of the ist rib to the sterno- clavicular articulation, where it unites with the internal jugular to form the innominate vein. At the angle of junction enters the thoracic duct on the left side of the body and the right lymphatic duct on the right side. In its course it receives the external and anterior jugular veins and a branch from the cephalic. Describe the Venae Innominatae. The two innominate veins are each formed by the union of the subclavian and internal jugular, and unite below the 1st costal cartilage to form the superior vena cava. The Right In- nominate is about I y^ inch long, and receives, besides its constituent branches, the right in- ternal mammary, right inferior thyroid, and right superior intercostal veins. The Left In- nominate'^ is about 3 inches long, and in its course it receives the vertebral, inferior thy- roid, internal mammary, and superior inter- costal veins of the left side. Describe the Superior Vena Cava.^ It is a short trunk about 2^ or 3 inches in length, formed by the union of the venae innominatae, and receives all the blood from the upper half of the body, termi- nating in the right auricle of the heart. It is half covered by the pericardium, and receives the vena azygos major and small pericardiac and mediastinal veins. Name the Principal Veins of the Lower Extremity. They are in two sets, superficial and deep. The deep are the Vena Comites of the anterior and 118 ANATOMY. posterior tibial and peroneal arteries, which collect the blood from the deep parts of the foot and leg, and unite in the — Popliteal, which becomes the Femoral, and it the External Iliac in the same manner as the respectively-named arteries. The superficial veins of the lower extremity are the — Internal or Long Saphenous, on the inside of the leg and thigh, enters the femoral at the saphenous opening i^ inch below Poupart's ligament. In its course it receives the following : — Cutaneous Branches. Superficial Circumflex Iliac. Superficial Epigastric. Pudic. Communicating Branches. External or Short Saphenous, formed by branches from the dorsum and outer side of the foot, it ascends behind the outer malleolus, up the middle of the back of the leg, and empties into the popliteal vein. Describe the Internal Iliac Vein.'o It is formed by the venae comites of the branches of tlie internal iliac artery, except the umbilical. It terminates with the external iliac, at the sacro-iliac aiticulation, to form the common iliac vein. It receives the following veins : — Gluteal. Internal Pudic. Hemorrhoidal and Vesico- Uterine and Vagi- Sciatic. Obturator. prostatic, in the male. nal Plexuses, in the female. Describe the Common Iliac Veins.^^ They are each formed by the union of the two iliac veins as above described, and unite between the 4th and 5th lumbar vertebrae to form the inferior vena cava, the right common iliac being the shortest of the two. Each receives the Ilio-lumbar, sometimes the Lateral Sacral, and the left one in addition the Middle Sacral Vein, which sometimes ends in the vena cava. Describe the Inferior Vena Cava.^ It extends from the junction of the two common iliac veins, passing along the front of the spine, through the tendinous centre of the diaphragm, to its termination in the right auricle of the heart. It receives the following veins : — Lumbar}''- Penal}^ Phrenic. Right Spermatic}^ Supra-renal. Hepatic}^ Describe the Portal System. The portal system is formed by the Superior and Inferior Mesenteric, Splenic, and Gastric Veins, which collect the blood from the digestive viscera, and by their union behind the head of the pan- creas form the Portal Vein, which enters the transverse fissure of the liver, where it divides into 2 branches, and these again subdivide, ramifying through- out that organ, therein receiving blood also from the branches of the hepatic artery. Its contents enter the inferior vena cava by the hepatic vein. The portal vein is about 4 inches long, receives the Gastric and Cystic Veins, and is { THE ABSORUIINTS. 119 formed by the union of the superior mesenteric and splenic veins, the inferior mesenteric joining the splenic, which also receives one of the gastric, the other emptying into the portal. Name the Cardiac Veins. They return the blood from the tissue of the heart into the right auricle. They are the — Great Cardiac Vein. Anterior Cardiac Veins. Posterior Cardiac Vein. Vencc Thebesii, Coronary Sinns, is a dilatation of the great cardiac vein, receiving the pos- terior cardiac and an oblique vein from the left auricle. Describe the Pulmonary Veins. They alone of the veins carry arterial blood, beginning in the capillaries of the lungs, forming a single trunk for each lobule, which, uniting into a single trunk for each lobe, form two main trunks from each lung which open separately into the left auricle. Sometimes the 3 lobe-trunks of the right lung remain separate to their termination in the auricle, and not unfrequently a common opening serves for the 2 left pulmo- nary veins, THE ABSORBENTS. What are the Lymphatics ? They are very delicate, transparent vessels, formed of three coats like arteries and veins, found in nearly every part of the body, except the brain, spinal cord, eyeball, cartilage, tendons, membranes of the ovum, placenta, umbilical cord, nails, cuticle, hair, and bone. They are nourished by nutrient vessels, and have valves, but no nerves, so far as known. They convey lymph to the blood. What are the Lacteals ? They are the lymphatics of the small intestine, conveying the chyle therefrom into the blood. What are the Lymphatic Glands? Small solid bodies placed in the course of the absorbent vessels, and found chiefly in the mesentery, along the great blood-vessels, in the mediastina, axilla, neck, front of the elbow, groin, and popliteal space. The lymphatics and lacteals before entering these glands break up into smaller branches, the afferent vessels, which form a plexus in the gland, and pass out as efferent vessels to unite again in I trunk. They also contain spheroidal bodies about ■^-^■^■^ inch in diameter. These glands are named after the regions in which they are situated, as the axillary, inguinal, mesenteric, etc. Describe the Thoracic Duct. It is the main channel for the lymph and chyle from the whole body except the right arm and lung, right side of the head, heart, neck, and thorax, and the convex surface of the liver. It begins in the Receptaculum Chyli, in front of the 2d lumbar vertebra, passes through the aortic opening in the diaphragm, and at the upper border of the 7th cer- 120 ANATOMY. vical vertebra it curves forwards, outwards, and downwards, terminating in the left subclavian vein at its junction with the internal jugular. Describe the Right Ljnnphatic Duct. It is about an inch long, termi- nating in the right subclavian vein at its union with the internal jugular, and draining the lymphatics of those parts which are not connected with the tho- racic duct. THE NERVOUS SYSTEM. How is the Nervous System divided? Into the Cerebrospinal, or nervous system of animal life ; and the Sympathetic, or nervous system of organic life. What is the Structure of the Nervous tissue ? It is formed of two substances essentially different from each other, the White or fibrous, and the Gray or vesicular matter. Chemically these contain phosphorized fat, albumen, and water. A third form, the Gelatinous, is yet a subject of disagreement among authorities. Describe the White Nerve-matter. It is composed of a number of tubes, each consisting of a central Axis- cylinder, surrounded by the White Substance of Schwann, and this again enclosed in the tuliular membrane, or Nerve-sheath. The whole arrangement is precisely analogous to that of a submarine telegraphic cable. A bundle of such tubes is invested by a covering, the Neurilenuna, or perineurium, and is called a N'erve, and is nourished by a minute capillary system of blood-vessels. How do Nerves terminate ? Sensory nerves end peripherally as plexuses in their end-organs in the tissues. Motor nerves end peripherally in muscles as plexuses, or plates. Their central termination is not yet understood. Of what does the Cerebro-spinal system consist? Of the brain, the spinal cord, the ganglia, and the cranial and spinal nerves. THE BRAIN. What are the Membranes of the Brain ? The dura mater, the arach- noid, and the pia mater. Describe the Dura Mater. It is a dense fibrous membrane lining the interior of the skull, and forming the internal periosteum of the cranial bones. It is continuous with the dura mater of the spinal cord, and is attached to many parts of the base of the skull. It presents the following for exami- nation : — Falx Cerebri, an arched process sent into the longitudinal fissure of the brain, contains in its upper and lower margins the superior and inferior longi- tudinal sinuses. THE BRAIN. 