COLUMBIA LIBRARIES OFFSITE HX00018287 RECAP lEi ruiifruOrnJUirmifnnlfrmlfpiiiininll SI Digitized by the Internet Archive in 2010 with funding from Columbia University Libraries http://www.archive.org/details/atlasofhumananat34told AN ATLAS OF HUMAN ANATOMY FOR STUDENTS AND PHYSICIANS BY CARL TOLDT, M.D. ASSISTED BY PROFESSOR ALOIS DALLA ROSA, M.D. a^apte^ to Englisb an^ American aiiD Jnternational XCermlnoloo^ BY M. EDEN PAUL, M.D. Brux., M.R.C.S., L.R.C.P. THIRD SECTION D. AIYOLOGY n-M(;i-iu-;s 4Q0 to (^o and ixdex) REVISED EDITION 9t/oo' NEW YORK REBMAN COMPANY^ 141, ] 13 Axn ] 1.5 WEST SOtii STREET Copyright, 1919, by REBMAN COMPANY V, ^'^ M YOLO GI A MYOLOGY ^3 MYOLOGY— GENERAL CONSIDERATIONS 260 Nuclei of the muscular fibre ^ MYOL OG Y^GENERAL CONSIDERA TIONS Sarcolemma / Perimysium of a primary fasciculus of muscular fibres Cross-striated contractile substance Fig. 490. — A Portion of an Isolated Cross- striated Muscular Fibre. -Sa. jojomA* a .Cross-stnated contractile substance Nuclei of the ; muscular fibre^ ^Individual fibres of a primary fasciculus 1 mm^ Perimysium of a fasciculus of muscular fibres I Nuclei of the connective - -" [ tissue cells I Nuclei of the |_ muscular fibres ~^^**^JIndomysium of the muscular fibres Fig. 491. — A Portion of an Isolated Cross- striated Muscular Fibre in which for A Short Distance the Contractile Sub- stance HAS been removed FROM THE Sarcolemma. Muscular fibres^;-._ Fig. 492. — Fasciculus of Muscular Fibres FROM A Longitudinal Section of the Human Sartorius Muscle, hardened in Picric Acid Solution. ,.^Capillary bloodvessels Perimysium; of a fasciculus of muscular fibres Bloodvessel...''-'' ^^^^l^Jhr ~~— ^i^Endomysium of the muscular fibres Fig. 493. — Fasciculi of Muscular Fibres in Transverse Section. Some of the Fasciculi have fallen out of the Section. In the Perimysium of the Fasciculi numerous Capillary Bloodvessels are seen in Transverse Section. (From a Transverse Section of the Human Sartorius Muscle, hardened in Picric Acid Solution and Alcohol.) Elementary Constituents and Structure of Muscle. MYOLOG Y— GENERAL CONSIDER A TIONS 261 Capillary bloodvessels Endomysiiun of the. muscular fibres Sarcolemma- Muscular fibres"^^ Endomysium undergoing transition to tendon Perimysium of the muscular fibres Thickening of the periosteum at the site of origin of a muscle Direct origin of muscular fibres from the periosteum Periosteum I'eriosteum - Muscular fibres Bursa beneath the tendor,. Bursa mucosa subtendinea Indirect insertion of muscle by tendon Fig. 494. — Diagrammatic Representation OF THE Relation of the Muscular Fibres to the Endomysium. Fig. 495. — Diagrammatic Representation of the Relation of the Perimysium to the Origin and the Insertion of the Muscle (the In- sertion in this Case being by Tendon). Perimysium of the <:;^-- secondary fasciculi \"" ..-Nerve filament Primary fasciculi Perimysium of theism '"^'^^BSUK&B^bHUtlB^KMKB^'iSf^ Epimysium (the investment or primary fasciculi ^^"VS^Si^^BK^WBi^^Si^^^^ -sheath of areolar tissue sur- rounding the entire muscle) Fig. 496. — Transverse Section through the Saktokius .\1uscli-; of a New-born Infant, showing the Primary and Secondary Fasciculi of Muscular Fibres. Structure of Muscle. 262 MYOLOGY— GENERAL CONSIDERATIONS . Tendon " Tendo ^Head Caput Belly "Venter Fig. 497- — Musculus FusiFORMis ; Fusi- FCRM Muscle. Fig. 498. — Musculus Fig. 499. — Musculus Unipennatus; Pen- Bipennatus; Bipen- NiFORM Muscle. niform Muscle. Tendon Tendo Fig. 500. — Musculus Biceps ; Double- headed Muscle. _ Belly Venter Fig. 501. — Broad Muscle. Fig. 502. — Strap-shaped Muscle. Fig. 503.^Musculus BivENXEEi Digastric Muscle. The Principal Muscular Forms. MYULOGV —GENERAL CONSIDERA TlONa 263 Common head for the coracobrachialis muscle anc' the internal or short head of the biceps muscle - Antagonists in relation to the shoulder-joir Biceps flexor cubiti muscle_ (acting on three joints) ~ In relation to the humero ulnar articulation Antagonists - Synergists (flexors)v . Supinator radii brevis (acting on one joint) "~ radio ulnar articulation Axis of the trochoid articulation or pivot joint (the radioulnar articulation) Synergists in relation the shoulder -joint Coracobrachialis muscle (acting on one joint) Head acting on | two joints I of the triceps extensoi Head acting on I cubiti muscle one joint I Biachialis anticus muscle (acting on one joint) Axis of the ginglymus or hinge-joint (the humero-ulnar articulation) \^ Pronator radii teres muscle I (acting on two joints) Synergists (supinators) "j in relation to the radio-ulnar articulation Synergists (pronators) ) ronator quadratus muscle (acting on one joint) Fig. 504. — The Muscles ov the Akm and the Pronator and Supinator Muscles or the Forearm as Examples of the Relation of Various Muscles to One or Several Joints, and also ok the synergistic or antagonistic action of muscles in relation to a Particular Joint. Relation of the Muscles to the Joints. 264 MYOLOGY— GENERAL CONSIDERA TIONS Investing portion of the deep fascia of the arm Fascia brachii (Lamina superficialis) The internal cutaneous nerve piercing the deep fascia Epimysium of the biceps flexor cubiti muscle Layer of the deep fascia of the arm between the biceps and the brachialis muscle Fascia bracliii (Lamina profunda) Musculocutaneous nerve N. cutaneus antibrachii lateralis Brachial artery with its accompanying veins and nerves Basilic vein — Vena basilica Internal intermuscular septum Septum intermusculare mediate Ulnar nerve — N. ulnaris Investing portion of the deep fascia of the arm Fascia bracliii (Lamina superficialis) Skin " Integumentum commune Superficial fascia ' Fascia superficialis Cutaneous vein (the cephalic vein) ■ Vena cutanea (V. cephalica) _ Biceps flexor cubiti muscle IVI. biceps brachii Junction of the areolar septum be- tween the biceps and the brachialis muscle with the general investing portion of the deep fascia of the arm Brachialis anticus muscle y\. bracliialis . Musculospiral nerve — N. radialis Supinator radii longus muscle M. brachioradialis The humerus — Humerus External intermuscular septum Septum intermusculare lateraie Triceps extensor cubiti muscle M triceps brachii Superficial fascia — Fascia superficialis Skin — Integumentum commune Fig. 505. — Aponeurosis or Fascia. The Relation of the Deep Fascia to the Various Groups OF Muscles and to the Bone. The Intermuscular Septa. The Superficial Fascia. (Fascia of the Right Arm.) The individual muscles with their investing fascia in the lower third of the arm have been divided transversely at varying levels. Skin Integumentum commune Superficial fascia Fascia superficialis Brachial artery with its accompanying -^. veins and nerves Basilic vein Vena basilica Ulnar nerve N. ulnaris Internal intermuscular septum Septum intermusculare mediale The humerus Humerus Triceps extensor cubiti muscle M. triceps brachii Investing portion of the deep fascia of the arm Fascia brachii (Lamina superficialis) N^ Biceps flexor cubiti muscle _\^,— "' M. biceps brachii '^)^\ - Cephalic vein— Vena cephalica Layer of the deep fascia of the arm between the biceps and the brachialis muscle (i) Brachialis anticus muscle — M. brachialis _ Musculospiral nerve N. radialis Supinator radii longus muscle M. brachioradialis External intermuscular septum ' Septum intermusculare lateraie (i) Fascin brachii (Lamina profunda) Fig. 506.— The Grouping of the Muscles of the Arm, and the Relation of these Muscles to the Deep Fascia. (Transverse Section through the Right Upper Arm in the Neighbourhood of its Distal Extremity; Proximal Cut Surface. Semi-Diagrammatic.) Aponeurosis or Fascia. MUSCULI TRUNCI THE MUSCLES OF THE TRUNK 266 THE MUSCLES OF THE TRUNK Auricularis superior, or attollens auriculam, muscle Aurlcularia posterior, orretrahens auriculam, muscle Transversus nuclise muscle cvar ) Complexus, or semispinalis capitis, muscle Sternocleidomastoid muscle Levator anguli scapulse muscle M. levator scapulae -Occipitalis muscle Deep cervical fascia Fascia nuchae Seventh cervical vertebra Vertebra cer\ icalis Vli. Spine of the scapula bpina scapulas Deltoid muscle Triceps extensor cubiti muscle (middle or long head) M. triceps brachii (Caput longum) Teres major muscle Latissimus dorsi muscle External oblique muscle of the abdome/i M. obliquus externus abdominis Gluteal portion of the fascia lata of the thigh Fascia glutaea Triceps extensor cubiti muscle M. triceps brachii ■~ Latissimus dorsi muscle Twelfth dorsal vertebra Vertebra thoracalis XII. Superficial or posterior layer of the lumbar fascia^ External oblique muscle of ' the abdomen ~ M obliquus externus abdominis Triangle of Petit Trigonum lumbale (Petiti) Crest of the ilium Crista iliaca Posterior superior spine of the ilium Spina iliaca posterior superior ' See notes to pp 267 and 285 for an account of the different portions of the lumbar fascia. Fig. 507. — First (Superficial) Layer of the Muscles of the Back (Wide Muscles of the Back) : the Trapezius Muscle (Cucullaris) ; the Latissimus Dorsi Muscle. Super- ficial OR Posterior Layer of the Lumbar Fascia. Musculi dorsi — Muscles of the back. THE MUSCLES OF THE TJWNK 267 Highest Curved line I Suprema Linea rmchaej Supenor (.Superior Complexus, or semispinalis capitis, muscle Sternocleidomastoid muscle (divided and turned aside) M. sternocleidomastoideub Splenius capitis muscle Splenius colli, or splenius cervicis. muscle Levator anguli scapulae muscle M. levator scapula* Serratus posticus superior muscle M. serratus posterior superior Vertebral aponeurosis Fascia lumbodorsali-s Lambdoid or occipitoparietal suture feiitura lambcioidea Ligamentum nucha: Deep cervical fascia (deep layer) tascia nuchae (Lamina profunda) Spinous process of the seventh cervical vertebra Processus spinosus vertebrae cervicalis VII. Serratus posticus superior muscle M serratus posterior superior Rhomboideus minor muscle Rhomboideus major muscle Supraspinous fascia Fascia supraspinata Infraspinous fascia Fascia infraspinata External intercostal muscles Mm. intercostales e\terni Serratus posticus inferior muscle M. serratus posterior inferior Latissimus dorsi muscle (arising from the superficial or posterior layer of • t^e lumbar fascia) Internal oblique muscle of the abdomen M. obliquus internus abdominis External oblique muscle of the abdomen M. obliquus externus abdominis Superficial or posterior layer of the lumbar fascia Fascia lumbodorsalis Gluteus medius muscle M j;luta;us medius Gluteus maximua muscle M. glutaius raaximus Serratus magnus muscle M, serratus anterior Spinous process of the twelfth dorsal vertebra Processus spinosus vertebrae thoracalis XII. Latissimus dorsi muscle (arising from the three lowest ribs) External oblique muscle of the abdomen M. obliquus externus abdominis Triangle of Petit Trigonum lumbale (Petili) , Crest of the ilium Crista iliaca Gluteal portion of the fascia lata Fascia "luta'a Fig. 50S. — SiicoND Layer of the Musclms of thf. Back (Wide Muscles of the Back), shown liY THE Removal of the Latissimus Doksi and the Tkai'e;^ius. Muscles; on the Left Side, the Rhomboideus Major and Rhomboideus Minor Muscles have also been removed. The muscles of the second layer arc: Rhomboideus major, rhomboideus minor, serratus posticus superior, serratus posticus inferior, and levator anguli scapui.e. 'I'he superficial or posterior layer of the lumbar fascia,' by means of which the latissimus dorsi and the serratus posticus inferior muscles are attached to the spines of the vertebra', and the vertebral aponeurosis, are also shown. The name of lumbar /ascia 11 by wme anatomisls rcslriclcd to the deeper hiycrs uf this structure (s( here call Ihc superficial or poilirior layer 0/ the Imuliar fascia is in that case cither rcEarded as the Imi^rr puriion 11/ the a/omaroi// (with which it is conlinuoiu), or cIk is termed the ' ' I that case either regarded i : aponeurosis 0/ the latissimus dorsi muscle. Musculi dorsi— Muscles of the back. i'\—- 268 THE MUSCLES OF THE TRUNK Complexus, or semispinalis capitis, muscle Splenius capitis muscle Scalenus posticus muscle M. scalenus posterior Splenius colli muscle M. splenius cer\icis Serratus magnus muscle Spinalis dorsi muscle Musculus accessorius ad iliocostalem M. iliocostalis dorsi Longissimus dorsi muscle Serratus posticus inferior muscle M, serratus posterior inferior Externa oblique muscle of the abdomen M. obliquus externus abdominis Iliocostalis or sacrolumbalis muscle M. iliocostalis lumborum Superficial or posterior layer of the lumbar fascia' (turned outwards) Fascia lumbodorsalis Obliquus capitis superior muscle —Complexus, or semispinalis capitis, muscle Trachelomastoid muscle M longibsimus capitis Transversalis cervicis muscle M longissimus cervicis Ligamentum nuchse Spinalis cervicis muscle Cemcalis ascendens muscle M iliocostalis cervicis Serratus magnus muscla Longissimus dorsi muscle " (outer row of insertions) Spinalis dorsi nmscle Musculus accessorius ad iliocostalem M. iliocostalis dorsi External intercostal muscles Mm. intercostales externi Internal oblique muscle of the abdomen M. obliquus internus abdominis ^ See note to p. 267. Fig. 509.— Third Layer of the Muscles of the Back (Long Muscles of the Back), shown BY the Removal of the First and Second Layers of Muscles and of the Superficial or Posterior Layer of the Lumbar Fascia and the Vertebral Aponeurosis; on the Right Side the Musculus Accessorius ad Iliocostalem has been drawn Outwards. The muscles of the third layer are: The erector spina, consisting of the iliocostalis (sacrolumbalis) and the longissimus dorsi, with their prolongations upwards— accessorius, spinalis, and splenius muscles. Musculi dorsi— Muscles of the back. THE MUSCLES OE THE TRUNK Superior curved line Linea nucha? su] ei Complexus, or semispinalis capitis, muscle Splenius capitis muscle Levator anguli scapulsp muscle M. le\ator scapula:- Cervicalis ascendens muscle (insertion! M- iliocostalis cervicis '^ Splenius colli muscle— M splenius cervici Scalenus posticus muscle — M. scalenus p sten i Hasculus accessorius ad iliocostalem (insertioni M. iliocostalis dorsi Cervicalis ascendens muscle ( divided and the lower extremity turned inwardsi M iliocostalis cervicis "Insertion of the serratus posticus superior muscle into the ribs Musculus accessorius ad iliocostalem (the tendons of insertion have been divided, the uppermost excepted jl. iliocostalis dorsi Angle of the sixth rib Angulus costa:- VI, Iliocostalis or sacrolumbalis muscle (in-,. sertion) — M iliocostalis lumborum Longissimus dorsi muscle - Iliocostalis or sacrolumbalis muscle (ten- dons of insertion, divided and turned — upwards)— M. iliocostalis lumborum Hasculus accessorius ad iliocostalem (origin) Iliocostalis or sacrolumbalis muscle (insertion by muscular slips into the eleventh and twelfth ribs; ~" M. iliocostalis lumborum Serratus posticus inferior muscle : (insertion into the ribs) M. serratus posterior inferior External oblique muscle of the abdomen M. obliquus fcxternus abdominis Transversalis abdominis muscle M. transversus abdominis Iliocostalis or sacrolumbalis muscle . M. iliocostalis Internal oblique muscle of the abdomen M. obliquus internus aljdominis External oblique muscle of the abdomen M. oblifjuus externus abdominis G iuteus maximuB muscle M xlutxus maximus Trapezius muscle Ligamentum nuch% /Rhomboideus minor muscle Spinous process of the first dorsal vertebra I icccssus sp 1 sus vertebrae thoracalis I. Levator anguli scapulae muscle ■' \I Icvati r sc ipulae Serratus posticus superior muscle M serratu p >sterior superior .Rhomboideus major muscle ==" Trapezius muscle Deltoid muscle "M. deltoideus -Infraspinous fascia Fascia inlraspinata Teres major muscle Middle or long head of the triceps exten- sor cubiti muscle \Latissimus dorsi muscle (insertion) Serratus posticus inferior muscle M. serratus posterior inferior *Latissimus dorsi muscle (origin) The lowest slips of origin of the external oblique muscle of the abdomen Internal oblique muscle of the abdomen M obliquus internus abdominis External oblique muscle of the abdomen M. obliquus externus abdominis Superficial or posterior layer of the lumbar fascia' Fascia lumbodorsalis Gluteal portion of the fascia lata Fascia gluta'a ' See note to p. 267. Fig. 510.— The Divisions of the Iliocostalis ok Sacrolumbalis Muscle and its Accessory Slii's of Origin, shown dy the Removal of Portions of the Muscle. The Levator Anguli Scai'UL/E, the Splenius Capitis, and the Splenius Colli Muscles. The Serratus Posticus Superior and the Serratus Posticus Inferior Muscles. The last-named muscle has, in respect of the width of its slips of insertion, a very different appearance from that shown in Kig. 508. Musculi dorsi Muscles of the back. 270 THE MUSCLES OF THE TRUNK Superior curved line Linea nuchffi superior Mastoid process Processus mastoideus Trachelomastoid muscle M. longissiraus capitis Complexus, or semispmahs _ capitis, muscle Semispinalis colli muscle M. semispinalis cervicis Transversalis cervicis muscle with the accessory slip from - the longissimua dorsi muscle Semispinalis dorsi muscle External intercostal muscles J Mm. intercostales externi j ^ u Longissimus dorsi muscle Multifidus spinse muscle M. multifidus Longissimus dorsi muscle (inner row of insertions [ntemal oblique muscle of the abdomen M. obliquus internus abdominis Obliquus capitis superior muscle _Eectus capitis posticus minor muscle M. rectus capitis posterior minor -Rectus capitis posticus major muscle _ M. rectus capitis posterior major Obliquus capitis inferior muscle Interspinales muscles Scalenus medius muscle Semispinalis colli muscle M. semispinalis cervicis Scalenus posticus muscle M. scalenus posterior TLevatores costarum muscles i Mm. levatores costarum [ breves 1 ^External intercostal muscles "J Mm. intercostales externi .. r Levatores costarum longiores muscles - \^Mm. levatores costarum longi Maltifidus spinse muscle M. multifidus ( Intertransversales laterales muscles Mm. intertransversarii posteriores laterales Middle layer of the lumbar fascia, forming the posterior aponeurosis of the transver- salis abdominis muscle — Lig. lumbocostale Transversalis abdominis muscle M transversus abdominis Gluteus medius muscle M. gluteus medius Gluteus maximus muscle M. glutseus maximus Fig. 511. — Fourth Layer of the Muscles of the Back (Long Muscles of the Back); on the Left Side the Longissimus Dorsi and the Transversalis Cervicis have been drawn Outwards, showing the Connexion between the Two, and their Attachments to the Transverse "Processes of the Vertebra; on the Right Side the Erector Spin^ Muscle HAS been entirely REMOVED ; THE SEMISPINALIS DORSI, SEMISPINALIS CoLLI, SEMISPINALIS Capitis (Complexus), and the Multifidus Spin^ Muscles make up the Fourth Layer. Regarding the insertion of the longissimus dorsi muscle into the lumbar vertebrae and the elventh and twelfth ribs, see also Fig. 592. Musculi dorsi — Muscles of the back. <. THE MUSCLES OF THE TRUNK 271 Jomplexus, or semispinalis capitis, muscle - Obiiqv.us capitis superior muscle - - "3 jLiQuus capitis inferior muscle interspinales muscles ^altifidus spinas muscle ^1. multitidus External intercostal muscles f "' U Mm. intercostales externi j ' Middle layer of the lumbar fascia, forming the posterior aponeurosis of the trans versalis abdominis muscle Lif; luTiibrjcostale Interspinales muscles Mm. interspinales Transversalis abdominis muscle M. transversus abdominis Superior curved lino l^inca nucluf superior Bectus capitis posticus minor muscle M. rectus capitis posterior minor Bectus capitis lateralis muscle Bectus capitis posticus major muscle M rectus capitis posterior major Posterior mtertransversales muscles I Mm intertransversarii posteriores Seventh cervical vertebra Vertebra cervicalis VII. Botatores longi muscles Levator costse longior muscle M . levator costae lonsus ^Levatores costarum muscles 1 (Mm. levatores costarum breves ^ Botatores dorsi muscles Mm. rotatores breves Levator costse longior muscle M. levator costae longus Twelfth dorsal vertebra W-rtebia thoracalis XII. /"IntertransverEales mediates J or interaccesBorii muscles j Mm intertransversarii [ posteriores mediales Intertransversales laterales muscles . I\!m, intertransversarii posteriores [ laterales i-iG. 512. — Fifth (Deepest) Layer of the Muscles of the Back (Short Muscles of the Back): Rotatores Longi, Rotatores Doksi ; Interspinales; Intertransversales; Levatores Costarum. The short posterior cranioveitcbral or stiliorcipital muscles also belong to tlie fifth layer of the muscles of the back. Musculi dorsi Muscles of the Dack. 272 THE MUSCLES OF THE TRUNK Rectus capitis posticus minor muscle (ongin) __ j^^^^ M. rectus capitis posterior minor r Transverse process of the atlas ^Sc-^ Processus transversus atlantis ^"*\>™*. Obliquus capitis inferior muscle (ongin) Rectus capitis posticus major muscle (origin) M. rectus capitis posterior major Spinous process of the axis Processus spinosus epistrophei Multifidus spins muscle (insertions) M. multifidus Semispinalis colli muscle (insertions) M. semispinalis cervicis Rotatores longi muscles Interspinales muscles Spinous process of the seventh cervical vertebra — Processus spinosus ver- tebrae cervicalis VII. Rotatores longi muscles Rotatores dorsi muscles Mm. rotatores breves Third rib Os costale III.- — Multifidus spinas muscle (insertions) M. multifidus Spinous process of the third dorsal vertebra Processus spinosus vertebrae thoracalis III. Rectus capitis lateralis muscle (origin) Obliquus capitis superior muscle (origini Obliquus capitis inferior muscle (insertion) Insertions of the transversalis cervicis (longissimus cervicis) muscle Spmal dura mater Dura mater spinalis The uppermost slips of origin of the com- plexus or semispinalis capitis, muscle The uppermost slips of origin of the multifidus spinae muscle Slip of insertion of the transversalis cervicis (longissimus cervicis) muscle Slips of insertion of the cervicalis ascendens liliocostalis cervicis) muscl: Posterior intertransversales muscles Mm mtertransversarii posteriores Slips of origin of the complexus, or semispinalis capitis, muscle Tubercle of the first rib Tuberculum costae I. Outer row of insertions of the longissimus dorsi muscle ~_ Angle of the second rib Angulus costa; II. Insertions of the museulus accessorius ad iliocostalem (iliocostalis dorsi) Inner row of insertions of the longissimus dorsi muscle Fig. 513. — Origin and Insertion of the Long and the Short Muscles of the Back in THE Cervical and Upper Dorsal Region. Origin of the Short Posterior Cranio- vertebral or Suboccipital Muscles. Interspinales Muscles. Posterior Intertrans- versales Muscles. Rotatores Longi and Rotatores Dorsi Muscles. Musculi dorsi — Muscles of the back. THE MUSCLES OF THE TRUNK 273 Mastoid process Processus mastoideus Trachelomastoid muscle M. longissimus capitis Multifidus spinse muscle M. multifidus Cervicahs ascendens muscle M, iliocostalib cerMcis Transversalis cervicis muscle M. longisiimus cerMcis Superior curved line Linea nuchas superior Inferior curved line Linea nucha; inferior Complexus, or semispinalis capitis, muscle (outer portion) Complexus, or semispinalis capitis, muscle (inner portion) - Spinalis cervicis muscle ~ ^ Semispinalis colli muscle M semispinalis cervicis Longissimus dorsi muscle (outer row of insertions Longissimus dorsi muscle row of insertions) Angle of the seventh nb Angulus costae \\\ Slips of insertion of the iliocostalis (sacrolumbalis) muscle M. iliocostalis lumborum Musculus accessorius ad iliocostalem M. ihocostalis dor^i Rotatores longi and rotatores — dorsi muscles Iliocostalis (sacrolumbalis) muscle M. sacrospinalis niocostalis (sacrolumbalis) muscle M. iliocostalis Lumbar fascia Fascia lumbodorsalis Longissimus dorsi muscle M. longissimus Multifidus spinas muscle M. multifidus Spinous process of the first dorsal vertebra Processus spinosus vertebrae thoracalis I. Transverse process of the sixth dorsal vertebra Processus transversus vertebrae thoracalis VI. Semispinalis dorsi muscle Levatoies costarum muscles Mm. levatores costarum breves ■-~^_Levatores costarum longiores muscles Mm. levatores costarum longi Spinalis dorsi muscle Spinous process of the twelfth dorsal vertebra Processus spinosus vertebrae thoracalis XII. Intertransversales laterales muscles Mm. intertransversarii posteriores laterales Intertransversales mediales or interaccessorii muscles Mm. intertransversarii posteriores mediales Spinous process of the fifth lumbar vertebra Processus spinosus vertebras lumbalis V. Posterior superior spine of the ilium Spina iliaca posterior superior Dorsal surface of the sacrum Facics dorsalis ossis sacri Fi' 514. — Diagram showing the Origins and Insertions of the Long and the Short Muscles of the Back. Musculi dorsi Muscles of the back. 35 274 THE MUSCLES OF THE TRUNK Infraclaviculai triangle, oi Mohrenheinier's space Trigonum deltoideopectorali Deltoid muscle M deltoideus Subclavius muscle Clavicular portion Pars clavicularis Pectoralis major muscle Abdominal portion Pars abdomiralib Serratus magnus muscle' M. serratus antei External oblique muscle of the abdomen M. obliquusexternus abdominis Umbilicus Poupart's ligament Lig- inguinale (Pouparti) External or superficial abdominal ring Annulus inguinalis subcutaneus Spermatic cord Funiculus spermaticu Saphenous opening Fossa ovalis Pectoralis minor muscle Anterior or external intercostal aponeu- roses—Ligg. intercos- Pectoralis major muscle Biceps flexor cubiti muscle M biceps brachii } External intercostal muscles j Mm intercostales externi Aponeurosis of the external oblique muscle of the abdomen (turned inwards) Vponeurosis m. obliqui externi abdominis Sheaih of the rectus abdominis muscle (anterior layer) Internal oblique muscle of the abdomen M. obliquu.s internus abdominis Aponeurosis of the external oblique muscle of the abdomen (turned outwards) Anoneurosis in. obliqui externi abdominis -Cremaster muscle Suspensory ligament of the penis Lig. suspensorium penis Fig. 515. — The Thoracic and Abdominal Muscles are shown, on the Right Side the MOST Superficial Layer, and on the Left Side the Layer immediately beneath this. Pectoralis Major and Pectoralis Minor Muscles ; Subclavius Muscle ; External and Internal Oblique Muscles of the Abdomen. Musculi thoracis et abdominis — Muscles of the thorax and abdomen. THE MUSCLES OF THE TRUNK T75 Tendon of the subclavius muscle -^ i- \ Pectoralis major muscle I origin " \\\ of the clavicular portion) Pectoralis major muscle (origin of the sternocostal portion) Body of the second rib. Corpus costas II. Pectoralis minor muscle (slips of origin) Serratus magnus muscle / M serratus anterior Pectoralis major muscle (Sternocostal portion) Ensiform process Processus xiphoideus Cartilage of the seventh rib Cartilage costalis VII Linea alba Sheath of the rectus abdomici: muscle (posterior layer) Transversalis abdominis mnscle M. transversus abdominis Internal oblique muscle of the abdomen (partially removed) M. obliquus internum ahiloniini: Crest of the ilium Crista iliaca External oblique muscle of the abdomen M. obliquus externus abdominis Semilunar fold of Douglas Linea semicircularis — (iJouplasi) Anterior superior spine of the ilium Spina iliaca anterior superior Deep circumflex iliac artery A. circumflexa ilium profunda Spermatic cord l-'uniculus spermaticus Cremaster muscle Pyramidalis muacle'- Spiae of the pubis , ^ Tuberculum pubicum ' • By Englwh ai.atomi»l» the inferior or r'uhic altachmcnt of the rcctU! tuperinr or crwtal altachmeni :n its inirr/wn. — Tu. See p^f^es 386 and 387. bundle of iTiuKu'ar fibres in the poolerior wall of the inguinn r superficial 10 tlial portion of the conjoined tendon known •lip is dc»cril,cil neither by Quain nor by Macalislcr. 1 1 i and 3 Ai work. —Til. Fig. 516 Deltoid muscle (origin) M. deltoideus Pectoralis minor muscle (insertion) . Pectoralis major muscle (insertion) Pectoralis major muscle (slips of origin of the sternocostal portion) External oblique muscle of the abdomen (slips of origin) M. obliquus externus abdominis Rectus abdominis muscle (slips of origin)' Internal intercostal muscle M. intercostalis internus Transversalis abdominis muscle (origin) M. transversus abdominis Internal oblique muscle of the abdomen (cut edge) M. obliquus internus a.bdominis Parietal layer of the peritoneum leritonaum [ arietale External oblique muscle of the abdomen (cut edge) — M. obli- quus externus abdominis * External umbilical ligamenf- Lig. umbilicale laterale Transversalis fascia Fascia transversalis Poupart's ligament Lig, inguinale (Pouparti) Internal or deep abdominal ring Annulus inguinalis abdominalis Deep or inferior epigastric artery A. epigastrica inferior M. interfoveolaris' Pubic symphysis Symph\sis ossium pubis Tendon of the rectus abdominis muscle i abdominis is regarded .-is the ,rj/j;m of that muscle, and the I canal, running parallel with, but internal to, the spermatic cord, as the tif^nmrnlutn inler/oveoiarc or ligameHt 0/ Hcsselbtuh. s figured on a larger scale on p. 385, Section III., of the present -OkKHNS AND iNSIiUTIONS Op THIC TnoHACIC AND AhDOMINAL MuSCLES. Musculi thoracis et abdominis Muscles of the thorax and abdomen. 35- 276 THE MUSCLES OF THE TRUNK Abdominal portion of the pectoralis major muscle SerratuB magnus muscle ^ Tendinous intersections i Inscriptiones tendineae 1^ Internal oblique muscle of the abdomen M. obliquus internus abdominis Transversalis abdominis muscle Rectus abdominis muscle Internal oblique muscle of the abdomen M. obliquus internus abdominis Pyramidalis muscle M. pyramidalis Spermatic cord Funiculus spermaticus Suspensory ligament of the penis Lig. suspensorium penis Cremaster muscle M. cremaster Rectus abdominis muscle \Intemal intercostal muscles /Mm. intercostales interni "1 External intercostal muscles /Mm. intercostales extern! Linea alba Sheath of the rectus abdominis muscle (posterior layer) i\ ,\m^ gH- Tranversalis abdominis muscle Lmea semilunaris (Spigelii) Semilunar fold of Douglas, or plica semilunaris Linea semicircularis (Douglasi) Liaeaalba Internal oblique muscle of the abdomen (i) External oblique muscle of the abdomen (2) Internal or deep abdominal ring (3) Poupart's ligament (4) Transversalis fascia Saphenous opening Fossa ovalis (i) M. obliquus internus abdominis (2) M. obliquus externus abdominis (3) Annulus inguinalis abdominalis ^/a (4) Lig. inguinale (Pouparti) Fig. 517. — The Arrangeisient in Layers of the Abdominal Muscles as displayed by Partial Removal of the Superficial Layers. The Rectus Abdominis Muscle of the Left Side having been cut away, the Posterior Layer of the Sheath of that Muscle is exposed. Rectus Abdominis Muscle; Transversalis Abdominis Muscle; Pyramidalis Muscle. Musculi abdominis— Muscles of the abdomen. THE MUSCLES OE THE TRUNK 277 Styloid process Sternocleidomastoid muscle M. sternocleidomibtoideus Stylohyoid ligament Liy. style h\iiidcum Stylopharyngeus muscle Splenius capitis muscle M. splenius capitis Levator anguli scapulae muscle M. levator scapula Omohyoid muscle — M. omohvoidens Subscapularis muscle Styloglossus muscle Mylohyoid muscle Hyoglossus muscle Rectus capitis anticus major muscle M longiis capitis Thyropharyngeal portionof the inferior con- ■ stricter of the pharjraX-M. ihyreopharyngeus Thyrohyoid mUSCle-M- ihyreohyoldeus Thyroid cartilage Cartilage tbyreoidea - Scalenus medius muscle -ThjTToid body — Glandula tbyreoidea Sternothyroid muscle ' ' strrnothyrt-oideus Scalenus posticus muscle Scalenus anticus muscle Scalene space' Sternohyoid muscl; M sternohyoideus _ I External intercostal muscles I Mm. intercostales externi Internal intercostal muscles Mm. intercostales interni Rectus abdominis muscle Latissimus dorsi muscle Serratus magnus muscle Slips of origin of the latissimus dorsi muscle firom the tenth and eleventh ribs External oblique muscle of the abdomen M. obliquus externus abdominis Fig. 518. — Serratus Magnus Muscle. Latissimus Dorsi and Subscapularis Muscle. The Three Scalene Muscles and the *Scalene Space.i Levator Anguli Scapula Muscle. wnW by the scalenus nnticus ' Thi.* w a triangular xpace, the ba»c of which is formed by the upper surface of the first rib, the muKle, and the poKlerior wall by the Hcalenus medius muscle. It is occupied by the brachial plexus and the second part of the artery. ~T*t. Musculi thoracis— Muscles of the thorax. 278 THE MUSCLES OF THE TRUNK Superior curved line ^ Linea nucha: superior Splenius capitis muscle (insertion) ~- / Obliquus capitis superior muscle - Trapezius muscle (insertion)' Obliquus capitis inferior muscle Levator anguli scapulae muscle (slips of origin) "Vy, M. levator scapulae "■" Complexus muscle (inner portion) M. semispinalis capitis Complexus muscle (outer portion) M. semispinalis capitis Occipitalis muscle Sternocleidomastoid muscle (insertion) M. sternocieidomastoideus Mastoid process ■ rrocessus mastoideus Trachelomastoid muscle 1 (insertion) r AI. longissimus capitis Stylohyoid muscle M. stylohyoideus -~'P Longus colli muscle Scalenus medius muscle Scalenus posticus muscle (insertion) M. scalenus posterior Serratus posticus superior muscle I slips of insertion) M. serratus posterior superior \\ Shaft of the fifth lil Corpus costae V Scalenus anticus muscle (slips of origin) M. scalenus anterior Scalenus anticus muscle (insertion) M. scalenus anterior Subclavius muscle (insertion)'' Serratus magnus muscle (the ^^ two uppermost slips' of origin) M. serratus anterior Pectoralis major muscle (upper part of the origin of the sternocostal portion) Serratus magnus muscle (slips of origin) M. serratus anteiior External intercostal muscles , Mm. intercostales externi ^ ■ Internal intercostal muscles Mm. intercostales interni Serratus magnus muscle (slips of origin) M. serratus anterior Serratus posticus inferior muscle (slips of insertion) M. serratus posterior inferior Latissimus dorsi muscle (slips of origin) Pectoralis minor muscle (slips of origin) Pectoralis major muscle (lo'wer part of . he origin of the sternocostal portion) Serratus magnus muscle (slips of origin) M. serratus anterior Rectus abdominis muscle (slips of origin)-' External oblique muscle of the abdomen (upper slips of origin M. obliquus externus abdominis Internal intercostal muscles Mm. intercostales interni ' Ot^Vk according to English anatomists. - li-nglish anatomists regard this as the oH External oblique muscle of the abdomen ( lower slips of origin) M obliquus externus abdominis ^\us muscle. — Tr. Fig. 519.— Origins and Insertions of the Muscles on the Anterior and Lateral Walls OF THE Thorax. Seen from the Right Side. Musculi thoracis et abdcminis-Muscles of the thorax and abdomen. THE MUSCLES OE THE TRUNK 279 Rectus capitis lateralis muscle Obliquus capitis superior muscle Rectus capitis posticus majoi muscle M rectus capitis posterior nnj n Obliquus capitis inferior muscle Rectus capitis posticus minor muscle M. rectus capitis posterior minor Spinous process of the axis Processus spinosus epistrophei Ligamentum nucha; Transverse process of the sixth cemcal vertebra I'rocessus transversus vertebrae cervicilis \ I Scalenus posticus muscle M. scalenus postc 1 1 i 'Scalene space' Aponeurotic arch for the origin of the uppermost digitation of the serratus magnus muscle Fifth rib Costa V. External intercostal muscles I Mm. intercostales extern! i interspinous ligament Lig. interspinale Spinous process of the twelfth dorsal vertebra Processus spinosus vertebrx- thoracalis XII. Interspinales muscles | Supraspinous ligament I-iK supraspinale Internal oblique muscle of the abdomen M. obliquus internus abdominis Mastoid process l'r"cessns mastoideus Digastric muscle (posterior belly) M digastiKiis (\ enter posterior) Mylohyoid muscle X M nnlohyoideus Wj Digastric muscle (anterior belly) '^T M di„istricus (venter anterior) Accessory slip connecting the anterior bellies of the digastric muscles (var ) ^ Slips of origin of the scalenus anticus muscle Scalenus medius muscle Scalenus pleuralis (var.) M sLilenus minimus (var.) Cervical pleura Cupula pk ura; Scalenus anticus muscle (insertion) M scalenus anterior Pectoralis minor (slips of origin) I Internal intercostal muscles ) Aim. intercostales interni External oblique muscle of the abdomen M, obliquus e.xternus abdominis Aponeurosis of the external oblique muscle of the abdomen Aponeurosis m. obliqui extern! abdominis Crest of the ilium Crista iliaca Gluteal portion of the fascia lata Fascia glutxa ' See note to p. 277 Fig. 520.— Musculi Intkrcostales Extekni, the External Intercostal Muscles; Musculus Oruqvvs Externus Abpominis, the External Oblique Muscle of the Abdomen; the Scalene Muscles, with the Anomalous Scaij.nus Minimus or Scalenus Pleuralis. Musculi thoracis et abdominis Muscles of the thorax and abdomen. 280 THE MUSCLES OF THE TRUNK ) Internal intercostal muscles /Mm. intercostales interni '^ External intercostal muscles J Mm. intercostales externi Anterior superior costotransverse ligaments Ligg. costotransversaria anteriora Subcostal muscles Mm. subcostales ^ Posterior or internal intercostal I aponeuroses j Ligg. intercostalia interna Fig. 521. — The Muscles on the Inner Surface of the Lateral Wall of the Thorax, shown on the right side of the body, the diaphragm having been removed : Musculi Intercostales Intern Internal Intercostal Muscles; Musculi Sub- costales, Subcostal Muscles. Musculi thoracis — Muscles of the thorax. THE MUSCLES OF THE TRUNK 281 Interclavicular ligament Lig intercla\ic»l in Sternothyroid muscle /~J^\ M. sternothyreoideiii . -' - - Sternohyoid muscle M sternohyoideus The clavicle C lavicula First rib Costa I. tntemal intercostal muscles Mm. intercostales interni Triangularis stemi muscle M. transversus thoracis Transversalis abdominis muscle Sternal portion of the diaphragm /4 Pars sternalis diaphragmat Sheath of the rectus abdominis muscle posterior layer) Transversalis abdominis muscle Costal portion of the diaphragm Pars costalis diaphragmatis Sheath of the rectus abdominis muscle (anterior layer) — Vagina m. recti abdominis (lamina anterior) Internal oblique muscle of the abdomen M. obliquus internus abdominis External oblique muscle of the abdomen M. obliquus externus abdominis Fig. 522. — The Muscles on the Inner Surface of the Anterior Wall of the Thorax. The slips of origin of the diaphragm from the costal cartilages and the ensiform process have been retained, in order to show their relation to the slips of origin of the transversalis abdominis muscle. The anterior wall of the abdomen has been divided horizontally at the level of the anterior extremities of the tenth pair of ribs to show the relation of the anterior aponeuroses of the external oblique, internal obli((ue, and transversalis muscles of the abdomen to the sheath of the rectus muscle, and to display the two layers of this sheath. The transversus thoracis or triangularis stemi muscle and the origins of the sternohyoid and sternothyroid muscles are also shown. Musculi thoracis et abdominis — Muscles of the thorax and abdomen. 36 282 THE MUSCLES OE THE TRUNK Subcutaneous bursa of the laryngeal prominence Bursa subcutanea prominentia; laryngea: Deep cervical fascia (superficial layer) Fascia colli (lamina superficialis' Platysma myoides Subcutaneous bursa of the chin , Bursa subcutanea prsementalis Infraclavicular triangle, or Mohrenheimer's space Trigonum deltoideopectorale Deltoideopeotoral groove Sulcus deltoideopectoralis Costocoracoid membrane Fascia coracoclavicularis Cephalic vein Vena cephalica Deltoid muscle M. deltoideus Superficial layer of the pectoral fascia Stemalis muscle (var. ) Pectoralis major muscle Deep layer of ^ the pectoral „ ■" 1 iciscia Axillary fascia Fascia axillaris Pectoralis major muscle Superficial layer of the pectoral fascia F:g. 523 — /.'he Fascia of the Anterior Wall of the Thorax, Fascia Pectoralis, the Pectoral Fascia, and its Connexions with the Fascle of the Adjoining Regions of THE Body. The Anomalous Sternalis Muscle. On the right side of the body, the skin and the superficial fascia having been removed, the superficial layer of the pectoral fascia is displayed, and its continuity with the aponeurosis of the arm is shown ; on the left side, the greater part of the pectoralis major muscle has been removed, in order to display the deep l;iycr of the pectoral fascia, with its specialized band the costocoracoid membrane, and to show the continuity of this deep layer with the axillary fascia. Musculi thoracis — Muscles of the thorax. THE MUSCLES OE THE TRUNK 283 Aponeurosis of the arm or brachial fascia Fascia bracliii The axilla, or armpit Posterior fold (or wall) of the axilla (Border of the latissimus dorsi muscle 1 I'lica axillaris posterior Fascia of the latissimus dorsi muscle Pectoral fascia Fascia pectoralis Anterior fold (or wall) of the axilla Border of the pectoralis major muscle) Plica axillaris anterior Foramina for the emergence of the cutaneous vessels and nerves Axillary arch Superficial layer of the pectoral fascia Fascia pectoralis (lamina superficialis) I'lG. 524. — The Axilla with the Anterior and Posterior Axillary Folds, Plica Axillaris Anterior et Plica Axillaris Posterior. Fascia Axillaris, the Axillary Fascia, with the "Axillary Arch of Langer. The axillary fascia forms the base or inferior boundary of the axillary fossa, riie cutaneous vessels and nerves have been removed. Mi'sculi thoracis Muscles of the thorax. 36- 284 THE MUSCLES OF THE TRUNK Spinous process Processus spinosus Transverse process Processus transversus I Deep dorsal muscular layer of the trunk . Superficial dorsal muscular layer of the trunk Posterior primary division of spinal nerve Ramus posterior nervi spinalis Anterior primary division of spinal nerve Ramus anterior nervi spinalis Ventral (subcostal) ,.. muscular layer of the trunk Kib .. Costa ..Ventral (intercostal) - muscular layer of the trunk Muscular layer belonging to the extremities (or appendicular layer) Skin Integumentum commune \ Ventral (subcostal) muscular layer of the trunk Fig. 525. — Diagrammatic Representation of the Muscles of the Trunk and of the Distribution of the Segmental Nerves by which they are supplied, shown in a Thoracic Segment. NOTE. A brief explanation of this diagram seems needful, in the interest of students who have not made a special study of comparative anatomy. The muscles are grouped, first of all, into dorsal and ventral, the former being supplied by the posterior and the latter by the anterior primary divisions, respectively, of the spinal nerves. The dorsal muscles form the great mass lying chiefly in the hollow between the spinous processes and the angles of the ribs. They are classed in two groups— superficial and deep. These need not be further considered. The ventral muscles are shown to be arranged in three layers. In the abdominal region these are represented by three actual muscles, to name them from within outwards : the transversalis, the internal oblique, and the external oblique. Continuous with the deepest of these, the transversalis, for the purposes of this classification, are the triangularis sterni, the subcostals, the sternal and costal portions of the diaphragm and part of the levator ani — these form the s^tbcastal layer. Continuous with the internal oblique are the iuter- costals, the posterior serrati, the scalene muscles, and the quadratus lumborum— these form the intercostal layer. Continuous with the external oblique are all tire muscles connecting the scapula with the trunk, viz.: the trapezius, levator anguli scapulse, serratus magnus, and rhomboidei muscles, also the latissimus dorsi, the pectorals, the sternocleidomastoid, and the superficial perineal muscles — these constitute what may be called the afifiendicular layer. There is finally a more .superficial layer still (not shown in the figure), superficial indeed to the deep fascia, corresponding to the panniculosus carnosus of lower mammals, but represented in man only by the platysma myoides, the occipitofrontalis, and the muscles of the ear and face. — Tk. Musculi trunci — Muscles of the trunk. THE MUSCLES OF THE TRUNK 285 Posterior layer of the lumbar fascia' Kascia lumbodorsalis Middle layer of the lumbar fascia' Lig. lumbocostale ; Ouadratus lumborum muscle Fatty tissue Transversalis fascia Latissimus dorsi muscle Iliocostalis or sacrolumbalis muscle Costal process of the fourth lumbar vertebra Processus tostarius vertebra- himbalis IV. Longissimus Multifidus spinse muscle dorsi muscle ,, bpinous process of the third — niZCTT J lumbar vertebra — ■ — ^^~o'L'T I'rocessus spinosus \ertebre lumbahs III. Erector spinae muscle Upper surface of the body of the fourth lumbar vertebra Transversalis abdominis muscle M. transversus abil^munis Internal oblique muscle of the abdomen ; M- obliquus internus abdominis External oblique muscle of the abdomen M. obliquus externus abdominis Superficial fascia Skin Integumentum commune Rectus abdominis muscle Posterior layer Lamina anterior ' Linea alba Umbilicus Sheath of the rectus abdominis muscle Vagina m. recti abdominis In the n with this figure, an account of the differ abdomen and_ the nomenclature commonly employed by English to most English authors, is regarded as consisting of three layers. The sufierficial tutttbodorsnlis, is the layer passing behind the composit^mass of the erector spina: (see note to p. 267). The micidU layer, called by Toldl (see Fig. 526 on this page passes in front of the erector spins, between that mu»clc and the qiiadratus lumbo' transverse^ prr>cesses of the lumbar vertebra:. At the outer edge of the the posterior aponeurosis of the author's nomenclature of the fasciae or the back and U suitably be given. The luttibar fascia, according ^posterior layer' ZiAWA by Toldt(see Fig. 526) /ama luscle to be attached to the tips of the spinous processes nd also Fig. 512 on p. 271) li^aincntuin lumbocostale, m, to be attached to the tips of the costal (o cle the posterior and middle layer: 1-called > form i abdominis mu.scle.~ T\\e anterior layer 0/ the liiinl>ar/ascia{cMeA by Toldt/gomaticus Buccal fat-pad^ c orpus adiposum buccas Eisorius muscle Depressor anguli oris or - triangularis menti muscle M. triangularis bometimes, but inappropriately, named the sucking-pad. — Tr Fig. 532. — The Platyswa Myoides of the Right Side. Musculi colli— Muscles of the neck. THE MUSCLES OF THE HEAD AND NECK 291 Parotideomasseteric fascia' i-ascia parotideomasseterica Sternocleidomastoid muscle M. sternocleidomastoideub Deep layer of the deep cervical fascia Lamina profunda fasciae colli Sternocleidomastoid muscle M. sternocleidomastoideus Trapezius muscle Deep layer of the deep cervical fascia Lamina profunda fascia colli Superficial layer of the pectoral fascia ~ Platysma myoides Platysma Platysma myoides Platysma Deep layer of the deep cervical fascia Lamina profunda fasciae colli Superficial layer of the deep cervical fascia Anterior region of the neck Regio colli anterior Jeep layer of the deep cervical fascia Lamina profunda fasciae colli ' In England, the portion of the deep cervical fascia covering the parotid gland is usually distineuished as the parotid fascia ; that covering the masseter muscle, as the masseteric fascia. — Tr. Fig. 533.— Fascia Colli, the Deep Cervical Fascia, displayed on the Right Side of the Neck by the Removal of the Platysma Myoides. In those places in which the deep layer of the fascia is clearly differentiated from the superficial layer, the latter has been partially removed. The submaxillary gland has been taken away, and the middle portion of the sternocleidomastoid muscle has been cut out, to lay bare in each case the deep layer of the fascia ; between the cut ends of the sternocleidomastoid, and between the lower portion of this muscle and the trapezius, the anterior and posterior bellies respectively of the omohyoid muscle are visible beneath the deep layer of the fascia. Musculi colli — Muscles of the neck. 37- 292 THE MUSCLES OF THE HEAD AND NECK Stylohyoid ligament . Lig. stylohyoideum Stylohyoid muscle M. stylohyoideus Digastric muscle (posterior belly) M. digastricus (venter posterior) Prevertebral fascia Fascia prae\ ertebrahs Sternocleidomastoid muscle M. sternocleidomabtoideus Deep layer of the deep cervical fascia Fascia colli (lamina profundri) Trapezius muscle Mylohyoid muscle 'SI. mylohyoideus Styloglossus muscle ^' Digastric muscle (anterior belly) — !\I. digastricus (venter anterior) Hyoid bone— Os hyoideum Thyiohyoid mUSOle-M. thyreoliyoideus Thyropharyngeal portion of the inferior con- strictor of the pharynx— M. thvreopharyngeus Omohyoid muscle (anterior beUy) JI oniohyoidriis (venter superior) Thyroid body Glandula thyreoidea Sternothyroid muscle iSI sternothyreoideus Sternohyoid muscle M sternohyoideus Fig. 534. — The Muscles of the Front of the Neck, shown on the Right Side of the Body. M. Sternocleidomastoideus, Sternocleidomastoid Muscle ; M. Digastricus, Digastric Muscle ; the Relations of the Latter to the Stylohyoid and Mylohyoid Muscles. Portions of the Muscles arising from the Styloid Process, of the Lower Muscles of the Tongue, and of the Trapezius Muscle, are displayed. In the preparati 'n of the muscles both the superficial and the deep layers of the deep cervical fascia have been removed, except in the posterior triangle of the neck, where the deep layer has been leh. iatact. Musculi colli— Muscles of the neck. THE MUSCLES OF THE HEAD AND NECK 293 Scalenus medius muscle — Scalenus anticus muscle M, scalenus anterior Trapezius muscle Deep layer of the deep cervical fascia Lamina profunda fasciae colli Deltoid muscle -£ Infraclavicular tnangle, or Mohrenheimer'a space Trigonum deltoideopectorale Sternocleidomastoid muscle — Stylopharyngeus muscle Stylohyoid ligament Lig. stylohyoideum Splenius capitis muscle Middle constrictor of the pharynx M. constrictor pharyngis medius Rectus capitis anticus major muscle M. longus capitis Levator anguli scapulae muscle M, levator scapulae Masseter muscle Depressor anguli oris or triangularis menti muscle M triangularis "Styloglossus muscle -Mylohyoid muscle Hyoglossus muscle Thyrohyoid muscle M. thyreohyoideus Omohyoid muscle (anterior bellyXi) Thyropharyngeal portion of the in- ferior constrictor of the pharynx M thvreopharyngeus Sternohyoid muscle— M. sitrnuhyuidtu> Sternothyroid muscle ternotliyreoideus Longus colli muscle (i) M. omohyoideus (v Sternothyroid muscle M steiroth\reoideus Sternocleidomastoid muscle superit/r) fiG. 535._The Muscles of the Neck, displayed on the Right Side, the Sternocleido- mastoid, Digastric, and Stylohyoid Muscles having been removed. The Infrahyoid Group of Muscles, Sternohyoid, Sternothyroid, Thyrohyoid, and Omohyoid. The ^ Mylohyoid Muscle, the Anterior and Middle Scalene Muscles, and the Levator Anguli Scapula ; Portions of the Muscles of the Face, and of the Deep Lateral AND Prevertebral Muscles of the Neck. Musculi colli — Muscles of the neck. 294 THE MUSCLES OF THE HEAD AND NECK Internal oblique line, or mylohyoid ridge Linea ravlohyoidea Mylohyoid muscle M. mylohyoideus Geniohyoid muscle M. geniohyoideus Small cornu ~\ Cornu minus , ^. . . , , I of the hyoid bone _, . I ossis hyoidei .Great cornu I -' Cornu majusj Fig. 536. — M. Mylohyoideus, the Mylohyoid Muscle, the Muscles of the Right and Left Side together forming a Floor below the Anterior Part of the Mouth, the DiAPHRAGMA ORIS, AND THE GENIOHYOID MuSCLE, SEEN FROM AbOVE AND BeHIND Small cornu of the hyoid bone, Cornu minus ossis hyoidei ' Stylohyoid ligament_- Lig. stylohyoideum Great cornu of the hyoid bone Cornu majus ossis hyoidei Thyrohyoid membrane, or middle thyrohyoid ligament Membrana hyothyreoidea Bursa of the thyrohyoid muscle' ,*--'" Bursa musculi thyreohyoidei Thyrohyoid muscle (lower portion)-- M. thyreohyoideus Inferior constrictor of the pharynx M. constrictor pharyngis inferior /Thyrohyoid muscle (divided and turned upwards) ' M thYreohyoideus Body of the hyoid bone Corpus ossis hyoidei Sternohyoid muscles (turned upwards) Mm. sternohyoidei Bursa of the sternohyoid muscle- Bursa musculi sternohyoidei Thyroid cartilage Cartilago thyreoidea Cricothyroid membrane, or middle cricothyroid ligament Lig cricothyreoideum (medium) Cricothyroid muscle M. cricothyreoideus Trachea Trachea "■'■ /I m„JlJo*L%t"Jft°/"'"^"''Tl'TJ^'\"'-''/"'"?'^°'''^°"'''=(',''^'^''" '" "== ?<■==="' instance), is situate beneath the thyrohyoid muscle on the antener sunace of the thyrohyoid membrane, external to the bursa of the sternohyoid muscle.— Tr. membrane clme to the mli^ V '"% '^ situate beneath the upper extremity of the sternohyoid muscle and in front of the thyrohyoid Fig. 537._The Burs.e below the Hyoid Bone. The Sternohyoid and Thyrohyoid Muscles HAVE BEEN DIVIDED TRANSVERSELY, AND THE PORTIONS OF THESE MuSCLES LEFT ATTACHED TO THE Hyoid Bone have been turned upwards. Seen obliquely from the Right Side AND Before, Musculi colli-Muscles of the neck. IHE MUSCLES OF THE HEAD AND NECK 295 Sphenoidal sinus Sinus sphenoidalis Eustachian cartilage Cartilage tubae auditivse Carotid canal Canalis caroticus Levator paiati muscle (origin) M levator veli palatini Circtunflexua or tensor paiati muscle (origim M tensor veli prd.itjni Pterygoid process Processus pterygoidcu Hamular process Hamulus pterygoideu Interartloular disc, or meniscus Capsular ligament (i) Head of the condyle Capitulum maridibula: — External pterygoid muscle M. pterygoideus externus Internal pterygoid muscle M pterygoideus internus Genioglossus or geniohyoglossus muscle Geniohyoid muscle M geniohyoideus Mylohyoid muscles Median raphe of the mylohyoid muscles Raphe m, mylohyoidei (i) Capsula articularis Body of the hyoid bone Corpus ossis hyoidei Fig. 538.— M. Mylohyoideus, the Mylohyoid Muscle, the Right and Left Muscles FORMING the DiAPHRAGMA OrIS, SEEN FROM AbOVE AND BEHIND. ThE PTERYGOID MuscLF.s, External and Internal, are displayed, both Intact on the Right Side, WHILE on the Left Side the Internal Pterygoid Muscle has been removed in order to lay bare in its Whole Extent the Posterior Surface of the External Pterygoid Muscle. The levator paiati and the circumflexus or tensor paiati muscles have been cut away close to their respective origins. Muscull colli et capitis -Muscles of the head and neck. 296 THE MUSCLES OF THE HEAD AND NECK Styloglossus muscle Hyoglossus muscle / Lmgualis inferior or inferior lingual muscle longitudinalis inferior Genioglossus or '■^'' 1 geniohyoglossus muscle Geniohyoid muscle M geniohyoideus Cricothyroid muscle M. cricothyreoideus Fig ■i^Q— The Muscles of the Tongue, with the Geniohyoid Muscle, seen from the Right Side: the Hyoglossus, the Styloglossus, and the Genioglossus or Geniohyoglossus Muscles. Also the Thyro- hyoid AND Cricothyroid Muscles. Body of the mandible Corpus mandibulae Edge of the tongue """ Margo lateralis lingua; ~ Genioglossus or geniohyoglossus muscle M. genioglossus Iiingualis inferior or inferior lingual muscle M. longitudinalis inferior Hyoglossus muscle (cut away) M. hyoglossus Styloglossus muscle Middle constrictor of the pharynx M. constrictor pharyngis medius / Ceratopharyngeus muscle M. ceratopharyngeus Chondrophaiyngeus muscle ' I IVI. chondropharyngeus Great comu — Cornu majus Transversalis linguae muscle or transverse muscle of the tongue M. transversus linguae --.Chondroglossus muscle Membranous connexion of the geniohyoglossus muscle with the body of the hyoid bone -- Body of the hyoid bone Corpus ossis hyoidei Stylohyoid ligament ' Lig. stylohyoideum j Small comu Cornu minus Fig. 540.— The Muscles of the Tongue seen from the Right Side and Below, displayed by the Removal OF THE Hyoglossus Muscle : M. Longitudinalis Inferior, the Inferior Lingual Muscle ; M. Transversus (vel Transversalis) Lingua, thk Transverse Muscle of the Tongue, and its Relation to the Genio- hyoglossus Muscle; the Chondroglossus Muscle. Musculi colli et capitis— Muscles of the head and neck. THE MUSCLES OF THE HEAD AND NECK Levator anguli oris muscle, or musculus caninus Parotid duct or duct of Stenson Ductus parotideus Zygomaticus major muscle (cut away) M. zygomaticus Buccinator muscle . M, buccinator Depressor anguli oris or triangularis menti muscle (cut away) M. triangularis iicumflexus or tensor palati muscle M tensor \ ell palatini Levator palati muscle M le\ator veil palatini Stylopharyngeus muscle Digastric muscle (posterior belly) (\t liter p( sterior) Hamular process Hamulus pterygoideus Superior constrictor of the pharynx istrittoi ] iiai)nt,ib superior PterygomaxiUary or ptery; omandibular ligament— Raplie pteijgomandibulari Styloglossus muscle Stylohyoid muscle M btylohyoideus , Middle constrictor of the pharyn M. constrictor pharyngis mediiis Digastric muscle (anterior belly) M. digastricus (venter anterior) Mylohyoid muscle M. mylohyoideus Fig. 541.— The Muscles arising from the Styloid Process with the Digastric Muscle; the Circumflexus OR Tensor Palati, the Levator Palati, and the Buccinator Muscle; seen from the Left Side. The ramus of the jaw has been removed. Spinous process of the sphenoid bone Spina annularis Pterygoid process Processus pterygoideus Sphenomaxillary fossa Fossa pterygopalatina Circur-.flerus or tensor palati muscle (origin|--M. tensor veli palatini Tuberosity of the superior maziUary bone .., Tuber maxillare Out edge of the external pterygoid plate Bursa of the hamular process liursa m tensoris veli palatini Circumflexus or tensor palati (insertion) M tensor veli palatini Vestibule of the labyrinth -'' Vestibulum labyrinthi Tympanic orifice of the Eustachian tube ""Ostium tympanicum tuba;- auditiva; — Foramen ovale Petrous portion of ths temporal bone Pars petrosa ossis temporalis Levator palati (origin) M. levator veli palatini Fascia salpingopharyngea, ormembranous portion of the Eustachian tube — Lamina membranacea tub^^auditi\a3 Eustachian cartilage -Cartilage tuba; auditivae Pharyngeal orifice of the Eustachian tube Ostium pharyngeum tubas auditivai Levator palati muscle (insertion) M. levator veli palatini - Soft palate Velum palatinum /, , Hamular process Hamulus pterygoideus Fig. 542.— Origin and Insertion of the Circumflexus or Tensor Palati Muscle and of the Levator Palati Mu.scle, wijh the Synovial IUjrsa of the Hamular Process, seen from the Left Side. Musculi colli et capitis — Muscles of the head and neck. 38 298 THE MUSCLES OF THE HEAD AND NECK Basilar portion of Petrous portion of the occipital bone the temporal bone Pars basilaris Pars petrosa Styloid process 1 Processus styloideus ^ Mastoid process Processus mastoideus Rectus capitis anticus major muscle M. longus capitis Cervical pleura Cupula pleura Rectus capitis lateralis muscle Digastric muscle (posterior belly) M. digastricus (venter posterior) Anterior tubercle of the atlas Tuberculum anterius atlantis Rectus capitis anticus major muscle M longus capitis Levator anguli scapulae muscle M. levator scapulae Longus colli muscle Scalenus medius muscle Scalenus anticus muscle \I. scalenus anterior Scalenus posticus muscle M. scalenus posterior Scalene space^ Eminence for the attach- ment of the serratus magnus muscle Tuberositas costae II. Fig. 543. — The Deep Lateral and Prevertebral Muscles of the Neck, displayed by THE Removal of the Facial Portion of the Skull and the Cervical Viscera. Seen FROM Before. Scalenus Anticus, Medius, and Posticus Muscles ; Longus Colli Muscle ; Rectus Capitis Anticus Major Muscle. The Relation of the Scalene Muscles and the Longus Colli Muscle to the Cervical Pleura. The Scalene Space.^ ^ See note to p . 277. Musculi colli— Muscles of the neck. THE MUSCLES OF THE HEAD AND NECK 299 Basilar portion of Petrous portion of the occipital bone the temporal bone Pars basilaris ossis c Hectos capitis anticus minor muscle M. rectus capitis anterior Rectus capitis lateralis muscle Posterior intertransversales muscles Mm. intertransversarii posteriores 1 Anterior intertransversales muscles Mm. intertransversarii anteriores Insertion of the scalenus medius muscle Groove for the subclavian artery Sulcus subclavicx- Insertion of the scalenus anticus muscle Insertion' of the .- subclavius muscle First costal cartilage Cartilago costalis 1. \ Anterior intertransversales muscles l\lm intertransversarii anteriores Longus colli muscle Scalenus medius muscle Scalenus posticus muscle Vt scalenus posterior ' English anatomists regard this as the nn'gin of the subclavius muscle. — Tk. Fig. 544. — The Deep Latekal and Pkevektebkal Muscles of the Neck, the Rectus Capitis Anticus Major and Scalenus Anticus Muscles having been removed. On the Right Side the Longus Colli and the Scalenus Medius and Posticus Muscles HAVE also been REMOVED. SeEN FROM BEFORE. INTERTRANSVERSALES MuSCLES ; Rectus Capitis Anticus Minor and Rectus Capitis Lateralis Muscles. Musculi colli — Muscles of the neck. 38- 300 THE MUSCLES OF THE HEAD AND NECK Pericranium Orbicularis palpebrarum muscle (orbital portion) M. orbicularis oculi (pars orbital Corrugator superoilii muscle . Orbicularis palpebrarum (palpebral portion) M. orbicularis oculi (pars palpebralis) Internal tarsal or palpebral ligament Lig. palpeljrale mediale Pyramidalis nasi muscle' . M. procerus /■Levator labii superioris alseque nasi Caput angulare Levator labii superioris - propius Caput infra-orbitale M.quadratus labii superioris- Zygomaticus minor Caput zygomaticum Depressor labii infenoris or . quadratus menti muscle M. quadratus labii inferioris Epicranial or occipitofrontal aponeurosis Frontalis muscle Skin Integumentum commune Auricuiaris superior or - attoUens auriculam muscle Auricuiaris anterior or attrahens auriculam muscle Parotideomasseteric fascia' Levator anguli oris muscle, or musculus caninus Zygomaticus major muscle M zygomaticus Eisorius muscle Depressor anguli oris or triangularis menti muscle "\I triangularis Platysma myoides Platysma Transversus menti (var.)'' 1 The pyramidalis «fls/ muscle {Musculus pvocenis) is regarded by the author as a portion of the occipitofrontalis muscle. — Tr. - In England the levator labii superioris altrqiie nasi, the levator labii superioris prot'rius, and the :ygo?iiaiicus minor, are regarded as three separate muscles, not, as in the nomenclature of the German Anatomical Society, as the three heads, the angular head, the infra-orbital head, and the zygomatic head, respectively, of a single muscle, the quadratus labii superioris. — Tr. '■' See note to p. 291. Fig. 545. — The Superficial Layer of the Muscles of Facial Expression and their Relation to the Platysma Myoides. Depressor Anguli Oris or Triangularis Menti Muscle ; Risorius Muscle ; Zygomaticus Major Muscle ; Levator Labii Superioris Al^que Nasi, Levator Labii Superioris Proprius, and Zygomaticus Minor Muscles (see note ^ above) ; Orbicularis Palpebrarum Muscle. The Anterior Portions of the Occipitofrontalis Muscle — the Frontalis and the Pyramidalis Nasi Muscles {see note 1 above). Auricularis Superior or Attollens Auriculam and Auricularis Anterior OR Attrahens Auriculam Muscles. The Epicranial Aponeurosis ; the Pericranium ; the Parotideomasseteric Fascia {see note ^ above). Seen obliquely from the Left Side and Before. Musculi faciei— Muscles of the face.* '' See note ' on page 303. THE MUSCLES OF THE HEAD AND NECK Corrugator supercilii musclei 301 Orbital portion of the orbicularis palpebrarum muscle Palpebral portion of the orbicularis palpebrarum muscle Levator anguli oris muscle, or musculus caninus M. caninus Pyramidalis nasi muscle M. procerus Internal tarsal or palpebral ligament Lig. palpehrale mediale Fasciculus of the orbicularis palpebrarum muscle inserted into the skin beneath the inner commissure of the eyelids Nasalis muscle' M. nasalis Levator labii superioris alaeque nasi muscle' Caput angulare m. quadrati labii superioris 1 This consists of the compressor natis muscle and of the outer fart of the depressor ala nasi muscle of English anatomists. — Tr. 2 See note - to p. 300. Fig. 546.— The Attachment of the Orbicularis Palpebrarum Muscle in the Neighbourhood OF the Inner Canthus, and its Relation to the Corrugator Supercilii Muscle, seen FROM Before. Right Side. Corrugator supercilii muscle Palpebral portion of the orbicularis palpebrarum muscle Frontal sinus Sinus frontalis Orbital arch, or supra- orbital margin Margo orbitalis superior Puncta lachrymalia Tensor tairsi muscle ' Parslacrimalis(M. Horneri) — - Lachrymal sac Saccus lacrimalis Lachrymal groove Fossa sacci lacrimalis Maxillary sinus, or -antrum of Highmore Sinus maxillaris Orbital portion of the orbicularis palpebrarum muscle Fig. 547. — The Three Portions^ of the Orbicularis Palpebrarum Muscle, and the Relation OF this Muscle to the Corrugator Supercilii Muscle, seen from Behind. Left Side. The soft parts in the neighbourhood of the eyelids, with the exception of the origin of the orbicularis palpebrarum muscle, have been detached from the bone ; and by the removal of the conjunctiva, the tarsal cartilages and the palpebral fascia (septum orljitale). t'le orbicularis muscle has been laid bare from behind. " Called also/crs lachrymalis musculi orbicularis palpebrarum , Horner's muscle, or musculus sacci lachrymalis. — Tr. ■* These three portions being the orbital, palpebral and lachrymal portions; the last-mentioned, however, is by English anatomists usually described as a distinct muscle, the tensor tarsi (see also note ■•). — Tr. M. orbicularis oculi Orbicularis palpebrarum and tensor tarsi muscles. ^02 THE MUSCLES OF THE HEAD AND NECK .Pericranium Tensor tarsi muscle- Pars lacnmalis M. orbicularis oculi (M. Kornen Levator labii superioris proprius- Caput infra-orbitale M. quadrat! labii superiorly Compressor naris muscle M. nasalis (pars transversa) -, Zygomatious major muscle M. zygomaticus _ i Depressor alse nasi f muscle (outer part) M. nasalis (pars alaris) L3vator anguli oris muscle, or musculus caninus Parotidductorductof Sten- . son— Ductus parotideus Buccopharyngeal fascia — Fascia buccopharyngea Depressor labii inferioris or quadratus menti muscle M. quadratus labii inferioris Epicranial or occipito- — frontal aponeurosis Galea aponeurotica Superficial layer of the temporal fascia Occipitalis muscle Auricularis posterior or re- traheus auriculam muscle Transversus nuchse muscle (var.) Masseter muscle (superficial portion) Sternocleidomastoid muscle M . sternocleidomastoideus Spleuius capitis muscle Buccal glands Glandulae buccales Platysma myoides Platysma ' See notes ^ and * on p. 301. - See note ^ on p. 300. Fig. 548. — The Deep Layer of the Muscles of Facial Expression with the Masseter Muscle, displayed by the Removal of the Levator Labii Superioris Al^que Nasi, Levator Labii Superioris Proprius, Zygomaticus Minor, and the Depressor Anguli Oris or Triangularis Menti Muscles, of the Parotideomasseteric Fascia, and of THE Parotid Gland : Levator Anguli Oris Muscle, or Musculus Caninus ; Depressor Labii Inferioris or Quadratus Menti Muscle ; Compressor Naris and Depressor PiLM Nasi Muscles. Occipitalis Muscle. Epicranial or Occipitofrontal Aponeurosis; Pericranium; Temporal Fascia and Anterior Portion of Buccopharyngeal Fascia. Left Side. Musculi faciei— Muscles of the face.s » See note' on page 303. i THE MUSCLES OF THE HEAD AND NECK 303 Compressor naris muscle M. nasalii pars transversa' Inciaivus superior muscle /j( M iaci3i\'us labii superioris ^}m Depressor alae nasi muscle (outer " " parti — M. ni^jlli (pars alaris) Depressor alae nasi muscle (inner part)— M. depressor septi Orbicularis oris muscle Levator labii inferioris or levator menti muscle M. mentalis Incisivus inferior muscle M. incisivus labu infenons' Superficial layer of the temporal fascia Deep layer of the temporal fascia Levator anguli oris muscle, or musculus caninus Masseter muscle (deep portion) Zygomaticus major muscle (cut away) M. zygomaticus Buccinator muscle Eisorius muscle (cut away) Depressor anguli oris or triangularis menti muscle (cut away) M triangularis Pepressor labii inferioris or quadratus menti muscle (cut away) M. quadratus labii inferioris Fig. 549.— The Deep Layer of the Muscles of Facial Expression, and the Relation of THE Orbicularis Oris Muscle to the Adjoining Muscles. Seen obliquely from Before and the Left Side. Buccinator Muscle, the Buccopharyngeal Fascia having been dissected off; Accessory Slips of the Orbicularis Oris Muscle known respectively as Incisivus Superior and Incisivus Inferior Muscles; Levator Labii Inferioris or Levator Menti Muscle; Compressor Naris Muscle^; Depressor Ale Nasi Muscle^ ; Levator Anguli Oris Muscle, or Musculus Caninus. The Deep Portion of the Masseter Muscle, displayed by the Partial Removal of the Larger Superficial Portion. Pericranium ; Temporal Fascia. i The principal differences between tlie autnor's grouping of the lacia! muscles ana tnat usual in lingland M saown in the following table : Toldt's (Jfetng the nometictature o/the German A nalamical Soiie/y). = pars transversa | ^^^^^^,5 ^^^^y^^ = pars alaris j = musculus depressor septi. I-evator labii superioris alaeque nasi muscle = caput angulare \ I,evator labii superioris proprius muscle = caput infra-orbitale V musculi quadrati labii superioris. Zygomaticus minor muscle = caput zygomaticum J — Tr. English. Compressor naris muscle Depressor alae nasi muscle { °" ^^ P^"^, •^ I inner part Musculi faciei — Muscles of the face {see nole above). 304 THE MUSCLES OF THE HEAD AND NECK Depressor sXse nasi muscle (outeT- part) M. nasalis (pars alans) Depressor ala3 nasi muscle (inner part) M. depressor septi i~j»- Buccinator muscle Incisivus superior muscle M incisivub labii superioris Depressor labii inferioris or quadratus menti muscle ^ Levator anguli oris muscle, ai musculus caninus M. caninus - Orbicularis oris muscle '^\oY — Euccinator'musele Orbicularis oris muscle Transversus menti muscle (var ) M. transversus menti (var.) Levator labii inferioris or levator menti muscle M. mentalis Mucous membrane of the moutli I Tunica mucosa oriB ' Incisivus inferior muscle M. incisivus labii inferioris Fig. 550. -Orbicularis Oris Muscle, and its Relation to the Adjoining Muscles, seen FROM Behind. The soli parLS m tne iieignbourhood of the mouth and the cartilag-inous portion of the nose were together detached from the bone, and the muscles laid bare from behind by the removal of the mucous membrane of the mouth. On the right side, a narrow strip of mucous membrane, passing outwards from the angle of the mouth, has been retained, to show the partial attachment thereto of the buccinator and orbicularis oris muscles. M. orbicularis oris — Orbicularis oris muscle. THE MUSCLES OF THE HEAD AND NECK 305 Inner part of the depressor ala; nasi muscle j\I. depressor septi Orbicularis ons muscle — - Labial glands Glandulae labiales' Hucous membrane of the mouth . Tunica mucosa oris ''^ Sebaceous glands Glandulae sebacess Skin Integumenlum commune Scattered fasciculi of the orbicularis oris muscle Fig. 551. — Sagittal Section through the Middle of the Upper Lip, showing i'he Situation in the Lip of the Okbicularis Oris, and the Shape of that Muscle in Cross-Section. Numerous thin fasciculi of the muscle are shown radiating to the skin. M. orbicularis oris — Orbicularis oris muscle. 39 306 THE MUSCLES OF THE HEAD AND NECK Temporal fascia (superficial layer) Fascia temporalis (lamina superficialis) Jfrontal bone- Parietal bone i-m Temporal musoie Occipital bone 1 Temporal fascia (deep layer) Fascia temporalis (lamina profunda) Zygoma Processus zygomaticusi ossis temporalis Fig. 552. — Temporal Muscle, displayed on the Left Side of the Head, after Partial Removal of the Zygomatic Arch, by dissecting off the Superficial and Deep Layers of the Temporal Fascia. Tip of the coronoid process, seen through the tendon of insertion of the temporal muscle Slip to the temporal muscle from the zygomatic arch External oblique line Linea obliqua mandibulse Buccinator muscle M buccmatoi Temporal muscle M temporalis Incisivus superior M. incisivus labii inferioris -"- Levator labii inferioris or levator menti muscle M. mentalis Mental foramen Foramen mentale Head of the condyle Capitulum mandibute . Sigmoid notch Incisura mandibular -j/ Masseter muscle (deep portion) M. masseter (pars profunda) Masseter musoie (superfi^'al portion) M masseter (pars superficialis) Platysma myoides 1 latysma Depiessor anguli oris or triangularis menti muscle \ M. triangularis Depressor labii inferioris or quadratus menti muscle M. quadratus labii inferioris Fig. 553.— Attachment of Muscles to the Outer Surface of the Inferior Maxillary Bone. Left Side. Musculi masticatorii— Muscles of mastication. THE MUSCLES OF THE HEAD AND NECK 307 Infratemporal crest "Crista infratemporalis Capsular ligament Capsula articularis Interaxticalardisc or meniscus "Discus articularis Superior and inferior neads of the external pterygoid muscle , Internal pterygoid muscle M. pterygoideus internus Fig. 554. — MuscuLi Pterygoidei, iixternus et Internus, External and Internal Pterygoid Muscles, displayed by the Removal of the Zygomatic Arch and of a Portion of the Ramus of the Inferior Maxillary Bone. Seen from the Left Side. Vhts temporomandibular articulation has been opened, in order to show the insertion of scwe of the fibres of the superior head of the external pterygoid muscle into the anterior border of ;he inter- articular fibiocartilage and the capsular ligament of the articulation. Temporal muscle .^M. temporalis Interarticular disc or meniscus Discus articularis Head of the condyle Capitulum mandibula:- External pterygoid muscle M. pterygoideus externus Mandibular or inferior dental foramen Foramen mandibulare Mylohyoid groove Sulcus mylohyoidcu: Internal pterygoid muscle M. pterygoideus inlcrnui 'Buccinator crest •Crista biiccinatoria Pterygomaxillary or pterygomandibular ligament ^ Raphe pterygomandibularis y Buccinator muscle Genioglossus or geniohyoglossus muscle Mental spine •'Spina mentalis Mylohyoid muscle M. myloliyoideus Geniohyoid muscle M. geniohyoideus 7:, Digastric muscle (anterior belly) M. digastricus (venter anterior) f^'f-- 555- — Attachment of Muscles to the Inner Surface of the Inferior Maxillary Bone. Right Side. Musculi masticatorii Muscles of mastication. 39—2 308 THE MUSCLES OF THE HEAD AND NECK Masseter muscle (superficial portion) Masseter muscle (deep portion) Slip to the temporal muscle from the zygomatic arch Temporal muscle M. temporalis External pterygoid muscle M. pterygoideas externus Internal pterygoid muscle M. pterygoideus internus Circumflexus or tensor palati muscle M. tensor veli palatini Levator palati muscle M. levator veli palatini Styloglossus muscle Stylohyoid muscle M. stylohyoideus _ Stylopharyngeus muscle Eectus capitis -■ lateralis muscle Sternocleidomastoid muscle M. sternocleidomastoideus Digastric muscle (posterior belly) M. digastricus (venter posterior) Trachelomastoid muscle M. longissimus capitis ] Splenius capitis muscle' Obliquus capitis superior muscle' Rectus capitis posticus major muscle < M. rectus capitis posterior major Eectus capitis posticus minor muscle M. rectus capitis posterior minor Complexus, or semispinalis capitis, muscle' M. semispinalis capitis Trapezius muscle Internal pterygoid plate Processus pterygoideus (lamma medialis) External poerygoid plate Processus pterygoideus (lamina lateralis) Infratemporal crest Crista mfratemporalis Membranous portion of the Eustachian tube Lamina membranacea tubse auditivas Eustachian cartilage (outer fold) — Cartilago tubs auditivEe (lamina lateralis) Eustachian cartilage (inner fold) — Cartilago tubae auditivas (lamina medialis) Spmous process of the sphenoid bone Spina angularis Styloid process Processus styloideus Mastoid process Processus mastoideus Digastric fossa Incisura mastoidea Crest for the rectus capitis posticus major muscle Crista m. recti capitis posterioris majoris '-^ Inferior curved line Lmea nuchas inferior Crest for the rectus capitis posticus minor muscle — Crista m. recti capitis posterioris minoris Superior curved Ime Linea nuchse superior i Rectus capitis anticus major muscle \ M. longus capitis 'Rectus capitis anticus minor muscle M. rectus capitis anterior External occipital protuberance Protuberantia occipitalis externa Fig. 556. — Basis Cranii Externa, External Aspect of the Base of the Skull. Areas of Origin and Insertion of the Muscles attached to the Base of the Skull. The muscular attachments are shown on the right side only of the base of the skull ; the bony prominences, etc., on the left side. Attachment of Muscles to the External Aspect of the Base of the Skull. MUSCULI EXTREMITATIS SUPERIORIS THE MUSCLES OF THE UPPER EXTREMITY 310 THE MUSCLES OF THE UPPER EXTREMITY SupraspinatuB mascle Spine of the scapula i _^^^P}^^^ bcdpula Infraspinatus muscle Teres minor muscle Teres major muscle ?Mceps extensor cubiti muscle M. triceps brachii TlieeteVlcle Aoroimoil Deltoid muscle Biceps flexor cubiti muscle M. biceps brachii Brachialis anticus muscle M. brachialis Fig. 557. — M. Deltoideus, Deltoid Muscle, of the Right Side, Dorso-External Aspect, SHOWING ITS Relations to the Adjoining Muscles of the Shoulder and of the Upper Arm. Musculi articulationis humeri— Muscles of the shoulder. THE MUSCLES OF THE UPPER EXTREMITY 311 Subcutaneous bursa of the acromion Burbd subcutanea acromialib Acromion \ciomion Integumentura commune Subdeltoid or subacromial bursa / Bursa subdeltoidea / Infraspinatus muscle Acromial or scapular extremity of the claTicla E\tremitas acromialis claviculae Deltoid muscle (origin) — M. deitoideus Coraco-acromial ligament Lig. coraco-acromiale The clavicle Subclavlus muscle Pectoralis minor muscle Teresnninor muscle - Teres major muscle Middle or long head of the triceps extensor cubiti muscle M. triceps brachii External head of the triceps extensor cubiti muscle M. triceps brachii External intermuscular septum Septum intermusculare laterale Tendon of the pectoralis major muscle Deltoid muscle (insertion) M deitoideus Biceps flexor cubiti muscle M biceps brachii Brachialis anticus muscle (outer process of origin) M brachialis Fig. 558.— Arrangement of the Muscles adjoining the Right Shoulder-Joint and in THE Proxima' Portion of the Upper Arm, as seen from the Outer Side, after the Removal of the Greater Part of the Deltoid Muscle. Subdeltoid or Subacromial Bursa and Subcutaneous Bursa of the Acromion. Musculi articulationis numeri— Muscles of the shoulder. 312 THE MUSCLES OF THE VPPER EXTREMirY Supraspinatus muscle Spine of the scapula Spina scapulas 'Internal axillary space' Teres major muscle — V'/C^"-' ~— ~ _,-- Infraspinatus muscle Great tuberosity of the humerus Tuberculum majus humeri Teres minor muscle " External axillary space' Middle or long head of the triceps extensor cubiti muscle External head of the triceps extensor cubiti muscle Deltoid muscle M. deltoideus Brachialis anticus muscle M. brachialis Internal or deep head of the triceps extensor cubiti muscle ' Caput mediale m. tricipitis brachii I Intcrjial and External Axillary Spaces. — Between the lower horder of the teres minor muscle, the upper part of the humerus, and the axillary border of the scapula, covered in front by the subscapularis muscle and behind by the teres minor muscle, is a triangular space, divided, as shown in the figure, by the middle or long head of the triceps into an outer, quadrilateral, and an inner, triangular, compart- ment, called respectively by Toldt the internal and the external axillary space. These names are not in use in England, but are suitable, and may well be adopted. Through the external axillary space the posterior circumflex nerve and vessels pass backwards; and through ternal axillary space the dorsal branch of the subscapular artery passes round the margin of the scapula into the infraspinous -Te. Fi<^' 559- — Muscles of the Right Shoulder, seen from Behind: Supraspinatus and Infraspinatus Muscles; Teres Major and Teres Minor Muscles; the Adjoining Parts of the Triceps Extensor Cubiti Muscle. The *Internal and the *External Axillary Space (see note above). Supraspinatus muscle Spine of the scapula Spina scapulas Bursa of the infraspinatus muscle- Bursa m. infraspinati Infraspinatus muscle Acromial or scapular extremity of the clavicle Extremitas acromialis claviculse Subdeltoid or subacromial bursa Bursa subacromialis Capsular ligament Capsula articularis Teres major muscle. Middle or long head of the triceps extensor cubiti muscle i Caput longum m. tricipitis brachii External head of the triceps extensor cubiti muscle Caput laterale m. tricipitis brachii = The bursa of the infraspinatus muscle lies between the infraspinatus muscle and the capsular ligament of the shoulder-joint.— Te. Fig. 560. — In a Preparation similar to that last described, the Origin of the Infraspinatus Muscle ■WAS detached from the Spine of the Scapula, to show the Bursa between that Muscle and the Capsule of the Shoulder-Joint. The Subdeltoid or Sub-i^cromial Bursa has also been opened. Musculi articulationis humeri — Muscles of the shoulder. THE MUSCLES OF THE UPPER EXTREMITY 313 Bursa of the subscapularis muscle' Bursa m siibscip'i'aris Ooracoid process (cut away at its base) Processus coracoidcus Acromion /Acromion Supraspinatus muscle Gr£at tuberosity _ Tuberculum majus Small tuberosity Tuberculum minus •fextemal axillary space- Latissimus dorsi muscle Fectoralis major muscle Long head of the biceps flexor cubiti muscle Caput longum m. bicipitis brachii Coracoscapular or suprascapular ligament Lig transversum scapulae superius Subscapularis muscle •Internal axillary space- Teres major muscle Middle or long head of the triceps extensor cubiti muscle Caput longum m. tricipitis brachii Internal or deep head of the triceps extensor cubiti muscle Caput mediale m. tricipitis brachii Brachialis anticus muscle M. brachialis ' The bursa of the subscapularis muscle is situate between the upper border and posterior surface of the subscapularis muscle and the coracoid process and neck of the scapula. — Tr. - See note ' on p. 312. Fig. 561. — Muscles of the Right Shoulder, seen from Before. Subscapularis Muscle, WITH ITS Bursa; Supraspinatus Muscle; Teres Major Muscle. Adjoining Portions of the Muscles of the Upper Arm and of the Muscles passing from the Trunk TO THE Upper Limb. The *Internal and the *External Axillary Space {see note * on p. 312). Musculi articulationis humeri — Muscles of the shoulder. 40 314 THE MUSCLES OF THE UPPER EXTREMITY Subclavius muscle Pectoralis minor muscle Coracoid process Processus coracoideus Bursa of the subscapularis muscle' Bursa m. subscapularis Bursa of the coracobrachialis muscle'^ Bursa m. coracobrachialis Subscapularis muscle Bursa of the latissimus dorsi muscle' — Bursa m. latissimi dorsi Latissimus dorsi muscle Teres major muscle ' Bursa of the teres major muscle^ - Bursa m. teretis majoris Coracobrachialis muscle Biceps flexor cubiti muscle M. biceps brachii Omohyoid muscle (posterior belly) M. omohyoideus (venter inferior) Coracoscapular or suprascapular ligament — Lig. transversura scapulas superius \ . Subscapular fossa Teres minor muscle Teres major muscle of the triceps extensor cubiti muscle M. tricipitis brachii 'Deep fascia of the arm Internal intermuscular septum Septum intermusculare mediate Internal condyle Epicondylus medialis Deep fascia of the forearm Subcutaneous bursa of the olecranon Bursa subcutanea olecrani : See note ", p. 313. » The />itr-sa of the coracobrachialis muscle is situate between the anterior surface of the subscapularis muscle and the upper ends ot the biceps and the coracobrachialis muscles. — Tr. 3 1 he bursa 0/ the latissi/ints dorsi muscle is situate between the tendon of the latissimus dorsi muscle and that of the teres major muscle. — Tk. 4 The bursa of the teres major muscle is situate between the tendon of the teres major muscle and the humerus. — Tr. Fig. 562. — Arrangement of the Muscles in the Proximal Portion of the Right Upper Arm, AND THE Relation of these Muscles to the Insertions of the Muscles of the Shoulder AND of the Muscles passing from the Trunk to the Upper Limb. Seen from the Inner Side. Burs^ of this Region. Distal Portion of the Deep Fascia of the Upper Arm AND Proximal Portion of the Deep Fascia of the Forearm. Subcutaneous Bursa of the Olecranon. Musculi brachii — Muscles of the upper arm. THE MUSCLES OF THE UPPER EXTREMITY 315 Coracoscapular or suprascapular ligament Lif . transversum scapula; superius j Pectoralis minor muscle Coracoid process Processus coracoideuo Pectorali; iiiajor muscle -novial cavity between the two boi es. Behind, the sac is in contact with the interosseous membrane and the oblique ligament: projecting forward, it separates the.tendon of the brachialis amicus on the inner side from the tendon of the biceps and the upper part of the insertion of the supinator radii hrevis on the outer side. Thus the tendon of the biceps at its insertion lies between the bicipitoradial bursa and the interosseous bursa of the elbow. The condition known as " lawn-tennis elbow "depends on inflammation of one or both of these bursas. — Tr. 3 Ot Jlcxor perforatus mu^K. * Ot /lexor per/orans muscle. • Fig. 569. — The Origin of the Palmar and Radial Muscles of the Right Forearm, and THEIR Relations to the Brachialis Anticus Muscle in the Neighbourhood of the Antecubital Fossa. Anterior Aspect, the Forearm being supinated. The Bicipito- radial Bursa (see note ^ above) and the Interosseous Bursa of the Elbow {see note ^ above). The brachialis anticus muscle has been drawn slightly inwartJs. The two superficial muscles of the radial group, the supinator radii longus and the extensor carpi radialis longior, have been cut away, except for their proximal extremities, which have been turned outwards, in order to lay bare the deep layer of muscles of the radial group : these arc the extensor carpi radialis brcvior and the supinator radii brevis. The superficial layer of the palmar group of muscles has also been removed. Musculi antibrachii -Muscles of the forearm. 4» rf22 THE MUSCLES OF THE UPPER EXTREMITY Biceps flexor cubiti muscle M. biceps brachii Supinator radii brevis muscle M. supinator Supinator radii longus muscle M. brachioradialis Extensor carpi radialis longior muscle^ M. extensor carpi radialis longus Flexor sublimis digitorum muscle' (radial head) M. flexor digitorum sublimis (caput radiale) Flexor longus pollicis muscle M. flexor pollicis longus *Radial furrow of the forearm Sulcus antibrachii radialis Anterior annular ligament of the wrist (superficial layer) Sec note -'■' oil l^agc 7281 Lig. carpi volare Aperture for the ulnar artery Thenar eminence ' Thenar n Brachialis anticus muscle AI bracliialis Semilunar or bicipital fascia Lacertus fibrosus Antecubital fossa Fossa cubitalis Pronator radii teres muscles M. pronator teres Flexor carpi radialis muscle Palmaris longus muscle Flexor sublimis digitorum muscle' M. flexor digitorum sublimis Flexor carpi ulnaris muscle Ulnar furrow of the forearm Sulcus antibrachii ulnaris Palmaris brevis muscle Hypothenar eminence Hvpothenar Palmar fascia Aponeurosis palmaris ' Or Jlexor/ierforatusmmde. - English anatomists group the pronator and flexor muscles of the fori pronator radn teres, flexor carpi radialis, palmaris longus, and flexor suUimi profundus digitorum, flexor longus pollicis, and pronator quadratus muscle, as enumerated in the description at the foot of Figs. 570, 571, and 572. — Tr. onim muscle luthor, howe nly: a svperficia^^ comprehending the ; and a deep, comprehending the flexor ;r, groups these muscles in y2>wr layers, Fig. 570.— The Superficial Layer (see note " above) of the Palmar Group of Muscles of THE Right Forearm: Pronator Radii Teres Muscle, Flexor Carpi Radialis Muscle, Palmaris Longus Muscle, Flexor Carpi Ulnaris Muscle. The Superficial Layer of the Radial Group of Muscles : Supinator Radii Longus Muscle, and a Portion of the Extensor Carpi Radialis Longior Muscle. The Antecubital Fossa, and the Ulnar and Radial Furrows of the Forearm. Ligamentum Carpi Volare, the Anterior Annular Ligament of the Wrist, and the Palmar Fascia wiTh the Palmaris Brevis Muscle. Musculi antibrachii— Muscles of the forearm. THE MUSCLES OF THE UPPER EXTREMITY 323 Biceps flexor cubiti muscle M. biceps brachii Supinator radii brevis muscle M. supinator Pronator radii teres muscle M. pronator teres Flexor sublimis digitorum muscle' (radial head) M. flexor digitorum sublimis (caput radiale) Pronator quadratus muscle Supinator radii longus muscle M. brachioradialis Flexor carpi radialis muscle M. flexor carpi radialis Ridge or tuberosity of the trapezium Tuberculum ossis muitaii^^uli majoris Bursa of the flexor carpi radialis muscle- Bursa m. flexoris carpi radialis Opponens pollicis muscle - j M- opponens pollicis " First dorsal interosseous or abductor indicis. muscle M. interosseus dorsalis 1. # Internal condyle lipicondylus medialis Brachialis anticus muscle M. brachialis Flexor sublimis digitorum muscle' (humeral head) M. flexor digitorum sublimis (caput humerale) Flexor carpi ulnaris muscle Abductor minimi digiti muscle M. abductor digiti quinti ' Ox Jlexor prrforatus muscle. _ . * This bursa .ics beneath the tendon of the flexor carpi radialis muscle as it crosses the scaphoid bone and the trapezium. — Tr. Fig. 571.— The Sfxond Layer (sec note'' tn p. 2,21) of the Palm.\r Group of Muscles of the Right Forearm: Flkxok .Sublimis Dkjitorum or Flexor Ferforatus Muscle. The Ulstal Attachments (Insertions) OF THE Tendons of the Flexor Carpi Ulnaris, Flexor Carpi Radialis, and Supinator Radii Longus Mu.scLES. The Superficial Musclks of the Hypothenar Eminence, and the Interosseous MuscLts of the H*NIJ that are VISIIiLE FRO.M THE PaLMAR SIDE. THE I'jURSA OF I'HE FLEXOR CaRPI RADIALIS Muscle isee note = above). After the removHl of the muscles of the superficial layer and the anterior annular ligament of the wrist, the flexor sublimis rligiiorum mu-cle was laid bare. In order to show clearly the disposition of the tendons of the flexor sublimis digitorum muscle, the flexor profundus digitorum muscle was removed. Musculi antibrachii — Muscles of the forearm. 41— a 324 THE MUSCLES OF THE UPPER EXTREMITY Brachialis anticus muscle - M. brachialis Tendon of the biceps flexor cubiti muscle ' Internal intermuscular septum beptura intermusculare mediale Internal condyle Epicondylus medialis Supinator radii brevis muscle M. supinator Flexor sublimis digitorum muscle' (radial head) M. flexor digitorum sublimis (caput radiale) Flexor profundus digitorum muscle^ M. flexor digitorum profundus Flexor longus poUiois muscle M. flexor pollicis longus Interosseous membrane or ligament of the forearm Membrana interossea antibrachii Pronator quadratus muscle M. pronator quadratus Remains of the anterior annular ligament of the wrist (Deep layer) See note -^^ on page 7281 Abductor pollicis muscle M. abductor pollicis brevis- Flexor brevis pollicis muscle'^ - M. flexor pollicis brevis Adductor pollicis muscle'^ - ' First dorsal interosseous or abductor indicis muscle M. interosseus dorsalis I. 1 rwTi-wtfe Pisiform bone Os pisiforme Unciform process of the unciform bone Hamulus ossis hamati Flexor brevis minimi digiti muscle M flexor digiti quinti brevis Abductor minimi digiti muscle M abductor digiti quinti _ \Lumbricales muscles ^-/Mm. lumbricales \Vaginal ligaments'* , /Ligg. vaginalia ' OrJ7exor per/oratus muscle. = The aut.nor adheres to the old nomenclatu adopted by English anatomists. Following this used to be called the dee/> head of the flexor obliquus pollicis, the largest of the thumb muscle bones, the os magnum, the anterior carpal 1' of the short muscles of the thumb, but that introduced by Cunningham is now generally titer, the former addjtctor pollicis is called the adductor pollicis traits^'crsiis, and what :z'is pollicis muscle is divided into two parts. The larger part, known as the adductor consists of several slips arising from the upper ends of the second and third metacarpal .. and the sheath of the flexor carpi radialis muscle ; the muscle is inserted, i 'ith the adductor transversns and the deep head of the flexor brevis, into the inner side of the bL_ Vhat is now termed the deep head of t\\& flexor brevis pollicis is a very small slip, deeply placed bet nd the outer head of the abductor indicis. It arises from the ulnar side of the upper part of the first Iready described.— Tr. See also Figs. 573, 585, and 586. 3 Ot flexor per/bratis muscle. 4 See note 3 to p. 334. of the first phalanx of the thumb, veen the adductor obliquus pollicis netacarpal bone, and is inserted as Fig. 572.— The Third Layer of the Palmar Group of Muscles of the Right Forearm, after the First AND Second Layers and the Anterior Annular Ligament of the Wrist have been removed : Flexor Profundus Digitorum or Flexor Perforans Muscle, and Flexor Longus Pollicis Muscle. In the Fourth Layer we see a Portion of the Pronator Quadratus Muscle. Lumbricales Muscles, and THE Superficial Muscles of the Thenar and Hypothenar Eminences : Abductor Brevis Pollicis, Adductor Pollicis {see note ^ above), Flexor Brevis Pollicis, Flexor Brevis Minimi Digiti and Abductor Minimi Digiti Muscles. Musculi antibrachii— Muscles of the forearm. THE MUSCLES OF THE UPPER EXTREMITY 325 Supinator radii longus muscle M. brachioradialis V Extensor carpi radialis longior muscle - M. extensor carpi radialis longus Extensor carpi radialis brevior muscle-^ M. extensor carpi radialis brevis Annular or orbicular ligament of the radius ,_ Lig. annulare radii Supinator radii brevis muscle (origin) — M. supinator' Supinator radii brevis muscle (deep insertion - M. supinator Tendon of insertion of the biceps flexor cubiti muscle Supplementary origin of the,- flexor longus poUicis muscle Supinator radii brevis muscle (superficial insertion) ' M. supinator Pronator radii teres muscle M. pronator teres Flexor sublimis digitorum muscle' (radial head) - M. flexor digitorum sublimis (caput radiale) Fleshy origin of the flexor - longus poUiois muscle Accessory slip from the radius to the flexor profundus digitorum muscle- < Pronator quadratus muscle"" Styloid process of the radius — . Tuberosity of the scaphoid bone Tuberculum ossis navicularis Deep head of the flexor brevis poUicis muscle ■ Opponens pollicis muscle (insertion) Tendon of insertion of the/ flexor carpi radialis muscle Carpal head of the adductor pollicis muscle'' , Metacarpal head of the adductor pollicis muscle^ Brachialis anticus muscle M. brachialis Internal intermuscular septum Septum intermusculare mediale Fasciculi of the brachialis anticus muscle attached to the anterior ligament of the elbow-joint Internal condyle ,■ Epicondylus medialis L^ Common tendon of the pronator radii teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris, and flexor sublimis digitorum' muscles Flexor sublimis digitorum muscle' (humeral head) M. flexor digitorum sublimis (caput humerale) -Pronator radii teres muscle ( ulnar head) M. pronator teres (caput ulnare) Tendon of insertion of the brachialis anticus muscle Aponeurotic origin of the flexor carpi ulnaris muscle from the ulna ~ Fleshy origin of the flexor sublimis digitorum muscle- Interosseous membrane or ligament of the forearm Membrana interossea anlibrachii -Pronator quadratus muscle Inferior radio-ulnar articulation - Articulatio radio-ulnaris distalis Tendinous insertion of the flexor carpi ulnaris muscle Pisiform bone /Os pisiforme ,Pisi-imcinate ligament — Lig. pisohamatura — Pisimetacarpal ligament— Lig. pisometacarpeum ,^ Tendinous insertion of the extensor carpi ulnaris muscle ^-Unciform process of the unciform bone lamulus ...si- h.iii.ali Flexor brevis minimi digiti and opponens mmimi digiti muscles (origin)— Mm Hexor digui quinti brevis el npponers dij^iti L]uinti Opponens minimi digiti muscle (insertion) M. opponens digili quinti ' Or Jlexor per/oratusTn^iw:\t:, =• Or Jlexor per/orans muscle. ' .'^cc nole 2 lo p. 324. 4 What the author calls the carpal head 0/ the adductor pollicis muscle is part of the adductor pollicis obliijuus according to Cunningham, whilst what he calls the metacarpal head 0/ the adductor pollicis is the adductor pollicis transversus of Knglish anatomists. See nole ^ 10 p. 324. Fig. 573. — Attachment of Muscles to the Palmar Surface of the Forearm and the Hand. Musculi antibrachii— Muscles of the forearm. 326 THE MUSCLES OE THE UPPER EXTREMITY Triceps extensor cubiti muscle (external head) M. triceps brachii (caput laterale External intermuscular septum Septum intermusculare laterale Supinator radii longus muscle M. brachioradialis External condyle Epicondylus lateralis Extensor carpi radialis longior muscle M. extensor carpi radialis longus Anconeus muscle - M. anconaeus Extensor communis digitorum muscle M. extensor digitorum communis Extensor carpi ulnaris muscle Extensor minimi digiti muscle M. extensor digiti quinti proprms Extensor indicis muscle M. extensor indicis propnub Head of tlie ulna Capitulum uln;e Posterior annular ligament of the wrist Brachialis anticus muscle ^M. brachialis Outer bicipital furrow Sulcus bicipitalis lateralis Biceps flexor cubiti muscle "IVI. biceps brachii Extensor carpi radialis brevior muscle M. extensor carpi radialis brevis Extensor ossis metacarpi poUicis' or abductor longus poUicis muscle M. abductor pollicis longus Extensor primi intemodii pollicis' or extensor brevis pollicis muscle RI. extensor pollicis brevis Extensor secundi intemodii pollicis' or extensor longus pollicis muscle M. extensor pollicis longus 1 have given the preference to the old names as more distinctive and therefore more suitable, of the three extensor muscles of the thumb, ejtrrcnsor OSSIS mi:/iuar/'i/'ol/ic/s, xt }i\n primi int > no iti pollicis ;iXiA. txUnsorsccundiintcriiodii pollicis. QuainC* Anatomy," loth ed.) has, however, adopted the Coiumciual n :)mencWtur<. in the case of the two latter muscles, which he terms respectively extensor brevis pollicis and exicnsor longus pollici ^\ hil t ^ et )ther names have been adopted by Macalister, who terms the extensor of the iirst phalanx, extensor pollicis minor, attd the e\len or of the st-cond phalin\ t xttnsor pollicis major. The names used in the text are, however, more familiar to students, both in England and America and there seems no good reason for any change. While speaking oi| these muscles, it maj be mentioned that their tendons viz those of the extensor ossis metacarpi pollicis and extensor primi intemodii pollicis on the radial side, and that of the extensor secundi intemodii pollicis on the ulnar side, bound the deep hollow to be seen on the outer (radial) side of the wrist and behind the metacarpal bone of the thumb, when this member is fully extended. This hollow is known as the tabatiirc anatomique, or anatomical snvff.box (called by Toldt foveola radialis, see Fig. 575). Beneath the tendons of the extensors of the thumb, and across the intervening hollow, the radial artery passes from the front to the back of the wrist, its direction being indicated by a line from the front of the styloid process of the radius to the proximal end of the first interosseous space ; and the artery is crossed by the superficial radial vein, which usually forms a distinct prominence in the hollow between the tendons.— Tk. 2 By English anatomists the supinator and extensor muscles are, like those of the front of the forearm, divided simjjlv into two layers : a superficial, containing seven muscles, viz., the supinator radii longus, extensor carpi radialis longior, extensor carpi radialis brevior, extensor communis digitorum, extensor minimi digiti, extensor carpi ulnaris, and anconeus muscles ; and a deep layer, containing five muscles, viz., the supinator radii brevis, extensor o-ssis metacarpi pollicis, extensor primi internodii pollicis, extensor secundi intemodii pollicis, and extensor indicis muscles. The author's classification of these muscles is to he found in the description at the foot of Figs. 574, 575, and 576.— Tr. Fig. 574. — The Superficial Layer {see note -above) of the Dorsal Group of Muscles of the Right Forearm: Extensor Communis Digitorum, Extensor Carpi Ulnaris, and Anconeus Muscles. The Radial Group OF Muscles seen from the Dorsal Side, and the Deep Layer of Muscles of the Dorsal Group that are visible in the Distal Portion of the Forearm between the Superficial Layer of Dorsal Muscles nd the Radial Muscles : Extensor Carpi Radialis Longior and Extensor Carpi Radialis Brevior (Muscles of the Radial Group); Extensor Ossis Metacarpi Pollicis, Extensor Primi Internodii Pollicis, and Extensor Secundi Internodii Pollicis (Muscles of the Deep Dorsal Layer). Ligamentum Carpi Dorsale, the Posterior Annular Ligament of the Wrist. Musculi antibrachii — Mnsrlpt; nf thp fn THE MUSCLES OF THE UPPER EXTREMITY 327 Brachialis anticus muscle M. brachialis Supinator radii longus muscle 11. brachioradialia Extensor carpi radialis longior muscle: M. exteusor carpi radialis longus Aperture for the posterior interosseous nerve, between the two layers of the supinator radii brevis muscle Extensor carpi radians brevier muscle M. extensor carpi radialis brevis Supinator radii brevis muscle M. supinator Intermuscular septum Septum intermusculare Extensor carpi radialis brevior muscle M. extensor carpi radialis brevis Extensor carpi radialis longior muscle M. extensor carpi radialis longus Deep fascia of the forearm Fascia antibrachii Posterior annular ligament of the wnst Lig. carpi dorsale Fascia of the dorsum of the band Fascia dorsalis manus Ox Jlexor perforatum muscle. Biceps flexor cubiti muscle M. biceps brachii Semilunar or bicipital fascia Lacertus fibrosus Pronator radii teres muscle ' humeral head) M. pronator teres (caput humeralej — Aperture for the median nerve between the two heads of the pronator radii teres muscle Pronator radii teres muscle (ulnar head) M. pronator teres (caput ulnare) Flexor carpi radialis muscle M. flexor carpi radialis Flexor sublimis digitorum muscle' (radial head) M. flexor digitorum sublimis (caput radiale) Supinator radii longus muscle M. brachioradialis Tabatiere anatomique, or anatomical snufl-box- Foveoia radialis Dorsal metacarpophalangeal subcutaneous bursa Bursa subcutanea metacarpo- phalangea dorsalis Dorsal subcutaneous bursa of the index finger 1-lursa subcutanea digiti II. dorsalis % ' See second paragraph of note ' to p. 326, ^^^- 575- — The Akkange.mknt of the Muscles in the Deeper Part of the Antecuuital Fossa when the Hand is hkonated. The muscles of the radial group, with the exception of the deepest of these, the supinator radii brevis, have been partly removed. The semilunar or bicipital fascia has been cut across, and its distal extremity has been drawn inwards together with the pronator radii teres muscle, in order to display the ulnar head of this muscle. In this distal half of the forearm and on the back of the hand we see the deep fascia and the posterior annular ligament of the wrist. Musculi antibrachii — Muscles of the forearm. 328 THE MUSCLES OF THE UPPER EXTREMITY Triceps extensor cubiti muscle (internal or deep head) //j M- triceps brachii (caput mediale) i Anconeus muscle M. anconaeus Ulna Ulna Extensor seoundi internodii pollicis or ejrtensor longus pollicis muscle' M. extensor pollicis longus Extensor indicts muscle - M. extensor indicis proprius Styloid process of the ulna Processus styloideus ulnae ' Posterior annular ligament of the wrist Extensor carpi ulnaris muscle M. extensor carpi ulnaris Capitellum of the humerus Capitulum humeri External condyle— Epicondylus lateralis _ External lateral ligament of the elbow-Joint Li:; collaterals radiale Annular or orbicular ligament of the radius Lig. annulare radii Supinator radii brevis muscle "M. supinator Pronator radii teres muscle M. pronator teres Radius Radius Extensor ossis metacarpi pollicis or abductor longus pollicis muscle' M abductor pollicis longus Extensor primi internodii pollicis or extensor brevis pollicis muscle' M. extensor pollicis brevis Extensor carpi radialis brevier muscle M. extensor carpi radialis brevis Extensor carpi radialis longior muscle M. extensor carpi radialis longus 1 I 1 ' See note to p. 326. Fig. 576. — The Deep Layer of the Dorsal Group of Muscles of the Right Forearm, displayed by the removal of the extensor communis digitorum and the extensor Carpi Ulnaris Muscles : Extensor Ossis Metacarpi Pollicis, Extensor Primi Inter- nodii Pollicis, Extensor Secundi Internodii Pollicis, and Extensor Indicis Muscles. In the proximal segment of the pronated forearm, the supinator radii brevis muscle and the anconeus muscle are seen. Musculi antibrachii — Muscles of the forearm. THE MUSCLES OF THE UPPER EXTREMITY 329 Triceps extensor cubiti muscle (internal . or deep head) M. triceps brachii (caput mediale) Posterior ligament of the elbow-joint Capsula articularis Triceps extensor cubiti muscle (tendon of insertion) M. triceps brachii Olecranon . Olecranon Flexor carpi ulnaris musole (ulnar head) - M. flexor carpi ulnaris (caput ulnare) Intermuscular septum - Septum intermusculare Anconeus muscle (origin')'' M. ancona;us Posterior border of the ulna" Margo dorsalis ulnae Extensor carpi ulnaris muscle Intermuscular septum Septum intermusculare Supinator radii longus muscle M brachioradialis Extensor carpi radialis lougior muscle M extensor carpi radialis longus Anconeus muscle (insertion' ) -' M, ancona:us — External condyle — Epicondylus lateralis _ Extensor carpi radialis brevier M. extensor carpi radialis brevis Annular or orbicular ligament of the radius I ig, annulare radii Neck of the radius — Collum radii Extensor communis digitorum muscle M txtensiir digitorum communis ~ Supinator radii brevis muscle M supinator -^ Aperture for the posterior interosseous nerve, between the two layers of the supinator radii brevis muscle _ Extensor ossis metacarpi poUicis or abductor longus poUicis muscle- M. alxluctor pollicis longus Interosseous membrane or ligament of the forearm Membrana interossea antibrachii Extensor indicis muscle M. extensor indicis proprius ^ Extensor primi intemodii pollicis or extensor brevis pollicis muscle- M. extensor pollicis brevis -Extensor secundi intemodii pollicis or extensor longus pollicis muscle- M. extensor pollicis longus Styloid process of the ulna Processus styloideus ulnae Tendon of insertion of the extensor carpi ulnaris muscle Posterior or dorsal proximal intermetacarpal, ligaments -Ligg basium dorsalia Fotirth dorsal interosseous muscle (origin) - Third dorsal interosseous muscle (origin) - Third and fourth dorsal interosseous — =i muscles (distal extremities) Dorsal aponeuroses of the extensor — - tendons ' Sec note 2 to p. 319. Tendon of insertion of the supinator radii longus muscle Styloid process of the radius P'rocessus styloideus radii Extensor carpi radialis brevier muscle M- extensor carpi radialis brevis Extensor carpi radialis longior muscle M. extensor carpi radialis longus Insertion of the extensor ossis metacarpi follicis muscle- interosseous or abductor indicia muscle (origin) M. interosseus dorsalis I. Second dorsal interosseous muscle (origin) Partial insertion of the first dorsal interosseous or abductor indicis muscle into the dorsal aponeurosis of the extensor tendon Partial Insertion of the dorsal aponeurosis of the extensor tendon Into the base of the proximal phalanx Dorsal aponeurosis of the extensor tendon divided longitudinally % ' See note ' ) p. 336. Fig. 577. — Attachment of Muscles to the Dorsal Surface of the Forearm and the Hand. Musculi antibrachii — Muscles of the forearm. 330 THE MUSCLES OF THE UPPER EXTREMITY Extensor Tninimi digiti muscle M. extensor digiti quinti proprius Extensor communis digitorum muscle . M. extensor digitorum communis Extensor indicis muscle M. extensor indicis proprius__ Extensor carpi ulnaris muscle Head of the ulna Capitulum ulnse Synovial sheath of the tendon of the extensor carpi ulnaris muscle u' Synovial sheath of the tendons of the extensor communis di^torum and extensor indicis muscles t ; i Synovial sheath of the tendon of the extensor minimi digiti muscle ( j) Vincula of the extensor tendons Juncturae tendinum Dorsal subcutaneous meta- carpophalangeal bursa Bursa subcutanea meta- carpophalangea dorsalis Dorsal subcutaneous bursae of the fingers Bursas subcutaneae digitorum dorsales (i) Vagina tendinU in. extensoris carpi ulnaris (2) Vagina tendinum mm. extensoris digitorum et extensoris indicis (3) Vagina tendinis m. extensoris digi igiti quinti Extensor ossis metaoarpi pollicis and extensor primi internodii pollicis muscles' Mm. abductor longus et extensor brevis pollicis Extensor secundi internodii pollicis muscle' M. extensor pollicis longus Tendons of the extensor carpi radialis longior and extensor carpi radialis brevior muscles 1 Posterior annular ligament of the wrist Synovial sheath of the tendons of the ex- .-— — tensor ossis metacarpi pollicis and extensor primi Internodii pollicis musclesMj> Synovial sheath of the tendons of the ex- tensor carpi radialis longior and extensor carpi radialis brevior muscles ts) — Synovial sheath of tlie tendon of the extensor secundi internodii polUcis muscle' (6) Dorsal interosseous muscles Mm. interossei dorsales — Dorsal subcutaneous meta- carpophalangeal bursa Bursa subcutanea meta- carpophalangea dorsalis Intermetacarpophalangeal bursas Bursae intermetacarpophalang^ae (4) \ psina tendinum mm. abductoris longi et extensoris bre\-is pollicis (3) Vagma tendinum mm. extensorum carpi (6) Vagina tendinis m. e.xteiisoris poliicis longi Fig. 578. — The Disposition of the Extensor Tendons at the Back of the Wrist and Hand, and the Synovial Sheaths of these Tendons. Right Hand. The Connexions between the Extensor Tendons (Vincula) on the Dorsum of the Hand, and the Dorsal Aponeuroses of the Extensor Tendons. The Intermetacarpophalangeal BuRS.E, the Dorsal Subcutaneous Metacarpophalangeal Burs.e, and the Dorsal Subcutaneous Burs^ of the Fingers. The Dorsal Interosseous Muscles. The synovial sheaths of the tendons were injected with strong alcohol before dissection. A portion of the posterior wall has been removed from the sjTiovial sheath of the tendons of the extensor communis di.gitorum and extensor indicis muscles.' Musculi manus — Muscles of the hand. THE MUSCLES OF THE UPPER EXTREMITY 331 The radius Radius Canals for the tendons— of the extensor secundi intemodii poUicis muscle' of the extensor communis digitorum and extensor indicis muscles of the extensor "I'Tiimi digiti muscle of the extensor carpi ulnaris muscle — Tendon of the extensor carpi ulnaris muscle Dorsal interosseous muscles Mm. interossei dorsales Dorsal aponeuroses of the extensor tendons Aponeuroses tendinum extensorum digitorum Canals for the tendons— of the extensor carpi radialis longior and extensor carpi radialis brevier muscles of the extensor ossis metacarpi poUicis and extensor pnmi intemodii poUicis muscles^ Cansular ligament Bursa of the extensor carpi radialis brevior muscle- Tendon of the extensor carpi radialis longior muscle Dorsal aponeurosis of the extensor tendons of the thumb Aponeurosis tendinum extensorum pollicis Adductor pollicis muscle'^ ■ See note ■ to p. 326. ' This bursa !s situate beneath the tendon close to its insertion.— Tr. 3 See note » to p. 324. Fig. 579.— The Dors.\l Aponeuro.sks of thk Extensor Tenuon.s. Right Hand. Dorsal Interosseous Muscles. The osseo-fibrous canals for the extensor tendons have been opened by the removal of the posterior annular ligament of the wrist. The distal extremity of the tendon of the extensor carpi radialis brevior muscle has been turned down- wards, in order to display the bursa that lies beneath it. Dorsal aponeurosis Tendon of the flexor sublimis digitonur muacle- Metacarpal bone Os metacarpale Dorsal interosseous muscle M. interosseus dorsalis Lumbricalis muscle Tendon of the flexor profundus digitorum muscle ■ ■ Viruula Tendinum— 'XW'ai are folds of syi Their nome.iciaturc \% Munewhat v.iriable. Macalister write"! ififi. cit. the two tendons al first, and the deep tendon is tied to the l>one bv on** tt.ey are generally free, but when the deep tendon has passefl through round cord ' ' - • " e another and to ihe phalanges. le of the digital sheath enwraps tinaaila). Where the tendons, pass each c : synovial s (retinae 1o8): A-o flat band:. ^ - -,- ..... , is lied to the superficial tendon, now underlying it, by a soft OTd (vinculum). Finally the deep tendon is tied 10 the distal end of the second ph:.lanx by a flat retinacuum in/trius.' Accord- Quain (op. cil.. vol. ii.. p. 22?.), '' The synovial m'mbrane 'orms small folds (viruula accessorta tendi, and Ihe bonen. There ate two sets of these : ihe one, linninen'a hrnia, broad and membranous, passing bet insertion and the lower part of the phalanx immediately above ; the other. l!/;amfnta Inncn, slendi tendo laimm), . bi the finger*."- ') between the the tendonsnear their id less constant hands, joining the hgamentum breve of the deep flexor is a small band of yellow elastic tissue {vinculum iub- the head of the second phalanx, and may assist in drawing down Ihe tendon after flexion of I O, flexor p,r/o, » Ox Jlexor per/oratus muscle. Fk;. 580.— The Distal Kxtre.mities of the Flexor anij Kxtensor Tendons of the Right Middle Finger seen FRO.M THE Radial Side. The Relation of the Lu.mhricai.is and of the Inteko.sseous Mu.sclk to the Dorsal Aponeurosis of the Kxtensor Tendon. Vincula Tendinu.m (see note ' abmie). Musculi manus Muscles of the hand. 42 — 2 333 THE MUSCLES OF THE UPPER EXTREMITY First lumbricalis muscle M. lumbricalis I. — Tendon of the palmaris longus muscle Deep fascia of the forearm Fascia antibrachii Anterior annular ligament of the wris (Superficial layer) Lig. carpi volare See note -" on page 7281 — Talmaris brevis muscle Palmar fascia Aponeurosis palmaris Fourth lumbricalis muscle M. lumbricalis IV. Superficial transverse ligament of the fingers Fasciculi transversi aponeurosis palmaris Fig. sSi.^Aponeurosis Palmaris, Deep Fascia of the Palm, or Palmar Fascia ; the Insertion of the Tendon of the Palmaris Longus Muscle into this Fascia; the Processes passing from the Palmar Fascia to the Digital Sheaths ; the Super- ficial Transverse Ligament of the Fingers. Palmaris Brevis Muscle. Musculi manus — Muscles of the hand. THE MUSCLES OF THE UPPER EXTREMITY 333 Tendon of the flexor longus pollicis muscl Synovial sheath of the tendon of the flexor longus pollicis muscle Vagina m. flexoris pollicis longi Digital synovial sheaths of ~ the flexor tendons Vaginae tendinum digitales '^Tendons of the flexor sublimis digitorum^ and flexor profundus digitorum' muscles Tendon of the flexor carpi ulnaris muscle Synovial sheath of the tendons of the flexor sublimis digitorum' and flexor profundus digitorum- muscles Vagina tendinum mm. flexorum ccmmunium Fig. 582.— The Synovial Sheaths of the Flexor Tendons,^ prepared after injecting them with Alcohol. Right Hand. The palmir fascia and the anterior annular ligament of the wrist have been removed. Flexor sublimis digitorum muscle' M. flexor digitorum sublimis "^ Flexor longus pollicis muscle M. flexor pollicis longub Tendon of the flexor carpi radialis muscle Synovial sheath of the tendon of the flexor longus pollicis muscle Vagina tendinis m. flexoris pollicis longi Synovial sheath of the tendon of the flexor carpi radialis muscle Vagina tendinis m. flexoris carpi radiafis Remains of the anterior annular - ligament of the wrist Synovial sheath of the extensor ossis metacarpi.'-'' pollicis and extensor primi intemodii pollicis muscles' — Vagina tendinum mm. abductoris longi et extensoris brevis pollicis Tendon of the supinator radii long^us muscle The radius Radius f Flexor profundus digitorum muscle- ( M. flexor digitorum profundus . Flexor carpi ulnaris muscle Btirsa of the flexor carpi ulnaris muscle' "-- Bursa m flexoris carpi ulnaris Synovial sheaths of the tendons of the flexor sublimis digitonun' and flexor profundus digitorum- muscles Vagina tendinum mm. flexorum communium '■Mesotenon'' -Pronator quadratus muscle Interosseous membrane or ligament of the forearm "Membrana interossea antibrachii The ulna Ulna ■ Or yfexar /er/oralus muscle. 0\ flex(n- ferforans muscle. _ , . . . 3 The synovial sheath of the common flexors in the canal of the carpus beneath the anterior annular liRamcnt of (he wnst is sometimes known as the prial carpal bursa. It extends upwards to the level of the radiocarpal articulation, and downwards about halfway along the metacarparii"nes endini; in blind pouches in the case of the index, middle, and ring fingers, the digital sheaths of which are separ.-ite : in the case of the little finger, however, the digital sheath of the flexor tendon is continuous with the great carpal bursa. The sheath of the flexor longu« pollicis is entirely distinct in the carpal canal from the sheath of the common flexors. — Tk. < See note ' to p. 126. 5 This bursa is situate heneath the tendon close to its insertion.— TR. ' Mitolcnon.—TWv. term is not used hy English anatomists. The synovial sheath of the common flexors beneath the anterior annular ligament i> in most cases divided by an incomplete septum attached to the middle finger tendon of the deep flexor. It is to this structure that the term mtiotenon is applied.— Tk. Fig. 583.— The Synovial Sheaths ok the Flexor Tendons, displayed, after the Removal of the Anterior AsNLLAR Ligament of the Wrist, by turning down the Flexor Tendons into the Palm of the Hand. Left Hand. The synovial sheaths and bursic have all been opened. Musculi manus — Muscles of the hand. 334 THE MUSCLES OF THE UPPER EXTREMITY Tendon of the supinator radii longus muscle Pronator quadratus muscle Tendon of the flexor carpi radialis muscle ' ;$ Tendon of the extensor ossis metacarpi poUicis muscle^ Opponens pollicis muscle Abductor pollicis muscle M. abductor pollicis brevis Flexor brevis pollicis muscle (superficial head)- M. flexor pollicis brevis (caput superficiale) Flexor brevis pollicis muscle (deep head)--^-" M. flexor pollicis brevis (caput profundum) J Adductor pollicis muscle---"" / ^^ First dorsal interosseous or — jibductor indicis muscle Lumbricales muscles M. lumbricales Middle vaginal band^ Lig. vaginale Tendon of the flexor carpi ulnaris muscle Anterior annular ligament of the wrist (Deep layer) Lig. carpi transversum See note =" on page 7281 Abductor minimi digiti muscle ~ M. abductor digiti quinti Opponens minimi digiti muscle M. opponens digiti quinti Third and fourth dorsal interosseous muscles Second and third palmar interosseous muscles Flexor brevis minimi digiti muscle M. flexor digiti quinti brevis Transverse metacarpal ligament (anterior or palmar distal intermetacarpal ligaments) Ligg. capituloriim (ossiiiin metacarpalium) t"""'-" Superior vaginal bands^ Fibrae annulares JB Tendon of the flexor sublimis digitorum^ muscle ~" Superior crucial bands'' Fibrae cruciatae Middle vaginal band^ Lig. vaginale ;^J ~- — Tendon of the flexor profundus ^^ digitorum muscle* ^ See note i to p. ^z6. = See note = to p. 324. 3 The author does not enumerate all the component parts of the anterior wall of the digital sheaths of the flexor tendons. These are : (i) Superior vaginat band (called by Toldt fibne annulares), strong transverse fibres crossing the tendon at the level of the upper half of the proximal pha'anx (to the rough margins of the anterior surface of which bone the fibres are attached) ; {:i) mlterlor crucial ^a«(f (called by Toldt fibres cruclatcs), X-shaped bands at the level of the distal end of the r'roxinial phalanx ; (3) inldd'e vaginal band, a slight transverse slip at the level of the proximal interphalangeal articulation (called by Toldt lleavicnhnn vagi'iale) ; (4) oblique band, passing downwards and inwards across the proximal extremity of the medial phalanx ; (5) inferior vaginal band, across the middle of the medial phalanx ; (6) Inferior cnictal band, in front of the distal interphalangeal articulation. — Tr. 4 Or fie.vor/ierforatus muscle. 5 Or fiexar pe^firans m\xic\. 324) ; Opponens Minimi Digiti; Flexor Brevis Minimi Digiti. By the removal of that portion of the adductor polHcis musrlc which arist-s from the third metacarpai bone, the portion of this muscle arising froin the carpal ligaments, and the dorsal and palmar interosseous muscles, are exposed to view. The vaginal ligaments of the fle.xor tendons have been opened, and in the index and middle fingers the commissure of the tendons (see note '^ above) of the superficial flexor is shown. Musculi manus— Muscles of the hand. 336 THE MUSCLES OF THE UPPER EXTREMITY Scaphoid bone Os naviculare Tendon of the flexor carpi radiahs muscle Abductor pollicis muscle M abductor polhcis bre\ IS Opponens poUieis muscle Extensor ossis metacarpi poUicis muscle' M. abductor pollicis longus Flexor brevis pollicis muscle' (superficial — bead) M. flexor pollicis brevis i caput superficnl'-^l Flexor brevis pollicis muscle- (deep bead M. flexor pollicis brevis (caput profuntbun) First dorsal interosseous or abductor indicis muscle M. Flexor brevis pollicis muscle' (in-«i- SertiOn)— M. flexor pollicis brevis Abductor pollicis muscle- (insertion) M. abductor pollicis brevis Adductor pollicis muscle--— (insertion) M. adductor pollicis Flexor longus pollicis muscle (insertion) IM. flexor pollicis longus First palmar interosseous' muscle M. interosseus volaris I. /' Partial insertion of the first dorsal interosseous or abductor indicis muscle and of the first lumbricalis muscle into the dorsal aponeurosis of the extensor tendon of the index finger / Tendon of the flexor sublimis digitorum or' flexor perforatus muscle Attachment of the vaginal ligament Insertion of the flexor sublimis digitorum or'' ) flexor perforatus muscle Insertion of the flexor profundus digitorum or flexor perforans muscle Lunar (or semilunar) bone Os lunatum I Pyramidal or cuneiform bone I Os triquetrum Tendon of the flexor carpi ulnaris muscl" Anterior annular ligament of the wrist Lig carpi transversum Pisiform bone— Os pisiforme Tendon of the extensor carpi ulnaris muscle Abductor minimi digiti muscle ~ M abductor digiti quinti - Flexor brevis minimi digiti muscle M. flexor digiti quinti brevis Opponens minimi digiti muscle M. opponens digiti quinti Second and third palmar interosseous muscles (origin) Mm interossei volares II. et III. Third and fourth dorsal interosseous muscle afe III. . IV. Ilexor brevis minimi digiti muscle M. flexor di.^iti quinti brevis Abductor minimi digiti muscle (partial insertion into the dorsal aponeurosis of the extensor tendon) (i) Third and fourth lumbricales muscles Mn III. : IV. Partial insertion of the third palmar interosseous muscle into the dorsal aponeurosis of the extensor tendon Insertion of the flexor sublimis digitorum or flexor perforatus muscle Insertion of the flexor pro- fundus digitorum or flexor perforans muscle Insertion of the flexor sublimis digitorum or flexor perforatus muscle Insertion of the flexor profundus digitorum or flexor perforans muscle (i) M. abductor digiti quinti See note ' to p. 326. See note 2 to p. 324. Fig. 586. — Attachment of Muscleb to the Palmar Surface of the Hand. Musculi manus — Muscles of the hand. MUSCULI EXTREMITATIS INFERIORIS THE MUSCLES OF THE LOWER EXTREMITY 43 338 THE MUSCLES OF THE LOWER EXTREMITY Gluteus maximus muscle M. glutjeus maximus Crest of the ilium Crista iliaca Anterior superior spine of the ilium Spina iliaca anterior superior Tensor vaginse femoris or tensor fasciae femoris muscle M. tensor fasciae latas Deep fascia of the thigh, or fascia lata (superficial layer) Fascia lata (lamina superficialis) Deep fascia of the thigh, or fascia - lata (superficial layer) Fascia lata (lamina superficialis) Iliotibial band or ligament Fig. 587. — Deep Fascia of the Thigh, or Fascia Lata, seen from the Outer Side, with THE Thickened Portion of this Fascia, known as the Iliotibial Band or Ligament; Insertion of the Tensor Vagina Femoris (Tensor Fasciae Femoris, Tensor Fascia Lat^) Muscle and Partial Insertion of the Gluteus Maximus Muscle into the Iliotibial Band or Ligament. Right Thigh. Musculi coxae et femoris — Muscles of the hip and thigh. THE MUSCLES OF THE LOWER EXTREMITY 339 Spinous process of the twelfth dorsal vertebra Processus spinosus vertebrae thoracalis XII, Intertransversales mediales or inter- ^ accessoril muscles I Mm. intertransversani posteriores mediales Interspinales muscles Iliolumbar ligament Lig. iliolumbale Gluteus mazimuB muscle M. glutaeus maximus Uppermost portion of the middle layer of the lumbar fascia, which forms the posterior aponeurosis of the transversalis abdominis muscle Lig. lumbocostale I Intertransversales laterales muscles J Mm intertransversarii posteriores laterales Quadratus lumborum muscle Semitendinosus muscle — Biceps flexor cruris muscle (long head) M. biceps femoris (caput longum) Fig. 588.— Gluteus Maximus Muscle, seen obliquely from I^ehind and Without, con- stituting THE Superficial Layer of the External Muscles of the Hip. Quadratus Lumborum Muscle; Interspinales, Intertransversales Laterales, and Intertrans- versales Mediales or Interaccessorii Muscles of the Lumijar Region ; seen from Behind. Right Side. Musculi coxae— Muscles of the hip. 43—2 340 THE MUSCLES UF THE LOWER EXTREMITY Quadratus lumborum muscle M quadratus lumborum Crest of the ilium Crista iliaca Gluteus maximus muscle (proximal portion) M. glutaeus maximus Pyriformis muscle M. piriformis Posterior or great sacrosciatic ligament Lig. sacrotuberosum Anterior or small sacrosciatic ligament Lig. sacrospinosum Gemellus superior muscle^ " Obturator intemus muscle' Gemellus inferior muscle' — Quadratus femoris muscle - Trochanteric bursa of the gluteus __ maximus muscle'^ Bursa trochanterica m. glutasi maximi Biceps flexor cruris muscle (long head) M. biceps femoris (caput longum) Semimembranosus muscle Gluteus maximus muscle (distal portion) M. glutaeus maximus Vastus extemus muscle M. vastus lateralis '-Gluteus medius muscle -Iliotibial band or ligament »« 1^ gemelh muscles may be regarded as portions of the obturator internus muscle arising outside the pelvis, and for this reason Macaliister has given to the three muscles the name of iria-/>s rotator femoris muscle, but the term is rarely used.— Tr. f i he trochanteric lursa of tli^gtuteus inaxiiims muscle is situate, as its name implies, between the fascial insertion of the gluteus ma.\imus muscle and the great trochanter of the femur. In most cases it is a large compound or multllocular bursa, but is occasionally represented by several distinct smaller bursa.— Tr. Fig. 589. — Second Layer of the External Muscles of the Hip, displayed by the Division OF THE Gluteus Maximus Muscle and the Posterior Portion of the Fascia Lata: Gluteus Medius Muscle; Pyriformis Muscle; Obturator Internus and Gemellus Superior and Inferior Muscles; Quadratus Femoris Muscle. Origin and Femoral Insertion of the Gluteus Maximus Muscle. Trochanteric Bursa of the Gluteus Maximus Muscle. Right Hip, seen from the Outer Side. Musculi coxae — Muscles of the hip. THE MUSCLES OF HIE LOWER EXTREAUTY 341 Quadratus lumborum muscle Crest of the ilium Crista iliaca Posterior superior spine of the ilium Spina iliaca posterior superior ^Ju M Pyriformis muscle M. piriformis Posterior or great sacrosciatic ligament Lig. sacrotuberosum ) I J Anterior or small sacrosciatic ( ' ligament — Lis sacmspinrjsum \^S' Gemellus superior muscle' Obturator intemus muscle' Bursa of the obturator intemus muscle-'— Bur>a m. uLlurat jri- inlcrni Gemellus inferior muscle Tuberosity of the ischium Tuber ischiadicum Gluteus medius muscle Gluteus minimus muscle Anterior superior spine of the ilium Spina iliaca anterior superior — Obturator extemus muscle _ Great trochanter Trochanter major Quadratus femoris muscle > Sec note ' lo p. 340. , J , •■ A ' The buna o/the ohturntor intemus muscle is situate between (he tendon of the obturator internus muscle and the cartilage-covered irothlcar surface or groove of the ischium (i.e., the hollowed portion of the bone between the s[>ine and the tuberosity) ; r •■ ■- loHK and narrow, lies between the tendon of the muscle and the capsule of the hipjoint : often, combine to form a single structure. — Tr. econd burs: in Fig. 590, these two bursa: Fig. 590. — Deep External Muscles ok the Right Hip, displayed hy the Removal of the Gluteus Maxi.mus and Gluteus Medius Muscles: Gluteus Minimus Muscle; Pyri- formis Muscle. Seen obli(,)Uely from the Right Side and Behind. The tendon of the obturator internus muscle has been divided, and the inner half has been turned inwards over the posterior or ^'reat sacrosciatic lit,'ament, in order to display the bursa of the obturator internus muscle. The quadratus femoris muscle has been drawn downwards a little, and slightly separated from the },'<-'nie"us inferior muscle, in order to bring into view between them a portion of the obturator externus muscle. Musculi coxae- Muscles of the hip. 342 THE MUSCLES OF THE LOWER EXTREMITY Subcntaaeoiis bursa of the posterior superior spinE of the iliiim Bursa subcntanea spia=E iliaca postericiis SubcutaiieDUE bursa of the sacnnn Bursa snbcutanea sacral^; SubcutaJioous bursa of ti coecjx Bursa snbcmtanea coccygea Superior bursa of the Weep flexor cruris muEde^ Bursa m. bicjpitis femoiis superior Semimembranosus muscle Adductor magnus muscle. Biceps flexor cruris muscle M. biceps femcris SeimtendiiiDEUs muscle - Tbe .vx^rripr fwrtra ■of i^ IHcips _0£XBr trwris matsaic is aEcBM (bsrv -■- of tbe senmnembranDSns masdle. — Ts- , _ . _ = The fipstcripr trpdhwKltrnr ^rursa pfihc g'^cus rrfscjBus mjxs^Ir as a smBll bursz it zmd tbe inseraon of the tendon of the jrj-iifonms inrasde. — ^Tk- 3 See DOie = 10^1. 340. * The gixtaifcmKnal licma is sJtlBle ibcitweEn ihe festial msKrtioa laT !|4ie gtatcy ej'ternns musdt. — Tr. 5 See mote ' to p. 31^0. : nn ^t&at inmRtQ^ ftiStncBBB Fig. 591. — Deep External Mtjsci-Es of the Right Hep seen fkom Beeekd, showtog thei?. Relation to the Posteeiok Femokal ok Hamstkimg Muscues A3BD TO THE Addhctc?. Magnus Muscle. Insektion of the Gluteus Maslmchs esto toe Glipteal Ridge of THE Femur and into the Fascia Lata. Burs^ of the Sacral amd Gluteal Regions. The g^emelli musdes have bees kit nmdktiiiiljed in Aor dk^e pnaxiinitf to idbe abffiimatar Moscoli cozs — Muscles of the hip. THE MUSCLES OF THE LOWER EXTREMITY 343 Outer row of insertions of the longissimus dorsi muscle Slips of origin of the multifidus spinae muscle Twelfth dorsal i Mamillary process vertebra I Processus mamillaris \ertebra | Accessory process thoracalis XII. Ij'rocessus accessorius Inner row of insertions of the longissimus dorsi muscle Accessory process of the first lumbar vertebra I'rocessus accessonus vertebrae lumbalis I. Intertransversalis medialis or inter- accessorius muscle M Intertransversarius posterior medialis Origins of the multifidus spinae muscle Isolated slip of the multifidus spinae muscle Spinous process of the third lumbar vertebra processus spinosus vertebrse lumbalis III. Mamillary process of the fourth lumbar ver tebra-Prucessu.-. mamillaris vertebra: Kimljali, I\'. Insertions of the multifidus spinae muscle Tendon of the origin of the longissimus dorsi muscle Eleventh rib Costa XI Uusculus accessonus ad iliocostalem (origin) Middle layer of the lumbar fascia, forming the u'Vv. posterior aponeurosis of the transversaus " " abdominis muscle— Lig- lumiocosiale Slips of insertion of the iliocostalis or sacrolumbalis muscle - Serratus posticus inferior muscle M , serratus posterior inferior — Intertransversalis lateralis muscle M intertransvcrsarius posterior lateralis Outer row of insertions of the longissimus dorsi muscle . - Iliocostalis or sacrolumbalis muscle M. iliocostalis lumborum ..Inner row of insertions of the longissimus dorsi muscle Intertransversalis medialis or interaccessorius muscle M intertrans\ersarius posterior medialis Costal process of the fourth lumbar vertebra Processus costarius vertebra:- lumbalis IV. Origin of the iliocostalis. or sacrolumbalis muscle Crest of the iliiun Crista iliaca Holtifidus spinae muscle - M. multifidus Origin of the longissimus dorsi muscle Dorsal orposterior surface of the first sacral vertebra fa..iv->d.r^!isverlel.ri sa.rah, I. Posterior superior spme of the Uium .Spina il,aca i,.,l„i jr supcn.jr Surface of origin of the multifidus spins muscle Surface of origin of the gluteus maximus ' muscle Gemellus superior muscle ^origin Posterior or great sacrosciatic ligament Lig. sacr')tuberosum Gemellus inferior muscle (origin; Common tendon for the long head of the biceps flexor cruris muscle and for the semitendinosus muscle Crest of the ilium Crista iliaca Surface of origin of the gluteus medius muscle Su-fice of origin of the gluteus minimus muscle Proximal portion of the pyriformis muscle in the great sciatic or ilio- sciatic notch Anterior i uferior spine of the ilium ^pina iliaca anterior inferior Origin of the rectus femoris muscle Tendon of insertion of the pyriformis muscle Tendon of the obturator intemus muscle Tendon of the obturator extemus muscle '--• Insertions of the quadratus femoris muscle Posterior intertrochanteric ridge or line Crista intertrochanterica Quadratus femoris muscle (origin) I'IG. 5fj2. — ATTACIlMliNT OF MlSCLBS TO THE POSTERIOR SURFACE OF THE LUMBAR VERTEBKJi ANO OF THE HiP-BoNE. Musculi coxae — Muscles of the hip. 344 THE MUSCLES OF THE LOWER EXTREMITY Quadratus lumborum muscle Psoas magnus muscle M. psoas major Psoas parvus muscle (var.) . M. psoas minor (var.) Iliacus muscle M. iliacus Anterior superior spine of the ilium Spina iliaca anterior superior Iliac fascia Fascia iliopectinea^ Transversalis fascia Fascia transversalis Vascular compartment — Lacuna vasorum Poupart's ligament (superiicial femoral arch) Lig. inguinale (Pouparti) First lumbar vertebra Vertebra lumbalis I. Sacral promontory f romontorium Fyriformis muscle ~M piriformis Sacrococcygeus anticus or cuivator coccygis muscle Obturator internus muscle Coccygeus or levator coccygis muscle lliopectineal eminence Eminentia iliopectinea Pubic ligament of Astley Cooper, or Cooper's ligamenf- Lig pubicum (Cooperi) Pubic symphysis Symphysis ossium pubis Spine of the pubis , Tuberculum pubicum I Gimbemat's ligament Ijg, lacunars (Gimbernati) Internal or deep abdominal ring^' Annulus inguinalis abdominalis » See note > to p. 390. ^ See note = to p. 390. ■> Or internal ivguinat aperture. Fig. 593. — Internal Muscles of the Region of the Hip, seen somewhat obliquely from Before : Iliopsoas Muscle, consisting of Two Parts — the Iliacus Muscle and the Psoas Magnus Muscle; Psoas Parvus Muscle, the Tendon of which becomes incorporated with the Iliac Fascia. Obturator Internus Muscle. Pyriformis and Quadratus Lumborum Muscles. Lacuna Vasorum, or Vascular Compartment, of the Space between Poupart's Ligament (Superficial Femoral Arch) and the Concave Iliopubic Margin of the Hip-Bone. Right Side. Musculi coxae — Muscles of the hip. THE MUSCLES OF THE LOWER EXTREMITY 345 Psoas magnus muscle (slips of origin from the bodies of the vertebrje I M y \ niiJLi Quadratus lumborum muscle i insertion into the twelfth rib) Twelfth rib Costi \II Psoas magnus muscle (slips of origin from the costal processes! M. p^oas majDr Quadratus lumborum muscle (slips of origin from the costal processes; Slips of origin of the internal oblique muscle of the abdomen Costal process Processus costarius Middle layer of the lumbar fascia, forming the posterior aponeurosis of the transversalis abdominis muscle Lii; lumli.jcostale Psoas magnus muscle ( slips of origin from the costal processes) M. psoas major Quadratus lumborum muscle (insertion into the crest of the ilium) Iliolumbar ligament Lig. iliolumhale Transversalis abdominis muscle M. trans\ersus abdominis Internal oblique muscle of the abdomen M. obliquusinternus abdominis External oblique muscle of the - abdomen M. obliquusexternusabdominis Surface of origin of the'' iliacus muscle Surface of origin of the gluteus '' medius muscle Surface of origin of the gluteus minimus- muscle Margin of the acetabulum Surface of origin of the iliopsoas muscle from the capsule of the hip-joint Tendon of insertion of the pyriformis muscle Insertion of the gluteus. medius muscle Great trochanter '' Trochanter major Insertion of the gluteus ' minimus muscle Partial insertion of the gluteus - maximus muscle into the gluteal ridge of the femur Origin in layers of the vastus extemus muscle Twelfth dorsal vertebra \ eitebra thoracal is XII. 'Intermediate crus of the vertebral portion of the diaphragm' *Crus intermedium partis lumbalis diaphragmatis Portion of the internal arched ligament "Internal crus of the vertebral portion of the diaphragm' *Crus mediale partis lumbalis diaphragmatis Intervertebral foramen Foramen intervertebrale Psoas magnus muscle (slips of origin from the bodies of the vertebrse and from the intervertebral discs) iM. psoas major Sacral promontory Promontorium Anterior superior spine of the ilium Spina iliaca anterior superior Tensor vaginse femoris or tensor fasciae femoris muscle M. tensor fascije latas ' Sartorius muscle (origin) ...Poupart's ligament (superficial femoral arch) Lig. inguinale (Pouparti) Eectus femoris muscle (origin) Pubic portion of the iliopectineal line Pecten ossis pubis Pectineus muscle (origin) .. Spine of the pubis Tuberculum pubicum - Adductor longus muscle (origin) Adductor brevis muscle (origin) ' -^Gracilis muscle (origin) '^ Obturator extemus muscle (origin) ^^ Adductor minimus muscle (origin)'- Obturator membrane or ligament Membrana obturatoria 'Adductor magnus muscle (origin)'- ' Quadratus femoris muscle (origin) Fk;. 594.— Attachment ok Muscles to thk Antekior Suki'ack ok ihk Luin:.\i< Vektkhk.I'; and ok the Hip-Bone Musculi coxae- Muscles of the hip. 44 346 THE MUSCLES OF THE LOWER EXTREMITY Promontory of the sacrum Promontorium Psoas magnus muscle. M. psoas major Iliacus muscle *Linea arcuata' Iliac fascia Fascia iliaca Poupart's ligament (superficial femoral archXi) Obturator canal Canalis obturatorius White line of the pelvic fascia Arcus tendineus m. levatoris am Pubic symphysis Symphysis ossium pubis Inferior or descending ramus of the pubis Ramus inferior ossis pubis Adductor longus muscle - Gracilis muscle Adductor magnus muscle (i) Lig. inguinale (Pouparti \ -. Sacro-iliac articulation ' Articulatio sacro-iliaca ' Pyrif ormis muscle M. piriformis v -. Fifth sacral vertebra (2) [S-j Sacrococcygeus anticus or ■ curvator coccygis muscle (3) -— First coccygeal vertebra Vertebra coccygea I. Anterior or small sacrosciatic ligament Lig. sacrospinosum Obturator fascia Fascia obturatoria - Posterior or great sacrosciatic ligament Lig. sacrotuberosum Falciform process Processus falciformis Tuberosity of the ischium Tuber ischiadicum Semitendmosus muscle ( ) Vertebra sacralis V. (j) M. sacrococcygeus anterior I The *Unea arcuata marks the attachment of the iliac fascia along the brim of the pelvis to the iliopectineal line, where it is insepar- ably blended with the obturator fascia. — Tr. Fig. 595. — Internal Muscles of the Region of the Hip, seen from the Inner Side, with THE Obturator Fascia and a Portion of the Iliac Fascia : Pyriformis Muscle ; the Two Parts of the Iliopsoas Muscle, viz.. Psoas Magnus and Iliacus Muscles. Proximal Extremities of the Internal Femoral or Adductor Muscles, showing their Mutual Relations. White Line of the Pelvic Fascia. Right Side. Musculi coxae— Muscles of the hip. THE MUSCLES OF THE LOWER EXTREMITY 347 Psoas magnus muscle M. Dsoas major Iliacus muscle - Obturator canal " T Canalis obturatorius- niopsoas muscle Small trochanter Trochanter minor Bursa of the pectineus muscle Bursa musculi pectinei Promontory of the sacrum Pi omen tori um Sacro-iliac articulation ''\ * ■ \ " Articulatio sacro-iliaca Pyriformis muscle M. piriformis Coccygeus or levator coccygis muscle Obturator intemus muscle Posterior or great sacrosciatic ligament Lig. sacrotuberosum Pectineus muscle 'riy to the tendon of the pectli its insertion, betw Fig. 596. — The Internal Muscles of the Region of the Hip, seen from the Inner Side, THE Obturator Fascia having been removed, and the Iliopsoas Muscle fully exposed UP TO ITS INSERTION INTO THE SMALL TROCHANTER: PyKIFORMIS AND OBTURATOR Inteknus Muscles. Bursa of the Pectineus Muscle. Musculi coxae--Muscles of the hip. 44—2 348 THE MUSCLES OF THE LOWER EXTREMITY Pyriformis muscle (divided and turned outwards) M. pirilormis Bursa of the pyriformis muscle' Bursa musculi piriformis Gluteus minimus muscle M. glutaeus minimus Troclianteric bursa of the gluteus minimus muscle- Bursa trochantenca m. glutaii ■ Anterior trochanteric bursa of the gluteus meaius muscle ^ Baiaa trochanLerica m. glut^ei Gluteus medius muscle (divided and turned outwards) M. gluteus medius Vastus intemus muscle M. vastus medialis Kectus femoris muscle (divided and turned upwards) rectus femoriS muscle^ sculi recti femoris I Iliopectineal bursa'"' Bursa iliopectinea Iliopsoas muscle (divided and turned downwards and inwards) Bursa of the iliopsoas tendon" Bursa iliaca subtendinea Mass of adductor muscles * The bursa of the pyriformis jiuiscle is situate beneath the tendon of that muscle clos 2 The trochanteric bursa of tlie gluteus inijtijiius inuscte is situate beneath the tendon 3 The anterior troclianteric bursa of the gluteus tncdius nnisclc is situate beneath the the front of the outer surface of the great trochanter. — Tr. '' The bursa of the rectus femoris muscle is situate between the anterior tetidinou: anterior inferior spine of the ilium.— Tr. ^ The iliopectineal bursa is situate beneath the iliopsoas muscle as it passes c of the hip-joint. It frequently communicates with the joint. — Tr. 6 The bursa of the iliopsoas tendon is situate between the tendon of the iliopsoas muscl -Tr. luscle close to its insertion. — Tr. part of the tendon of that muscle and IS head of the muscle and the lower part of the liopectineal eminence and the capsular ligament id the femur immediately above its Fig. 597. — The Burs^ situate beneath the Tendons of the Muscles of the Hip adjacent TO their Insertions. Iliopectineal Bursa. Right Side. Seen from Before. The distal extremities of the muscles have been drawn away from the bone to e.xpose the bursas, which have been ooened. Musculi coxae — Muscles of the hip. THE MUSCLES OF THE LOWER EXTREMITY 349 Anterior superior spine of the ilium Spina iliaca anterior superior Aponeurosis of the external oblique muscle of the abdomen Aponeurosis m. obliqui externi abJominis Poupart's ligament superficial femoral arch) Lig. inguinale (Fouparti Superiorcornu'— Cornu supi luia Vascular compartment Lacuna vasorum Falciform border ^Iargo falcifoimi^ Saphenous opening (publc portion of the fascia lata x 1 1 Pectineal fascia, or pubic portion of the fascia lata i j) Inferior cornu Cornu inferius Deep fascia of the thigh, or fascia lata superficial layer)- Superficial fascia 1 ascia superficialis External or superficial abdominal ring* \nnulus inguinalis subcutaneus Upper or internal pillar (3) Lower or external pillar (4) Gimbernat's ligament iji; lacunare (Gimbernati) Spine of the pubis Tuberculum pubicum Supensory ligament of the penis Lig. suspensorium penis (3) Crus superius (4) Crus inferius (i) Fos'ia ovflIis(LaiT fasctz latx) (2) Fascia prctinea ' The superior cornu o/llic saphenous opening passes completely to the inner side nf the femoral sheath to be attached to Gimbernat's ligament. This inner partof the superior cornu is termed the femoral ligament or Hey's ligament. — Tr. 2 The upper part of this portion of the fascia lata, lying to the outer side uf the saphenous opening, is termed the iliac portion of the /ascia tata.—'VK. 'Or external inguinal aperture. Fig. 598. — Deep Fascia of the Thigh or F"ascia Lata of the Right Side, seen from Before ; ITS Connexion with the Aponeurosis of the External Oblique Muscle of the Abdomen through its Attachment to Poupart's Ligament (Superficial F^emoral Arch). The External or Superficial Abdominal Ring (the External Inguinal Aperture), lying immediately above the Inner Extremity of Poupart's Ligament, which f"orms the Lower or External Pillar of the Ring. The Saphenous Opening (Fossa Ovalis) which forms the Femoral Aperture of the Femoral or Crural Canal. The Pubic Portion OF the Fascia Lata, or Pectineal Fascia, attached above to the Iliopectineal Line, forms the Floor of the Saphenous Opening, and, passing outwards, dips deeply beneath the Falciform Border of the Iliac Portion of the Fascia Lata and behind the Femoral Vessels to form the Back of the Femoral or Crural Sheath, by Means of which it is continued into the Iliac Fascia. The vessels that descend through the vascular comparlment or lacuna vasorimi benc.itli Poupart's ligament (femoral artery and femoral vein) have been removed. Musculi coxae et femoris— Muscles of the hip and thigh. 350 THE MUSCLES OF THE LOWER EXTREMITY 'IhJ Iliacus muscle Anterior superior spine of the ilium Spina iliaca anterior superior Tensor vaginae femoris or tensor fasciae femoris muscle M. tensor fascia; latse Sartorius muscle Rectus femoris muscle Vastus internus muscle M. vastus medialis Deep fascia of the thigh, or fascia lata Prepatellax subcutaneous bursa Bursa pr^patellaris subcutanea Infrapatellar subcutaneous bursa Bursa infrapatellaris subcutanea Psoas magnus muscle W. psoas major Poupart's ligament (superficial femoral arch) Lig. inguinale (Pouparti) Iliopectineal fossa Fossa iliopectinea Pectineus muscle — Adductor longus muscle Gracilis muscle ill Internal intermuscular septum Septum intermusculare mediale Fig. 599. — Anterior and Internal Muscles of the Right Thigh, as seen from Before with THE Limb rotated outwards : Sartorius Muscle ; Portions of the Quadriceps Extensor Cruris Muscle, of the Internal Femoral or Adductor Muscles, and of the Iliopsoas Muscle. *Iliopectineal Fossa. The Triangular Area, the Base of which is formed BY Poupart's Ligament, the Sides by the Sartorius and Adductor Longus Muscles, respectively, and the Floor by the Iliopsoas and Pectineus Muscles, is known as Scarpa's Triangle (Fossa Scarpa Major, Trigonum Femorale). Prepatellar and Infra- patellar Subcutaneous Burs^e. In the region of the knee the fascia lata has not been removed. Musculi femoris— Muscles of the thigh. THE MUSCLES OF THE LOWER EXTREMITY 351 Anterior superior spine of the ilium Spina iliaca anterior superior Iliopsoas muscle Sartorius muscle Tensor vaginsB femoris or tensor fascisB femoris muscle il. tensor fascia; latae Rectus femoris muscle Vastus intemus muscle M. vastus medialis ^Poupart's ligament (superficial femoral arch) Lig. inguinale (Pouparti) Pubic symphysis bymphysis ossium pubis Inferior or descending ramus of the pubis Ramus interior ossis pubis -Pectineus muscle -Adductor maguus muscle Adductor brevis muscle Gracilis muscle Adductor longus muscle Semimembranosus muscle Semitendinosus musciD Entrance to the lower part of Hunter's canal Canalis adductorius (Hunteri) Internal intermuscular septum Septum intermusculare mediale Semimembranosus muscle Sartorius muscle Aponeurotic expansion of the tendon of the gracilis muscle Aponeurotic expansion of the tendon of insertion of the sartorius muscle Pes anserinus' ■ Pts /I /iserinus.— The tendon of insertion of the sartorius muscle sends off from its upper border an aponeurotic expansion to join tiiat of Ihc common extensor over the front of the capsule of the knee-joint, and Irom its lower border another to the deep fascia of the leg ; immediately below and behind this latter is a similar aponeurotic expansion from the ic'.don of insertion of the gracilis mufcle to the deep fascia of the leg. From the resemblance of the aponeurotic expansions of the sartorius tendon to the foot of a goose, it is called by the author /« anserinus, but it is to he noted that this name is given by English anatomists to an entirely different strnclure— to wit, the plexus formed in the substance of the parotid gland and on the side of the face by the freely communicating twigs of the temporofacial and cervicofacial branches of the facial nerve, known also as the " parotid plexus " (see l''ig. 1314, p. 871, sect. vi. of this work).— Tr. Fig. 600.— Anterior and Internal Muscles of the Right Thigh, as .seen from Hefore with the Limb ROTATED outwards, 'IHE SARTORIUS MUSCI.E HAVING BEEN REMOVED. OF THE QUADRICEPS EXTENSOR Cruris Mu.scle, we see the Long Head, the Rectus Femoris Muscle, and the Inner Head, the Vastus Internus Muscle: of the Internal Femoral or Adductor Mu.scle.s, we seethe Gracilis, Adductor Longus, Adductor Urevis, and Pectineus Muscles. Behind the Gracilis Mu.scles we see Portions of the Posterior Femoral or Hamstring Mu.scles: Skmimemhranosus Muscle and Semi- tendinosus Muscle. Benfath the Sartorius Muscle and between the Vastus Internus Muscle, ON THE Outer Side, and the Adductor Longus (auovr) and the Adductor Magnus (below), on the Inner Side, lies Hunter's Canal (Canalis Adductorius Huntkri), the Fa.scial Roof of which has BEEN removed EXCEPT FOR A SHORT SFACE AT THE LOWER END OK THE CANAL. Musculi femoris Muscles of the thigh. 352 THE MUSCLES OF THE LOWER EXTREMITY Surface of origin of the gluteus medius muscle Surface of origin of the gluteus minimus muscle Rectus femoris muscle (proximal extremity) Tendon of the gluteus medius muscle Tendon of the gluteus minimus muscle Vastus intemus muscle ivi. vastus raedialis Crureus muscle M. vastus intermedius vastus extemus muscle- M. vastus lateralis Quadriceps extensor cruris muscle Rectus femoris muscle - (distal extremity) \ Biceps flexor cruris muscle M. biceps femoris Crest of the ilium Crista iliaca Anterior superior spine of the ilium Spina iliaca anterior superior _ Iliopsoas muscle M. iliopsoas Poupart's ligament (superficial femoral arch) Lig. inguinale (Pouparti) Pubic symphysis Symphysis ossium pubis -Pectineus muscle Adductor brevis muscle Adductor longus muscle Adductor magnus muscle Fig. 6oi. — Anterior and Internal Muscles of the Right Thigh, with the Limb in the Normal Position, the Sartorius, Gracilis, and Rectus Femoris Muscles having been Removed. Seen from Before. Vastus Externus, Crureus, and Vastus Internus Muscles, the Outer, Middle, and Inner Heads of the Quadriceps Extensor Cruris Muscles; Adductor Longus and Adductor Brevis Muscles, and the Inner Portion of the Adductor Magnus Muscle ; Pectineus Muscle. Musculi femoris — Muscles of the thigh. THE MUSCLES OF THE LOWER EXTREMITY 353 Crest of the ilium Crista iliaca Tensor vaginae femoris or tensor fasciae femoria muscle (origin) — M. tensor fasciae lata; Gluteus minimus muscle M. glutafus minimus Rectus femoris muscle (tendon of origin) M. rectus ienirtris Capsular ligament of the hip-joint Capsula articularis Gluteus medius muscle (insertion) M. glutaeus medius Great trochanter Trochanter major Upper limit of the origin of the vastus extemus muscle Quadriceps extensor cruris muscle ■ M. quadriceps femoris Quadriceps extensor cruris muscle Upper limit of the origin of the crureus muscle Superficial layers of the vastus extemus muscle Deep layers of the vastus externus muscle Outer surface of the femur Facies lateralis femoris / Aponeurosis of insertion of the vastus extemus muscle Bundles of muscular fibres passing from the crureus to the vastus extemus muscle (divided) M. quadriceps femoris I Tendonof insertion of the rectus \ femoris muscle Fascia lata (iliotiblal band or ligament) Fascia lata (tractus ihotibialis) Head of the fibula Capitulum fibul i , Body of the fifth lumbar vertebra ' Corpus vertebra; lumbalis V. —Anterior superior spine of the ilium Spma iliaca anterior superior ~ Sartorius muscle (origin) Iliopsoas muscle Pubic ligament of Astley Cooper, or Cooper's ligament' 1-ig. piibicum ((■ooperi) Pectineus muscle (origin) Spine of the pubis Tuberculum pubicum Obturator canal Canalis obturatorius Obturator extemus muscle -Adductor brevis muscle Adductor longus muscle Crureus muscle \ M, vastus intermedins Vastus intemus muscle M. vastus medialis Common tendon for the crureus and vastus intemus muscles Vastus intemus muscle M. vastus medialis Bundles of muscular fibres passing from the vastus intemus muscle to the tendon of the rectus femoris muscle (which has been dividedl / Patella Patellar ligament, or infrapatellar tendon r ig. patelhc Tubercle of the tibia — Tuberositas tibi;e Quadriceps extensor cruris muscle M. quadriceps femoris Fig. 602.— Stratification of the Vastus Externus Muscle, as seen after the Removal OF the Rectus Femoris Muscle, the Layers of the Vastus Externus Muscle having been well separated from the Femur. Outer Limit of Origin of the Crureus ^Vastus Intekmedius) Muscle. Stratification of the Tendons (Aponeuroses) of the Vastus Externus, Crureus, and Rectus Fi:moris Muscles above the Knee-Joint. The thigh, which has been rotated inwards, is seen from before. The bundles of the vastus externus muscle that arise from the fascia lata are shown in Fig. 616. Musculi femoris — Muscles of the thigh. 