121 Tentorium Cerebelli, a lamina of dura mater supporting the posterior lobes of the brain, and covering the upper surface of the cerebellum. It incloses the lateral and superior petrosal sinuses. Falx Cerebelli, projects between the lateral lobes of the cerebellum, from the tentorium to the foramen magnum. Pacchionian Bodies, clusters of white granulations situated on the outer and inner surfaces of the dura mater, in the superior longitudinal sinus, and on the pia mater, found only after the 7th year, and . of unknown function. Describe the Arachnoid. It is the serous sac which forms the middle membrane, having a visceral and a parietal layer, the latter being reflected over the inferior surface of the dura mater. The Anterior Sub-arachnoid Space is the interval between it and the pia mater of the brain at the base, where it is extended across between the 2 middle lobes. The Posterior Sub-arachnoid Space is a similar interval between the hemispheres of the brain and the me- dulla oblongata. These spaces communicate together across the crura cere- bri ; and also with the general ventricular cavity, by an opening in the lower boundaiy of the 4th ventricle ;; and contain the cerebro-spinal fluid which forms a water-bed for the nervous centres. The sac of the arachnoid also contains a serous fluid in small quantity. What is the Pia Mater ? It is the vascular membrane, being supplied by the branches of the internal carotid and vertebral arteries. It covers the sur- face of the brain, dipping down into all the sulci, and forms the velum inter- positum and choroid plexus of the 4th ventricle ; and contains lymphatics and nerves. How is the Brain divided ? Into the cerebrum, cerebellum, pons Varolii, and medulla oblongata. Its average weight in the male adult is 49^ oz., in the female 44 oz., of which the cerebrum is about seven -eighths. The ex- treme weights in 278 male cases were 65 oz. and 34 oz., — in 191 female cases, 56 oz. and 31 oz. Describs the principal Lobes and Fissures of the Cerebrum. Each lateral half of the cerebrum, or hemisphere, has the following 5 lobes and 8 fissures, besides many of less importance. Frontal Lobe, bounded internally by the longitudinal fissure, below by the fissure of Sylvius, and posteriorly by the fissure of Rolando. Parietal Lobe, extending down to the fissure of Sylvius, and antero poste- riorly from the fissure of Rolando to the parieto-occipital. Occipital Lobe, behind the parieto-occipital fissure. Temporo-sphenoidal Lobe, lying in the middle fossa of the skull, and bounded in front by the fissure of Sylvius. 11 122 ANATOMY. Central Lobe, or Island of Reil, lies in the fissure of Sylvius, covered by the frontal and temporo-sphenoidal lobes. Longitudinal Fissure, separating the two hemispheres. Fissure of Sylvius, at the base of the brain, extending outwards on each side, and dividing into 2 branches, an ascending and a horizontal one. It lodges the middle cerebral artery. Fissure of Rolando, on the superior surface, extending from the longitudi- nal fissure about its centre, downwards and forwards towards the fissure of Sylvius, separating the frontal and parietal lobes. Parieto-occipital Fissure, extends from the longitudinal fissure outwards for about an inch between the parietal and occipital lobes. It is l)etter marked in a longitudinal section of the brain. Calloso-marginal Fissure, above the gyrus foniicatus on the inner surface of the hemisphere. Transverse Fissure, between the middle lobe and the crus cerebri, at the base of the brain. It admits the pia mater to the lateral ventricle. Calcarine Fissure, also seen on the inner surface, extending from the lower end of the parieto-occipital fissure outwards to the posterior border of the occipital lobe. First Temporo-sphenoidal Fissure, below the fissure of Sylvius, on the lateral surface of the brain. Name the principal Convolutions of the Cerebrum. The superior and inner surfaces of each hemisphere are formed of convolutions [gyri) with intervening furrows [sulci) of various depths, both gyri and sulci being formed of gray matter thus arranged to enable it to present a great extent of surface. The convolutions are not uniform in all brains as to arrangement, nor are they symmetrical in the 2 hemispheres. The most constant are the following : — Gyrus Fornicatus, the convolution over the corpus callosum, seen on the inner surface, arching from before backwards. Convolution of the Longitudinal Fissure, along the edge of that fissure on the superior surface, curving over the front and back of each hemisphere, to the base of the brain. Ascending Frontal, lies in front of the fissure of Rolando. Asce7tding Parietal, lies behind the fissure of Rolando. Angular Gyrus, or Pli Courbe, around the posterior end of the first temporo- sphenoidal fissure. Many other convolutions are named by writers on the localization of cere- bral functions, such as the temporo-sphenoidal, occipital, supra-marginal con- volutions, etc. Their names will be found sufficiently explanatory of their several locations. The Cuneus, Precicncus, and Paracentral Lobule are names THE BRAIN. 123 given to the regions between the calcarine, parieto-occipital, and calloso-marginal fissures, the last-named locality lying in front of the last-named fissure. Name the Points in view on the Inferior Surface of the Brain. From before backwards, excluding the cranial nerves, are the following: — Longitudinal Fissure, its anterior portion. Corpus Cailostim, the great transverse commissure of the brain. Lamina Citterea, a thin, gray layer, beneath the optic tracts. Fissure of Sylvius, between the anterior and lemporo-sphenoidal lobes. Anterior Perforated Space, for vessels to the corpora striata. Optic Commissure, formed by the junction of the optic tracts. Tuber Cinereum, a gray lamina behind the optic commissure, forming part of the floor of the 3d ventricle. Lnfundibulum, a hollow process, connecting the pituitary cavity with the 3d ventricle in the foetus. Pituitary Body, a vascular bi-lobed body, of glandular structure, projects from the infundibulum into the sella turcica of the sphenoid. Corpora Albicantia, two round, white eminences, united together; they are the anterior crura of the fornix folded on themselves. Posterior Perforated Space [Pons Tarini), for vessels to the optic thalami. Crura Cerebri, or cerebral peduncles, connect the cerebrum with the cere- bellum, spinal cord, and medulla oblongata; containing the fibres passing to the basal ganglia. They, with the optic tracts, form the boundaries of the Inter-peduncular Space. Pons Varolii, to be described separately. [See page 126.] What Ganglia are comprised in the Brain ? Besides the gray matter of the cerebral hemispheres, of the cerebellum, and of the medulla oblongata, there are the following at the base of the brain : — Olfactory Bulbs. Optic Thalami. Tuber Annulare. Corpora Striata. Tubercula Quadrigemina. Describe the Basal Ganglia. They are as follows, viz. — Olfactory Bulbs are the ganglia of the sense of smell, lie one on each side of the median line, upon the cribriform plate of the ethmoid, and are connected with the hemispheres by the Olfactory Tracts. Corpora Striata, the motor ganglia, are situated in the floor of the lateral ventricles, and therefore within the hemispheres. Each coqDUS striatum has a — Caudate Nucleus, — the intraventricular part. Lenticular Nucleus, — the extra ventricular part. Internal Capsule, — divides these two parfs. Optic Thalami, the sensory ganglia, are in the floor of the lateral ventricles, 124 ANATOMY. behind the corpora striata. Each thalamus opticus is divided into an anterior tubercle seen in the lateral ventricle, and a posterior tubercle beneath the fornix. Corpora Quadrigemina, or Optic Lobes (2 nates and 2 testes), lie beneath the posterior lobes, near the union of the cerebrum and cerebellum. They form two single ganglia for vision. [Described under Meso-cephalon.] Tuber Annulare, a ganglion in the substance of the pons Varolii, the seat of indistinct sensation probably. Name the Commissures of the Brain. These connecting bands number 19 in all, of which 10 are longitudinal, and 9 transverse in direction, viz, — Longitudinal commissures. Transverse co7nmissures. Olfactory Tracts. Anterior Commissure of 3d ventricle. Taenia Semicircularis. Middle Commissure of 3d ventricle. Crura Cerebri. Posterior Commissure of 3d ventricle. Processes e Cerebello ad Testes. Corpus Callosum. Peduncles of the Pineal Gland. Optic Commissure. Fornix. Pons Varolii. Infundibulum. Fornix is a transverse commissure as Lamina Cinerea. well as a longitudinal one. Gyrus Fornicatus. Posterior Medullary Velum. Fasciculus Unciformis. Valve of Vieussens. What are the Ventricles of the Brain ? They are 5 cavities, each of which is situated as follows : — Two Lateral Ventricles, within the substance of the hemispheres. Third Ventricle, between the optic ihalami, on the base of the brain. Fourth Ventricle, between the cerebellum and the medulla oblongata. Fifth Ventricle, between the two lateral, in the septum lucidum. Ventricle of the Corpus Callosum, so called, is merely the space between the upper surface of that commissure and the margins of the hemispheres above {labia cerebri'). The Foramina of Monroe connect the 2 lateral ventricles with the 3d ; the Iter e Tertio ad Quartam Ventriculum, or aqueduct of Sylvius, connects the 3d with the 4th. Describe and bound the Lateral Ventricles. They each have 3 cornua, the anterior, middle, and posterior, and are bounded as follows: — Roof, — the corpus callosum. Lloor, — the corpus striatum, taenia semicircularis or horny band of Tarinus, optic thalamus, choroid plexus, corpus fimbriatum, and the fornix. Internally, — the septum lucidufn. Externally, behind and in front, — the brain substance. THE BRAIN. 