45 854 THE MUSCLES OF THE LOWER EXTREMITY Capsular ligament of the hip-joint v- Capsula articularis Upper limit of the origin o the crureus muscle Crureus muscle M. "astus intermedin Vastus internus muscle (divided and turned forwards) Common tendon for the vastus internu: and crureus muscles Adipose tissue of the internal alar ligament (plica alaris medialis) Patella ligament, or infrapatellar tendon Lig. patellae Tendon of the sartorius muscle Tubercle of the tibia Tuberositas tibiae — Head of the femur Caput femoris Tendon of insertion of the iliopsoas muscle Small trochanter Trochanter minor Insertion by muscular fibres of the iliopsoas muscle Upper limit of the origin of the vastus internus muscle Vastus internus muscle (line of origin from the inner lip of the linea aspera) Inner surface of the femur Facies medialis femoris Deep fascia of the leg Fascia cruris Fasciculus of the subcrureus muscle Fasciculus m. articularis genu ,Tendon of insertion of the adductor magnus muscle with the internal intermuscular septum ,\ .Capsule of the knee-joint ''Capsula articularis genu jinsertion and aponeurotic expansion of the semimembranosus muscle _, Tendon of the gracilis muscle Tendon of the semitendiuosus muscle '/'JF B^"- ^"'''^^'^^1 surface of the tibia /^*^^jH Facies medialis tibiae --Popliteus muscle -^ Soleus muscle FiG. 603. — Inner Limit of the Origin of the Crureus (Vastus Intermedius) Muscle, and THE Blending of the Fasciculi of that Muscle with those of the Vastus Internus (Vastus Medialis) Muscle in their Insertion into the Deep Aponeurosis of the Quadriceps Extensor Cruris Muscle. Right Thigh, seen from Within. The vastus internus muscle has been divided longitudinally throughout its entire length, and has been turned fcrvards. Musculi femoris — Muscles of the thigh. VHE MUSCLES OF THE LOWER EXTREMITY 355 t^adriceps extensor cruris — muscle M. quadriceps femoris Subtendinous prepatellar — \ bursa ' Bursa prspatellaiis subtendinea Subfascial prepatellar bursa' Bursa prspatellaris subfascialis Patellar ligament, or infrapatellar tendon Lig. pateilse Subcutaneous bursa of the — tubercle of the tibia Bursa subcutanea tuberositatis tibiae Deep fascia of the thigh, or fascia lata Sartorius muscle Bursa propria of the sartorius muscle' Bursa musculi sartorii propria Deep fascia of the leg Fascia cruris ' The htrsa propria of the sartorius muscle is situate between the sartorius muscle at the point where the muscle become*; tendinous. U is to be distinguished from a mc - -I of the tendon of the sartorius, called by the autlior bttrsa anserina. See not' nd the upper part of the capsule of the knee-joint e distally situate bursa beneath the aponeurotic I to p. 362.-TR. Fig. 604.— Demonstration of Certain Burs^ in the Anterior Region of the Knee. Bursa Propria of the Sartorius Muscle. Subcutaneous Bursa of the Tubercle of THE Tibia. Region of the Right Knee, seen obliquely from Before and Within. The subfascial prepatellar Durs.i was opened by a longitudinal incision through the fascia lata over the front of the patella, and the subtendinous prepatellar bursa was opened by a longitudinal incision through the common tendon of the quadriceps extensor cruris muscle ("suprapatellar tendon) immediately above the patella. Musculi femoris — Muscles of the thign. 4S— 2 356 THE MUSCLES OF THE LOWER EXTREMITY Iliopsoas muscle Eectus femoris muscle Iliopectineal bursa- Bursa iliopectmea Iliopsoas muscle Pectineus muscle Grureus muscle Vastus extemus muscle Bsctus femoris muscle Patellar ligament, or infrapatellar tendon Lig. patellsE '-Peotineus muscle Gracilis muscle ■ Obturator extemus musde > Adductor brevis muscls Adductor longus muscle Adductor magnus muscle Opening in the adductor magnus muscle through ■which the femoral vessels pass into the popliteal space, forming the inferior orifice of Hunter's canal Hiatus adductorius --Internal intermuscular septum Septum intermusculare mediale .Vastus intemus muscle M. vastus medialis Bursa of the aponeurotic _expansion of the sartorius muscle^ Bursa anserina V4 Fig. 605. — Internal Femoral or Adductor Muscles, displayed by the Removal of the Sartorius, Gracilis, Pectineus, Rectus Femoris, and Vastus Internus Muscles, the Limb being rotated outwards. Right Thigh, seen from Before. Adductor Brevis and Adductor Longus Muscles ; Inner Portion of the Adductor Magnus Muscle,' WITH the Internal Intermuscular Septum, and the Opening (Hiatus Adductorius) through which the Femoral Vessels pass into the Popliteal Space. (This Opening constitutes the Inferior Orifice of Hunter's Canal.) Obturator Externus Muscle. Bursa of the Aponeurotic Expansion of the Sartorius Muscle (Bursa Anserina) (see note ^ to p. 362)- Musculi femoris — Muscles ot the thign. THE MUSCLES OF THE LOWER EXTREMITY 357 Pectineus muscle Obturator canal I Canalis obturatorius Obturator extemus muscle Iliopsoas muscle Pectineus muscle — Adductor brevis muscle Subcrureus muscle M. articularis genu Vastus intemus muscle M. vastus medialis Adductor longus muscle -Adductor brevis muscle -Inferior or descending ramus of the pubis Ramus inferior ossis pubis Quadratus femoris muscle Adductor brevis muscle Adductor magnus muscle Adductor longus muscle Openmg in the adductor magnus muscle through which the femoral vessels pass into the popliteal space, forming the inferior orifice of Hunter's canal Hiatus adductorius Internal intermuscular septum Septum intermusculare mediale Fig. 606. — Adductor Magnus Muscle with the Internal Intermuscular Septum and the Opening (Hiatus Adductorius) through which the Femoral Vessels pass into the Popliteal Space. (This Opening constitutes the Inferior Orifice of Hunter's Canal.) Right Thigh, seen from Before. Obturator Externus Muscle. Subcrureus Muscle. The quadriceps extensor cruris, pectineus, adductor longus, and adductor brevis muscles have been removed. The limb is in the position of external rotation. Musculi femoris— Muscles of the thigh. 358 THE MUSCLES OF THE LOWER EXTREMITY Posterior or great sacrosciatic ligament Lig. sacrotuberosum Tuberosity of the ischium Tuber ischiadicum Semitendinosus muscle. Pyntormis muscle— M piriformis Gemellus superior muscle' M gemellus superior ^.Obturator intemus muscle* M. obturator internus Great trochanter Trochanter major Gemelliis inferior muscle' M . gemellus inferior Quadratus femoris muscle Adductor minimus muscle'^ Adductor magnus muscle'^ ..Vastus extemus muscle M. vastus lateralis _.„Linea aspera of the femur Linea aspera femoris Biceps flexor cruris muscle (long head) M. biceps femoris (caput longum) —Biceps flexor cruris muscle (short head) M. biceps femoris (caput breve) Semimembranosus muscle Popliteal space (the ham)^. Fossa poplitea , „ .r n _. , . '^ ^ '"' ■ »'^ » Plantans muscle Gastrocnemius muscle (outer head) M. gastrocnemius (caput laterale) _Head of the fibula Gastrocnemius muscle (inner head) ( 1/ Capitulum fibulae M. gastrocnemius (caput mediale) I See note * to p. 340. = See note 2 to p. 345. Fig. 607. — Muscles on the Posterior and Outer Sides of the Right Thigh, the Limb BEING ROTATED INWARDS. SEEN FROM BEHIND. BlCEPS FlEXOR CRURIS MUSCLE ; SEMI- TENDINOSUS MuSCLE ; DiSTAL PORTION OF THE SEMIMEMBRANOSUS MuSCLE. RELATIONS OF THE Gastrocnemius Muscle to these Muscles. Popliteal Space (the Ham). Quad- ratus Femoris Muscle, with the Adductor Magnus Muscle {see note ^ above) in Contact WITH its Lower Border. Adductor Minimus Muscle (see note ^ above), not clearly SEPARABLE ABOVE FROM THE ADDUCTOR Magnus Muscle (see note ^ ubove). Vastus Externus Muscle, the Outer Head of the Quadriceps Extensor Cruris Muscle. Musculi femoris — Muscles of the thigh. THE MUSCLES OF THE LOWER EXTREMITY 359 Gemellus superior muscle Obturator intemus muscle'— Gemellus inferior muscle Obturator extemus muscle Biceps flexor cruris muscle (long head). M. biceps (emoris (caput longum) Semitendinosus muscle- Adductor magnus muscle Semimembranosus muscle- Internal intermuscular septum ... Septum intermusculare mediale Internal condyle of the femur- Condylus medialis femoris Gastrocnemius muscle ' See note • to p. 340. Pynformis muscle M piriformis Great trochanter Trochanter nia'or Quadratus femoris muscle Small trochanter Trochanter minor Adductor minimus muscle- Adductor magnus muscle- Vastus extemus muscle M. vastus lateralis Linea aspera of the femur Linea aspera femoris Biceps flexor cruris muscle (short head) M. biceps femoris (caput breve) Biceps flexor cruris muscle (long head) M. biceps femoris (caput longum) Popliteal surface of the femur Planum popliteum femoris Plantaris muscle Head of the fibula ('apitiilum fibulae Fig. 608. — Muscles at the Back of the Right Thigh, the Limb being rotated inwards, THE Long Head of the Biceps Flexor Cruris and the Semitendinosus Muscle having been removed. Seen from Behind. Semimembranosus Muscle; Short Head of the Biceps Flexor Cruris Muscle ; Adductor Magnus {see note - above) and Adductor Minimus {see note ^ above) Muscles; Vastus Externus Muscle. By the removal of the quadratus femoris muscle, the outer portion of the obturator extemus muscle has been exposed. Musculi femoris — Muscles of the thigh. 360 THE MUSCLES OF THE LOWER EXTREMITY Surface of origin of the gluteus maximus muscle Posterior or great sacrosciatic ligament I^ig. sacrotuberosum Tuberosity of the ischium Tuber ischiadicum Adductor magnus muscle' (origin^ Adductor minimus muscle' (origin) y Gracilis muscle (origin! ^ Adductor brevis muscle (origin) Pubic symphysis - Adductor loagas muscle (tenion of origin) '' Pectineus muscle (origin) Iliopsoas muscle (insertion) Pectineus muscle (tendon of insertion)' Adductor brevis muscle (tendon of insertion) ' Adductor longus muscle (tendon of insertion Adductor magnus muscle' (insertion) Vastus intemus muscle M. vastus medialis Opening In the adductor magnus muscle through which the femoral vessels pass into the popliteal space, forming the inferior orifice of Hunter's canal Hiatus adductorius Popliteal surface Planum popliteum Internal intermuscular septum (tendon of the adducbor magnus muscle) Septum intermusculare mediale Inner head of the — gastrocnemius muscle Tendon of the semimembranosus muscle — Posterior ligament of 'the knee-joint Lig. popliteum obliquum Common tendon of origin for the semitendinosus muscle and the long head of the biceps flexor cruris muscle ^ Tendon of origin of the semimembranosus muscle Quadratus femoris muscle (origin) ,- Gluteus medius muscle M. gluteus medius Gluteus maximus muscle (divided and turned outwards) M. glutreus maximus — Obturator externus muscle — Great trochanter Trochanter major —-Quadratus femoris muscle (insertion) Small trochanter Trochanter minor Adductor minimus muscle' (tendon of insertion) Tendmous insertion of the gluteus maximus muscle into the gluteal ridge Partial insertion of the gluteus maximus muscle into the fascia lata Deep fascia of the thigh, or fascia lata Vastus externus muscle M \ astus lateralis Short head of the biceps flexor cruris muscle (origin) Lmea aspera of the femur Lmea aspera femoris External intermuscular septum Septum intermusculare laterale -Plantaris muscle -Tendon of insertion of the biceus flexor cruris muscle ■ Outer head of the gastrocnemius muscle Head of the fibula Capitulum fibulae Popliteus muscle , Soleus muscle M. soleus Fig. 609. Attachment of Muscles (Origins and Insertions) to the Outer Aspect of the HiP-BONE AND TO THE POSTERIOR AsPECT OF THE FeMUR. RiGHT SiDE, SEEN FROM BeHIND. Musculi femoris — Muscles of the thigh. I THE MUSCLES OF THE LOWER EXTREMITY 361 Great sacrosciatic foramen Foramen ischiadicum maji s ^v^-^-^" Posterior or great sacrosciatic x-^'^ ligament Lig. sacrotuberosum Extremity of the coccyx Ape\ ossis coccygis Tuberosity of the ischium Tuber ischiadicum Surface of origin of the obturator extemus muscle Obturator canal Canalis obturatorius" Pubic symphysis .J^ Symphysis ossium pubis Spine of the pubis-'' y Tuberculum piibicum ^'- - — Insertion of the iliopsoas muscle' Insertion of the pectineus muscle into'' the pectineal line of the femur Upper limit of the origin of the vastus intemus muscle '"-Deep fasciculi of origin of the vastus extemus muscle Lower limit of the origin of the vastus intemus muscle Internal intermuscular septum . Septum intermusculare medial Inner head of the gastrocnemius muscle (origin) Posterior ligament of the knee-joint— ^ Lig. popliteum obliquum Semimembranosus muscle (tendon of insertion; Internal lateral ligament of__ the knee-joint Lig collaterale tibiale PopUteus muscle — M. popliteus Posterior superior spine of the ilium bpin-i ihici posterior superior Middle gluteal line /U S Middle curved line 1 1I1C1 ^'luti-a anterior Ma of the ilium \la ossis ilium' Great trochanter 1 rochanter major Upper limit of the origin of the vastus extemus muscle Small trochanter Trochanter minor Tendinous insertion of the gluteus maximus muscle into the gluteal ridge Inner surface of the femur Facies medialis femoris Origin of the vastus intemus muscle from the inner lip of the liuea aspera Outer surface of the femur Facies lateralis femoris Linea aspera of the femur Linea aspera femoris Origin of the vastus extemus muscle from the outer lip of the linea aspera Lower limit of the origin of the vastus extemus muscle _. Popliteal surface Planum popliteum Plantaris muscle (surface of origin) Outer head of the gastrocnemius muscle (origin) External lateral ligament of the knee-joint Lig. collaterale fibulare -Biceps flexor cruris muscle (tendon of insertion) Head of the fibula Capitulum fibula; The as an indeclinable nou English anatomists, h< nd I have followed him he when using Latin tern as in the section on Osteology, in writing aia c ology, generally decline iiiuin, speaking oi dor. Fig. 6io. — Attachment of Muscles OF (Origins and Insertions) to the Posterior Aspect THE Right Femuh. Musculi femoris- Muscles of the thigh. 46 362 THE MUSCLES OF THE LOWER EXTREMITY Semitendinosus muscle — Gracilis muscle— Sartoriua muscle ^=; Bursa of the aponeurotic expansion — of the sartorius muscle' Bursa anserina Popliteus muscle Deep fascia of the leg Fascia cruris Biceps flexor cruris muscle M. biceps femoris -Semimembranosus muscle Gastrocnemius muscle (inner head) Bursa of the imier head of the gastrocnemius muscle" Bursa m. gastrocnemii medialis Bursa of the semimembranosus muscle' Bursa m. semimembranosi Plantaris muscle Gastrocnemius muscle (outer head) ■ The l>m the aponeuroti note ' on sam passes more dt = The iur and the tendo tendon of ihe communicate ■ 3 The iui sa of ihe aponeurotic expansion of the sartorius muscle (called by the author bursa, anserina) is situate between the root of : expansion of the tendon of insertion of the sartorius muscle (^pes anserintts, according to Toldt, see Fig. 600, p. 35I; t page) and the subjacent tendons of insertion of the gracilis and semitendinosus muscles. A prolongs epiy between these latter tendons and the subjacent internal lateral ligament of the knee-joint. — Tr. !ao/ tlic inner head of the gastrocnemius muscle is situate between the inner head of origin of the gast 1 of the semimembranosus muscle. This bursa frequently communicates with the knee-joint. Higher inner head of the gastrocnemius muscle and the femur, there is usually a second, smaller synovial bursa nth the knee-joint.— Tr. of the semimembranosus muscle is situate between the tendon of insertion of the semimembranosus muscle and the 1 of the bursa nuscle p. between the which may also prominent upper margin of the gr( inserted. — Tr. the internal tuberosity of the tibia into which the ainly Fig. 611. — Region of the Knee, seen obliquely from Behind and Within. Right Limb. BuRS^ (Subtendinous Mucous Burs^) in the Inner Part of the Posterior Region OF the Knee, as seen after Division of the Inner Head of the Gastrocnemius Muscle : Bursa of the Inner Head of the Gastrocnemius Muscle, Bursa of the Semi- membranosus Muscle, Bursa of the Aponeurotic Expansion of the Sartorius Muscle (Bursa Anserina). Bursse mucosae regionis genu posterioris — Bursse of the posterior region of the knee. THE MUSCLES OF THE LOWER EXTREMITY 363 Semimembranosus muscle Inner head of the gastrocnemius muscle— Bursa of the inner head of the - gastrocnemius muscle' Bursa m. gastrocnemii medialis Popliteus muBcle- BuTsa of the popliteus muscle Bursa m. poplitei 'Popliteal canal' *Canalis popliteu Short head of the biceps flexor cruris muscle Caput breve m. bicipitis femoris Long head of the biceps flexor cruris muscle Caput longum m. bicipitis femoris Plantaris muscle Bicipitogastrocnemial bursa* I ursa bicipitOKastrocnemialis Outer head of the gastrocnemius muscle C iput laterale m. gastrocnemii Bursa of the outer head of the gastrocnemius muscle^ Bursa m. gastrocnemii lateralis Inferior bursa of the biceps flexor cruris muscle" Bursa m. bicipitis femoris inferior Tendinous arch of the soleus muscle' Arcus tendineus m. solei PeroneuB longus muscle M perona;us longus Soleus muscle ' See note = to p. 362. » The liursa 0/ the popliteus muscle (so-called) is an expansion of the synovial cavity of the knee-joint passing downwards between the tendon of origin of the popliteus muscle and the back of the outer tuberosity of the tibia. —Tk. 3 •Popliteal Canal. — Wni name is not used by English anatomists. It is given by the author to the space beneath (anterior to) the tendinous arch of the soleus muscle (see note 7 on this page) through which the posterior tibial vessels and nerve pass from the popliteal space tieneath the soleus muscle. — Th. ■I The bicipitogastrocnemial bursa is situate between the biceps flexor cruris muscle and the outer head of the gastrocnemius muscle. — Tr. . . ^ , L J r u i The bursa 0/ tlu outer head 0/ the gastrocnemius muscle is situated beneath the tendon of origin of the outer head ol the gastroc- nemius muscle, between that tendon and the femur. — Tk. ' The inferior bursa of the iicefs fle;cc lateral ligament of the knee-joint. — Fk. 7 The tendinous arch of the soleus muscle, passing from the upper part of the back of the fibula obliquely downwards and inwards to the upper part of the back of the tibia, arches over the tibial vessels and i ' ^ ., - • _•- -^ -1- jji.. muscle. -Tk. : muscle is situate between the tendon of insertion of that muscle and the external ; for the origin of the middle fibres of the soleus Fig. 612.— Region of the Knee, seen from Behind. Right Limb. Burs^i (Subtendinous Mucous BuRs.E) IN the Outer Part of the Posterior Region of the Knee, as seen AFTER Removal of Both Heads of the Gastrocnemius Muscle and of the Plantaris Muscle: Bicipitogastrocnemial Bursa, Bursa of the Outer Head of the Gastrocnemius Muscle, Inferior Bursa of the Biceps Flexor Cruris Muscle, Bursa of the Popliteus Muscle, Bursa of the Inner Head of the Gastrocnemius Muscle. Tendinous Arch of the Soleus Muscle, and beneath it (anteriorly) the Entrance to the •Popliteal Canal. Bursae mucosse regionis genu posterioris— Bursae of the posterior region of the knee. 46 — 2 364 THE MUSCLES OF THE LOWER EXTREMITY Head of the fibula Capitulum fibulx Anterior (peroneal) intermuscular septum Septum intermusculare (fibulare) anterius Deep fascia of the leg Fascia cruris Tubercle of the tibia Tuberositas tibise — - Internal surface of tlie tibia Facias medialis tibise Anterior border of the tibia Crista anterior tibiae Tibialis anticus muscle M. tibialis anterior Extensor longus digitorum pedis muscle M. extensor digitorum longus I Extensor longus vel extensor proprius hallucis muscle- M. extensor hallucis longus Anterior annular ligament of the ankle, or ligameutum lambdoideum Lig. cruciatum cruris Extensor brevis hallucis muscle- M. extensor hallucis brevis Peroneus tertius muscle IVI peronseus tertius External malleolus . Malleolus lateralis *Bursa of the sinus of the tarsus *Bursa sinus tarsi "Inferior retinaculum of the peronei tendons' -' "Retinaculum mm. peronaiorum inferius Extensor brevis digitorum pedis muscle^ M. extensor digitorum brevis Peroneus longus tendon ' M. peronseus longus Peroneus brevis tendon M. peronaeus brevis Abductor minimi digiti pedis muscle M. abductor digiti quinti *Oppouens minimi digiti pedis muscle *M. opponens digiti quinti » Immediately behind and below the external malleolus the tendons of the peroneus longus and brevis muscles are contained in a single synovial sheath, tlie fibrous strand which binds ihem down, passing from the point of the outer malleolus to the outer side of the calcaneum, being called by the author retinaculum mm. perom^ojiim supcrncs (see Fig. 615, p. 366), and by English anatomists the external annular ligament of the ankle. ]\Iore distally, on the outer side of the calcaneuin, each tendon has its own sheath, the two being separated by a fibrous septum and by the trochlear process or peroneal spine of the calcaneum, when that process exists. The fibrous band which binds the two tendons to the calcaneum has received no special name ix' ^m English anatomists, but is called by the author retinaculum mm. ferono'oriini in/crius (xn Fig. 613, supra, Fig. 615, p. 366, and Fig. 621, p. 372).— Tr. 2 By many English anatomists the e.xtcnsor brez'is hallucis muscle is regarded, not as an independent muscle, but merely as the inner- most slip of the extensor bre:ns digitorum pedis muscle, and under these circumstances the extensor lo7igus hallucis muscle is termed extejtsor profrius hallucis. — Tr. . 3 The name opf>oncns minimi digiti {pedis') is sometimes given to tbat portion of the Jlexor brevis minimi digiti pedis muscle which is inserted into the fifth metatarsal bone (the bulk of the muscle being inserted into the base and external border of the proximal phalan.x. Occasionally (3*s per cent.) this porli')n of the muscle is entirely separate from the rest ; while somewhat more frequently (lo per cent.) the insertion of the flexor brevis minimi digiti into the metatarsal bone is entirely wanting. — Tr. Fig. 613. — Muscles on the Front of the Right Leg: Tibialis Anticus Muscle; Extensor Longus Digitorum Pedis Muscle, with the Peroneus Tertius Muscle : Extensor Longus vel Extensor Proprius Hallucis Muscle (see note 2 above). Anterior (Perone.^l) Intermuscular Septum. Extensor Brevis Digitorum Muscle {see 7iote ^ above). BURSA OF THE SiNus OF the Tarsus. That portion of the deep fascia of the leg from which numerous fasciculi of the two first-named muscles arise has been retained, also that portion which covers the peronei muscles on the outer side of the leg, and the anterior annular ligament of the ankle (ligamentum lambdoideum, ligamentum cruciatum cruris). Musculi cruris — Muscles of the leg. THE MUSCLES OF THE LOWER EXTREMITY 365 Head of the fibula Capitulum fibulae Peroneus brevis muscle M. peronaeus brevis Extensor longus vd extensor proprius hallucis muscle' M. extensor hallucis longus Interosseous membrane, or ligament, of the leg Membrana interossea cruris Extensor longus digitorum _ pedis muscle M. extensor digitorum longus Fimdiform ligament- I-ig. fundiforme pedis Extensor brevis digitorum pedis muscle M. extensor digitorum brevis Tubercle of the tibi? Tuberositas tibis Anterior border of the tibia Crista anterior tibiae Tibialis anticus muscle M. tibialis anterior Internal surface of the tibia Facies medialis tibiae Anterior annular ligament of the ankle, or Ugamentum lambdoideum (divided) Lig cruciatum cruris 5l Extensor brevis hallucis muscle' M. extensor hallucis brevis > P- 364- The futidi/onit ligamtnt of Relzius is the name given to the single outer half of the •<-shaped lower band of th ligament of the ankle ; attached externally to the calcaneum, it projects upwards and inwards, forming a loop th of the extensor longus digitorum pedis and peroneus tertius muscles pass from the front of the leg to the di terior annular L-h the tendons of the foot.— Tr. Fig. 614. — Muscles on the Front of the Right Leg, the Extensor Longus Digitorum Pedis and Peroneus Tertius Muscles having been removed: Extensor Longus vel Extensor Proprius Hallucis Muscle ; Tibialis Anticus Muscle. By the removal of the peroneus longus muscle, the fleshy belly of the peroneus brevis muscle has been laid bare. The anterior annular lij,'ament uf the ankle (lij,'anientum lainbdoidcutii, li^jamentuin cruciatum cruris) has been divided between the tendons of the extensor lonjjus diyitortim pedis and the extensor longus tiI extensor proprius hallucis muscles, and the outer portion of this ligament has been turned downwards, in order to demonstrate the loop of the fundiform iiKainent of Retzius (sre /7o/^ -rt^az/i;) surrounding the tendons of the extensor longus digitorum pedis and peroneus tertius muscles. Musculi cruris Muscles of the leg. 366 THE MUSCLES OF THE LOWER EXTREMITY External lateral ligament of the knee-joint . _ Lig. collaterale iibulare Tendon of the popliteus muscle y^M Tendo m. poplitei §f\ Head of the fibula '« ^ Capitulum fibula; Peroneua longus muscle M. peronaeus longus Deep fascia of the leg Fascia cruris Peroneus brevis muscle M. peronaeus brevis Tendo Achillis Tendo calcaneus (Achillis) External annular ligament of the ankle^ Retinaculum mm. peronasorum superius 'Inferior retinaculiim of the peronei tendons' ^Retinaculum mm. peronaeorum inferius Patella Patellar ligament, or infrapatellar tendon Lig patellae Deep infrapatellar bursa Bursa infrapatellaris profunda Superior annular ligament of the ankle, or upper band of the anterior annular ligament of the ankle Lig. transversum cruris Anterior annular ligament of the ankle, or ligamentum lambdoideum Lig cruciatum cruris Abductor minimi digiti muscle M. abductor digiti quinti > See note ^ to p. 364. 2 According to English insertion. — T 1? . , \.\i& fciuoral attachment of the poplil Deep fascia of the dorsum of the foot Fascia dorsalis pedis origin of th id the tibial attachment its Fig. 615. — Muscles on the Outer Side of the Right Leg: Peroneus Longus Muscle; Peroneus Brevis Muscle. Tendon of Insertion of the Popliteus Muscle {see note - above). Deep Infrapatellar Bursa. Deep Fascia of the Leg and Deep Fascia OF the Dorsum of the Foot. Superior Annular Ligament of the Ankle (Ligamentum Transversum Cruris) and Anterior Annular Ligament of the Ankle (Ligamentum Lambdoideum, Ligamentum Cruciatum Cruris). Musculi cruris — Muscles of the leg. THE MUSCLES OF THE LOWER EXTREMITY 367 Deep fascia of the thigh, or " fascia lata, turned outwards Fascia lata i'ascicali of the vastus extemus muscle ' arising from the fascia lata - Vastus extemus muscle M \astus lateralis External condyle of the femur Condylus lateralis femoris Insertion of the popliteus muscle' External lateral ligament of the knee-joint Lig. coUaterale fibulare Head of the fibula Capitulum fibula- Aperture for the passage of the external popliteal nerve Anterior (peroneal) intermuscular septum Septum intermusculare (fibulare) anterius Surface of origin of the peroneus lougus muscle Surface of ongin of the extensor longus digitorum pedis muscle Capsule of the knee-joint Capsula articularis genu Patellar ligament, or infrapatellar tendon Ligamentum patellae Aperture for the passage of the anterior tibial artery between the attachments of the tibialis anticus muscle to the tibia and fibula respectively Tubercle of the tibia Tuberositas tibiae Surface of origin of the tibialis anticus muscle Interosseous membrane, or ligament, of the leg Membrana interossea cruris Surface of origin of the extensor longus vel extensor proprius hallucis muscle- Anterior border of the tibia Crista anterior tibia? Surface of origin of the peroneus brevis muscle Origin of the peroneus tertius muscle External surface of the tibia Facies lateralis tibia; Fasciculi of the tibialis anticus muscle arising from the fibula Anterior border of the fibula Crista anterior fibuia; Tendo Achillis Tendo calcaneus (Achillis) Tuberosity of the calcaneum Tuber calcanei 'Inferior retinaculum of the peronei tendons' •kelinaculum mm perona-orum inferius Tendon of the peroneus longus muscle • Insertion of the peroneus brevis muscle Deep limb of the outer portion of the lower band of the anterior annular ligament of the ankle^ Crus prolundum lig, cruciati cruris Origin of the extensor brevis digitorum pedis muscle- Calcaneocuboid articulation- Articulatio calcaneocuboidea Insertion of the peroneus tertius muscle Origin of the dorsal interosseous muscles Insertion of the extensor brevis hallucis muscle- Insertion of the extensor longus vel extensor proprius hallucis muscle- 4 Thi» is ihe deep limb of iht: /ittldi/o and peroneus tertiu!^ riiu-sclcs (see rig. 614, p. 365, and Sec note ' to p. 364. ligaiitent o{ Retzius, the loop surrounditiK tht 1 same p>gc).— Tk. 1 See note » to |3. 364. xleiisor longus digitorum pedis Fig. 616. — Origin of Muscles from thk Front and Outer Side of the Leg and from the Dorsum of the Foot. Fasciculi of the Vastus Externus Muscle arising from the Fascia Lata. Musculi cruris Muscles of the leg. 368 THE MUSCLES OF THE LOWER EXTREMITY Internal intermascular septum - Septum intermusculare mediale Internal condyle of the femur Condylus medialis femoris Inner head of the gastrocnemius muscle - Caput mediale m. gastrocnemii Popliteal surface of the femur Planum popliteum femoris Plantaris muscle Outer head of the gastrocnemius muscle Caput laterale m. gastrocnemii ,4 Gastrocnemius muscle Tendon of tne plantaris muscle — Deep layer of tTie deep fascia of the leg, between the gastrooremius and soleus muscles and the deep posterior muscles of the leg Lamina profunda fasciae cruris .Superficial layer of the deep fascia of the leg Lamina superficialis fasciae cruris Fig. 617.— Superficial Groups of the Posterior Muscles of the Right Leg, First Portion : Gastrocnemius Muscle, constituting the Two Superficial Heads of the *Triceps Sur^ Muscle.^ Of the deep fascia of the leg, the lower portion of the superficial layer, which binds down the tendo Achillis, and the deep layer, which passes from side to side between the superficial and the deep posterior muscles of the leg, have been reiained. The plantaris muscle and its tendon are partially visible. ; The author divides the posterior muscles of the leg into three groups or layers, the first, most superficial, consisting of the gastroc- nemius muscle ; the second consisting of the plantaris and soleus muscles ; and the third, deepest, consisting of the popliteus, flexor longus J I'^v ' '''^'""' l""Eus digitorum pedis (or flexor perforans), and tibialis posticus muscles. This arrancement appears a very artificial one, and I have therefore adhered to the arrangement usually adopted by English anatomists, according to which the muscles are grouped in two layers only : a superficial, consisting of the gastrocnemius, soleus, and plantaris muscles ; and a deep, consisting of the muscles already ""'""'■"■'—' -s making up the author's third layer.— Tr. 2 Triceps Surte Muscle. — This name is given by the nuscle. The name is not usua'.ly employed in England.— utho Tr. I the gastrocnemius and soleus, considered j ngle three-headed Musculi cruris— Muscles of the leg. THE MUSCLES OF THE LOWER EXT REM FT Y 369 Semimembranosus muscle -._„ Inner bead of the gastrocnemius muscle Caput mediale m, gastrocnemii Bursa of the inner head of the gastrocnemius muscle' Bursa m. jjastn.^cnemii medialis Posterior ligament of the knee-joint Lig. popliteum obliquum _ Biceps flexor cruris muscle M. biceps femoris Outer head of the gastrocnemius musci? Caput laterale m. gastrocnemii - Plantaris muscle Popliteus muscle --Soleus muscle -Gastrocnemius muscle Tendon of the plantaris muscle — Deep layer of the deep fascia of the leg, between the gastrocnemius and soleus muscles and the deep posterior muscles of the leg Lamina profunda fasciae cruris Tendo AchiUiEi Tendo calcaneus (Achillisj Fig. 6i8.— Superficial Group of the Posterior Muscles of the Right Leg, Second Portion (see note ' top. 368), as seen after the Removal of the Two Superficial Heads of the *Triceps SuR^c Muscle {i.e., the Upper Part of the Gastrocnemius Muscle): Soleus Muscle; Plantaris Muscle. Tendo Achillis, the Common Tendon of the Three Heads of the •Triceps Sur^ Muscle (i.e., the Tendon formed hy the Union of the Flat Tendons of the Gastrocnemius and Soleus Muscles). Of the Deep Group of Posterior Muscles OF the Leg, the Popliteus Muscle is partly visihle. Deep Layer of the Deep Fascia of the Leg, which passes from Side to Side between the Superficial and the Deep Posterior Muscles of the Leg. Musculi cruris— Muscles of the leg 47 370 THE MUSCLES OF THE LOWER EXTREMITY Inner head of the gastroonemiu muscle Caput mediale m. gastrocnemii Posterior ligament of the knee-join Lig. popliteum obliquum Bursa of the semimembranosus muscle Bursa m. semimerabranosi Popliteus muscle Semimemhranosus muscle- Tibialis posticus muscle M. tibialis posterior Flexor longus digitorum pedis muscle- | M. flexor digitorum longus Internal malleolus Malleolus mediahs Internal annular ligament of the ankle Lig. laciniatum . Outer head of the gastrocnemius muscle Caput laterale m. gastrocnemii External lateral ligament of the knee-joint Lig. collaterale fibulare Bursa of the popliteus muscle* — Bursa m. poplitei Head of the fibula Capitulum fibulas Flexor longns hallucis muscle M. flexor hallucis longus Deep fascia of the leg Fascia cruris Posterior process of the astragalus Processus posterior tali Bursa of the tendo Achillis^ Bursa tendinis calcanei (Achillis) ' See note 3 to p. 362. 4 The Ifursa o/thc tendo Achillis i 3 See note = to p. 363. - Ot Jlcxor pcr/oratis •mM%t^^. 3 See note = to p. between that tendon and the upper part of the tuberosity of the calcaneum. — ^Tr Fig. 619.— Deep Group of the Posterior Muscles of the Right Leg {see note ^ top. 368), as see .\FTER THE REMOVAL OF ALL ThREE HeADS OF THE ^TRICEPS SUR.E MuSCLE (THAT IS, OF TH Gastrocnemius and Soleus Muscle), the Plantaris Muscle, and the Deep Layer of th Deep Fascia of the Leg, which covers the Deep Muscles beneath the Gastrocnemii AND bOLEUs Muscles: Flexor Longus Hallucis Muscle; Tibialis Posticus Muscle; Flexo longus Digitorum Pedis Muscle {see note 2 above); Popliteus Muscle. Bursa of the Tend achillis, Bursa of the Popliteus Muscle, Bursa of the Semimembranosus Muscle. In the region of the peronei muscles the deep fascia of the leg. with the posterior (peroneal) inter- muscular septum, has been retained. Musculi cruris— Muscles of the leg. THE MUSCLES OF THE LOWER EXTREMITY 371 Internal tuberosity of the tibia-- Condylus medialis tibis Site of insertion of the semimembranosu; muscle Head of the fibula Capitulum fibulas Entrance to the *popIiteal canal' Surface of origin- of the popliteus muscle Inner Jlne of origin of the soleus muscle Tendon of origin for the tibialis - posticus and Sexor longus digitorum pedis muscles' ^Upper line of origin of the soleus muscle ■""Tendinous arch of the soleus muscle' Arcus tendineus m. solei Aperture in the upper part of the interosseous "membrane, between the attachments of the tibialis posticus muscle for the passage of the anterior tibial artery -Posterior surface of the fibula Fades posterior fibula: -Outer line of origin of the soleus muscle v^ Surface of origin of the tibialis posticus muscle Surface of origin of the flexor longus- digitorum pedis muscle' Internal border of the tibia - MargO' medialis tibise Posterior surface of the tibiaC:^ Facies posterior tibia; Aperture for the passage of the tendon of the tibialis posticus muscle Lower limit of the origin of the flexor . longus digitorum pedis muscle Tendon of the tibialis posticus muscle -~ Tendon of the flexor longus digitorum - pedis muscle' Plantar nerves and arteries^' Nn. et Aa plantares Internal annular ligament of the ankle - Lig. laciniatum Tendon of the plantaris muscle' _ Internal border of the fibula Crista medialis fibulas — Surface of origin of the flexor longus hallucis muscle --Posterior (peroneal) intermuscular septum Septum intermusculare (fibulare) posterius --Lower limit of the origin of the tibitdis posticus muscle Feroneus brevis muscle M. peronjeus brevis -Tendon of the peroneus longus muscle Tendon of the flexor longus hallucis muscle "Ji^ Astragalocalcaneal articulation iriffl Articulatio talocalcanea Posterior surface of the tuberosity of the calcaneum Insertion of the tendo Achillis Abductor hallucis muscle ' See note 3 to p. 361, n p. 36,. ' See no'e ' 10 p. 366. _ I for the poslerior tibial nerve and artery 10 divide the internal annular ligament of the ankle. — Tr. 5 Sec note 7 to p. 363. j^. 3 Or Jlexor ptr/oraHS muscle, the external and internal plantar unlit they have passed beneath Fig. 620.— Surfaces of Origin of the Posterior Muscles of the Leg. Musculi cruris— Muscles of the leg. 47—2 372 THE MUSCLES OF THE LOWER EXTREMITY Peroneus tertius muscle M. peronseus tertius Synovial sheath of the tendons of the peroneus longus and peroneus brevis muscles Vagina tendinum mm. peronjEorum communis External annular ligament of the ankle^ Retinaculum mm. peronaeoru superius Inferior retinaculiun of the peronei tendons' "" Retinaculum mm. peronaeorun inferius Extensor brevis digitorum pedis muscle- M. e.xtensor digitorum brevis Abductor minimi digiti pedis muscle <^^ M. abductor digiti quinti Opponens minimi digiti pedis muscle M. opponens digiti quinti Superior annular ligament of the ankle, or upper band of the anterior annular ligament of the ankle Anterior annular ligament of the ankle, or ligamentum lambdoideum Synovial sheath of the tendon of the tibialis antious muscle Vagina tendinis m. tibialis anterioris Synovial sheath of the tendons of the extensor longus digitorum pedis and peroneus tertius muscles Vagina tendinum m. extensoris digitorum pedis longi — Sjmovial sheath of the tendon of the extensor longus ( t/proprius)hallucis muscle \ agma tendinis m. extensoris hallucis longi Extensor brevis hallucis muscle- M extensor hallucis brevis > See note ' to p. 364. = See note = to p. 364. 3 See note 3 to p. 364. Fig. 621. — Muscles of the Dorsum and of the Outer Border of the Foot : Extensor Brevis Digitorum Muscle {see note '^ to p. 2,(>^) ; Extensor Brevis Hallucis Muscle {see note^ to p. ^6/[) ; Abductor Minimi Digiti Pedis Muscle; Opponens Minimi Digiti Pedis Muscle {see note ^ to p. 364). Synovial Sheaths of the Tendons on the Dorsum of the Foot and in the External Retromalleolar Region, as seen after Injection with Strong Alcohol. Retinacula Tendinum Musculorum Perin^orum, Superius et Inferius (External Annular Ligament of the Ankle and Inferior Retinaculum OF the Peronei Tendons — see note ^ to p. 364). Right Foot. Musculi pedis — Muscles of the foot. THE MlSCLES of THE LOWER EXTREMITY 373 Fundifonn ligament of Eetzius ideep limb Lig. fundiforme pedis (crus profundum) Extensor brevis digitorum pedis muscle (the distal extremity having been removed) M. extensor digitorum brevis Abductor ininimi digiti pedis muscle . M abductor digiti quinti Tendon of the peroneus brevis muscle Abductor minimi digiti pedis muscle M. abductor digiti quinti Deep fascia of the leg Fascia cruris Anterior annular ligament of the ankle, or lig^amentum lambdoideum Lig. cruciatum cruris Tendon of the extensor longus {rel proprius) hallucis muscle - Tendon of the tibialis anticus muscle Dorsal interosseous muscles Mm. interossei dorsales Dorsal aponeuroses of the extensor tendons of the toes Aponeuroses tendinum extensorum digitorum pedis ' See note 2 to p. 365 and note 4 to p. 367. Fig. 622. — Muscles of the Dorsum of the Foot, after Removal of the Tendons of the Long and Short Extensors of the Toes and the Superficial Limb of the Fundi- FORM Ligament of Ret2ius. Partial Origin of the Extensor Brevis Digitorum Pedis Muscle from the Deep Limb of the Fundiform Ligament of Retzius. Dorsal Interosseous Muscles. Aponeurotic Expansions of the Extensor Tendons on the Dorsal Surf.\ce of the Toes, Right Foot. Muscuii pedis — Muscles of the foot. 374 THE MUSCLES OF THE LOWER EXTREMITY Tendon of the plantarlg muscle Tendo ra. plantaris Tendo Achillis Tendo calcaneus (Achillis) Deep layer of the deep fascia of the leg, passing from side to side of the limb between the super- ficial and the deep posterior muscles Lamina profunda fasciae cruris Superficial layer of the deep fascia of the leg Lamina superficialis fasciae cruris r Subcutaneous bursa of the internal J malleolus (Bursa subcutanea malleoli medialis Internal annular ligament of the ankle Lig. laciniatum Subcutaneous bursa of the calcaneum Bursa subcutanea calcanea Subcutaneous fat of the sole of the foot , Panniculus adiposus plantae Skin of the sole of the foot Cutis plantse Abductor hallucis muscle M. abductor hallucis Fig. 623— Internal Malleolar and Internal Retromalleolar Regions of the Right Foot, with the Superficial Layer of the Deep Fascia of the Leg, the Internal Annular Ligament of the Ankle, and the Subcutaneous Bursa of the Internal Malleolus. The Inner Border of the Foot with the Abductor Hallucis Muscle. Subcutaneous Bursa of the Calcaneum. Seen from the Inner Side. Musculi pedis — Muscles of the foot. THE MUSCLES OF THE LOWER EXTREMITY 375 Inner plantar furrow Sulcus plantaris medialis Inner plantar eminence Eminentia plantaris mediali -Outer plantar furrow Sulcus plantaris lateralis — Outer plantar eminence Eminentia plantaris lateralis Central plantar eminence Eminentia plantaris intermedia -Superficial transverse ligament of the toes Easciculi transversi aponeurosis plantaris Fig. 624. — Aponeurosis Plantaris, Deep Fascia of the Sole, or Plantar Fascia, with THE Superficial Transverse Ligament of the Toes ; the Fibres passing from the Plantar Fascia to the Skin, and the Processes to the Digital Sheaths; the Plantar Eminences and Furrows (Eminentia Plantares et Sulc^ Plantares) dependent ON the Disposition of the Muscles and the Intermuscular Septa. Right Foot. Musculi pedis — Muscles of the foot. 376 THE MUSCLES OF THE LOWER EXTREMITY Posterior process of the astragalus Processus posterior lali Tendon of the flexor longus digitorum pedis muscle' Tendon of the tibialis posticus muscle Internal malleolus Malleolus medialis Abductor hallucis muscle Flexor longus digitorum pedis muscle' M. flexor digitorum longus Flexor brevis digitorum pedis muscle- M. flexor digitorum brevis Flexor longus hallucis muscle M. flexor hallucis longus Flexor brevis hallucis muscle M. flexor hallucis brevis Flexor accessorius muscle M. quadratus plantae — Tendon of the flexor longus hallucis muEcls Plantar fascia Aponeurosis plantaris Abductor minimi digiti pedis muscle M. abductor digiti quinti Fourth dorsal interosseous muscle M. interosseus dorsalis IV. Flexor brevis minimi digiti pedis muscle M. flexor digiti quinti brevis Lumbricales muscles ''^Mm. lumbricales Transverse metatarsal ligament (plantar distal intermetatarsal ligaments) ' — Ligg. capitulorum (ossium metatarsalium) transversa "Vaginal ligaments Ligg. vaginalia I Or Jlexor /er/oraiis mascl 3 Like the author, English ai at of the author is given in the descripl 5 of the flexor hrevis digitorum (or fl of the tendons of the flexor longus digitor and himbricales muscles ; the f/iird \aye and flexor brevii' minimi digiti muscles ; and the fourth layer tendons of the tibialis posticus ai d peroneus longus muscles. — ' 2 Or Jiejcor perforatus xmi'i,<^^. group the muscle_s of the sole in four layers, but the two classifications are not entirely identical. According to English anatomists, the^rjz' or superficial layer and abductor minimi digiti muscles ; the second layer c k ngus hallucis muscles, together with the flexo adductor obliquus hallucis, adductor trans' the foot of Figs. 625 t r perforatus), abductor hallui (or flexor perforans) and fle.v of the flexor brevis hallu ' of the dorsal and pla nterosseous muscles, together with the Fig. 625. — First or Superficial Layer of the Muscles of the Sole {see note ^ above), upon WHICH THE Three Plantar Eminences depend, as seen after Removal of the Plantar Fascia. Of this Latter, the Middle Portion only at the Back of the Sole has been retained, in so far as it gives Origin to the Muscles. Abductor Hallucis Muscle; Flexor Brevis Hallucis Muscle; Flexor Brevis Digitorum Pedis Muscle {see note ^ above) ; Flexor Brevis Minimi Digiti Pedis Muscle; Abductor Minimi Digiti Pedis Muscle. Right Foot, extended. Plantar Aspect. The sheath of the flexor tendons of the toes (vaginal ligament) has been opened longitudinally in the second and third toes, but in the others has been left intact. Musculi pedis — Muscles of the foot. THE MUSCLES OE THE LOWER EXTREMITY 377 Tendon of the tibialis posticus muscle Tendon of the flexor longus digitorum pedis muscle' Tendon of the flexor longus ballucis muscle Tendon of the tibialis auticus muscle - Tendinous slip passing from the tendon of the flexor longus hallucis muscle to that of the flexor longus digitorum pedis muscle Junctura tendinis m. flexoris hallucis longi cum m. flexore digitorum longo Abductor hallucis muscle (the proximal portion of which has been cut awayi M. abductor hallucis Flexor brevis hallucis muscle M. flexor hallucis brevis Origin of the abductor hallucis muscle . Origin of the flexor brevis digitorum I pedis muscle- -Origin of the abductor minimi digiti pedis muscle Or flixor pcr/o. , Long plantar ligament Lig. plantare longum Tendon of the peroneus longus muscle Flexor accessorius muscle M quadratus plantae Abductor minimi digiti pedis muscle M. abductor digiti quinti Flexor brevis minimi digiti pedis mtiscle ( 1 1 _- Dorsal interosseous muscle M. interosseus dorsalis Lumbricales muscles 'Mm. lumbricales Tendons of the flexor brevis digi- torum pedis muscle- (divided and turned forwards) (i) M. flexor digiti quinli brevis -• Ox Jlcxor per/oraltis \ Fig , 626. — Second Layer of the Muscles of the Sole with the Tendons of the Deep Posterior Muscles of the Leg, as seen after the Partial Removal of the Muscles ok the First Layer: Tendon of the Flexor Longus Digitorum Pedis Muscle {see note ^ above) and its Division into Four Tendons passing to the Four Smaller Toes; Flexor Accessorius (Quadratus Plants) and Lumbricales Muscles ; Tendon of the Flexor Longus Hallucis Muscle and its Slip to the Tendon of the Flexor Longus Digitorum Pedis Muscle; Lnsertion of the Tibialis Anticus and Tibialis Posticus Muscles; Flexor Brevis Hallucis Muscle; Flexor Brevis Minimi Digiti Pedis Muscle. Right Foot. Musculi pedis — Muscles of the foot. 48 378 THE MUSCLES OF THE LOWER EXTREMITY Posterior process of the astragalus Processus posterior tali Tendon and synovial sheath of the tendon of the flexor longus digitorum pedis muscle'— Tendo et vagina tendinis m. flexoris digitorum longi Tendon and synovial sheath of the tendon of the tibialis posticus muscle Tendo et vagina tendinis m. tibialis posterioris Tendon of the tibialis anticus muscle Subtendinous bursa of the tibialit anticus muscle- Bursa subtendinea m. tibialis anterioris Flexor brevis hallucis muscle M. flexor hallucis brevis Abductor hallucis muscle (the proximal portion having been removed) Tendon and synovial sheath of the tendon of the flexor longus hallucis muscle / Tendo et \agina tendinis m. flexoris hallucis longi Flexor accessorius muscle (of which all but 'the proximal extremity has been cut away) M. quadratus planta; Long plantar ligament Lig. plantare longum Synovial sheath of the tendons of the peroneus longus and peroneus brevis muscle Vagina tendinum mm- peronaeorum communis Tendon of the peroneus longus muscle Plantar synovial sheath of the tendon of the peroneus longus muscle Vagina tendinis m. peronsi longi plantaris : Oljlexorferforans muscle. ■ The sttbteTidinous bursa of the tibialis anticus muscle i See note 3 to p. 364. Adductor obliquus hallucis muscle M adductor hallucis (caput obliquum) Interosseous muscles Mm. interossei *Opponens minimi digiti pedis muscle'' (i) Flexor brevis minimi digiti pedis muscle^ M flexor digiti quinti brevis Adductor transversus hallucis muscle (2) -Tendon of the abductor minimi digiti >-• i» \C3 pedis muscle J ^-= — S-— Transvprse metatarsal ligament (plantar //iV^teffl distal intermetatarsal ligaments) (3) if— Vll^ "- -ir^s^Vaginal ligaments f 'Wr^^^ Ligg- vagmalia (1) M. opponens digiti quinti (2) M. adductor hallucis (caput (3) Ligg. capituloi i situate heneath the tendon close to i Fig. 627. — Third Layer of the Muscles of the Sole : M. Adductor Hallucis, Caput Obliquum et Caput Transversum, or, according to English Anatomists, Adductor Obliquus Hallucis and Adductor Transversus Hallucis Muscles ; Flexor Brevis Hallucis Muscle ; Flexor Brevis Minimi Digiti Pedis and Opponens Minimi Digiti Pedis Muscles (see note ^ to p. 364). Synovial Sheaths of the Tendons of the Tibialis Posticus, Flexor Longus Digitorum Pedis, Flexor Longus Hallucis, and Peroneus Longus Muscles. Subtendinous Bursa of the Tibialis Anticus Muscle. Right Foot. The vaginal ligaments of the toes have been opened, and their -connexion with the transverse meta- tarsal ligament (plantar distal intermetatarsal ligaments) is displayed. Musculi pedis — Muscles of the foot. THE MUSCLES OF 1 HE LOWER EXTREMITY 379 Tendon of the flexor longus hallucis muscle (distal portion cut away ) Tendon of the flexor longus digitorum pedis muscle ' distal portion cut away Subtendinous bursa of the tibialis posticus muscle' (i) Tendon of the tibialis posticus muscle (divided, and the distal extremity turned forwards Flexor brevis hallucis muscle iproxinral extremity, turned backwards/ Sesamoid bones Ossa sesamoidea"' Flexor brevis hallucis muscle (distal •' extremity, turned forwards) (i) Rursa sublcndir . til>ialU posterioris Flexor accessorius muscle (of which " all but the proximal extremity has been cut away) M, quadratus plantas Long plantar ligament 1 ig. plantare longum endon of the peroneus longus muscle Plantar interosseous muscles *VIm interossei plantares Opponens minimi digiti pedis muscle- (2) .Dorsal interosseous muscles Mm interosbei dorsales (2) M. opponens digiti quinti ubtendinaus l>ursn of the til.ialUpos.lU. ote 1 to p. 364. ; situate beneath tlie tendo Fig. 628.— Foukth or Deepest Layer of the Muscles of the Sole, as seen after the Removal of the Flexor Brevis Hallucis, Adductor Obliquus Hallucis, Adductor Tkansveksus Hallucis, and Flexor Brevis Minimi Digiti Pedis Muscles: Plantar AND DoRs\L Interosseous Muscles. Relation of the Insertion of the Two Bellies OF the Flexor Brevis Hallucis Muscle to the Sesamoid Bones on the Plantar Surface of the Metatarsophalangeal Articulation of the Great Toe. Subtendinous Bursa of the Tibialis Posticus Muscles. Right Foot. Ill order to (lemonstr,-ite the course of the tendon of the peroneus longus muscle through the sole of the foot and the insertion o.> this tendon into the outer side of the tuberosity of the first meta- tarsal bone, the anterior portions of the long plantar ligament liave been removed. Musculi pedis - Muscles of the foot. 380 THE MUSCLES OF THE LOWER EXTREMITY Flexor brevis hallucis muscle-, (outer belly) M. flexor hallucis brevis (caput laterale) Flexor brevis hallucis muscle (inner belly )___^ M. flexor hallucis brevis (caput mediale) Intermetatarsophalangeal bursaee^,, Barsae intermetatarsophalangese Lumbricales muscles Mm. liimbricales Adductor transversus hallucis muscle M. adductor hallucis (caput transversum) BuissB of the lumbricales muscles of the foot' ^ Bursae mm. lumbricalium pedis Fig. 629. — BuRS^ of the Lumbricales Muscles of the Foot and Intermetatarsophalan- geal BURS^, AS SEEN FROM THE PlANTAR SURFACE. THE BuRS^ HAVE BEEN OPENED. First Three Toes of the Right Foot, widely separated. Dorsal aponeurosis of the extensor tendons Vinoula tendinum-^'" Intermetatarsophalangeal bursa,,-''' Bursa intermetatarsophalangea /' Bursa of the lumbricalis muscle' / Bursa m. lumbricalis Dorsal interosseous muscle M. interosseus dorsalis ' Lumbricalis muscle M. lumbricalis \ Tendon of the flexor longus digitorum pedis muscle-' Tendon of the flexor brevis digitorum pedis muscle* '_ The hirsa of the lumbricales muscles 0/ the foot proximal phalanges. — Tr. " The arrangement of the (i-xor tendons of the toes, with th Fig._58o on p. 331, and note ' on that page.— Tr. r perforayis muscle. 3 Or/?f; situ.tte between the tendons of the lumbricales muscles and the bases of the la, closely resembles that of the flexor tendons of the fingers. See ^ Or fleji-or perforates muscle. Fig. 630.— Distal Extremities of the Extensor and Flexor Tendons of the Second Toe of the Right Foot, seen from the Inner Side. Dorsal Aponeurosis of the Extensor Tendons. Bursa of the Lumbricalis Muscle of the Foot and Intermetatarso- phalangeal Bursa. Vincula Tendinum. Musculi pedis— Muscles of the foot. SUPPLEMENT TO THE MYOLOGY CANALIS INGUINALIS, THE INGUINAL CANAL, AND CANALIS FEMORALIS, THE FEMORAL OR CRURAL CANAL 382 INGUINAL CANAL AND FEMORAL CANAL Superficial epigastric vein Vena epigastrica superficialis Superficial fascia of the abdomen Fascia superficialis abdominis Superficial circumflex iliac vein Vena circumflexa ilium superficialis \ Superior superficial inguinal lymphatic \ ,, glands — LymphoglandulE inguinales Poupart's ligament (superficial femoral arch Lig. inguinale (Pouparti) Cribriform fascia Fascia cribrosa -— Internal or long saphenous vein Vena saphena magna Deep inguinal lymphatic gland Lymphoglandula subinguinalis profund i Intercolumnar or spermatic fascia' Fascia cremasterica (Cooperi) False suspensory ligament of the penis'' Lig. fundi forme penis ,,^ Deep fascia of the thigh, or fascia lata Scrotum- Lymphatic vessels -Vasa lymphatica f Inferior superficial : inguinal lymphatic Lymphoglandulae sub- ( inguinales superficiales Superficial fascia Fascia superficialis Internal or long saphenous vein Vena saphena magna Lymphatic vessels Vasa lymphatica I Fascia Cremasterica {Coo/>eri). — This is Cooler, but the intercoijtjitnar or spennatic/n = The suspensory lig^ament of the penis suspensory hgavtent. The former, called by the author /'^ abdomen and the dorsu,m of tlie penis (of which it forms a^'part), .. ^ ^, surfaces directed forwards and backwards, respectively. The latter, called by the aut"hor7/faOT«;/«,« suspcnsorium penis, when dissected out, has an anterior free edge, a lostero-supenor edge attached to the front of the puWc symphysis, and a postero-inferior edge attached to the dorsum of the penis, whilst its surfaces look to right and to left (see Fig. 632). The false suspensory ligament contains many yellow elastic fibres ; the true consists of white fibres only.— Tr. 3 Often called \\\e /ciitoral lymphatic glands. cremasteric fascia of English anatomists, nor is it i\\i fascia propria of AsiUy See note I to p. 501 in Partly.— Tr. of two parts: a superficial, iVi^ fa'se supensory'ligainevt : and 2, deep, the trut fundforme penis, when artificially separated from the fascia of the led piece of connective tissue with edges directed laterally and Fig. 631. — Superficial Fascia of the Anterior Wall of the Abdomen, with the False Suspensory Ligament of the Penis (Ligamentum Fundiforme Penis) and the Cre- masteric Fascia (Fascia Cremasterica Cooperi) covering the Spermatic Cord. In THE Portion of the Left Thigh from which the Skin has been removed we see THE Superficial Fascia with the Superficial Inguinal and Femoral Lymphatic Glands AND THE Subcutaneous Veins. In the Right Thigh the Superficial Fascia, the Superficial Lymphatic Glands, and the Subcutaneous Veins, have been removed, and the Fascia Lata and the Cribriform Fascia are laid bare. Subcutaneous Structures of the Hypogastric and Inguinal Regions. J INGUINAL CANAL AND FEMORAL CANAL 383 Linea alba Linea alba Sheath of the rectus abdominis muscle » (anterior layer) , \ Vagina m recti abdominis \ (Lamina anterior) Aponeurosis of the external oblique muscle of the abdomen / External oblique muscle of the abdomen M ( bhi|Lius externus abdominis External or superficial abdominal ring' Annulus inguinalis subcutaneus remoral or crural septum Septum femorale (Cloqueti; Saphenous opening Fossa ovalis f Triangular fascia- Lig. inguinale reflexum''' (CoUesi) Upper or internal pillar^ Crus superius Lower or external pillar ' Crus inferius Spine of the pubis Tuberculum pubicum True suspensory ligament''^ of the penis' Lig. suspensorium penis I Interoolumnar fibres ' Fibras collaterales^ Poupart's ligament (superficial femoral arch) Lig inguinale (Fouparti) Intercolumnar fibres ,\ ihrae intercrurales"* Superior cornu'' ( rnu superius Lymphatic gland in the femoral ring ('gland of RosenmuUer) Femoral or crural sheath \ agma vasorum Falciform border Margo falciformis Pectmeal fascia^ Fascia pectinea Inferior cornu ( ornu inferius Intercolumnar or sper- matic fascia? I-aMia reinasterica (Cooperi) Internal or long saphenous vein \ cna saphena magna Deep fascia of the thigh, or fascia lata (superficial layer)' 1 ascia lata (lamina superficialis) » Or external inguinal aperture. ^ The triani^nlar fascia, or tigamentum in^inale rejlexum Collesi, consists of some of the fibres of Gimbernat's hgament and of the outer pillar of the external abdominal ring which pass upwards and inwards beneath the spermatic cord in front of, and incorporated with, the anterior layer of the sheath of the rectus abdominis muscle to reach the middle line, where they interlace with the fibres of the opposite side. The development of this fascia is variable, being inversely proportional with that of the pyramidalis muscle, of the sheath of which it forms a specialized part. — Tr. 3 .See note * to p. 382. l -n r 4 Intercolumnar Fibres. — The author distinguishes the lower intercolumnar Jidrtis, those which cross the gap between the pillars of the external or superficial aljdominal ring, 3& fil>ra' intercntrales ; whilst those intercolumnar fibres which are situate entirely above the ring, he calls yf^r^ collaterales. i See note ■ to p. 349. <" Or puiic portion 0/ the fascia lata. 7 See note ' to p. 382. ^ See note = to p. 349. Fig. 632. — In the Hypogastric Region, by the Removal of the Superficial Fascia, the Aponeurosis of" the External Oblique Muscle of the Abdomen and the Anterior Layer of the Sheath of the Rectus Abdominis Muscle have been laid bare. In the Inguinal Region, on the Right Side OF the Body, we see the External or Superficial Abdominal Ring (External Inguinal Aperture) with its Two Pillars, Upper or Internal, and Lower or External, respectively, which are FULLY displayed BY THE REMOVAL OF THE SpERMATIC CoRD ; ON THE LeFT SiDE, ON THE OTHER HaND, the Spermatic Cord with its Coverings has been left intact, and the External Abdominal Ring is, consequently, closed. In the Subinguinal Region, the Cribriform Fascia having been removed, the Saphenous Opening (Fossa Ovalis, Femoral Aperture of the Femoral or Crural Canal) is laid bare, with its Falciform Border and Superior and Inferior Cornua, on the Left Side also with the Internal or Long Saphenous Vein and the Femoral ok Crural Sheath, whilst on the Right Side the Femoral Artery and Vein have been removed. The relation of the external abdominal ring 10 the spermatic cortl .ind to the saphenous opening is to be noted. Annulus inguinalis subcutaneus— External or superficial abdominal ring. Fossa ovalis -Saphenous opening. 384 INGUINAL CANAL AND FEMORAL CANAL Poupart's ligament (superficial femoral arch) Lig. inguinale (Pouparti^ External obliquemuscle of theabdomen AI obhquus externub abdominis t Sheath ai the rectus abdominis muscle Linea alba Triangular fascia' Lig. inguinale reflexuin (CoUesi Anterior superior spine of the ilium I Spina iliaca anterior superior Internal oblique muscle of the abdomen Aponeurosis of the ex- ternal oblique muscle of the abdomen Upper or internal pillar of the external or super ficial abdominal ring'^ Crus superius annuli inguinalis subcutanei Lower or external pillar of the ex- ternal or superficial abdominal ring' Crus inferius annuli inguinalis subcutanei Ilioinguinal nerve N. ilioinguinalis Cremaster muscle M. cremaster Spermatic cord Funiculus spermaticus ■ See note = to p. 383. : Or external inguinal aperture. Fig. 633. — Inner Portion of the Left Inguinal CanaL; from the External or Superficial Abdominal Ring (External Inguinal Aperture) to the Aperture for the Spermatic Cord in the Internal Oblique Muscle of the Abdomen,, displayed by the Removal of A Portion of the External Oblique Muscle of the Abdomen. Continuity of the Cremaster Muscle with the Lowermost FasciCuli of the Internal Oblique Muscle OF the Abdomen. Triangular Fascia, or LiC omentum Inguinale Reflexum (Collesi). The lower part of the aponeurosis of the external oblique muscle of the abdomen, together with the upper or internal pillar of the external abdominal ring, has been turned downwards. Canalis inguinalis — Inguinal canal. INGUINAL CANAL AND FEMORAL CANAL 385 External oblique muscle of the abdomen M. obliquus externus abdominis Internal oblique muscle of the abdomen M, obliquus interniis abdominis / Sheath of the rectus abdominis muscle Linea alba Tendinous inter- section Inscriptio tendinea Rectus abdominis muscle Sheath of the rectus abdominis muscle (anterior layer) Vagina m. recti abdominis (lamina anterior) TransTersaiis fascia i Fascia trans\er3alis Triangular fascia' f divided) Lig. inguinale reflexum 'CoUasi) Pyramidalis muscle M. pyramidalis External or superficial abdomioal ringr' An.iulus inguinalib subcutaneus ' See note » lo p. 383. Transversalis abdominis muscle \ Internal oblique muscle of the abdomen (turned downwards) M. obliquus internus abdominis \Transversali3 fascia Fascia transversalis , \ Internal or deep abdominal ring^ \ \ Annuius inguinalis alidominalis V Aponeurosis of the external oblique muscle of the abdomen (turned downwards) Aponeurosis musculi obliqui externi abdom-ni Spermatic cord — Funiculus spermaticus Musculus interfoveolaris- See note 3 to p. 275. Cremaster muscle ' M cremaster nlernal t}tffuinal n/'frhcrt: I Or external Ingnhml afertun. Frr.. 634.— Outer Portion of the Left Inguinal Canal, from the Aperture for the Spermatic Cord in the Internal Oblique Muscle of the Abdomen to the Internal OR Deep Abdominal Ring (Internal Inguinal Aperture), displayed by the Removal of a Portion of the Internal Oblique Muscle of the Abdomen. Musculus Inter- foveolaris {see note ^ to p. 27^), the Fibres of which lie in Front of the Ligamentum Interfoveolare or Ligament of Hesselbach {see note ^ to p. 387), which is itself not defined in the Figure. Canalis inguinalis — Inguinal canal. 49 386 INGUINAL CANAL AND FEMORAL CANAL Anterior crural or femoral nerve N. femoralis \ Iliac fascia Fascia iliaca '/ Parietal peritoneum Peritom;um paiietale Epigastric fold' Plica epigastrica Iliopsoas muscle M. iliopsoas / Spermatic vessels / / Vasa spermatica /' / External iliac artery / / A. iliaca externa / / External iliac vein / V. iliaca externa / Pubovesical fold Plica pubovesicalis External inguinal pouch Fovea inguinalis lateralis ,- • ) Internal inguinal pouch- \ I o\ ea ingumalis medialis ^ Hypogastric or external umbilical \ \^ ^ fold — Plica umbilicalis lateralis \ \ Urachal or medisu umbilical fold' \ \ l"ica umbilicalis media \ \ Supravesical pouch' — Fovea supravesicalis \ Urinary bladder \ Vesica urinaria Lateral false ligament of the bladder or transverse vesical fold Plica vesicalis transversa I By some authorities :he space between the urachal fold and the hypogastric fold (called here supyavesical poucli) is termed internal I7i^uina.l fouch : and the space between the hypogastric fold and the epigastric fold (called here i7itern(it inguinal ^oudt) is termed ?niddle inguinal pouch. The author's nomenclature is to be preferred. The epigastric fold, on the outer side, and a line drawn on the inner surface of the anterior abdominal wall corresponding to the outer margin of the rectus abdominis muscle, on the inner side, form the sides, while Poupart's ligament forms the base, of a triangular space, usually called the triangle of Hessclbach, through which a direct ingumal hernia passes. — Tr. ~ Also called the superior/alse li§;avtcnt^ or suspensory ligaine7it, of tlic bladder. Fig. 635. — Lower Portion of the Anterior Wall of the Abdomen seen from Behind, SHOWING THE PARIETAL PERITONEUM WITH ITS FOLDS AND PoUCHES : PlICA UmBILICALIS Lateralis, the Hypogastric or External Umbilical Fold-; Plica Umbilicalis Media, THE Urachal or Median Umbilical Fold {s&e note ^ above) ; Plica Epigastrica, the Epigastric Fold. Fove. p. 388. Fig. 638. — Annulus Inguinalis Abdominalis, Internal or Deep Abdominal Ring (Internal Inguinal Aperture), and Annulus Femoralis, Femoral or Crural Ring, laid bare ON THE Left Side of the Body by the Removal of the Parietal Peritoneum and the Transversalis Fascia ; seen from Behind. Ligamentum Interfoveolare (Hessel- bachi), Ligament of Hesselbach, and Falx (Aponeurotica) Inguinalis, Ligament of Henle. Relation of the Obturator Autkry, which in this Instance arises from THE Deep Epigastric Artery, to the Femoral or Crural Ring. Abdominal Apertures of the Inguinal and Femoral Canals. 390 INGUINAL CANAL AND FEMORAL CANAL Anterior superior spine of the ilium Spina iliaca anterior superior /• Iliac compartment Z Lacuna musculorum Fig. 639- Anterior inferior spine of the ilium Spina ihaca anterior inferior Iliac fascia Fascia iliopectinea^ Poupart s ligament (superficial femoral arch) Lig inguinale (Pouparti) Vascular com.partment Lacuna vasorum Iliopectineal eminence Eminentia iliopectinea Pectineal fascia ' Fascia pectinea y Gimbemat's ligament / Lig lacunare (Gimbernati) Triangular fascia' / Lig. inguinale reflexum (CoUesi) -Spine of the pubis Tuberculum pubicum .ACUNA Musculorum et Lacuna Vasorum, Iliac Compartment and Vascular Compartment. •Seen from Behind. Anterior superior spine of the ilium Spina iliaca anterior superior Internal oblique muscle of the abdomen M. obliquus internub abdominis Aponeurosis of the external oblique muscle of the abdomen 1 Transversalis fascia — Fascia transversalis ■ Anterior crural or femoral nerve — Nervus femoralis ' illiac fascia — Fascia iliopectinea' I Poupart's ligament (superficial femoral arch) jl-ig. inguinale (Pouparti) ,■ Femoral artery / Arteria femoralis / Femoral or crural sheath Vagina vasorum , Femoral vein Vena femoialis , Femoral or crural ring / Annulus femoralis Gimbemat's ligament \v /' Lig lacunare (Gimbernati) Rectus abdominis muscle Cut eage of the iliac fascia — r.^" Iliopsoas muscle — M iliopsoas ' Iliopectineal eminence — Eminentia iliopectinea Surface of the symphysis I : I Facies s-\ mphyseos Ligament Of Henle 3 (i)- . I E3rtemal or superficial aDdommal rings— Annulus inguinalis subcutaneus I Pubic ligament of Astley Cooper, or ; Cooper's ligament=— Lig. pubicum (Cooppn) •Transversalis fascia— Fascia transversalis (i) Falx (aponeurotica) inguinalis I Fascia Iliofcct!i,ea.—'Y\\artment and the vascular compart- ment of the space beneath that ligament, and passing inwards behind the femoral vessels to form the posterior layer of the femoral or crural sheath becomes continuous with x.\\ntermetatarsal. plantar distal, 376, 378 iaterosseous, of the forearm, 324, 325, 329 of the leg, 365, 367 lambdoideum, 364, 366, 372, 373 metatarsal, transverse, 376, 378 oblique (radio-ulnar), 317 obturator, 345 palpebral, internal, 300 patellar, 353, 355, 356, 366, 367 „ „ „ Pouparl's, 274, 276, 344, 345, 349, 382, 383. 309. 390 pterygomandibular, 297, 307 pter3'goniaxillarj', 297, 307 pubic, of Astley Cooper, 344, 353, 390 and note sacrosciatic, anterior, 340, 341, 346 great, 340, 341, 343 posterior, 340, 341, 343 small, 340, 341, 346 stylohyoid, 292-294, 296 suspensory, of the penis, 274, 276, 349, 382, 383 "true " and " false," 382, note tarsal, internal, 300 th3'roh3'oid, middle, 294 of the toes, superficial transverse, 375 transverse metacarpal, 334 vaginal (of the fingers), 334-336, and note to P-334 of the toes, 376, 378 Ligamentum ve/ ligamenta : arcuatum externum, 286 internum, 286 brevia, 331, note capitulorum (ossium metacarpalium) trans- versa, 334 (ossium metatarsalium) trans- versa, 376 carpi dorsale, 326-328, 330 transversum, 324, 334 volare, 322, 332 cricothyreoideum (medium), 294 cruciatum cruris, 364, 366, 372, 373 t fundiforme pedis, 365, 373 penis, 382 inguinale [Pouparti], 274, 276, 344, 345, 349, 3S2, 383. 389. 390 reflexum [CoUesi], 383-385, 390, and note to p. 383 interfoveolare [Hesselbachi], 385, 3S7 and note, 389 intercostalia externa, 274 interna, 280 laciniatum, 370, 371, 374 lacunare [Gimbernati], 344, 349, 389, 390 longa, 331, note lumbocostal e, 270, 271, 285, 286, 343, 345 nuclide, 267, 26S palpebrale mediale, 300 patella;, 353, 355, 356, 366, 367 pubicum [Cooperi], 344, 353, 390 sacrospinosuni, 340, 341, 346 sacrotuberosuni, 340, 341, 343 st3'loh}'oideuin, 292-294, 296 suspensorium penis, 274, 276, 349, 383 transversum cruris, 366, 372 umbilicale laterale, medium, 387 vaginale digitorum (manus), 334-336 (pedis), 376, 378 Linea alba, 274, 276, 3S3-385, 389 t arcuata, 346 and note semicircularis [Douglasi], 275, 276, 387, 389 semilunaris [Spigeli], 276, 389 Line, white, of the pelvic fascia, 346 Margo falciformis, 349, 383 Membrana hyothyreoidea, 294 interossea antibrachii, 324, 325, 329 cruris, 367 obturatoria, 345 Membrane, costocoracoid, 282 cricothyroid, 294 interosseous, of the forearm, 324, 325, 329 of the leg, 365, 367 obturator, 345 thyrohyoid, 294 tMesotenon, 333 and note Muscle or muscles (see also Latin names under "Musculus vel musculi") : of the abdomen, 274-276, 278, 279, 281 abductor hallucis, 371, 374, 376 indicis, 323, 324, 331, 336 minimi digiti (manus), 323, 324, 334, 336 (pedis), 364, 366, 372, 373, 376, 377 pollicis brevis, 324, 334, 336 longus, 326, 328-330, and note to p. 326 accessorius ad sacrolumbalem, 268, 269, 272, 273, 343 adductor brevis, 345, 351-353. 356, 357, 360 longus, 345, 346, 350-353. 356, 357. 360 magnus, 345 and note, 346, 351, 352, 354, 356-360 minimus, 345 and note, 358-360 obliquus hallucis, 378 pollicis, note to p. 324 pollicis, 324, 325, 334-336, and note to P- 324 transversus hallucis, 378, 380 pollicis, note to p. 324 anconeus, 31S, 319, 326, 32S, 329 antagonistic, of the arm, 263, 315-320 attoUens auriculam, 266, 300 attrahens auriculam, 300 auricularis anterior, 300 posterior, 266, 302 superior, 266, 300 of the back, 266-273 biceps flexor cruris, 352, 358-363 cubiti, 314, 315, 317, 325 bipenniform, 262 brachialis anticus, 315-317, 319, 321, 325 broad, 262 buccinator, 297, 303, 304, 306, 307 canine, 297, 300-304 ceratopharj'iigeus, 296 cervicalis ascendens, 268, 269, 272, 273 chondroglossus, 296 chondropharyngeus, 296 circumflexus palati, 295, 297, 308 cocc3-geus, 2S8, 347 complexus, 267-279, 272, 273, 27S, 308 compressor naris, 301-303, and note to p. 301 constrictor of the pharynx, inferior, 297 middle, 293, 296 superior, 297 coracobrachialis, 314-317 corrugator supercilii, 300, 301 cremaster, 274-276, 384, 385 cricoth3Toid, 294, 296 crureus, 352-354, 356 cucullaris, see "Muscle, trapezius" curvator cocC3'gis, 288, 344, 346 deltoid, 266, 269, 274, 275, 310, 317, 319 depressor alse nasi, 301-305, and note to p. 301 anguli oris, 290, 293, 297, 300, 303, 306 labii inferioris, 300, 302-304, 306 digastric, 262, 292, 297, 298, 307, 308 double-headed, 262 elementary constituents, 260 epitrochleo-anconeus, 320 and note INDEX 397 Muscle or muscles : extensor brevis digitonim pedis, 364 and note, 36=;, 36.7. 372. 373 hallucis, 364 and note, 365, 367, 372 pollicis, 326, 32S-330, and note to p. 326 Carpi radialis brevior, 317, 321, 326-329 longior, 317, 319, 321, 322, 326-329 ulnaris, 31S, 325, 326, 32S, 329 coccygis, 2SS communis digitoruni, 326-329 indicis, 326, 32S-330 iOngus digitorum pedis, 364, 365, 367 hallucis, 364 and note, 365, 367 pollicis, 326, 32S-330, and note to p. 326 minimi digiti, 326 ossis metacarpi pollicis, 326, 32S-330, and note to p. 326 primi internodii pollicis, 326, 32S-330, and note to p. 326 proprius hallucis, 364 and note, 365, 367 secundi internodii pollicis, 326, 328-330, and note to p. 326 external oblique, of the abdomen, 266-269, 274-276, 27S, 279, 3S4, 3S5 of the face, 300-307 of facial expression, difference between the author's grouping of these and that usual in England, note to p. 303 flexor accessorius, 376-37S brevis digitorum pedis, 376 hallucis, 376-37S minimi digiti (manus), 324, 325, 334-336 (pedis), 374 and note, 376-378 polhcis, 324, 325, 334, 336, and note to P- 324 carpi radiahs, 317, 322. 323, 325 ulnans, 317-320, 322, 323, 325 Icngus digitorum pedis, 370, 371, 376, 377 hallucis, 370,371, 376,377 polhcis, 322, 324, 325, 336 perforans (manus), 324, 325, 331, 335, 336 (pedis), 370, 371, 376, 377 perforatus (manus), 317, 321-323, 325, 331, 335, 336 (pedis), 376 profundus digitorum, 324, 325, 331, 335, 336 sublimus digitorum, 317, 321-323, 325, 331, 335 of the foot, 372-380 of the forearm, 321-329 forms of, 262 frontalis, 300 fusiform, 262 gastrocnemius, 358-363, 368, 369 gemellus inferior, 340 and note, 341, 343, 358, 359 superior, 340 and note, 341, 343, 358, 359 general considerations, 259-264 genioglossus, 295, 296, 307 geniohjoglossus, 295, 296, 307 geniohyoid, 294-296, 307 gluteus maximus, 338-340, 342, 343, 360 medius, 340, 343, 345, 353 minimus, 341-343, 345,353 gracilis, 345, 346, 350, 351, 354, 360, 362 of the hand, 330-336 of the head, 295-297, 300-308 of the head and neck, 289-308 of the hip, 338-349 Horner's, see " Tensor tarsi " and notes 3 and 4 to p. 301 iliocostalis, see under " Musculus" iliacus, 344, 346, 347, 350 iliopsoas, ,J44, 346-348, 350, 353, 354, 360, 361, 386, 390 incisivus, inferior, 303, 304, 306 superior, 303, 304 inferior lingual, 296 Muscle or muscles : infraspinatus, 312, 318, 319 insertion, 261 intercostal, external, 268, 271, 274, 276-280 internal, 275-281 internal oblique, of the abdomen, 267-270, 274-276, 384- 385 interosseous, dorsal, of the foot, 373-379 of the hand, 329, 331, 334-336 palmar, 334-336 plantar, 376, 379 interspinal es, 270-272, 279, 339 intertransversales, 270-273, 299, 339, 343 latissimus dorsi, 266, 267, 269, 277, 278, 317 of the leg, 364-371 levator anguli oris, 297, 300-304 scapula, 266, 267, 269, 277, 278, 293, 29S, 319 ani, 288 coccygis, 288, 347 labii inferioris, 303, 304, 306 superioris alaeque nasi, 300 and note, 301 proprius, 300 and note, 302 menti, 303, 304, 306 palati, 295, 297, 308 lingualis inferior, 296 longissimus, see under " Musculus " of the lower extremity, 337-3S0 lumbricales (manus), 324, 326, 332, 336 (pedis), 376, 377 masseter, 293, 302 deep portion, 303, 306, 308 superficial portion, 302, 306, 308 of mastication, 306, 307 multifidus spina, 270, 273, 343 mylohyoid, 292-295, 297, 307 of the neck, 290-299 oblique, of the abdomen, external, 266-269, 274-276, 278, 279, 3S4, 3H5 internal, 267-270, 274-276, ... . 384. 385 obliquus capitis inferior, 270-272, 278, 279 superior, 26S, 270-272, 278, 279, 308 obturator externus, 341, 343, 345, 353, 356, 357, 359-361 internus, 340 and note, 341, 342, 344, 347, 358, 359 occipitalis, 266, 278, 302 occipitofrontalis, 300, 302 omohyoid, 277, 292, 293, 314, 317, 319 opponens minimi digiti (manus), 325, 334-336 (pedis), 364 and note, 372, 37S pollicis, 325, 334-336 orbicularis oris, 303-305 palpebrarum, 300-302, and notes 3 and 4 to p. 301 pars lachr3'malis, or lachrymal portion, see "Tensor tarsi" and notes 3 and 4 to p. 301 pars orbitalis, or orbital portion, 300, 301 pars palpebralis, or palpebral portion, 300, 301 origin, 261 palmaris brevis, 322, 332 longus, 332 pectineus, 345, 347, 350-353- 357. 360, 361 pectoralis major, 274, 275, 317 abdominal portion, 274 clavicular portion, 274, 275, 317 sternocostal portion, 274, 275, 278 minor, 274, 275, 27S, 317 penniform, 262 peroneus brevis, 364-367, 371, 373 lonjjus, 364, 366, 367, 379 tertiu,s, 364, 367, 372 platysma, 282, 290, 291, 300, 302, 306 plantari.s, 358-362, 368, 369, 37' popliteu.s, 360-363, 366, 369-371 pronator quadratus, 323-325, 333, 334 radii teres, 317, 322, 325, 327, 328 398 INDEX Muscle or muscles : psoas niagnus, 286, 344-347. 35° parvus, 344 0 pterygoid, external, 295, 307. 30f internal, 295, 307, 30b pyrauiidalis nasi, 300, 301 pyriformis, 340-347, 358> 359 qiadratus femoris, 34p-343> 345> 34^ „„.^._ _ .