125 What are the parts above-named ? Some, as the corpus striatum, optic thalamus, etc., have been described already; the others are — Corpus Callosum, the great transverse commissure, arching backwards to become continuous with the fornix, reflected below, forming the Peduncles at the entrance of the fissure of Sylvius; and marked above by a depres- sion, the Raphiy and longitudinal elevations, the Strice Longitudinales or Nerves of Lancisi. Tcenia Semicircuiaris, consists of commissural fibres between the corpus striatum and the optic thalamus. Choroid Plexus of Veins, is the margin of a fold of pia mater which enters at the transverse fissure, passes up the descending cornu, passes through the foramen of Monroe, and as the Velum Interpositum spreads out over the roof of the 3d ventricle. Corpus Fimbriatuniy or Tania Hippocampi^ is a white band, the edge of the posterior pillar of the fornix. Fornix, is a commissure situated beneath the corpus callosum, but continuous with it posteriorly, the Septum Lucidum separating them in front. It. is of triangular form with the apex in front. Its Anterior Crura curve down- wards to the base of the brain, are there reflected, forming the Corpora Albicantia, and end in the optic thalami. Its Posterior Crura pass down the descending horns of the lateral ventricles, as the Hippocampi Majores. The Lyra is a series of markings on its under surface. Septum Lucidum, consists of 2 layers of white and gray matter, lined by epithelium ; is placed vertically between the lateral ventricles, from the raph6 of the corpus callosum above to the fornix below. The cavity in its centre is the 5th ventricle. Describe the Comua of the Lateral Ventricles. The Anterior Cornu curves over the anterior end of the corpus striatum into the anterior lobe. The Posterior Cornu curves downwards and inwards in the occipital lobe, and contains a smooth eminence, the Hippocampus Minor. The Middle Cornu descends into the middle lobe to the transverse fissure at the base of the brain, curving backwards, outwards, downwards, forwards, and inwards (B. O. D. F. I.). On its floor are the following: — Hippocampus Major, the doubled-in surface of the gyrus fornicatus. Pes Hippocampi, rounded eminences at the end of the hippocampus. Pes Accessorius, or Eminentia Collateralis, between the hippocampi, at the junction of the middle and posterior comua. Corpus Fimbriatum, a continuation of the posterior pillar of the fornix. Choroid Plexus of Veins, a process of pia mater, already described. Fascia Dentata, the gray serrated edge of the middle lobe. Transverse Fissure, at the extremity of the cornu, extending to the median 11* 126 ANATOMY. line, between the hippocampus major and the optic thalamus. It opens at the base of the brain between the middle lobe and the crus cerebri, and admits the pia mater to the middle cornu. Describe and bound the Third Ventricle. It is a mere fissure, situated between the optic thalami in the median line. It communicates with the lateral ventricles above by the foramina of Monroe, and with the 4th ventricle behind by the iter e tertio ad quartam ventriculum. It is crossed by 3 bands, the anterior, middle, and posterior commissures, the middle one being of gray matter, the others of white. In the foetus its cavity communicates with the 5th ventricle, and through the infundibulum with the cavity of the pituitary body. It is bounded as follows : — Roof, — the velum interpositum, and above it the fornix. Floor, — the parts comprised in the interpeduncular space at the base of the brain, viz. — the lamina cinerea, tuber cinereum, infundibulum, corpora albicantia, and posterior perforated space. Anteriorly, — the anterior crura of the fornix, and the anterior commissure •of the ventricle. Posteriorly, — the posterior commissure, and the iter e tertio, etc. Laterally, — the optic thalami and the peduncles of the pineal gland. Describe and bound the Fourth Ventricle. The fourth, or ventricle of the cerebellum, lies between the medulla oblongata and the cerebellum. It is considered by some to be a dilatation of the central canal of the spinal cord, and is enclosed posteriorly by the pia mater ; an opening in which admits the entrance and exit of the sub-arachnoid fluid from the sub-arachnoidean space of the brain and spinal cord, and a fold of the pia mater called the Choroid Plexus. It also communicates with the 3d ventricle by the iter e tertio, etc. Its boundaries are as follows : — Roof, — the valve of Vieussens, and the cerebellum. Anteriorly, — the medulla oblongata, and the pons Varolii. Posteriorly, — the cerebellum. Laterally, — the processus e cerebello ad testes, the posterior pyramids and the restiform bodies of the medulla oblongata. Floor, — the posterior median fissure of the medulla, the orifice of the cen- tral canal of the cord, the locus ceruleus and taenia violacea (both of blue color), the fasculi teretes (2 spindle-shaped elevations) and eminences of origin of certain nerves. Describe the Fifth Ventricle. It is situated between the two layers of the septum lucidum, and therefore between the lateral ventricles. Its roof is formed by the corpus calIosum,and in the foetus it communicates with the 3d ventricle by an opening between the pillars of the fornix. It usually contains fluid. THE BRAIN, 127 What is the Meso-cephalon ? It comprises tlie parts which connect the cerebrum wiili tlie cerebelhim and the medulla oblongata, and includes the following structures, viz : — Pons Varolii, a great transverse commissure seen at the base of the brain in front of the medulla. Its fibres connect the hemispheres of the cere- bellum with each other and the medulla. Crura Cerebri, or Peduncles of the Cerebrum, extend from the pons to the corpora striata and optic thalami, and consist of the Peduncular Fibres which pass from the medulla to the ganglia named, and thence upwards to the gray matter of the hemispheres as the Corona Kadiata. Each crus contains in its centre a mass of gray matter called the locus niger. Valve of Vieussens, is a thin lamina forming the roof of the iter e tertio ad quartam ventriculum, and stretched between the two processus e cerebello ad testes. Its Frenulum is a ridge descending on its upper part from the corpora quadrigemina. Corpora Quadrigemina, or Optic Lobes, are 4 spherical eminences placed together above the valve of Vieussens, and behind the 3d ventricle be- neath the posterior border of the corpus callosum. The anterior pair are called the Nates, the posterior, the Testes, and they are connected with the optic thalami and optic tracts by 4 bands, their Brachia ; and with the cerebellum by a white cord on each side, the Processus e Cerebello ad Testes. They form two ganglia for the centre of vision. Pineal Gland, is a small conical reddish body situated between the nates, on which it rests. Its 4 peduncles connect it with the anterior crura of the fornix, and the optic thalami. It is very vascular, and has a small cavity (said to communicate with the 3d ventricle) which contains a viscid fluid, and some concretions formed of the phosphates of lime, magnesia, and ammonia, etc., called the Acervul^ Cerebri. Describe the Medulla Oblongata. This ganglion is the upper enlaiged part of the spinal cord, extending from the upper border of the atlas to the pons Varolii. Its posterior surface forms the floor of the 4th ventricle, its anterior surface rests on the basilar groove of the occipital bone. It is divided into two lateral halves by the Anterior and Posterior Median Fissures, and con- tains gray matter scattered throughout it, from which the cranial nerves from the 5th to the 12th inclusive arise entirely or in part. In