^ labii supenons, 300, 302, and note to p. 300 lumborum, 339> 344, 345 menti, 300, 302-304, 306 quadriceps extensor cruris, 35p-353, 355, 3bo rectus abdominis, 275, 276, 278, 3f>5, 3«7, 389, 3^ capitis anticus major, 277, 293, 294, 298, 308 minor, 299, 308 lateralis, 271, 272, 279, 298, 299, 308 posticus (major and minor), 271, 272, 279, 308 femoris muscle, 343, 345. 350-353 retrahens auriculam, 266, 300 rhomboideus major, 267, 269, 319 minor, 267, 269, 319 risorius, 290, 300, 303 rotatores dorsi, 271-273 sacrococcygeus anticus, 2S8, 344, 34° posticus, 288 sacrolumbalis, see "Musculus iliocostalis" sacrospinalis, see " Musculus iliocostalis sartorius, 345, 350. 35i, 353-355, 362 scalenus anticus, 277279, 293, 298, 299 medius, 270, 277, 278, 293, 298, 299 pleuralis, 279 posticus, 268, 269, 277, 278, 298, 299 semimembranosus, 351, 354. 358-363 semispinalis, see under " Musculus colli, 270, 272, 273 semitendinosus, 351, 354. 358, 360, 362 serratus magnus, 267, 268, 274-278, 317, 319 posticus inferior, 267-269, 27S, 343 superior, 267, 269, 278 of the shoulder, 310-313 soleus, 363, 369, 371 spinalis, see under " Musculus cervicis, 26S, 273 splenius capitis, 266-269, 277, 278, 293, 30S colli, 267-269 sternalis, 282 sternocleidomastoid, 278, 292, 293, 308, 317 sternohyoid, 281, 292-294 sternomastoid, 278, 292, 293, 308, 317 sternothyroid, 277, 281, 292, 293 strap-shaped, 262 structure, 260, 261 stylohyoid, 278, 292, 297, 308 stvlopharyngeus, 293, 297, 308 subclavius, 274, 275, 27S, 299, 311, 314, 31? subcostal, 280 subcrureus, 354, 357 subscapularis, 277, 313, 315-317 supinator radii brevis, 317, 319, 321. 323-325, 327-329 longus, 317, 319, 321-323, 325-327, 329 supraspinatus, 310, 312, 313, 319 synergistic, 263 temporal, 306-308 tensor fascise femoris, 338, 345, 350, 351, 353 latae, 338, 345, 350, 351, 353 palati, 295, 297, 308 tarsi, 301, 302, and notes 3 and 4, p. 301 vagina; femoris, 338, 345, 350, 351, 353 teres major, 266, 269, 311, 313, 316-319 of the thorax, 274, 275, 277-283 thyroh3'oid, 277, 292-294, 296 thyropharyngeus, 293, 294 tibialis anticus, 364, 365, 367, 377, 378 posticus, 370, 371, 377. 379 trachelomastoid, 268, 270, 272, 273, 278, 30b transversalis abdominis, 269-271, 275, 276, 281, 385, 387. 389 cervicis, 268, 270, 272, 273 linguse, 296 Muscle or muscles : transverse, of the tongue, 296 transversus menti, 300, 304 nuchse, 266, 302 trapezius, 266, 269, 278, 292, 293, 308, 319 triangularis menti, 290, 293, 297, 300, 303, 30b sterni, 281 triceps extensor cubiti, 266, 310-320, 329 , rotator femoris, 340, note « surae, 368 and note, 369 of the trunk, 265-288 of the upper arm, 3x5-320 of the upper extremity, 309-336 vastus externus, 345, 352, 353, 356, 358-3pi internus, 348, 350-354. 360, 361, 36? zygomaticus major, 290, 297, 300, 302, 303 minor, 300 and note Musculus vel musculi (see also English names under " Muscle or muscles ") : abdominis, 274-276, 278, 279, 281 abductor digiti quinti (manus), 323, 324, 334, 336 (pedis), 364, 366, 372, 373, 376, 377 hallucis, 371, 374, 37^ poUicis brevis, 324, 334, 33° longus, 326, 328-330 adductor brevis, 345, 351-353, 356, 357, 360 hallucis, 378, 380 longus, 345, 346, 350-353, 356, 357. 360 magnus, 345, 346, 35i. 352, 354, 356-360 minimus, 345, 358-360 pollicis, 324, 325, 334-336 anconeus, 318, 319, 326, 328, 329 antibrachii, 321-329 articularis genu, 354, 357 articulationis humeri, 310-313 auricularis anterior, 300 posterior, 266, 302 superior, 266, 300 biceps, 262 brachii, 314, 3^5. 3I7. 325 femoris, 352, 358-363 bipennatus, 262 t biventer, 262 brachialis, 315-317, 3I9, 321. 325 brachii, 315-320 brachioradialis, 317, 319, 321-323, 325-327, 329 buccinator, 297, 303, 304, 306, 307 caninus, 297, 300-304 capitis, 295-297, 300-308 ceratopharyngeus, 296 chondroglossus, 296 chondropharyngeus, 296 coccygeus, 288, 347 colli, 290-299 et capitis, 289-308 constrictor pharyngis inferior, 297 medius, 293, 296 superior, 297 coracobrachialis, 314-317 , t corrugator supercilii, 300, 301 coxjE, 338-349 ^ „ _ cremaster, 274-276, 384, 385 cricothyreoideus, 294, 296 cruris, 364-371 deltoideus, 266, 269, 274, 275, 310, 317, 319 depressor septi, 303-305 digastricus, 292, 297, 29S, 307, 308 dorsi, 266-273 epicranius, 300, 302 epitrochleo-anconaeus, 320 extensor carpi radialis brevis, 317, 321, 326-329 longus, 317, 319, 321, 322, 326-329 ulnaris, 31S, 325, 326, 328, 329 digiti quinti proprius, 326 digitorum brevis, 364, 365, 367, 372, 373 communis, 326-329 longus, 364, 365, 367 INDEX 399 Musculus vel musculi : ex'^nsov hallucis brevis, 364, 365, 367, 372 longus, 364, 365, 367 indicis propius, 326, 328-330 pollicis brevis, 326, 32S-330 longus, 326, 32S-330 extremitatis iuferioris, 337-380 superioris, 309-336 faciei, 300-307 femoris, 350-361 flexor carpi radialis, 317, 322, 323, 325 ulnaris, 317-320, 322, 323, 325 digiti quinti brevis (manus), 324, 325, 334-336 (pedis), 376, 37S digitorum brevis, 376 longus, 370, 371, 376, 377 profundus, 324, 325, 331, 335, 336 sublimis, 317, 321-323, 325, 331, . 335. 336 hallucis brevis, 376-378 longus, 370, 371, 376, 377 pollicis brevis, 324, 325, 334, 336 longus, 322, 324, 325, 336 frontalis, 500 fusifonnis, 262 gastrocnemius, 358-363, 368, 369 gemellus (inferior, superior), 340 and note, 341, 343. 35«. 359 genioglossus, 295, 296, 307 geniohyoideus, 294-296, 307 glutaeus maximus, 338-340, 342, 343, 360 niedius, 340, 343, 345, 353 minimus, 341-343, 345, 353 gracilis. 345, 346, 350, 351, 354, 360, 362 Horneri. 301, 302 hj'oglossus, 293, 296 iliacus, 344, 346, 347, 350 iliocostalis, 26S, 269, 273, 343 cervicis, 26S, 269, 272, 273 dorsi, 268, 269, 272, 273, 343 lumborum, 268, 269, 273, 343 iliopsoas, 344, 346-348, 350, 353, 354, 360, 361, 386. yp incisivus labii inferioris, 303, 304, 306 superioris, 303, 304 infraspinatus, 312, 318, 319 X interfoveolaris, 275 and note, 385 intercostales externi, 268, 271, 274, 276-280 interni, 275-281 interossei dorsales (manus), 329, 331, 334-336 (pedis), 373-379 plantares, 376, 379 volares, 334-336 interosseus dorsalis I. (manus), 323, 324, 331, 336 interspinales, 270-272, 279, 339 intertransversarii anteriores, 299 posteriores, 271, 2'72, 299 t lateraies, 270, 271, 273. 339. 343 t mediales, 271, 273, 339. 343 latissimus dorsi, 266, 267, 269, 277, 278, 317 levator ani, 288 scapute, 266, 267, 269, 277, 278, 293, 298, 319 veil palatini, 295, 297, 308 levatores costarum breves, 270, 271, 273 longi, 270, 271, 273 longissimus, 268, 273 capitis, 268, 270, 272, 273, 278, 308 cervicis, 268, 270, 272, 273 dorsi, 268-270, 272, 273, 343 longitudinalis inferior (lingua-), 29(5 longus capitis, 277, 293, 294, 298, 308 colli, 278, 293, 295, 298, 299 lumbricales (manus), 324, 330, 332, 336 (pc.lis), 376, 377 manus, 330-336 tnasseter, 293, 302 t profunda, 303, 306, 30S t pars superficialis, 302, 306, 308 Musculus vel musculi : t masticatorii, 306, 307 mentalis, 303, 304, 306 multifidus, 270-273, 343 mylohyoideus, 292-295, 297, 307 nasalis, 301-304 pars alaris, 302-304 transversa, 302, 303 obliquus capitis inferior, 270-272, 278, 279 superior, 268, 270-272, 278, 279, 308 externus abdominis, 266-269, 274-276, 278, 279, 384, 385 internus abdominis, 267-270, 274-276, 384. 385 obturator externus, 341, 343, 345, 353, 356, 357, 359-361 internus, 340-342, 344, 347, 358, 359 occipitalis, 266, 278, 302 omohyoideus, 277, 292, 293, 314, 317, 319 opponens digiti quinti (manus), 325, 334-336 (pedis), 364, 372, 378 pollicis, 325, 334-336 orbicularis oculi, 300-302 pars lacrimalis [M. Horneri], 301, 302 orbitalis, 300, 301 palpebralis, 300, 301 orbicularis oris, 303-305 palmaris brevis, 322, 332 longus, 322 pectineus, 345, 347, 350-353, 357, 360, 361 pectoralis major, 274, 275, 317 pars abdoniinalis, 274 clavicularis, 274, 275, 317 sternocostalis, 274, 275, 278 pectoralis minor, 274, 275, 278, 317 pedis, 372-380 peronaeus brevis, 364-367, 371, 373 longus, 364, 366, 367, 379 tertius, 364, 367, 372 piriformis, 340-347, 358, 359 plantaris, 358-362, 36S, 369, 371 popliteus, 360-363, 366, 369-371 procerus, 300, 301 pronator quadratus, 323-325, 333, 334 teres, 317, 322, 325, 327, 328 psoas major, 286, 344-347, 350 minor, 344 pterygoideus externus, 295, 307, 308 internus, 295, 307, 308 pyramidalis, 275, 276, 385 quadratus femoris, 340-343. 345. 34^ labii inferioris, 300, 302-304, 306 superioris, 300-302 caput angulare, 300, 301 infra-orbitale, 300, 302 zj'gomaticum, 300 quadratus lumborum, 339, 344, 345 plantEE, 376-378 quadriceps femoris, 350-353. 355. 360 rectus abdominis, 275, 276, 27S, 385, 387, 389, 390 capitis anterior, 299, 308 lateralis, 271, 272, 279, 298, 299, 308 posterior (major, minor), 271, 272, 279, 308 femoris, 343, 345, 350-353 rhomboideus (major, minor), 267, 269, 319 risorius, 290, 300, 303 rotatores breves, 271-273 longi, 271-273 sacrococcygeus anterior, 288, 344, 346 posterior, 288 sacrospinalis, 268, 273, 285 sartorius, 345, 350, 351, 353-355. 362 scalenus anterior, 277-279, 293, 298, 299 medius, 270, 277, 278, 293, 298, 299 minimus, 279 posterior, 268, 269, 277, 278, 298, 299 semimembranosus, 351, 354, 358-363 400 INDEX MuscuUis vel musculi : semispinalis, 270 capitis, 267-270, 272, 273, 278, 308 cervicis, 270, 272, 273 dorsi, 270, 273 semitendinosus, 351, 354, 358, 360, 362 serratus anterior, 268, 274-278, 317, 319 posterior inferior, 267-269, 27S, 343 superior, 267, 269, 278 soleus, 363, 369, 371 spinalis, 268 cervicis, 268, 273 spinalis dorsi, 268, 273 splenius capitis, 266-269, 277, 27S, 293, 308 cervicis, 267-269 sternalis, 2S2 sternocleidomastoideus, 27S, 292, 293, 30S, 317 sternohyoideus, 281, 292-294 sternothyreoideus, 277, 2S1, 292, 293 styloglossus, 292, 293, 296, 297, 308 stylohyoideus, 278, 292, 297, 30S stylopharyngeus, 293, 297, 308 subclavius, 274, 275, 278, 299, 311, 314, 317 subcostales, 280 subscapularis, 277, 313, 315-317 supinator, 317, 319, 321, 323-325, 327-329 supraspinatus, 310, 312, 313, 319 temporalis, 306-308 tensor fascia; lats, 338, 345, 350, 351, 353 veli palatini, 295, 297, 308 teres major, 266, 269, 311, 313, 316-319 minor, 311-314, 318, 319 thoracis, 274, 275, 277-283 thyreohyoideus, 277, 292-294, 296 tliyreophar3'ngeus, 293, 294 tibialis anterior, 364, 365, 367, 377, 37S posterior, 370, 371, 377, 379 transversus abdominis, 269-271, 275, 276, 281, 385, 387, 389 linguEe, 296 menti, 300, 304 nuchse, 266, 302 thoracis, 281 trapezius, 266, 269, 278, 292, 293, 308, 319 triangularis, 290, 293, 297, 300, 303, 306 triceps brachii, 310-320, 329 sur^e, 368, 369 trunci, 265-2S8 unipennatus, 262 vastus intermedins, 352-354, 356 lateralis, 345, 352, 353, 356, 358-361 medialis, 348, 350-354, 360, 361, 367 zygomaticus, 290, 297, 300, 302, 303 Muscular fibres, 260, 261 Myology, general considerations, 259, 264 N. Nuclei of the muscular fibres, 260 O. Opening in adductor magnus for femoral vessels, 356, 357, 360 Opening (in the diaphragm), aortic, 286, 287 caval, 286, 2S7 oesophageal, 2S6, 2S7 Opening, saphenous, 274, 276, 349, 383 Orifice, inferior, of Hunter's canal, 356, 357, 360 P. Pericranium, 300, 302, 303 Perimysium, 260, 261 externum, 261 Peritonaeum parietale, 275, 386, 38S Peritoneum, parietal, 275, 3S6, 388 Pes anseriuus, 351 and note Pillar of the external or superficial abdominal ring: lower or external, 349, 383 upper or internal, 349, 383 Pillars of the diaphragm, see " Diaphragm " Platysma, 282, 290, 291, 300, 302, 306 myoides, 282, 290, 291, 300, 302, ^06 Pleura, cervical, 279 Plica (see also " Fold ") ; axillaris anterior, 2S3 posterior, 283 epigastrica, 386 hypogastrica, 275, 387 pubovesicalis, 386 umbilicalis lateralis, 386 media, 386 urachi, 386 vesicalis transversa, 386 Portion of the diaphragm, costal, 286, 287 sternal, 2S6, 287 vertebral, 286, 287 Pouch, inguinal, external, 386 and note internal, 386 and note middle, 386 and note supravesical, 386 and note Process, falciform, 346 Raphe, median, of the mylohyoid muscle, 295 musculi mylohyoidei, 295 pterygomandibularis, 297, 307 Retinacula, 331, note Retinaculum mm. peronaeorum inferius, 364, 366, ^72 superius, 372 of the peronei tendons, inferior, 364 .ind note, 366, 372 superior, see " Liga- ment, annular, of the ankle, ex- ternal " Ring, abdominal, external or superficial, 274, 349, 383, 385 internal or deep, 275, 276, 344, 385, 387-389 crural, 389, 390 femoral, 389, 390 Sarcoleinma, 260, 261 Segment, thoracic, diagram of, 2S4 and note Septum, crural, 3S3, 388 femoral, 383, 388 femorale [Cloqueti], 383, 388 intermuscular, 264 of the forearm, 329 peroneal, anterior, 364, 367 posterior, 370, 371 of the thigh, external, 360 internal, 350, 351, 353, 356, 357, 359 of the upper arm, external, 311, 319 internal, 314-317, 319 mtermusculare, 264 femoris laterale, 360 mediale, 350, 351, 353, 356, 357> 359 fibulare anterius, 364, 367 posterius, 370, 371 humeri laterale, 311, 319 mediale, 314-317. 3I9 Sheath of the rectus abdominis muscle, 274-276, 281, 285, 385, 389 Sheath or sheaths, synovial, of the tendon or tendons (see also " Vagina vel vaginae — tendinis vel ten- dinum "): of the extensor carpi radialis longior and extensor carpi radialis brevior muscles, 330 of the extensor carpi ulnaris muscle, 330 of the extensor communis digitorum and extensor indicis muscles, 330 of the extensor longus digitorum pedis and pero- neus tertius muscles, 372 of the extensor longus vel proprius hallucis muscle, 372 of the extensor longus pollicis nmscle, 330 of the extensor mimimi digiti muscle, 330 INDEX 400a Sheath of the extensor ossis metacarpi pollicis and extensor primi internodii pollicis muscles, 330, 333 of the extensor secundi internodii pollicis muscle, 330 of the flexor carpi radialis muscle, 333 of the flexors of the fingers, 333 of the flexor longus digitorum pedis muscle, 37S , of the flexor longus hallucis muscle, 378 of the flexor longus pollicis muscle, 333 I of the flexor sublimis and flexor profundus digit- orum muscles, 333 ! of the peroneus longus muscle (plantar region), 378 I of the peroneus longus and peroneus brevis muscles, 372, 37S of the tibialis anticus muscle, 372 of the tibialis posticus muscle, 378 " Snuff-box, anatomical," 326 and note, 327 •Space, axillarj-, external, 312 and note, 313 * internal, 312 and note, 313 Mohrenheimer's, 274, 282, 293 popliteal, 358 scalene, 277 and note Stratification of themuscles of the trunk and their associatea fasciae, 2S4, 2S5 Structure of muscle, 260, 261 "Sucking-pad," 290, note Sulci plantares, 375 Sulcus (see also •' Furrow " and " Hollow ") : t autibrachii radialis, 322 ulnaris, 322 bicipitalis lateralis, 326 medialis, 315 t deitoideopectoralis, 282 subclav-iae, 299 Synergists, 263 Tabaliere anatoiniqne, 326, note, 327 Tendo, 261, 262 Achillis, 366, 367, 369, 371 calcaneus [Achillis], 366, 367, 369. 371 Tendon, 261, 262 common, for the origin of the palmar muscles of the forearm, 317, 321, 325 of diaphragm, central, 286, 287 cordiform, 286, note - trefoil, 286, note- in frapatellar. 353. 355, 356, 366, 367 Thenar, 322, 324 Tractus iliotibialis [Maissiati], 338, 340, 342 Triangle, infraclavicular, 274, 282, 293 of Petit, 266, 267 Scarpa's, 350 Trigonum deltoideopectorale, 274, 2S2, 293 femorale, 350 lumbale [Petiti], 266, 267 V. Vagina musculi recti abdominis, 274-276, 281, 285, 385, 389 Vagina vel vaginse— tendinis vel tendinum : digitales (manus), 333 m. extensoris carpi ulnaris, 330 digiti quinti, 330 digitorum pedis longi, 372 hallucis longi, 372 pollicis longi, 330 t m. flexoris carpi radialis, 333 digitorum (pedis) longi, 378 hallucis longi, 378 pollicis longi, 333 m. perontei longi plantaris, 378 m. tibialis anterioris, 372 posterioris, 378 mm. abductoris longi et extensoris brevis pollicis, 330, 333 mm. extensorum carpi radialium, 330 mm. extensoris digitorum communis et extensoris indicis, 330 mm. flexorum communium, 333 mm. peronaeorum communis, 372, 378 Venter (musculi), 262 Vincula of the extensor tendons of the fingers, 330, 331 and note of the toes, 3S0 tendinum (digitorum manus), 331 (digitorum pedis), 380 Vinculum subflavum, 331, note Wall of the axilla, anterior, 283 posterior, 283 White line of the pelvic fascia, 346 AN ATLAS OF HUMAN ANATOMY FOR STUDENTS AND PHYSICIANS BY CARL TOLDT, M.D. ASSISTED BY PROFESSOR ALOIS DALLA ROSA, M.D. !a^aptc^ to lEngltsb an^ amedcan an& Jnternational tTerminology BV M. EDEN PAUL, M.D. Brux., M.R.C.S., L.R.C.P. FOURTH SECTION E. SPLANCHNOLOGY (figures 641 TO 932 AND TNDEX) REVISED EDITION 9(/oo' NEW YORK REBMAN COMPANY 141, 143 AND 145 WEST 3Gtii STREET Copyright, 1919, by REBMAN COMPANY SPLANCHNOLOGIA SPLANCHNOLOGY 51 SPLANCHNOLOGY— GENERAL CONSIDERATIONS 51—2 404 SPL A NCHNOL OGY— GENERAL CON SI DEE A TIONS Columnar cells Striated border or cuticular layer I Basement membrane , Cubical cells Pavement cells Fig. 641. — Columnar, or Fig. 642. — Cubical Cylinder, Epithelium. Epithelium. Simple Epithelium^ in Vertical Section. Fig. 643. — Pavement Epithelium. Fusiform celk Spheroidal cell - —Columnar or pyramidal cells — Basement membrane Fig. G44.— Transitional! Columnar Ciliated Epithelium in Vertical Section. Capillary bloodvessels Arterioles =-'-' Venous network - Flattened cells Cells becoming flattened —-Spheroidal cells -Cylindrical cells - Papilla Areolar tissue of the mucous membrane (corium) Lamina propria mucosae Fig. 645. — Stratified Epithelium^ in Vertical Section (Mucous Membrane of the Lower Lip). The bloodvessels of the mucous membrane have been artificially injected. ' Classification of Epiihelia.—hn epithelium consisting of a single layer of cells is called a simple epithelium, in contradistinction to a stratified epithelium, which consists of numerous layers of cells. Where two or three layers of cells only are found, the cells nearer the basement membrane being usually smaller, and dovetailed among the bases of the superficial cells, the epithelium is called transitional. Transitional and stratified epithelium are grouped together as compotcrid epithelia. — Tr. Epithelium. SPLANCHNOLOGY— GENERAL CONSIDERATIONS 405 Excretory orifice • l^dus of the gland Nuclei of the • secreting cells Gland cells (secreting cells) Basement membrane Membrana propria Gland cells 'secreting cells j Fig. 646. — Simple Tubular Gland. Fig. 647. — Convoluted Tubular Gland. Fig. 648. — Branched Tubular Gland. GLANDULJi TUBULOS^ TUBULAR GlANDS. .Corium (areolar tissue of the mucous membrane) Lamina propria mucosae - Submucous areolar tissue Tela submucosa - Accessory lobule -Excretory orifice Excretory duct Fig. 649. — Racemose or Acinous Gland (Glandula Alveolaris Simplex'), the Ducts of WHICH have been INJECTED (LaBIAL GlAND). Artery to the gland ; Main artery Arterial offsets to the lobes of the gland Excretory duct Ductus excretorius Primary branches of^': the excretory duct Lobules of the glana Ixjbuli glandula' Lobes of the gland Lobi glandula; bu.. 650.— Racemose ok Acinous (,l.\mj (.ulandula Alveolaris Composita'), the Lobes oi-- which have been artificially isolated AND DRAWN APART (THE SUBMAXILLARY GlAND). • Thouzh ihc Ubial gland shown in Fig. 649 is called by the author glandula alveolaris „m/>U.r, and the sul.n.axillary gland oglossu Hyoid bone — Os hyoideum Thyrohyoid muscle M. thyreohyoideus Omohyoid muscle M. omoh\oideus Sternohyoid muscle M. sternoh^ oideus Sternothyroid muscle M. sternoth\ rcoideus Deen cervical [Superficial layer ?o=!.T I Lamina superficialis Fasda colli "If ^^Pl^y-'^, , l Lamina profunda *Jugular venous arch *Arcus vtnosus juguli Left innominate vein V. anonyma sinistra Manubrium — Manubrium sterni Thymus gland - Thymus Ascending aorta Aorta ascenden: Right auricular appendix Auricula cordis de\tra Styloglossus muscifc / Stylopharjmgeus muscle Glossopharyngeal nerve-^ N. glossopharyngeus Facial artery' — A. maxillaris externa Digastric muscle — M. digastricus Lingual artery— A. lingualis Stylohyoid muscle — M. stylohyoideus Superior thyroid artery A thyreoidea superior Deep cervical fascia (deep layer) Fascia colli (lamina profunda) Carotid sheath Vagina vasorum Prevertebral fascia Fascia prjevertebralis First dorsal vertebra \ ertebra tlioracalis I. ._ Inferior thyroid artery \. thyreoidea inferior Common carotid artery A carotis communis Subclavian artery \ subclavia Innominate artery V anonyma Mediastinal pleura I amina mediastinalis pleurae Right pulmonary artery A. pulmonalis dextra Pericardial cavity ' Cavum pericardii , , Posterior mediastmum- ', Cavum mediastinale posterius Pericardium 1 Facial Artery. — Quain gives external maxillary and Macalister exferfial mandibular as an alternative name for this artery, but it is so rarely in England called anything but thi: facial artery, that I have not thought it necessary to mention these synonyms in the text. — Tr. 2 Mediastinum. —Thft word med!asfinu7n {per mt-diiim tcnsnm^ " stretched through the middle ") properly denotes the bilaminar median partition between the right and left pleural cavities ; the space between these layers, cavum mediastinale, should, strictly, be spoken of as the mediastinal caz'ity or space. In England, however, it is customarj'. when speaking of the various divisions of this cavity, to call them, by metonymy, simply anterior mediastinum, middle mediasti7tnm, /tostericr mediastinum, and sifperior mediastin itm. — Tr. 3 Jugii'ar fenoHS .-i;v//.— This term is not used by English anatomists. It is applied by Toldt to the communicating branch in the suprasternal space {s/'atiunr i nicraponeuroticum suprasterttale, or Burns's space) between the two anterior jtisular veins, and to those portions of the anterior jugular veins below the communicating branch, which run outwards on each side behind the origin of the sterno- cleidomastoid muscle to open into the lower end of the external jugular vein. A transverse venous arch is thus formed at the root of the neck between ihe external jugular veins. — Tr. 4 See note 3 to p. 411. 5 Or ninth cranial nerve. Fig. 659. — Visceral Cavity (C(Elom) of the Head and Neck, and its Connexion with the Visceral Cavity (Cceloii) of the Thor.-\x, in Median Sagittal Section. From a Well-hardened Body, DIVIDED SAGITTALLY IN THE MEDIAN PLANE, WITH THE ViSCERA REMOVED. RiGHT SiDE. Cavu 1 viscerale capitis et colli — Visceral cavity (coelom) of the head and neck. CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS 411 Nasal cavity Cavum nasi Cartilaginous septum of the nose Septum cartilagineum nasi Colunma nasi Septum mobile Oral cavity* Cavum oris Aperture of the mouth Kima oris Vestibule of the mouth Vestibulum oris Upper surface, or dorsum, of the tongue Dorsum linguas Lymphatic gland L\ mphoglanduia Mylohyoid muscle M. mylohyoideus Hyold bone — Os hyoideum Vestibule of the larynx \'estibulum larjngib Prominence of the larynx Prominentia !ar\n,ea Laryngeal cavity Ca\ um larj ngis Trachea Trache i Isthmus of the thyroid body Isthmus glanduK thjreoidea Sternothyroid muscle M. sternoth}reoideus Inferior thyroid vems Vena- thyrec iJe t Left innominate vein Vena anonyma sinist Thymus gland Thymus Pericardial cavity . Cavnm pericardii Right auricular appendix'' — Auricula cordis destra Body of the sternum, or gladiolus Pericardium Auriouloventricular furrow Hard palate Palatum durum Pharyngeal tonsil' fonsilla phar\ngea ''Pharyngeal orifice of the Eustachian tube Ostium phar\ n^eum tuba: Arched summit of the pharynx l-orni\ pbarj ngis Nasal part of the pharynx, nasopharynx, or post nasal space — Pars nasalis pharyngis Isthmus of the fauces I thmus faucium Soft palate, or velum pendulum palati Velum palatinum (Palatum moUe) The axis Lpistropheus Oral part of the phar3mx, or fauces Pars oralis pharyngis Root of the tongue Kadi\ Iin,,UA Laryngeal part of the pharynx 1 ars lar\ n„ea pharyngis Prevertebral fascia i ascia pr-Evertebralis Spinous process of the seventh cervical vertebra Vertebra prominens Body of the first dorsal vertebra \ ertebra thoracalis 1 , Cervical portion of the oesophagus I sophagus (pars cervicalis) Innominate artery Arteria anonyma ^_ Ascending aorta Aorta ascendens Bifurcation of the trachea Hifurcatio tracheae Right pulmonary artery Arteria pulmonalis dextra Atrium of the right auricle ^ Atrium cordis ik-xuuin Pericardial cavity • 1 •; ; Thoracic portion of the oesophagus ] 1 ';; CEsophagus (pars thoracalis) j I ' Bronchial lymphatic glands- LymphoglanduliE bronchiales I Pericardium ' Atrium of the left auricle'' Atrium cordis sinistrum h the tottsiU proper (amygdala:, tonsllla; ue round the commencement of the f.tuccs, has been called by Waldeyer the lymphoid /aucial • Known alwj as /.uschfta's gland or Lusclika's lonsil (third tonsil). This combim palatina:) and x\\k tin^itat tons// {(itunh tonsil, see note 4 to p. 416) to form a ring of lymphoid the com inutty of which in the earlier stages of development is almost unbroki rr'if^, — Tk. » Or pomttnt Attanti. ... . . • c 1 1 ' On the Continent, the siKnificTlinn of the term auricula is restricted to its proper and primitive meaning, dei nting what in bngland is u-ually called the nur/cu/ar n/'Pni Labium inferius Buccinator muscle M. buccinator Parotid duct, or duct of Stensen Ductus parotideus ' Some n( the iucca/ eZ/ttiifs \\c bttween the buccinator muscle ami [he mucous memhrane and lh.-chtc);. Those here figured, however, '.arser than ihc rest, arc between the buccinator and masseter muscles. They open by separate ducts near the last molar tooth, and are distinguished as ntolar f^ianiis. — Tk. Fig. 663.— Mucous Glands of the Lips and the Cheeks, Labial and Buccal (Molar) Glands, laid bare by the Removal of the Skin, the Orbicularis Oris, and the Adjacent Muscles. The Mucous Membrane is seen from Before. f>n the left side the buccinator musrlc h;ts not been rcmtwed. Labia oris The lips. 414 CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS The vomer Vomer Nasal crest of the superior maxillary bone— Crista nasalis^ Palatine process of the superior maxillaiy bone \^ Processus palatinus maxillse \ \ Mucous membrane of the hard palate \ alatine glands— rxlandulae palatina;^^ Buccal fat-pad- \ Corpus adiposum buccas ' eptum of the nose — Septum nasi Inferior turbinate bone — Concha nasalis inferior / , Superior or descending palatine artery / / Arteria palatina major^ ' / Maxillary sinus, or antrum of Highmore Sinus maxillaris (Highmori) ; Masseter muscle— M. masseter Malar bone — Os zygo- jiiaticum hi I Vestibule of the mouth Vestibulum oris Buccopharyngeal fascia Kdscia buccopharyngea Buccinator muscle M. buccinator Gum Gingiva Body of the tongue. Corpus linguae Sublingual fold Plica sublingual s Sublingual gland Glandula sublinguahs- Submaxillary duct, or duct of Wharton— Ductus submaxillaris ' Lingual nerve— Nervus lingual Deep cervical / Deep layer (2) ' fascia (i) I Superficial layer (3) ' , Eanine artery — Arteria profunda linguae 1 Skin — Integumentum commune Facial artery^ Arteria maxillaris externa Floor of the mouth Mylohyoid muscle— M. mylohyoideus Digastric muscle -M. digastricus . V Platysma myoides — Platysma Geniohyoid muscle— M- geniohyoideus Genioglossus or geniohyoglossus muscle (2) Lamina profunda (3) Lamina superiiciali; 1 See note ' to p. 410. 2 Sometimes, but inappropriately, named the siickin^~Jyad, — Tr._ 3 A lare:e cavity, sucli as i< llerf represeme'J, does not usually exist in the tongue is almost in apposition with the palate, being separated from it 4 Arter'a Palatina Major.— '["h'K name is given by the author to I descL'ndens, after its emergence on to the inferior surface of the hard palat uth. Normally when the it '3-itir or descettding pala'ii 7-tery, artefia palatina Fig. 664. — Coronal Section through the Face between the First and Second Molar Teeth, Walls of the Oral Cavity: Upper Wall, or Roof of the Mouth, consisting of the Hard Palate, Palatum Durum ; Lower Wall, or Floor of the Mouth, with the Sublingual Gland ; Lateral Walls of the Mouth, formed by the Mucous Membrane of the Cheeks. Cavum Oris, Oral Cavity, the Interior of the Mouth (.vee note. ^ above) ; Vestibulum Oris, the Vestibule of the Mouth. The Diaphragma Oris, formed by the Two Mylohyoid Muscles and strengthened by the Two Geniohyoid Muscles. Seen from Before. Cavum oris — The oral cavity. CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS 415 Epiglottis Pharyngeal cavity Cavum pharyngis Pharyngo-epiglottic fold' I Plica pharyngo-epiglcttica Superior cervical ganglion (ianglion cer\'icale siiperiu Internal carotid artery- Art. carotis interna; Pneiunogastric. glossopharyngeal, and hypoglossal | nerves— Nn- \amis, glos.scpharyngeus et hypoglossus ; I Internal jugularvein — Vena jugularis interna ; ; I External carotid artery— Art. carotis externa . i i i Retromandibular process of the ' ! i parotid gland Processusrelromaiuiil'Ular I nduK p r t 1 Parotid gland The axis Epistropheus Rectus capitus anticus minor muscle M. rectus capitis anterior Rectus capitis anticus major muscle— M. longus capitis Prevertebral fascia -Fascia pr3c\ertebrali3 Superior constrictor of the pharynx ; M.o.nstric-rph.rynsi, superior 1 i Stylopharyngeus muscle i j ; Styloglossus muscle I ' i i Stylohyoid muscle— M. stylohyoideuE '■ ' i ' , Digastric muscle I M ciuistricus Masseter muscle Posterior pillar of the fauces' Arcus pharyngopalatinus \\ ~ j' '' Tonsil (amygdala) \ ♦ Tonsilla palatina Palatine glands ■v Glandule palatina" y ,^ 'Tonsillar sinus — *Sinus tonsillans-' \\ /^ Anterior pillar of the fauces' W Arcus glossopalatinus Facial artery*' Art maxillaris externa Vestibule of the mouth Vestibulum oris Parotideomasseteric fascia' Fascia parotideomasseterica Ramus of the mandible Ramus mandibula: Internal pterygoid muscle M pterygoideus inernus Masseter muscle v/ // *Buccinator crest / *Cnsta Luccinatoria Buccinator muscle ' Buccopharyngeal fascia Fa^ci.i Mitoj[ihi„yngea Buccal glands ^molar glands)- Glandula; buccales Gum Cingi Tip of the tongue ' ' Lower lip Apex linguse Labium inferiu: Angle of the mouth Angulus oris ually distinguished as ^^ parotid fai that ' In England the portion of the deep cervical fascia covering the parotid gland is L covering the masseter muscle, as the masseteric Jtiscia. — Tr. * See note ' to p. 413. 3 Also known as \.\i^ posterior paiatine, ot pharyngopalatiue, arch, 4 Sinus i'onsillaris. — " The tonsil, in the fcetus, develops in a depression between the pillars of the fauces, called the *tonsilIar sinus. As ' rule this depression is not completely filled by the tonsil when that organ has attained its full size, and there usuallyremains above the tonsil ^ triangular hollow, \hc sitpra'oiisil/ar/ossa, which persists through ut adult life. In front of and behind the tonsil the pillars of the fauces may either remain distinct, with a groove of variable depth, the remains of the tonsillar sinus, between them and the tonsil ; or else the tonsil • both I ! pilla -pillar of the (a or f^lossopalatit portion of the latter, becoming con\'erted into lymphoid tissue, comes id Toldt's " Anatomy," 7th ed., p. 300. (Fig. 671. p. 418, shows such ■< ).-Tk. ay l»ecome united with one form an actual constiiuent i»arl ot the ton adhesion between ihc tonsil and the poster: 5 Known also as the anterior palatine ^ See note > to p. 410. 7 Piica Pharyngoepi^iottica.-IVxft^ folds of 'ateral glosio-epighttic /old (Fig 673, p. 419, and Kig. •}•]%, p. 461) i as>"es forwards to the side of the tong (V'\%. 778, p. 461) passes backwards and inwards to the epiglottis ; and the phnryngo-epiglottic/oldy betwee lateral wall of the pharynx. It forms the boundary between the oral and the laryngealpart of the pharyn, Virane is a thin strand of fibrous tissue, cotmecting the side of the epiglottis with the lower bord< pharyngo-epiglottic ligament. — Tk. nbrane pass from each side of the epiglottis t the: :. Beneath thi of the Eustachian cartilage, I adjacent structures. The ar^-teno-epiglottic fold Fig. 665. — Lower Wall of the Oral Cavity, or Floor of the Mouth, with the Tongue and the Lower Lip, and the Middle ok Oral Portion of the Pharynx (Fauces), seen from Above, The cheeks, the tonsils with the palatine arches fpillars of the fauces), and the lateral and posterior walls of the pharynx, have been divided horizontally, likewise the rami of the mandible with the muscles attached thereto, and the parotid glands. Cavum oris — The oral cavity. 416 CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS Papilla palatina, or incisive pad' Papilla incisiva Unilateral remnant of the.^^ nasopalatine canal' Transverse rugae of the hard palate^ ^ Plicae palatinae transverscE •' ' Longitudinal ridge or raphe of the palate Raphe palati Hard palate Palatum durum' Orifices of the palatine glands Soft palate, or velum pendulum palati Palatum molle (Ve'um. palatinum) The uvula Uvula palatina Pharyngeal cavity _ Cavum pharyngis Upper lip Labium superms Frsenum of the upper lip Frenulum labii superioris Angle of the mcuth Angulus oris ^j§' . Orifice of the parotid duct, '" or duct of Stensen ■Mucous membrane of the cheek Tunica mucosa buccae ■Vestibule of the mouth Vestibulura oris ^Grum Gingiva Circumvallate papillae Papillse vallatse Upper surface, or dorsum, of the tongue Dorsum lingua ^,Suprationsillar fossa" Fossa supratonsillaris Tonsil (amygdala) Tonsilla palatina Posterior pillar of the fauces^ Arcus pharyngopalatmus — Anterior pillar of the fauces^ Arcus glossopalatinus •Triangular fold'' *Plica triangularis ^Lingual tonsil, or fourth tonsU''- Tonsilla lingualis I Also known as \.\iunsirictor pharyn.qis si.ptrior Palatopharyngeus muscle' —---- M pharyngopalatinus Palatoglossus muscle, or constrictor isthmi faucium' M. glossopalatinus Buccopharjmgeal fascia Fascia buccopharyngea TonsU (amygdala) Tonsilla palatina — Styloglossus muscle ~ Isthmus of the fauces Isthmu-s faucium Upper surface, or dorsum, of the tongue Dorsum linguae pharyngopalatinc , arch. ^losxflpaiatine, ttrc/i. Fig. 667.— Muscles of the Soft Palate and of the Pillars of the Fauces or Palatine Arches, seen from Before. Aponeurotic Expansion of the Tendon of the Circum- flexus OR Tensor Palati Muscle (attached in Front to the Transverse Ridge on the Lower Surface of the Palate Bone, and forming posteriorly the Palatine Aponeurosis); Retiform Inti-.rlacement of the Fibres of the Two Levatores Palati Muscles. On the left side the mucous membrane has been removed to show the connexioii of tiie buccinator muscle with the superior constrictor of the pharynx through the intermediation of the pterygo- iiaxillary or pterygomandibular ligament. The parts were prepared as in tig. 666. Cavum oris— I'he oral cavity. S3 418 CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS Palatopharyngeus muscle' .. M. pharj'ngopalatinus Motor uvulae or azygos uvulae muscle^ — M. uvulae Interlacing fibres of origin of the two palatopharyngei muscles -Mucous membrane of the pharyngeal surface — Expansion of the tendon of the circumflexus or tensor palati muscle (palatine aponeurosis) -Palatine glands Glandulae palatinae -^ Mucous membrane of th3 .,, oral surface 7l Fig. 668.— Transverse Section thr'ough the Uppermost Portion of the Soft Palate, in the Region of THE Aponeurotic Expansion of the Circumflexus or Tensor Palati Muscle. Palatopharyngeus muscle M. pharj'ngopalatinus Motor uvulae or azygos uvulae muscle' M. uvulas Interlacing fibres of the two levatores palati and palatopharyngei muscles — Mucous membrane of the pharyngeal surface - Levator palati muscle M. levator veli palatini — Palatine glands 6landulae palatinae tlG 669.- _Mucous membrane of the oral surface -Transverse Section through the Soft Palate Midway between its Attached and Extremities, in the Region of the Levator Palati Muscle. Free Tonsillar crypt Fossula tonsillaris Expanded termination of a deep crypt Anterior pillar of the fauces^. Arcus glossopalatinus * Tonsillar sinus'^ " *Sinus tonsillaris Superior constrictor of the pharynx M. constrictor pharyngis superior , -Connective-tissue septa , Adenoid tissue f Lymphoid follicles ' \ Noduli lymphatici Tonsillar crypt Fossula tonsillaris Posterior pillar of the fauces^ Arcus pharyngopalatinus - Mucous gland Glandula mucosa ^ Buccopharyngeal fascia Fascia buccopharyngea Fig. 670.— Horizontal Section through a Large Projecting Tonsil (Tonsilla Palatina) and through THE Pillars of the Fauces. (From an Executed Male Criminal, aged Twentv-two Years.) Anterior pillar of the fauces^ Arcus glossopalatinus Adenoid tissue - Lymphoid follicles Noduli lymphatici Crypts of the tonsil Fosbula; tonsiUares ,— Posterior pillar of the fauces'^ ^Vrcus pharyngopalatinus \ ^~jk;--''Connective-tissue septa - Superior constrictor of the pharynx M. constrictor pharyngis superior Fv? 67s.— Horizontal Section through a Small Sunken Tonsil (Tonsilla Palatina) and through the Pillars of the Fauces. (From a Female, aged Fifty-two Years.) The posterior pillar is united with the tonsil. 5 ' The name motor itziiia sn to the muscle when it w: ~ Known also as the fiostc 3 See note ^ to p. 417. 4 Known also as the ante, suggested by Macalister, is to be preferred s erroneously supposed to be a single median r -ior palatine , or pjtaryngopalatinc^ arcll. Cavum oris — The oral cavity. CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS 419 Superior dental axch Arcus dentalis superior Eaxd palate Palatum durum Fimbriated fold^ Plica fimbriata Commissure of the lips Commissura labnjrum Frsenum of the tongue 1-renulum linguae Floor of the mouth Inferior dental aich Arcus dentalis inferi Frsenum of the lower lip Frenulum labii inferioris Lower Up Labium inferiu Median lobe, or median tubercie, of the upper lip Tuberculum labii superioris .Tip of the tongue Aoex lingua-' Upper surface or dorsum of the tongue Dorsum lingua; - Edge of the tongue Margo lateralis linguae Lower surface of the tongue Fades inferior lingUEe Sublingual fold Plica sublingualii - Submaxillary papilla (caruncula sublingualis), with the orifice of the submaxillary duct, or duct of Wharton -Gum Gingiva Fig. 672.— The Mouth, widely oi'exe.d, with the Tip of the Tongue drawn upwards, to show the Fr/Enum Lingu.e, the Sublingual Fold, the Submaxillary Papilla (Caruncula Sublingualis), and the F1MBRIA.TED Fold. Epiglottis Median glosso-epiglottic fold' Phca glosso-epiglottica mediana Glosso-epiglottic fossa or sinus Vallecula epiglottica Lateral glosso-epiglottic fold Plica glosso-epiglottica lateralis Foramen caecum — Foramen caecum lingua; (Morgagnii) Sulcus terminalis of the tongue Sulcus terminalis linguae Lenticular papillae Papilla- lenticulares Circumvallate papillae I'apilla; sallat;c Foliate papillae Papilke foliat 1 Conical papillae^ Papillae conicx- Fungiform papillae '-■ Papilla; fungiformes Filiform papillae Papillae filiformes efiiglottidis. 4 .See note J lo p. 4 16. Root of the tongue Radix lingu;t Lingual tonsil, or fourth tonsil- Tonsilla hn^ualis /Lymphoid follicles or follicular i' I I glands of the tongue Folliculi linguales Tonsil (amygdala), in horizontal section Tonsilla palatina ♦Tonsillar sinus' *Sinus tonsillaris ♦Triangular fold^ *l'lica triangularis Anterior pillar of the fauces ' Arcus glossopalatinus Body of the tongue (upper surface or dorsum) Corpus lingua' (dorsum) Edge of the tongue Margo lateralis lingua; Median raphe of the tongue Sulcus medianus linguae Tip of the tongue Apex lingux' ^ See note 4 palatine, or giossopatatine, arch. Fig. 673.— The Tongue, Lingua, with the Epiglottis: Radix Lingu.-k, the Root of the Tongue ; Dorsum lingu/e, the upoer surface of the tongue ; apex lingu/e, the tip of the tongiie. Cavum oris — The oral cavity. 53- 420 CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS Body of the hyoid bone Corpus ossis hyoidei "^--^ Small cornu Cornu minus ^~ Great corau Cornu majus Chondroglossus muscle Chondropharyngeus muscle' Transversalis linguae muscle, or transverse muscle of the tongue —- ' M. transvcrsas lingua: Lingualis inferior, inferior lingual muscle, or inferior longitudinal — ' muscle of the tongue ^^ jM. longitudiiialis inlc-rior _^^ Hyoglossus muscle " Genioglossus or geniohyoglossus muscle Lingualis inferior, inferior lingual muscle, or inferior longitudinal muscle of the tongue I^T. longitudinalis inlerior Cut edge of the mucous membrane of the tongue * chondropharyngeus Muscle. — See Fig. 706, p. 433, and note ' o s ^ This is not a single gland on each side, but a group of glands Membranous attachment of the ^genioglossus or geniohyoglossus muscle to the body of the hyoid bone -Hyoglossus muscle Septiun of the tongue Septum lingUK _ Edge of the tongue Margo lateralis linguae Lower surface of the tongue Facies inferior linguse Apical lingual gland (gland of Blandin, gland of Nuhn)- Glandula lingualis anterior ' (Blandini, Nahni) Tip of the tongue Apex linguae ;ated i a small oblong s Most of the glands Fig. 674.— Muscles of the Tongue with the Septum Lingua and the Apical Lingual Glands (Glands OF Blandin or Nuhn, Glandul^e Linguales Anterxores). On the left side the hyoglossus muscle has been removed, to display the chondroglossus and transversalis lingus muscles. Submucous fibrous stratum, or fascia of the tongue — Fascia lin^uje , Lingualis superior, superficial lingual muscle or superior longitudinal muscle of the tongue M. longitudinalis superior Transversalis linguae, or transverse muscle of the tongue — M. transversus linguae Tip of the tongue - Apex linguae Mucous membrane of the tongue Tunica mucosa linguae Foramen caecum Foramen CECum linguae (Morgagnii) Lingual duct (var. )•' Ductus lingualis (var.) Lingual glands -^ Glandulae linguales . — Cartilage of the epiglottis Cartilage epiglottica Hyo-eplglottic ligamenf* Genioglossus or geniohyo- ^ \"\i ^"^11^ " ^^T^"^ l fEi^ "^ ^*^' '^y°"SP^gl°"''^"™ glossus muscle \ HgX V^^^H^^^^ .^^St' ^ Periglottis-* M. genioglossus Inferior maxillary bone, or mandible Mandibula Geniohyoid muscle M. geniohyoideus Membranous attachment of the ''^^^''' Geniohyoid muscle CiT.'fn'r.' °;; g/°i'l^y°glf ^^^Z"' BolyTSroldbone - muscle to the body of the hyoid Corpus ossis hyoidei / bone Middle portion of the thyrohyoid membrane, or middle thyrohyoid ligament Lig, hyothyreoideum medium Thsrroid cartilage Cartilago thjTeoidea 3 See Appendix, Dote ^. 4 See Appendix, note =. Fig. 675.— The Tongue, with the Inferior Maxillary Bone, the Hyoid Bone, and the Epiglottis, in Sagittal Section. Muscles and Mucous Membrane of the Tongue ; Glandulae Linguales, Lingual Glands ; Ductus Lingualis, Lingual Duct. The larynx has been drawn somewhat away from the tongue. Cavum oris — The oral cavity. CEt'HALIC AND CERVICAL FURTIUNS UF THE DIGESTIVE ORGANS 421 Transversalis linguae muscle, or transverse muscle of the tongue M. transversus lingua Submucous fibrous stratum, or fascia of the tongue Fascia linguae Mucous membrane of the tongue . Tunica mucosa lingua: Lower surface of the toagu Facies inferior lingua; Vertical muscle of the tongue M, verticalis lingua: Lingualis superior, superficial lingual muscle, or superior longitudinal muscle of the tongue M. longuudinalis superior Apical lingual gland (gland of Blandin, gland of Nuhni 7l Ulandula lingualis anterior (lilandini, Nuhm) Fimbriated fold — Plica fimbriata Septum of the tongue Septum lingua; Fig. 676.— Coronal Section through the Tip of the Tongue. Glandula Lin(;ualis Anterior, Apical Lingual Gland (Gland of Blandin, Gland of Nuhn). Submucous fibrous stratum, or fascia of the tongue Fascia lingua- Mucous membrane of the tongue , Tunica mucosa lingua: Edge of the tongue Margo lateralis lingua: Ranine artery Art. profunda linguae - Lingual nerve Nervus lingualis Transversalis linguae muscle, or transverse muscle of.the^ Vertical muscle of the tongue ,^M. verticalis lingiuT Lingualis superior, superficial lingual muscle, or superior longitudinal muscle of the tongue M. longitudinalis superior Lingualis inferior, inferior lingual muscle, or inferior longitudinal muscle of the tongue M. longitudinalis inferior Hypoglossal nerve' Nervus hypoglossus ■ Genioglossus or geniohyoglossus muscle Septum of the tongue Septum lingua; Fig. 677.— Coronal Section through the Body of the Tongue. Circumvallate papilla in the foramen caecum Mucous membrane of the tongue Tunica mucosa linguae \ Lymphoid follicle or follicular gland of the tongue — Folliculus lingualis Anterior pillar of the..L fauces' Arcus glossopalatinus \alnt!Hr,«r ghsiopalalint. arch. / » MacaliMcr »*cal!!l of the intrinsic niii>cle< of the longuc as strata, four in numi ''^''""t","ltl}"itr^'nL'IZ'"^^ in that of Willis. Sometimes known a.s the Imgwl motor turi'e. — 'Ik. Cavum oris— The oral cavity. 422 CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS Filiform epithelial processes Secondary papillae Connective-tissue substance or corium, of the papilla Epithelium of the papilla Areolar tissue of the mucous membrane (corium) Lamina propria mucosfe u Fig. 679. — Papilla Filiformes, Filiform Papill.e of the Tongue. Very Large Form, which projects markedly from THE Surface. Longitudinal Section. liSlMA ^Vi Fungoid proliferation on the filiform epithelial processes __ Secondary papillae Stratified epithelium Connective-tissue sub- stance, or corium, of the papilla Areolar tissue of the mu- cous membrane (corium) Lamina propria mucosae Submucousfibrous stratum or fascia of the tongue Fasciculi of the vertical muscle of the tongue, ex- tending into the fascia Lingualis superior, superfi- cial lingual muscle, or superior longitudinal muscle of the tongue M. longitudinalis lingua: superior Fig. 680. — Papilla Filiformes, Filiform Papillae of the Tongue. Small Form, which projects but slightly from the Surface. Longitudinal Section. stratified epithelium Secondary papiUas^ Connective-tissue substance or corium, of the papilla Filiform papilla Papilla filiformis Areolar tissue of the mucous membrane (corium) Lamina propria mucosae Fungiform papilla Papilla fungiformis Fig. 681. — Papilla Fungiformis, Fungiform Papilla of the Tongue, in Longitudinal Sec- tion. stratified epithelium ,^- Secondary papillae Conical papilla Papilla conica Filiform papilla Papilla filiformis - Capillary bloodvessels Arteriole Venule Areolar tissue of the mucous membrane (corium)— I^amina propria mucosa; Submucous fibrous stratum, or fascia of the tongue Fascia lingua; Muscle Fig. 682. — Papilla Conica, Conical Papilla of THE Tongue, among Filiform Papilla, in Longitudinal Section. The bloodvessels of the mucous membrane have been injected : the arteries, red ; the veins, blue. Cavum oris — The oral cavity. CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS 423 Connective-tissue substance of the papilla Taste-buds.^ /'a Excretory duct of a serous gland Areolar tissue of the mucous membrane (corium) Lamina propria mucosae Muscular fasciculi Secondary papillae Stratified epithelium Circular vallum of the papilla Circular fossa of / the papilla Serous glands ^M!^' , J (^'andula; serosae Fig. 683.— Papilla Vallata, Circumvallate Papilla of the Tongue, in Longitudinal Section. Lymphoid follicle Nodulus lymph-iticus Adenoid tissue Papillary layer of the mucous membrane Excretory duct of a mucous gland Mucous glands Glandula- mucosae Lenticular papilla Papillae lenticulares Stratified epithelium Lobules of adipose tissue Areolar tissue of the mucous membrane (corium) Lamina propria mucosae Submucous fibrous stratum, or fascia of the tongue Fascia lingua; Fig. C84. Two Lenticular Papilla of the Tongue, in Longitudinal Sfxtion, Papillary layer of the ,^ mucous membrane '.^ Crypt of a lingual lymphoid follicle Areolar tissue of the mucous membrane 'corium) l-amina propria mucosa; Snbmucons fibrous stratum, or fascia of the tongue Fascia linfju.i: Mucous glands Glandula; mucosx' Stratified epithelium Adenoid tissue Lymphoid follicle Noduli lympliatici Veins in transverse section ^ Muscular fasciculi Fig. 685. -Two Lingual Lymphoid Follicles, or Follicular Glands of the Tongue, in Longitudinal Section. Cavum oris— The oral cavity. 424 CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS Socia parotidis Glandula parotis accessoua Parotid gland Glandula parolisl Superficial temporal artery, \ A. temporalis superlicialis \ \ Auriculotemporal nerve N. aunmlotempor lU-. \ Superficial temporal vem \ - V. temporalis superhcialis ^ Cartilage of the external auditory \ meatus — Cartilage meatus auditcrii externi Pinna, or auricle - Auricula Lobe or lobule of the external . ear (turned upwards) Lobulus auriculas Great auricular nerve -' N. auricularis magnus Sternocleidomastoid muscle M. sternocleidomastoideus Kxternal jugular vein V. jugularis externa * See note ^ to p. 413. 2 In the author's nomenclature, the facial vein and the iejnporomaxiUary v posterior/acial, respectively, and the short trunk formed by the union of the facia! 1 •I facial \An.~1:K. Orbicularis palpebrarum muscle M orbicularis oculi Zygomaticus major muscle ^I z}gomaticus ,-Parotid duct, or duct of Stensen / Ductus parotidetis (Stenonis) \ ^^ Buccal glands (molar '^^ glands)' (ilandulae buccales Buccinator muscle Masseter muscle Facial vein- ~"\'. facialis anterior ^Facial artery'' V. maxillaris externa D gastric muscle M digastricus Submaxillary gland * . mdula submaxillaris Common facial veiu'^ \ f iciahs communis Superficial layer of the deep cer'vical fascia Lamma superhcialis lascije colli Deep layer of the deep cervical fascia Lamina profunda lasci^e colli Sternohyoid muscle M. sternohyoideus ' ximists are termed anterior and [■ division of the temporomaxillary Fig. 6bo.— Glandula Parotis, the Parotid Gland ; Glandula Submaxillaris, the Submaxillary Gland. Right Side. Tonsil (amygdala) — Tonsilla palatina , Internal pterygoid muscle I\[. pterygoideus internus Connective-tissue capsule of the submaxillary gland Facial arterys— A. maxillaris^-,j externa f Submaxillary gland -— f Glandula submaxillaris Digastric muscle — M. digastricus Stylohyoid muscle— M. stylohyoideus Lingual artery— A. lingualis Lesser sublingual ducts'' Ductus sublinguales minores Common carotid artery- A, carotis communis Sublingual fold Plica sublingualis Submaxillary papilla Caruncula sublingualis ^Greater sublingual duct^ Ductus sublingualis major Sublingual gland Glandula sublingualis \ Submaxillary duct, or duct of Wharton Ductus submaxillaris (Whartoni) Mylohyoid muscle M. mylohyoideus 4 See Append Fig. 6S7. — Glandula Sublingualis, the Sublingual Gland, with a Portion of the Submaxillary Gi.and, SEEN FROM the Inner (Oral) Side. Excretory Ducts of these Glands. Left Side. Glandulae salivales — Salivary glands. CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS 425 Parotid duct, or duct of Stensen Ductus parotidcu^ (Sttn Masseter muscle. Ramus of the inferior maxillary bone Ramus mandibula;- Lingual nerve- N. liiigualis Inferior dental nerve N. alveolaris inferior Internal maxillary artery A. maxillaris interna Parotid gland Glandula parotis ' Parotid gland (retro mandibular process) Gl. i.aroli (pr t^ us Internal pterygoid muscle M. ptcMsoideusint^rn External carotid artery A. caroliscN-tern.'i Styloglossus muscle Stylohyoid muscle 'M. stylohyoideus Digastric muscle ' M. digastricus Facial artery' A. maxillaris externa' Submaxillary ganglion- Ganglion submaxillare Facial vein' Vena facialis anterior ' See note < to p. 4 « Or tu'cZ/i/i . motor w^rrr. — Tr, Hard palate 1 ilitum duium Mucous membrane of tie mouth Tongue — Lingua Submaxillary duct, or duct of Wharton I t l)inaxill.,ris(\Vhartoni) Sublingual gland < 1 uidula sublingualis Inferior maxillary bone dibula , Lingual artery A. lingualis Genioglossus or geniobyoglossus muscle Geniohyoid muscle M. qrniohyoideus Mylohyoid muscle M. myl.ihyoideus Digastric muscle M. digastricus Hypoglossal nerve* N hypoglos^ius Hyoglossus muscle Tendon of the digastric muscle Omohyoid muscle M nni )h)'oideus Superior thyroid artery \ tin 1 < idea superior Common facial vein-' \ til I fit lalis communis Common carotid artery V L u lis communis Sternocleidomastoid muscle W sternicleidomastoideus Deep cervical fascia Fascia colli Fig. 688. — Glandula Sublingualis, the Sublingual Gland; Glandula Submaxillakis, tiii: Submaxillary Gland; Glandula Parotis, the Parotid Gland: displayed on the Right Side of the Body after the Removal of a Portion of the Inferior Maxillary Bone. Relations of these Glands to Muscles, Vessels, and Nerves. The anterior ed^e o: me parotid gland with tlie adjoining portion of the parotid duct has been rcii'oved. Glandulac salivales — Salivary glands. 54 426 CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS Orifice of the pulp-canal. Foramen apicis dentis Apex of the fang Apex radicis dentis Crusta petrosa, or cement - Substantia ossea Radical portion of the pulp-cavity^ Canalis radicis dentis Root of the tooth Radix dentis Neck of the tooth CoUum dentis Crown of the tooth Corona dentis Fig. 689. — Dens Incisivus Superior Medialis, Upper Central or Mesial Incisior Tooth, IN Sagittal Section. Substantia Eburnea, THE Dentine; Substantia Adamantina, the Enamel ; Substantia Osse\, the Cement or Crusta Petrosa ; Cavum Dentis, the Pulp-Cavity ; Canalis Radicis Dentis, the Pulp-Canal. 2 Enamel Substantia adamantina Dentine Subbtantia eburnea Gum Gingiva Transition of the dental periosteum' into the periosteum of the outer surface of the jaw- Dental pulp Pulpa dentis Capillary system of the pulp Vein Artery Nerve filaments Dental periosteum' 1 eriosteum alveolare Crusta petrosa, or cement substantia ossea dentis Alveolus or socket Vlveolus dentalis Compact tissue of the mandible Substantia compacta mandibulae Bundle of vessels and nerves for the pulp Medullary spaces of the mandible Fig. 6go. — Dens Caninus Inferior, Lower Canine Tooth, with the Alveolar Portion of the Mandible, the Gum, the Dent.al Periosteum, and the Dental Pulp, IN Longitudinal Section. Dentine of the root of the tooth Substantia eburnea radicis dentis " , Dental periosteum^ Periosteum alveolare Pulp-canal- Canalis radicis dentis ' crusta petrosa, or cement, of the . root of the tooth Substantia ossea radicis dentis -Wall of the alveolus .Medullary spaces ot the alveola process of the maxilla Fig. 691.— The Root of the Upper Central or Mesial Incisor Tooth with the Alveolus and the Dental, Periosteum, in Transverse Section. The soft vascular tissue between the crusta petrosa or cement of the root and the bone, called here simply dental periosteum. 5 divisible into two layers : an outer, the alveolar periosteum, and an inner, the peri-odontal membrane. By dental periosteum is named the pericemental membrane. — Tr. 2 The term pulp-canal, which is in England applied tooth, does not appear to correspond strictly to the author and to the radical portion o/ihe fijUfi-cavity. — Tr. 3 The term root is applied to all that portion of a tooth which is sunk in the alveolus. This root mav consist of one or moxft/a?i£s. — Tr. the canal by which the pulp-cavity is entered through the root of the canalis radicis dentis, which is applied by him alike to tiiQ pul/i-canal Dentes— Teeth. CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS 427 Upper teeth. Denies superiores Lower teeth Denies inferiores Central or mesial and lateral incisor teeth — Dentes INCISIVI, MEDI- alis et lateralis Canine tooth — Dens caninds First and second molar teeth' — Dentes molares I., Fig. 692.— Dentes Decidui, Temporary or Deciduous Teeth, or Milk-Teeth, seen from their Outer (Labial and Buccal) Sides. Upper teeth Denies superiores Lower teeth Dentes inferiores Central or mesial and lateral incisor teeth — Dentes incisivi. medi- alis et lateralis First and second bicuspid or premolar TEETH — Dentes pr«- MOLARES I., II First, second, and third MOLAR teeth' — DeNTES molares I., II., III. Fig. 693.— Dentes Permanentes, Permanent Teeth, showing the Outer Edge of the Incisors and Canines, and the Posterior Surface of the Premolars and Molars. Dentine Substantia eburnea Orifice of tnc palp-canal Foramen apicis dentis Badical portion of the pulp cavity- Canalis radicis dentis Pulp-cavity r^avum clfntis Crown of tne tooth Corona dentis Enamel Substantia . adamantina Upper central or mesial Second lower pre INCISOR TOOTH — DeNS INCI- MOLAR OR BICUSPID SIVUS SUPERIOR MEDIALIS TOOTH — DENS PR/E- MOLARIS INFERIOR II. Second uppkk pre- molar OR BICUSPID tooth — Dens pr.t.- molaris superior ii. _,, Apex of tne fan^ 7 Apex radicis dentis Pulp canal- . Canalis radicis. dentis Pulp- cavity Cavum dentis Tubercles or cusps of the crown ■■'■• Tubercula corunx Jcnli First upi'EK '/, molar tooth — ■ DkNS MOLARIS SUPERIOR I. Fig. 694.— Puli'-Cavii V and Puli'-Canal as seen in Teeth dividkd longitudinally. ■ Known also j,'. grimltn or tiiultuus/:ids. '' Sci; note ' to p. 426. Dentes— Teeth. 54- 428 CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS Lateral and central or mesial incisor teeth ^ Dentes incisivi, lateralis et medialis Canine tooth Dens caninu First and second molar teeth ^- Dentes molares, I., II . Germ of the first permanent molar tooth Alveolus for the second permanent molar tooth Cnli Fig. 695.— Dentes Decidui, Temporary or Deciduous Tekth, or Milk-Teeth, of the Upper Jaw of a Boy AGED Three Years. The Arabic numerals indicate the months of life in which the eruption of the individual teeth usually occurs. Crowns -of the teeth Corona dentis , Lingual surface Facies hnffualis Tubercles or cusps of the crown fubercula coronas dentis Germ of the first permanent molar tooth Masticatory surface Facies masticatoria Buccal surface Facies buccalis Alveolus for the second permanent molar tooth Posterior surface Facies posterior Fig. 696.— Dentes Decidui, Temporary or Deciduous Teeth, or Milk-Teeth, of the Lower Jaw of a Boy AGED Three Years. Areas of ahsorption Central or mesial dpper incisor tooth — Dens incisivus, superior medialis Areas of absorption c:| .5. Remains of the fangs 3 ' Vi First lower molar TOOTH — Dens molaris inferior I. Fig. 697.— Dentes Decidui, Temporary or Deciduous Teeth, or Milk-Teeth, in Various Stages of Absorption, preparatory to their being shed and replaced by the Permanent Teeth. Dentes— Teeth. CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS 429 Lateral and central or mesial incisor teeth Denies incisivi, lateralis et mediahs Canine tooth Derib caninus First and second premolar or bicuspid teeth Denies praemolares, I II First, second, and third molar teeth Denies molares, I. -Ill Wisdom tooth Dens serotinus 18-25 Mucous membrane of the hard palate ' Tunica mucosa palati duri Fig. 698. — Dentes Permanentes, Permanent Teeth, of the Upper Jaw of a Man aged Twenty-six Years, with the Gums. Facies Masticatori^, Masticatory Surfaces- The Arabic numerals indicate the years of life in which the eruption of the individual teeth usually occurs. Crowns of the teeth Corona dentis Tubercles or cusps of the crowns Tubercula coronae dentis Gum Gingiva •^:,"'"' 7 ( Lingual surface ( Facies Im^ualis Outer edge ^ Facies lateralis J^ % Posterior surface ■* '^*'' 1 acies posterior Masticatory surface Facies masticatoria Posterior surface Facies posterior Buccal surface Facies buccalis Fig. 699. — Dentes Permanentes, Permanent Teeth, of the Lower Jaw of a Man aged Twenty-six Years, with the Gums. Facies Masticatori.c, Masticatory Surfaces. Dentes— Teeth. 430 CEPHALIC AND CERVICAL PORTIONS OE THE DIGESTIVE ORGANS Anterior nasal spine^ Spina nasahs anterior Labial surface Fades labialis Outer edge Facies lateralis Buccal surface Facies buccahs Incisor teeth Dentes incism Canine tooth Denscaninus Premolar or bicuspid teeth / Dentes praemolares Buccal surfaoj Facies buccalis Wisdom tooth Dens serotinus Molar teeth Dentes molares I Mental foramen Foramen mentale Fig. 700. — Left Half of the Permanent Teeth, with the Roots laid bare, seen from THEIR Outer (Labial and Buccal) Sides. Normal Relative Positions of Upper and Lower Rows. Pterygoid process ^ Processus pterygoideus Tuberosity of the superior maxillary bone Tuber ma\illare Lingula of the inferior maxillary bone Lingula mandibulas MandibilSfi-or inferior - der-isl Toramen Foramen niandibulare ,^ Anterior palatine groove Canalis incisivus ^■Root of the tooth Radix dentis Neck of the tooth CoUum dentis ,.,-^ Crown of the tooth Corona dentis Surface of contact Facies contactus -Inner edge Facies medialis Lingual surface Facies lingualis _ Median sagittal section of the body of the inferior maxillary bone Roots of the teeth / Radices dentis Fig. 701. — Left Half of the Permanent Teeth, with the Roots laid bare, seen from their Inner (Lingual) Sides. Normal Relative Positions of Upper and Lower Rows. Dentes— Teeth. CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS 431 Temporary canine tooth Dens caninus deciduus Central or mesial temporary incisor teeth Denies incisivi decidui ■ mediales Lateral temporary incisor tooth Dens incisivus deciduus lateralis Gums Gingiva- Central or mesial and lateral temporary - incisor teeth Denies incisi%'i decidui, medialis et lateralis Temporary canine tooth Dens caninus deciduus First and second temporary molar teeth •vD ntes molares decidui, I., II. First permanent upper and lower molar teeth ^Dens molaris I. permanens, superior et inferior '^ First and second temporary molar teeth Denies molares decidui, I,, II. Fig. 702.— Dent-\l GER^rs (Dental S.^cs) of an Infant born at Full Term, displayed f,y the Removal OF THE Walls of the Alvf:oli on the Left Side of the Face. The dental sacs of the upper canine, the lower central incisor, and the first lower molar temporary teeth have beea opened, in order to show the teeth developing in their interior. First and second premolar or bicuspid teeth '' Denies pi cmolares, I., II. Alveolus for the second permanenu T. i • i. i.1, >v!\ ■'^K, .^js^ /■ ■ By molar tooth Permanent canme tootn ^—^^s— r _ Dens caninus permanen Central or mesial and lateral permanent incisor teeth '-- Denies incisi\-i permanentes, medialis et lateralis Central or mesial and lateral temporary incisor teeth -- Denies incisivi decidui, medialis et lateralis Temporary canine tooth Dens caninus deciduus First aiid second temporary molar teeth - Denies molares decidui, 1., II Permanent incisor teeth ., Denies incisivi permanentes Permanent canine tooth Dens caninus permanens Fig. 703.— Left Half of ihl Temporary or Deciduous Teeth, or Milk-Tekth, of a Roy aged Two and a Half Years. By the removal of the appropriate portions of the alveolar walls, the germs of the permanent teeth have been exposed, and the relation of these germs to the roots of the temporary teeth has been made manifest. ■• First permanent upper ais£ lower molar teeth Dens molaris I. permaneno, superior et inferior First and second premolar or bicuspid teeth Denies praeinolares, I., II 9 Q Ten Months Three Years. Five Years. 1 iG. 704.— Stages of Development of the Lateral Permanent Incisor Tooih and of iiie Second i,ower Permanent Molar Tooth. The fourth tooth of each series was already cut. Denies— Teeth. 432 CEPHALIC AND CERVICAL PORTIONS OF TRIE DIGESTIVE ORGANS Carotid canal Canalis caroticus, Cochlea Jugulax fossa tossa jugulans Petrobasilar sjmchondrosis , Synchondrosis petro-occipitalis Fibrocartilage of the foramen lacerum medium Fibrocaitilago basahb Pharyngeal aponeurosis — Fasria pharyngobasilaris Petropharyngeus muscle (var.)i Superior constrictor of the pharynx M. constrictor pharyngis superior Middle constrictor of the pharynx M. constrictor pharyngis medius External pterygoid muscle M pter\ goideus externus Styloid process Processus st\loideus Diagastnc muscle (posterior belly) AI digastncus (venter posterior) Stylohyoid muscle M St} loh-v oideus Stylopharyngeus muscle Internal pterygoid muscle M pter} goideus internus -- Styloglossus muscle Raphe of the pharynx Raphe pharyngis Inferior constrictor of the pharynx M. co:istrictor pharyngis inferior Muscular coat of the oesophagus- Tunica muscularis oesophagi Fig. 705.— The Pharynx, and its Transition into the CEsophagus, seen from Behind. By the Removal OF the Tunica Adventitia Pharyngis,- the Outer Muscular Layer of the Pharynx has been laid bare : Musculi Constrictores Pharyngis, Superior, Medius, et Inferius ; the Superior, Middle, and Inferior Constrictors of the Pharynx. The Muscles arising from the Styloid Process, and the Posterior Belly of the Dig.4stric Muscle. The Pharyngeal Aponeurosis. f .1! ^^''^'/''"^^y'l-S^^^ Muscle.— This, ihe commonest of the supernumerary elevators of the pharynx, arises from the under surface ,t P'^V?"^ f',°"'= ™ "°"' of •''« carotid canal, or from the vaginal process of the ttmporal hone. Others, less often met with, Z.K ine splienoplmryn^eus, ansmg from the spine of the sphenoid ; fetropliaryngeus externus, arising from the hamular process; occipitofliaryngeus, ansmg from the basilar process ; and the mastopjiaryngeus (very rare), arising Irom the mastoid process. They are inserted variably into one or other of the constrictors, or, passing between these muscles, directly into the fibrous layer of the pharyn.\ jpnaryngeal aponeurosis). Another occasional accessory slip is the azygos p/iarytigis, passing frcm the pharyngeal tubercle of the occipital bone to the r iphe or to the posterior wall of the pharyn p. 466. The Pharynx. CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS 433 Internal pterygoid plate Procebsub pterjgoideub (lamina medialis) I CiTcumflexus or tensor palati muscle M tensor \eli palatini Membranous portion of the Eustachian tube Lamina membranacea tubae auditivae Pterygomaxillary or pterygo mandibular ligament Raphe pterjgomandibularis Buccinator muscle Mylohyoid muscle- _ Levator palati muscle M. levator veli palatini ^Pharyngeal aponeurosis 'Fascia pharyngobasilaris Pterygopharyngeus muscle Buccopharyngeus muscle Mylophar3mgeus muscle -M. myloh>oideu3_r- Hyoglossus muscle Tendon of the digastric muscle Tendo m. d Thyrohyoid membrane Membrana hyothyreoidea Superior constrictor of the pharynx' M. con- strictor pharyngis superior Glossopharyngeus muscle Stylopharyngeus muscle Styloglossus muscle Middle con- strictor of the pharynx' M. constrictor pharyngis medius Accessory slip arising from the tendon of the stylohyoid muscle (var.) Thjrroid cartilage Cartilago thyreoidea Chondropharyngeus muscle Ccratopharsmgeus muscle Sternothyroid muscle M. sternothyreoideus Tendinous intersection- — Cricothjrroid muscle M. cricothyreoideus Thyropharyngeus muscle Cricopharyngeus muscle Inferior constrictor of the pharynx' (■ M. constrictor pharyngis inferior Cricoid cartilage Cartilago cricoidea (Esophagus « Constrictors o/ the Pharynx. — \i,i\\tt names given by the author to the different portions of these muscles are not often used in England, it seems expedient to explain their signification. Of the superior constrictor: the pterygopharyngeus is that portion which arises from the lower third of ihe hinder edge of ihs internal pterygoid plate and from the hamular process ; the buccopharvngeus is that portion which arises from the ptcry^oinaxilUry ligament, bv means of which it is connected with the origin of the buccinator muscle; the myh^haryngeus is that portion which arises from the posterior tifth of the internal oblique line or mylohyoid ridge of the inferior maxillary tK.»ne; and the t;'.os\o/>ltaryiigeus is that portion which arises from the side of the tongue. Of the middle conitrictor : the chondropharyngeus is that portion wnich ari.ses from the small cornu of the hyoid bone and the stylohyoid ligament ; and the ceratopharyngeut is that portio i which arises from the great cornu of the hvoid bone. Of the inferior constrictor : the thyropharyngeus is that portion which irises from the inferior cornu, oblique line or ligament, and superior tubercle of the thyroid cartilage ; and the cricopharyntcus is that portion which arises from a flat ridge on the side of the cricoid cartilage.— Tr. : of the I the two muscl the phai ;». -Tk. perficial fibres of the ly, however. intersection almost always contin the: fibri /ith those of the 11 ks the; boundary V\rj. 706.— Outer Muscular Lavkk of the Pharynx, laid bark on the Lrft Side, by the Removal of the Kamu.sof the Infekior Maxii.i.aky Hone, the Muscles arising from the Siyloid Process, the Posterior Uellvofthe Dioa.stric Muscle, and the Mylohyoid Muscle: Musculi Constrictor i-s Pharyngis, the Thrkk Con.strictors of the Pharynx, with iheir Various Suhdivisions {see twtc ' above'). Connexion of the Buccinator Muscle with the Superior Constrictor of the Pharynx hy Means of the Ptervcomaxillary or Pteryoomandibular Ligament. The Pharynx. 55 434 CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS Cushion of the Eustachian orifice Torus tubarius Lateral recess of the pharynx, or fossa of RosenmuUer Recessus pharyngeus (Rosenmuelleri) Pharyngeal bursa (var. )^ Bursa pharyngea (var.) Pharyngeal tonsil- Tonsilla pharyngea Digastric muscle M. digastricus Salpingopharyngeal fold' . „ Plica salpingopharyngea , Parotid gland JL ^ ' Glandula paroti Boot of the tongue Radix linguae Angle of the inferior maxillary bone Angulus mandibula; Posterior pillar of the fauces' Arcus pharyngopalatinus Submaxillary gland Glandula submaxiUaris Pharyngo-epiglottic fold^ Plica pharyngoepiglottica Superior aperture of the larynx Aditus laryngis Thyroid body Glandula thyreoidea_ Posterior nares Choanas Nasal part of the pharynx, nasopharynx, or post-nasal space (i) Ramus of the inferior maxillary bone (=) Soft palate, or velum pendulum palati Velum iMlatiniim Isthmus of the fauces Isthmus faucium Oral part of the pharynx, or fauces Pars oralis pharyngis Tonsil (amygdala) Tonsilla palatina laryngeal part of the pharynx Pais laiyngea pharyngis *Fold of the laryngeal nerve^ * Plica ner\i laryngei Pyriform sinus Recessus piriformis Mucous membrane of the oesophagus Tunica mucosa oesophagi (i) Pars nasalis pharyngis (2) Ramus mandibute is a flask-shaped pit in the mucous membrane, constant in the fetus and iw orifice is on the posterior wall of the nasopharynx, immediately beneath Widening within, the cavity passes upwards and their curves forwards blindly in the median line immediately above the summit of the pharynx, inus a fold of mucous membrane running obliquely downwards and inwards laryngeal nerve, and is therefore called ^lica 7u:rvila.ryngci-i\i>^foldo/ ^ T\\z pharyngeal btlrsa^ or mesial recess of tlie pkaryn. the infant, and occasionally persistent in the adult. Its iiai the pharyngeal tonsil, and looks downwards and forwards, through the substance of the pharyngeal tonsil, and lerminat its fundus being just below the pharyngeal tubercle. — Tr, - See note ' to p. 411. 5 '^ Fold of the Laryngeal Nerve. — " Within the pyriforn is occasionally to be seen. This fold is occupied by the supe: tlie laryngeal nerve." — Von Langer and Toldt's " Anatomy," 7th ed., p. 301 4 Known also as \h& posterior palatine., or pharyngopalaiine, arc/i. 5 See note ^ to p. 415. 6 See Appendix, note •*. Fig. 707.— Cavum Pharyngis, the Pharyngeal Cavity, seen from Behind. Tunica Mucosa Pharyngis, THE Mucous Membrane of the Pharynx. The Three Divisions of the Pharynx ; Pars Na.salis Pharyngis, the Nasal Part of the Pharynx, Nasopharynx, or Post-Nasal Space; Pars Or.alis Pharyngis, the Oral Part of the Pharynx, or Fauces ; Pars Laryngea Pharyngis, the Laryngeal Part of the Pharynx. The Openings into the Pharyngeal Cavity. The posterior wall of the pharynx was divided throughout in the median line, separated from its attachments to the base of the skull, and then turned outwards on each side. The Pharynx. CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS 435 Eustachian cartilage CartiIa,L;>. till . Levator palati muscle M levator veil j lUtini Salpingopharjmgeus muscle M. salpin^L>phar\ ei Superior constrictor of tbe pharynx ■via... ,.h..,5n^,~-ut r Motor uvulae or azygos uvulae muscle' — M lu iil t Palatopharyngeus muscle — M. phaiyn- [ lUtinus Isthmus of the fauces Isthmus fauciutn Uvula Uvula palatina Tonsil I amygdala) Tonsilla palatina Root of the tongue Radix linguae Pharyngo-epiglottic fold' . Plica pharyngo-epiglottica Superior aperture of the larynx. Aditus larvngis Uacous membr?jie of the pharynx Tunica mucosa pharyngis 'Cricopharyngeal ligament''-- 'I-ig. criropharyngeum Muscular coat of the oesophagus Tunica muscularis (Rsophagi Mucous membrane of the oesophagus Tunica mucosa oesophagi 3 Salpingopharyn^eus Muscle. Eustachian cartilage to the wall of the pharynx. 4 See note ' to p. 418. 5 See Circumflexus or tensor palati muscle M. iLiis.jr vcli |,.,lalir.i Internal pterygoid muscle M pterjg deus internus _ Levator palati muscle M ItMtor %ehpilalini Styloid process Pr e I tjlo.deus — Stylopharyngeus muscle Digastric muscle — M. digastricus Palatopharyngeus muscle- M. pharyngopalatinus Radiation of the fibres of the stylopharyngeus muscle ..Muscular coat of the pharynx Tunica muscularis pharyngis Mucous membrane of the pharynx Tunica mucosa pharyngis Areolar or submucous coat of the pharynx Tela submucosa pharyngis .. Areolar or submucous coat of the oesophagus Tela submucosa ixsophagi note ■ to p. 411. consists of a few slender fasciculi t is usually regarded lie ^ top. 415. i which descend from the lower and ante muscJT- accessory portion of the palatoph.irj'ngeus 6 .See Fig. 771, p. 459, and note ' on sa me page. Fig. 708.— Muscles of the Soft Palate (Velum Pendulum Palati), and the Vertical Muscles (Elevators) of the Pharynx, displayed by opening the Pharynx from Behind by a Median Longitudinal Incision and removing the Mucous Membrane. On the right side, the levator palati muscle and a small portion of tlie wall of the pharynx have been removed, in order to display the circumflexus or tensor palati muscle and a great part of the stylopharyngeus muscle. In the immediate neighbourhood of the superior aperture of the larynx faditus laryngis), the mucous membrane of the pharynx has not been removed : also along the borders of the median longitudinal incision a narrow strip of the mucous membrane has been left. The Pharynx. 55— 2 436 CEPHALIC AND CERVICAL PORTIONS OF THE DIGESTIVE ORGANS Ala of the vomer Ala vomens Pterygoid process Processus pterye;oideas Membranous portion of the Eustachian tube Lamina membranacea tubae audituae Circumflexus or tensor palati muscle M. tensor veli palatini Salpingopharyngeal fascia Fascia salpingophar\ngea Pharyngeal orifice of the Eustachian tube Ostium pharynf,enm tubx Cushion of the Eustachian orifice Torus tubarius Pharyngeal tonsil^ Tonsilla pharyngea Soft palate, or velum pendulum palati - Velum palatinum Tonsil (amygdala; Tonsilla palatina Fibrocartilage of the foramen lacerum medium Fibrocartilago basalis Osseous portion of the Eustachian tube • Pars obbca tubse auditivte I I Tensor tympani muscle Tympamim or tympanic cavity— Cavum tympani Cartilage of the ex- ternal auditory meatus Cartilago meatus auditorii externi Tympanic plate Firs lympanica ossis temporalis Eustachian cartilage CartUii^o tubae auditiva2 Levator palati muscle •' " ■ .alatini Styloid process--Processus styloideus Stylopharyngeus muscle Superior constrictor of the pharynx M constrictor pharyngis superior Posterior wall of the pharynx Panes dorsalis pharyngis Fig 7oq— Pars Nasalis Pharyngis, the Nasal Part of the Pharynx, Nasopharynx; or Post-Nasal Space, SEEN FROM BEFORE. CORONAL SECTION THROUGH THE HEAD. TONSILLA PHARYNGEA, THE PHARYNGEAL TONSIL. On the left side, the greater part of the pterygoid process, the anterior wall of the tympanum, and the outer wall of the Eustachian tube, have been removed. Arched summit of the pharynx Fornix pharyngis I Sphenoidal sinus Sinus sphenoidahs /'' X m •v Middle turbinate bone of the nose. Conclia nasalis media Middle meatus of the nose iVIeatus nasi medius Inferior turbinate bone of the nose_ Concha nasalis inferior Inferior meatus of the nose _ Meatus nasi inferior -Palatum durum fel Hard palate Nasopharyngeal part of the inferior meatus, or posterior nasal sulcus^ ' . Sulcus nasalis posterior V^ Nasopharyngeal or salpingopalatine fold^ y Plica salpingopalatina ^ ' Levator cushion^ Soft palate, or velum pendulum palati Velum palatinum Lateral wall of the pharynx Paries lateralis pharyngis Fibrocartilage of the foramen lacerum medium .''Fibrocartilago basalis Pharyngeal tonsil' Tonsilla pliar> ngea \ Pharyngeal bursa (var.)^ 'Bursa phar\n£;ea (var.) Pharyngeal aponeurosis ''Fascia pharyngobasilaris Lateralrecess of the pharynx, or fossa of Kosen- muUer — Recessus pharyngeus (Rosenmuelleri) Cushion of the Eustachian orifice rus tubarius Pharyngeal orifice of the Eustachian tube O Hum pliaryupeum tubje audilivai Anterior occipito-atlantal ligament Membrana atlanto-occipitalis anterior Salpingopharyngeal fold^ Plica salpingopharyngea Posterior wall of the pharynx Paries dorsalis pharyngis Prevertebral fascia Fascia praevertebralis Posterior pillar of the fauces'* Arcus pharyngopalatinus Fig. 710.