it are supposed to lie the centres for the vaso-motor and the cardiac nerves, also centres of respira- tion, phonation, deglutition, mastication, and expression. On each side it pre- sents the following, — Anterior Pyramid, formed by the anterior and lateral columns of the spinal cord. 128 ANATOMY. Olivary Body, behind the pyramid, from which it is separated by the groove of the hypoglossal nerve. It contains a capsule of gray matter in its cen- tre, the Corpus Dcntatu7)i. Lateral Tract, continuous with the lateral column of the spinal cord, lies behind the olivary body and in front of the restiform. Restifortn Body, the posterior lateral portion of the medulla, also called the Fasciculus Cuneatus. Posterior Fyra?nid, or Fasciculus Gracilis, the most posterior portion, is formed by the posterior median column of the spinal cord. It diverges from its fellow at the apex of the 4th ventricle and forms the lateral boundary of the Calamus Scriptorius. What is the Cerebellum ? It is that portion of the brain situated in the inferior occipital fossse, beneath the posterior lobes of the cerebrum. It is an oblong flattened ganglion, divided into two lateral hemispheres, and a central portion, the Vermiform Process. Name the Fissures of the Cerebellum. They are 3 in number,— 2 ver- tical and I horizontal, viz. — Incisura Cerebelli Anterior. Great Horizontal Fissure, from which Incisura Cerebelli Posterior. secondary fissures originate. Name the Points on the surfaces of the Cerebellum. They comprise 15 lobes, 2 commissures, and 3 projections, as follows; — On the upper surface of each hemisphere, — Anterior or Square Lobe. Posterior or Semilunar Lobe. On the under surface of each hemisphere, from before backwards, — Flocculus, Subpeduncular Lobe, or Pneuviogastric Lobule. Amygdala Lobe, or Tonsil, projects into the 4th ventricle. Digastric Lobe. Slender Lote. Posterior Inferior Lobe. On the vermiform process are the — Lobulus Centralis. ^ Pyramid. "j Monticulus Cerebelli. > superiorly. Uvula. \ inferiorly. Commissura Simplex. ) Commissura Brevis. ) The Vallecula, or valley of the cerebellum, is the central depression on its under surface between the two lateral hemispheres. Name the Peduncles of the Cerebellum, They are 3 in number on each side, and from below upwards are as follows : — Processus e Cerebello ad Medullam, to the medulla oblongata. Processus e Cerebello ad Pontem, connect the hemispheres. Processus e Cerebello ad Testes, to the cerebrum. Describe the Gray Matter of the Cerebellum. It occupies the surface of THE CRANIAL NERVES. 129 the mass in laminated shape, and is traversed by curved furrows, between the laminae. A veilical section gives an appearance called the Arbor Vita. Corpus Dentatum, is a capsule of gray matter in the centre of the white and is open anteriorly. It is sometimes called the ganglion of the cere- bellum. THE SPINAL CORD. Describe the Spinal Cord. It is that part of the cerebro-spinal axis which is situated in the spinal canal. Its length is about i6 inches, terminating at the lower border of the 1st lumbar vertebra in the Cauda Equina. It is cylin- drical in general form, with 2 enlargements, one in the cervical region, the other in the lumbar. It is composed of gray and white matter, the gray being inside (instead of outside, as in the cerebrum), and arranged so as to present a crescentic appearance in horizontal section, joined by a transverse commis- sure, and forming, by their extremities, the Anterior and Posterior Horns, from which regions respectively the anterior and posterior roots of the spinal nerves have their apparent origin. Membranes of the cord are 3, as in the brain, — dura mater, arachnoid, and pia mater. The Dura Mater is not adherent to the spinal column, but is connected thereto by fibrous tissue. The Arachnoid is arranged as on the brain, its sub-arachnoid space being filled with its fluid, for the protection of the chord. The Pia Afaterhas a fibrous band on each side, the ligamentum denticulatum, connecting it to the dura mater by some 20 serrations. Fissures, number 8, — the anterior and posterior median, the anterior and posterior lateral on each side, and the two posterior intermediaiy in the cervical region. Columns, are 8 in number, 4 on each side of the cord, — an anterior, lateral, posterior, and posterior median. The Anterior is continuous with the anterior pyramid of the medulla ; the Lateral, with the lateral column of the medulla; the Posterior, with the resliform body; the Posterior-median, with the posterior pyramid. Central Canal, or Ventricle of the Cord, extends through its entire length in the foetus and in some adults, but is usually closed except for one-half inch below its orifice in the floor of the 4th ventricle. THE CRANIAL NERVES. Describe 'each Cranial Nerve, stating its function, apparent and deep origin, foramen of exit, principal branches and distribution. There are 12 pairs of cranial nerves (9 according to Willis), of which those from the 6th to the 1 2th inclusive have their deep origin wholly or in part from the floor of the 4th ventricle. They are the — I 130 ANATOMY. tertio ad quartam Fig. 6i. jst, Olfactory, nerve of smell, — arises by 2 roots from the anterior cerebral lobe and i root from the middle lobe, deeply from the optic thalamus, island of Reil, corpus striatum, and anterior commis- sure ; exi^hy 20 branches through the cribriform plate, to the Schnei- derian membrane. Its bulb is a lobe of the cerebrum. 2d, Optic, nerve of sight, — arises from the optic commissure'* and tracts, deeply from the optic thal- amus, corpora geniculata,and cor- pora quadrigemina; exit through the optic foramen to the retina. 3d, Motor Oculi,^ motor of the eye, — a7-ises from the crus cerebri, deeply from the floor of the iter e entriculum ; exit through the sphenoidal fissure, to all the muscles of the orbit except the superior oblique and the external rectus, also to the iris. 4th, Patheticus,8 motor of the eye, — arises from the outer side of the crus, deeply from the valve of Vieussens; ^xzV through the sphe- noidal fissure, to the superior ob- lique muscle of the eye. 5th, Trigeminus,^ nerve of sensa- tion, motion, and taste, — arises by two roots, — from the side of the pons Varolii,^ deeply from tlie pyramidal body (motor root), lateral tract of the medulla, the pons, and cerebellum (sensory root). Exit of ophthalmic divi- sion by the sphenoidal fissure; of superior maxillary by the fora- men rotundum ; of inferior max- FlG. 62 THE SPINAL NERVES, 133 THE SPINAL NERVES. Describe the Spinal Nerves. There are 31 pairs of spinal nerves, of which the cervical number 8, the dorsal 12, the lumbar 5, the sacral 5, and the coc- cygeal I. The 1st cervical escapes above the 1st vertebra, each of the others below the corresponding vertebra through the intervertebral foramina. Each nerve arises by 2 roots, an anterior motor root, and a posterior sensory one, the latter having a ganglion on it. These unite, and the nerve then divides into 2 branches, both having motor and sensory fibres. The posterior branches are small and generally unimportant ; they supply the muscles and integument of the back. The anterior branches supply the neck, front, and sides of the trunk, and the extremities, uniting in various regions to form plexuses from which important nerve-trunks originate. How is the Cervical Plexus formed and distributed? It is formed by the anterior branches of the first 4 cervical nerves, and rests on the levator anguli scapulae and scalenus medius muscles. Its branches (10) comprise 4 superficial to the integument of the head and neck, and the following deep branches, viz. — Phrenic. Commiinicans Noni, 2 Muscular. 