— Pars Nasalis Pharyngis, the Nasal Part of the Pharynx, Nasopharynx, or Post-Nasal Space, AND its Connexion with the Nasal Foss«, in Median Sagittal Section. View of the Right Lateral Wall of the Nasopharynx, with the Pharyngeal Orifice of the Eustachian Tube. Tonsilla Pharyngea, the Pharyngf.al Tonsil; Bursa Pharyngea, the Pharyngeal Bursa. Sulcus Nasalis Posterior, the Nasopharyngeal Part of the Inferior Meatus of the Nose, or *Posterior Nasal Sulcus, corresponding to the Nasopharyngeal Meatus {see Part /., p. 90, Fis;. 203) ; Plica Salpingopalatina, the Nasopharyngeal OR Salpingopalatine Fold; Plica Salpingopharynge.a., the Salpingopharyngeal Fold.'' '_ Salpingopharyngeal Fascia.- uses it to denote strands of fibrous ti; ■' See note ■ top. 40. ^ — When the levatores palati naris, called the levator cushion, ihis i: Appendix, note 4. 5 Known also as \.\\it posterior palatim portion of the Eustachic Quain applies this name to the membrano sue passing from the Eustachian cartilage t( 3 See note ^ to p. 434. ted, the upper surface of the soft palate presents a convt nally seen in the dead body."— Quain's " Anatomy,' alatine, arch. tube itself, but the author 2 of the pharyn.x. — Tr. behind each posterior part iv. , p. 57. See also See Appendix, note ^ The Pharynx. ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS 438 ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS CEsophagus (abdominal portion) CEsophagus (pars abdominalisj Small curvature of the stomach Curvatura ventriculi minor Small cul-de-sac of the stomach, or pyloric antrum—Antrum pylc Pyloric portion of the stomach Parsp>loriLa\tiilnciili Pylorus ligament cf Helvetius Ligariientum pylon Superior portion of the duodenum (first part) Pars superior duodeni *Superior flexure of the -' duodenum'^ •p'lexura duodeni superior Descending portion of the duodenum (second part) Pars descendens duodeni Cardiac portion of the stomach , Pais cardiaca ventriculi Gieat cul-de-sac, or fundus, of the stomach Fundus ventriculi Lines showing the limits of the attachment of the vis- ceral peritoneum to the wall of the stomach Body of the stomach (anterior wall) Corpus ventriculi (paries anterior) Great curvature of the stomach Cui \ atura ventriculi major Duodenojejunal flexure Flexura duodenojejunalis ^Inferior flexure of the duodenum- •Flexura duodeni inferior - ~- Jejunum Intestinum jejunum Transverse portion of the' 'Ascending portion of the duodenum i,third part) \ , ' duodenum (fourth part) Pars horizontalis (inferior) " ' ' Pars ascendens Inferior portion of the duodenum'* Pars inferior duodeni See Append!: : S. - See Appendix, note 6. 3 See Appendix-, note ''. Fig. 711. — Ventriculus, the Stomach, moderately distended, with the Lov/est Portion OF THE CEsophagus, and the Duodenum. Seen from Before. Mucous membrane of the cesophagus Tunica mucosa cesophagi Muscular coat of the stomach ■ Tunica muscularis ventriculi Mucous membrane of the — stomach Tunica mucosa ventriculi Eugae of the mucous . membrane Plicae mucosa; Areolar or submucous coat of the stomach Tela submucosa ventriculi ""- Muscular coat of the oesophagus Tunica muscularis cesophagi Boundary between the mucous membrane of the stomach and that of the oesophagus Pyloric sphincter / M. sphincter pylori Pyloric orifice Pylorus Mucous membrane of the duodenum Tunica mucosa duodeni Ridge of the pyloric ring^ Valvula pylori - Muscular coat of the stomach Tunica muscularis ventriculi ■* See Appendix, note ^. Fig. 712.— -Anterior Half of the Stomach, which has been divided in Two by Incisions along the Great and Small Curvatures ; seen from the Inside. Transition of the Mucous Membrane of the CEsophagus into that of the Cardia. Pylorus, or Pyloric Orifice. ti^iCM Mucosa Ventriculi, Rug^ of the Mucous Membrane of the Stomach. Tubus digestorius— Alimentary canal. ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS 439 Circular layer Stratum circulare Longitudinal layer Stratum lonritudinale Ligament of Helvetius Ligamentum pylori Fig. 713.— Superficial Laver of the Muscular Coat of the Stomach : Longitudinal Layer. Areolar or ^submucous coat Tela submucosa Fig. 714. — Miiidle and Deep Layers of the Muscular Coat of the Stomach : Circular Layer, and Oblique Fibres. Strips of the circular layer have been removed, in order to display the oblique fibres beneath. Cardia Oblique fibres Fibrae obliqua? u\ _,Circular layer Stratum circulare Small curvature Curvatura minor Fig. 715.— Muscular Coai- .-vr the Cardia, seen FROM Within, the Mucous Membrane havin(; r.KEN REMOVED. Submucous areolar tissur - Tela submucosa Circular layer Stratum cin ulare Duodenum Pyloric sphincter M sphincter pylori Fig. 716.— Muscular Co.\t in the Pyloric Region, laid bare from within. Pyloric sphincter M spliUKli 1 pylori -V Circular fasciculi of tho pyloric sphincter Htucular coat of the dnodeniun Tunica muscularis duodcni Longitudinal layer Stratum longitudinale Serous coat/ Tunica serosa Fasciculi of the longitudinal layer which enter the pyloric sphincter Longitudinal layer of fibres^ FIG. 7.7.-M. SI-HINCTER PYLORI, THE PYLORIC SPHINCTER, IN LONGITUDINAL SECTION. Tubus digestorius -Alimentary canaL 440 ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS Superior portion of the duodenum (first part) Pars superior duodeni *Superior flexure of the duodenum' *Flexura duodeni superior Duodenal papilla, with the orifice of the accessory pancreatic duct (duct of Santorini) Papilladuodeni(Santonni) Descending portion of the duodenum (third parti Pars descendens duodeni Solitary glands (lymphoid follicles) Noduli lymphatic! solitarii Longitudinal fold, or caruncula major, of the duodenum= Plica lonsitudinalU duodeni Fraenulum carunculse Circular rugse, valvulas _,V conniventes, or valves of Kerkring Plicae circulares (Kerkringi) *Inferior flexure of the duodenum' *Flexura duodeni inferior Pylorus Pyloric portion of the stomach Pars pylorica ventriculi Duodenojejunal flexure Fle\ura duodenojejunalis Jejunum Intestinum jejunum Ascending portion of the duodenum (fourth part) Pars ascendens duodeni Transverse portion of the duodenum (third part) -/ Pars horizontalis (inferior) duodeni I Fig. 718. — Duodenum, seen from Before. The Descending Portion has been opened, and the Anterior Wall turned to the Left. Plica Longitudinalis Duodeni, the Longitudinal Fold, or Caruncula Major, of the Duodenum, at the Lower End of which is the Orifice of the Duodenal Diverticulum, Diverticulum Duodenale (Vateri).^ Papilla Duodeni, the Duodenal Papilla, with the Orifice of the Accessory Pancreatic Duct, or Duct of Santorini. Edge of the divided - intestinal wall Muscular coat Tunica muscularib" Mucous membrane - Tunica mucosa Orifice of the common bile-duct (ductus communis choledochus) -* Edge of the divided anterior wall- of the duodenal diverticulum Mucous membrane _ Tunica mucosa Fraenulum carunculse'-' - Head of the pancreas Caput pancreatis Pancreatic duct, or duct of Wirsung ■Ductus pancreaticus (Wirsungi) Common bile-duct Ductus choledochus .Orifices of the mucous glands of the common bile-duct Orifice of the pancreatic duct, or duet of Wirsung Diverticulum duodenale (Vateri), the duodenal diverticulum (so-called), with its peculiar system of folds'-^ "-'j'^ifl '" — Lower extremity of the longitudinal ^"^ J fold, or caruncula major, of the duo- /i denum- FiG. 719. — The Duodenum having been excised, a Longitudinal Incision has been made into the Sac-like , Dilatation, Diverticulum Duodenale (Vateri),^ to show the Imbricated Transverse Folds^ in its Interior. Longitudinal Incisions have also been made into the Lower Extremities of the Common Bile-Duct and the Pancreatic Duct, or Duct of Wirsung, which open into the Duodenal Diverticulum. See Appendix - See Appendix, note 9. 3 See Appendix-, note * Tubus digestorius — Alimentary canal. ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS 441 I Pylorus Groove for the splenic vein Groove for the splenic artery J Superior border — Mar^o superior ^//Accessory pancreas (var.) '' Pancreas accessorium (var.) Common bile-duct Ductus choledochus Tail of the pancreas Cauda pancreatis Body of the pancreas y" (posterior surface) Corpus pancreatis (facies posterior) Anterior border Marge anterior Posterior border Margo posterior Inferior surface Facies inferior *Notch of the pancreas *Incisura pancreatis •Uncinate process, or 'pancreas of Winalow' •Processus uncinatus (pancreas Winslowi) Descending portion of the duodenum (second part) Pars descendens duodeni Head of the pancreas Caput pancreatis Fig. 720. — The Paxcreas ; its Relations to the Duodenum and to the Common Bile-Duct. Accessory Pancreas. Seen from Behind. Accessory pancreatic duct, or duct of Santorini Ductus pancreaticus accessorius (Santonni Entrance of the accessory pancreatic duct, or duct of Santorini, into the duo- denum Descending portion of the duodenum second part) Pars descendens duodeni Entrauce of the pancreatic duct, or duct of Wirsung into the duodenum Anterior surface Facies anterior Tail of the pancreas Cauda pancreatis Anterior border — Margo anterior Body of the pancreas — Corpus pancreatis Pancreatic duct or duct of Wirsung Ductus pancreaticus (\\iisungi, Head of the pancreas Caput pancreatis 'Uncinate process, or "pancreas of Winslow' •Processus uncinatus (pancreas Winslowi) Fig. 721.— The Pancreas, with its Ducts dissected out, seen from Before. Pancreatic Duct, or Duct of Wirsung; Accessory Pancreatic Duct, or Duct of Santorini. ' That portion of the head of rh*r pancreas which extends to the left the author the *uncinaU process, or 'pa, '' "-'-■"-'- = termed the lesser pancreas. — Tk. ni.i,... ^^..^i.uB »., ..1^ .^ » jk-like manner behind the mesenteric vessels, called by 0/ Winslmu, is sometimes completely separate from the rest of the gland, and is then The Pancreas. 56 442 ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS Serous coat Tunica sero'^a Mucous membrane Tunica mucosa Circular rugae, valvules conniveutes, or valves of Kerkring — PlicEe cir- culares (Kerkringi) Solitary glands Noduli lymphatici| solitarii Serous coat Tunica serosa Mucous mem- brane Tunica mucosa Fig. 722. — The Jejunum, in part opened. Fig. 723. — The Ileum, in part opened. Intestinum Tenue — The Small Intestine. Mucous membrane of— the pylorus Tunica mucosa pj'lori Brunner's glands (duodenal glands) Glandulae duo- denales (Brunneri) Accessory pancreatic duct, or duct of San torini Ductus pancreaticus ^^j accessorius Common bile-duct Ductus choledochus Pancreatic duct, or duct of Wirsung Ductus pancreaticus Duodenal diver- ticulum' Diverticulum duo- denale (Vateri) ' See Appendix, note Fig. 724. — Outer Surface of the Mucous Membrane of the Duodenum, with Brunner's Glands (Duodenal Glands), displayed by the removal of the mus- CULAR Coat. Agmmated glands, or? Peyer's patches Noduli lymphatici aggregati (Peyeri) Solitary glands Noduli lymphatici solitarii Fig. 725. — Noduli Lymphatici Aggre- gati, Agminated Glands, or Peyer's Patches, from the Ileum. Crypts or follicles of Lieberkiihn (Lieberkiihn's glands) Gland u las intestinales (Lieberkuehni Intestinal villi Villi intestin- ales 4 Solitary & «? gland (lymphoid „ follicle) ,1 Nodulus -I lym- phaticus solitarius Fig. 726. — Mucous Membrane of the Ileum, WITH A Solitary Gland (Lymphoid Fol- licle). Tubus digestorius — Alimentary canal. ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS 443 Bands of longitudinal -t muscular fibres ; TaenijE coli Inner or free band , Taenia libera -5, Saccules or pouchei of the colon Haustra coli Fig. 727. — Tunica Muscularis, THE Muscular Coat, of the Opened Large Intestine (Transverse Colon), dis- played FROM THE Outer Side by the Removal of THE Serous Coat. Posterior or mesocolic band i Fspnia mesocolica Sigmoid folds of the colon V^ Plicae semilunares coli I Mesocolon Fig. 728. — Intestinum Crassum, the Large Intestine. in PART opened ALONG THE LiNE OF ATTACHMENT OF THE Mesentery. The piece of intestine is in the contracted state. Crypts or follicles of Lieberkiihii <' (Lieberkuhn's glands) Glandula; intestinales I l.ieberkuclini) .c ' 0/ Baxthhi and as the 7>alz>e 0/ Tulpius, but was descrilied by Fallopius at an earlier date than by either of these anatomists. Macalister distinguishes the upper or cnlic lip or segment as the ileocolic valve, aid the lower or cjecal lip or segment as the ileoccrcal valzw. Thfi /rima or retinacitta of the valve are prominent folds in front and behind the orifice formed by the union of tHe two segments; they p:\s^"r>uind the gut to unite opposite the orifice, forming a shelf which separates the caecum from the ascending colon. This shelf is sometimes called ihe/w««i« 0/ Morgagni.—TR. Tubus digestorius — Alimentary canal. ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS 445 Band of longitudinal muscular fibres Taenia coli Muscular coat (longitudinal layer Tunica musculan^ (stratum longitudinale) Levator ani muscle . Prostate gland, in . transverse section Fig. 734. — Intestinum Rectum, the Rectum, the Longitudinal Layer OF Muscular Fibres having been exposed. Seen from Before. Some of the longitudinal fibres are seen to pass on 10 the surface of the prostate gland, and others between the fasciculi of the levator ani rnuscle. Visceral peritoneum Peritonaeum viscerale Mucous membrane I'unica mucosa Muscular coat longitudinal layer) Tunica muscularis (stratum longitudinale) Muscular coat (circular layer) Tunica muscularis (stratum circulare) Tntemal sphincter of the anus' M. sphincter ani internus Skin Integumentum commune Fig. 735. — Outer Surface of the Rectum, WHICH has been isolated AND OPENED FROM Behind. In the lower half the longitudinal layer of the muscular coat has been removed, in order to display the circular layer and the continuity of this latter with the internal or circular sphincter of the anus. Transverse fold of the rectum- _ Plica transversalis recti Third sphincter of the anus M. sphincter ani tertius Mucous membrane Tunica mucosa Hnscular coat Tunica muscularis f Longitudinal layer Stratum longitudinale Circular layer — Stratum circulare Columns of the rectum Columnx' rectales (MorgaKnii) 'Sinuses of the rectum'-. *Sinus rectales External or superficial sphincter of^ the anus .M sphincter ani extcrnus Internal sphincter of the anus' " M. sphincter ani internus Solitary glands (lymphoid follicles) Noduli lymphatic! solitarii Mucous folds Plicae mucosae Anal portion of the rectum (anal canal)-' I'ars analis recti 'Haemorrhoidal ring^ *Annulus haumorrhoidalis ... Skin Integumentum commune Fig. 736.— Mucous Membrane of the Lower Part of the Rectum and its Continuity with the Skin. ' Known also as the f/frfi or circuiar tphincter 0/ the i 3 Sec Appendix, noic '^. * Kn 2 See Appendix, note • -.irculnr sphincter of the anus- Tubus digestorius— Alimentary canal. 446 ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS Diaphragm (costal portion Diaphragma (pars msfnli^; Central tendon' Centrum tendmeum ' Coronary ligament of the liver- .^ Lig coronanum liepatib Right lateral ligament Lig. triangalare dextrum Fibrous appendix of the liver (var.)*^ 'Appendix fibrosa hepatis (var.) Left lateral ligament I, iff. triangulare sinistrum Iieft lobe (superior surface) bus sinister (facias superior) jinterior border of the left lobe \Iargo anterior lobi sinistri Falciform, broad, or suspensory ligament of the liver Lig. falciforme hepatis Umbilical notch Incisura umbilicalis Bight lobe (superior surface) Lobus de-xtra (facies superior) " Round ligament of the liver Lig. teres hepatis Anterior border of the right lobe Margo anterior lobi dextri Fundus of the gall-bladder Fundus vesicae fellese Fig. 737. — Superior Surface of the Liver and its Attachjvients to the Diaphragm. Fibrous appendix of the liver (var. )■' — '\ Appendix fibrosa Aberrant vessels of -^ the liver' Vasa aberrantia hepatis *Ligament of the ../ ductus venosus *Lig. venosum Left hepatic vein V hepatic sinistra Inferior vena cava v. cava inferior Eight hepatic vein — V. hepatica dextra Spigelian lobe' '' Lobus caudatus (Spigeli) ,^ Ligament of the vena cava, or ponticulus hepatis^— *Lig. ven:e cava; Posterior surface 1 1 -. posterior Area bare of peritoneum, and attached to the diaphragm by areolar tissue (Arantii) Omental tuberosity Tuber omentale I Gastric impression / Impressio gastrica Hepatic artery Art liepatica Falciform, broad, or suspensory ligament., of the liver — Lig falciforme hepatis Round ligament of the liver _ Lig teres hepatis Common bile-duct — Ductus choledochus ' / / Hepatic duct — Ductus hepaticus ' / Cystic duct / Ductus cysticus Gall-bladder Vesica fellea Colic Impression Impressio colica Eenal impression Impressio renalis Anterior border Margo anterior I Fig. 738.— Inferior Surface of the Liver ; the Structures occupying the Fissures of the Organ. 3 See Append: Called also the £re/oz/ ^oTffi tendon of the diaphrai ^ See Appendi: o See Appendix, note '7. 7 Or adrenalimp; See Appendix, note 13. 5 See Appendix, i Hepar — The liver. ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS 447 Upper line of reflection of the peritoneum ralciform, broad, or suspensory ligament of the liver Lig. falciforme hepatic Hepatic veins -^ Vena: liepatica: Left lobe Lobus sinister (Esophageal impression Impressio cesophagea Left lateral ligament - Lig. triangulare sinistrum •Fibrous appendix of the liver' "Appendix fibrosa Right lobe (superior surface) Lobus dexter (facies superior) - Posterior surface Facies posterior Fissure of the ductus venosus Fossa ductus venosi Area bare of peritoneum, and attached to the diaphragm by areolar tissue Right lateral ligament Lig. triangulare dextrum Lower line of reflection of the peritoneum ♦Ligament of the vena cava, or ponticulus hepatis' •Lic.a.K-nluni >cn.>e cavE Fissure or fossa of the vena cava Fn.ssa ven;,; ca^■a; Spigelian lobe' Lobus caiidalus (Spigeli) Fig. 739.— Posterior Surface of the Liver, with the Orifices of the Hepatic Veins. 'Fibrous appendix of the liver, with aberrant vessels' 'Appendix fibrosa cum vasis aberrantibus Omental tuberosity Tuber omentale Gastric impression Impressio gastrica Longitudinal fissure Cleft sagittal fissure)'' *Fossa sagittalis sinistra Left lobe Lobus sinister Umbilical fissure Fossa vena- umbilical (Esophageal impressions Impressio 'X-sophagea Fissure of the ductus venosus Fossa ductus venosi Spigelian lobe Lobus caudatus (Spigeli) Quadrate lobe Lobus (|uadr.itii-. Umbilical notch Incisura umbilical •Ligament of the vena cava, or ponticulus hepatis, with aberrant vessels' Posterior surface Facies posterior Suprarenal impression^ Impressio suprarenalis Fissure or fossa of the vena cava Fossa ven,-e cavae *Right sagittal \. fissures or fossae" FosScP sagittales dextrae Renal impression Impressio renalis Eight lateral liga- ment—i.ii;. Itiannuiare Duodenal impression Impressio duodenalis k Fissure or fossa of the gall-bladder Fossa vesica' fcilea: Colic impression impressio colica Tuber papillare Processus papillaris -Right lobe Lobus dexter Caudate lobe- — I'rocessus caudatus Transverse or portal fissure, or porta hepatis Fig. 740. — Inferior Surface of a Liver which was hardened in situ before the Body WAS opened, the Structures occupying the Fissures of the Organ having been entirely removed. ■ S« Appendix, noic '7. » Sec Appendix, note '^. 3 Known also as the trsoplmgeal groove or (esophageal sulcus. « Sec Appendix, nole '4. 5 Or ailrenat im/tression. '' Sagillai Amiort. -Thii nam* is not iinc'l in England. The umbilical fissure and \\\ Areolar or fibrous coat of the liver, or capsule of Glisson Capsula fibrosa (Glissoni) ■ Mucous Glands of the Biliary Ducts. — Quain writes (" Anatomy," tenth ed., vol. iii.. part iv., p. 135) : " Inthe portal canals . the ducts present numerous openings on the inner surface which are scattered irregularly in the larger ducts, but in the subdivisions a arranged in two longitudinal rows, one at each side of the vessel. These openings were formerly supposed to be the orifices of muco glands; but, while the main ducts are studded with true mucous glands of lobulated form and with minute orifices, the openings now referred to belong to saccular and tubular recesses, which are often branched and anastomosing, and may be beset all over with tubular projections (Theile)." — Tk. Fig. 743. — Vasa Aberrantia Hepatis, Aberrant Biliary Ducts, with Mucous Glands (Glandule Mucosa Bilios.e), from one of the Portal Canals, injected with Prussian Blue. Hepar — The iiver. I ft ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS 449 Fundus of the gall-bladder Fundus vesicae fellese ' Serous coat \ Cystic duct Ductus cysticus Ridges and alveoli of the mucous membrane I'licif tunicfe mucosa' Mucous membrane of the ,^ gall-bladder Tunica mucosa vesicae fellea Body of the gall-bladder Corpus vesicae felleae Neck of the gall-bladder Collum vesicae felleae Hepatic duct Ductus hepaticus Common bile-duct Ductus choledochus Fig. 744. — Vesica Fellea, the Gall- Bladuek, moderately distended, with THE Cystic Dl'ct (Ductus Cysticus) AND THE Junction of the Latter with THE Hepatic Duct (Ductus Hepaticus) to form the Common Bile-Duct (Duc- tus Communis Choledochus). Spiral valve of the cystic duct (valve of Heister) Valvula spiralis (Heisteri) Hepatic duct Ductus hepaticus Common bile-duct Ductus choledochus Orifices of the mucous glands of ■''the biliary ducts Fig. 745. — The Gall-Bladder and the Cystic Duct, opened longitudinally. Valvula Spiralis (Heisteri), the Spiral Valve of the Cystic Duct, ok Heister's Valve. Hepar — The liver. 57 450 ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS Superior extremity Extremitas superior Short gastric artery A. gastrica brevis Hilum of the spleen -- j Hilus lienis Posterior border Margo posterior Splenic artery A. lienalis Splenic vein V. lienalis Left gastro-epiploic artery A- gastro-epiploica sinistra Eenal surface Facies renalis Small curvature of the stomach Curvatura ventriculi major _ Superior extremity Phrenic surface Facies diaphragmatica Anterior border 'Margo anterior Gastric surface les gastrica Inferior extremity Extremitas inferior Gastric surface ' Facies gastrica Fig 746. — Lien, the Spleen, Inner or Gastric Aspect, with the Branching Termination of the Splenic Artery AND Vein laid bare.^ Gastrosplenic omentum or ligament^ Ligamencum gastrolienale Inferior extremity Extremitas inferior Hilum of the spleen Accessory spleen (var. ) Lien accessorius (var.) Fig. 747. — The Spleen, with the Gastro- splenic Omentum left aitached, seen FROM Before. Lien Accessorius, an Accessory Spleen. Pulp of the spleen Pulpa lienis ■' Malpighian corpuscles, or lym- f, phoid follicles of the spleen ^pSj^ Noduli lymphatici lienales (Malpighii) /r t j ' Branch of the splenic artery _, Ramus arteri^ lienalis iibrous coat or capsule (tunica propria) Tunica aJbuginea Fig. 748.— a Portion of the Cut Surface of the Spleen of a Young Male Suicide, in which the Malpighian Corpuscles or Lym- phoid Follicles of the Spleen (Noduli Lymphatici Lienales Malpighii) are very abundant. ' C5ee Appendi,x, note i". Reticular framework (trabeculse) of the spleen — Trabeculas lienis ;\ Fibrous coat or capsule (tunica . ' '' propria) — Tunica albuginea \^ Serous coat n Tunica btrosi ^ Pulp of the spleen ' Pulpa lienis I Branches of the splenic artery Rami arterise lienalis Fig. 749. — A Portion of the Cut Surface of a Spleen from which the Pulp has been par- tially removed by Long-continued Affu- .■^lON WITH Water, so that the Fibrous Framework of the Organ has been isolated. ' See Appendix, note ly. Lien — The spleen. ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS 451 Spleen Lien Great curvature of the stomach Curvatura veniricuh major Me sogastrinm Mesogastrium Common mesentery Mesenterium commune Umbilical loop of the intestine' Rudiment of the csecum. — Abdominal aorta Vorta abdominalis Coronary artery of the stomacii (gastric artery) A. gastnca sinistra Splenic artery — A. lienalis Coeliac artery i coeliac axis) "A. cceliaca Hepatic artery ""- A. hepatica — Duodenojejunal flexure Flexiira (lufuk-nnjejunalis ■— Superior mesenteric artery A. mesenterica superior '~~ Splenic flexure of the colon Flexura coli sinistra "Inferior mesenteric artery A. mesenterica interior Bescending mesocolon Mesocolon descendens ■ ( '<«(V//ta/ Zoo* «///u- /«&i//«f —'The small intestine is . . . at first quite short and straight, with a wide aperture to the yolk-sac, but eradually lengtiiens a^* the communication with the yolk-sac becomes more contracted, and . . . develops a long vshaped loop opposite the attachment of the vitallinc duct."— Quain, <>>. cil., vol. i., part l., p. 104. Fig. 750.— Condition- of the Human Alimentary Canal and Mesentery in the Sixth Week OF Intra-uterine Life. Diagrammatic. Mesogastrium (axial portion) Small curvature of- the stomach Common bile-duct Ductus choledochus— ^ Mesodnodennm Duodenojeiunal flexure Flexura duodenojejunalis Common mesentery Mesenterium commune Spleen Lien Mesogastrium (peri- pheral portion) Great curvature of the stomach Curvatura ventriculi major Splenic flexure of the colon Flexura coli sinistra Descending mesocolon Mesocolon descendens Ascending mesocolon M esocolon ascendens Body of the stomach C ( rpus ventriculi Splenic flexure of the colon 1 Icxura coli sinistra Transverse mesocolon (i) Duodenojejunal flexure I k vura duodeno- jejunalis Descending mesocolon":^) Mesentery Mesenterium Sigmoid mesocolon Mesocolon sigmoideuni Fig. 751. — Condition of the Human Ali- mentary Can.^l and Mesentery in the Eighth Week of Intra-uterine Life. Diagrammatic. Fig. 752. — Condition of the Human Ali- mentary Canal and Mesentery in the Middle of the Fourth Month of Intra- uterine Life (Months of Four Weeks Each). Diagrammatic. Peritonseum— Peritoneum. — Mesenterium— Mesentery. 57—2 452 ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS Pancreas Pancreas Mesogastrium (axial portion) Omental sac I j Small or gastrohepatic omentum Mesogastrium (peripheral portion), Mesogastrium Parietal peritoneum Pentonffium panetale Peritoneal cavity— Cavum pemonaei Vestiljule of tlie omental sac ■ Vestibulum bursK omentalis Fig. 753.— Mesogastrium and Omental Sac (Bursa Omentalis, Lesser Cavity of the Peritoneum) before THE Adhesion of the Axial Portion of the Mesogastrium to the Parietal Peritoneum. Beginning of the Third Month of Intra-uterine Life (Months of Four Weeks Each). Transverse Section. Diagrammatic, Mesogastrium (axial portion) Mesogastrium Omental sac I Bursa omentalis Mesogastrium (peripheral portion) Mesogastrium i Stomach Ventriculus 1 Small omentum ' Omentum minus Ductus venosus (Arantii) c Vestibule of the omental sac— Vestibulum bursae omentalis -'Spigelian lobe of the liver= — Lobus caudatus bepatis Left lobe of the liver' Lobus smibter hepati; Site of adhesion of the mesogastrium ' Aorta Parietal peritoneum Peritonseum parietale Suprarenal capsule (adrenal) Glandula suprarenalis Fig. 754.— Mesogastrium and Omental Sac (Bursa Omentalis, Le??s2. Cavity' of the Peritoneum) after the Adhesion of the Axial Portion of the Mesogastrium to the Parietal Peritoneum. End of THE Fourth Month of Intra-uterine Life (Months of Four Weeks Each). Transverse Section. Diagrammatic. Muscular r Longitudinal layer J Stratum longitudinale Serous coat of the intestine Tunica serosa intestini Subserous areolar tissue Tela subserosa , Serous layer of the mesentery Tunica serosa mesenterii | Epithelium ! (endothehum) ^^ Mucous membrane Tunica mucosa ; Submucous areolar tissue Tela submucosa Connective tissue ground substance of the mesentery ' 1 propr a Adipose tissue Penetration of the intestinal wall by fibres belonging to the connective tissue ground / substance of the mesentery Venule Fig. 755.^'--The Mesentery of the Small Intestine and its Attachment to the Intestine. Transverse Section. •' See note = to p. 479. '^ See Appendix, note 16. Peritonaeum — Peritoneum.— Mesenterium — Mesentery. ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS 453 Cscum Intestinum caecum Left lobe of the liver Lobus sinister hepatis \ Round ligament of the liver \ Li,£;, teres liepatis ^ ^ Freely movable portions \ of the colon Gall-bladder Vesica fellea ■jlleum ;' Intestinum ile Peritoneal fold passing from the gall-bladder to the parietal peritoneum Mesoduodenum with the head of the pancreas Duodenojejunal flexure Flexura duodenojejunalis I Parietal peritoneiun ' Peritonaeum parietale I Common mesenteiy Mesenterium commun'5 ^Jejunum Intestinum jejunum _Spleen Lien Splenic flexure of the colos Flexura coli sinistra 'Descending mesocolon' *Mesocolon descendens Line of attachment of the descending mesocolon Sigmoid mesocolon Mesocolon sigmoideum ' 'Descending Mesocolon. — I follow England, however, the use of the term tni alimentary canal, and is no lonfjer applied has become adherent to the parietal perilo rare.— Tr. uthor in the use of this term for the peritoneum internal to the descending colon. In y is usually restricted to the peritoneal folds suspending freely nioz'abtc portions of the es in which, as here in the case of the descending mesocolon, the originally free mesentery The existence of a distinct descending mesocolon (in the English sense of the term) is Fig. 756.- -Mesenterium Commune, Common Mesentery, of an Infant aged Three Weeks (Variety). The adhesion of the duodenum to the parietal peritoneum of the posterior wall of the abdominal cavity has taken place after the normal manner ; but the adhesion of the colon and of the ascending' mesocolon to the anterior surface of the duodenum and to the posterior wall of the abdominal cavity has failed to take place, so that the ascending colon is freely movable, and has been turned upwards with the c;ccum and the coils of the jejunum and ileum ; the delimitation of the ascending colon from the transverse colon is lacking. The ascending mesocolon combines with the transverse mesocolon and the mesentery of the small intestine to form a freely movable common mesentery, which corresponds to the mesentery of the primitive umbilical loop of the intestine (see Fit;. 750 on paj^e 451, and note ' to that pai;e). In the right half of the lower part of the abdominal cavity the primary parietal peritoneum remains exposed ; whereas in the left half the parietal peritoneum is, as is normally the case, represented by the anterior layer of the adherent descending mesocolon (see note ' above). Peritonaeum -Peritoneum. — Mesenterium Mesentery. 454 ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS Transverse colon ^ ( ^*^\!Vv Colon transversum \ O"^ ^■''^J^^^^J?^ Transverse mesocolon "^^ ^j^ Mesocolon transversum ^ Duodenojejunal flexure C Flexura duodenojejunalis Jejunum Intestinum - , Duodenojejunal fold' Plica duodenojejunalis Line of attachment of the transverse mesocolon Splenic flexure of the .'«■■ " colon M Ti^lexura coli sinistra ;>it Inferior mesenteric vein "/ A' mesenterica inferior Anastomotic branch from the left colic to the middle colic artery Duodenojejunal fossa' Recessus duodenojejunalis *Desoending mesooolon" *iMesocolon descendens Duodenomesocolic fold' Plica duodenomesocolica Ascending portion of the duodenum (fourth part Pars ascendens duodeni ^-' Root of the mesentery Radix mesenterii Fig. 757.— Recessus Duodenojejunalis, Duodenojejunal Fossa.^ The transverse colon has been turned upwards ; the jejunum and ileum have been pushed as far to the rioht as possible, to expose the duodenojejunal flexure, the lower (posterior) surface of the transverse mesocolon, and the *descending mesocolon. A sound has been passed into the lower part of the duodenojejunal fossa {i.e., the inferior duodenal fossa — see Appendix, note ="), which extends beside the ascending portion of the duodenum for its wiiole length, and is bounded in front by the duodenomesocolic fold (inferior duodenal fold) *Fibrous appendix of the liver* *Appendix fibrosa hepatis Parietal peritoneum Peritoueeum parietale Phrenohepaiic fossa (var.)" Recessus phrenico- hepaticus (var.) Left lobe of the liver Lobus sinister hepatis Entrance to the phreno- hepatic fossa* Anterior border of the liver Margo anterior hepatis Fig. 758.— Recessus Phrenicohepaticus, Phrenohepatic Fossa.'' A Portion of the Left Lobe of the Liver, WITH THE Fibrous Appendix of the Liver, and a Portion of the Diaphragm. See Appendix, note i4. ■ See note i to p. 453. 5 See Appendi? i See Appendix, note = PeritonEeum — Peritoneum. — Mesenterium — Mesentery. ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS 435 Margin of adhesion of the descending mesocolon Sigmoid flexure of the color Colon sigmoideum Intersigmoid fossa Recessus intersigmoideuj_ Sigmoid mesocolon Mesocolon sigmoideum . Line of attachment of the sigmoid mesocolon Parietal peritoneum Peritoneum parietale Mesorectum Mesorectum Rectum Intestinum rectum Ovary Ovarium Descending mesocolon' Mesocolon descendens Descending colon Colon descendens "% ^Paracolic fossae Iveoessus paracolici -Parietal peritoneum Peritonaeum parietale Peritoneal fold """1 lica serosa Suspensory ligament of the ovary lufundibulopelvic or ovariopelvic fold or ligament) Luamentum suspensorium ovarii -Fallopian tube Tuba uterina (Falloppii) Fig. 759. — Recessus IntersiGxMoideus, Intersigmoid Fossa ; Recessus Paracolic:, Paracolic Fossae. Left Iliac Fossa with the Left Lateral Wall of the Pelvis. The Sigmoid Mesocolon passing into the Mesorectum. Seen from Before. The sigmoid fle.'iure has been drawn upwards. Margin of adhesion of the caecum Retroc3ecal pouches Recessus retroc i c il Subcaecal fold Plica ca,calis Subcsecal fossa ^^ Fossa cairc 1I1-) Parietal peritoneum Peritonxum parietale Caecum IntestMium c 1 cum ■^v Rudiment of the vaginal process of the peritoneum, or canal of Nuck / Kuciiiiientum processus vaginalis / Bound ligament of the uterus . Ligamentum teres uteri / Parietal peritoneum' Peritonaeum parietale .^ICT —Ileum Intestinum ileum Ileocaecal fold- .-.Plica ileocjecalis Ileocsecal or inferior ileocsecal fossa^ - Recessus ileoca-calis inferior Meso-appendix Mesenteriohim processus vermiformis Vermiform appendix "^Processus vermiformis Brim of the pelvis Linea terminalis Fig 760.— Fossa C^ecalis, Subc-ijcal Fossa; Recessus Retroci-xales, Retrocecal Pouches; Recessus Ileo- c/ecalis Inferior, Inferior Ileocecal Fossa. Right Iliac Fossa with the Right Lateral Wall of THE Pelvis. Seen ouLiguELv from Before and the Lefi- Side. The ca-cum has l«;en drawn upwards. " Called by 'Ircvcs the MooJ/tii/oM.-TH. 3 See Apperdix. note »3. Peritonaeum— Peritoneum.— Mesenterium — Mesentery. 456 ABDOMINAL AND PELVIC PORTIONS OF THE DIGESTIVE ORGANS '^\ Left innominate vein Vena anonjma s nistra Thymus gland Thjmi Anterior mediastinum Cavum mediastinale anter us Gladiolus, or body of the sternum Corpus sterni Pericardium Pericard um Pericardial cavity Cavum pericard Omental sac Bursa omentalis. "Transverse mesocolon Mesocolon transversum. Transverse colon Colon transversum. t Anterior layer Great or gastro- ( Lamina anterior. colic omentum- "i „ . , Omentum mains Posterior layer *- Lamina posterior. Mesentery Mesenterium- \ H Ileum Intestinum ileum' Small intestine Intestinum tenue' Preperitoneal space, or cavity of Retzius Spatium prsperitonaeale (Retzii) Urinary bladder Vesica urinaria ' Pubic symphysis Symphysis ossium pubis Tunica vaginalis Tunica vaginalis propria Testicle Testis -" First dorsal vertebra Vertebra thoracalis i. Trachea - (Esophagus — Right pulmonary artery A. pulmonalis dextra ■Peritoneal cavity Cavum pericardii ■Pericardium r T^-f'- Posterior mediastinum' K \ I Cavum mediastinale posterius "TiT— Diaphragm ^^' Diaphragma Small or gastrohepatic omentum Omentum minus - Pancreas Pancreas Retroperitoneal space Spatium retroperitonasale Duodenum (transverse portion) Duodenum (pars horizontalis) Peritoneal cavity Cavum peritonasi Retroperitoneal space Spatium retroperitonseale Sacral promontory Promontorium -> Rectum Intestinum rectum Rectovesical pouch Excavatio rectovesicalis ^ See Appendix, note 24. - Epiploon, the Greek word for omentum, is occa- 3 The visceral layer of peritoneum covering the Hi ^Anus Anus nally used to denote the great omentum. — Tr. - is not indicated in the diagram by a coloured Hue — Tr Fig. 761.— Diagrammatic Representation of the Norimal Course and Arrangeivient of the Peritoneum, THE Mesentery, and the Omental Sac. The blue lines indicate the primary parietal peritoneum ; the red lines, the mesogastrium ; and the yellow lines, the visceral peritoneum, including the peritoneal layers of the mesentery. The continuous lines indicate the free sur- faces of the peritoneum ; the dotted lines, those parts of the peritoneum in which, owing to secondary adhesion, the free surfaces have disappeared (see note 3 above]. Peritonaeum — Peritoneum. — Mesenterium — Mesentery. APPARATUS RESPIRATORIUS RESPIRATORY ORGANS 5^ 458 RESPIRATORY ORGANS Arytenoid facet Facies articnlaris . arytsenoidea Plate or lamina Lamina Thyroid facet Facies articularis thyreoidea Arytenoid facet 1 icies articularis aryta;noidea Plate or lamina I imina Thyroid facet — Facies articularis thyreoidea Ring or arch — Arcos Fig. 762. — Seen from the Left Side. Fig. 763. — Seen from Behind. C.\RTlLAGO CriCOIDEA, the CRICOID CARTILAGE. Superior or great cornu Cornu superius Superior tubercle Tuberculom thy-eoidsam superius V Left ala Lamina sinistra- Thyroid notch' Incisura thyreoidea superior Inferior tubercle Tuberculum thyreoideum inferius Superior or great cornu -- Cornu superius Thyroid notch^ .-- Incisura thyreoidea superior — Superior tubercle Tuberculum thyreoideum superius Inferior tubercle Tuberculum thyreoideum inferius -Inferior or small cornu Cornu inferius Inferior or small cornu — Cornu mfenus Fig. 764.— Seen from the Left Side. ^'^G- 765-— Seen from Before. Cartil.ago Thyreoidea, the Thyroid Cartilage. ♦Fovea triangularis'' — jp* *Fcves, oblongu ^ Muscular process Processus muscularis Comiculum larjmgis, or cartilage of Santorini ^;— -Cartilage corniculata (Santorini) *Crista arcuata' „,..-^._ ^„o^ ,_ „ ColUculus^ Vocal process Processus vocalis Articular surface ■"Facies articularis Fig. 766.— Seen from the Outer Side. Fig. 767. — Seen from Behind. Fig. 768.— Seen from the Inner Side. Cartilago Aryt.'ei'IOidea Sinistra, the Left Arytenoid Cartilage,^ with the Corniculum Laryngis, or Cartilage of Santorij^i. Stalk of the epiglottis . Petiolus epiglottidis Fig. 769. — Cartilago Eptglottica, Cartilage of the Epiglottis. Seen from Behind. ■ See Appendij Or great median tiotch of the thyroid cartilage, ote 23. 3 See Appendix, nota *^. The Larynx. RESPIRATORY ORGANS 459 Great comu of the hyoid bone Cornu majus ossis hyoidei Thyrohyoid membrane Membrana hyothyreoidea ' Triticeal cartUage Cartilago triticea "^^ Lateral thyrohyoi Jigament Lig. hyothyrc ije lateral- Comlculo arytenoid syndesmosis Syndesmosis arycorni u] l i Thyro-epiglottic ligament Lig. thyreo-epigl tliLUm Foramen of the thjrroid cartilage (var Forame.it Posterior crico- arytenoid ligament (i) Posterior ceratocncoid ligament Lis- «ralJCr,coideum Cricothyroid articulation Articulalio eric othyreoidea Lateral ceratocricold ligament Lig. cer,tocr,coide„m laterale Cricotracheal membrane or ligament I.i2. cricotrache •Annular ligaments of the trachea •Ligg. annularia (tracheaha) (.)Lig. >-ar>'tanoideum pDStei , articu- __ J J. Mucous membrane of the pharynx Tunica muc sa pharyngis Membranous wall of the trachea Paxits membranaceus Lnacheas iBody of the hyoid bone ■Corpus ossis hyoidei Hyo-eplglottic ligament L '4. hvQ.cpigk'tticum Middle portion of the thyrohyoid membrane, ' or middle thyrohyoid ligament (2) Bursa of the sternohyoid muscle Pursa n.usculi sternohyoidei Thyro-epiglottic ligament Li, thyreo-cpiglotti.-nm i) 1 / Inferior thyro- "W j arytenoid ligament 1 / Lig. vocale / ''Comiculopharyngeal Superior thyro-arytenoid or ventricular ligament Lig. ventriculare ligament' *1 t, coniicLilopharyngeum Middle portion of the cricothyroid membrane, or middle cricothyroid ligament (3) *Cricopharyngeal ligament' *Li., cricopharyngeum Tracheal glands Glandulse tracheales (2) Lig. hjrothyreoideutn medium (3) Lig. cricothyreoideum (medium) Fig. 770. — LIGAMENT.S of ThK Larvnx, and THE Thvrohvoid Meimbrane, seen from Behind. Fig. 771.— Ligaments of the Larynx, and THE Thyrohyoid Membrane, shown in the Left Half of a Sagittally-hemi- SECTED Larynx. Seen from Within. Inferior thyro-arytenoid ligaments Ligamenta vocalia Thyroid cartilage Cartilago thyreoidea *Conu8 elasticus' Middle portion of the cricothyroid membrane, or middle cricothyroid ligament (4) Cricoid cartilage Cartila,:;o cricoidea (4) Lig. cricolhyreoideum (med ^ Aperture of the glottis j Rima glottidis Vocal process of the arytenoid cartilage I'rocessus vocalis Thyroid cartilage Cartilago thyreoidea Cricoid cartilage /Cartilage cricoidea , Inferior thyro-ars^tenoid ligament — Lig. vocale -Aperture of the glottis Kima glottidis — *Conus elasticus^ Vocal process of the arytenoid cartilage I nicessus vocalis Capsule of the crico- — arytenoid articulation Posterior cricoarytenoid articulation Lig. crico-arytasnoideum posterius Fio. 772.— ♦CoNus Elasticus,* with the Inferior Thvro-arvtenoid Ligaments, which Latter form the Elastic Elements of the True Vocal Cords (I'lic.e Vocale.s). Seen from THE Left Side. The parts have b-^en laid bare by the r'mov;il of the greater part of the left ala of the thyroid cartilage. ■ Sec Appendix, note 27, ' Sec Appendix, I Fig. 773.— *Conus Klasticus,'' with the Inferior Thvro-arvtenoid Ligaments, displayed from Above by the Removal of the Upper Por- tions of the Al>ic of the Thyroid Cartilage AND the Soft Parts internal to the Al^. 3 Sec Appciidi? The Larynx. 58— 2 460 RESPIRATORY ORGANS Thyrohyoid membrane Membrana hyothyreoidea | Mass of fat , Hyoid bone if7'~' Os hyoideum Middle portion of the thyrohyoid membrane, or middle thyrohyoid ligament Lig. hyothyreoideum medium Thyroid cartilage Cartilage thyreoidea Middle portion of the cricothyroid membrane or middle cricothyroid ligament Lig. cricothyreoideum (medium) Cricothyroid ("inner portion muscle I pars recta M. crico- 'I outer portion thyreoideus tpars obliqua Lateral thyrohyoid ligament I Lig. hyothyreoideum lateralt j Fasciculus of the stylo- I pharyngeus muscle ! Triticeal cartilage Cartilago triticea Foramen of the -thyroid cartilage (var ) —Foramen th\ reoideum (var. ) Anterior cerato- — cricoid ligament Lig cerato ricoideum anterius / Ceratocricoid muscle (var M. ceratocricoideus (\ar ) Arjrteno-epiglottideus muscle M. aryepiglotticus / Glands of the aryteno- y ■ epiglottic fold' Glandulae laryngeje mediae Mucous membrane of the larynx Tunica mucosa laryngis Arytenoideus (proprius)muscle (decussating oblique fibres) Mm irytsnoidei obliqui Arjrtenoideus (proprius) muscle (transverse fibres) M arj tsnoideus Cricothyroid mu-scle M cricothyreoideus Cricothyroid articu- lation — Articulatio cricothyreoidea Posterior cricoarytenoid muscle M crico arytsenoideus posterior Fig. 774. — The L.\rynx with the Thyrohyoid Membrane and the Cricothyroid Muscle, seen obliquely from the left side and Before. Fig. 775. — The Muscles of the Larynx seen from Behind. The right ala of the thyroid cartilage has been in part removed. Mucous membrane of the larjmx Tunica mucosa laryngis Laryngeal pouch or saccule Appendix ventriculi laryngis Thyro-epiglottideus muscle M. thyreo-epiglotticus Superior thjrro- arytenoid muscle (var.) M. thyreo-arytsenoideus superior (var.) (External) thyro-arytenoid muscle — M. thyreo-ary- tcenoideus (externus) Lateral crico-arytenoid muscle M. crico-aryta^noideus lateralis Cricothyroid muscle M. cricothyreoideus Cuneiform cartilage, or cartilage of Wrisberg Tuberculum cuneiforme (Wrisbergi) Post-arytenoid glands Glandulae laryngese posteriores — Cuneiform cartilage, or cartilage of Wrisberg Cartilago cuneiformis (Wrisbergi) Posterior crico-arytenoid muscle M. crico-arytajnoideus /j posterior Post-epiglottio glands' Glandulae laryngeae anteriores Glands of the aryteno- epiglottic fold Glandulae larynges medise *Arymembranaceus muscle (var.) *M. arymembranaceus (var.) Arytenovocalis muscle' M. vocalis Cricothyroid muscle M. cricothyreoideus Fig. 776.— The Muscles of the Larynx as seen FROM the Left Side after the Removal of the Greater Part of the Left Ala of the Thyroid Cartilage. The laryngeal pouch or saccule (the recess leading upward from the anterior part of the ventricle) is unusually large. Fig. 777. — The Muscles and Mucous Glands of the Larynx, as seen from Within in the Left Half of a Sagittally-hemisected Larynx. Part of the nuicous membrane covering the true and false vocal cords has been left in siiu. ' See .Appendix, rote 3i. 3 ATytenovocaiis Muscle.- The Larynx. RESPIRATORY ORGANS 461 Superior aperture of the larynx Aditiis laryngis Glosso epiglottic fossa or sinus \ Vallecula epiglottica Lateral glosso-epiglottic fold Plica glosso epiglottica lateralis Pharyngo-epiglottic fold Plica pharyngo-epigl t a Aiyteno-epiglottic fol Plica aryepiglottica Eminence of the cuneifor cartilage, or cartilage of Wrisberg— luber ui .-lii.ororme OVr,,be ) Eminence of the corniculum laryngis, or cartilage of Santorloi- i ubrn. i Pyriform sinus Recessus piritormi Interarytenoid notch Incisura interarytaenoidea' (Esophagus -' Root of the tongue K idi\ lingua •Fold of the laryngeal nerve ' laryneei Membranous / wall of the / trachea— Paries tracheae Cartilage of the epiglottis Cartilago epiLjIottica Vestibule of the laTynx Superior or false vocal cord, or ventricular band Plica ventricularis Ventricle or sinus of the larynx \ triculus laryngis (Morgagnii) Inferior or true vocal cord I lica vocalis *Lip of the glottis * Labium vocale^ Mucous me-nbrane of the larynx T, ica mucosa laryngis Laryngeal cavity (lower or infirarimal division) Ca\-um lar\'ngis Mucous membrane of the trachea Tunica mucosa tracheae Tracheal glands Glandnlae tracheales Tracheal cartilages Cartilagines tracheales Fig. 778. — Anterior Wall of the Laryngeal Part OF THE Pharynx with the Superior Aperture OF the Larynx. The posterior wall of the pharynx has been divided along the median line, and the laler.^1 walls- have been turned outwards. Fig. 779.— Left Half of a SAGiTTALLY-fir.MisECTED Larynx. Plica Vocalis, Inferior or True Vocal Cord; Plica Ventriculaki.s, Superior or False Vocal Cord.or Ventricular Band ; Ventriculus Laryngis, Ventricle or Sinus of the Larynx. Epiglottis Tncercle, cushion, or pnivinar of the epiglottis Tul»;r.;uUim epi;;lcuicum I.aryngeal pouch or saccule .Appendix vcniriculi lar>ngis Superior or false vocal cord, or ventricular band Plica vcntricuL.ris Ventricle or sinus of the larynx Ycnlrirulu%lar>n.;iv Inferior or true vocal cord Laryngeal cavity lower or infrarimal division] Cavum laryngis Pharyngeal cavity Cavum pharyngis _^ Pyriform sinus Aperture of the glottis Kiniagloltidis (i) Ventriculus laryngis (Morgagnii) (2) M. ihyreo-arytrcuoid <4) Pars intercartilaginea rima: glottidi^ Fig. 780.— Anterior Half of a Coronallv-divided Larynx. The Vocal Afpar.\tus, or (W.ottis ; the Aperture of the Glottis, Kima Ci.ottidis ; the inferior or True Vocal Cord, Plica Vocalis, WITH the Labium Vocale ; the Superior ok False Vocal Coko, ok Ventricular Band, Plica Ventri- < UI.AKIS ; XHE VENTRICLE OR SlNUS OF THE LAKYNX, Ventriculus Larvnois, and the Laryngeal Pouch OR Saccule, Appendix Ventriculi Laryngis. ■ S«e Appendix, note y. " See note 7 to p. < 15. ^ See ncic- Ventricle or sinus- j of the larynx \'enlriciilus laryngi: (Morgagnii) Arytenoideus (proprius) muscle (transverse fibres) M. arytrenoideus transversus Arytenoideus (proprius) muscle (decussating oblique fibres) i\I. ar> l.L-noideus obliquus .,*Aperture of the vestibule "Rima vestibuli Ventricle or sinus of the larynx (i) Laryngeal pouch or saccule cushion, or pulvinar of the epiglottis TMberculiimepiglnuicum (External) thyro-arytenoid muscle (;) Intercordal or vocal por- tion of the aperture of the glottis (0 Arytenovocalis muscle* M, vn. alis Interarytenoid or respiratory portion of the aperture of the glottis (4) Arytenoid cartilage (vocal process) (5) (5) Cartilago aryt.-enoidi Fig. 781.— Upper and Lower Halves of a LARv^x, divided into Two Farts by a Horizoni al Sectiov passing IHKOl'GH THE VENTRICLES OF THE LARYNX, with THE Adjacent Part of the Pharynx. In the lower half on the right .side the mucous membrane of the ventricle of the larynx has been removed, to show the arylenovocalis* and (external) thyro-arytenoid muscles. 5 .Sec Appi-n.ll! The Larynx. 462 RESPIRATORY ORGANS Thyrohyoid membrane Membrana hyothyreoidea— Middle portion of the cricothjrroid mem- brane, or middle cricothyroid ligament Lig. cricothyreoideum (medium) Cricotraoheal membrane or ligament Lig. cricotracheale _ Hyoid bone Os hyoideum Wi - ^ _Thyroid cartilage Cartilage thyrcoides ■■■Annular ligaments of the trachea -■ *Ligg. annularia (trachealia) Bifurcation of the trachea Bifurcatio trachea; Eight bronchus Bronchus dexter Eparterial branch of the right bronchus Ramus bronchialis eparterialis Ventral (hyparterial) branches Rami bronchiales '^ ventrales (hyparteriales) ^^ Cricoid cartilage "Cartilage cricoidea First tracheal cartilage Cartilago trachealis I. ^ Tracheal cartilages -^ Cartilagines tracheales , I eft bronchus / Bronchus sinister First and second -, dorsal branches Rami bronchiales " dorsales, I., II. Internal branch Ramus bronchialis medialis Third and fourth dorsal branches —Rami bronclii- ales dorsales, III., IV. Third and fourth dorsal branches /■ Rami broncliiales dorsales, III., IV. First ventral hyparterial) branch Ramus bronchialis ntralis I. (hyparteriali^ Second, third, and fourth ventral _ hyparterial) branches Rami bronchiales \entrales, II. — IV. (hyparteriales) \ Fig. 782. — The Trachea, its Bifurcation into the Right and Left Bronchial Trunks (Bronchi), and the Larger Subdivisions of these (Rami Bronchiales). Seen from Before. The air-passages were filled with tallow before opening the thorax. Subsequently the parts were dissected out and dried. The Trachea and the Bronchial Ramification, RESPIRATORY ORGANS 463 Larynx Thsnroid body Glandula thyreoidea^^ Apex of the Iimg Ape\ pulmonis Bight bronchus Bronchus dexter Ventral branchial branches of the upper lobe Rami bronchiale^ \t ntrales lobi superi n^ Bronchial branch of the middle lobe (first ventral hypartenal branch of the right bronchus) Ramus bronchialis lobi medii Ventral bronchial branches '' of the lower lobe Rami bronchiales ventrales lobi inferioris Left bronchus hronclius sinister Inner or mediastinal surface of the lung Facies mediastinalis pulmonis Ventral bronchial branches of the upper lobe Rami bronchiales ventrales lobi superiorig Dorsal bronchial branches I Rami bronchiales dorsales Ventral bronchial branohea of the lower lobe Rami bronchiales ventrales lobi inferioris Fig. 783.— The Trachea, its Bikukcation into the Right and Left Bronchial Trunks (Bronchi), and the Larger Subdivisions of these (Rami Bronchiales). Relations OF the Bronchial Branches to the Lobes of the Lung and to the Different Regions of these Lobes. Seen from Before. After the lungs had been steeped in alcohol, the bronchial tubes were exposed from the inner or mediastinal surface of the lungs by the removal of the portions of lung tissue by which they were covered. The lungs were drawn a little apart from one another anteriorly. The Trachea and the Bronchial Ramification. 464 RESPIRATORY ORGANS Upper lobe Lobus superior | »jit;erlobar fissure' ^En>^ Incisura mterlobari , ' ; Middle lobd .Lobus mediLis Anterior border 1 Margo anterior Loarer lobe Lobus inferior Apex of the lung Apex pulmonis Upper lobe r (I bus superior Outer or costal surface Facies costalis Interlobar fissure^ Incisura nterlobaris Lower lobe Lobus inferior I Inferior border \ ' Margo inferior Lower, phrenic, or diaphragmatic surface — Facies diaphragmatica Inferior border' Margo inferior Base of the lung ' Basis pulmonis Fig. 784.— Right Lung. Outer or Costal Surface. Fig. 785.— Left Lung. Outer or Costal Surface. Fissures of the Luytg. — The si ; distinguished as great Jisi rrentary Jissure. — Tr. line of reflection of the pulmonary | pleura on to the root of the lung gle fissure of the left lung, and (he lower, more oblique, of the two fissures of the right lung, are '■res from the upper, nearly horizontal fissure of the right lung, which may be called the supple- Hilum of the lung \ Hilus pulmonis ^' Anterior border , y/ Margo anterior I Aortic groove Sulcus aorticus ) Bronchial artenes, Aa. bronchiales Bronchial lymphatic gland ( Lymphoglandula pulmonalis Subclavian groove Sulcus subclavius Koot of the lung , Radix pulmonis Pulmonary artery ^>,^.-' A.rteria pulmonalis Bronchus ^ Pulmonary veins ' Vv pulmonales Inner or mediastmal Facies mediastinalis / Ligamentum latum pul- monis, or broad ligament of the lung — Lig. pulmonale Fig. 786.— Right Lung. Inner or Mediastinal SURF.A.CE, with the Hiluj-; t.aid bare by the Removal of the Structures forming the Root of the Lung. Boundary lines u! t.iij ' pulmonary lobules Ligamentum latum .. pulmonis or broad ligament of the lunf- ,^ Lig. pulmonale Infenoi border Margo inferior Lower, phrenic, or diaphragmatic surface— Facies diaphragmatica Fig. 787. — Left Lung. Inner or Mediastinal Surface, with the Root of the Lung cut ACROSS. Pulmo— The lung. RESPIRATORY ORGANS 465 Membranous wall of the trachea Paries membranaceus tracheae Left bronchus Bronchus sinister Tracheal glands Glandula' tracheales Left pulmonary artery A. pulmonalis ^ramu3 sinister) Hyparterial bronchial branches Rami bronchiales hyparteriales Left pulmonary veins Vena; pulmonales sinistrae Right bronchus ,l!iunchus dexter ,/ Right pulmonary artery /A. pulmonaUs (ramus dexter) Eparterial branch of the right bronchus Kimus bronchialis eparterialis Interlobar fissure ' Incisura interlobaris Bronchial glands - -\ ijlandulae bronchiales Bronchial cartilages ^ 1 _;, -^^Cartilagines bronchiales J,— ^- Venae pulmonales dextrae Atrium of the left auricle' Atrium cordis sinistrum : small mucous glands in the walls of the ijMnchi, and nfounded with the bronchial Fig. 788.— Roots of the Lungs, IL\dices Pulmonum, seen from Behind. Mutual Relations OF THE Pulmonary Artery, the Pulmonary Veins, the Main Bronchial Trunk, and the Primary Bronchial Branches, as they enter the Hilum of Each Lung. Pulmonary alveoli.,. Alveoli pulmonum ~\,~ ~ Bronchioles L- Bronchioli Alveolar passages Ductuli alveolares -. I Pulmonary alveoli - ( Alveoli pulmonum Lobular or respiratory bronchiole Bronchiolus respiratorius Fig. 789.— Ultimate Extri'Mities of the Air-Passages. After filling the bronchial ramification with resin, the lung tissue sunotinding the air passages was removed by maceration in hydrochloric acid. Pulmo— The lung. 59 466 RESPIRATORY ORGANS Hyoid bone Os hj'oideum Pyramid or middle lobe of the thjrroid body (var Lobus pyramidalis (var Thyrohyoid muscle M. thyreohyoideus Middle portion of the crico- thyroid membrane, or middle cricothyroid ligament Lig. cricothyreoideum (medium) Levator corporis thyroidei muscle (var.) II. levator glandulas thyreoidea; (\-..i Right lateral lobe Lobus dexter Isthmus of the thyroid body Isthmus glandulae thyreoideE Lobules of the thyroid body Lobuli glandulse thyreoidese^ Fifth tracheal cartilage -- Cartilage trachealis V Left lateral lobe / Lobus sinister *Adventitious coat of the pharynx (post-pharyngeal fascia) ' *Tunica adventicia pharyngis Right lateral lobe of the thyroid body Lobus dexter glandulas thyreoideae Remnants of the thymus gland Left lateral lobe of the thyroid body Lobus sinister glandulae thyreoideaa (Esophagus Fig. 790. — Glandula Thyreoidea, the Thykoid Body, with the Larynx AND Trachea, seen from Before. Fig. 791. — The Thyroid Body, with the (Esophagus, seen from Behind. Thyroid cartilage Cartilago thyreoidea Thyrohyoid muscle M. thyreohyoideus Levator corporis thyroidei muscle (var.) M. levator glandulse thyreoidese (var.) Thyropharyngeus muscle M. thyreopharyngeus Middle portion of the crico- thyroid membrane, or middle cricothyroid ligament / Lig. cricothyreoideum (medium) ' Pyramidal lobes (var, 1 Lobi pyramidales (var. 1 Lateral ligament of the thyroid body— Lie. su^ pensorium gl. thyreoidwc Lobules of the thyroid body — Lobuli glandulas thyreoidea; Eight lateral lobe Lobus dexter Left lateral lobe Lobus sinister Fig. 792.— Glandula Thyreoidea, the Thyroid Body, with the Isthmus wanting, and with Bilateral Pyra- midal Lobes (Variety). Geniohyoid muscle M geniohyoideus Suprahyoid accessory thyroid ~ body (var. ) — Glandula thyreoidea accessoria suprahyoidea (var.) "Mylohyoid muscle M. mylohyoideus , Accessory thyroid bodies (var.) Glandulas thyreoideas accessoriae (var.) Middle portion of the cricothyroid membrane _ or middle cricothyroid ligament Lig. cricothyreoideum (medium) " Left lateral lobe Lobus sinister '"- Isthmus of the thyroid body Isthmus glandulae thyreoidese Right lateral lobe Lobus dexter Fig. 793. — Thyroid Body with Several Accessory Thyroids ; One of the Latter is situate above the Hyoid Bone, behind the Mylohyoid Muscle. See Appendi; Glandula thyreoidea — Thyroid body. RESPIRATORY ORGANS 467 Hyoid bone __ Os hyoideum Process of the right lobe of the thymus gland (var. ) Thymus gland (right lobe) ^ Thymus (lobus dextei) Bight lung Pulmo dexter Pyramid or middle lobe of the thyroid body (var.) Lobus pyramidalis glandula; tliyreoideac (var. i — Thyroid body Glandula thyreoidea Thymus gland (left lobe) Thymus (lobus sinister) —Left lung I'ulmo sinister -Pericardium Fig. 794. — The Thymus Gland, with the Thvroid Body, the Peric.4rdium, and the Lungs, OF A Human Fcetus in the Sixth Month of Intra-uterine Life (Months of Four Weeks E.\ch). Seen from Before. TTjyroid body Glandula thyreoidea. Thymus gland (right lobe) Thymus (lobus de.^iter' Thymus gland (left lobe) Thymus (lobus sinister) Costal pieura Pleura costalis • Cu^la PUurir.—'nK term \% applied by the author to the dome-shaped summit of the pleun but as this portion o. lOe pleura projectA through the superior aperture of the thorax into the root of the neck, it isgencrill> known in England ai the cervica/ fi/eu? a. — Tr, Fig. 795.— The Thymus Gland, with the Pericardium, as seen from Before after the Lungs have been entirely removed. From a Boy aged Five Weeks. The Thymus Gland. 59—2 468 DEVELOPMENT OF THE VISCERA Fore-gutv Wall of the pharynx—; Amnion Amnion Stomodaeum, or buccal invagination Pedicle of the yolk-sac, or splanchnic staiJi -Hypoblast Entoderm Mesoblast Mesoderm Fig. 796. — Human Embryo in the Beginning of the Third Week (Diagrammatic). Fore-gut Visceral cleft Kudiment of the lung ^ Notochord Chorda dorsalis ^v. Dorsal rudiment of the pancreas Ventral rudiment of the - pancreas Wolffian body, mid-kidney, or mesonephros— Corpus Woirfi Rudiment of the gall-bladder Mid-gut Primitive mesentery Allantois Umbilical vesicle Vesicula umbilicalis Hypoblast Entoderm -Mesoblast Mesoderm C'X^—Vmhilica.l or vitelline duct Ductus omphalo-entericus Chorion . P^ nj — Pleuroperitoneal cavity 'J' KjU'-^ (coelom) *" --Hind gut ^- Rudiment of the uterus Wolffian or mesonephric duct Ductus Wolffi Fig. 797. — Human Embryo in the Beginning of the Fifth Week (Diagrammatic). Epithelium (hypoblast) J Epithel um (e toder ) Peritoneal epithelium / Muscular coat I Tunica muscularis ■i„r ,., i Areolar tissue of the Mesoblast J mucous membrane Mesoderm (corium) Lamina propria \ mucosae I Rudiment of the spleen- Omental sac Bursa omentalis — Duodenum 1^3 ^^^y Common bile-duct j^ Ductus choledochus ' Pancreas Pancreas ^ Portal vein Vena ports Fig. 798.— Rudiment of the Spleen. Human Embryo in the Sixth Week. Transverse Section Mesogastnum Parietal peritoneum Peritoneum parietale Splenic vem — ^ ena henal Abdominal aorta Aorta abdominalis Rudiments of the Viscera. TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA 470 TOPOGRAPHICAL ANATOMY OF THE HORACIC AND ABDOMINAL VISCERA Sternocleidomastoid muscle — M. sternocleidomastoideus Laryngeal part of the pharynx Pars laryngea phary^gib \\ Thyroid Dody \\ Glandula thyreoidea '" (Esophagus (cervical portion) CEsophagus (pars cervicalis' Superior mediastinum Descending aorta --^P" -w Aorta descendens Left bronchus Bronchus sinister W-—i' *Bronoho-cesophageus muscle' *Pleuro-oesophageus muscle- CEsophagus (thoracic portion) Qisophagus (pars thoracalis) (Esophageal plexus Plexus oesophageus posterioi -_ Phrenocostal (diaphragmatioo- costal) supplemental pleural space ^ Sinus phrenicocostalis pleurae (Esophageal opening Hiatus oesophageus Descending thoracic aorta- Aorta descendens Aortic opening Hiatus aorticus - Right common carotid artery V caiotis ciimmunis dextra Internal jugular vein \ jugularis interna Pneumogastric nerve N \ as;us Inferior thjrroid artery A th-\renidea inferior Inferior laryngeal nerve ^ N larjngeus inferior Furst rib Costa I — Cervical pleura" \ Cupula p'ajrs — Pneumogastric nerve N vagus Eight bronchus Bronchus dexter Pulmonary vein Vena pulmonalis Posterior mediastinum Ca\ um mediastinale posterius Mediastinal pleura Pleura mediastinalis Costal pleura Pleura cos talis Pericardium (posterior surface) Pericardium (facies posterior) 1 S Twelfth rib Costa XII. Diaphragm (vertebral portion) Diaphragma (pars lumbalis) Outer crus or pillar'' ' Crus laterale Intermediate crus or pillar '" Crus intermedium Inner crus or pillar^ Crus mediale of the diaphragm ' diaphrag- matis 3 See Append i: i the recurrent laryilgeal t. See Appendix, note 36. Fig. 799- — Course of the Thoracic Portion of the CEsophagus in the Posterior Medi- astinum, AND its Passage through the Esophageal Opening in the Diaphragm. The CEsophagus is seen from Behind, having been exposed by the Removal of the Vertebral Column, the Posterior Extremities of the Ribs, and the Greater Part of the Descending Thoracic Aorta. Broncho-cesophageus and Pleuro-cesophageus Muscles. The pleura has been left intact. Topographical Anatomy of the CEsophagus. I TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA 471 Spinous process of the fifth orsal vertebra . Processus spinosus vertebrae thoracalis \' ! (Esophagus, Azygos vein' — V. azygop^ \ Bronchial lymphatic glands I.\mphoglandula: lirunchiales Eight bronchus— Bronchus dexter\ Eight pulmonary artery ^ y:~ A. pulmonaJis (ramus dexteri ^ S.,mrlinK. calle-l ihc riglil or larx-l azyeo< vein. 'See Apptndix, note *. 1 See note l to p. 4 . i . < JlZ/^iZ'Zl'li'r^'''''' ''' 5 See note 1 lop. 411. 'Or mitral orifice. 7 See Appendix, note *. "r Iruusl-id o, ijice. Topographical Anatomy of the Thoracic Organs. 472 TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA Falciform, broad, or suspen- sory ligament of the liver Lig. falciforme hepatis Parietal peritoneum Peritonaeum parietale Round ligament of the liver Lig. teres hepatis Eight lobe of the liver Lobus hepatis dexter Fundus of the gall- bladder Fundus vesicje fellese' Hepatic flexure of the colon Flexura coli dextra Ascending colon Colon ascendens Ensiform or xiphoid process Processus xiphoideus » Arch of the ribs nS' Arcus costarum CaBcum Intestinum cascum- Hjrpogastric or external- umbilical fold Plica umbilicalis lateralis Urachal or median umbilical fold (superior false ligament, ^,- or suspensory ligament of E the bladder) ^ Plica umbilicalis media V -Left lobe of the liver Lobus hepatis sinister -Stomach (anterior wall) \'entriculus (paries anterior) Great or gastrocolic omentum' (free portion, anterior layer) Omentum majus (pars libera, lamina anterior) Small intestine "Intestinum tenue Sigmoid flexure of the colon Colon sigmoideum Parietal peritoneum Peritonaeum parietale * Or epiploon. See note = to p. 456. Fig. 802. — Position of the Abdominal Viscera as seen after the Abdominal Cavity has BEEN OPENED IN THE UsUAL MANNER AND THE CoSTAL ArCHES HAVE BEEN LAID BARE. The visible portions of the large intestine (colon) are moderately distended with gas ; the great or gastrocolic omentum (omentum majus) is in its natural position. Topographical Anatomy of the Abdominal Viscera. TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA 473 Anterior or omental band Taenia omentalis Hepatic flexure of the colon Flexura coli dextra Inner or free band Taenia libera Ascending colon Colon ascendens , Caecum Intestinum caecum xic uiii ^ «r Intestinum ileum' * -- Great or gastrocolic omentum' (free portion, posterior layer) Omentum majus (pars libera, lamina posterior) Transverse colon Colon transversum Jejunum Intestinum jejunum - Sigmoid flexure of the colon Colon sigmoideum Parietal peritoneum Peritonaeum parietale ■ Or efiifilofln. See note ^ to p. 456. Fig. 803. — Position of thk Viscera in the Lower Portion of the Abdominal Cavity, AFTER THE GrEAT OR GASTROCOLIC OMENTUM HAS BEEN TURNED UPWARDS. RELATION OF THE Great Omentum to the Transverse Colon (Colon Transversum) ; Position OF THE C;Ccum (Intestinum Caecum) and of the Ascending Colon (Colon Ascendens) IN Relation to the Loops of the Free Portions of the Small Intestine (Intestinum Tenue) : Jejunum (Intestinum Jejunum) and Ileum (Intestinum Ileum). Topographical Anatomy of the Abdominal Viscera. 60 474 TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VfSCERA Transverse colon Colon trans\ ersum Great or gastrocolic omentum^ (free portion, posterior layer) Omentum majus (pars libera, lamina posterior) Inner or free band Taenia libera Jejunum Intestinum jejunum^N^f Mesentery (of the small intestine) Mesenterium (intestini tenuib) Transverse mesocolon /' Mesocolon transversum Duodenojejunal flexure Flexura duodenojejunalis Line of attachment of the transverse mesocolon Costocolic or phrenocolic ligament or pleurocolic fold- Lig. phrenicocolicum — Splenic flexure of the colon Flexura coli sinistra Duodenojejunal or superior duodenal fold^ Plica duodenojejunalis -Duodenojejunal fossa^ Recessus duodenojejunalis Duodenomesocolic or inferior duodenal fold'' Plica duodenomesocolica Descending colon Colon descendens "Descending mesocolon^ "Mesocolon descendens Sigmoid mesocolon ^Mesocolon sigmoideura Ileum — Intestinum ileum Csecum — Intestinum caecum Vermiform appendix Processus vermiformis I Or epiploon. 3 See Fig. 757 t Sigmoid flexure of the colon Colon si^moideum ~ Known also as s^tstentaaduiu Hcnis. See Appendix, note 4i. 4 See note ^ to p. 453. Fig. 804. — The Free Portions of the Small Intestine (Intestinum Tenue), the Jejunum (Intestinum Jejunum), and the Ileum (Intestinum Ileum), have been turned as far as possible to the Right, and the Transverse Colon (Colon Transversum) has been drawn upwards, to show the Transition of the Latter into the Descending Colon (Colon Descendens), and of the Descending Colon into the Sigmoid Flexure of the Colon (Colon Sigmoideum). The Mesentery and its Root (Mesenterium et Radix Mesenterii) are seen from the Left Side. Of the Mesentery of the Large Intestine, or Meso- colon, the Left Half of the Transverse Mesocolon with its Line of Attachment, the *Descending Mesocolon {see note * above), and the Sigmoid Mesocolon are visible. Recessus Duodenojejunalis, Duodenojejunal Fossa (see note ^ above). Topographical Anatomy of the Abdominal Viscera. TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA 475 Transverse mesocolon Mesocolon transversum Line of attachment of the transverse mesocolon Hepatic flexure of the colon Flexura coli dextra Ascending colon Colon ascendens 'Ascending mesocolon i 'Mesocolon ascendens Ileocolic or superior ileocaecal fossa^ Recessus ileoca?caIis superior nenm Intestinum ileum Caecum Intestinum cfpcum Meso-appendix Mesenteriolum processus vermiformis Vermiform appendix Processus vermiformis Pelvic cavi Cavum pel Great or gastrocolic omentum- (free portion, posterior layer) Omentum majus (pars 111 era, lamina posterior) Transverse colon Colon transversum Duodenojejunal flexure Flexura duodenojejunalis Mesentery (of the small intestine) Mesenterium (intestini tenuis) Root of the mesentery Radix mesenterii Descending colon Colon descendens — Sigmoid flexure of the colon Colon sitimoideum Rectum Intestinum rectum ■ See Appendix, nole ». ' Or rpil>loon. Sec note = to p. 456. 1 See Appendix, note '3. Fig. 805— The Fkeely-movable Portion of the Small Intestine has, with the Exception OF the Commencement of the Jejunum and the Termination of the Ileum, been cut AWAY FROM THE MESENTERY, AND THIS LaTTER HAS BEEN TURNED TO THE LeFT. ThE Mesentery and its Root (Mesenterium et Radix Mesenterii) are seen from the Right Side. Of the Mesentery of the Large Intestine, or Mesocolon, the Right Portion of the Transverse Mesocolon with its Line of Attachment, and the *Ascending Mesocolon {sec Appendix, note •^) are visible. Recessus Ileoc^ecalis Superior, Ileocolic or Superior Ileocecal Fossa {see Appendix, note '^). Intestinum C^iCUM, the C^cum; Colon Ascendens, the Ascending Colon ; Colon Transversum, the Transverse Colon ; Colon Sigmoideum, the Sigmoid Flexure of the Colon, and its Transition into the Rectum (Intestinum Rectum). Topographical Anatomy of the Abdominal Viscera. 60 — 2 476 TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA Superior mediastinum' Cavum mediastinale Cervical pleura' Cupula pleurae — Eight lung (upper lobe Pulmo dexter (lobus superior) Eight layer of the mediastinum (cut edge) Lamina mediastinalis dextra Eight lung (middle lobe; Pulmo dexter (lobus medius) Plicae villosse, villous or- fatty folds, of the pleura Plica; adiposEB pleurae Diaphragmatic pleura - Pleura diaphragmatica Diaphragm Diaphragma" Falciform, broad, or suspen-- sory ligament of the liver Lig. talciforme hepatis Eight lobe of the liver— Lobus dexter hepatis Bound ligament of the liver - Lig. teres hepatis Fundus of the gall-bladder - Fundus vesicae felleas ♦Gastrocolic ligament' ' *Lig. gastrocolicum Great or gastrocolic omentum^ (free portion, anterior layer) Omentum majus (pars libera, lamina anterior) ec Sternal extremity of the clavicle Extremitas sternalis claviculas Thymus gland (right and left lobes) rh5mus (lobus dexter et sinister) ~- Left layer of the mediastinum Lamina mediastinalis sinistra Left lung (upper lobe) Pulmo sinister (lobus superior) Pericardial pleura Pleura pericardiaca — Anterior mediastinum'-* Cavum mediastinale anterius Pleural cavity Cavum pleura? Left lobe of the liver Lobus sinister hepatis Great curvature of the stomach " Curvatura ventriculi major Omental sac Bursa omentalis Transverse colon Colon transversum Great or gastrocolic omentum^ (free portion, 'posterior layer) Omentum majus (pars libera, lamina posterior) Lower part of the omental sac Recessus inferior omentalis ■ See note ' to p. 467. ' See note = to p. 410 and Appendix, note =4. 3 See Appendix, note 4°. j Or efiplooti. See note - to p. 456. Fig. 806. — Position of the Viscera in the Thoracic Cavity and the Upper Portion of THE Abdominal Cavity, as seen after the Removal of the Anterior Walls of the Thorax and Abdomen. The sternum, the costal cartilages, and the anterior extremities of the bodies or shafts of the ribs, have been removed. Cavum Mediastinale Anterius, the Anterior Mediastinum- — Anterior and Superior Mediastina of English Anatomists (see note ^ above) — with the Remains of the Thymus Gland and the Anterior Wall of the Pericardium. Laminae Mediastinales, the Two Layers of the Mediastinum. The Anterior Border and a Portion of the Outer or Costal Surface of Both Lungs. Position of the Stomach in Relation to the Liver and the Transverse Colon. Great or Gastrocolic Omentum (Omentum Majus) seen from Before. The anterior layer of the great omentum, attached above to the great curvature of the stomach, has been divided by a vertical incision to the left of the middle line, and the margins of the incision have been drawn a little apart, in order to show the interior of the lower part of the omental sac (recessus inferior omentalis). Through the aperture thus made, a small portion of the transverse colon, and the posterior layer of the great omentum, are visible. Topographical Anatomy of the Thoracic Organs and of the Viscera in the Upper Part of the Abdominal Cavity. TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA 477 Cervical pleura Cupula pleur.T Innominate artery anonjma I Trachea Right innominate vein \'. anonvma dextra Superior vena cava V. cava superior Pericardial pleura Pleura pericardiaca Bight lung Pulmo dexter Left common carotid artery A. carotis communis sinistra ' Left innominats vein anonyma sinistra Costal pleura I leura costalis Left lobe of the liver Lobus sinister hepatis Small or gastrohepatic omentum Lig. hepato- gastricum , thick portion I pars condensa omenti minon- , thin portion ' pars flaccida I omenti minori' *Hepatoduodenal ligament or omentum' *Lig hepatoduodenalo GaU-bladder Vesica fellei Hepatocolic ligament or omentum' Lig. hepatocolicum (var) Superior portion of the duodenum (first part) Pars superior duodeni Pyloric portion of the stomach Pars pylorica ventriculi Hepatic flexure of the colon Flexura coli dextra Omental sac Bursa omentali Transverse mesocolon fwith the posterior layer of the great omentum adherent to it; Mesocolon transversum S«e Appendix, note * See no[e ' to p. 467. See note * to p. 456. :d below with the great c Pulmonary pleura 1 leura pulmonalis Pericardial pleura 1 'leura pericardiaca Left lateral ligament of the liver Lig. riangulare sinistrum .-—Diaphragmatic pleura Pleura diaphragmatica Great cul-de-sac, or fundus, of the stomach Fundus ventriculi — Cardia Spleen (anterior border) Lien (margo anterior) Gastrosplenic omentum or ligament ' Lig, gastrolienale -- Splenic pouch' Saccus lienalis '" Costocolic or phrenocollc ligament, or pleurocollc fold'- Lig. phreiiicocolicum "- Splenic flexure of the colon Flexura coli sinistra - Great or gastrocolic omentum (anterior layer) Omentum majus (lamina anterior) Transverse colon Colon transversum Great or gastrocolic omentum- (free portion, posterior layer) Omentum majus (pars libera, lamina posterior) e Appendix, note 42. n regarded a.s a part of it. — Tr. Fig. S07.— The Thoracic Organs and the Viscera in the Uppf.r Part of the Abdominal Cavity as seen after the Removal of the Whole of the Anterior Wall of the Thorax and Abdomen. liy means of a coronal section, the anterior portions of both lungs and of the two layers of the mediastinum have been removed, so that the greater part of the anterior surface of the pericardium is exposed to view. The various parts of the diaphragm and the pleura arc seen in section. The liver has been drawn as far as possible to the right, in order to show the stomach in its natural position, and the small omentum, consisting of three portions (.fcf Appendix, note ^''■) ; the Spigehan lobe of the liver (tubus caudatus according to Toldt — sve Appendix, fiote '") is visilile through the thin portion of the small omentum. liy the removal of the greater part of the anterior layer of the great or gastrocolic omentum, the posterior wall of the lower part of the omental sac has been exposed ; this posterior wall is constituted by the posterior layer of the great omentum, and in part by the transverse mesocolon, adherent thereto. i'opographical Anatomy of the Thoracic Organs and of the Viscera in the Upper Part of the Abdominal Cavity. 478 TOPOGRAPHICAL ANATOMY OF THE THOkACIC AND ABDOMINAL VISCERA Right common carotid artery A. carotis communis dextra Innominate artery— \ anonyma Eight subclavian artery A. subclaMa de\tra Right innominate vein V. anon) ma de\tra Superior vena cava V. cava superior Right bronchus Bronchus dexter Trachea Left common carotid artery \ carotis communis sinistra /Left irmommate vem (Esophagus (thoracic portion)—- Descending thoracic aorta__ Aorta descendens Quadrate lobe of the liver Lobus quadratus hepatis Small or gastrohepatic . omentum Lig. hepatogastricum Gall-bladder .