2 Communicating. Describe the Phrenic Nerve. It arises by 3 heads from the 3d, 4th, and 5th cervical, descends across the front of the scalenus anticus, crossing the sub- clavian and internal mammary aileries, in the middle mediastinum, and is dis- tributed to the inferior surface of the diaphragm. It is often called the Inter- nal Respiratory Nerve of Bell. It sends filaments to the pericardium and pleura, and communicates with the plexuses of the sympathetic in the abdo- men. Describe the formation and distribution of the Brachial Plexus. It is formed by the union of the 4 lower cervical nerves and the ist dorsal. The 5th, 6th, and 7th unite into one trunk externally to the scalenus medius, as also do the 8th cervical and ist dorsal behind the same muscle. Below the line of the clavicle both these trunks bifurcate ; the two adjacent branches unite be- hind the axillary artery making the Posterior Cord, and the remaining 2 form the Outer and Inner Cords, referred to the artery. Each of these cords bifur- cates, but the 2 adjacent branches of the outer and inner cords unite over the artery, to form the Median Nerve, leaving 4 other branches, the Ulnar, Mus- ctdo- cutaneous, Musado-spinal, and Circumflex Nerves, the last 2 being de- rived from the posterior cord. The branches of the brachial plexus are as follows, viz. — Above the clavicle are given off 4, the — Communicating, completing the phrenic nerve. Muscular, to the longus colli, scaleni, rhomboidei, and subclavius muscles, 12 134 ANATOMY. Posterior, or Long Thoracic, external respiratory nerve of Bell, to the serra- tus magnus, arising from the 5th and 6th cervical. Suprascapular, from the ist trunk of the plexus, to the scapular muscles. Below the clavicle are 12, the, — 2 Anterior Thoracic, from outer and inner cords to the pectoral muscles. J Stibscapular, from the posterior cord, to the subscapularis, teres major, and latissimus dorsi muscles. Circumflex, from the posterior cord, to the muscles and integument of the shoulder, and the shoulder-joint. Musculo- cutaneous, from the outer cord, to the forearm externally, piercing the coraco-brachialis muscle. Internal Cutaneous, from the inner cord, to the arm and forearm. Lesser Internal Cutaneous (nerve of Wrisberg^ from the inner cord to the inner side of the arm. Is sometimes wanting, sometimes connected with the intercosto-humeral. Median, from outer and inner cords, passes between the 2 heads of the pro- nator radii teres, supplying the pronators, flexors, first 2 lumbricales, and the integument of the thumb, 2^ fingers, and the radial side of the palm. Its branches are all in the palm, the — Muscular. Anterior Interosseus. Palmar Cutaneous. Ulnar, from the inner cord, passes between the 2 heads of the flexor carpi ulnaris at the inner condyle of the humerus, supplying the elbow- and wrist-joints, several muscles, and the palmar and dorsal integument of the little finger and half of the ring finger. Branches are the — 2 Articular. Cutaneous. Superficial Palmar. Muscular. Dorsal. Deep Palmar. Musculo-spiral, from the posterior cord, accompanies the superior profunda artery and vein in the spiral groove of the humerus, and at the external condyle it divides into the radial and posterior interosseus nerves. Its branches are — Muscular. Cutaneous. Radial. Posterior Interosseous. The Radial supplies the outer side and ball of the thumb, and the dorsal integument of 2^ fingers. The Posterior Interosseus supplies all the muscles on the back of the fore- arm except 3, and also sends a filament to the wrist-joint. What is the Intercosto-humeral Nerve ? It is the lateral cutaneous branch of the 2d intercostal (anterior branch of the 2d dorsal) ; it pierces the external intercostal muscle and crosses the axilla, joining with a filament from the lesser internal cutaneous (nerve of Wrisberg), and supplying the skin of the upper half of the inside of the arm. THE SPINAL NERVES. 135 Fig. 63. Describe the Lumbar Plexus. It is formed by communicating loops from the anterior branches of the first 4 lumbar nerves, in the following manner. From the First lumbar nerve are given off the — Ilio-hypogastricy to the abdominal and gluteal regions. Ilio-inguinal, to the inguinal region and the scrotum. Communicating Loop, to the second lumbar nerve. From the Second lumbar nerve are given off the — External Cutaneous, to the integument of the outside of the thigh. Genito-crural, to the spermatic cord and front of the thigh. Communicating Branch, to the third lumbar nerve. From the Third and Fourth lumbar nerves are given off the following by a branch of origin from each, viz. — Obturator, through the obturator foramen to the ex- ternal obturator and adductor muscles and the hip- and knee-joints. Accessory Obturator (often absent), to the pectineus and hip-joint. Communicating, from the 3d lumbar to the 4th. Communicatittg, from the 4th lumbar to the 5th. Anterior Crural, which descends through the psoas muscle, and beneath Poupart's ligament to the thigh, where it divides into an anterior and pos- terior division. Its branches are, — To the Iliacus muscle. Long Saphenous. To the Femoral artery. Muscular. Middle and Internal Cutaneous. Articular. Describe the Sacral Plexus. <^ It is formed by the union of the upper 4 sacral nerves^ with the 5th lum- bar and a loop from the 4th, the two latter forming the Lumbosacral Cord A It lies upon the pyriformis muscle and gives off the following 5 branches, viz. — Superior Gluteal,b from the lumbo-sacral cord, sup- plies the glutei and tensor vaginae femoris. Muscular Branches, to the pyrifonnis, obturator internus, gemelli, and quad- ratus femoris muscles. rudic,e escapes by the great sacro-sciatic foramen, crosses the ischiatic 136 ANATOMY. spine, and re-enters the pelvis by the lesser sacro-sciatic foramen, supply- ing the perineum, anus, and genitalia. Small Sciatic,/ to the gluteus maximus, and integument of the perineum, scrotum, and back of the thigh and leg. Great Sciatic,g the largest nerve of the body, and the direct continuation of the sacral plexus, escapes by the great sacro-sciatic foramen, sends an Articular Branch to the hip-joint. Muscular branches to the adductor magnus, semimembranosus, semitendinosus, and biceps muscles, and ter- minates in the External^ and Internali Popliteal nerves, generally about the lower one-third of the thigh. Describe the External Popliteal Nerve. It passes from the bifurcation of the great sciatic along the outer side of the popliteal space, gives off Articular and Cutaneous branches, and about an inch below^ the head of _the fibula it divides into the — Anterior Tibial, ^"^ supplying the extensors, and the integument of the adja- cent sides of the great and 2d toes. Musculo-cutaneous,n by 2 branches (internal and external) to the peroneal muscles, the integument of the ankles, and the dorsal integument and sides of all the toes, except the outer side of the little toe and the ad- joining sides of the great and 2d toes. Describe the Internal Popliteal Nerve. It is the largest of the two, and descends along the middle of the back of the leg, becoming the Posterior Tibial^ at the lower border of the popliteus muscle, and dividing into the External and Internal Plantarl below the inner malleolus. Its branches are as follows : — Articular, 3 in number, to the knee-joint. Muscular, to the gastrocnemius, soleus, plantaris, and popliteus. External or Short Saphenous, P formed by a filament from both popliteal nerves, supplies the integument of the little toe and outer side of the foot. Muscular, to the tibialis posticus, flexor longus pollicis, and flexor longus digitorum. Plantar Cutaneous, to the skin of the heel and inner sole of the foot. Internal Plantar, to the inner plantar muscles, sole of the foot, and the plantar integument of the inner 3^ toes. External Plantar, to the external plantar muscles, and the plantar integu- ment of the outer \y^ toes. THE SYMPATHETIC NERVE. What is the Sjnupathetic Nerve ? It consists of a series of ganglia situated on each side of the vertebral column, connected together and to the cerebro- THE SYMPATHETIC NERVE. 137 spinal system by intervening cords, beginning in the ganglion of Ribes on the anterior communicating artery, and ending in the ganglion impar^ in front of the coccyx. Name the Ganglia of the Sympathetic in the Cranium and its vicinity. They are 9 in number, as follows : — Ganglion of Ribes, on the anterior communicating artery. Ganglion of Laumonier, on the internal carotid artery. Ciliary, or Ophthalmic Ganglion, in the orbital cavity. Spheno-palatine {MeckeV s) Ganglion, in the spheno-maxilfery fossa. Otic [Arnold's) Ganglion, under the foramen ovale. Submaxillary Ganglion, above the submaxillary gland. Ganglion of Cloquet, in the incisive fossa, on the naso-palatine nerve. Ganglion of Bidder, below the foramen spinosum, on the middle meningeal artery. Ganglion of Bochdalek, on a branch between the spheno-palatine ganglion and the inferior dental nerve. Describe the Ganglia connected with the 5th Cranial Nerve. There are 4 such, each having a motor, a sensory, and a sympathetic root, viz. — Ciliary, or Ophthalmic Ganglion, is situated in the orbit, between the optic nerve and the external rectus muscle. Its sensory root is derived from the nasal branch of the ophthalmic, its motor root from the 3d nerve, its sympathetic root from the cavernous plexus. Its branches are the short ciliaiy nerves, and are distributed to the ciliary muscle and the iris. Spheno-palatine, or Meckel s Ganglion, is a large ganglion situated in the spheno-maxillary fossa. Its sensory root is derived from the superior maxillary, its motor root from the facial by the Vidian and large petrosal, its sympathetic root from the carotid plexus, by the carotid branch of the Vidian. Its branches are the — Ascending. Middle Palatine. Vidian. Anterior