^ Vesica fellea *Hepatoduodenal ligament ^^ or omentum'' *Lig. hepatoduodenale Cervical pleura' Cupula pleurct Arch of the aorta .,'' Arcus aortas Left bronchus Bronchus sinister - Mediastinal pleura Kli Pleura mediastinalis Caudate lobe of the liver- Processus caudatus hepatis Foramen of Winslow Foramen epiploicum (Winslowi) Right lateral ligament of^^ the liver Lig. triangulare dextrum Hepatorenal ligament' Lig. hepatorenale Parietal peritoneum '' Peritoneum parietale Descending portion of the duodenum (third part) Pars descendens duodeni . Pulmonary pleura Pleura pulmonalis Costal pleura Pleura costalis Omental tuberosity of the liver Tuber omentale hepatis /Great or gastrocolic omentum" (anterior layer) Omentum majus (lamina anterior) Great curvature of the stomach Curvatura ventriculi major - Posterior wall of the stomach Paries posterior ventriculi Splenic flexure of the colon Flexura coli sinistra '"~^-,.. Omental sac (posterior wall) Bursa omentalis Anterior or omental band Taenia omentalis Transverse mesocolon Mesocolon transx ersum i Omental tuberosity of the pancreas Tuber omentale pancreatis Transverse colon Colon transversum - Or epiploon. See note = to p. 456. 3 See Appendix, note 4=. 3 p. 410 and Append!.^, note -4. Fig. 808.— The Thoracic and Abdominal Walls have been removed as far back as the Axillary Line {see Fig. Si 8, /. 488). The Anterior Portions of Both Lungs have been removed in Front of the HiLUM, AND the Pericardial Sac and the Heart have been taken away, so that the Hinder Part OF THE Middle and Superior Mediastina and the Posterior Mediastinum {see note ° above) are seen FROM THE Front,- and the Bronchial Ramification, the CEsophagus, and the Descending Thoracic Aorta, are partially displayed. The Free Portion of the Great or Gastrocolic Omentum having been cut away by Incisions passing along its att.^ch.ments to the Gre.4T Curvature of the Stomach and to the Transverse Colon, THE Liver and the Stom.^ch were drawn upwards as far as possible, in order to show the Entrance to the Omental Sac by Means of the Foramen of Winslow (Foramen Epiploicum Winslowi), and the Interior of the Omental Sac (Bursa Omentalis), the Posterior Wall of which is to a Large Extent laid bare ; in this Area, and covered by the Posterior Layer of the Great Omentum, the Pancreas is visible. A sound has been passed through the foramen of Winslow into the omental sac. Topographical Anatomy of the Thoracic Organs and of the Viscera in the Upper Part of the Abdominal Cavity. TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VlSChiiA 473 Head of the first rib Capitulum costae I., Body or shaft of the first rib Corpus costal- I. '* Innominate artery A anonyma Bight bronchus bronchus dexter Trachea I Cervical pleura^ — Cupula pleurae , Left conunon carotid artery Arch of the aorta \rcus aortEC . Left bronchus Bronchus sinister Eight layer of the mediastinum Lamina mediastmalis dextra Posterior mediastinum' — Cavum , mediastinaie pofiterius Area of the diaphragm bare of peritoneum and attached by areolar tissue to the correspond ing area of the liver Parietal pleura Pleura piarietalis Inferior vena cava V, cava inferior 'Superior fossa of the omental sao- "Recesrsus superior oinentalis Phrenocostal (diaphragmatico- costal) supplemental pleural space ■ — Sinus phrenicocostalis •Hepatoduodenal ligament or omentum"'-*Lig. hef atoduodenale Foramen of Winslow Foramen epiploicum (Winslowi) *Ve3tibule of the omental sac- *\"est:bulum bursae omentalis Parietal peritoneum Periton.-eiim parielalc Pancreaticogastric fold Plica gastropancreatica Fatty capsule (tunica adiposa) of the kidney Capsula adiposa ranis Omental tuberosity of the pancreas Tuber omentale pancreatis Transverse portion of the duodenum third part) — Pars liorizontaiis (inferior) duodeni Psoas magnus muscle— M- psoas major Superior mesenteric vein — V. mesenterica superior Superior mesenteric artery — A. mesenterica superior Left layer of the mediastinum Lamina mediastinalis sinistra --Descending thoracic aorta Aorta descendens — (Esophagus (thoracic portion) -Pleural cavity C a\um pleurae Costal pleura I l<-ura costalis Diaphragmatic pleura 1 leura diaphragmatica GBsophagus (abdominal portion) Spleen (gastric surface) Lien (facias gastrica) Gastrosplenic omentum or liga- ment'— Lig. gastrolienale Omental sac (posterior wall) bursa omentalis Costocolic or phrenocolic liga- ment, or pleurocoUc fold '- Lig. phrcnicocolicum Splenic flexure of the colon 1 lexura coli sinistra Transverse mesocolon Mesocolon transvarsum *Descending mesocolon" "^Mesocolon descendens Descending colon ( olon descendens Left kidney Ken sinister Quadratus lumborum muscle Ascending portion of the duodenum (fourth part) Pars ascendens duodeni ' Sec Appendix, note * s Sec note ' to p. 467. = See Appendix, note 44. 6 See Appendix, note 4'. 3 See Appendix, note ^ See note ■ to p. 453- 4 Sec Appendix, note 4=. s See Appendix, no*e 45. Fig. 809.— The Thoracic and Abdominal Walls have been removed as far back as the Axillary Line (see Fig. 818, A 488)- The Pericardium, the Heart, and the Lungs have been completely removed, so that THE Two Pleural Cavities covered by the Costal (Parietal) Pleura, and between these the Posterior Mediastinum and the Posterior Part ok the Superior Mediastinum, are seen. The Liver, the Stomach, and the Greater Part of the Intestine have been removed, in order to SHOW THE 'mutual REL.vnONS OF THE DUODENUM, THE PaNCREA.S, AND THE SPLEEN. ThE POSTERIOR Wall of the *Ve.stieule of the Omental Sac, consisting of Parietal Peritoneum, and the POSTERIOR Wall of the Omental Sac, consisting of the Axial Portion of the Mesogastrium, are visible, also the *Superior Fossa and the »Splenic Fossa of the Omental Sac. Topographical Anatomy of the Thoracic Organs and of the Viscera in the Upper Part of the Abdominal Cavity. 480 TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA Diaphragm (right inner crus or pillar ') Diaphragma (crus mediale dextrum) Eight kidney (upper extremity) Ren dexter (extremitas superior) Retroperitoneal space— Spatium retroperitonaeale Peritoneal cavity — Cavum peritonaei Parietal peritOnEeum— Peritoneum parietale^ Diaphragm (costal portion) ] Diaphragma (pars costalis) i ' Pleural cavity (phrenocostal or diaphragmaticooostal supple- mental pleural space ') J^ Cavum pleure (sinus pbr-niLOCOstaUs) Spinous process of the twelfth dorsal vertebra Processus spinosus vertebrse thoracalis XII. Descending thoracic aorta — Aorta descendens Diaphragm (left intermediate crus or pillar ■) 1 Diaphragma (crus mediale sinistrum) f . , Left suprarenal capsule = (jlandula suprarenalis sinistra I Twelfth rib— Costa XII. Left kidney — Ren sinister , Pancreas (tail) — Pancreas (cauda) Spleen— Lien Hepatorenal ligament Lig. hepatorenale Right lobe of the liver— Lobus tjexter liepatis'' ; I ♦Hepatoduodenal ligament or omentum 4 ' ,' *Lig. hepatoduodenale / Inferior vena cava — V. cava inferior Portal vein — V. portae / Pancreas (body) — Pancreas (corpus) Round ligament of the liver Lig. teres hepatis Gastrosplenic omentum cr liga- ment ■' — Lig. gastrolienale • Omental sac — Bursa omentalis Stomach (body)— Ventriculus (corpus) Peritoneal cavity— Cavum peritonaei Small or gastrohepatic omentum (*gastrohepatic liga- ment)6 — Omentum minus (lig. hepatogastricum) Left lobe of the liver — Lobus sinister hepatis Falciform, broad, or suspensory ligament of the livei Lig. falciforme hepatis ' See Appendix, note 37. s Called also suprarenal body, or adrenal. 5 The gastrosplenic ontenUan is connected below with the great 07nentu7>t, 6 See Appendix, note 42. 3 See Appendix, note 36. nd is often regarded as a part of it.- See Appendix, note 4a. Fig. 8io. — Horizontal Section through the Trunk passing between the Bodies of the Twelfth Dorsal and First Lumbar Vertebra. The section cuts the liver almost through its greatest transverse (horizontal) dimension, the stomach above the middle of its body, the spleen about the middle of its vertical extent, the body and tail of the pancreas near the upper border of that organ, the right kidney near its upper extremity, the left kidney above its middle ; both suprarenal capsules also appear in the section. Between the vena cava inferior and the *hepatoduodenal ligament (see Appendix; note *-), the section passes through the foramen of Winslow (foramen epiploicum Winslowi), into which the caudate lobe of the liver {processus caudaius hepatis — see Appendix, note '") projects ; behind the small or gastro- hepatic omentum {see Appendix, note ''-) the *vestibule of the omental sac (see Appendix, note *•) is cut across. The aorta is divided as it passes through the aortic opening in the diaphragm, the vena cava inferior below its entrance into the fissure or fossa of the vena cava, and the portal vein just after it has passed between the layers of the small or gastrohepatic omentum. Topographical Anatomy of the Abdominal Viscera. TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA 481 Erector spinae muscle M. sacrospinalis Psoas magnus muscle M p^oas major Quaftratus lumborum muscle , ' fatty capsule turica adiposa) \ of the kidiiey Capsula adiposa Spinous process of the third lumbar vertebra I Processus spinosus \ertebra lumbalis III Upper surface of the body of the fourth lumbar vertebra , Retroperitoneal space- Spatium retroperitonaEale Descending mesocolon" Jejunum- -Intestinum jejunum Descending colon Right kidney ' Ren dexl Ascending colon Colon ascendens Peritoneal cavity-Cavuni peritonx-i "Inferior flexure of the duodenum •Fle.xuraduodeni inferior i Transverse colon— Colon transversum | Transverse portion of the duodenum (third part) Pars horizontalis (inferior) duodeni Inferior vena cava — V. cava inferior Umbilicus Great or gastrocolic omen- tum-- Omentum majus Transverse colon Colon transversum Transverse mesocolon Great or gastrocolic omentum' Omenliim majus Mesentery of the small intestine Parietal peritoneum— Peritonaeum parietale Abdominal aorta— Aorta abdorainalis ■ See r > P- 453- ■Or efii/iloon. See note = to p. 456. ; See Appendix, note 6. Fig. Six—Horizontal Section through the Trunk at the Level of the Umbilicus, PASSING BETWEEN THE BODIES OF THE ThIRD AND FOURTH LUMBAR VeRTEBR^. The right kidney is divided near its inferior extremity, but the left kidney is entirely above the Diane of sect on As regards the small intestine, the whole length of the transverse port on of he Centum anpears in the section, in addition to several coils of the jejunum. 1 he ascendmg colo.i fs dwided ckfse to "he commencement of the hepatic flexure. The greater part of the transverse colon is distended and is divided nearly in the direction of its lotig axis ; m the "^'^hbou hood of ^hesnlenic flexure however, it is contracted, and is divided transversely ; the dcscendmg colon s also seen in trans vere section. The section further shows portions of the great or Kafocohc omen um of the^esentery of the small intestine, and of the *descendmg mesocolon {sec note ■ above). Topographical Anatomy of the Abdominal Viscera. 482 TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA Innoiniiiate artery A. anonyma *Venous angle^ •Angulus venosus ^^ Trachea Internal jugular vein V. jugularis interna /Arch of the aorta — Arcus aortae / , Subclavian vein / -' V subclavia Coracoid process Processus coracoideus Superior mediastinal or cardiac lymphatic glands^ LymphoglandulfE mediastinales anteriores Ascending aorta Aorta ascendens Superior vena cava V. cava superior Semilunar or sigmoid valves of the aorta Valvulassemilunares aortse Mitral or bicuspid valve - Valvule bicuspidalis Right lung Pulmo dexter Orifice of the coronary sinus Eustachian valve Valvula venaB cavas - (Eustachii) Branches of the hepatic veins Phrenocostal or diaphragmatico costal supplemental pleural "" space- Sinus phrenicocostalis Branches of the portal vein • with Glisson's capsule Rami venae portae cum capsula fibrosa (Glissoni) Gall-bladder Vesica felle" Hepatic flexure of the colon Flexura coli dextra Clavicle Clavicula — Body or shaft of the first rib Corpus costae I. Mediastinal pleura Pleura mediastinalis _ , Costal pleura Pleura costalis Left lung — Pulmo sinister Pulmonary artery A. pulmonalis Pericardial cavity Cavum pericardii Pericardium Pericardium -Pleural cavity Cavum pleura — -Left ventricle Ventriculus cordis sinister —Apex of the heart Apex cordis Diaphragm Diaphragma — - Left lobe of the liver Lobus sinister hepatis Body or shaft of the seventh ri,. Corpus costae VII. — Spleen (inferior extremity) Lien (extremitas inferior) '"-- Body of the stomach Corpus ventriculi Transverse colon Colon transversum Duodenum (superior portion or first part) Duodenum (pars superior) Pyloric portion of the stomach Pars pylorica ventriculi Pylorus - to the junction of the internal jugular and subclavian veins to ' AngtiUis venosus, the '^vc7tous angle, is the name given by the autl form the innominate vein. The term is not used by English anatomists. - = See Appendi.v, note 3^. 3 There are three or four lymphatic glands behind the lower part of the body of the sternum, between that bone and the pericardium, known z%\\\^ antcriormediastinnllymphatic glands. Those figured here are, however, in ihe sufier-ior jjietliasiinuin of 'KngW'^h anatomists, and are, therefore, superiormcdiastinal lymphatic glands {?.ee note i to p. 456). As they receive the lymphatics of the heart in addition to those of the greater part of the pericardium and of the thymus gland, they are often called the cardiac lymphatic glands. — Tr. Fig. 812. — Coronal Section through the Trunk; on the Right Side of the Body the Section passes through the Anterior Axillary Fold, on the Left Side a little in Front of this Fold. The left ventricle, the ascending aorta, and the superior vena cava are divided longitudinally, while the pulmonary artery is divided transversely. The right auricle is divided in front of the orifices of the inferior vena cava and the coronary sinus. The liver is cut across almost in its greatest transverse (vertical) dimension. The situation of the contracted stomach and of the superior or first part of the duodenum in relation to the liver and to the greatly distended transverse colon is to be noted. [The superior and middle mediastina of English onatomists are seen in coronal section ; the plane between them is at the level of the reflection of the pericardium on the ascending aorta, above the transversely divided pulmonary artery. See note - to p. 410 anii Appendix, note ^^. — Tr.] Topographical Anatomy of the Thoracic Organs and of the Viscera in the Upper Part of the Abdominal Cavity. TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA 483 I Transverse process of the first dorsal vertebra Processus transversus vertebra thoracalis I. Apex of the lung — Apex pulmonis. Body or shaft of the first rib ^ Corpus costa; I. Upper lobe of the right lung Lobus superior pulmonis dextri Interlobar fissure' Incisura interlobaris' Lower lobe of the right lung Lobus inferior pulmonis - dextri Bl'onchial branches— Rami bronchiales Base of the lung-- Basis pulmonis Inferior border of the lunf Margo inferior pulmonis Vertebral portion of the diaphragm Pars lumbalis diaphraainatif Costal j)ortiou of the diaphragm Par»cistal]Mjiaphra.;mali PhrenocosteLl or diaphrag maticocostal supplemental — pleural space <• Sinu- phrcnic.jcostalis Bight lobe of the liver Lobus dexter hepatU Parietal peritoneum Peritonaeum parietal Right kidney Ren dexter Right suprarenal capsule-" / Glandula. suprarenalis dextra Psoas magnus muscle M. psoas major Body of the second dorsal vertebra Corpus vertebrae thoracalis 11. Cervical pleura' Cupula pleurae - Superior mediastinum- Mediastinal layer of "the pleura— Lamina mediastinalis pleurae ..Pleural cavity, Cavum pleura: -Upper lobe of the left lung Lobus sufierior pulmonis sinistri Interlobar fissure-' Incisura interlobaris Posterior mediastinum- - Cavum mediastinale posterius Lower lobe of the left lung l.nl.us inferior pulmonis sinistri Mediastinal layer of the pleura Lamina mediastinalis pleura; Costal pleura Pleura costalis _ Gieat cul-de-sac or fundus of the stomach (posterior wall I I' niKiu^ venlricuii (paries posterior) -. Superior extremity of the spleen Extremitas superior lienis - Spleen — Lien Splenic vein Jl- V henalis J I Pancreas (tail) Pancreas (cauda) Splenic pouch* "Saccus lienalis Costocolic or phrenocollc liga- ment, or pleurocoUc foldt' Li>;. phienicocolicum Splenic flexure of the colon 1 ra , uh sinistra ' Left kidney — Ren sinister , Left suprarenal capsule'' — Glandula suprarenalis sinistra Body of the first lumbar vertebra Corpus vertebra;- lumbalis I. 3 See note --' to p. 410 and Appendix, note 24. 5 Called also suprarenal 6ody, or adrenal. 3 See note ' to p. 464. 6 See Appendix, note 3^. Fig. 813. — Coronal Section through the Trunk, a little behind the Axillary Line {see Fig. 8i8, p. 488). The section passes (/trough the bodies of the uppermost and lowertnost dorsal vertebni,', but passes infrnnt ^ythe bodies of the fifth to the tenth dorsal vertebra; ; hence those portions of the viscerji that lie in the posterior portions of the thoracic and abdominal cavities on cither side of the spinal column appear in the section. The hmgs are divided very nearly in their greatest vertical dimension. In the right side of the abdominal cavity, the relations of the kidney and the suprarenal capsule ^see note '' uboTe) to the liver are shown ; in the left side, the relations of the spleen to the great cul-de-sac or fundus of the stomach, to the tail of the pancreas, and to the splenic flexure of the colon. Topographical Anatomy of the Thoracic Organs and of the Viscera in the Upper Part of the Abdominal Cai^ity. 61 — 2 484 TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA Scalenus anticus muscle~-- M. scalenus anterior Subclavian artery — A. subclavia Subclavian vein V. subclavia Clavicle Clavicula First costal cartilage Cartilage costalis I Superior mediastinal or cardiac lymphatic glands'- — Lymphoglandula, mediastinales anteriores Costal pleura • Pleura costalis Left auricular appendix' — Auricula cordis sinistra Eight ventricle Ventriculus cordis dexter' Interventricular septum Septum ventriculorum cordis Pericardium — Pericardium Pericardial cavity — Cavum pericardii Diaphragm Diaphragma — Left lobe of the liver - Lobus sinister hepatis Body of the stomach- Corpus ventriculi Parietal peritoneum — -rn Peritonaeum parietale \ V Peritoneal cavity- V Cavum peritonaei Duodenojejunal flexure Flexura duodenojejunalis- See Appendix, note 36. Scalenus medius muscle Body or shaft of the first rib Corpus costae I. Brachial plexus Plexus brachialis Left lung Pulmo sinister Bronchial lymphatic glands I I^ymphoglandulas bronchiales Hilum of the lung Hilus pulmonis .Bronchial branches Rami bronchiales — Pulmonary pleura Pleura pulmonalis - - Parietal pleura Pleura parietalis __-Pleural cavity Cavum pleurae Diaphragmatic pleura Pleura diaphragmatica _. Great cul-de-sac or fundus of the stomach Fundus ventriculi -_Phren0G0stal or diaphragmatico- costal supplemental pleural space^ — Sinus phrenicocostalis Spleen Lien —Body or shaft of the twelfth rib Corpus costas XII. Splenic artery and vein ■~-A. et V. lienalis Omental sac Bursa omentalis / — Pancreas ""-- Fatty capsule (tunica adiposa) of the kidney — Capsula adiposa renis Left kidney— Ren sinister = See note 3 to p. Fig. 814. -Sagittal Section through the Trunk, 4 Centimetres (i"575 Inches) to the Left of the Median Plane. The section passes through the hilum of the left lung, and divides the lung itself very nearly in its greatest vertical dimension ; the two ventricles are divided obliquely. The body and the great cul-de-sac or fundus of the moderately distended stomach are divided approximately in their long axis, so that the position of the cardia at the upper end of the small curvature of the stomach is well shown. The relations of the stomach to the left lobe of the hver, to the spleen, to the pancreas, and to the duodenojejunal flexure, are to be noted. Topographical Anatomy of the Thoracic Organs and of the Viscera in the Upper Part of the Abdominal Cavity. TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA 485 Body or shaft of the first rib (posterior or vertebral extremity) , Corpus costie I. Apex of the lung-. Apex pulmonis Cervical pleura' /Cupula pleural Subclavian artery /A. siibclavia Subclavian vein V. subclavia Scapula—-, Scapula ^Clavicle ( 1 1\ icula Upper lobe of the right lung Lobus superior pulmonis de\tri Interlobar fissure ' Incisura interlobaris' Costal pleura Pleura costali Lower lobe of the right lung Lobus inferior pulmonis dextr Base of the right lung Basis pulmonis dextri Central tendon of the diaphragm* Centrum tendineum diaphragmatis Diaphragmatic pleura Pleura diaphragmaticri Area of attachment of the liver to the diaphragm by areolar tissue Inferior border of the right lung Margo inferior pulmonis dextri Phrenocostal or diaphragmatico- costal supplemental pleural space - Sinus phrenicocostalis Parietal peritoneum Feritonoeum parietale" Body or shaft of the twelfth rib Corpus costse XII. Bight kidney-' Ren dexter •Superior flexure of the duoaenum"'- •Flexura duodeni superior Fatty capsule (tunica adiposa) of the kidney— Capsula adiposa rcnis Ascending colon Colon ascendens See I r>/,y^r 2 See Append!) f tfndttn of the diaphragm. Fig. 815. — Sagittal Section through the Trunk, 6 Right of the Median Body or shaft of the first rib antenor or sternal extremity) L orpus costa; I. Costal pleura I leura costalis - Fourth costal cartilage Cartilago costalis IV. - Middle lobe of the right lung Lobus medius pulmonis dextri Inferior border of the right lung Margo inferior pulmonis dextri Phrenocostal or diaphragmatico- 'costal supplemental pleural space -' Sinus phrenicocostalis Diaphragm 1 Uaphragraa Right lobe of the liver 1 (ibus dexter hepatis -Parietal peritoneum IVntonjcum parietale Ninth costal cartilage (anterior extremity) Cartilago costalis IX. ""Gall-bladder \ esK a lellea Transverse colon Colon traiisversum Centimetres (2-362 Inches) to the Plane. The section passes to the right of the hilum of the lung, and divides all three Irilx-s of the organ. Tlie other organs seen in the section are : The right lobe of the liver, the gallbladder, the right kidney, and portions of the ascending and transverse colon, which latter is moderately distended. The ♦superior flexure of the duodenum is also shown, its right (convex) wall appearing in the section. Topographical Anatomy of the Right Lung and of the Viscera in the Upper Part of the Abdominal Cavity. 486 TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA Pu.monary axtery A. pulmonalis Ascending aorta Aorta ascendens Superior vena cava — V. cava superior ^ Anterior median line Linea mediana anterior Sternal line'— Linea sternalis , Parasternal line - .-' Linea parasternalis -Mamillary line ' Linea mamillaris Lines of reflection of the_ costal pleura to form the layers of the mediastinum Atrium of the right auricle^ Atrium cordis dextrum Dome or vault of the diaphragm Cardia Ensiform or xiphoid process Processus xiphoideus Right lobe of the liver Lobus dexter hepatis Costal pleura Pleura costalis Outer or costal surface of the lung Facies costalis pulmonis I Nipple or mamilla \ /""Papilla mammae Anterior border of the lung Marge anterior pulmonis Apex of the heaxt — Apex cordis Great cul-de-sac or fundus of the stomach — Fundus ventriculi Inferior border of the lung Margo inferior pulmonis Inferior extremity of the spleen Lien (extremitas inferior) Fundus of the gall-bladder Fundus vesicae felleae Anterior border of the liver Margo anterior hepatis Transverse colon Colon transversum Anterior superior spine of the ilium Spina iliaca anterior superior Poupart's ligament (superficial femoral arch) Ligamentum inguinale (Pouparti) Great curvature of the stomach Curvatura major ventriculi Lower limit of the pleura Descending colon Colon descendens Sacral promontory Promontorium Sigmoid flexure of the colon Colon sigmoideum Rectum Intestinum rectum — .Urinary bladder Vesica urinaria .,.._ Pubic symphysis / "■~~ Symphysis ossium pubii Fig. 8i6.— Projection-Outlines of the Thoracic and Abdominal Organs on the Anterior Surface of THE Trunk. The red line indicates the outline of the heart and the great vessels (superior vena cava, ascending aorta, and pu'monary artery) ; the continuous blue lines indicate the outhnes of the two lungs ; the doited blue lines, the boundaries of the pleural cavities. The violet hne indicates the projection-outhne of the liver and the fundus of the gall-bladder ; the yellow lines indicate the projection-outline of the stomach and the different sections of the large intestine. The projection-outlines of the dome or vault of the diaphragm and of the inferior extremity of the spleen are black. GUIDE-LINES for THE DETERMINATION OF THE POSITION OF THE THORACIC ORGANS : ANTERIOR MEDIAN LiNE, Sternal Line {see Appendix, note ^8), Parasternal Line {see Appendix, note *'), and Mamillary Line (see Appendix, }tote*^). The Ribs are distinguished by Roman Numerals. Projection-Outlines of the Thoracic and Abdominal Viscera. I TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA 487 Cervical pleura Cupula pleurae Apex of the lung Apex pulmonis Upper lobe of Ihe left lung Lobus superior pulni'mis sinistri Interlobular fissures Incisura interlobaris . Lower lobe of the left lung Lobus interior pulmonis sinistri Posterior median line Linea mediana posterior Spinous process of the first dorsal vertebra . -■ Processus spinosus vertebn thoracalis I. Scapular line^ Linea scapularis Dome or vault of the diaphragm - Cardia— -— "i" j Lower limit of the pleura— Sigmoid flexure of the colon Colon sigmoideum Rectum Intestinum rectum_ (Esophagus Descending thoracic aorta Aorta descendens Inferior angle of the scapula Angulus interior scapulae Lines of reflection of the '^costal pleura to form the layers of the mediastinum Inferior border of the right lung "•Margo inferior pulmonis dextri Spinous process of the twelfth dorsal vertebra Processus spinosus vertebrae thoracalis XII, ' Pylorus Right kidney Ren dexter -. . Duodenum Ascending colon Colon ascendens Spinous process of the fifth lumbar 'vertebra — Processus spinosus ver- tebrae lumbalis V. ..Sacral promontory Promontorium Caecum Intestinum caecum Posterior or great sacroaciatic ligament Lig. sacrotuberosum Extremity of the coccyx Apex ossis coccygis Tuberosity of the ischium Tuber ischiadicuiT'. the !)ack of the trunk passing tliroiifjh the 3 See note ' to p. 464. Fir;. 8t7. — Projection-Outlines of the Thoracic and Abdominal Organs on thk Posterior Surface OF THE Trunk. The red lines indicate the outlines of the descending thoracic aorta, the abdominal aorta, and the spleen ; the continuous tilue lines indicate the oullines of the two lungs and of their upper and lower lobes ; the dott>d blue lines, the tjoundaries of the pleural cavities. The yellow lines indicate the projeciion-outlines of the stomach, the duodenum, and various portions of the large intestine. The projection outlines of the dome or vault of the diaphragm and ot the two kidneys are black. Guide Links for the Determination of the Position of the Thoracic Organs: Po.sterior Median Link and Scapular Line {see note ^ above). The Ribs are distinguished bv Roman Numerals. Projection-Outlines of the Thoracic and Abdominal Viscera. TOPOGRAPHICAL ANATOMY OF THE THORACIC AND ABDOMINAL VISCERA Axillary line ^ Linea axillaris Upper lobe of the right lung Lobus superior pulmonis dextri Interlobar fissures'* Incisurae interlobares. .,=- Middle lobe of the right lung Lobus raedius pulmonis dextri - -» Lower lobe of the right lung Lobus inferior pulmonis dextri Inferior border of the right lung — Margo inferior pulmonis Lower limit of the pleura Ascending colon Colon ascendens Cfficum Intestinum caecum.. Rectum Intestinum rectum Cervical pleura^ Cupula pleurae Mamillary line''^ Lmea mamillaris Pulmonary artery A pulmonalis Aorta Aorta Nipple or mamilla Papilla mammae - Dome or vault of the dia ahiagm Anterior border of the r^ght ventricle Liver Hepar Trsjisverse colon Colon transversum Prostate gland Prostata Sacral promontory Promontorium Anterior superior spine of the ilium Spina iliaca anterior superior Urinary bladder Vesica urinaria Pubic symphysis Symphysis ossium pubis ^ see note ^ to p. 467. Fig. 8x8. — Projection-Outlines of the Thoracic and Abdominal Organs on the Right Side of the Trunk. 'i'he red line indicates the outline of the heart and the pulmonary artery ; the continuous blue lines indicate the outlines of the right lung and its three lobes ; the dotted blue line indicates the boundaries of the pleural cavity. The violet line indicates the projection-outline of the right lobe of the liver ; the yellow lines indicate the projection-outlines of the right kidney and the different sections of the large intestine. Guide-Lines for the Determination of the Position of the Thoracic Organs : Axillary Line (see Appendix, note •*'*) and Mamillary Line {see Appendix, note ^^). The Ribs are dis- tinguished BY Roman Numerals. Projection-Outlines of the Thoracic and Abdominal Viscera. APPARATUS UROGENITALIS GENITO-URINARY APPARATUS ORGANA UROPOETICA URINARY ORGANS 63 490 URINARY ORGANS •Hepatic impression' •Impressio hepatica Internal border Margo medialis \ Hilum of the kidney Hilus renalis ; External border Margo lateralis Superior extremity ,, Extremitas superior •Splenic impression^ •Impressio lienalis Fig. 819.— Ren Dexter, the Right Kidney. Facies Anterior, Anterior Surface. Inieiior extremity Extremitas inferior Fig. 820. — Ren Sinister, the Left Kidney. Facies Anterior, Anterior Surface. *Muscular impression- "Impressio muscularis Flattened area of contact witli the psoas magnus muscle Fig. 821. — Ren Sinister, the Left Kidney. Facies Posterior, Posterior Surface. Fig. 822. — Ren Dexter, the Right Kidney. Facies Posterior, Posterior Surface. ■esponding to the areas of contact 1 ■med itnpressions. The word is i 1 hnpressioTis, — When the solid viscera are hardened in situ^ their surface presents facets one another and with the structures forming the wall of the abdominal cavity. Such facets an most frequently in connexion with the impressions of the liver.— Tr. 2 The muscular im/>ression is a flattening, very variable in extent, indicating the area of contact of the kidney with the anterior surface of the quadratus lumborum muscle (see .^Iso note ')■ — Tr. Ren — The kidney. URINARY ORGANS 491 Cut surface of the renal parenchyma Calix' Calyx renalis Sinus of the kidney Internal border binus renalis IMargo medialis Hilum of the kidney iiilus renalis Pelvis of the kidney Pelvis renalis Ureter Ease of the pyramid Basis pyramidis I Pyramid of Malpighi Pvramis renalis '(Malpighii) Column of Berlin, or septulum renum Columna renalis (Bertini) Cortex Substantia corticalis Renal papilla Papilla renalis Calices Calj ces minores' Superior extremity Extremitas superior Calices' ilyces minores Posterior surface 1 icu i posterior Sinus of the kidney binub renalis Infuadibula' C -iJNces majores External border Mirgo lateralis Calices' Cil)cesmino;ef Sinus of the kidney "-.inus renalis Inf undibulum ' Calyx major Inferior extremity Extremitas inferior Fig. 823.— Horizontal Section through THE Middle of the Right Kidney and THE Renal Pelvis. Fig. 824.— Pelvis Renalis, the Pelvis of the Kidney WITH THE Calices and Infundibula (Calyces Renales Minores et Majores) laid bare by the Removal of a Portion of the Renal Parenchyma fro.m Behind. Columns of Bertin, or septula renum Columnse renales (Bertini) Cortex Substantia corticalis Base of the pyramid 1 Basis pyramidis Pyrainid of MalpigM Pyia,.,isren.iiis(Malpigha) Kenal papilla 'lla renalis Arterial arch R enal papiUa Papilla renalis Medulla Substantia medullaris Cortex Stbitantia corticalis Infundibulum ' Calyx major Capsule, fibrous coat, or tunica / albuginea of the kidney Tunica fibrosa Calices ' Calyces minores 1;. 825.— Coronal Section through the Right Kidney and the Renal Pelvis. Suhstaniia Cor- iiCALis, the Cortex; sri'.,r\MiA Medullaris, ihe Medulla. 1 Base of the pyramid Basis pyramidis Renal papilla I ' Pyramid of Malpighi Papilla renalis' Pyramis renalis (Malpighii) Fig. 826.— Sinus Renalis, the .Sinus of the Kidney, displayed in a CoRONALi.YiiisEcrED Kidney by Removal ok the Renal Pelvis AND the BLOODVESSKIS PnerVRlOR HALF. Sec Appendix, note so. Ren — The kidney. 6? — 2 492 URINARY ORGANS *Area cribrosa^ 'Area cribrosa 1 Orifices of the uriniferous tubules (excretory \ Ji-5. tubules') — Foramina Dapillaria ^ Wall of renal calix Fig. 827. — *Area Cribrosa^ of the Renal Papilla. Lobules of the ^ kidney Lobi renales Suprarenal capsule^ Glandula suprarenalis - Pelvis of the kidneys- Pelvis renalis Inferior extremity Extremitas inferior - Hilum of the kidney — Hilus renalis Lobules of the kidney Lobi renales - Ureter Fig. 82R.— Right Kidney and Suprarenal Cap- suLE^ from a Human F(i;tus in the Middle OF the Skventh Month (Months of Four Weeks Each). Seen from Behind. Ilenal papillse -'# Papilla renale: Hilum of the — kidney Hilus renal -Base of the pjrramid Basis pyramidis Sinus of the kidney "'Sinus renalis , Pjrramid of Malpighi ir"'l'\rarais renalis (Malpighii) irW-Cortex ' Substantia corticalis ''Columns of Bertin, or septula renum Columnar renales (Bertini) Fig. 829.— Sinus of the Kidney, displayed IN THE Coronally-bisected Kidney of an Infant aged Three Weeks Superior border Margo superior.^ Anterior surface 1 Facies anterior 1 Apex ',Apex suprarenalis *Posterior surface ^ *Facies posterior Hilum Hilub Internal border Margo medialis Inferior suprarenal artery A suprarenalis inferior 'J- Suprarenal or capsular vein ij V suprarenalis u Fig. 830. — Right Suprarenal Capsule,- SEEN FROM Before. Supoiior suprarenal arteries iiprarenales superiores Supi arenal nerves uprarenales ■ Accessory suprarenal capsule Glandula suprarenalis accessoria (var.) Fig. 831. — Left Suprarenal Capsule,^ SEEN from Behind. Cortex Substantia corticalis , Medulla Substantia.,^ meduUaris Fig. 83 -Horizontal Section through THE Left Supra- renal Capsule.2 See Appendi: = Called also s:i/r al body, or adietiai. 3 See Appendij Ren— The kidney. —Glandula suprarenalis — The suprarenal capsule {see note ^ above). URINARY ORGANS 493 Capsule, fibrous coat, ^ - or tunica albuginea of ^'^ the kidney J v Tiuiica fibrosa '^ ~ Labyrinth of the cortex -.,(ii|~ Pars convoluta lobuli |^^: corticalis C-J Medullary rays of the - cortex (pyramids of Ferrein) Pars radiata lobuli corticalis (processus Ferreini) Cortex Substantia corticalis Interlobular or radiate vein V. interlobularis Venous arch in transverse section V. arciformis Mednlla Substantia medulla Convoluted tubules I'libuli reiiales contorti Malpighiau corpuscles Corpuscula renis (Malpighii) Interlobular or radiate artery A. interlobularis First convoluted tubule Tubulus renalis contortus -Glomerulus Capsule of the ""glomerulus (Bowman's capsule) Capsula glomeruli EflFerent vessel of the glomerulus Vas efferens Capillary vessels f/';r-"'-;=-Straight tubules ,. Tubuli renales '■ recti ,^ Afferent vessel of the glomerulus \ Vas af^erens Interlobular or radiate artery A. interlobularis Fig. 833.— Part of a Sf.ction through the Cortex OF THE Kidney in the direction of the Straight Tubules. Fig. 834.— Corpusculum Renis (Malpighii), Malpighian Corpuscle of the Kidney. Diagramm.\tic. Second convoluted tubule' First convoluted tubule Tubulus contortus Malpighian corpuscle of the kidney Ojrpuiculuiii reniv(M;,lpi.r . Looped tubule of Henle Collecting tubule Straight tubules ' Tubuli renales recti Looped tubule of HenI Collecting tubules Capsule, fibrous coat, or tunica albuginea of the kidney— Tunica fibrosa - Stellate veins stellate ,._^ Glomeruli ^y>' Glomeruli J;; Capillary plexus of the cortex * Interlobular or radiate vein V. interloliularis Interlobular or radiate artery A. InlerloliiikirU Pseudarteriae rectse, or vasa recta spuria^ Arteriolar rect^ Arterial arch A. arciformis Venous arch V. arcilormis Vena recta Veniila recta Benal papilla. -- Papilla renalis Excretory tubules, or ducts of Bellini Ductus papillares Capillary plexus of the medulla Attachment of the wall of the renal calix to the periphery of the papilla Benal calix (.*:ilyx reiiiilis minor - Plexus of venous radicles surrounding the orifices of the ducts of Bellini ' See Appendix, note >j. ' S=e Appendix, note 54. 3 Sec Appendix, note 55. ' See Appendix, note 56. 835.— UlAGRAMM.'MIC REPRESENTATION OF THE ARRANGEMF.NT OF THE URINIFEROUS TUiiULES AND THI: IlLOODVESSELS IN THE KIDNEY. Ren — The kidney. 494 URINARY ORGANS Toratt costal cartilage Cartilage costalis IV. Right layer of the mediastinum^ Lamina mediastinalis dextra Plicse villosse, villous or fatty folds, of the pleura Plica; adiposK pleura Diaphragmatic pleura Pleura diaphragmatica Hepatic veins Vv. hepaticae Ceni-ral tendon of the diaphragm^ Centrum tendineum diaphragmatis CcEliac artery (coeliac axis) A. cceliaca Superior mesenteric artery - I A. mesenterica superior Body of the stemiun, or gladiolus Corpus sterni Anterior mediastinum' Cavum mediastinale anterius / Pericardial pleura / Pleura pericardiaca Left layer of the mediastinum Lamina mediastinalis sinistra \ - Left lung Pulmo sinister Diaphragm Diaphragma Abdominal portion of the oesophagus Pars abdominalis cesophagi Vertebral portion of the diaphragm rs lumbalis diaphragmatis Suprarenal capsule- Glandula suprarenalis Left kidney Ren sinister Renal artery and vein A. at V. renalis Inferior vena cava V. cava inferior Receptaculum chyli '^iSterna chyli Abdominal aorta Aorta abdominalis Spermatic artery and vein A. et V. spermatica inter Ureter (abdominal portion Ureter (pars abdominalis) Iliacus muscle - M. iliacus Iliac fascia Fascia iliopectinea Sheath of the rectus. abdominis muscle (posterior layer) Vagina m. recti abdominis Vas deferens — Ductus deferens . y Hypogastric or external umbilical fold ' Plica umbilicalis lateralis '' Urachal or median umbilical fold^ Plica umbilicalis media Suspensory muscle of the duodenum M. suspensorius duodeni Duodenojejunal flexure Flexura duodenojejunalis Transversalis abdominis muscle M. transversus abdominis Psoas magnus muscle i\I psoas major Psoas parvus muscle lU psoas minor Quadratus lumborum muscle " Iliacosubfascial fossa (var. )■■■ ••Fossa iliacosubfascialis (var.) - Parietal peritoneum Peritonaeum parietale Sacral promontory— Promontonum Rectum Intestinum rectum Summit or apex of the bladder Vertex vesicae urinaria; 410 and Appendix, note =4. 3 Called also suprarenal body, ote 57. 4 Called also the tre/oH or cardi/o upcrtor/alse ligament, or sus/>cnsory ligaiiieni, of the bladder. adrenal. i tendon of the diaphragm. Fig. 836. — Posterior Wall of the Abdominal Cavity, as seen after the Removal of the Parietal Peritoneum; Spatium Retroperitoneale, the Retroperitoneal Space. Position of the Kidneys and the Suprarenal Capsules {see. note ^ above). Abdominal Portion of the CEsoPHAGUs. MuscuLus Suspensorius Duodeni, the Suspensory Muscle of the Duodenum. In the left iliac fossa the parietal peritoneum has been left attached, in order to display the *iliaco- subfascial fossa of the peritoneum, which exists in this specimen. (Compare with this figure Fig. 809, p. 479.) Retroperitoneal Space and Topographical Anatomy of the Kidney. URINARY ORGANS 495 Diaphragm (vertebral portion) Diaphragma (pars lumbalis) Psoas magnus muscle M. psoas major ; Retroperitoneal space Spatium retropentonaeale \ Quadratus lumborum muscle Right kidney, Ren dexter Parietal peritoneum Peritona:um parittale Twelfth rib Costa XII Spinous process of the first lumbar vertebra Processus spinosus \ertebra; lunibalii I. Superior mesenteric artery iA. mesenterica superior ! Abdominal aorta Aorta abdominalis Suprarenal capsule ' ; .'Glandula sui]i..r<:>.ali-, I , Left kidney Omental sac — Bursa omentalis Tail of the pancreas Spleen Diaphragm (costal portion) Diaphragma (pars costalis) Parietal peritoneum j Peritoni'um parietale Eight lobe of the liver — Lobus dexter hepatis Gall-bladder —Vesica fellea' Duodenum superior portion, or first part) Du.j(icnum(par5v,i[x;ri-.r| ^ 1 Inferior vena cava— V cava inferior Superior mesenteric vein — V, mesenterica superior' Falciform, broad, or suspensory ligament of the liver Lig. falciforme hepatis Gastrosplenic omenttim or liga- ment*— Lig. gastrolienale Stomach — Ventriculus Peritoneal cavity — Cavura peritonaei 1 Left lobe of the liver \ Lobus sinister hepatis Pancreas — I'ancreas Small or gastrohepatic omentum-— Omentum minus •Vestibule of the omental sac' *Vestibulum bursae omentalis Also known as x.\\z sufirareiuii l/oiiy, or adrenal, ^ See Appendix, note 4=. 'i\it gastrosplenic omentum is connected below with \\\k gyeat omentum^ and is often regarded : 1 Sec Api.endi: L part of it.— Tk. Fig. .S37.— Horizontal Section through the Trunk, passing through the Body of the First Lumhar Vertebra close to its Upper Surface. The Position of the Kidneys IN Relation to the Abdominal Wall, the Liver, the Spleen, and the Pancreas. The rif,'ht kidney is divided above, tine left below, the middle of its vertical extent. The stomach is divided below the middle of its body ; the pancreas, near its inferior surface ; the spleen, near its inferior extremity. In the hepatic reKion the section crosses the umbilical fissure (fossa v na} umbilicalis) and the body of the gall-bladder. Close to the latter the superior or first part of ih£ duodenum is seen. (Compare this section with those shown in Figs. 810 and 811.) Topographical Anatomy of the Kidney. 496 URINARY ORGANS Superior or asoenaing ramus of the pubis Ramus superior ossis pubis Vas deferens Ductus deferens Ampulla of the vas deferens Ampulla ductus deferentis Seminal vesicle Vesicula seminalis Tuberosity of the ischium— -^ Tuber ischiadicum Urachus, or *median umbilical ligament- *Lig umbilicale medium Summit or apex of tho bladder Vertex vesicae Body of the bladder Corpus vesicEe Base or fundus of the bladder Fundus vesicsE Ureter (pelvic portion) Ureter (pars pelvina) Basis prostatae Fig. 838. — External Layer of the Muscular Coat of the Bladder (Stratum Externum Tunica MuscuLARis Vesica Urinaria). The Contracted Male Bladder in its Natural PgsitioNj WITH THE Pelvic Portion of the Ureter, the Vas Deferens, and the Seminal Vesicle- Seen from Behind. Outer longitudinal fibres,., passing into the middle layer of the muscular coat Internal orifice of the urethra Orificium urethrae internum Cervix or neck of the bladder- Fasciculi of muscular fibres passing from the bladder on to the ureter Fasciculi of the internal layer of the muscular coat Middle layer of the muscular coat Stratum medium tunicas muscularis Internal longitudinal fibres passing into the middle layer of the muscular coat Region of the trigone of the bladder Regio trigoni vesicae - Ureter (external layer of the muscular /j coat) — Ureter (stratum externum tunicae muscularis) Fig. 839.— Middle and Internal Layers of the Muscular Coat of the Bladder (Stratum Medium et Stratum Internum Tunica Muscularis Vesica Urinaria), seen from Before and Below in the Moderately-distended Bladder. ' See Appendi.\, note 58. See note 3 to p. 387 in Part III. Vesica urinaria— Urinary bladder. URINARY ORGANS 497 Vas deferens Ductus deferen: Base or fundus of the bladder Fundus vesica? Right seminal vesicle \'esicula seminalis dextra Rectum j, , ^ Imestinum rectum — a \ li'roEtate gland Prostata External or superficial \ sphincter of the anus M. sphincter ani externus "" — Urachus, or "median umbilical ligament ' Lig unibilic ile medium — Siunmit or apex of the bladder \ erte\ \LSica Body of the bladder Corpus \ebicae , Anterior true ligament of the bladder. / or pubopiostatic ligament' , (,.ul ..le) , - Pubic symphysis Sn mphysis ossium pubis %^ Pubovesical muscle M pubo\esicalib ^Obturator internus muscle \ Rectal fascia 1 asLia dnphnj^matis pelvis superior ^Levator am muscle -^ Inferior ramus of the ischium 7b Ramus inferior ossis ischu Fig. 840.— txTERXAL Layer of the Muscular Coat (Stratum Externum Tunic.e Muscularis) OF THE Contracted Bladder. Relations of the Seminal Vesicle and the rRo<^TATE Gland to the Bladder and the Rectum. Seen from the Right Side. The prostate gland is hypertrophied. Anterior true ligament of the bladder, or puboprostatic ligament' Lig. puboprostaticum (pubo- vesicale) medium Wluue line, or 'tendinous arch,r, of the pelvic fascia' Arcus tendineus fasciae p< Pubic symphysis S)mpli)sis ossium pubis Pubovesical muscle' M pubovesicalis Levator ani muscit. Urachus, or 'median umbilical ligament' Lig umbilicale medium Prostate gland (right lateral lobe) Prostata (lobus dexter) — - Body of the bladder Corpus vesica; Summit or apex of the bladdei Vertex vesica: Fig. 841.— External Layer of the Muscular Coat (Stratum Externum TuNic^i Muscularis) OF the Contracted Bladder, seen from Before and Above. The bUdder has been drawn as far as possible backwards away from the pubes. On tlic rijjht side the levator ani muscle is exposed ; on the left side the rectal fascia' covering upper or pelvic surface has been left intact. : Appendix, note SO*, ■ Set Ajipend.x, note Vesica urinaria — Urinary bladder. 63 498 URINARY ORGANS Mucous folds, or rugse of the bladder Plicaa mucosas Mercier's bar Ureteric fold' Plica ureterica Internal orifice of the urethra Orificium urethrje internum Prostate gland — Prostata Prostatic utricle'' — - Utriculus prostaticu: Orifice of the common seminal or— ejaculatory duct Second, membranous, or muscular portion of the urethra Pars membranacea urethrae .lixtemal layer tratum externum - -Middle layer of the musculai' Stratum medium] '""'^^ muscularis Mucous membrane of the bladdei Tunica mucosa vesicse — Orifice of the ureter Oriiicium ureteris Trigone of the bladder- Tngonum vesicse (Lieutaudi) Uvula of the bladder Uvula vesicas Sphincter vesicse (intemus) or * urethral ring- *Annulus urethralis — First or prostatic portion of the urethra "■"•Pars prostatica urethra^ Colliculus seminalis, verumontanum, or caput gallinaginis-' *°-- Orifices of the prostatic ducts ~ Crest of the urethra-' Cribta urethralis Fig. 842. — The Male Bladder and the First or Prostatic Portion of the Urethra, with THE Prostate Gland, opened from Before. The bladder was in a moderately distended state. Mucous folds or rugae of =:z::z2 the bladder Plicae mucosa Trigone of the bladder' Trigonum vesicae (Lieutaudi) — Sphincter vesicse, or 'urethral ring, *Annulus urethralis Muscular coat of the urethra (layer of unstriated muscular fibres) Tunica muscularis urethra Layer of cross-striated muscular fibres Orifices of the urethral glands''^ Labium minus, or nympha Labium minus pudendi JExtemal layer "j Stratum e.xtei uum l_ of the muscular coat \- Middle layer | tunica; muscularis Stratum medium J — Mucous membrane of the bladder Tunica mucosa vesica' Submucous areolar tissue Tela submucosa Post-trigonal pouch^ Internal orifice of the urethra Orificium urethras internum Crest of the urethra'' *Crista urethralis External orifice of tne urethra Orificium urethrse externum ,^' Vestibule of the vagina-'' Vestibulum vaginse Glans clitoridis Prseputium clitoridis Fig. 843.— The Female Bladder and Urethra, opened from Before The bladder was nearly empty, and contracted. ' Sec Appendix, note 61 = See Appendix, note & 3 See Appendix, note 63. 4 See Appendix, note 64. 5 See Appendix, rote '5. Vesica urinaria— Urinary bladder. ORGANA GENITALIA VIR1.LIA MALE REPRODUCTIVE ORGANS '3 — 2 50G MALE REPRODUCTIVE ORGANS Urinary bladder Vesica Ampulla of the vas aeferens Ampulla ductus deferentis Seminal vesicle Vesicula seminalis Vas deferens Ductus deferens Common seminal or ejaculatorj^. duct — Ductus ejaculatorius Prostatic utricle- — Utriculus prostaticus Prostate gland— Prostata Cowpers gland 3 GlanHula bulbo-urethralis (Cowperi) Bulb of the urethra Bulbus urethrse Paradidymis, or organ of Giraldes Testicle Testis Scrotum Peritoneum Peritonaeum Pubic symphysis Symphysis ossium pubis Corpus spongiosum, or corpus cavernosum urethrae Corpus cavernosum penis Hydatid of Morgagni, or appendix of the testicle' Appendix testis (Morgagniil 1 See Appendix 2 Known also £ 3 Known also t : ^t prostatic sinus, prostatic vesicle, J i the sjlburethyal gtand. s pocularis, and idcrtis ntasculinus. Fig. 844. -Diagrammatic Representation of the Male Reproductive Organs and their Relations to the Bladder and the Urethra. Lateral View. Fallopian tube (istnmus) Tuba uterina (isthmus) Paroophoron Infundibulum of the Fallopian tube _ Infundi&uiM.-; tubas uterinEe Abdominal orifice, or pavilion, — of the Fallopian tube Ostium abdominale tubae uterinse Epoophoron, parovarium, or organ' of RosenmuUer /' Ovary / Ovarium Os uteri externum' Orificium externum uteri Bartholin's gland^ Glandula vestibularis major (Bartholin! * See Appendix, note 66. Uterine orifice of the Fallopian tube' Ostium uterinum tubae , Urinary bladder Vesica urinaria y^ — Peritoneum Peritonaeum Pubic symphysis Symphysis ossium pubis 5 See Append!; Vestibule of the vagina'' Vestibulum vagina -^.Labium minus, or nympha ■^ Labium minus pudendi "Labium majus Labium majus pudendi (• See Appendix, note 5° Fig. 845. — Diagrammatic Representation of the Female Reproductive Organs and their Relations to the Bladder and Urethra. Lateral View. Comparative Diagrams of the Male and Female Reproductive Organs. MALE REPRODUCTIVE ORGANS 501 I External or superficial abdominal ring- Annulus inguinalis sub cutaneus Accessory slip of origin of the cremaster muscle Spermatic cord Funiculus spermaticus, Cremaster muscle - M. cremaster I Septum of the scrotum Septum scroti Dartos tunic Tunica dartob — Raphe of the scrotum.. Raphe scroti Vas deferens Ductus deferens Spermatic artery A testicularis (spermatica interna) Nerve filaments of the spermatic plexus Artery of the vas deferens, or deferential artery A deferentialis — Infundibuliform fascia' Tunica vaginalis communis Spermatic or pampiniform plexus Plexus pampiniformis Epididymis Parietal layer of the tunica V aglnaUs, or tunica vaginalis scroti Tunica vaginalis propria testis Testicle Testis Scrotum (skin) Scrotum (integumentum commune) Fig. 846. — The Scrotum. The Penis has been turned upwards, and the Anterior Wall of THE Scrotum has been removed. On the Right Side, the Spermatic Cord, the Infundi- buliform Fascia, and the Cremaster Muscle, are displayed; on the Left Side, the Infundibuliform Fascia has been divided by a Longitudinal Incision passing along the Front of the Cord and the Testicle, and a Portion of the Tunica Vaginalis Scroti (Parietal Layer of the Tunica Vaginalis) has been removed, to display the Testicle and a Portion of the Head or Globus Major of the Epididymis, which are covered by the Tunica Vaginalis Testis, or Visceral Layer of the Tunica Vaginalis. Spermatic artery A. testicularis Spermatic or pampiniform plexus I'lexus pampiniformis Cremaster muscle (deepest fasciculi) M. cremaster inlernus Branches of the artery of the vas deferens, or deferential artery Nerve filaments of the spermatic plexus Vas deferens Ductus deferens se tissue Fasciculi of the cremaster muscle Intercolumnar or spermatic fascia' I'ascia cremasterica (Coopcri) Infundibuliform fascia' Tunica vaginalis communis External layer Middle layer Internal layer Stratum ijilcrnuiii layer "\ cn.uiii I ^^ the muscular coat Pic. 847.— Transverse Section through the Spermatic Cord not i ak 1 rom its Emergence FROM the Inguinal Canal. I ' See Appendix, note «. •' Known also a.s ihc exlcrnal inguinal aftrlurc. Scrotum— The scrotum.— Funiculus spermaticus -The spermatic cord. 502 Head or globus major of the epi- didymis—Caput epidid) midis\^ Pedunculated hydatid of Morgagni, or appendix of the epididymis (var j ^ Appendix epidi' midis (var.) Sessile hydatid of Morgagni, or appen dix of the testicle Appendix testis (Morgagnii) MALE REPRJDUCTIVE ORGANS Spermatic cord Funiculus spermaticu= Spermatic cord Funiculus spermaticus Tunica vaginalis Tunica vaginalis propria testis Infundlbuliform fascia= — Tunica Internal surface of tile testicle Facias medialis testi: Anterior tiorder of the testicle— :Margo Inferior extremity of the testicle Extremitas inferior testis Superior extremity of the testicle Extremitas superior testis^ Infundihuliform fascia , Tunica vaginalis com- P'/' munis ! Head or globus major of the epididymis '. \ Caput epididymidis , ,' 'Superior ligament of the epididymis 3 \ "^Li^. epididymidis superius 1 ,' . Digital fossa Sinus epididymidis Body of the epi- " didymis — Corpus epididymidis I Anterior border of / ^-s^ ^ the testicle / ^^ Margo anterior testis' ^- Parietal layer of the tunica i vaginalis, or tunica vaginalis scroti — Tunica vaginalis pro- pria testis (lamina parietalis) Posterior border of the testicle ,_,.-' 'ilar.qo posterior testis '^ \ Tai! or globus minor of the ! , epididymis-C.-n-d-. epididymidis ! ' Inferior ligament of the epi- didymis^ I *Lig- epididymidis inferius ' External surface of the testicle Testis (facias lateralis) Fig. 848.— The Left Testicle with the Epididymls, THE Infundibulifor:^! Fascia and the Parietal Laykr of the Tunica Vaginalis (Tunica Vaginalis ScRon) having been divided. Seen from Before. Fig. S49. — The Left Testicle with the Epididymis, the L.atter being drawn a little backwards. The Infundibuliform Fascia and the Parietal Layer OF THE Tunica Vaginalis (Tunica Vaginalis Scroti) have BEEN DIVIDED. SEEN FROM THE OUTER SiDE. Spermatic or pampini- form plexus Plexus pampiniformis Infundibuliform fascia^ Tunica vaginalis communis Paradidymis, or organ of Giraldes Parietal layer of the tunica va^aUs, or tunica » vaginalis scroti Tunica vaginalis propria testis Head or globus major of the epididymis — c. 1 , epididymidis Sessilj hydatid of Morgagni, or appendix of the ^ testicle jr Appendix testis -'' (jVIorgagnii) External surface of the testicle Facias lateralis testis Line of attachment of the parietal layer of the tunica vaginalis Vas deferens Ductus deferens Artery of the vas deferens, or deferential artery— .\. deferentialis Nerve filament of the spermatic plexus Coni vasculosis Lobuli epididymii Efferent ducts (vasa efferentia) of the testicle Ductuli effarantes testis' Infundibuliform fascia - Tunica vaginalis communis Posterior border of the testicle Margo posterior testis Vas deferens Ductus deferens Canal of the epi- didymis— Ductus epididymidis Vas aberrans •superior (var.)^ Ductulus aber- rans superior (var.) Body of the epi- didymis— Corpus epididymidis 'Vas aberrans (inferior)'"' Ductulus aberrans h (inferior) fl Fig. 850. — The Testicle with the Pampinif.'Km Plexus, the Serous Sac of the Te.sticle (Tunica \'-\ginalis") having been opened from the inner Side. Fig. 851.— The Testicle with its Efferent Ducts AND "the Canal of the Epididymis dissected out. Seen from the Outer Sil>e. : See .Appendi.--;, note See Appendix, note 73. 5 See Appendix, 3 See Appendix, note 7°. Testis — The testicle. — Epididymis — The epididymis. 1 MALE REPRODUCTIVE ORGANS Reflection of the parietal layer of the tunica vaginalis i tunica vagi nalis scroti i into the visceral layer of the tunica vaginalis (tunica, vaginalis testis; /\ Vas deferens Ductus deferens ?-^'r of the epididymis 'IS epididymidis — Jisitaj fossa ~ nus epididymidis Mediastinum testis, ^ or corpus Highmori Septa of the testicle^- Septula testis Lobules of the testicle ■'- Lobuli testis Tunica albuginea or fibrous capsule of the testicle — Tunica albuginea testis Head or globus major of the epididymis C ipm i--| l.lulyinidis Spermatic or pam- piniform plexus i'lexus pampiniformis Spermatic or pam- piniform plexus Pajietal layer of the tunica vaginalis or -tunica vaginalis scroti i iiliica v;iginalis propria testis Can.ina parietalis) Visceral layer of the tunica vaginalis, or tunica vaginalis testis Tunica vaginalis piopria testis (lamina viscrralis) InfimdibuUform fascia Tunica vaginalis communis Body of the epididymis ' Corpus epididymidis Mediastinimi testis, or corpus Highmori Superior extremity Fig. 852.— Horizontal Section through the Right Fic. 853.— Testicle and the Epididymis, and through the oi- the Tunica X'aginalis and the iNKUNUir.LLiiOR.M Testis, Fascia. Septa of the testicle Septula testis Lobules of the testicle 1 >buli testis Anterior border of the testicle Margo anterior testis Tunica albuginea or fibrous capsule of the testicle — Tunica ilbiiginea testis 'Tail or globus minor of the epididymis Cauda epididymidis S.agittal Section through the Middle Right Testicle. The Mediastinum OR Corpus Highmori. Efferent ducts (vasa efferentia) of the testicle— Ductuli etTerentes Coni vascnlosii— Lobul cpididyniid" Tunica albuginea or fibrous capsule of the testicle Tunica albuginea testis Lobules of the testicle '■^ Lobuli testis Seminiferous tubule (convoluted! Tubuli seminileri contort! I V. M I iG. 854.— The Parenchyma of the Testicle, I'AkllALI.V ISOLATED HV MACERATION IN HYDRO- CHLORIC Acid Solution. » Set Appemlix, note ?'. Vas deferens Ductus deferens ^ Canal of the epididsnnis Paradidymis, or organ of Giraldfes Efferent ducts (vasa effer- / entia) of the testicle (i) Mediastinum testis, or crpus Highmori 'Seminifercus tubules ; j (convoluted) (3) '1 t emlnlferous tubules (straight) 1 'I iil.uli scminifcri rcrti Reto vasculosura testis Kctc testis (Halleri) ' Vas aberrans superior (var.) - Dl,..nlusal„-,r.,Ms superior (var.) Vas aberrans (inferior) nlus . (inferior) (1) Ductuli efTerentes (j) Tubuli Fig. 855.— Diacjrammatic Representation ok Yhe Course and Connexions ok the 'Iubules of iHE Testicle and the Kpididvmis. » Sec Appendix, nole 7'. Testis The testicle.— Epididymis-The epididymis. 504 MALE REPRODUCTIVE ORGANS Body of the seminal vesicle Corpus vesiculcB seminalis _Vas deferens Ductus deferens Vas deferens Ductus deferens- Body of the seminal vesicle Corpus vesiculas seminalis Excretory duct of the seminal ' vesicle Ductus excretorius vesiculffi seminalis Saccules of the ampulla Diverticula ampullse Ampulla of the vas deferens Ampulla ductus deferentis Common seminal or ejaculatory duct - Ductus ejaculatorius Excretory duct of the seminal vesicle Ductus e\cretonus vesiculje semmalis Common seminal or ejaculatory duct Ductus ejaculatorius 1 Ampulla of the vas deferens Ampulla ductus deferentis Fig. 856. — Cast of the Interior of the Right Seminal Vesicle, the Ampulla of the Vas Deferens, and the Common Seminal or Ejaculatory Duct. Fig. 857. — Longitudinal Section through the Right Seminal Vesicle, the Ampulla of the Vas Deferens, and the Common Seminal or Ejaculatory Duct. Base or fundus of the bladder Fundus vesica urinariaa Seminal vesicle Vesicula seminalis Ampulla of the — vas deferens Ampulla ductus deferentis Orifice of the excretory duct — of the seminal vesicle Common seminal or ejaculatory duct — Ductus ejaculatorius Prostate gland Prostata / Prostatic utricle' Utriculus prostaticus Second, membranous, or muscular portion of the urethra — Pars membranacea urethrgs Cowper's gland'^ — Glandula bulbo-urethralis (Cowperi) ' Bulb of the urethra Bulbus urethrae J Uvula of the bladder ' Uvula vesicse Middle lobe of the prostate Isthmus prostatse , First or prostatic por tion of the urethra Pais piostatica urethra Corpus cavemosum penis ' Third, spongy, or penile portion of the urethra — Pars cavernosa urethrae s Excretory duct of Cowper's gland Ductus excretorius glandulae bulbo-urethralis - - Crus penis Known also as Aia prostatic sinus, prostatic tie Known also as the suburetJiral gland. tiG. 858.— Sagittal Section through the Male Urethra. Left Half. Urethral Orifices of the Common Seminal or Ejaculatory Duct and the Excretory Duct of Cowper's Gland {see note - above). The Prostatic Utricle [see >iote ' above). Vesicula seminalis— The seminal vesicle. — Ductus deferens— The vas deferens. - Ductus ejaculatorius — The common seminal or ejaculatory duct. MALE REPRODUCTIVE ORGANS 50» Middle lobe of the prostate gland- ' Isthmub prostata Middle lobe of the prostate gland Lobus medius (var ) Base or vesical surface - of the prostate gland Basis prostatae Right lateral lobe Lobus dexter Anterior or pubic siuface Facies anterior Ai>ex of the prostate gland Apex prostata;- Ampulla of the vas deferens ArnpiiUa ductus deferentis Seminal vesicle. - V'esicula seminalis Left lateral lobe Lobus sinister Fig. 859.— The Prostate (;land, isolated and seen FROM Before. Excretory duct of the seminal vesicle Ductus excretorius Nesiculir seminalis Base of the prostate gland Lasis prostata; ^Common seminal or ejaculatory duct Ductus ejaculatorii Posterior or rectal surface of the prostate gland I acies posterior prostatas Prostatic utricle" Utriculus prostaticus Second, membranous, or muscular portion of the urethra Pars membranacea urethrae Fig. 860. — The Common Seminal or Ejaculatory Ducts and the Blind Extremity of the Pro- static Utricle, laid bare from Behind ky the Removal of a Portion of the Prostate Gland. Circular muscular layer of the urethra Cross striated muscular fibres I Anterior surface I Facies anterior ^Pirst or prostatic portion of the urethra ^^ Pars prostatica urethra' Colliculus seminalis or crest of the urethra^ Prostatic utricle- Utriculus prostaticus ' Common seminal or ejaculatory duct Ductus ejaculatorii =- Prostatic ducts Ductus prostatici Connective-tissue stroma'' Glandular substance- Corpus tHn lul ir External layer of unstnated muscular fibres - M prostaticus Pelviprostatic capsule or prostatic fascia' Fascia prostatsn Posterior or rectal surface Facies posterior '1 Glandular sub- i stance Corpus glandulare Fig. 86i.-HoRizoxrAL Section through the Middle of the Prostate Gland of a Muscular Man TWENTV-FOUR YEARS OK AGE TRAN.SVERSE SECTION OF THE COLLICULUS SEMINALIS OR CREST 01' IHE Urethra. 3 ' Sc« Appendix, n.^le 71, » Known alv> .IS the firottatic linui, ^rottttic vesicU, tin 1 Known alw* :is the verumontanum or cafiut K^llinagim < Thin Ho-caltcd connective-tissue stroma iliiniif^ntyebixtro *> Sec Appendix, note 74, f /^ocularis, and uUrus maiculinus. See Appendix, note »'. . . . „ , • , m, Toldl) of the prostate gland con«iHt« chiclly of unstnated 1 Prostata— The prostate gland.— Ductus ejaculatorii— The common seminal or ejaculatory ducts. I 64 506 Base or fundus of // the bladder V ' Fundus vesicjE Prostate gland (posterior or rectal surface) Prostata ffacies posterioi Cowper's glands' G!andul,-e bulbo urethral. (Cowperi) Cms penis, Bulb of the urethra Bulbus urethreas Corpus spongiosum, or corpus cavernosum urethrsa Corpora cavernosa penis MALE REPRODUCTIVE ORGANS /^^- Vas deferens ^'j Ductus delerens /■JJ /^•^l-~.-Seminal vesicle \'esicula seminalis First or prostatic portion of the urethra ' S'econd, niembranous, muscular portion urethra (2 Second, niembranous, or muscular portion of the urethra (3) Third, spongy, or penile portion of the urethra Pars cavernosa urethra; Corona glandis- - Glans penis Glans penis External orifice of the urethra Orificium urethrae externum Sphincter vesicje (intemus) or *urethral ring- \nnulus urethralis Crest of the urethra' Lribta urethralis Colhculus seminalis, verumontanum, or caput gallinaginis" Prostatic utricle^ L triculus prostaticus Orifice of the common seminal or ejaculatory duct Crest of the urethral-Crista urethralis Bulb of the urethra bulbus urethrse -Cms penis Orifice of the excretory duct of Cowper's gland Pectiniform septum of the penis Septum penis Artery of the corpus cavernosum, or deep artery of the penis Aileria profunila Jicnis Fibrous capsule of the corpora cavernosa Tunica alljuginea Corpus cavernosum penis Corpus spongiosum, 3r corpus cavernosum urethrse Lacunse or recesses of the urethra Lacunse urethrales (Morgagnii) t^j] Fossa navicularis of the urethra Fossa navicularis urethrae (Morgagnii) (i) Pars prostatica iirethrae. (2) Pars meml Fig. 862. — The Penis, with the Urethra, Cowper's Glands,^ the Prostate Gland, AND THE Seminal Vesicles, seen from Below and Behind. (3) Pars membranacea urethrse Fig. 863. — The Male Urethra, opened FROM Above and Before by a Sagittal Section close to the Pectiniform Septum of the Penis. * Known also r , the subnrctliral glands. .iiown also as ^^ prostatic sii - See Append i: , prostatic vesicle, siiiw. 3 See Appendix, note ^. Penis — The penis. — Urethra virilis — The male urethra. MALE REPRODUCTIVE ORGANS 507 External orifice of the urethra Orificium urethras externum Corona glandis . Glans penis- Urethral furrow of the corpora cavernosa Fades urethralis IPl Corpus spongiosum, or corpus cavemosum urethrae Cms penis Bulb of the urethra Hulbus uretlirrr^ Fig. 864. — The Penis, with the Pubic Bones. Seen from Before and Below. The corpus spongiosum, or corpus cavemosum uretlir;c, with the glans penis, has been .■separated from the corpora cavernosa penis for the anterior half of its extent, and turned to one side. Glans penis Corona glandis Dorsal furrow of the penis Sulcus dorsalis penis Pubic symphysis Symphysis ossium pub v," Body of the penis ■ ipus penis Inferior or descending ramus ' of the pubis K.uiuis inferior ossis pubis Left lateral lobe or hemisphere of the bulb of the urethra— I iemispharium (sinistruni) bullji urethra Entrance of the u ethra into the corpus spongiosum, or corpus cavemosum urethrse Fig. 865.— The Pknis, with the Puhic Bones. Seen from Ahove and Behind. The urethra has been cut away at its cntnince into the corpus spongiosUBi, or corpus caver- noMum iirethrx'. The Penis. 64- 508 MALE REPRODUCTIVE ORGANS Cervix or neck of the glans CoUum glandis Corona glandis Subcutaneous aieoiar tissue or superficial fascia— Tela subcutanea I'ibrous capsule of the corpora cavernosa — Tunica albugmea Deep fascia of the penis - Fascia penis' Skin Integumentum commune- External orifice of the Tirethra Orificium urethrae externum Prepuce or foresldu Prasputium Frsenum of the prepuce Frenulum praeputii - - Free border of the prepuce Fig. 865.— Free Portion, or Body, of the Penis seen from the Right Side. ■Vtie skin has been divided along the dorsum of the penis, and the right.half of the prepuce or foreskin has been turned downwards. The subcutaneous areolar tissue or superficial fascia and the deep fascia have been partially removed. Skin Integumentum commune ^_^ Deep fascia of the penis ■ Fascia penis' Corpus cavernosum penis Cervix or neck of the glans ; ; Corona glandis Pectinifonn septum of the penis ' Septum penis Fibrous capsule of the corpora cavernosa' Tunica albuginea Corpus spongiosum, or corpus cavernosum urethras Glans penis -Prepuce or foreskin (inner and outer layers) — Prs-putium External orifice of the urethra Orificium urethras externum Fossa navicularis of the Urethra Fossa naviculai-is urethrs (Morgagnii) Frsenum of the prepuce Frenulum praeputii Third, spongy, or penile portion of the urethra Pars cavernosa urethrae Fig. 867.— Median Sagittal Section through the Free Portion, or Body, of the Penis. Dorsal vein of the penis— V. dorsalis penis Dorsal artery of the penis A. dorsalis penib Fibrous capsule of the corpora \ cavernosa — Tunica albuginea Artery of the corpus caver- nosum, or deep artery of ' the penis— A. pnifundi p m Pectiniform septum of the penis Septum penis Corpora cavernosa penis ' Deep fascia of the penis Fascia penis' Corpus spongiosum, or corpus cavernosum urethrae Glans penis Corpus spongiosum or corpus cavernosum urethrae — Corpus cavernosum urethrae Urethra (fossa navicularis) Middle of the Penis. Anterior Portion of the Glans Penis. Septum of the glans penis Septum glandis Posterior Portion of THE Glans Penis. Fig. -Transverse Sections through the Penis. ■ Fastia Peah,—Th\s. term, as used by the author, denotes not only the deep fascia of^ the fenis of English anatomists, which fotms a sheath for the free portion or body of the penis, but also the fascial layer (structurally continuous with the deep fascia of the penis) which covers the root of the organ, and belongs to the peiineum. This latte* U usually known in England by the name of CoUes' s fascia. See Fig. 914, p. 52(^, and note - on that page. — Tr. The Penis. ORGANA GENITALIA MULIEBRIA FEMALE REPRODUGTIVE ORGANS 510 FEMALE REPRODUCTIVE ORGANS Body of.the uterus I Corpus uteri Fallopian tube Tuba uterina (Falloppii)| Ovary — Ovarium . j Neck of the uterus or cervix uteii Broad ligament of the uterus ^' Lig. btum men Vaginal portion of the cervix^ Portio vaginalis (Ler% icis) Vagina (mucous membrane) Fig. S60.-INTERNAL Genital Organs of a New- born, POWERFULLY-DEVELOPED FEMALE INFANT. Seen from Behind. The posterior wall of the vagina has been divided by a median longitudinal incision and the seg- ments turned to the right and the left. Suspensory ligament of the ovary (infundibulopelvic or ovariopelvic fold or ligament! Lig, suspensorium o\ am Ovary — Ovarium" Neck of the uterus, or cervix uteri Vagina Rectum Intestinum rectum Fallopian tube luba uterina (Falloppii) Body of the uterus < orpus uteri Peritoneum Peritonaeum Urinary bladder Vesica urinaria Ve stibule of the vagina- Vestibulum vagina:' Hymen Fig. 870. — Reproductive Organs of a New- born, -Powerfully-developed Female Infant IN Median Sagittal Section. Left Half. Infundibulum of the Fallopian tube Infundibulum tubffi uterina; Ovary Ovarium Body of the uterus Corpus uteri Suspensory ligament of the ovary (infundibulopelvic or ovariopelvic /, fold or ligament) ' / Lig suspensorium ovarii ' . Fallopian tube Tuba uterina (Falloppii) Neck of the uterus or cervix uteri Uterosacral ligament, or fold of Douglas 3 -l'licnrccto-ut=rina(Dougla: Urinary bladder— Vesica urinaria Fallopian tube Tuba uterina Ligament of the ovary | Li^ ovaru proprium 1 Neck of the uterus or rervix uteri Vaginal portion of the cervix Portio vaginalib (cervicis) Vagina (posterior wall turned outwards) Fig. 871.— Internal Genital Organs of a Girl AGED Eight Years. Seen from Behind. •*g^y - Glans clitoridis :^x Labium minus pudendi, or nymph a ^ Labium majus pudendi External orifice of the urethra Hymen— Hymen (femininus) Fig. 872.— Reproductive Organs of a Girl aged Ten Years in Median Sagittal Section. Left Half. Anus Perineum (obstetrical, - see rtppeiidix, note 75. 2 See Appendix, note 90. ■ . . u j 3 Known also as cndix, note •'. Fk;. 881. — Sagittal Section through the Female Pelvis, 4 Centimetres (1-576 Inches) to the Right of the Median Plane. The Section passes through the Right Broad Ligament of the Uterus, AND SHOWS THE CONTINUITY OF THE TwO LaYERS OF THIS LiGAMENT WITH THE PaRIETAL PERITONEUM OF THE Floor of the Pelvis. *Parami-:trium, or Parametric Connective Tissue (see Appendix, note *'). Diaphragma Pelvis, the Pelvic Diaphragm (see Appendix, note *'), with its Superior AND Inferior Fascial Layers, and Inferior to the Latter of these the Fatty Tissue of the Ischiorectal Fossa. From a Frozen Preparation. The long axis of the uterus in this specimen is vertical, tlft organ being pathologically retrovcrtcd. Tuba uterina — The Fallopian tube. — Ligamentum latum uteri — The broad ligament of the uterus. *Parametrium — The parametric connective tissue. 65 514 FEMALE REPRODUCTIVE ORGANS ,i\^lf^\l^f^kt\-h ■ Mons Veneris Mons pubis Prepuce of the clitoris Prasputium clitoridis Anterior commissure of the vulva Commissura labiorum anterior -Labium majus Labium majus pudendi . Eima urogenitalis, or vulval cleft Rima pudendi Posterior commissure of the vulva Commissura labiorum posterior — Perineum (obstetrical) Post-anal furroW; or crena clunium _ Crena ani Fig. S82. — Pudendum Muliebre, the Female Pudendum, or Vulva, with the Labia Majora. Rima Urogenitalis, the Vulval Cleft. Female Perineum (Obstetrical Perineum). Mons Veneris, with the Pubic Hair. Prepuce of the clitoris— Pra^putium clitoridis Glans clitoridis — Glans clitoridis Frsenum of the clitoris Frenulum clitoridis Labium minus, or nympha - Labium minus pudendi Vestibule of the vagina' Vestibulum vaginae Carunculse myrtiformes Carunculse hymenales Orifice of the duct of Bartholin's gland^ Fossa navicularis (of the vulva Fossa navicularis (vestibuli vaginas ) Fourchette, or frsenulum pudtud Frenulum labiorum pudendi I See Appendix, noie ^. 3 See Appendix, note 89. 4 Glandula vestibularis major, k 5 See Appendix, note 9°. 2 ]^aginal coiujnns, lown also as Duverne Anterior commissure of the vulva Commissura labiorum anterior , Labium majus Labium majus pudendi Orifice of Skene's tubule or *para-urethral duct' Ductus para-urethralis — —External orifice of the urethra Orificium urethrse externum Urethral ridge, or carina urethralis (vaginae) Anterior vaginal column, or columna rugarum anterior- Vaginal orifice Orificium vagins ~~""~ Posterior vaginal column, or columna rugarum posterior^ Posterior commissure of the vulva Commissura labiorum posterior erior and posterior. These may be either single or double. — Tr. S^la>id And the siil'urethral gland. (See Appendix, note 6&.) Fig. 883. — Vestibule of the Vagina {see note ^ above) with the Labia Minora or NYMPHiE, the Vaginal and Urethral Orifices, and the Glans Clitoridis. The labia majora have been drawn outwards, and the rima urogenitalis, or vulval cleft, has thus been widely opened. Partes genitales externae muliebres — The female external genital organs. FEMALE REPRODUCTIVE ORGANS 515 Suspensory ligament of the clitoris Lig. suspensorium clitoridis Body of the clitoris- Corpus clitoridis Glans clitoridis Crus clitoridis Vaginal bulb, or bulb — of the vestibule' Bulbus vestibulj Venous plexus- Plexus venosus Pubic symphysis Symphysis ossium pubis Frsenum of the clitoris 1 lenulum clitoridis External orifice of the urethra Orificium urethra:- externum - Vestibule of the vagina' Vestibulum vaginae Vaginal orifice Orificium vaginae Fossa navicularis (of the vulva) ^ Fossa navicularis (vestibuli vaginas) Fig. 884. — The Clitoris and the Vaginal Bulb or Bulb of the Vestibule/ injected WITH Resin through the Veins, and fully exposed by Removal of the Labia Majora AND Minora. Seen from Before and Below. Prepuce of the clitoris _. Praeputium clitoridis Glans clitoridis Crus clitoridis - Vaginal bulb, or bulb of the vestibule ' Bulbus vestibuli External orifice of the urethra Orificium urethrac externum Orifice of the duct of Bartholin's gland — Excretory duct of Bartholin's gland Bartholin s gland ' Glandula vestibularis major (Bartholini) Fraenum of the clitoris I lenulum clitoridis 'jabium minus or nympha ibium minus pudendi —Labium majus Labium majus pudendi Vestibule of the vagina' Vestibulum vaginae — Hymen Hymen (femininus) Vaginal orifice Oiificium vagma; Fig. 885. — Female Exteunal CiicNiTAL Okgans. The mucous membrane has been removed from tlic right side of the vestibule" and from the vf;lvai area on the rixht side of the vaginal orifice, and the right labium majus Hnd labium minus have been cut away, to show the relative positions of the crus clitoridis, the vaginal bulb' and Bartholin's gland." On the left side the labium majus and labium minus have been drawn outwarci:;. ■ .S«e Appendix, ntrtc ■>'. ' .Sfc .-.piKnilix, noic ''-. 1 Sec Appendix, note «>. 5 Known also a> Duvernry's gland ut ihc lutunl/tral gland. (Sec Appendix, nole <■•.) > Sec Appendi) Partes genitales exterrice— The female external genital organs. 65—2 516 FEMALE REPRODUCTIVE ORGANS .NfV_ Prepuce of the clitoris^ n^ Praeputium clitoridis "A Glans clitoridis Fraenum of the clitoris - Frenulum clitoridis Labium minus, or nympha Labium minus pude.idi Hymen Hymen (femininus) — Urethral ridge, or carina urethralis (vaginas) Posterior vaginal column, or i a columna rugarum posterior ^ >>•> Anterior vaginal column, or columna rugarum anterior' Transverse rugse of the vagina Rugs vaginales Posterior wall of the vagma Paries posterior vaginas Vaginal fornix- Fornix vaginae Vaginal portion of the cerviz Portio vaginalis (cervicis) Supravaginal portion of the cervix^ Portio supravaginalis (cervicis) Mons Veneris Mons pubis /Labium majus •— Labium majus pudendi .External orifice of the urethra Orificium urethrse externum ■ Orifice of Skene's tubule, or para-urethral duct^ Ductus para-urethralis |(pf_ Orifice of the duct of Bartholin's gland'' Bartholin's gland \ in section Mucous membrane of the vagina Tunica mucosa \-agina^' Muscular coat of the vagina Tunica muscularis vaginje —Anterior wall of the vagina Paries anterior vaginffi Anterior lip of the cervix Labium anterius ~— Os uteri externum^ Oriiicium externum uteri Posterior lip of the cervix Labium posterius ote 78. 3 See Appendix, note 75. s Duvcrncy s gland and the su/mrcthral gland. 6 See Appendix, note ^7. ?e Appendi: : Appendix, Fig. 886. — Female External Genital Organs of a Virgin, attached to the Vagina, WHICH HAS been ISOLATED AND OPENED, AND A PORTION OF THE CeRVIX UTERI. HyMEN (Femininus). The Vaginal Fornix (see Appendix, note '*), with the Anterior and Posterior Lips of the Cervix, and the Os Uteri Externum (see Appendix, note *^'^). The Vaginal Columns, Columns Rugarum, and the Transverse Rug^ of the Vagina, Rug^ Vaginales. The posterior wall of the vagina has been divided longitudinally throughout to the left of the meaian line, and has been turned to the right. Near the vestibule {see Appendix, note *") the section passes through the left Bartholin's gland {see note '" above). The Vagina. FEMALE REPRODUCTIVE ORGANS 517 Anterior fold of the axilla Plica axillaris anterior Upper arm- Brachium Sebaceous glands of the- areola (Montgomery's Glandule areolares (Montgomerii) Nipple or mamilla Papilla mammae Areola —Areola mamma; - Supernumerary mamma (var. ) Mamma accessoria (var.) Fig. 887.— Mamma, the Breast, of a Virgin aged Eighteen" Years. Inner border . Deep fascia of the pectoral region, or pectoral fascia ~-->y Fascia perti-rralis Pectoralis major muscle — -j Panniculus adiposus _. Skin Integumentum commune--; Lobules of the breast •; I^^^jbuli mammi Lobes of the breast l^bi mammae Hippie or mamilliy , Papilla mammse Galactopborous or mamillary ductS Ampullae or sinuses' of the ducts Sinus lacliftri Body of the breast Corpus mamma; Body of the breast orpus mamma- Ampullae or sinuses , of the ducts ^c Sinus lactiferi Galactopborous or mamillary ducts Ductus lactiferi Nipple or mamilla Papilla mamma' Fig. 8. — Horizontal Section through thk Female Breast. Panniculus adiposus Skin Integumentum commune Fig. 889.— Breast oka Nursinc; Mother, hardened in .Strong Alcohol; from One Hale oe the Or(;an THE Skin and .Suhcutaneous Kattv Tissue have ueen RE.MOVED, and THE GAI.ACTOPHOROUS OR MAMILLARY IliTTs WITH iiiEiR Sinuses have heen laid hare. Mamma The breast. 518 FEMALE REPRODUCTIVE ORGANS Deoidua serotina Membrana decidua basalis Decidua reflexa Membrana decidua capsulans ^ Decidua vera Membrana decidua \era^ Ligament of the ovary Lig. ovarii propri Corpus luteum Body of the uterus (muscular coat) Corpus uteri (tunica mascularis^ Neck of the uterus or cervix uteri sac (umbilical vesicle) Amnion - Fallopian tube Tuba uterina (Falloppii) Uterme cavity Ca\ um uteri Embryo Os uteri internum' Orificium internum uteri Cavity of the cervix, or cervical canal Canalis cervicis uteri Os uteri externum- Orificium externum uteri Fig. Sgo.— Uterus in the Fifth Week of Pregnancy, opened from Behind. By the removal of parts of the membranes ihe cavity of the amnion has been opened. Fundus of the uterus (muscular coat Fundus uteri (tunica muscularis) Placental insertion of the^ umbilical cord Placenta Placenta , Uterine cavity \ um uteri Umbilical cord Funiculus umbilicalis Corpus luteum Deoidua vera and decidua, reflexa. united Cavity of the cervix, or cervical canal Canalis cervicis uteri Os uteri externum- Orificium externum uteri Fig. 891.— Uterus in the Sixth Month of Pregnancy (Months of Four Weeks Each), opened by the Removal of the Posterior Wall. The Fcetus, with its Membranes, and the Placenta, in Transverse Section. Uterus gravidus — The gravid uterus. FEMALE REPRODUCTIVE ORGANS 519 Umbilical vein V. umbilicalis Umbilical arteries^ Aa. umbiUcales Anastomosis of the ' umbilical arteries Amnion ( folded back over the placenta) Fig. 892.— Ixteknai. or Fcetal Surface of the Placenta at Full Teral The umbilical vessels have been injected. Decidua serotina Membrana decidua (basalisl Tom uterine (utero-->~^ placental, veins ( Cotyledons, lobes, or loculi of the placenta Lobi placenta: Umbilical cord - 1" uniculus umbilicalis Fig. 893.— External, Maternal, or Uterine Surface of the Pl.acenta at Full Term, with the Umbilical Cord (Funiculus Umhilicalis). Branches of the umbilical artery in cross-section Opening of a uterine (uteroplacental) artery into the sinuses of the maternal portion of the placenta (placenta uterina) Villi of the foetal por- . tion of the placenta (placenta fcetalis)' Sinuses of the maternal portion of the placenta [ Muscular coat of the uterus I'linica imiscularis uteri Decidua serotina Membrana decidua (basal is) Serous coat of the uterus I'eritona'iim viscerale Opening of a uterine uieroplaceniiai vem into the sinuses of the maternal portion of the placenta (placenta uterinaj ' These villi arc known indifTercnlly -.a/u-lal villi ^m\ dwrioni villi. liG. 894— Uterus and Placenta in Transverse Section. Sixth Month of I'kegnancv (Months of Four Weeks Each). The Placpnta. ■i20 DEVELOPMENT OF THE REPRODUCTIVE ORGANS Abdominal orifice of the Miillerian duct Malpighian corpuscles -r Transverse tubules of the Wolffian '-' body, or mesonephric tubules Wolffian or mesonephric duct - Ductus WolfB Miillerian or pronephric duct Ductus Muelleri Common orifice of the Miillerian or pronephric ducts Rudiment of the kidney Primitive renal pelvis Rudiment of the genital or reproductive gland Wolffian body, mid-kidney, or mesonephros Corpus Wolffi Ureter AUantois -^^Cl Orifices of the Wolffian or mesonephric ducts Hind-gut — Inferior united part of the Miillerian or pronephric ducts — Genital eminence or genital tubercle ■Marginal lip of the cloacal orifice' Cloacal orifice- FiG. 895. — Diagrammatic Representation of the Primitive Urogenital Organs of the Embryo PRIOR TO Sexual Differentiation. The Wolffian Body (Mid-Kidney or Mesonephros) with THE Wolffian (Mesonephric) and Mullerian (Pronephric) Ducts. Pedunculated hydatid of Morgagni, or appendix of the epididjrmis ■' Appendix epididymidib Sessile hydatid of Morgagni or appendix of the testicle - Appendix testis Epididymis' Rete vasculosum testis Rate testis Testicle Testis Vas deferens Ductus deferens Paradidymis or organ of Giraldesc^ - Vas aberrans (inferior)^ ul-i Ductulusaberrans (inferior).^ "^ r^Ji^ Ureter Urachus or *median umbilical ligament" Lig. umbilicale medium Urinary bladder Vesica urinaria Urogenital sinus Sinus urogenitahs Penis - Orifice of the urogenital sinus Rudiment of the scrotum' __--Seminal vesicle Vesicula seminalis Prostatic utricle'' Utriculus pros- taticus Fig. 896.- -Development of the Male Genito- urinary Apparatus. Infimdibulum of the Fallopian tube Infundibulum tubas uterinae Hydatid of Morgagni Appendix vcbiculosa (Morgagnu) Ovary Ovarium " Epoophorou''-'^ Longitudinal tubule of the epoophoron, or duct of Gartner Ductus epoophori longitudinally? (Gartner!) Fallopian tube Tuba uterina , Paroophoron " Urinary bladder Rectum Intestinum rectum Rudiment of the uterus and vagina Urogenital sinus Sinus urogenitahs Clitoris Vestibule of the vagina Vestibulura vagmje Labium majus — Labium' majus pudendi Fig. 897.— Development of the Female Genito- urinary Apparatus. » See Appendix, note 9^. 4 See Appendix, note ^i. ^ Known also as the prostatic vesicle^ prostatic i - See Appendix, note 94. 5 Known also as the/ \us poai^aris^ and icterus inasculinus. See Appendix, note 69. . , _. arcan of Rosejunuller, 7 See note 3 to p. 387, Part III. Diagram showing the Development from a Common Type of the Male and the Female Genito-Urinary Apparatus. DEVELOPMENT OF THE REPRODUCTIVE ORGANS 521 Ventricles of the heart Ventriculi cordis Inferior vena cava- V. cava inferior Genital or reproductive gland^A i Wolffian body, mid-kidney, or mesonephros — Corpus Woltti Ascending limb of the um-.^ bilical loop of the intestine ' Umbilical vein - \'. umbilicalis Cascum Distal extremity of the primitive umbilical loop of the intestine' Omphalomesenteric or vitelline artery A. omphalomt/senterica Diaphragm '— Diaphragma Superior or diaphragmatic ligament of the Wolffian body ' Mesentery separated from the intestine! Umbilical cord Funiculus umbilicalis Fio. 898. — Human Fcetus at the End of the Sixth Week. The Genital or Reproductive Glands and the Wolffian Bodies are laid hare by the Removal OF the Liver, the Stomach, and the Descending Limb of the Umbilical Loop of the Intestine.' Suprarenal capsule ■' iijianduH suprarenalis Kidney ' Ken Hind-gu Genital cord'' Wolffian body, mid-kidney, or mesonephros Corpus WoHli Testes Inferior or inguinal ligament of the Wolfiian body (plica gubernatrlx)' Hypogastric or umbilical artery— A. umbilicalis ^ Ureter Urinary bladder Vesica urinaria Fig. 899.— Genito-Urinarv Organs of a Male Fcetus at the End of the Tenth Week. #(*««**''' Sigmoid flexure of the colon__ Colon sif;moideum Ovary - Wolffian body, mid-kidney, or mesonephros - Corpus Wolifi Urinary bladder / Vesica urinarir. Umbilical vein V, umbilicalis Left lobe of the liver Lobus sinister hepatis Small intestine Intestinum tenue Superior or diaphragmatic ligament of the Wolffian body- Inferior or inguinal ligament of the Wolffian body (plica gubernatrix) Umbilical artery A. umbilicalis Fig. 9oo.~Ai!DO.\iinal Organs of a Female Fayer-^ M. sphincter ani | externus [ deep layer Levator am muscle , Fifth ooccygeal vertebra / Vertebra coccygea V. \ Ischiorectal fossa luSS^ lsUll..lnlllis Tuberosity of the ischium Tuber ischiadicum Gluteus maximus muscle M eliit• «,-f muscle without qualilica'ti< nally distinguished as the ti-anf:'t I firm hand of areola ^ origin on each side I tissue stretching in the mcdir llie fihres of the superficial or fi*o/uHdus (the deep • cal muscle. whilst the r firp/tindus I line from the tip ixternal sphincter Musculi perinei Muscles of the perineum. 528 MUSCLES OF THE PERINEUM External or superficial sphincter f Superficial layrr of the anus j M. sphincter ani externus ( Deep layer Connexion (at the central point of the perineum) of the hulbocavernosus or ejaculator urinae muscle with the external or superficial sphincter of the anusy Ischiocavemosus or erector ^ i penis muscle / \^ ' Bulbocavernosus or ejaculator n urinse muscle "' Anus with surrounding skin / Post-anal furrow, or crena clunium ' / Crena ani / / Obturator fascia — Fascia obturatoria Falciform process of the great sftcrosciatic ligament Processus falciformis Posterior or great sacro- sciatic ligament Lig. sacrotuberosum Constrictor or compressor urethrse, or deep transverse perineal muscle ■ M. transvcTMis perintl prjfiindus. Obturator membrane, or ligament Membrana obturatoria Tuberosity of the ischium Tuber ischiadicum Anococcygeal ligament^ Lig. anococcygeum Ligament of the tip cf the coccyx" *Lig. apicis coccygis Acetabulum' Obturator internus muscle Spine of the ischium Spina ischiadica Fourth posterior sacral foramen Foramen sacrale posterius IV. Posterior or great sacrosciatic ligament Lig. sacrotuberosiui. °°';n'^?^^-c°J^?f=T.?J°''\i'elvicdiaphrasm4 coccygis muscle V nianhrni! nircelvS Levator ani muscle J i^iaparagma peivib I See note ■ to p. 527. = See note = to p. 527. 3 Ligamentum Apicis Coccygis. — "From the tip of the coccy.v," writes Quain ("Anatomy," loth ed., vol. 11., part u., p. 178), *' a fibrous band passes lO the integument, which is often, especially in the infant, marked by a depression i^fffvcola coccyged) at this spot." This is the ligament shown in the accompanying figure, and called by Toldt the '^li^ament of t lie tip 0/ tlie coccyx. — Tr. 4 See Appendix, note ^1. Fig. 916. — The Muscles of the Perineal Region of the Male seen from the Left Side. Levator Ani, and Coccygeus or Levator Coccygis Muscles, forming the Pelvic Diaphragm. The skin surrounding the anus, and covering the coccy-x and the lower part of the sacrum, has been drawn away from the tissues beneath, in order to di-play the radiation to the skin of fascicuH of the external or superficial sphincter of the anus (musculus sphincter ani externus). A portion of the posterior or great sacrosciatic ligament has been removed, in order to display somewhat more fully the inferior surface of the coccygeus or levator coccygis muscle. Musculi perinei — Muscles of the perineum. MUSCLES OF THE PERINEU 529 Labium majus Labium majus pudend Vaginal orifice— Orificium vaginae i Labium minus, or nympha— Labium mmus, pudendi | External orifice of the urethra Onticium Glans clitoridis Ischiocavemosus or erector clitoridis muscle 1 Superficial layer of the triangular ligament of the ; urethra^ — Fascia diaphragmatis urogenitalis interior ' I Superficial transverse perineal muscle^ ' M trans\ersu3 perinei superhcialis Tuberosity of the ischium Tuber ischiadicum Wall of the vestibule of th vagina in section Sphincter vaginae or bulbo- cavemosus muscle Ischiocavemosus or erector clitoridis muscle Posterior border of the Obturator fascia Fascia obturatoria Ischiorectal fossa Fossa ischiorectalis 'urogenital diaphragm' \^ Ischiorectal fossa Fossa ischiorectal Obturator fascia Fascia obturator: Obturator internus muscle Posterior or great saorosciaiic '- ligament — Lig. sacrotuberosum Spine of the ischiu. Spina ischiadica External or super- ficial sphincter of the anus M. sphincter ani externus Anococcygeal ligament* Li^' anoroccygeum Tip of the coccyx" Apex ossis coccygis I Coccygeus or levator coccygis \ muscle— M. coccvKeus Levator ani muscle filiac portion)" M. levator ani (pars iliaca) Levator ani muscle (pubic portion)'' M. levator ani (pars pubica) Pelvic diaphragm Diaphragma pelvis Fig. 917. — The Muscles of the Perineal Region of the Female seen from the Left Side. Of the External Genital Organs, the Labium Majus and the Labium Minus or Nympha have been removed on the Left Side. Levator Ani and Coccygeus or Levator Coccygis Muscles, forming the Pelvic Diaphragm. cted poste in/er rs uf the superficial and deep layers of ihc triangular ligament of the • layer of the triangular ligament (see Appendix, note **). ethra (see Appendii « That is, the c note »), — Tk. » Known also as the anterior c 3 See note < to p. 527. 4 See note » to p. 527. 5 Ajex Ossis Coccygis.— \n the first part of this work (p. 32), I gave extremity 0/ the coccyx as the English equivalent of this Latm term. The coccyx, however, has two extremities, and for this reason the expression tip o/the coccyx, which^ though somewhat colloquial, is employwl hy most anatomists to designate the inferior extremity of the coccyx, is to be preferred. Macalister, like Toldt, speaks of the apex o/the coccyx, a term that would he more suitable if the coccyx were more distinctly triangular in form. — Tk. 6 Parts o/the Levator Ani Musc/e.— The levator ani muscle is divided into two parts by a cleft beginning just below the obturator canal. The anterior portion only is directly connected with the rectum; it springs from the pubis .iiid adjoining part of the fascial origin O'.e,, the * tendinous arch o/the levator ani niuscU— sec Appendix, note "W); it is called bv Toldt the />uh'c fiortion o/the levator ani mitscle, and by Savage the fiuSococcy^eus muscle. The posterior portion arises from the 'jjhite line 0/ the pelvic /ascia behind the obturator caruil and from the spine of the ischium ; it is called by Toldt the iliac portion 0/ the levator ani muscle, by Henle the ischiococcygcus muscle, and by Savage the obturatococcygeus muscle. — Tr. Musculi perinei — Muscles of the perineum. 67 530 MUSCLES OF THE PERINEUM Sacrococoygeus posticus or extensor ooccygis muscle M. sacrococcygeus posteric Tip of the coccyx' Apex OS31S coccjgis Coccygeus or levator ooccygis muscle Hiatus of the sacnun Hiatus sacralis Spine of the ischium _ Spina ischiadica Levator ani muscle (iliac portion M. levator ani (pars iliaca) Levator ani muscle (pubic portion)^ M. levator ani (pars pubica^ Part of the external or super- ficial sphincter of the anus Fibres of the levator ani muscle inserted -^ into the anterior wall of the rectum Extremities of the posterior or great sacro- 'sciatic ligament, the intervening portion having been cut away -Iliosciatic or great sciatic notch Incisura ischiadica major Tuberosity of the ischium Tuber ischiadicum Ischiorectal fossa Fossa ischiorectalis _ Obturator fascia Fascia obturatoria Inferior or descending ramus of the pubis Ramus inferior ossis pubis Inferior pubic or subpubic ligament Lig. arcuatum pubis Fig. gi8. — Levator Ani and Coccygeus or Levator Coccygis Muscles, seen from Below. Sacrococcygeus anticus or curvator coccygis muscle M. sacrococcygeus anterior Aponeurosis of the pubic portion of the levator am muscle'^ Coccygeus or levator coccygis muscle Rectococcygeus muscle^ Second sacral vertebra Vertebra sacralis II -Posterior or great sacrosciatic ligament Lig sacrotuberosum Anterior sacrococcygeal ligament Lig sacrococc^geum anterius Obturator mtemus muscle Obturator fascia — Fascia obturatoria ♦Tendinous arch of the levator ani muscle^ — *Arcus tendineus m. levatoris ani C iliac portion-' Levator ani muscle | pars iliaca M. levator ani 1 pubic portion V pars pubica Obturator canal Canalis obturatorius Rectum Intestinura rectum Superior or ascending ramus of the pubis— Ramus superior ossis pubis Pubic symphysis Symphysis ossium pubis Fig. 919. — Levator Ani and Coccygeus or Levator Coccygis Muscles, seen from Above. After division of the pubic symphysis, the innominate bones have been drawn apart * See note 5 to p. 529. = See note ^ to p. 529. 3 Or apoiisit See Appendix is of tJie pubococcygeus muscle. See note 6 to p. 529. 5 See Appendix, note 98. Musculi perinei — Muscles of the perineum. MUSCLES OF THE PERINEUM 531 Inferior pubic or subpubic ligament Lig arcuatum pubis Inferior or descending ramus of the pubis Ramus inferior ossis pubis Second, membranous, or muscular portion of the urethra — Pars membranacea urethr i Flat surface on which the bulb of the urethra lies* Inferior ramus of the ischium Ramus inferior ossis iscliii Dorsal vein of the penis V. dorsalis penis .Dorsal nerve of the penis ''' N. dorsalis penis ,, Dorsal artery of the penis A. dorsalis penis ^.Transverse ligament of the pelvis- Lig. transversum pelvis Muscular fasciculi passing to the upper sur'ace of the corpus spongiosum or corpus cavemosum urethrae, and between the crura of the penis Curved longi- ^ . ^ -tudinal fasciculi of tlie constrictor or com- I pressor urethra or trans- J versus perinei profundus muscle^ Fig. 920. — Constrictor or Compressor Urethr.e or Transversus Perinei Profundus Muscle^ of the Male, forming the Muscular Part of the *Urogenital Diaphragm.^ Seen from Before and Below. Dorsal vein of the clitoris dorsalis clitondis Dorsal nerve of the clitoris N dorsalis clitoridis Dorsal artery of the clitoris A. dorsalis clitoridis Pubic symphysis Symphysis ossium pjl Inferior pubic or subpubic ligamen'^ Lig. arcuatum pubis Transverse ligament of the pelvis . Lig. transversum pelvis External orifice of the urethra - Onficium urethrae externum Vagina in transverse section- immediately above the vaginal orifice; Inferior ramus of the ischium — Kamus inferior ossis ischii Fig. 921. — Constrictor Urethr.e or Transversus Perinei Profundus Muscle'' of the Female, forming the Muscular Part of the *UROG!:NrrAL Diaphragm.^ Seen from Before and Below. ' Sec Appendix, note W, v Sec Appendix, note ""'. * The superficial layer of the triangular ligament, of course. of the constrictor urethrae or transversus perinei pro- fundus muscle' Musculi perinei — Muscles of the perineum. 67 — 2 532 MUSCLES OF THE PERINEUM Obturator canal Canalis obturatorius Acetabulum White line, or *tendinous arch, of the pelvic fascia" Arcus tendineus fascia: pehis Origin of the pubic portion of the levator ani musclei Inferior pubic or subpubic ligament — Lig- arcuatum pubis Transverse ligament of the pelvis-' Lig. transversum pelvis Constrictor or com- I Oblique pressor urethrae or J fasciculi transversus perinei 1 Transverse profundus muscle ' 1^ fasciculi Inferior ramus of the ischium Ramus inferior ossis iscliii Pubic symphysis Symphysis ossium pubis Origin of the pubic portion of the levator ani muscle (turned upwaids)' Tendinous arch of the levator ani muscle'' iVrcus tendineus m, leva- toris ani Obturator fascia Jrascia obturatoria Obturator internus muscle Branches of the dorsal vein of the penis - Veins of the corpus caverno- sum of the penis Vv. profundse penis Internal pudic vein- V. pudenda interna * Sphincter of the membranous urethra' *iVr. sphincter urethrae membranacese - Internal pudic artery'-^ A. pudenda interna 'Divided edge of the obturator fascia' Fig. 922.— Constrictor or Compressor Urethra or Transversus Pertnei Profundus Muscle^ of the Male, forming the Muscular Part of the *Urogenital Diaphragm.^ Seen from Behind and Above. Origin of the Pubic Portion of the Levator Ani Muscle.' Obturator internus muscle Subserous areolar tissue Tela subserosa Cross section of the white line, or tendinous arch of the pelvic fascia'-' — Arcus tendineus fascisB pel\is Visceral layer of the pelvic fascia'* Fascia endopelvina Obturator internus muscle Obturator fascia Fascia obturatoria Rectal fascia''— Fascia diaphragmatis pelvis supeuor Levator am muscle Pelviprostatic capsule or pros- tatic fascia"" — B'ascia prostatas Ischiocavernosus or erector penis muscle (Superficial) transverse perineal muscle'' M. transversus perinei superficialis Ampulla of the vas deferens Ampulla ductus defereatis , Base or fundus of the [ bladder— iuiidub \es Posterior inferior spine of the ilium — Spina iliaca posterior inferior , ^Pudendal venous plexus'" ' ■'■plexus (venosus) puden- d.a!is Great sciatic or iliosciatic notch— Incisura ischiadica major Spine of the ischium S[_ina ischiadica Seminal vesicle \ esicula seminalis Obturator fascia fascia obturatoria Anal fascia" — Fascia diaphragmatis pelvis inferior Prostate gland (posterior or rectal suriace) Prostata (facies posterior) Internal pudic artery'-^ A pudenda interna Tuberosity of the ischium / Tuber ischiadicum Deep layer of the triangular ligament of the urethra'^ Fascia diaphragmatis urogenitalis superior Bulbocavemosus or ejaoulator urinse muscle Fig. 923.— The Position of the Seminal Vesicle and of the Ampulla of the Vas Deferens in Relation TO the Bask or Fundus of the Bladder and to the Prostate Gland. Fascia of the Pelvic Outlet. Seen from Behind. The levator ani has been divided coronally. The pelviprostatic capsule or prostatic fa=cia'6 has on the right side been completely removed ; on the left side, its upper part, extending over the seminal vesicle, has been detached from that organ, and turned backwards. ^ See note 6 to p. 529. 5 See Appendix, note '°'. ' See Appendix, note 59. ■3 See Appendix, note 59. - See Appendix, note ^°^. 3 See Appendix, note i°3. 4 See Appendix , note 100 6 See Appendix, note 104. 7 See Appendix, note 93. 8 See Appendix , note 99. 10 See Appendix, note ^o5. " See Appendix, notes S5 and 87. 12 See Appendix , note 99. 14 See Appendix, note 106. 15 See Appendix, notes 86 and 87. 16 See Appendix , note 74. i7 See not e I to p. 527. Muscles and Fascise of the Pelvic Outlet. MUSCLES OF THE PERINEUM 533 Vas deferens and artery of the vas deferens or deferential artery Ductus deferens et A. deferentiali-- Iliac fascia Fascia iliaca Spermatic or pampiniform^ plexus I'iexus pampiniformis ^ Obturator nerve ~^, N. obturatorius External iliac artery^. A. iliaca externa External iliac vein V. iliaca externa Ante] lor superior spine of the ilium ""Spina iliaca anterior superior ,Poupart's ligament (superficial femoral arch) ILg inguinile ( r lupirti) 1 Internal or deep abdominal ring- (i) I Deep or inferior epigastric artery — k 1 and vein ^ \ ' ^ et \ V epi-,astric I inferiores Vestige of the obliterated hypogastric artery, or 'external umbilical ligament" (•;) Obturator artery and vein I \ 1 1 jturia ^Rectal fascia ' L liaphragmatis pelvis superior Pubic symphysis symphysis ossium pubis .Lateral true ligament of the bladder* Lit,', piiboprostaticum pul'ovesicale) laterals Anterior true ligament of the bladder, or pubo- prostatic ligament* Lil;. pi]l...pn.sIatioiTn (pubo- ^White line, or tendinous arch, of the pelvic fascia* Arcus tendineus fa^ci.f pelvic ^Visceral layer of the pelvic fascia — Fascia endopelvina • Urinary bladder \ esica urinaria — Urachus or *median umbilical ligament'^ *Lig umbilicale medium ^^^Eectum— Intestinum rectum (i) Annulus inguinalis abdominalis (2) I.ig. umbilicale laterale Fig. 924.— Fascia Endopelvina, the Visceral Layer of the Pelvic Fascia {see Appendix, note '^'^^),^vfH the Arcus Tkndimeus Fascia Pelvis, the White Line or Tendinous Arch of -jhe Pklvic Fascia (see Appendix, note''^). The Posimon of THEV^ssELs and Nkkves at the Upper Part of the LATbRALWALL of the Pelvis. btEN obliquely from Above and Within. The urinary bladder has been drawn away Ironi the wall of the pelvis as far a^ possible in a backward and downward direction. Common iliac artery A. iliaca communis Common iliac vein V. iliaca communis Internal iliac artery'''' A. hypogastrica Sacral promontory Promontorium Internal orifice of the urethra Parietal peritoneum 1 ( r t 11 in 1 Tri t lit Fossa of the acetabulum Fossa acetabuli 'Pudendal venous plexus •plexus purlendalis Obturator intemus muscle Obturator ej ternus muscle Pelvic diaphragm Vas deferens Ductus deferens Obturator fascia I 1 iraloria Visceral layer of the pelvic lascia — 1 I endopelvina White line or tendinous arch of the pelvic fascia \ icndineus fascia- pelvi Rectal fascia I I 1 I 1 I is superior Anal fjscia . Inferior or descending ramus of the pubis I< u 1 il 11 r ssis pubis •Urogenital d.aphragm •DiaphraK'nia urogenitale Collea's fascia'" I'ascia penis Prostate gland I rrstata Secon'J. membranou') or muscular portion of the urethra i n ir rilrt IschiocavemosuB or erector penis muscle .M. ischiocavernosus Bulb of the ure'.hra with the septum of the bulb of the urethra Fig. 02;.— Coroval .Section thkou(;h the Male Pelvis in the Plane of the Internal Omwick of the Urethra. Fascia Endoi-klvina, hie Visceral Layer of the Pelvic Fasci.\ {see Appendix, nnle ™) ; Fascia Diaphragmatis Pelvis .Superior, the Rectal Fascia (see /appendix, notes "", ". '"") ; and the Upper Part of the Ohiurator Fascia— as Constituent Parts of the Pelvic F.-vscia. Seen from Mefork. The urinary bladder is In a stale of almost complete contraction. . Sec Appfrn.lix, nolc "1. ' C.-ille,! aUo ihe InlrrHal i„Kuhml ap^rUtt. 3 See Appendix, "otes », »7, ■«'«. 4 See A .peixlix note ». S See Appen.lix, note ■*. ' Sm Appenchx, no e '«J, 7 .i^e Ap^ndix; Le ". ' Sec Appendix! note, -^ «7. ' See Appendix, r- >o Set note » 10 p. -.je. " See note * 10 p. 387 in Part III. ' Sec note 3 10 p. J87 1 Fascia pelvis et fascia endopelvina— The pelvic fascia and its visceral layer. 534 TOPOGRAPHICAL ANATOMY OF THE PELVIC VISCERA Parietal peritoneum Peritoneum parietale , Sigmoid mesocolon Mesocolo 1 I'^moideum Sacral promontory Promontormm Sigmoid flexure of the colon Colon sigmoideum Retroperitoneal space bpatmm retrcperitonEale Vas deferens Ductus deferens Ureter Seminal vesicle Vesicula seminalis\ Prostate gland Prostata Visceral peritoneum* Peritoneum \ iscerale \ Pelvic diaphragm'^ > Diaphragm! peh ib Parietal peritoneum Peritoneum parietat Summit or apex of the bladder Vertex vesicae Preperitoneal space, or cavity of RetzLus Spatium preoeritonaeale (Ketzii) Pubic symphysis Syraphyiis ossium pubi^ Crus penis- Body of the penis Corpus penis i. Scrotum Second, membranous, or muscular portion M of the urethra-Pars membranacea urethrae Bulb of the urethra— Bulbus urethrae *Urogenital diaphragm-- *Diaphragma urogenitale Cowper's gland.3 with its excretory nuct Glandula bulbo-urelhralis (Cowperi) cum ductu excret Perineum Sacral curve of the rectum^ Flexura sacralis recti Tip of the coccyx^ Apex ossis coccj-gis Coccygeal gland or glomerulus Glomus coccygeum ' Rectovesical pouch Excavatio rectovesicalis Pelvic diaphragm'— Diaphragraa pelvis External or superficial sphincter of the anus M- sphincter ani externus Anus * Perineal curve of the rectum^ * Flexura perinealis recti Fig. 926. — Position of the Pelvic Viscera in the Male and their Relations to the Muscles of the Pelvic Outlet (or Perineal Muscles), shown in the Right Half of the Pelvis, seen from the Left Side. The urinary bladder is fully distended, the rectum nearly empty. 99. 3 Known also as the suburethral gland. .vail of the pehas, in a curve the concavity of which is directed forward, e, runs forwards along the upper surface of the posterior part of at an angle slightly more obtuse than a right angle, it perforates canal. In this" course the rectum describes two curves: a larger, 'ith the concavity directed backwards, yZi-XK^-a perinealis " (Von ^ nd Toldt's "Anatomy," 7th ed., pp. 446, 447). In choosing English equivalents for these terms (which are not to be found in the works of Quain and Macalister), I have preferred to speak of the sacral and perineal curz'es 0/ the rechait. for the reason that the former, at any rate, is too prolonged and too open a bend to be appropriately termed a flexure. — Tr. S See note 5 to p. 529. r See Appendi.x-, note 87. - See Appendix, 4 'Curves of the Rectum —"The rectum follows the poste as far as the tip of the coccyx, and thence, still continuing the the pelvic diaphragm ; then, bending downwards and a little backwards that diaphragm in a direction perpendicular to its plane to form the anal .vith the concavity directed forwards, y7tu'7/ra sacralis ; Topographical Anatomy of the Pelvic Viscera. TOPOGRAPHICAL ANATOMY OF THE PELVIC VISCERA 535 Visceral peritoneum (perimetrium) ' covering the posterior or intestinal ( / surface of the uterus J /; reritona:um viscerale i perimetrium) j ,Ji Ul , , 'Hi Parietal peritoneum of the lateral wall of the pelvis Sacral promontory 1 romontonum Sigmoid flexure of the colon ' Colon bi^moideum Visceral peritoneum Peritonaeum viscerale Uterosacral ligament or Void of Douglas- Plica recto-utenna (UougUsi) Retractor uteri muscle ^ in transverse section M. recto-uterinus Pouch of Douglas, or rectovaginal pouch Excavatio recto-utenna (cavum Douglasi; * Sacral curve of the rectum "Flexura sacralis recti Tip of the coccyx Apex ossis cocc) gi Sigmoid mesocolon Mesi colon sismoideum Suspensory ligament of the ovary (infundibulopelvic or ovariopelvic fold or ligament) Lig. suspensonuni ovarii Fallopian tube Tuba uterini (Falloppii) Mesometrium'' * Parametrium' Round ligament of the uterus Lig. teres uteri Uteroveaical pouch Excavatio vesico-uterina Lateral false ligament of the bladder— Plica vesicalis transversa Vagma Levator am muscle Anus External or superficial sphincter of the anus M. sphincter ani externus 'Perineal curve of the rectum ♦Flexura perinealis recti tubis— Os pubis Visceral peritoneum Pentonseum viscerale Body of the bladder ( rrpus vesicae I 'i ' Urethra I Erectile tissue of the female urethra' ' Corpus spon}.;iosum urethra; 'Urogenital diaphragm''— *Diaphragma urogenitale \ Vaginal bulb, or bulb of the vestibule '" ' ISulbus vestibuli £ai i holin's gland ' ' Glandula vestibularis major (Barlholini) ' Perimetrium. — This name, for the peritoneal coat of the ulc the derivative term perimetritis is in frequent use. — Tr. - Known also as the recto-uteiine/otti or tigatiient. See note 3 Quain mentions tlie presence in the f Ids of Tluuglas of some however, calls them the retractorcs uteri, — Tk. ^ See Appendix, note **^ 7 .See Appendix, note 84, •^ Sec Appendix, no e '^'. " Known also as /.iMff/wri'V^^'/rtw;/ or ll: rus, is rarely employed by PInglish anatomists. 3 to p. 51C non-stnje, 8 .See Appendix, note "^s. nuscular fibres, but leav ■etitr. em unnamed. s See note 5 tc '^ See Append' 'and. See Appendix, note '^ Macalister, Fig. 927. — Position of the Pelvic Viscera in the Female, and their Relations to the Muscles of the Pelvic Outlet (or Perineal Muscles), shown in the Left Half OF the Pelvis, seen from the Right Side. The *Parametrium (sec Appendix, note ^*). The urinary bladder and the rectum are nearly empty. The sigmoid flexure of the colon has been dra«n up out of Douglas's pouch, .ind the ri^ht broavl li^aiTient of the uterus, the rif,'ht Fallopian tube, the riuht ovary, and the right roimd ligament of the uterus, have been cut away together by a sagittal section passing close to the body of the uterus. Ti e connexion of the two layers of the broad ligament of the uterus with the parietal p- ritoneum of the floor of the pelvis is seen, also the reflection of the visceral peritoneum covering the uterus {pcrimclrittm—sec note ' above) on to the wall of the bladder in front and the wall of the rectum behind. Topographical Anatomy of the Pelvic Viscera. 536 TOPOGRAPHICAL ANATOMY OF THE PELVIC VISCERA Root of the mesentery- Radix mesenterii * Ascending mesocolon ^ 'Mesocolon ascendens Fourth lumbar vertebra ! Vertebra lumbalis IV. ■ Abdominal aorta / Aorta abdominalis / Sacral promontory / Fromontonum Mesorectum Ascending colon ^ Colon ascendens N ' Descending mesonolon- ■" Mesocolon descendens Descending colon Colon descendens Ureter (visible through the peritoneum) Rectum Intestinum rectum"^- Csecum ,'M-. Intestinum csecum Spermatic vessels - (.visible through the peritoneum) Vasa spermatica *" Vas deferens (visible through the peritoneum) Ductus deferens Sigmoid mesocolon Mesocolon sigmcideum External inguinal pouch Fovea ingumalis laterali Epigastric fold , ■ ; Plica epigastrica' ; / Internal inguinal pouch''j ; Fovea inguinalis medialib ,' Body of the bladdei ' Corpus vesicse Supravesical pouch Fovea supravesicalis Sigmoid flexure of the colon Colon sismoideiim Parietal peritoneum Teiitonsum parietale Rectovesical fold or posterior ^' false ligament of the bladder I'lica reciovesicalis \ \ Lateral false ligament of the bladder \ or *transverse vesical fold \ »Plicn ^■esi.:alis transversa \ Summit or apex of the bladder — Vertex vesicae \Urachal or *median umbilical fold* Plica umbilicalis media hypogastric or external umbilical fold Plica umbilicalis lateralis ■ See Appendix, note 39. = See note ' to p. 453. 3 By some authorities the space between the urachal /old and the /n'/>og-astrlc /oUl {cM&i here supravesical pcntcJt) is named the internal inguinal poucit ; and the space between the liyfiogastric fold and the epigastric /old (called here internal inguinal pouch) is named the middle inguinal pouch. The author's nomenclature is to be preferred. — Tr. 4 Often called the superior false ligament of the bladder, and sometimes the suspensory ligament of the bladdei: Fig. 928. — View from Above and Before of the Pelvic Viscera of the Male j,y Sitv AND covered by THE PERITONEUM : THE BODY AND THE SuMMIT OR APEX OF THE Bladder and the Uppermost Portion of the Rectum. The Position of the C^cuM and of the Sigmoid Flexure of the Colon. The Relations of the Peri- toneum in the Pelvic Cavity and on the Adjoining Portion of the Anterior Wall OF the Abdomen : Plica Umbilicalis Media, the Urachal or *Median Umbilical Fold (see note * above) ; Plica Umbilicalis Lateralis, the Hypogastric or *External Umbilical Fold ; Plica Vesicalis Transversa, the Lateral False Ligament of the Bladder or *Transverse Vesical Fold ; Plica Rectovesicalis, the Rectovesical Fold or Posterior False Ligament of the Bladder. Through the Peritoneum, THE Following Structures are visible: The Epigastric Artery, the Ureter, the Vas Deferens, and the Spermatic Vessels. Topographical Anatomy of the Pelvic Viscera. TOPOGRAPHICAL ANATOMY OF THE PELVIC VISCERA 537 Rectum Intestinum rectum Pouch of Douglas, or rectovaginal pouch \ Excavatio recto uterina (cavum Douglasi) Vermiform appendix i roceisub \ ermitormis Caecum— Intebtini Uterosacral ligament or fold of Douglas' Plica recto-uterina (Uouglasi) Sigmoid mesocolon 1 Mesocolon sinmoideum Sigmoid flexure of the colon 1 Colon sir,nioideum Descending colon — Colon descendens Subcecal fossa Fossa cx'calib Suspensory ligament of the ovary ( infundibu o pelvic or ovariopelvic fold or ligament Lig. suspensoriuni o\aiii Epigastric fold Plica epigastnca Anterior superior spine of the ilium Spina iliaca anterior superior Fallopian tube Tuba uterina (Falloppii) Upper limit of the pelvic cavity, / ,' or brim of the pelvis ('' Round ligament of the uterus-Lig. teres uten Hypogastric or external umbilical fold nbilit Lateral false ligament of the bladder or 'trans , verse vesical fold— ' Plica \ usicalib. transversa I Urachal or *median umbilical fold *Plica umbilicalis media \ \ Mesosalpinx- | Broad ligament of the uterus ^Mesometrium- I Ligamentum latum uteri Uterovesical pouch j Body of the uterus (anterior or vesi-cal surface) I Corpus uteri (facies ye^icalis) Urinary bladder Vesica urinaria Fig. 929. — Pelvic Viscera of a Female aged Twenty-nine Years, seen from Above and Before. Sacral promontory Prom nt'jiium Snspensory ligament of the ovary in fandibolopelvic or ovariopelvic fold or ligament) — Lig. suspense num < \ 1 u Bursa ovarica'^ Infandibulum of the Fallopian tube Infundibulum tubtt o/llie blaititer, and sometimes tin a See Appi-nilii note * to p. SM- ^ See Appemli: lisfiensiny /ixaltient pf the htntUlcr. Topographical Anatomy of the Pelvic Viscera. 68 538 TOPOGRAPHICAL ANATOMY OF THE PELVIC VISCERA Sacral promontory Promontorium First anterior sacral foramen Foramen sacrale anterius I Great sacrosciatio foramen Foramen ischiadicum majus *Sacral curve of the rectum *Flexura sacralis recti Mucous folds -_ Plica mucosas *Perineal curve of the rectum^-- -__ *Flexura perinealis recti \ Anal portion of the rectum (anal canal)*— Pars analis recti *H£emorrhoidal ring^ ■*Annulus baemorrhoidalis""" Anus— ■ Sacroiliac articulation Articulatio sacro-iliaca Pyrifoimis muscle M pirilormis Obturator internus muscle Coccygeus or leva-"\ Pelvic tor coecygis muscle I diaphragm I Diaphragma Levator ani muscle j pelvis V2 Ischiorectal fossa Fosba ischiorectalis Tuberosity of the ischium Tuber ibchiadicum Internal sphincter of the anus^ M sphincter ani internus External or superficial sphincter of the anus M. sphincter ani externus Fig. 931. — Position and Form of the Empty and Contracted Rectum as seen in a Coronal Section THROUGH the PELVXS OF A FROZEN BODY. SEEN FROM BEFORE. The inferior extremity of the rectum is opened by a section passing obliquely downwards and backwards. After removing the peritonenm and the great vessels, the muscles of the pelvis have been exposed. Sacral promontory PromontoriQiri Parietal peritoneum Peritonasum parietale Pyriformis muscle M. piriformis Eectum (* sacral curve)* Intestinum rectum (*flexura--=|^_v'j-^ sacralis) Transverse fold of the rectum" Plica transversalis recti Rectal ampulla'' Ampulla recti *Perineal curve of the rectum^ *Flexura perinealis recti Anal portion of the rectum (anal canal) Pars analis recti Post-anal furrow, or crena clumum Crena ani Fig. 932. — Position and Form of the Rectum when gre.'^tly Coronal Section through the Pelvis of a Frozen Fifth lumbar nerve Nervus lumbalis V. Internal iliac vein^ Vena hypogastrica Kectal fascia^ Fascia diaphragmatis pelvis superior Levator ani muscle - Obturator internus muscle Ischiorectal fossa Fossa ischiorectalis Internal pudic artery^ Arteria pudenda interna Falciform process of the great sacrosciatio ligament— Processus falcilormis Tuberosity of the ischium Tuber ischiadicum luttrnal sphincter of the anus' M. sphincter ani internus External or superficial sphincter of the anus M sphincter ani externus distended with Fj€ces, as seen in a Body. Seen from Before. In the region of the first and second sacral vertebras, the peritoneum.and the mesorectum have been left intact; in the lower part of the pelvis, the pelvic fascia is laid bare. The inferior extremity of the rectum has been opened as in the previous figure. 5 .^ee -Appendix, 3 See Appendix, Known also as the deej> or circular sphincter of the anus. 3 See Appendix, note ". 6 See Anpendix, note "7. ^ See Appendix, notes 86, 9 Kncwn also as the deep or circular sphincter of the anus. 4 See note "* to p. 534, i?, and MS. Form and Position of the Rectum. APPENDIX TO PART IV. NOTES BY TRANSLATOR [' Lingual Duct (Fig. 675, p. 420). — According to His, the forimen cascum indicates the position of the epithelial out- I growth from which the middle portion of the thyroid body has \ been formed. As in course of development the thyroid body ' becomes more remcte from the tongue, a long, slender tube, onnecting it with that organ, persists, the lliyroglossal duct or tubtracheal tube. The upper part of this tube may remain pervious as a canal leading from the foramen caecum towards the hyoid bone. This is known as the lingual duct. (His, ■' Der Tractus Thyroglossus und seine Beziehungen zum Zun- genbein," Archiv. jiir Anatotnie, 1891. But see also Kan thack's views in his article on " The Thyreoglossal Duct," Journal of Anatomy and Physiology, i8gi.) ' Periglotlis (Fig. 675, p. 420). — This somewhat inappro priate name is given by Macalister to the structure shown in the figure, a tough, elastic, areolar and fatty mass, which intervenes between the front of the epiglottis and the back of the thyrohyoid membrane. It was at onetime, but erroneously, called the epiglottic gland. The middle portion of the upper border of the periglottis is elastic, and constitutes the hyo efiglollic ligament. Still higher, a median sagittally placed fold attaches it to the base of the tongue, and it is the mucous membrane covering this fold that forms the median glosso epiglottic fold, or jrcenum epiglottidis. (See Fig. 673, p. 41.).) ° Sublingual Ducts (Fig. 687, p. 424). — I have preferred in the text the names of greater sublingual duct and lesser sub lingual ducts for the e-xcretory ducts of the sublingual gland, (or the reason that the other names used by English anatomists to denote these structures are applied in a somewhat con- flicting manner. Quain terms the lesser ducts, six to twenty in number, the ducts of Rivinus. They open separately in a row along the sublingual fold; the foremost of their number, however, usually terminates in the duct of Wharton. The long slender duct (proceeding, according to Toldt, from the anterior lobe of the gland) which runs parallel v.ith the duct of Whar- ton, called in the text greater sublingual duet, may join the duct of Wharton near its anterior extremity, but more com- monly has an independent orifice beside that duct on the submaxillary papilla. To this duct Quain gives the name of duct of Bartholin. Macalister, on the other hand, calls the lesser ducts the ducts of Va'ther, and to the greater duct (which he describes as proceeding from the posterior lobe of the sublingual gland, and therefore nearly an inch in length) he gives the name cf duct of liivini. Macalister's authority notwithstanding, this duct is far more often spoken r,f as the duct of Bartholin. * Note on the Anatomy of the Lateral Wall of the Naso pharnyx (Fig. 710, p. 430). — " The pharyngeal orifice of the Eu.stachian tube is bounded in front by a small fold passing to the soft palate, the salpingopalatine fold : and below the orifice of the tube is to be seen a more or less prominent swell- ing over the fibres of the levator palati muscle, the so-called hva'or prominenc [or levator cushion, according to Quain]. From the lower end of the cushion of the Fustachian orifice [which bounds that orifice above and behind] a vertical fold of mucous membrane, the salpingopharyngeal fold, extends downwards, and is lost below in the lateral wall of the pharynx" (\'on Langer and Toldt's "Anatomy," p. 301). " The posterior extremity of the outer wall of the nasal fossse consists of a shallow vertical furrow, the posterior nasal sulcus, immediately behind the posterior extremities of the middle and inferior turbinate bones. This is situated ovor the hinder part of the vertical plate of the palate bone and the internal pterygoid plate, and represents the nasopharyngeal meatus of lower mammals " [op. cit., p. 297). " The part of the inferior meatus which lies behind the incisor canal, together with the space immediately behind the posterior end of the superior and middle turbinals as far back as the orifice of the Eustachian tube, belongs to the primitive buccal cavity of the foetus, having become separated from the permanent mouth by the growth of the palate. It is known as the nasopharyngeal fart (ductus nasopharyngeus), and its mucous membrane is marked off behind from that of the pharynx by a prominence which is termed the nasopharyngeal fold " (Quain's " Anatomy," loth ed., vol. iii., part iii., p. 138). " (Fig. 7ir, p. 438.) " Two lateral bands {ligaments of Helvetius'), mostly of connective tissue, but containing a few muscular fibres belonging to the longitudinal layer, pro- duce the sacculation of the antrum pylori " (Macalister's •• Anatomy," pp. 396, 397). ' *Superior and ^Inferior Flexure of tlie Duodenum (Ibid.). — These flexures are not named by Quain or Macalister. The superior flexure is between the superior and the descending portion of the duodenum ; and the inferior flexure is between the descending and the transverse portion of the duodenum. (See note ' below.) ' (Ibid.) The duodenum was formerly described as con- sisting of three portions : first, or superior ; second, or middle ; and third, or inferior. The first two parts of the old descrip- tion are now usually called superior and descending portions, respectively; while the third or inferior part of the old description has been divided into two, called respectively transverse and ascending portions. ' (Fig. 712, p. 438.) Though the author uses the term valvula pylori, there is at the pylorus no valve, properly so railed, and I have therefore avoided using that term in the translation. • Diverticulum Duodenale {Vatcri) (Figs. 718, 719, p. 440). —This so-called diverticulum is a sac-like dilatation of the fxtremity of the united common bile-duct and pancreatic duct, or duct of Wirsung, as it passes obliquely through the duodenal wall. The dilatation is so frequently met with that ft can hardly be regarded as pathological. The vertical fold lovering the diverticulum is called by Macali,ster earuncula major, and the smaller vertical fold beneath the orifice of the diverticulum, frenulum earuncula. .See Macalister, op. cit., pp. 402 and 412, and Quain, op. cit., vol. iii., part iv., p. r42. '" (Fig. 719, p. 440.) The author regards the folds in the duodenal diverticulum as valvular in nature, their function being to prevent the entrance of intestinal secretions into the common bile-duct and the pancreatic duct. " Plica Transversalis Recti (Fig. 736, p. 445). — " When the rectum is empty and contracted, it exhibits numerous folds, most of which are obliterated by distension. Several trans- verse or oblique folds are, however, of a morn permanent rharacter, and have been designated ' valves of the rectum ' 68—2 538b APPENDIX (Houston) or ' plies recti.' One of these, usually the largest, is situated on the right side opposite the reflection of the peri- toneum from the rectum to the bladder, and was named by Kohlrausch the flica transversalis recti. There are generally two other folds, both on the left side, one about an inch above, the other about the same distance below, the fold on the right side. From the position and projection of these folds they may more or less impede the introduction of instruments. The dilatation of the rectum between the anal canal and the lowest of these folds is called the rectal amfulla" (Quain, "Anatomy," loth ed., vol. iii., part iv., pp. 115, 116). According to Von Langer and Toldt (" Anatomy," 7th ed., pp. 337, 33S), the plica transversalis recti is on the right and anterior walls of the rectum, about 10 centimetres (4 inches) from the anus (in Fig. 736, 2 inches only). In its substance is the thickening of the circular muscular fibres of the rectum which is known as the sphincter ani terlius. According to these authors, Ilouston^s valves are prominent only when the rectum is greatly distended, and are obliterated when the organ is quite empty and con- tracted. '- The Columns of the Rectum, the *Siiitises of the Rectum, and the Hcemorrhoidal Ring (Ibid.). — " We have to mention a further peculiarity of the lower end of the rectum, one which marks the transition from the mucous membrane to the skin. There are in this region from five to eight longitudinally dis- posed elevations of the mucous membrane, the cohimncc rectales of Morgagni, which widen as they approach the anus. Here their lower ends unite to form a ringed swelling, the annulus hminorrhoidalis, surrounding the gut ; and the columns and the ring thus bound a number of depressions or pockets in the mucous membrane, the sinus rectales. This portion of the rectum, in the male about 26 centimetres (i inch) in length, but somewhat shorter in the female, is known as the pars analis recti, or anal canal; while the actual external orifice is termed the anus " (Von Langer and Toldt, op. cit., P- 33S). " (Fig. 737, p. 446,) Folds of peritoneum connecting a solid viscus with the abdominal wall are called ligaments ; those passing from one viscus to another are called omenta; but the distinction is not always strictly maintained. '■' *Fibrous Appendix of the Liver (Figs. 737, 738, p. 446). — " Attached to the free extremity of the left lobe of the liver there is often a membranous appendix, appendix fibrosa hepatis, of variable size, from which the parenchyma of the liver has completely disappeared, only connective tissue and aberrant vessels remaining. The disappearance of the paren- chymatous tissue in this region can perhaps be explained in the following manner : In the embryo the umbilical veins open into the left portal vein, so that the left lobe of the liver is directly supplied with arterial blood from the placenta, and is thus placed under more favourable nutritive conditions than the right lobe; but this advantage is lost with the cessa- tion of the placental circulation. . . . After the disappear- ance of the parenchyma, however, the bile-ducts, and the branches of the portal vein and hepatic artery, persist, and all of these structures are included in the term vasa aberrantia hepatis" (Von Langer and Toldt's "Anatomy," 7th ed., p. 349). In rare cases there may be a small accessory liver in the situation of the fibrous appendix, connected with the left lobe by a fold of peritoneum and a leash of vessels. (See also note " below.) "^ *Ligament of the Ductus Venosus (Fig. 738, p. 446). This is a fine white cord, the vestige of the obliterated ductus venosus, lying in the fissure of the ductus venosus (the pos- terior portion of the longitudinal fissure). It is not usually termed a ligament by English anatomists. " Lobes of the Liver (Ibid.). — The author enumerates four lobes only : lobus dexter, right lobe ; lobus sinister, left lobe . lobus quadratus, quadrate lobe; and lobus caudatus (Spigeli), caudate lobe (of Spigelius) : the ridge connecting the lobus dexter with the lobus quadratus [Spigeli), between the trans verse or portal fissure (below), and the lower extremity of the fissure or fossa of the vena cava (above), he calls the processus caudatus (see Fig. 740, p. 447). English anatomists enumerate five lobes: the right, the left, the quadrate, the Spigelian, and the caudate; the three first-named being identical with those of the author; the Spigelian lobe corre sponding with the author's lobus caudatus [Spigeli), minm the processus caudatus ; and this latter being the caudate lobe of English anatomists. " Ponticulus Hepatis (Ibid.). — The inferior vena cava lies in a deep groove on tbs posterior surface of the liver, the fissure or fossa of the vena cava. Passing behind the vessel is a strand of fibrous tissue which forms a bridge connecting the right lobe with the Spigelian lobe. • It is called by the author *ligamentum vena cava, but is known in England as the ponticulus . Like the *fibrous appendix of the liver (see note '■' above), it is the remains of a rudimentary lobe, and contains aberrant vessels. Not very rarely it consists of perfectly formed hepatic tissue, so that the fissure of the vena cava is converted into a canal. '" (Fig. 747, p. 450.) The gastrosplenic omentum is con- nected below with the great omentum, and is often regarded as a part of it. With regard to the preference of the name of omentum for this structure over the name ligament, see Appendi.x, note " above. ^^ Descriptive .Anatomy of the Spleen (Fig. 746, p. 450). — The author enumerates three surfaces only : phrenic, renal, and gastric. By some anatomists (e.g., Cunningham) the blunt lower and outer end is regarded as a fourth surface, the basal. This surface lies against the tail of the pancreas, the splenic flexure of the colon, and the costocolic ligament (see note ■" below). In addition to the anterior and posterior borders, it is usual in England to speak of the ridge just internal to the hilum, which separates the gastric from the renal surface, as the inner border. '■" Duodenal Folds and Fossa (Fig. 757, p. 454). — Two folds of peritoneum usually pass to the left from the front of the ascending portion (fourth part) of the duodenum ; one, the lower, with its free edge directed upwards, from the junction of the transverse with the ascending portion of the duodenum ; the other, the higher, with its free edge directed downwards, from the duodenojejunal flexure. These are called by the author the duodenomesocolic and duodenojejunal folds, but it is perhaps better to use the names inferior and superior duodenal folds. Between these folds, to the right of the ascending portion of the duodenum, is a recess or fossa, called by the author recessus duodenojejunalis, the duodenojejunal fossa. The extension of this fossa behind the inferior fold is termed the inferior duodenal fossa: the e.xtension behind the superior fold the superior duodenal fossa. The folds and fossas in this region are, however, somewhat variable in their disposition. (See Quain's " Anatomy," loth ed., vol. iii., part iv., p. 326.) ^^ Peritoneal Fossce (Ibid.). — Some authors speak of all the peritoneal fosses as pouches — e.g., duodenojejunal pouch, subccecal pouch. I have not thought it necessary to indicate the alternative name in each individual instance. " Phrenohepatic Fossa (Fig. 75S, p. 454). — "The phreno- hepatic or diaphragmaticohepatic fossa of the peritoneum is occasionally present on the abdominal surface of the diaphragm. It is an elongated pouch or sinus of varying APPENDIX 538c dimensions, formed by the partial adhesion of the borders of the fibrous appendix of the liver [see note " above] and the left lateral ligament of the liver to the peritoneal invest- ment of the diaphragm " (Von Langer and Toldt's " Anatomy," 7th ed., p. j6(>). " Ileocecal Fossic (Fig. 760, p. 455). — These are two in number, superior and iiijerior. The superior ileocacal fossa (see Fig. S05, p. 47;) is situated in the angle between the ileum and the commencement of the ascending colon ; the inferior ileocacal jossa is behind and below the junction of the ileum and the ca'cum. It may extend upwards behind the ascending colon nearly as high as the right kidney and duodenum. Its mouth looks downwards and is bounded in front by the ileocacal fold (bloodless fold of Treves). In I'ig. 760 a sound is passed into the mouth of this fossa. By some authors the superior ileociecal jossa is termed the ileocolic fossa, and in this case the inferior ileocacal fossa is called the ileocecal fossa without qualification " Cavum Mediaslinale (Fig. 761, p. 456). — The author divides the mediastinal cavity into two portions only : cavum mediaslinale anterius and cavum mediaslinale poster ius. Knglish anatomists divide it into four portions : anterior medi- astinum, middle mediastitium , posterior mediastinum, and superior mediastinum. The English posterior mediastinum is nearly identical with the author's cavum mediaslinale pos- lerius; while his cavum mediaslinale anterius corresponds, with a slight variation, to the three others combined ; the superior mediastinum being that portion of the cavity above a plane passing from the lower border of the body of the fourth dorsal vertebra to the superior sternal synchondrosis, and thus including the upper portions of both anterior and posterior divisions of the author ; the anterior mediastinum being the portion of the cavity below the plane above men tioned and in front of the pericardium ; and the middle mediastinutn being the enlarged central portion of the cavity containing the pericardium with its contents, the roots of the lungs, and the bromliial lymphatic glands. (See alsonote ^ to p. 410.) -' (Fig. 765, p. 458.) The oblique line, connecting the superior and inferior tubercles of the thyroid cartilage, is regarded by the author as a variety. Though it varies greatly in prominence, and may be very indistinct, it is seldom entirely absent. Sometimes it is represented by a fibrous band, the oblique ligament, stretched between the tubercles. The oblique line or ligament serves for the insertion of the sterno- thyroid muscle and for the origin of the sternohyoid and thyropharyngeus muscles. -• Arytenoid Cartilage (Figs. 766 to 768, p. 458). — As several of the terms descriptive of the parts of this cartilage are used neither by Quain nor by Macalister, I quote the following passage from Von Langer and Toldt's " Anatomy," 7th ed., p. 318 : " The cartilage consists of an elongated plate, narrowing above to a point, the apex, and presenting beneath a thickened, nearly triangular base. The anterior border is very sharp, and exhibits just above the middle a small blunt protuberance, the *colliculus, and at its lower extremity a forwardly directed process for the attachment of the posterior extremity of the vocal cord, hence called the vocal process. The concave articular surface of the base looks downwards, and exhibits a blunt muscular process directed outwards. The inner surface is very narrow, and wider below, where it is continued on to the vrxal process, i'he outer surface gives attachment to muscles : it presents two hollows, the upper of which, *fovea triangularis, is a rounded triangle, embraced by a semicircular lip, the *crista arcuata, which begins above in the colli' ulus : while the lower, a rounded rectangle, * fovea oblonga, runs along the base and on to the muscular process, and is separated above from the fovea triangularis by the crista arcuata." -' *Corniculopliaryngeal Ligament (Fig. 771, p. 459). — This is a slender strand of fibrous tissue which pa.sses downwards and inwards on each side from the corniculum laryngis or cartilage of Santorini to the mucous membrane of the pharynx. Below these ligaments in the median plane is the *crico- pharyngeal ligament, a flattened band with surfaces laterally directed, attached by its anterior edge to the back of the cricoid cartilage, and by its posterior edge to the mucous membrane of the pharynx. These two ligaments are described neither by Quain nor by Macalister. " (Fig. 770, p. 459.) The corniculo-arytenoid articulation is usually, as in this instance, a syndesmosis, but is occasion- ally a synovial joint. -' (Ibid.) This foramen, when present, transmits an abnormal branch of the superior laryngeal artery. ^° *Conus Elasticus (Figs. 772, 773, p. 459). — As this term is not found in most English textbooks of anatomy, I quote the following description from Von Langer and Toldt's " Anatomy," pp. 320, 321 : " The *membrana elastica trachea [the fibro-elastic membrane in which the tracheal cartilages are embedded] passes upwards into the larynx to form the *membrana elastica laryngis. First of all it sheathes the inner surface of the cricoid cartilage in its whole extent, but above this it becomes detached from the cartilaginous wall of the larynx, and forms on each side a flat membrane, the only attachments of which to the cartilages are in front to the angle of union of the alas of the thyroid cartilage, and behind to the vocal processes of the arytenoid cartilage. Thus, the *elastic membrane of the larynx exhibits two surfaces, converging from each side of the upper border of the cricoid cartilage upwards towards the median plane, and at the level of the vocal processes terminating in two parallel free borders. This arrangement of the elastic membrane is known as the *conus elasticus, and the somewhat thickened free borders are called *ligamenta vocalia [the inferior thyro- arytenoid ligaments or ligaments of the true vocal cords]. At this level the *elastic membrane of the larynx terminates, being replaced above by a thin layer of areolar tissue. That portion of the ^elastic cone which connects the upper border of the front of the cricoid cartilage with the lower border of the front of the thyroid cartilage is seen from the front as a triangular membrane filling in the gap between the two cartilages, and is called the middle cricothyroid ligament [middle portion of the cricothyroid membrane]." This description appears alike more intelligible and more accurate than that given in most English textbooks, which is to the effect that the vocal cord may be regarded as the upper free edge of the cricothyroid membrane. "' Mucous Glands of the Larynx (Figs. 775, 777, p. 460). — The names used by Toldt — anterior, middle, and posterior laryngeal glands — are not commonly employed by l'',nglish anatomists. The anterior glands, situate on the back of the epiglottis, I have called the fost-epi glottic glands. The middle glands, most numerous above, where they form a prominence beneath the mucous membrane of the arytenoepiglottic fold immediately behind the cartilage of Wrisberg, and a chain running thence downwards and forwards along the false vocal I ord, may be best distinguished as the glands of the aryteno- rpigloltic fold. The posterior glands form a mass behind the arytenoid cartilage and beneath the cartilage of Santorini, and may be called post-arytenoid glands. All these must be carefully distinguished from the so-called epiglottic gland between the anterior surface of the epiglottis, the liyoid hi.ni', S38d APPENDIX and the root of the tongue, which is not a gland at all, but a mass of yellow fat and fibrous tissue. (See feriglottis in Fig- 675, p. 420, and note - above.) "- Labium Vocale (Fig. 779, p. 461). — The true vocal cords, writes Quain (" Anatomy," loth ed., vol. iii., part iv., p. 155), " are situated at the inner and free edge of a mass of tissue triangular on coronal section [see Fig. 7S0]. One surface of this mass looks upwards, and forms the floor of the ventricle ; another looks downwards and inwards, and bounds the lower division of the laryngeal cavity; while the third is external." This triangular mass constitutes the author's labium, vocale, or, as it may be called, the *li-p of the glottis, but the term is not current in England. " Macula Flava, the Cartilage of Luschka (Fig. 781, p. 461). — " In the anterior part of the vocal cord, near its attach- ment to the thyroid cartilage, there is a circumscribed mass of dense elastic tissue containing numerous cells. This is visible through the intact mucous membrane as a yellow spot (macula fiava), of about the size of a poppy-seed " (Von Langer and Toldt's " Anatomy," 7th ed., p. 323). "A small nodule of elastic cartilage [cartilage of Luschka) is found in the anterior and inferior part of the vocal cord " (Quain's "Anatomy," loth ed., vol. iii., part iii., p. 155). "■* Tunica Adventitia Pharyngis (Fig. 791, p. 466). — " The outermost layer of the wall of the pharynx consists of a thin stratum of connective tissue, the tunica adventitia -pharyngis, which forms a fascial covering for the constrictor muscles of the pharynx, and may be regarded as a continuation of the bucco-pharyngeal fascia. It is of importance for the reason that the primary ramification of the vessels and nerves of the pharynx takes place in its substance. In the middle line behind it is connected with the raphe of the pharynx, and above with the fascia fharyngobasilaris [the pharyngeal aponeurosis of English authors; see pp. 432, 433, and 436] . . . which (with the mucous membrane) alone forms the uppermost portion of the posterior and lateral walls of the pharynx, the muscular coat being here deficient, as the superior constrictor of the pharynx does not extend up to the base of the skull " (Von Langer and Toldt, op. cit., p. 305). The outer fibrous coat of the pharynx thus separates the constrictor muscles from the prevertebral fascia. On either side it is attached to the sheath of the great vessels of the neck. It is most strongly developed behind and (above) at the sides, and this portion is called by Macalister the -post- pharyngeal fascia, which name I have given in the text as an alternative, the name adventitious coat of the pharynx not being used by English anatomists. " Broncho-cesophageus and Pleuro-a;sophageus Muscles (Fig. 799, p. 470).—" The longitudinal fibres of the cEsopha- gus are sometimes joined by a broad band of smooth muscle, passing from the left pleura, and sometimes also by another from the left bronchus. According to Cunningham, the former is almost constantly present, and the latter 'very frequently" (Quain's "Anatomy," loth ed., vol. iii., part iv., p. 66). "' Supplemental Pleural Spaces (Ibid.).— The use of the term sinus for those regions of the pleural cavity in which two portions of parietal pleura are in apposition appears inappropriate. Quain suggests the preferable name of supplemental or complemental pleural space. There are three such regions in which the pleural cavity is unoccupied by lung : the phrenocostal (shown in Fig. 799), between the chest wall and the diaphragm, below the inferior border of the lung; the pericardiosternal or costomediastinal (shown in Figs. 800 and 801, p. 471), between the anterior surface of the pericardium and the posterior surface of the sternum and costal cartilages, internal to the anterior border of the lung, and more extensive on the left side than on the right ; and the mediastinodiaphragmatic (Macalister) or pericardiophrenic, between the lower margin of the pericardium and the diaphragm. ^' (Ibid.) The crura or pillars of the diaphragm described by English anatomists are two only in number — a longer right crus and a shorter left crus. Each of these is composed of all the fibres passing from the right and left sides, respectively, of the bodies of the lumbar vertebrje and the intervertebral discs to the central tendon. Thus, the crus of English authors corresponds to the combined inner crus and intermediate crus of Toldt ; while the outer crus of the latter is in England not considered to belong to the crural portions of the diaphragm. "■ Bulb of the Aorta (Fig. 800, p. 471). — This name is often given to the somewhat enlarged portion of the ascending aorta immediately above the aortic valve, which contains the three sinuses of Valsalva, ^' Ascending Mesocolon (Fig. 805, p. 475). — Fig. 756, on p. 453, shows an abnormal condition of the large intestine in which the posterior layer of the ascending mesocolon has failed to become adherent to the parietal peritoneum, and the ascending colon, like the transverse colon, is freely movable. Normally, however, as shown in Fig. 805, this adhesion takes place, and a strip of the posterior surface of the ascending colon is connected by areolar tissue with the fascia covering the quadratus lumborum muscle, and with the front of the right kidney. To call the adherent layer of peritoneum internal to the ascending colon by the name of ascending mesocolon is contrary to English usage. See also note ' to P- 453-) " *Gastrocolic Ligatnent (Fig. S06, p. 476). — This name is given by the author to that part of the great or gastrocolic omentum which connects the great curvature of the stomach with the transverse colon. *' Saccus Lienalis (Fig. 807, p. 477). — A fold of peritoneum, the costocolic or phrenocolic ligament , or pleurocolic fold, attached externally to the diaphragm opposite the tenth and eleventh ribs, passes horizontally inwards to the splenic flexure of the colon. It has a lunated free border directed forwards. It forms the lower boundary of a hollow containing the spleen ; the bcLsal surface of this organ (see note '° above) resting upon the ligament as on a shelf (see also Fig. 813, p. 483. Hence this ligament, though not attached to the spleen, is sometimes called susientactduin lienis, while the hollow above is called by the author saccus lienalis — the splenic pouch. This must be carefully distinguished from the ^splenic fossa of the otnental sac. See Fig. 8og, p. 479, and note " below. *^ Parts of the Small Omentum (Ibid.). — The small omentum consists of the following portions, enumerated in their position from left to right : (i) a thick portion [pars condensa omenti minoris), passing to the cardia ; (2) a thin portion [pars flaccida omenti minoris), passing to the lesser curvature — these form the gastrohepatic omentum proper ; (3) a thicker portion again, passing from the transverse or portal fissure of the liver to the pylorus and the first part of the duodenum, with a free border directed to the right, forming the anterior boundary of the foramen of Winslow, and con- taining between its layers the hepatic artery, portal vein, common bile-duct, and nerves and lymphatics of the liver (this portion of the small omentum is called bj' the author the hepatoduodenal ligament, but the term is not used by English anatomists). In the specimen shown in Fig. 807 the small omentum extends abnormally far to the left, to form a hepatocolic ligaynent or omentum. APPENDIX 538« " Siiferior Mediaslinum (Fig. 809, p. 479). — The lower margin of the cut surface of the aorta in this figure is at the level of the plane separating the superior mediastinum of English authors from the three lower divisions of the mediastinal cavity. See note ^ to p. 410 and note -' above. " Divisions of the Omental Sac (Ibid.). — " The omental sac is attached to the posterior abdominal wall in the median line in front of the aorta by the root of the mesogastrium. Here also is the boundary of the principal part of the cavity and the orifice giving access from the right to its interior. The boundary is constituted by a fold of peritoneum, the fancreaticogastric fold, v\-hich extends from the superior border of the pancreas vertically upwards along the line of attachment of the mesogastrium to the cardia of the stomach ; between the layers of this fold the coronary artery runs from the coeliac axis to the small curvature of the stomach. The pancreaticogastric fold forms the boundary between the principal part of the omental sac and the cavity situated behind the small omentum, and known as the vestibule of the omental sac. Regarding that portion of the omental sac which lies behind the stomach as the principal or middle portion of the cavity, we can distinguish three supplementary compartments : the largest of these extends downwards below the stomach between the two layers of the great omentum, and is called recessus inferior omentalis, the inferior fossa of the omental sac ; the second lies behind the gastrosplenic omentum, and is bounded on the left by the hilum of the spleen — this is known as recessus lienalis, the splenic fossa of the omental sac; the third, finally, stretches upwards, close to the abdominal portion of the oesophagus, and is termed recessus superior omentalis, the superior fossa of the omental sac " (Von Langer and Toldt's " Anatomy," p. 357). I have given this long extract because the omental sac is not adequately described in Quain's " Anatomy." Macalister, who treats the subject more fully and accurately, describes the omental pouch [sac] as " hour-glass-shaped," and terms the opening between the two sections, bounded behind by the pancreatico- gastric fold, the mesomental opening. The part of the sac to the right of this opening, and between it and the foramen of Winslow, he calls the lesser omental sac, which comprises the combined superior fossa and vestibule of the omental sac of Toldt. The splenic fossa of the omental sac is to be carefully distinguished from the splenic pouch of the greater peritoneal cavity, the two being separated by the gastrosplenic omentum. See Fig. 807, p. 477, and note *' above. ** (Ibid.) The gastrosplenic omentum is connected below with the great omentum, and is often regarded as a part of it. The name " omentum " is to be preferred to " ligament " for this structure (see note " above). '• (Fig. 816, p. 486.) The sternal line is a vertical line traced on the front of the trunk passing over the sterno- clavicular articulation. " (Ibid.) The parasternal line is a vertical line traced on the front of the trunk midway between the sternal line and the mamillary line. " (Ibid.) The mamillary line is a vertical line traced on the front of the trunk passing through the centre of the nipple or mamilla. " When the mamma; are pendulous, the mamillary line may be taken as corresponding to the perpendicular dropped from the middle of the clavicle" (Macalister). " (Fig. 818, p. 488.) The axillary line is a vertical line traced on the side of the trunk passing through the anterior fold of the axilla (Macalister), or through the summit of the axillary fossa (Toldt). It will be seen that the axillary line a: defined by Macalister is a little behind the axillary line as defined by Toldt. The latter line is, of course, the ; lie shown in the figure. °° Calices and Infundibula (Figs. 823 to 825, p. 491). — ' Quain writes : " The pelvis, within the sinus, divides usually into three, but sometimes only two, primary tubular divisions, and these at length end in a large number of short, truncated, but comparatively wide branches named calices or infundibula, which receive the papillae into their wide mouths. ... A single calix often surrounds two, sometimes even three, papillae, which are in that case united together ; hence the calices are in general not so numerous as the papillae " ("Anatomy," loth ed., vol. iii., part iv., p. 193). The author, it will be noticed, calls the primary divisions of the pelvis calyces majores; the secondary and terminal divisions, calyces minores. Macalister, whose usage I have followed, discrim- inates between infundibula and calices, applying the former name to the primary, the latter to the secondary divisions of the pelvis. Toldt and Macalister alike state that there is a calix for each papilla; but Quain's description is the more accurate. The calices usually number from eight to twelve, the papillae from twelve to twenty. " Area Cribrosa (Fig. 827, p. 492). — " At the summit of each pyramid the ductus fapillares — the uriniferous cr excretory tubules, or ducts of Bellini — five to fifteen in number, open by as many separate orifices. The area of the papilla containing these orifices (foramina papillaria), which are almost distinguishable by the naked eye, is known as the *area cribrosa " (Von Langer and Toldt's " Anatomy," loth ed., p. 370). A number of the orifices are often aggregated at the bottom of a slight depression near the summit of the papilla. This depression, when present, is termed the foveola. " (Fig. 831, p. 492.) Quain's nomenclature of the surfaces of the suprarenal capsules differs somewhat from that of Toldt. According to the former authority, the posterior surface of the left capsule " is divided into two parts by a prominent vertical ridge, the area mesial to the ridge looking inwards and back- wards and resting upon the left crus of the diaphragm, and the lateral area outwards as well as backwards against the kidney " (" Anatomy," loth ed., vol. iii., part iv., p. 303). The mesial of these two areas is the fades posterior of Toldt ; the lateral is named by him basis glandulie suprarenalis. Similarly in the case of the right capsule, the posterior surface, according to Quain, consists of two areas : one, the upper and larger, in contact with the diaphragm, being identical with the fades posterior of Toldt; the other, lower and smaller, in contact with the kidney, called by Toldt the basis. This aspect of the right capsule is, however, not shown in the Atlas. " (Fig. 835, p. 493.) The portion of the uriniferous tubule between the peripheral extremity of Henle's looped tubule and the commencement of the collecting tubule, called in Germany the SchaltstUck (intermediate portion), " because it is, in a sense, intermediate between the secretory and the excretory portion of the tubule " (Toldt), comprehends the irregular or zigzag tubule, the second convoluted tubule, and the junctional tubule, of English authors. " (Ibid.) This comprises the descending tubule of Henle, the loop of Henle, and the ascending tubule of Henle, of Eng- lish authors. " (Ibid.) The term straight tubule, as used by the author, includes all the tubules forming part of the pyramids and the medullary rays, whether these are descending and ascending tubules of Henle, collecting tubules, or ducts of Bellini. " Blood.Supply of the Medulla of the Kidney (Ibid.). — It will be noticed that I have written " pseudarteria recta, or vasa reda spuria " as the counterpart in the English nomcn- 538/ APPENDIX clature of the author's " arieriolcc recta:." There is, in fact, a conflict of opinion regarding the blood-supply of the medulla of the kidney. In Von Langer and Toldt's "Anatomy," 7th ed., p. 373, we find the following views expressed: "An important problem, with regard to the blood-supply of the kidney, is whether all the blood circulating in that organ, the medulla as well as the cortex, must necessarily pass through the glomeruli ; for if this be so, the nutrition of the medulla is dependent on the vessels of the cortex. It is an established fact that the efferent vessels of the large glomeruli adjacent to the medulla break up into leashes of straight vessels, arieriolcc reclre, which are continued into the capillary plexus of the pyramids of Malpighi. The question arises, whether, in addition to these vessels proceeding from the glomeruli, other arterioles, directly derived from the arterial arches, supply this capillary plexus. We may answer with considerable confidence that, even if such a direct arterial blood-supply to the p)'ramids exists, the blood thus conveyed would be insufficient in quantity, and that the nutrition of the pyramids is, in any case, dependent to a notable extent upon the blood- vessels of the cortex." Quain, on the other hand, writes (" Anatomy," loth ed., vol. iii., part iv., p. 202) : " The efferent vessels from the lowermost glomeruli break up wholly into pencils of straight vessels [-pseudarterice rectce), which pass directly into the boundary layer of the medulla, and there supply the continuation downwards of the medullary rays into the pyramid. . . . With the exception of the blood brought by the false arterias rectas, the blood-supply of the medulla is to a great extent independent of that of the cortex, although, of course, the capillary network is continuous throughout. The pyramids are chiefly provided with blood by branches which come off directly from the concave side of the arterial arches, and passing down into the boundary layer of the medulla there divide to form bunches or pencils of parallel or slightly diverging minute vessels [arteries recta], which, by alternating with the bundles of uriniferous tubules which are passing up to the cortex to form the medullary rays, produce the charac- teristic streaked appearance of this part of the pyramid." To sum up : In Toldt's view the blood-supply of the medulla is principally dependent on that of the cortex, and the existence of a direct blood-supply to the medulla must even be regarded as doubtful ; whereas, according to Quain, though the existence of a cortical element in the blood-supply of the medulla (by means of the false arterias rects) is admitted to be " an estab- lished fact," the direct element in the blood-supply of the medulla (by means of the true arteris rects) must be regarded as having considerably greater importance. Other English authorities — Foster, Halliburton, and Macalister — are in agree- ment on this question with the views of Schafer and Syming- ton as set forth in Quain's " Anatomy." Foster, indeed, lays especial stress, from the physiological point of view, on the fact that " the blood-supply of the pyramids, consisting chiefly of conducting tubules, is to a very large extent distinct from that of the cortex, where the tubules are chiefly secreting tubules " (" Physiology," sth ed., p. 665). Macalister calls the true arterije rectae recurrent straight branches, or vasa recta vera; and the jalse arterias rectae vasa recta s-puria. " (Fig. 836,. p. 494.) " The iliacosubfascial fossa is a roomy recess or pouch of the peritoneum met with as a very rare variety in the inner part of the iliac fossa. When present, it is formed in the following manner : The tendon of the psoas parvus muscle, as it passes to its insertion into the iliac fascia covering the iliopectineal line and eminence, separates a little from the iliacus muscle, forming a hollow, which extends for a certain distance inwards behind the psoas magnus muscle. The parietal peritoneum, as it coats the interior of this hollow, necessarily forms a peritoneal recess or pouch, and this recess, if, as usually when present, it is on the left side, is occupied by the lowermost portion of the descending colon " (Von Langer and Toldt's "Anatomy," 7th ed., p. 466). " Cervix or Neck of the Bladder (Fig. 839, p. 496). — This name is given by English anatomists to that portion of the bladder immediately in front of the base, at the junction of the organ with the urethra. The term is not used by Toldt. Other terms employed by English anatomists and not by the author, in describing the bladder, are given in note " below. '" ^Tendinous Arch .of the Pelvic Fascia (Figs. 840, 841, p. 497). — " The origin of the visceral layer of the felvic fascia and of the rectal and anal fascia (see note "" below) from the parietal layer of the pelvic fascia or obturator fascia takes place along a tendinous band that runs across the lateral wall of the pelvis, the arcus tendineus fascice felvis. This is seen as soon as the parietal peritoneum and the delicate sub- serous areolar tissue have been removed. It begins in front behind the pubic symphysis, at the level of the inferior pubic or subpubic ligament, runs backwards, crossing the upper part of the levator ani muscle about an inch below the obturator canal, towards the spine of the ischium, and can be traced yet further backwards, though thinner and less defined, on the surface of the coccygeus muscle, and as far as the fourth sacral vertebra. The foremost portion of this tendinous arch, which has a well-defined edge, is called ligamentum fuboprostaticujn [-piibovesicale) medium — the anterior true ligament of the bladder, or puboprostatic liga- ment; this ligament, with its fellow, bounds a deep hollow behind the symphysis, fovea -pubovesicalis — the *pubovesical fossa — at the bottom of which the dorsal vein of the penis is seen entering the pelvis and dividing into two. lateral branches. . . . Flattened bands of fibrous tissue, rein- forcing the pelvic fascia, and radiating from the tendinous arch upwards near the entrance of the obturator canal (often, however, but slightly developed), receive the name of liga- mentum fubofrostaticum (-pub ove sic ale] laterale — the lateral true ligament of the bladder" (see Fig. 924, p. 533). — Von Langer and Toldt's "Anatomy," 7th ed., pp. 444, 445. This passage shows that Toldt's arcus tendineus fascia felvis corresponds with the white line of the felvic fascia of English authors ; but also that the former term is used in a more com- prehensive sense that the latter. "" Pubovesical Muscle (Fig. 840, p. 497). — See Quain's "Anatomy," loth ed., vol. iii., part iv., p. 213, and Macalis- ter's "Anatomy," p. 447. By the latter authority these unstriated muscular fibres connecting the anterior wall of the bladder with the back of the pubis and with the prostate gland (in the male) are called fubofrostaticovesical fibres. " Boundaries of the Trigone of the Bladder (Figs. 842, S43, p. 498). — The base or posterior boundary of the trigone is formed by a curved elevation of varying prominence con- necting the summits of the ureteric orifices, and known as Mercier''s bar; it corresponds in position with a muscular band which joins these orifices to one another and to the neck of the bladder. At its outer extremities Mercier's bar is con- tinuous with the ureteric folds, above and outside the ureteric orifices ; these folds are supposed to act as valves preventing the regurgitation of urine into the urethra. The ureteric folds are continued downwards by the lateral boundaries of the trigone, two faint ridges which converge to the lower extremity of the uvula of the bladder and the back of the urethral orifice. These ridges correspond, like Mercier's bar, to muscular bands, which in this case, however, belong to the internal layer of longitudinal fibres, and they are known as APPENDIX 53Si; Bell's muscles. Behind Mercier's bar there is often, especially in old age, a depressed area, the fosl-lrigonal fouch. •= *Urelhral Ring (Fig. 842, p. 498). — " The internal orifice of the urethra, orificium urethra internum, is seen, in the contracted bladder, to be surrounded by a circular eleva- tion of the mucous membrane, annuhis urethralis, dependent on the great development in this region of the circular layer of the muscular coat. When the bladder is greatly distended, the urethral ring is hardly discernible " (Von Langer and Toldt's " Anatomy," 7th ed., p. 376). This is the sfhinctcr vesica (interniis) of some authors. Griffiths states there is no thickening of the circular fibres in this situation sufficient to justify the use of the term sphincter (" Observations on the Urinary Bladder and Urethra," Journal of Anatomy and Physiology, iScji). These fibres at the base of the prostate are called by Macalister sphincter vesica internus to distinguish them from an envelope of striated muscle fibres surrounding the urethra at the apex of the prostate, and called by Macalister sphincter vesica externus. " (Ibid.) Toldt distinguishes the coUiculus seminalis as the middle thickened section of the crest of the urethra, in which the prostatic utricle opens. In England, however, the names coUiculus seminalis, verumontanum , and caput gal- linaginis, are commonly employed as alternative names for the whole length of the crest of the urethra. " (Ibid.) Known also as the prostatic sinus, prostatic vesicle, sinus pocidaris, and uterus masculinus. " *Crest of the Female Urethra (Fig. 843, p. 498).