Palatine. Superior Nasal. Large Petrosal, carotid branch. Posterior Palatine. Naso-palatine. Pterygo-palatine. Otic Ganglion {Arnold's), is situated on the inferior maxillary nerve, imme- diately below the foramen ovale. Its sensory root is derived from the auriculo-temporal branch of the inferior maxillary ; its motor root from the internal pterygoid branch of the same, also from the facial and glosso- pharyngeal by the small petrosal ; its sympathetic root from the middle meningeal plexus. Its branches are distributed to the tensor palati and tensor tympani muscles. Submaxillary Ganglion, is situated above the submaxillary gland. Its sen- sory root is derived from the gustatory branch of the inferior maxillary, 12* 138 ANATOMY. its motor root from the facial by the chorda tympani, its sympathetic root from the facial plexus. Its branches are distributed to the submaxillary gland, its duct, and the mucous membrane of the mouth. Describe the Cervical Ganglia. They are 3 in number on each side, of which the superior is the largest, communicate with each other, and are as fol- lows, viz. — Superior Cervical Ganglion, lies behind the carotid sheath opposite the 2d and 3d cervical vertebrae. Its branches are distributed to the carotid, cavernous, and pharyngeal plexuses, and one of its internal branches is the superior cardiac nerve going to the cardiac plexus. Middle Cervical Ganglion, on the superior thyroid artery, opposite the 5th cervical vertebra, and gives off the middle cardiac nerve to the cardiac plexus, also communicating branches. Inferior Cervical Ganglion, on the superior intercostal artery, between the neck of the 1st rib and the transverse process of the 7th cervical vertebra. It gives off several communicating branches and the inferior cardiac nerve to the cardiac plexus. What are the other Ganglia of the Sympathetic ? There are on each side of the vertebral column 11 or 12 dorsal ganglia, 4 or 5 lumbar, 5 sacral, besides the single coccygeal Ganglion Impar in which terminates the double chain. Connected with the viscera are many ganglia, from which branches ramify around the arteries in plexuses named from their locations. Describe the Splanchnic Nerves. They are 3 in number on each side, and are derived from branches of the 6 lower thoracic ganglia, as follows, viz. — Great Splanchnic, from branches of the 6th to the loth, connecting with the upper six, and passes through the posterior mediastinum, perforates the cms of the diaphragm, to the semilunar ganglion. Lesser Splanchnic, ixonx the loth and 1 1 th, passes through the diaphragm with the great splanchnic, to the coeliac plexus. Smaller or Renal Splanchnic, from the last thoracic ganglion, also perforates the diaphragm, and ends in the renal and coeliac plexuses. Describe the Solar Plexus. This plexus, called also the " abdominal brain," is a network of nerves and ganglia, chiefly formed by the splanchnic nerves and the right pneumogastric. It lies behind the stomach, and in front of the aorta and the crura of the diaphragm, surrounding the coeliac axis and the root of the superior mes;enteric artery. Its two largest ganglia are the Semilunar Ganglia situated in front of the crura of the diaphragm. From it are del-ived branches which form Plexuses over most of the abdominal arteries, as follows : — THE SYMPATHETIC NERVE. W Phrenic. Gastric. Splenic. Renal. Superior Mesenteric. Cceliac. Hepatic. Suprarenal. Spermatic. Inferior Mesenteric. Mention some other Plexuses of the Sympathetic system. They art very numerous ; besides those already mentioned, the most important are tht following : — Carotid and Cavernous Plexuses, on the internal carotid artery. Meningeal Plextts, on the middle meningeal artery. Facial Plexus, surrounding the facial artery. Cardiac Plexuses, the deep in front of the bifurcation of the trachea, the superficial in front of the right pulmonary artery; the first-named lies beneath the arch of the aorta, the latter beneath it. Coronary Plexuses, anterior and posterior, accompanying respectively the left and right coronary arteries. Aortic Plexus, on the sides and front of the aorta between the superior and inferior mesenteric arteries. Hypogastric Plexus, on and between the common iliac arteries; supplying the viscera of the pelvic cavity. Inferior Hypogastric or Pelvic Plexuses, two in number, one on each side of the rectum and bladder. Their branches are the — Inferior Hemorrhoidal Plexus. Small Cavernous Nerve. Vesical and Prostatic Plexuses. Large Cavernous Nerve. Vaginal Plexus. Uterine Nerves. The End CATALOGUE No. 7. A CATALOGUE OF Books for Students; INCLUDING A FULL LIST OF The ? Quiz-Compends f AND MANY OF THE MOST PROMINENT Students' Manuals and Text-Books PUBLISHED BY P. BLAKISTON, SON & CO., Medical Booksellers, Importers and Publishers, No. 1012 WALNUT STREET, PHILADELPHIA. *** For sale by all Booksellers, or any book will be sent by mail, postpaid, upon receipt of price. Catalogues of books on Dentistry, Pharmacy, etc., supplied upon application. THE PQUIZ-COMPENDS? A NEW SERIES OF COMPENDS FOR STUDENTS. For Use in the Quiz Class and when Preparing for Examinations. Price of Each, Bound in Clotli, $1.00 Interleaved, $1.25. Based on the most popular text-books, and on the lec- tures of prominent professors, they form a most complete set of manuals, containing information nowhere else collected in such a condensed, practical shape. The authors have had large experience as quiz masters and attaches of colleges, with exceptional opportunities for noting the most recent advances and methods. The arrangement of the subjects, illustrations, types, etc., are all of the most improved form, and the size of the books as such that they may be easily carried in the pocket. No. 1. ANATOMY, (niustrated.) A Compend of Human Anatomy. By Samuel O. L. Potter, m.A., m.d., U. S. Army. With 63 Illustrations. *' The work is reliable and complete, and just what the student needs in reviewing the subject for his examinations." — The Physi- cia« and Surgeon's hivestigator , Buffalo, N. Y. •" To those desiring to post themselves hurriedly for examination, this little book will be useful in refreshing the memory." — New Orleans Medical and Surgical yournal. " The arrangement is well calculated to facilitate accurate memo- rizing, and the illustrations are clear and good." — North Carolina Medical journal. Nos. 2and3. PRACTICE. A Compend of the Practice of Medicine, especially adapted to the use of Students. By Dan'l E. Hughes, M.D., Demonstrator of CHnical Medicine in Jefferson Medical College, Philadelphia. In two parts. Part I. — Continued, Eruptive, and Periodical Fevers, Diseases of the Stomach, Intestines, Peritoneum, Biliary Passages, Liver, Kidneys, etc., and General Diseases, etc. Part II. — Diseases of the Respiratory System, Circu- latory System, and Nervous System ; Diseases of the Blood, etc. *4(.* These little books can be regarded as a full set of notes upon the Practice of Medicine, containing the THE ? QUIZ-COMPENDS ?. Synonyms, Definitions, Causes, Symptoms, Prognosis, Diagnosis, Treatment, etc., of each disease, and includ- ing a number of new prescriptions. They have been compiled from the lectures of prominent Professors, and reference has been made to the latest writings of Pro- fessors Flint, Da Costa, Reynolds, Bartholow, Roberts and others. " It is brief and concise, and at the same time possesses an accu- racy not generally found in compends." — yhs. M. French, M.D., Ass't to the Prof, of Practice, Medical College of Ohio, Cincinnati. " The book seems very concise, yet very comprehensive. . . . An unusually superior book." — Dr. E. T. Bruen, Demonstrator of Clinical Medicine, University of Pennsylvania. " I have used it considerably in connection with my branches in the Quiz-class of the University of La." — y. H. Bemiss, New Orleans. " Dr. Hughes has prepared a very useful little book, and I shall take pleasure in advising my class to use it." — Dr. George IV. Hall, Professor of Practice, St. Louis College of Physicians and Surgeons. No. 4. PHYSIOLOGY. A Compend of Human Physiology, adapted to the use of Students. By Albert P. Brubaker, m.d.. De- monstrator of Physiology in Jefferson Medical College, Philadelphia. " Dr. Brubaker deserves the hearty thanks of medical students for his Compend of Physiology. He has arranged the fundamental and practical principles of the science in a peculiarly inviting and accessible manner. I have already introduced the work to my class." — Maurice N. Miller, M.D., Instructor in Practical His- tology, formerly Demonstrator of Physiology, University City of New York. " 'Quiz-Compend' No. 4 is fully up to the high standard estab- lished by its predecessors of the same series." — Medical Bullet in Philadelphia. " I can recommend it as a valuable aid to the student." — C. N. Ellimvood, M. D. , Professor of Physiology, Cooper Medical Col- lege, San Francisco. " This is a well written little book." — London Lancet. No. 5. OBSTETRICS. A Compend of Obstetrics. For Physicians and Students. By Henry G. Landis, m.d.. Professor of Obstetrics and Diseases of Women, in Starling Medical College, Columbus. Illustrated. " We have no doubt that many students will find in it a most val- uable aid in preparing for examination." — The American fournal of Obstetrics. " It is complete, accurate and scientific. The very best book of its kind I have seen." — y. S. Knox, M.D., Lecturer on Obstetrics Rush Medical College, Chicago. THE ? QUIZ-COMPENDS " I have been teaching in this department for many years, and am free to say that this will be the best assistant I ever had. It is ac- curate and comprehensive, but brief and pointed." — Prof. P. D. Yost, St. Louis. No. 6. MATERIA ME3DIOA. A Compend on Materia Medica and Therapeutics, with especial reference to the Physiological Actions of Drugs. For the use of Medical, Dental, and Pharma- ceutical Students and Practitioners. Based on the New- Revision (Sixth) of the U. S. Pharmacopoeia, and in- cluding many unofficinal remedies. By Samuel O. L. Potter, M.A., M.D., U. S. Army. " I have examined the little volume carefully, and find it just such a book as I require in my private Quiz, and shall certainly re- commend it to my classes. Your Compends are all popular here in Washington." — John E. Brackett, M.D., Professor of Materia Medica and Therapeutics , Howard Medical College, Washington. " Part of a series of small but valuable text-books. . . . While the work is, owing to its therapeutic contents, more useful to the medical student, the pharmaceutical student may derive much use- ful information from it." — I\f. V. Pharmaceutical Record. No. 7. CHEMISTRY. A Compend of Chemistry. By G. Mason Ward, m.d., Demonstrator of Chemistry in Jefferson Medical Col- lege, Philadelphia. Including Table of Elements and various Analytical Tables. " Brief, but excellent. ... It will doubtless prove an admirable aid to the student, by fixing these facts in his memory. It is worthy the study of both medical and pharmaceutical students in this branch." — Pharmaceutical Record, New York. No. 8. VISCERAL ANATOMY. A Compend of Visceral Anatomy. By Samuel O. L. Potter, m.A., m.d., U. S. Army. With 40 Illustrations. *** This is the only Compend that contains full descriptions of the viscera, and will, together with No. i of this series, form the only complete Compend of Anatomy published. No. 9. SURGERY. lUustrated. A Compend of Surgery; including Fractures, Wounds, Dislocations, Sprains, Amputations and other opera- tions, Inflammation, Suppuration, Ulcers, Syphilis, Tumors, Shock, etc. Diseases of the Spine, Ear, Eye, Bladder, Testicles, Anus, and other Surgical Diseases. By Orville Horwitz, a.m., m.d., with 43 Illustra- tions. Price of Each, Cloth, $1.00. Interleaved for Notes, $1.25. STUDENTS' MANUALS. TYSON, ON THE URINE. A Practical Guide to the Examination of Urine. For Physicians and Stu- dents. By James Tyson, m.d., Professor of Path- ology and Morbid Anatomy, University of Pennsylva- nia. With Colored Plates and Wood Engravings. Fourth Edition. i2mo, cloth, $1.50 GILLIAM'S PATHOLOGY. The Essentials of Pathology; a Handbook for Students. By D. Tod Gilliam, m.d., Professor of Physiology, formerly Pro- fessor of Pathology, Starling College, Columbus, Ohio. 48 Illustrations. i2mo, cloth, ^2,00 BRUEN'S PHYSICAL DIAGNOSIS. 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A HANDBOOK OF THE THEORY AND PRACTICE OF MEDICINE. By Frederick T. Roberts, m.d., m.r.c.p., Assistant Professor and Teacher of Clinical Medicine in Uni- versity College Hospital, London, Assistant Physician in Bromp- ton Consumptive Hospital. Third Edition. Octavo. CLOTH, $5.00; LEATHEK, $6.00. "A clear, yet concise, scientific and practical work. It is a capi- tal compendium of the classified knowledge of the subject." — Prof, y. Adams Allen, Rush Medical College, Chicago. " I have become thoroughly convinced of its great value, and have cordially recommended it to my class in Yale College." — Prof David P. Smith. " I have examined it with some care, and think it a good book, and shall take pleasure in mentioning it among the works which may properly be put in the hands of students." — A. B. Palmer, M.D., Prof of the Practice of Medicine, University , of Michi- gaft, Ann Arbor, Michigan. "■ It is unsurpassed by any work that has fallen into our hands, as a compendium for students preparing for examination. It is thoroughly practical, and fully up to the times."— T"-^^ Clinic. " Our opinion of it is one of almost unqualified praise. The style is clear, and the amount of useful and, indeed, indispensable information which it contains is marvelous." — Boston Medical and Surgical journal . BIDDLE'S MATERIA MEDICA. Ninth Revised Edition. Recommended as a Text-book at Yale College, University of Michigan, College of Physicians and Surgeons, Baltimore, Baltimore Medical College, Louisville Medical College, and a number of other Colleges throughout the U. S. BIDDLE'S MATERIA MEDICA. For the Use of Students and Physicians. By the late Prof. John B. Biddle, m.d.. Profes- sor of Materia Medica in Jefferson Medical College, Philadelphia. The Ninth Edition, thoroughly revised, and in many parts re- written, by his son, Clement Biddle, m.d.. Past Assistant Surgeon, U. S. Navy, assisted by Henry Morris, m.d. CLOTH, $4.00 ; LEATHER, $4.75. " I shall unhesitatingly recommend it (the gth Edition) to my students at the Bellevue Hospital Medical College. — Prof. A. A. Smith, New York, June, 1883. " The standard ' Materia Medica ' with a large number of medi- cal students is Biddle's." — Btiffalo Medical and Surgical Journal. " The larger works usually recommended as text-books in our medical schools are too voluminous for convenient use. This work will be found to contain in a condensed form all that is most valuable, and will supply students with a reliable guide." — Chicago Medical Journal. *** This Ninth Edition contains all the additions and changes in the U. S. Pharmacopoeia, Sixth Revision. 4®»An Encyclopedia of Medical Knowledge."®^ INDEX OF DISEASES; WITH TREATMENT AND FORMULA. By THOS. HAWKES TANNER, M.D. REVISED AND ENLARGED BY DR. BROADBENT. Octavo, Cloth. Price $3.00. *** The worth of a work of this kind, by so eminent a professor as Dr. Tanner, cannot be over-estimated. -As an aid to physicians and druggists, both in the country and city, it must be invaluable. It contains a full list of all diseases, arranged in alphabetical order, with list of formulae, and appendix giving points of interest regard- ing health resorts, mineral waters, and information about cooking and preparing food, etc., for the invalid and convalescent. The page headings are so indexed that the reader is enabled to find at once the disease wanted ; its synonyms, classification, varie- ties, description, etc., with the course of treatment recommended by the best authorities, and is referred, by number, to the several prescriptions that have proved most efficacious. These prescrip- tions are also arranged so that they can be easily referred to, with directions how to use them, when to use them, and what diseases they are generally used in treating. The directions for cooking foods and preparing poultices, lotions, etc., are very full. The work will be found specially useful to students and young physicians. RICHTER'S CHEMISTRY. A TEXT-BOOK of INORGANIC CHEMISTRY for STUDENTS. By PROF. VICTOR von RICHTER, University of Breslau, Authorized Translation from the Third German Edition, By EDGAR F. SMITH, M.A., Ph.D., Professor of Chemistry in Wittenberg College, Springfield^ Ohio: formerly in the Laboratories of the University of Pennsyl- vania; Member of the Chemical Society of Berlin. 12mo. 89 Wood-cuts and Col. Lithographic Plate of Spectra. $2.00 In the chemical text-books of the present day, one of the striking features and difficulties we have to contend with is the separate presentation of the theories and facts of the science. These are usually taught apart, as if entirely independent of each other, and those experienced in teaching the subject know only too well the trouble encountered in attempting to get the student properly in- terested in the science and in bringing him to a clear comprehension of the same. In this work of Prof, von Richter, which has been received abroad with such hearty welcome, two editions having been rapidly disposed of, theory and fact are brought close together, and their intimate relation clearly shown. From careful observa- tion of experiments and their results, the student is led to a correct understanding of the interesting principles of chemistry. The de- scriptions of the various inorganic substances are full, and embody the results of the latest discoveries. The arrangement of types, size of the book, etc., are such as to facilitate its use. JUST PUBLISHED. RiCHTER's Inorganic Chemistry. FROM THE THIRD EDITION. A Text-Book for Students, in which the Theory and Facts of the Science of Chemistry are brought together and their intimate relations clearly shown. A TEXT-BOOK OF INORGANIC CHEMISTRY. By Prof. Victor VON RiCHTER, University of Breslau. Authorized Translation from the Third German Edition, by Edgar F. Smith, m.a., ph.d., Member of the Chemical Society of Berlin, Prof, of Chemistry, Wittenberg College, formerly in the Laboratories of the University of Pennsylvania. 89 wood-cuts and colored plate of Spectra. i2mo. 424 pages. Price, Cloth, $2.00. RECOM M KN"3DA.TION"S. " Knowing the value of the excellent work of Prof, von Richter in the original, I am pleased to hear of a forthcoming English translation, by such an able chemist and admirable trans- lator as Prof. Smith. " The work is of undoubted value. The theory of chemistry, which is generally the bugbear of students, is in this book very clearly explained, and the explanations are so well distributed through the book that students are brought easily from the simplest to the most difficult problems. " That part descriptive of the elements and their compounds is full, and all that could be de- sired in a text-book, while the cuts, with which the work is profusely illustrated, are an ex- cellent aid to the student. Altogether, it is one of our best modern works on chemistry."— John Marshall, M.D., Nat. Sc.D. {'lubingen), Demonstrator of Chemistry in the Univer- sity of Penyisylvania, Medical Department. 4I^In Press, ORGANIC CHEMISTRY, by the same Author and Translator. MARSHALL & SMITHES CHEMICAL ANALYSIS of URINE. ILLUSTRATED. As none of the existing books on Urine Analysis deal sufficiently with the chemi- cal side of the subject, this little handbook has beett prepared to fill the ga/ THE CHEMICAL ANALYSIS OF THE URINE. Based in part on Casselmann's Analyse des Harns. By John Marshall, m.d., Demonstrator of Chemistry, Medical Department, University of Pennsyl- vania, and Edgar F. Smith, ph.d., Professor of Chemistry, Wittenberg ' College. Illustrated, i2mo. Price, Cloth, $1.00. RTccoivriviKisriDAT^ioisrs. " It seems to me to be ver>- clearly written and well adapted for fjie use of the medical student and practitioner, as an available handbook, being detailed descriptions of the most trustworthy methods of detection of the chief normal as well as the abnormal constituents of the urine; and the accompaning calculations add greatly to its value as a handy reference book." — Prof Sam' I P. Sadtler, Prof essor of General and Organic Chemistry, University of Pennsylvania, and Prof . of Chemistry, Philadelphia College of Pharmacy. " The illustrations are well done, and in point of clearness of expression and accuracy of statement, the book leaves little to be desired." — N. Y. Medical Jozirnal. P. BLAKISTON, SON & CO., Medical Publishers and Booksellers, 1012 WALNUT STREET. PHILADELPHIA. BIDDLE'S Materia Medica. NINTH REVISED EDITION. 'ConUint all Chaneas in the Naw Pharmacopcsla.) Recommended as a Text-booh at Yale College, University of Michigan, College of Physicians and Surgeons, Baltimore, Baltimore Medical College, Louisville Medical College, and a number of other Colleges throughout the United States. BIDDLE'S MATERIA MEDICA. For the Use of Students and Physicians. By the late Prof. John B. Biddle, m.d., Professor of Materia Medica in Jefferson Medical College, Philadelphia. The Ninth Edition, thoroughly revised, and in many parts rewritten, by his son, Clement Biddle, m.d., Assistant Surgeon, U. S. Navy, assisted by Henry Morris, M.D. Containing all the additions and changes made in the last revision of the United States Pharmacopoeia. Octavo. Ready. Bound in Cloth. Price $4.00; Leather, $4.7S. BUOOMMEITDATIONS. " It will be found a useful handbook by students, especially, who may be under the instruction of its able and accomplished author." — American Med- ical yournal. •' In short, it is just the work for a student, embracing as it does what will be discussed in a course of lectures on materia medica." — Cincinnati Medical News. " In truth, the work is well adapted to the wants of students." — TJie Clinic. " Nothing has escaped the writer's scan. All the new remedies against disease are duly and judiciously noted. Students will certainly appreciate its shapely form, grace of manner, and general multum in pa}-vo style." — Ameri- can Practitioner. " Biddle's * Materia Medica ' is well known to the profession, being a stand- ard text-book in several leading colleges." — New York Medical Journal. " It contaii|s,5^n a condensed form, all that is valuable in materia medica, and furnishes the medical student with a complete manual on this subject." — Canada Lancet. " The necessity for a new edition of this work in so short a time is the best proof of the value in which it is held by the profession." — Medical and Surg- ical Reporter. " The standard ' Materia Medica ' with a large number of medical students is Biddle's." — Buffalo Medical and Surgical Journal. "The larger works usually recommended as text-books in our medical schools are too voluminous for convenient use. This work will be found to contain in a condensed form all that is most valuable, and will supply students with a reliable guide." — Chicago Medical Journal. *^* This Ninth Edition contains all the additions and changes in the U. S. Pharmacopoeia, Sixth Revision. P. BliASHSTON, SON & GO.. Publishers and BookseUars, 1012 WALNUT STREET, PHILADELPHIA. 00513159 M lllllillllllllll ^ER DiS€ 3 1378 00513 1597 IdrCIl. SEVENTH REVISED EDITION. Recommended at thirty-five of the principal Medical Colleges in the United States, including Bellevue Hospital, New York, University of Pennsylvania, and Long Island College Hospital. A PRACTICAL TREATISE ON THE DISEASES OF CHILDREN. By J. Forsyth Meigs, m.d., one of the Physicians to the Pennsylvania Hospital, Consulting Physician to the Children's Hospital, etc., and William Pepper, m.d,. Professor of Clinical Medicine, University of Pennsylvania, Provost and ex-officio President of the Faculty, Physician to the Philadelphia Hospital, Fellow of the College of Physi- cians, etc. The Seventh revised and improved edition. In one volume, of over looo royal octavo pages. Price, in Cloth, $6.00; Leather, $7.00 RECOMMENDATIONS. Tlie rapid sale of six large editions of Drs. Meigs and Pepper's work on Children, and the demand for the new edition now ready, is sufficient evidence of its great popularity. The large practice, of many years' standing, of the authors imparts to it a value unequaled, probably, by any other book on the subject now before the profession. The whole work has been again subjected to an entire and thorough revision. Some articles have been rewritten; many additions made; and great care observed by the authors that it should be most effectually brought up to the light, pathological and therapeutical, of the present day. The publishers have very many favorable notices of the previous editions, received from numerous sources, foreign and domestic. They append a few from leading journals, which will give a general idea of the value placed upon it, both as a text book for the student and a work of reference for the Genei-al Practitioner. " It is the most complete work upon the subject in our language. It contains at once the results of personal and the experience of others ; its quotations from the most recent authori- ties, both at home and abroad, are ample, and we think the authors deserve congratulations for having produced a book unequaled for the use of the student, and indispensable as a work of reference for the practitioner." — American Medical Journal. " But as a scientific guide in the diagnosis and treatment of the diseases of children, we do not hesitate to say that we have seldom met with a text-book so complete, so just, and so readable, as the one before us, which in its new form cannot fail to make friends wherever it shall go, and wherever great erudition, practical tact, and fluent and agreeable diction are appreciated."— American Journal of Obstetrics. " It is only three years since we had the pleasure of recommending the Fifth Edition of this excellent work. With the recent additions, it may safely be pronounced one of the best and most comprehensive works on diseases of children of which the American practitioner can avail himself, for study or reference." — Neiv York Medical Journal. P. BliAKISTON, SON & CO.. PubUshers and Book8*Uttrs. 1012 WALNUT STREET, PHILADELPHIA.