—" The mucous membrane of the female urethra exhibits in the median line of the posterior wall a longitudinal prominence, crista urethralis, which can be traced from the internal to the external orifice " (Von Langer and Toldt's " Anatomy," 7th ed., p. 409). This is the most prominent of several longi- tudinal folds in the female urethra. It is mentioned by Quain and Macalister, but not named. *' (Fig. 845, p. 500.) Known also as Duverney' s gland, or the suburethral gland. The latter name, though suitably applied to Cowper's gland, is given to Bartholin's gland only on the ground of its homology with Cowper's gland. " Os L'teri Externum (Ibid.). — This is commonly spoken of by clinicians as the os uteri, without qualification, though the word externum is properly added to distinguish it from the OS uteri internum. The external os was in former times called the os tincce, from its supposed resemblance to the mouth of a tench. '" Fascial Coverings of the Testicle and Spermatic Cord (Figs. 846, 847, p. 501). — The names given to these are various and conflicting. According to the best-established nomen- clature of English anatomists, the covering derived from the intercolumnar fibres of the external oblique muscle of the abdomen is called the intercolumnar or spermatic jascia. Next within this comes the cremaster muscle and the aponeu- rotic layer connecting its fibres, to which, considered as a whole, Quain gives the name of cremasteric fascia. Thirdly, within this, we come to the covering derived from the trans versalis fascia, and generally known in Ivngland as the infundibuliform fascia. But the divergen( ies from the nomenclature just given are manifold. Taking Toldt first, we find he gives the name of fascia cremasterica (Cooperi) to the intercolumnar or spermatic fascia of English anat- omists; and the name of tunica vaginalis communis testis et funiculi spermati to the infundibuliform fascia of English anatomists. (In England the use of the term tunica vaginalis is entirely restricted to the serous sar of the testicle.) Macalis- ter further complicates the use of the term cremasteric by describing as the tunica cremasterica, all three of the fascial layers enumerated at the beginning of this note, " which are so closely united as to be with difficulty separable from each other." It will be noted that Toldt appends the name of Astley Cooper to the layer he terms " cremasteric," but this is a further divergence from English usage. By the term fascia propria of Astley Cooper we denote, in England, the penultimate covering of an oblique inguinal hernia, that next to the peritoneum, which consists of the combined infundibuli- form fascia and the subserous areolar tissue between that fascia and the peritoneum. As a final alternative in the nomenclature of the fascial layers in this region, I give that of Young (U.S.), who enumerates the coverings of the cord as consisting of (i) external spermatic or intercolumnar fascia, (2) cremaster muscle, and (3) internal spermatic fascia or fascia propria. From this medley, the student will do well to select and impress on his memory the distinctive names of intercolumnar fascia, cremasteric fascia, and infundibuliform fascia. " Hydatids of Morgagni (Fig. 84S, p. 502).— " On the upper extremity of the testis and beneath the head or globus major of the epididymis is situated a hemispherical body of varying size, consisting of delicate and very vascular con- nective tissue, and often containing the remnant of a duct. This is known as the sessile hydatid of Morgagni, or appendix testis (Morgagnii), and is the rudiment of the cephalic extremity of the foetal Miillerian duct. Similar but smaller stalked bodies are frequently met with on the head or globus major of the epididymis, and are termed pedunculated hydatids, appendices epididymidis " (Von Langer and Toldt's " Anatomy," pp. 383, 384). The terms sessile and pedun- culated hydatid are employed by Macalister, but not by Quain ; the latter authority uses appendix of the testicle as an alternative name for the [sessile] hydatid of Morgagni. Some authorities call it corpus Morgagni. For the develop- ment of these structures from Miiller's duct, see Figs. 8g6, S97, p. 520. '° *Ligatnents of the Epididy7nis (Fig. 849, p. 502).— The epididymis is attached to the posterior border of the testicle (i) by the efferent ducts passing from the gland to the head or globus major of the epididymis ; (2) by a duplicature of the tunica vaginalis containing numerous bloodvessels passing between the testicle and the posterior border of the epididy- mis; (3) within the digital fossa (sinus epididymidis) are two strands of fibrous tissue covered by reflections of the tunica vaginalis connecting the upper and lower ends respec- tively of the body of the epididymis with the testicle. It is these last that are called by the author *superior and inferior ligaments of the epididymis. The names are not used by Quain or Macalister. " Vas Aberrans (Fig. 851, p. so^)-— " 'I'hc so-called ductulus aberrans is a tube with a blind termination, which opens by its proximal extremity into the canal of the epididymis near the tail of that organ. Coiled tightly, it forms a small lobe not attached to the testicle proper ; but occasionally also it is seen as a straight tube of varying length. It is a glandular canal, and represents that part of the Wolffian body which was not used up in the formation of the head or globus major of the epididymis. A similar canal, ductulus aberrans superior, is sometimes met with attached to the head or globus major of the epididymis. This, how- ever, is attached to the te.sticle, and is merely an efferent duct which has become strictured off from the canal of the epididymis, and has thus lost its connexion with the head of that organ " (Von Langer and Toldt's " Anatomy," 7th ed., P- .1^3). " lobes or Lobules of the Epididymis (I'lg. 854, p. 503). 69 538/s APPENDIX — Toldt by this term denotes the coils of the various efferent ducts of the testicle. These, however, form the coni vasculosi of English anatomists, who use the term lobes of the epididy- mis to denote the larger masses of the coiled canal of the efididymis, these lobes or masses being separated by incom- plete transverse fibrous partitions. '^ Middle Lobe or Isthmus of the Prostate Gland (Fig. 858, p. 504). — This is that portion of the prostate gland lying between the ejaculatory ducts and the neck of the bladder ; its forward projection lies beneath the uvula of the bladder. The term isthmus, though not commonly employed in England, is preferable to middle lobe, for it is only in pathological senile enlargement of the prostate that the organ becomes distinctly trilobate. The middle lobe of the prostate gland is sometimes also known as Home's lobe. '* (Fig. 861, p. 505.) The outer fibrous coat of the prostate gland is derived in part from the visceral layer of the pelvic fascia and the deep layer of the triangular ligament of the urethra, and in part from a dense but thin fibrous layet peculiar to the prostate beneath the outer fascial investment. To the compound fibrous coat thus formed Macalister gives the name of felvifrostatic capsule, expressing its joint origin. The prostatic plexus of veins ramifies between the two layers of this capsule ; and immediately beneath the inner layer is the external layer of unstriated muscular fibres to which Toldt gives the name of musculus prostaticus. " Divisions of the Cervix (Fig. 873, p. 511). — Most authorities are in agreement with the author in his division of the cervix uteri into two parts only — vaginal and supra- vaginal. Schroeder, however, speaks of three portions — infravaginal, intermediate, and supravaginal. (See Hart and Barbour's " Gynecology," 3rd ed., pp. 16, 17.) '"'(Figs. 873, 874, p. 511.) The mesovarium, or mesentery of the ovary, is the bilaminar fold of peritoneum by which the ovary is attached to the broad ligament of the uterus. (See also note "' below.) " Position of the Ovary (Fig. 873, p. 511). — Owing to the manner in which the broad ligament has been drawn out to its full length, the ovary has been pulled into a horizontal position, differing from that it normally occupies in the body, in which, according to some authorities, its long axis is oblique, according to others, vertical. Hence in situ the tubal extremity becomes superior; the uterine extremity inferior; and the surfaces, here represented as directed upwards and downwards, become external and internal. " Vaginal Fornix (Figs. 873, 874, p. 511). — This is the upper portion of the vagina, surrounding the vaginal portion of the cervix. Most English anatomists, however, speak, not of the vaginal fornix as a whole, but of its four parts : anterior fornix, posterior fornix, and right and left lateral fornices. " Bursa Ovarica (Fig. S74, p. 511). — This term is not used by Quain. Macalister describes it as a pouch at the back of the broad ligament of the uterus in which the ovary lies, between the ovariopelvic ligament [liganzentum suspensorium ovarii^ according to Toldt's nomenclature — see also note ', p. 511) and the rest of the broad ligament. The ovarian bursa must be distinguished from the ovarian fossa or fovea (fossa ovarii, Quain), which is a recess in the parietal peritoneum on the lateral wall of the pelvis, corresponding to the external sur- face of the ovary, and situated between the external and internal iliac arteries in front of the sacro-iliac articulation ; the ovarian fossa is often bounded behind and below by the ureter. '" (Fig. 875, p. 512.) Owing to the irregular, torn appear- ance of the fimbriated extremity of the Fallopian tube, sur- rounding the abdominal orifice, this orifice was by ancient anatomists named morsus diaboli. " (Ibid.) English anatomists usually speak of separate icterine and vaginal venous plexuses. These, of course, com- municate somewhat freely ; but on the whole the venous blood from the body of the uterus passes by means of the uterine plexus to the ovarian or pampiniform plexus and the inferior vena cava, that from the neck of the uterus and the vagina by means of the vaginal plexus to the internal iliac vein. "- Mesometrium, Mesovarium, and Mesosalpinx (Figs. 875, S76, p. 512). — As these terms are not employed by all English authorities, I append a description from Von Langer and Toldt's " Anatomy," 7th ed., p. 401 : " That portion of the broad ligament of the uterus which passes to the lateral wall of the pelvis, there to become continuous with the parietal layer of the peritoneum, conveys the vessels and nerves and the round ligament to the uterus, and is therefore called the mesentery of the uterus or mesometrium ; that part of the broad ligament which lies between the ligament of the ovary and the Fallopian tube, sometimes rising above the plain of the pelvic inlet, and terminating laterally in a free border (the infundibulo-ovarian border) is the mesentery of the Fallopian tube, or mesosalpinx ; and from this there branches off backwards the short mesentery of the ovary, or mes- ovarium." (See Fig. 876.) '^ *Corpus Albicans (Fig. 876, p. 512). — This name is given to the white, stellate mass of scar tissue into which the corpus luteum is ultimately transformed. '* Parametrium (Fig. 8S1, p. 513). — This name was first given by Virchow [Archives, No. xxiii.) to that part of the subserous connective tissue of the pelvis, abundantly supplied with bloodvessels and lymphatics, that lies beside the cervix and the upper part of the vagina, and between the layers of the broad ligament of the uterus at its lower and inner part. The term parametrium is rather a clinical than an anatomical one, and since, as Spiegelberg points out (" Midwifery," Eng. ed., vol. i., p. 43), the name conveys the idea of a definite organ whilst there is no line of demarcation between the parametric and the paravaginal, paravesical, and pararectal tissue, the name parametric connective tissue is to be pre- ferred. ^^ (Ibid.) The anal fascia is continued in front into what is called (in the male) the deep or superior layer of the trian- gular ligament of the uretfira, and by Macalister called the subpubic fascia. The name anal fascia is limited to that part which forms the inner wall of the ischiorectal fossa. '° Rectal Fascia (Ibid.). — This appears to be the most suit- able English equivalent for the author's fascia diaphragmatis pelvis superior, the fascia covering the upper surface of the levator ani muscle. " Pelvic Diaphragm (Ibid.). — In this the author includes, in addition to the coccygeus or levator coccygis and levator ani muscles, the superior and inferior fascice of the pelvic diaphragm — i.e., the rectal and anal fascia of English anatomists. (See also notes '° and '".) '' (Fig. 883, p. 514.) Skene's tubules (ductus para- urethrales) are two canals running parallel with the female urethra on either side, beneath the mucous membrane and embedded in the muscular coat. They open either just within or just without the urethral orifice (within, probably, in the virgin, and without, in the multipara, in whom slight eversion of the urethral orifice is almost constant). Their diameter is about I millimetre (^V inch), and their length from i^ to 3 centimetres (i inch to ij inches), but they never extend beyond the internal orifice of the urethra. Though not distinctly glandular in character, they are often called Skene's glands. APPENDIX 538f They were first described by Skene in the American Journal of Obstetrics for April, i8So. A third tubule, Schiiller's tubule, is occasionally present in the middle line behind, midway between Skene's tubules. " Vestibule (Ibid.). — Toldt includes in this the space at the sides of the vaginal orifice within the edges of the labia minora, as well as the space in front of that orifice. As defined by English anatomists, however, the i>estibule is the triangular space of which the clitoris forms the apex, the labia minora the sides, and a transverse line through the front of the vaginal orifice the base. '° Fossa Navicularis (Ibid.). — Macalister stands alone in applying this term to the space behind the fourchette, between that fold and the posterior commissure of the vulva. By all other authorities the fossa navicularis is defined as the space in front of the fourchette, between it and the posterior margin of the vaginal orifice. " Bulbus Vestibuli (Figs. SS4, 885, p. 515).— Though this mass of erectile tissue is commonly known in England as the bulb oj the vestibule, the use of this term is altogether incon- sistent, since it is only the partially detached anterior portion (fars intermedia of Kobelt) that lies in the region of the vestibule as defined by English anatomists (see note " above). Hence the alternative name of vaginal bulb is to be preferred. '- (Fig. 8S4, p. 515.) This venous ■plexus is the lower part of the vaginal plexus, which communicates freely behind with the lower part of the haemorrboidal plexus. " Marginal Lif of the Cloaca (Fig. 895, p. 5^0). — The name of cutaneous fold or greater cutaneous fold is sometimes given to this structure, which forms the scrotum in the male and the labia majora in the female. To avoid confusion, however, it is better to speak of it as the marginal lif, and to reserve the name fold for the genital folds (see Figs. goS-911, p. 524), which develop on each side within the marginal lip, and form in the male (by their fusion in the median line) the floor of the penile urethra, in the female the labia minora or nymphae. "" Cloaca (Ibid. I. — We must distinguish between the cloaca, which is the cavity formed by the united distal extremities of the alimentary and urogenital canals, and the cloacal orifice, by which the cloaca opens externally. " Ligaments of the Wolffian Body (Figs. 898 and 899, p. 521). — A strand of fibrous tissue mixed with involuntary muscular fibres is attached to each end of the Wolffian body, the upper passing to the diaphragm, the lower to the groin. These are called superior and inferior, or diaphragmatic and inguinal ligaments of the Wolffian body; the inferior or inguinal ligament in f^ngland is, however, usually known as the plica gubernatrix. As the Wolfiian body becomes atrophied, the superior or diaphragmatic ligament dis- appears; but concurrently with the development of the geni- tal or reproductive gland, in the female into the ovary, in the male into the testis, the plica gubernatrix becomes in the former the round ligament of the uterus, in the latter the gubernaculum testis. '• Genital Cord (Fig. 899, p. 521). — Behind the stalk of the allantois (subsequently the base of the bladder) the Wolffian ducts are closely approximated to one another before opening into the urogenital sinus (the ventral segment of the cloaca). Between and somewhat behind them lie the uniting lower extremities of the Miillerian ducts. The ducts are all embedded in a mass of connective tissue, and to the whole structure thus formed is given the name of genital cor a. " (Fig. 919, p. 530.) The rectococcygeus muscles are bands of unstriated but 1 jddish muscular tissue which passes backwards on each side of the rectum. Both Quain and Macalister describe these bands as attached behind to the front of the second and third pieces of the coccyx ; but as Toldt points out, and Fig. 919 shows, the actual muscular tissue does not extend so far back as this, and the attachment to the coccyx is through the intermediation of the aponeurosis of the pubic part of the levator ani muscle. " *Tendinous Arch of the Levator Ani Muscle (Ibid.). — ■' The levator ani muscle arises for the most part from a tendinous arch in the obturator fascia, arctis tendineus musculi levatoris ani, which can be traced from the ischial spine to near the obturator canal " (Von Langer and Toldt's " Anatomy," 7th ed., p. 438). " Diafhragma Urogenilale (Figs. 920 and 921, p. 531). — The author's application of the term pelvic diaphragm has been explained in note " above. In that structure there are two apertures — a circular one in the centre for the rectum, and a triangular one anteriorly for the urogenital canal (see Fig. giS, p. 530). The triangular space between the inferior or descending rami of the pubes is, however, too large to be completely filled in by the urogenital canal, and it is occupied by a musculofibrous plate bearing the same relation to that canal that the pelvic diaphragm bears to the rectum, and called by the author the urogenital diaphragm. The muscular portion of this diaphragm is by the author named musculus transversus perinei profundus, and in England constrictor or compressor urethrce. Its superficial and deep surfaces are covered by fascial layers which, like the muscle, are triangular in shape, with a truncated apex anteriorly and a free base posteriorly ; these constitute the bilaminar triangu- lar ligament of the urethra of English authors. The super- ficial layer of this ligament, called also anterior or inferior layer, is the author's fascia diaphragmatis urogenitalis inferior; it is continuous around the posterior margin of the (superficial) transverse perineal muscle with Colles's fascia, combining with that fascia to enclose a space in which lies the root of the penis and its accompanying muscles; it thus belongs to the extrapelvic system of fascia;. The deep layer of the triangular ligament of the urethra, called also posterior or superior layer, is the author's fascia diaphragmatis urogenitalis superior; though connected around the posterior margin of the compressor urethrae with the superficial layer of the ligament, it belongs to the intra- pelvic system of fasciae ; traced backwards it is seen to be a forward continuation of the anal fascia; laterally it joins the obturator fascia. The triangular ligament as a whole is some- times called the deep perineal fascia, but this name should be avoided, having been applied also to Colles's fascia. The name of subpubic fascia may also give rise to confusion, being applied by Macalister to the deep layer only of the triangular ligament, but by Quain to that structure in its entirety. The triangular ligament exists also in the female, and between its layers lies the constrictor urethra: or transversus perinei profundus muscle, but the *urogenital diaphragm thus formed is almost completely divided by the vagina and the urethra into lateral halves (see Fig. 921, p. 531). ""> Transverse Ligament of the Pelvis (Ibid.). — This occupies the subpubic angle adjacent to the truncated apex of the triangular ligament of the urethra, on a plane between that of the two layers of that ligament. Between the trans- verse ligament of the pelvis and the inferior pubic or sub- pubic ligament [Ugamentum arcuatum pubis, according to Toldt) which occupies the apex of the subpubic angle are three foramina : a central foramen for the dorsal vein of the penis or clitoris, and lateral foramina for the dorsal artery and nerve of the penis or clitoris (see Figs. 920 and 921, 69—2 538/ APPENDIX p. 531, and also Part II., Fig. 456, P- 220, and Figs. 45S and 459. P- 221). '"' Transversus Feritiei Projundus (Ibid.). — This name is here appHed to the whole triangular mass of muscle between the layers o£ the triangular ligament, not merely, as is some- times the case in English works on anatomy, to the posterior strand of transverse fibres only. Other names have been applied, especially by Guthrie and by Wilson, to different strands of fibres, which they described as distinct muscles, but later English authorities agree with Von Langer and Toldt in regarding this separation as purely artificial. In the female, owing to the greater width of the subpubic angle, the muscle is wider than in the male, and the name trans- versus ferinei ■profundus is obviously preferable to that of constrictor urethra;. (See Fig. 921.) '"- Internal Pudic Artery and Vein (Figs. 922 and 923 p. 532). — Macalister calls these vessels fudic without qualifica- tion. Usually, however, they are known as internal fudic, to distinguish them from the external fudic branches (suferior and inferior) of the femoral vessels. Macalister calls these latter the fubic vessels. (See also note "° below.) '°^ (Fig. 922, p. 532.) Though the ar.thor calls this the divided edge of the obturator fascia, it is, rather, the junction of the lower edge of this fascia with the lateral margins of the deep layer of the triangular ligament, the latter having been dissected off the upper surface of the transversus perinei profundus muscle. (See also notes °° and "' above.) '°'' M. Sphincter UrethrcE Membranacece (Ibid.). — The muscle called by the author the sf hinder of the membranous urethra consists merely of the circular fibres of the trans- versus perinei profundus muscle (see note "" above) immedi- ately surrounding the membranous part of the urethra. 105 ^Pudendal Venous Plexus (Fig. 923, p. 532). — This term is not employed by English anatomists. Von Langer and Toldt ("Anatomy," 7th ed., p. 550) write: "The fudendal flexus receives beneath the symphysis the dorsal vein of the penis or clitoris, and, running back beside the base of the bladder and in the female beside the vagina, receives in both sexes the blood from the vesical plexus, and in the female also the blood from the uterine and vaginal plexuses. The pudendal plexus opens by several large vessels into the internal iliac vein." From this account it is evident that the pudendal plexus of these authors is made up of veins belonging in the male to the prostatic and vesical plexuses, and in the female to the vesical, vaginal, and uterine plexuses, of English anatomists. "' Fascia Endofelvina (Ibid.). — ^Von Langer and Toldt's " Anatomy," 7th ed., p. 444 : " The visceral layer of the felvic fascia is exposed by the removal of the peritoneum and the subserous areolar tissue from the parietes of the bladder and the rectum. It is given off along the ivhite line of the felvic fascia [see note °' above] from the parietal layer of that fascia (obturator fascia), and, reaching the bladder, gives a complete fibrous investment to its anterior and lateral surfaces. Along the white line, the visceral layer is con- nected with the rectal fascia (fascia diafhragmatis pelvis suferior), but as they pass inwards the two layers separate, the rectal fascia, following the levator ani, the upper surface of which it covers, dips deeply into the pelvis, whilst the visceral layer stretches transversely across to the bladder. Thus, between the rectal fascia and the visceral layer there exists on each side of the bladder a space, the perivesical space, in which, in addition to the ureter, the nerves of the bladder and the vesical plexus are enclosed. Behind the bladder, the visceral layer of the pelvic fascia assists in form- ing the pelviprostatic' capsule or prostatic fascia [see note " above], and furnishes a delicate fibrous investment for the rectum." I quote this passage in order to indicate clearly the signifi- cance attached in this work to the names given to the different parts of the pelvic fascia. Three layers pass inwards from the parietal layer of the pelvic fascia : the lowest of these, the anal fascia, covers the perineal surface of the levator ani ; the next layer, the rectal fascia, covers the pelvic surface of that muscle : these correspond with the superior and interior fasciiz of the pelvic diaphragm in the author's nomenclature. The uppermost layer is that described in the above extract as the visceral layer of the pelvic fascia. The relative positions of the three layers are well shown in Fig. 923. It will be noticed that I have avoided the use of the term rectovesical fascia, which is in England applied, sometimes to all three of the layers just enumerated, sometimes to one or two of them separately considered, and this gives rise to much confusion. The complexity that is apt to surround the description of the pelvic fascia is also, doubtless, in part dependent on the fact that, as Macalister says, " much of the definiteness of these layers in the adult is created by the knife and forceps" (■' Anatomy," p. 446). '"' Hypogastric Artery (Fig. 924, p. 533). — In the German anatomical nomenclature, the common iliac is said to divide into the external iliac and the hypogastric arteries. In Eng- land, however, the name hypogastric artery is given to that branch of the internal iliac artery which at the navel becomes the umbilical artery. When the placental circulation ceases, it is obliterated, and is represented in the adult by a fibrous cord. '°' *Corpus Spongiosum Vrethr<2 (Fig. 927, p. 535). — This term, as applied to the female urethra, is not found in any works on anatomy to which I have access, not even in Von Langer and Toldt's " Anatomy." Quain (of. cit., vol. iii., part iv., p. 258) writes : " Outside the submucous areolar tissue of the female urethra, there is a highly vascular structure, in which are many large veins " ; and according to Macalister (op. cit., p. 454) : " Outside the mucosa [of the female urethra] is an elastic vascular submucosa covered by an imperfect erectile lamella. The use of the name corpus spongiosum ttrethrai for this erectile tissue is to be deprecated, suggesting as it does homology with the corpus spongiosum urethrEB of the male. The counterparts of this structure in the female are the vaginal bulbs and the partes intermedia of Kobelt. (See Figs. 884 and 885, p. 515, and note "' above.) '"' Rectal Ampulla (Fig. 932, p. 53S). — This is the portion of the rectum, usually dilated, situate immediately above the anal canal. According to Macalister, the upper boundary of the ampulla is the lowest of Houston's valves; according to Quain, however, the middle one of these three folds (the plica transversalis recti of Kohlrausch — see note " above). The rectal ampulla is sometimes known as the ampulla analis recti. "° (Ibid.) The pudic vessels run in a canal formed by the obturator fascia, shown here (and also in Fig. 922, p. 532) in cross-section, and known as AlcocVs canal. For the nomen- clature of these vessels see note '"" above. INDEX SPLANCHNOLOGY ^ 541 INDEX TO THE SPLANCHNOLOGY Cettair EnglUh n ; have an asterisk (*) prefixed ; these, as this work, but which are not commonly < - in the original worlc, but not included ii nore fully explained nployed bv iinglish ; the official i the Translator's Preface, being terms that form part of the atomists. To other names a dagger (f) is prefixed ; these are re of the " Anaioniische GesclUchafl." Abbreviation : App. = AUDO-MiXAL ring, external, 501 superficial, 501 viscera, projection outlines of, 486-488 Aditus laryngis, 434, 435, 461 Adrenal, 480, 492, 494, 495, 521 Adven'.-tious coat of the pharynx, 466 and App., note '* Ala nasi, 412 of the thyroid cartilage, left, 458 right, 458 Alimentary canal, 438-445 tAllantois, 468, 520 Alveoli of the mucous membrane of the gal! bladder, 449 pulmonary, 465 pulmonunj, 465 Alveolus dentalis, 426, 431 of tooth,' 426, 431 t-Amnion, 46S, 51S, 519 Ampulla analis recti, 538 and App., note "" ductus deferentis, 496, 500, 504, 505, 532 of the P'allopian tube, 511-513 rectal, 538 and App., note ""' recti, 538 tubae uterinae, 511-513 of the vas deferens, 496, 500, 504, 505, 532 Ampulla" of the galactophorous ducts, 567 Amygdala, 411 and note, 434-436 Anal portion of the rectum, 445, 538 Anatomy, topographical, of — abdominal viscera, 454-488 bladder, 494, 496, 5ro, 511, 513, 532-537 caecum, 472-475, 485-487, 521, 522 colon, 472-476, 481, 485-487 duodenum, 478, 479, 481, 482, 487, 495 Fallopian tube, 537 gall-bladder, 476, 482, 495 heart, 471, 482, 484, 486 intestine (large), 472-476, 481, 485-487 (small), 472, 473, 481 kidneys, 480, 481, 483, 485, 487, 494, 521 larynx, 511 liver, 476, 480, 482-487, 495 lungs, 47t, 476-478, 482-487, 494 oesophagus, 411, 456, 470, 471, 478, 479, 487 ovary, 537 pancreas, 478-4S0, 483, 484, 495 pelvic viscera, 532-538 peritoneum, 456', 472-484, 404, 405. 'i'3, 53353^ pleura, 470, 471, 476-479, 481-488, 494 prostate gland, 497, 532, 534 rectum, 486-488, 533-538 salivary glands, 424, 425 spleen, 479, 480, 482-484, 486, 4S7, 495 stomach, 472, 476, 477, 480, 482-484, 486, 487, 495, 522 suprarenal capsules, 480, 483, 4f)4, 495, 521 testis, 501 thoracic anrl abdominal viscera, 470-488 thymus gland, 410, 411, 467, 476 thyroid body, 411, 470 trachea, 411, 470, 471, 478, 482 tube, Fallopian, 537 ureter, 4fH, 532-536 urethra (female), 510, 511, 535 Anatomy, topographical, of — urethra (male), 533, 534 uterus, 513, 535, 537 vesiculae seminales and vasa deferentia, 496, 532-534 viscera, abdominal, 454-488 pelvic, 532-538 thoracic and abdominal, 470-488 Angle of the mouth, 412, 415417 * venous, 482 and note Angulus oris, 412, 415-417 venosus, 482 and note Annulus ha>morrhoidalis, 445, 538 inguinalis abdominalis, 533 subcutaneus, 501 urethralis, 498, 506 Antrum of Highmore, 414 pyloricum, 438 Anus, 488, 514, 520, 524, 526 529, 534, 535, 538 Aorta, abdominal, 481, 487, 494, 495, 521, 536 arch of, 478, 479, 482 ascending, 410, 411, 471, note, 482, 486 bulb of, 471 and App., note " descending thoracic, 470, 471, 478-480, 4S7 Aortic arch, 478, 479, 482 Aperture, auriculoventricular, left, 471 right, 47' of the glottis, 459, 461 interarytenoid portion, 461 intercordal portion, 461 respiratory portion, 461 vocal portion, 461 inguinal, external, 501 internal, 533 of the larynx, superior, 434, 435, 461 of the mouth, 411, 412 * of the vestibule of the larynx, 461 Apex of the bladder, 494, 496, 534, 536, 537 cartilaginis arytaenoideae, 458 and note cordis, 482, 486 of the heart, 482, 486 li iguae, 415, 419, 420 of the lung, 463, 464, 483, 485, 487 nasi, 412 of the prostate gland, 505 pulmonis, 465, 464, 483, 485, 487 radicis dentis, 426, 427 of the root of tooth, 426, 427 of the suprarenal capsule (right), 492 Aprneurosis, palatine, 417, 418 . pharyngeal, 432, 433, 436 '\p)aratus digestorius, 409-456 genito-urinary, 489-524 respiratorius, 457467 urogenitalis, 489-524 A'lDPndices epiploicae, 443 Appendix, auricular, 411, note left, 484 right, 410, 411, 471 epididymidis, 502, 520 fibrosa hepatis. 446, 447, 4^4 • fibrous, of theliver, 446 and App., note '*, 447, 454 testis fMorgagniil, 500, 502, 520, 521 ventriculi laryngis, 460, 461 vermiform, 444, 445, 474, 47";. .537 542 INDEX Appendix, vesiculosa [Morgagnii], 512, 520 Arbor vita; uterina, 512 Arch of the aorta, 478, 479, 482 of the cricoid cartilage, 458 dental, inferior, 419 superior, 419 glossopalatine, 415-419, 421 palatine, anterior, 415-419, 421 posterior, 41 5-41 S, 434, 436 pharyngopalatine, 415-418, 434, 436 tendinous, of the levator ani muscle, 530 and App., note ", 532 of the pelvic fascia, 497 and App., note '% 532, 533, venous, jugular, 410 and note Arched summit of the pharynx, 411, 436 Arches, arterial, of the kidney, 491, 493 venous, of the kidney, 493 Arcus aortas, 478, 479, 482 cartilaginis cricoides, 458 dentalis, inferior, 419 superior, 419 glossopalatinus, 415-419, 421 pharyngopalatinus, 415-418, 434, 436 tendineus fascias pelvis, 497, 532, 533 m. levatoris ani, 530, 532 Area cribrosa renis, 492 and App., note '' Areola mammae, 517 Arteria vel arteris : arciformes renis, 491, 493 bronchiales, 464 coeliaca, 451, 494 deferentialis, 501, 502, 533 dorsalis clitoridis, 531 penis, 508, 531 epigastrica, inferior, 533 gastrica brevis, 450 sinistra, 451 gastro-epiploica sinistra, 450 hepatica, 446, 451 hypogastrica, 533 iliaca communis, 533 externa, 533 interlobulares renis, 493 lienalis, 441, 450, 451 lingualis, 410, 424, 425 mesenterica, inferior, 451 superior, 451, 479, 494, 495 obturatoria, 533 omphalomesenterica, 521 ovarica, 511 profunda linguae, 414, 421 penis, 506, 508 pudenda interna, 513, 532, 5^7 pulmonalis, 471, 482, 486, 488 ramus dexter, 410, 411, 456, 465, 471 sinister, 464, 465 rectas, App., note '" renalis, 490, 491, 494 spermatica interna, 494, 501 submaxillaris, 405 suprarenales superiores, 492 suprarenalis, inferior, 492 • testicularis, 501, 522 thyreoidea, inferior, 410, 470 superior, 410, 425 umbilicales, 519, 521-523 uterina, 512 t uteroplacentaris, 519 Arterial arches of the kidney, 491, 493, and App., note '* Arteriote recta> renis, 493 and App., note °° Artery or arteries : bronchial, 464 cceliac, 451, 494 coronary of the stomach, 451 of the corpus cavernosum, 506, 508 deferential, 501, 502, 533 dorsal, of the clitoris, 531 of the penis, 508, 531 epigastric, deep, 533 Artery or arteries : epigastric, inferior, 533 external maxillary, 410 and note facial, 410 and note gastric, 451 short, 450 gastro-epiploic, left, 450 hepatic, 446, 451 hypogastric, 533 and App., note '"' obliterated, vestige of, 533 iliac, common, 533 external, 533 internal, 533 interlobular, of kidney, 493 lingual, 410, 424, 425 mesenteric, inferior, 451 superior, 451, 479, 494, 495 obturator, 533 omphalomesenteric, 521 ovarian, 511 of the penis, deep, 506, 508 dorsal, 508, 533 pudic, internal, 513, 532, 537 pulmonary, 471, 482, 486, 488 left, 464, 465 right, 410, 411, 456, 465, 471 radiate, of kidney, 493 ranine, 414, 421 renal, 490, 491, 494 short gastric, 450 spermatic, 494, 501, 522 splenic, 440, 450, 451 straight (true and false), of kidney, 493 and App., note ''° suprarenal, inferior, 492 superior, 492 thyroid, inferior, 410, 470 superior, 410, 425 umbilical, 519, 521-523 uterine, 512, 519 uteroplacental, 519 of the vas deferens, 501, 502, 533 vitelline, 521 Articulatio crico-arytsnoidea, 459 cricothyreoidea, 459, 460 Articulation, corniculo-arytenoid, 459 and App., note " crico-arytenoid, 459 cricothyroid, 459, 460 Atrium, 411, note (cordis) dextrum, 411, 471, 486 sinistrum, 411, 465, 471 of the left auricle, 411, 465, 471 of the right auricle, 411, 471, 486 Auricle, 411, note (equivalent to " pinna"), 424 left, 411, 465, 471 right, 411, 471, 486 Auricula cordis dextra, 410, 411, 471 sinistra, 484 Axis, coeliac, 451, 494 B. Band, ventricular, 461 Bands of longitudinal muscular fibres of the colon, 443, 444 anterior, 444, 473, 478 free, 443, 444, 473, 474 inner, 443, 444, 473, 474 mesocolic, 443, 444 omental, 444, 473, 478 posterior, 443, 444 Bar, Mercier's, 49S and App., note " Bartholin, duct of, 424 and App., note ' Bartholin's glands, 500, 514-516, 535 Base of the arytenoid cartilage, 458 and App., note '" of the bladder, 496, 497, 532, 533 of the lung, 464, 483, 4S5 of the nose, 412 of the prostate gland, 496, 505 of the renal pyramid, 491, 492 of suprarenal capsule, 492 and App., note " Basement membrane, 404 INDEX 543 Basis cartilaginis arytaenoidese, 45S and App., note -'* glandula; suprarenalis, 492 nasi, 41^ prostatae, 496, v'S pulmonis, 464, 483, 48^ pyramidis (renis), 491, 492 Bauhin, valve of, 444 and note Bell's muscles, App., note "' Bellini, ducts of, 492, 49J Bertin, columns of (renal), 491, 492 Bifurcatio trachea?, 411, 402 Bifurcation of the trachea, 411, 462 Bile-duct, common, 440-442, 446, 449, 468 Bladder, gall-, see ■■ Gall bladder " urinary, 456, 4S(.>, 4.S7, 496-498, 500, 504, 51 _, .. , 5'J> 5^'^'5-^J> 5J3"537 Blandin s gland, 420, 421 Blood-supply of medulla of kidney, -^PP-, note " Body of the bladder (gall-), 449 (urinary), 496, 497, 535, 536 of the breast, 517 of the clitoris, 515 of the epididymis, 502 of the gall-bladder, 449 • of the pancreas, 441, 480 of the penis, 507, 526, 534 of the seminal vesicle, 504 of the stomach, 438, 480, 482, 484 suprarenal, 480, 492, 494, 495, 521 thyroid, 408, 411, 434, 466, 467, 470 accessory, 466 of the tongue, 414, 419 of the uterus, 510, 511, 513, 518, 535, 537 Wolffian, 468, 520, 521 Border of the kidney, external, 490, 491 internal, 490, 491 of the liver, anterior, 446, 462, 486 of the lung, anterior, 464, 4S6 inferior, 464, 4S3. 4815-488 of the mesosalpinx infundibulo-ovarian, note '- of the ovary, anterior, 511 attached, ju convex, 511, 537 free, 511, 537 posterior, 511, 537 straight, 511 of the pancreas, anterior, 441 posterior, 441 superior, 441 of the prepuce, free, 508 of the spleen, anterior, 450 inner, 450 posterior, App., note '• striated, 404 of suprarenal capsule, internal, 492 superior, 492 of the testicle, anterior, 502, 503 posterior, 502 of uterus, lateral, s'2 Boundaries of the trigone of the bladder, App., note " Bowman's capsule, 493 Branches of arterial arches of kidney, recurrent slra App., note "* bronchial, 462, 463, 465, 483, 485 of the hepatic duct, 448 splenic, of the splenic artery, 450 Breast, the, 471, 517 supernumerary, 517 Bronchi (right and left), 462-465, 470, 471, 478 Bronchial branches, 462, 463, 465, 483, 485 Bronchioles, 46^ lobular, 465 respiratory, 465 Brunner's glands, 407, 442 Bucca, 412 Buccal fat pad, 414 and note Bulb of the aorta. 471 and App.. note " of the urethra, 500, 504, 506, 507, 533, 534 vaginal, 515 and App., note' , s,t^ App. Bulb of the vestibule, 515 and App., note ", 535 Bulbus aorta", 471 urethra-, 500, 504, 506, 507, 533, 534 ve.stibuh (vagime), 515, 535 bursa omentahs, 452, 45b, 46.S, 470-480, 4S4, 495 ovarica, 511 and App., note ", 537 pharyngea, 434 and note, 436 Ca-cum, 444, 455, 472.475, 486-488, 536 rudiment ot, 451 Calices of the kidney, 491 and App., note '°, 492 Calyces renales, 491, 492 majores, 491 minores, 491, 493 Canal, Alcock's, .'Vpp., note "" alimentary, 43S-445 anal, 445, 53s cervical, 01 uterus, 511, 512, 518 of the epididymis, 502, 503 incisor, 416 and note nasopalatine, remnant of, 410 and note obturator, 530 pulp, 426, 427 of Stensen, 416 and note Canalis cervicus uteri, 511, 512, 518 radicis dentis, 426, 427 Canals, portal, 448 Capsula adiposa renis, 479, 481, 484, 4S5 articularis crico-aryttenoidea, 459 fibrosa [Glissoni], 448, 482 glomeruli, 493 Capsule of the corpora cavernosa, fibrous, 506, 508 of the crico-arytenoid articulation, 459 of Glisson, 44S, 4S2 of Graafian follicle, fibrous, 512 of glomerulus, 493 of the kidney, fatty, 479, 481, 4S4, 4S5 fibrous, 491, 4()3 pelvi-prostatic, 505 and App., note "', 532 of the spleen, fibrous. 450 of the submaxillary gland, 424 suprarenal, 480, 492, 494, 495, 521 accessory, 492 of the testicle, fibrous, 503 Caput epididymidis, 502, 503, 521, 522 gallinaginis, 498 and note, 505, 506 pancreatis, 440, 441 Cardia, 438, 439, 477, 484, 486, 487 C'arina urethralis (vagina?), 514, 516 Cartilage or cartilages : arytenoid, 458 and App., note -", 459, 461 bronchial, 465 corniculate, 45S cricoid, 433, 45S, 459, 462 cuneiform, 460 of the epiglottis, 420, 45S, 459, 461 Eustachian, 410, 415, 4j(j of the external auditory meatus, 424 of the larvnx, 4158 of (Santorini, 458 th\Toid. 420. 43), 45S-460, 462 traclieal, 461, 462 triticeal, 459, 460 of Wrisberg, 460 Cartilage or cartilages: aryta'noidea, 45S and .\pp., note -', 459, 461 + bronchiales, 465 cornirulata [Santorini], 458 cricoidca. 43). 4i;8. 45.1. 462 cuneiformis fWri.sbergil, 460 poiKlottica, 420, 45S, 459, 461 laryngis, 458 thyreiiidea, 420, 433, 458-460, 462 tracheales, 461, 462 triticea, 450, 460 tubas auditiva;, 410, 435, 436 Carnnrnla major of duodenum, 440 ami App., note • sublingualis, 419, 424 figa 544 INDEX Caruncute hymenales, 514 mj'rtiformes, 514 Cauda epididymidis, 502, 503 pancreatis, 441, 4S0, 4S3 Cavity, abdominal, 472-4SS of the amnion, 518 of cervix uteri, 511, 512, 518 larj-ngeal, 411, 461 mediastinal, anterior, 456, 471, 476, 494 posterior, 410, 456, 470, 471, 479, 483 see also" Mediastinum," andin addition footnote to p. 410 and App., note "' nasal, 410, 411 oral, 411, 414-423, and note to p. 414 pelvic, 467, 536 pericardial, 410, 411, 456, 471, 4S2, 484 peritoneal, 40S, 452, 456, 480, 4S1, 484, 495 lesser, see " Sac, omental " pharyngeal, 415, 416, 434, 461 pulp, 426, 427 of Retzius, 456, 534 uterine, 511, 512, 518 visceral, of head and neck, 410 Cavum dentis, 426, 427 Douglasi, 535, 537 laryngis, 411, 461 niediastinale anterius, 456, 471, 476, 494 posterius, 410, 456, 470, 471, 479, 4S3 nasi, 410, 411 oris, 411, 414-423 pelvis, 467, 536 pericardii, 410, 411, 456, 47r, 482, 484 peritonjei, 408, 452, 456, 480, 481, 484, 495 pharyngis, 415, 416, 434, 461 pleurae, 467, 471, 476, 479, 480, 482-484 uteri, 511, 512, 518 t viscerale capitis et colli, 410 f'ells : chalice, 406 ciliated, 404 columnar, 404, 406 cubical, 404 cylindrical, 404 fusiform, 404 glandular, 405 goblet, 406 pavement, 404 pyramidal, 404 sphenoidal, 404 Cement, 426 Centrum tendineum (diaphragmatis), 446, 485 Cervix of the bladder, 496 and App., note *' of the glans penis, 508 uteri, 510-513, 518 divisions of, App., note " Cheek, 412 Chin, 412 Choana;, 434, 435 t-Chorda dorsalis, 46S tChorion, 46S, 51S, 519 Cilia, 404 Cisterna chyli, 494 Cleft, vulval, 514 Clitoris, 500, 514-516, 520 Cloaca, 520 and App., note '*, 524 Coat, adventitious, 407 of the pharynx, 466 and App., note " fibrous, of the kidney, 491, 493 of the spleen, 450 mucous, 406, 407 muscular, 406, 407, 452 of the bladder, 496-498 of the ileum, 407 of the rectum, 445 of the stomach, 439 of the urethra (female), 498 of the uterus, 512, 518, 519 of the vas deferens, 501 serous, 407, 408 of the spleen, 450 Coeliac axis, 451. 494 Coelom, see "Cavity, visceral" Colic extremity of the ileum, 444 Colliculus cartilaginis arytsnoidese, 458 and App., note '^ seminalis, 498, 505, 506 Collum dentis, 426, 430 glandis, 508 vesicjB felteas, 449 Colon, 443, 451-456, 472-487 ascending (ascendens), 444, 453, 473, 475, 4S5-4SS, 522, 536 descending (descendens), 455, 474, 485, 486, 536, 537 hepatic flexure (flexura dextra), 472, 473, 475, 477, 482 sigmoid flexure jsigmoideum), 455, 474, 475, 52r, 522, 534-537 splenic flexure (flexura sinistra), 451, 453, 474, 477- 479 transverse (transversum), 443, 446, 473-475, 4S1, 482, 485, 4S6, 4SS Column, vaginal, anterior, 514 and note, 516 posterior, 514 and note, 516 , Columna nasi, 411 rugarum anterior, 514, 516 posterior, 514, 516 Columns rectales [Morgagnii], 445 renales [Bertini], 49r, 492 Columns of Bertin (renal), 491, 492 of the rectum, 445 and App., note " Commissura labiorum (oris), 419 (pudendi) anterior, 514 posterior, 514 Commissure of the lips, 4r9 of the vulva, anterior, 514 posterior, 514 *Cone, elastic, 459 and App., note ''" Coni vasculosi, 502, 503 and App., note '- Connective tissue, parametric, 513 and App., note "', 535 Conus elasticus (laryngi), 459 Cooper, Astley, fascia propria of, App., note "' Cord, genital, 521 and App., note °° spermatic, 501, 502, 523 umbilical, 518, 519, 521, 522 vocal, false, 461 inferior, 459, 4*61 superior, 461 true, 459, 461 Corium, see " Tissue, areolar " Cornicula laryngis, 458 Cornu inferius cartilaginis thyreoideae, 458 superius cartilaginis thyreoideae, 458 of the thyroid cartilage, great, 458 inferior, 458 small, 458 superior, 458 Corona dentis, 426-430 glandis, 506-508 Corpus adiposum buccs, 414 albicans, 512 and note cavernosum penis, 500, 504, 506-508 urethrje, 500, 506-50S, 527 clitoridis, 515 epididvmidis, 502, 503 glandulare prostatas, 505 Highmori, 503 lingua, 414, 419 luteum, 512, 51S mammae, 517 Morgagni, App., note "" ; see also " Hydatid of Mor- gagni " pancreatis, 441, 480 penis, 507, 526, 534 spongiosum urethrae, 500, 506-508, 527 f muliebris, 535 and App., note uteri, 510, 511, 513, 518, 5:15, 537 ventriculi, 438, 480, 482, 484 vesicae felteae, 449 (urinaria), 496, 497, 535, 536 vesiculae seminalis, 504 Wnlffi, 468, 520, 52: INDEX 54» Corpuscles, Maipighian, of the kidney, 493 of the spleen, 450 of the \Volffian body, 5J0 i^orpuscula renis (Malpighii), 493 ' Ttex of the kidney, 491-493 of the suprarenal capsule, 492 Cotyledons of the placenta, 519 Cowper's glands, 500, 504, 50b Crena ani, 514, 52S, 53S clunium, 514, 528, 53S *Crest of the urethra (female), 498 and App., note " (male), 498 and App., note ", 505, i;o6 Crista arcuata cartilaginis arytaenoidea;, 45S and App., note "' urethralis (muliebris), 498 (virilis), 498, 506 Crown of tooth, 426-430 Crura of the diaphragm, 470, note Crus clitoridis, 515 penis, 504, 506, 507, 534 Crusta petrosa, 426 i Crypt of a lingual lymphoid follicle, 423 Crypts of Lieberkiihn, 407, 442, 443 tonsillar, 418 Cul-de-sac of the stomach, great, 43S, 477, 4S3, 484, 4S6 small, 438 Cumulus oophorus, 512 Cupula pleurae, 467, 470, 476-479, 483, 485, 487, 488 Curvatura ventriculi major, 438, 450, 476, 478, 486 minor, 438, 439 Curvature of the stomach, great, 43S, 450, 476, 478, 4S6 small, 43S, 439 *Curve of the rectum, perineal, 534 and note, 535, 5 58 sacral, 534 and note, 535, 5J8 *Curves of the rectum, 534, note Cushion of the epiglottis, 461 of the Eustachian tube, 434, 436 Cusps of the crowns of the teeth, 427-429 Cuticula, 404 Cuticular layer, 404 D. Dartos tunic, 501 Uecidua reflexa, 518 serotina, 518, 519 vera, 518 Dens serotinus, 429, 430 Dental pulp, 426 Dentes, 426-431 canini, 426-431 decidui, 427, 428, 431 incisivi, 426-431 + inferiores, 427 molares, 427-43? permanentes, 427-431 praemolares, 427, 429-431 + superiores, 427 Dentine, 426, 427 Dentition, 428, 429, 431 Descensus testis, 522, 523 Descent of the testicle, 522, 523 Diaphragm, 470. 479, 482-487, 494, S2t, 522 of the mouth, 414 pelvic, 513 and App., note *', 528, ijag, 533, 534 urogenital, V29, 531 and App., note ", 532-535 Diaphragma, 470, 479, 482-487, 494, 521, 52.-> oris, 414 pelvis, 5n, 528, 529, 533, 534 urogenitale, 529, 531-535 Digestive organs, 409-456 abdominal and pelvic portions, 437-456 cephalic and cervical portions, 409-436 Discus proligerus, 512 Diverticula ampullae (ductus deferentis), 504 ■fDiverticulum duodenale [Vateri], 440, 442 of Vater. 440 and App., note *, 442 Dorsum lingux, 411, 416, 417, 419 nasi, 412 of the nose, 412 of the tongue, 411, 416, 417, 419 Dntigla*, fold of, 510 and note, 511, 534, 537 Douglas, pouch of, 510, note, 511, 513, 535, 537 Duct or ducts : Bartholin's, App., note ' of Bellini, 492, 493 bile-, common, 440-442, 446, 449, 468 of Cowper's gland, excretory, 504, 506, 534 cystic, 446, 449 ejaculatory, 498, 500, 504-^06 excretory, 405, 40b galactophorous, 517 of Gartner, 512, 520, 521 hepatic, 446, 449 lingual, 420 and App., note ' mamillary, 517 mesonephric, 46S, 520, 521 Miillerian, 520, 521 pancreatic, 440-442 accessory, 440-442 paraurethral, 514 and App., note ", 516 parotid, 413, 416, 424, 425 pronephric, 520, 521 prostatic, 498, 505 Kivini's, App., note ' of Rivinus, App., note ' Santorini's, 440-442 seminal, 498, 500, 504-506 of seminal vesicle, excretor}', 504, 505 Stensen's, 413, 416, 424, 425 sublingual, greater, 424 and App., note ' lesser, 424 and App., note ' submaxillary, 414, 424, 425 of testicle, efferent, 502, 503 thyroglossal, App., note ' umbilical, 468 vitelline, 468 Walther's, App., note ' Wharton's, 414, 424, 425 Wirsung's, 440-442 Wolffian, 46S, 520, 521 Ductuli alveolares, 465 efferentes testis, 502, 503 epoophori transversi, 512 Ductulus aberrans (inferior), 502, 503, 520 (superior), "502, 503 Ductus choledochus, 440-442, 446, 449, 468 communis choledochus, 440-442, 446, 449, 46S cysticus, 446, 449 deferens, 494, 496, 500-504, 520, 522, 523, 533, 536 ejarulatorius, 408, 500, 504-506 epididymidis, 502, 503 epoophori longitudinalis [Gartneri], 512, 520, 521 excretorius, 405 glandulae bulbo-urethralis, 504, 506, 534 vesiculce seminalis, 504, 505 hepaticus, 446, 449 incisivus, 416 lactiferi, 517 lingualis, 420 Muelleri, 520, 521 nasopharyngeus, .Xpp., note * t omphalo-entericus, 46S pancreaticus accessorius [Santorini], 441, 442 fWursungi], 440-442 t papillares (renis), 403 paraurethrales, 514, 516 parotideus fStenonis], 413, 416, 424, 425 prostatici, 49S, 505 sublinguales minores, 524 sublingualis major, 524 submaxiParis [Whartoni], 414, 424, 425 venosus [Arantiij, 452, 521 Wolffii, 468, 520, 521' Duodenum, 438 and App., note ', 439-442, 451, 453, 456, 468, 47S. 479. 4S7 . , = J ascending portion (pars ascendens), 438 and App., note ', 440, 454 descending portion (pars descendens), 438 an4,S8, 513, 530, 533-538 pars analis, 445, 538 tenup, 442. 521 Isthmus of the Fallopian tube, 500, 511-513, 537 of the fauces, 411, 417, 434, 435 faucium, 411, 417, 434, 435 glandula" thyreoidea, 411, 466 prostatae, 504, 505 of the thyroid body, 411, 466 tubae uterinae, 500, 511-513, 537 uteri, 511, note J. Jejunum, 442, 454, 473-475. 4^1 Jugular venous arch, 410 and note, K. Kerkring, valves of, 440, 442 Kidney, 408, 479-481, 4S3-485, 487, 4S8, 490-495. $21 medulla of, blood-supply, App., note " Labia oris (inferius, superius), 4r2-4ig Labium anterius cervicis uteri, 511, 516 inferius valvulae coli, 444 majus pudendi, 510, 514 516, 520, 524, 529 minus pudendi, 510, 514-516, 524, 529 posterius cerVicis uteri, 511, 516 superius valvulae coli, 444 vocale, 461 Labyrinth of cortex of kidney, 493 Lacuna! urethrales [MorgagniiJ, 506 Lamina vel laminae : cartilaginis cricoideae, 458 thyreoidea; (dextra, sinistra), 458 mediastinales, 410, 476, 479, 483, 4S6, 4S7, 494 membranacea tuba; auditiva;, 433, 436 mesenterii propria, 452 muscularis mucosae, 406, 407 t omenti, vide " Omentum majus " propria mucosas, 404-407, 422, 423 Lamina of the cricoid cartilage, 458 Laryngeal prominence, 411 Laryn.K, 458-461, 463 Layer, circular, of muscular coat, 407, 452 of the rectum, 445 of the stomach, 439 cuticular, 404 longitudinal, of muscular coat, 407, 452 of the rectum, 445 of the stomach, 439 Layers of the mediastinum, 410, 476, 479, 4S3, 486, 487, 494 Lesser pancreas, 441, note Levator ani muscle, tendinous arch of, 530, 532, and App., note " Lieberkiihn's follicles, 407, 442, 443 Lien, 450-453, 477, 479, 480, 482-4S4, 4S6, 487, 495, 522 accessorius, 450 Lieutaud's trigonum vesicas, 498 Ligament or ligaments : * annular, of the trachea, 459-462 anococcygeal, 527 and note, 528, 529 of the bladder, false, lateral, 535-537 posterior, 536 superior, 472, 494, note, 536, note, 537, note suspensory, 472, 494, note, 536, note, 537, note true, anterior, 497 and App., note ". 533 lateral, App., note "' broad, of the liver, 446, 447, 472, 476, 4S0, 495 of the lung, 464 of the uterus, 510-513, 535, 537 ceratocricoid, anterior, 460 lateral, 459 posterior, 459 of the clitoris, suspensory, 515 corniculopharyngeal, 459 and App., note " coronary, of the liver, 446 ^^ costocolic, 474 and note, 477 and App., note , 479. 483 . crico-arytenoid, posterior, 459 * cricopharyngeal, 435, 459 and App., note " cricothyroid, 459, 460, 462, 466 cricotracheal, 459, 462 diaphragmatic, of the Wolffian body, 521 and App., note '^ * of the ductus venosus, 446 and App., note "* * of the epididymis, inferior, 502 and App., note '" superior, 502, and App., note " falciform, of the liver, 446, 447, 47-. 47^. 480, 495 gastrocolic, 476 and App., note '° gastrosplenic, 450, 477, 479, 4S0, 495 of Helvetius, 43S and App., note '', 439 * hepatoduodenal, 477 and App., note '-, 478-480 hepatorenal, 478, 480 hyo-cpiglottic, 420 and App., note % 459 infundibulopelvic, 455, 510, 511, 535, 537 inguinal, of the Wolffian body, 521 and App.. lateral, of the liver, left. 446, 447, 477 [note " right, 446, 447, 47S of the liver, broad, 446, 447, 472, 476, 480, 495 coronary, 446 falciform, 446, 447, 472. 476, 480, 495 lateral, left, 446, 447, 477 right, 446, 447. 478 round, 446, 453, 472, 476, 4S0 suspensory, 4415, 447, 472, 476, 4S0, 495 oblique, of the thyroid cartilage, App., note "' ovariopelvic, 455, 510, 511, 535, 537 of the ovary, 510-513, 518, 537 550 INDEX Ligament or ligaments : of the ovary (suspensory), 455, 510, 511, 535, 537 - of the pelvis, transverse, 531 and App., note '°°, 532 peritoneal, App., note " pharyngo-epiglottic, 4r5, note phrenocolic, 474 and note,' 477 and App., note ", 479. 483 pterygomandibular, 417, 433 pterygomaxillary, 417, 433 puboprostatic, 497 and App., note '"', 533 recto-uterine, 510, note, 537, note rectovaginal, 510, note round, of the liver, 44G, 453, 472, 476, 4S0 of the uterus, 455, 511, 513, 535, and App., note " , 537 suspensory, of the bladder, 472, 494, note, 536, note, 537, note of the clitoris, 515 of the liver, 446, 447, 472, 476, 480, 495 of the ovary, 455, 510, 511, 535, 537 thyro-arytenoid, inferior, 459 and App., note "° superior, 459 thyro-epiglottic, 459 thyrohyoid, lateral, 459, 460 middle, 420, 459, 460 of the thyroid body, lateral, 466 cartilage, oblique, App., note "' of the tip of the coccyx, 528 and note transverse, of the pelvis, 531 and App., note '°°, 532 triangular, of the urethra, deep layer, 529, and App., notes '^ and " superficial layer, 529, 532 and App., note " umbilical, lateral, 533 median, 496, 497, 520, 533 urachal, 496, 497, 520, 533 of the urethra, triangular, inferior or superficial layer, 529 and note, 531, note, App., notes '"'"'°' superior or deep layer, 529, note, 532, App., notes '■% uterosacral, 510 and note, 511, c;35, 537 of the uterus, broad, 510-513, 535, 537 round, 455, ;i,, 513, 535, 537 development of, App., note " of the vena cava, 446, 447 ventricular, 459 of the Wolffian body, 521 and App., note " Ligamentum vel ligamenta : anococcygeum, 527-529 annularia (trachealia), 459-462 t apicis coccygis, 528 ceratocricoideum anterius, 460 laterale, 459 posterius, 459 corniculopharyngeum, 459 coronarium (hepatis), 446 crico-arytsenoidpum posterius, 459 cricopharyngeum, 43L;, 459 cricothyreoideum (medium), 459, 460, 462, 466 cricotracheale, 459, 462 epididymidis inferius, 502 superius, 502 falciforme (hepatis), 446, 447, 472, 476. 4S0, 495 gastrocohcum, 476 - - -r > -,jo gastrolienale, 450, 477, 479, 4S0, 495 hepatocolicum, 477 hepatoduodenale, 477-4S0 hepatogastricum, 477, 47S, 480 hepatorenale, 478, 480 hvo-epiglotticum, 420. 459 hyothyreoideum laterale, 459, 460 , , , medium, 420, 459, 460 latum pulmonis, 464 uteri, 510-513, 535, 537 ovarii propnum, 510-513, 518, 537 Ligamentum vel ligamenta : phrenicocolicum, 474, 477, 479, 483 puboprostaticum (pubovesicale), laterale, 533 medium, 497, pulmonale, 464 pylori, 438, 439 suspensorium clitoridis, 515 glandute thyreoideas, 466 ovarii, 455, 510, 51 r, 535, 537 teres hepatis, 446, 453, 472, 476, 480 uteri, 455, 511, 513, 535, 537 thyreo-epiglotticura, 459 transversum pelvis, 531, 532 triangulare dextrum (hepatis), 446, 447, 478 sinistrum (hepatis), 446, 447, 477 umbilicale laterale, 533 medium, 496, 497, 520, 533 t venae cavas, 446, 447 venosum [Arantii], 446 ventriculare, 459 vocale, 459 Line, axillary, 4SS and App., note ■" mamillary, 486 and App., note ", 488 median, anterior, 4S6 posterior, 4S7 oblique, of the thyroid cartilage, 458 and App., note ■" parasternal, 4S6 and App., note "' scapular, 4S7 and note sternal, 486 and App., note ■'° white, of the pelvic fascia, 497 and App., note ^° Linea axillaris, 488 mamillaris, 486, 488 mediana anterior, 486 posterior, 487 obliqua (cartilaginis thyreoides), 458 parasternalis, 4S6 scapularis, 487 sternalis, 486 Lingua, 419-425 Lip of the cervix uteri, anterior, 511, 516 posterior, 511, 516 * of the glottis, 461 and App., note '^ of the ileocaecal valve, lower, 444 and note upper, 444 and note lower, 412-415, 419 marginal, of the cloacal orifice, 520 and App., note ", 524 upper, 412-414, 4t6, 417, 419 Lips, commissure of the, 419 Liver, 446-449, 456, 472, 476-478, 480, 482-4S6, 488, 495, 521, 522 accessory, App., note '* Lobe or lobes : of the breast, 517 of the bulb of the urethra, lateral, 507 of the epididymis, App., note '" of the external ear, 424 Home's (of the prostate), App., note " of the liver, App., note ^ caudate, 447, 47S and App., note '* left, 446, 447, 472, 476, 477, 480, 482, 484, 486, 495, 521 and App., note " quadrate, 447, 478 and App., note " right. 446, 447, 472, 476, 477, 480, 482, 4S3, 485, 486, 495. 522 and App., note " Spigelian, 446, 447, 452, 477 and App. , note " of the lung (inferior, middle, and superior), 464, 471, 483, 485, 487, 488 of the placenta, 519 of the prostate gland, lateral, 505 middle, 504. and App., note'', 550 of the thymus gland (right and left), 467 of the thyroid body (right, left, and middle), 466, 467 of the upper lip, median, 4r2, 419 Lobule or lobules : of the breast, 517 of the external ear, 424 glandular, 405 accessory, 405, 406 of the kidney, 492 of the liver, 448 of the lung, 464, 476 INDEX b"51 I obule or lobules ; of the testicle, 503 of the thyroid body, 466 Lobuli corticales (renis), 493 pars convoluta, 493 radiata, 493 epididymidis, 502, :;o3 glandulae thjreoidea', 466 hepatis, 44S mamma?, 517 ■ pulmonis, 464, 476 testis. 503 Lobulus glandulee, 405 Lobus vei lobi : caudatus [Spigeli], 446, 44J, 452, 477 (glandula"), 405 glandula* thyreoideae (dexter, sinister), 466 hepatis (dexter, sinister), 446, 447, 472, 476, 477, 4S0, 482-4S6, 495, 521, 522 mammae, ^17 placentae, 519 prostata? (dexter, medius, sinister), 505 puimonum (inferior, medius, superior), 464, 471, 4S3, 4S5, 4S7, 4SS pyramidalis (glandulae thyreoideae), 466, 467 quadratus (hepatis), 447, 478 renales, 492 thymi (dexter, sinister), 467 Loculi of the placenta, 519 Loop, Henle's, 493 and App., note ^' umbilical, of intestine, 451 and note, 521 Lungs, 463-465, 467, 471, 476-479, 482-4S8, 494 Luschka, cartilage of, 461 and App., note *' Luschka's tonsil, 411 and note, 434-436 Lymphatic glands, see " Glands, lymphatic " Lymphoglandulae bronchiales, 411, 471, 484 mediastinales (anteriores), 482, 484 pulmonales, 464 Lymphoid faucial ring, 411, note M. Macula flava (plicas vocalis), 461 and App., note " Mala. 412 Malpighi, pyramids of, 491, 492 Malpighian corpuscles of the kidney, 493 of the spleen, 4c;o of the Wolffian body, 520 Mamilta, 471, 4S6, 488, 517 Mamma, 471, 517 accessoria, 517 Margin of the nostril, 412 Margo anterior hepatis, 446, 462, 486 lienis, 450 pancreatis, 441 pulmonis, 464, 486 testis, 502, =;",3 inferior pulmonis, 464, 483, 485488 lateralis lingua;, 419-421 renis, 490, 491 uteri, 512 liber (ovarii), 51 1, 537 medialis glandulae suprarenalis, 492 renis, 490, 491 mesovaricus, 511 nasi, 412 posterior lienis, 450 pancreatis, 441 testis. 502 superior glandulae suprarenalis, 492 pancreatis, 441 Meatus, external auditory, cartilage of, 436 nasal, nasopharyngeal part. App., note* nasopharyngeal, 436 and App., note * naso()haryngeus, 456 Mediastinum, see also " Cavity, mediastinal," footnote to p. 410 and App., note " anterior, 410, note, 456, 471, 476 and App., note " middle, 410, note, 478, 482 and App., note " Mediastinum, posterior, 410 and note, 456, 470, 471', 478, 483 and App., note "'* superior, 410, note, 470, 476, 478, 479, 482, 483 and App., note "' testis, 503 Medulla of the kidney, 491, 493 blood-supply, App., note " of the suprarenal capsule, 492 Medullary rays of the cortex of the kidney, 493 Membranae deciduas (basalis, capsularis, vera), 51S, 519 Membrana granulosa, 512 hyothyreoidea, 433, 459, 460, 462 t propria (glandula-), 405 Membrane, basement, 404, 405 cricothyroid, 459 and App., note '"', 460, 462, 466 cricotracheal, 45c), 462 elastic, of the larynx, 459 and App., note " of the trachea, App., note ■"' mucous, 404, 406, 407 pericemental, 426, note peri-odontal, 426, note thyrohyoid, 433, 459, 460, 462 Mentum, 412 Mercier's bar, 498 and App., note " Mesenteriolum processus vermiformis, 455, 475 Mesenterium, 408, 451-456, 474, 475, 481, 512, 521, 536 commune, 451 ; var., 453 primitivum, 468 Mesentery, 408, 451, 452, 453 and note, 454-456, 474, 475, 4S1, 512, 521, 536 common, 451 ; var., 453 primitive, 468 Meso-appendix, 455, 475 Mesocolon, 443, 451, 474, 475 ascending (ascendens), 451, 453, 475 and App., note '*, 522, 536 descending (descendens), 451, 453 and note, 454, 4.S5. 474, 479. 481, 536 sigmoid (sigmoideum), 453, 455, 474, 534-537 transverse (transversum), 451, 454, 456, 474, 475, 477-479. 4S1 tMesoduodenum, 451, 453 Mesogastrium, 451, 452, 456, 468, 479 Mesometrium, 512 and App., note '", 513, 535, 537 Mesonephros, 468, 520, 521 Mesorchium, 522 Mesorectum, 455, 536, 537 Mesosalpinx, 510, 511, 512 and App., note "-, 513, 537 Me.sovarium, 511, 512 and App., note ", 537 Mid-kidney, 468, 520, 521 Milk-teeth, 427, 428, 431 Mitral orifice, 471 Mons pubis, 514, 516 veneris, 514, 516 Montgomery's glands, 517 Morgagni, body of, 502, note frasnum of, 444, note hydatid of, 500, 502 and App., note ", 512, 520, 521 Morsus diaboli, App., note "'° Mouth, 414-423 cavity of, 411, 414-423 Mucous glands of the biliary ducts, 448 and note Miillerian duct, 520, 521 Muscle or mu.scles : * arymcmbranaceus, 460 aryteno-epiglottideus, 460 arytenoideus (proprius), 460, 461 arytenovocalis, 460 and note, 461 azygos pharyngis. 4??, note uvuKt, 418 and note, 435 Bell's, App., note *' broncho-ccsophageus, 470 and App., note '* buccinator, 4IJ-4'.';. 4i7- 4^4. 4.?3 buccopharyngeus, 433 and note bulbocavernosus, 527-529, 532 cerattxricoid, 460 ccratopharyngeus, 433 and note chondroglossus, 420 chrondropharyngeus, 420, 433 and note circumfiexus palati, 410, 417, 418, 433, 435, 436 696 552 INDEX Muscle or muscles : coccygeus, 528-530, 5,38 compressor urethras, 527 and note, 528, 531, 532 and App., notes "', "', and "* constrictor isthmi faucium, 417 and note of the pharynx, inferior, 432, 433 and note middle, 432, 433 and note superior, 415, 417, 418, 432, 433 and note, 435. 436 urethras, 527 and note, 52S, 531, 532 and . App., notes °', "", and '"* cremaster, 501, 523 internus, 501 crico-arytenoid, lateral, 460 posterior, 460 cricopharyngeus, 433 and note cricothyroid, 433 and note, 460 ejaculator urins, 527, 532 erector clitoridis, 529 penis, 527, 528, 532, 533 genioglossus, 414, 420, 421, 425 geniohyoglossus, 414, 420, 421, 425 glossopharyngeus, 433 and note Guthrie's, App., note '"' hyoglossus, 410, 420, 421, 425, 433 ischiocavernosus, 527-529, 532, 533 ischiococcygeus, 529, note levator ani, 445, 497, 513, 519, 527-530, 532, 535, 538 parts of, 529, note coccygis, 528.530, 538 corporis thyroideas, 466 palati, 410, 417, 418, 433, 435, 436 lingual, superficial, 420-422 lingualis, inferior, 420, 421 superior, 420-422 longitudinal, of the tongue, inferior, 420, 421 superior, 420-422 mastopharyngeus, 432, note motor uvulas, 418 and note, 435 mylopharyngeus, 433 and note obturatococcygeus, 529, note obturator internus, 497, 529, 530, 532, 533, 538 occipitopharyngeus, 432, note orbicularis oris, 413 palatoglossus, 417 and note palatopharyngeus, 417 and note, 418, 435 of the perineum, 526-53r and App., notes ", '"', "■' petropharyngeus, 432 and note externus, 432, note of the pharynx, 410, 415, 417, 41S, 432 and note, 433 and note- 435, 436, 440 subdivisions of the constrictors, 533, note supernumerary elevators, 432, note pleuro-oesophageus, 470 and App., note " portio aryvocalis musculi thyro-arytenoidei, 461, note pterygopharyngeus, 433 and note pubococcygeus, 529, note pubovesical, 497 and App., note °° rectococcygeus, 530 and App., note " retractor uteri, 535 and note salpingopharyngeus, 435 and note sphenopharyngeus, 432, note sphincter of the anus, external or superficial, 445, . 497. 526-530, 534, 535, 538 internal, deep or circular, 445. 538 and note third, 445 of the bladder, 498 and App., note ", 506 of the membranous urethra, 532 and App., note "'' pylori, 43S, 439 vaginae, 529 styloglossus, 410, 415, 417, 421, 425, 432, 433 stylopharyngeus, 410, 415, 432, 433, 435, 436, 440 suspensory, of the duodenum, 494 tensor palati, 410, 417, 418, 433, 435, 436 Muscle or muscles : thyro-aryteuoid (external), 460, 461 portio aryvocalis (Ludwig), 460, note superior, 460 thyro-epiglottideus, 460 thyropharyngeus, 433 and note of the tongue, longitudinal, inferior, 420, 421 superior, 420-422 superficial, 420-422 transverse, 420, 421 vertical, 421, 422 transverse, of the tongue, 420, 421 transversaJis linguae, 420, 421 transversus perinei profundus, 527 and note, 528, 531, 532 and App., notes "', '"', and "' (superficialis), 527 and note, 529. 532 Wilson's, App., note '"' Muscular coat of the bladder, see " Coat, muscular " Muscularis mucosae, 406, 407 Musculi perinei, 526-531 and App., notes '", "", and '"' Musculus aryepiglotticus, 460 t arymembranaceus, 460 aryta»noideus obliquus, 460, 461 transversus, 460, 461 broncho-oesophageus, 470 buccinator, 413-415. 4i7. 424. 433 buccopharyngeus, 433 bulbocavernosus, 527-529, 532 ceratocricoideus, 460 ceratopharyngeus, 433 chondroglossus, 420 chondropharyngeus, 420, 433 coccygeus, 528-530, 538 constrictor pharyngis inferior, 432, 433 medius, 432, 433 superior, 415, 417, 41S, 432, 433. 435. 436 cremaster, 501, 523 internus, 501 crico-arytasnoideus lateralis, 460 posterior, 460 cricopharyngeus, 433 cricothyreoideus, 433, 460 genioglossus, 414, 420, 421, 425 glossopalatinus, 417 glossopharyngeus, 433 hyoglossus, 410, 420, 421, 425, 433 ischiocavernosus, 527.529, 532, 533 levator ani, 445, 497, 513, 519, 527-530, 532, 535, 538 glandulas thyreoides, 466 veli palatini, 410, 417, 418, 433, 435, 436 longitudinalis inferior (lingua), 420, 421 superior (linguae), 420-422 mylopharyngeus, 433 obturator internus, 529, 530, 532, 533, 53S orbicularis oris, 413 pharyngopalatinus, 417, 41S, 435 pleuro-oesophageus, 470 prostaticus, 505 and note pterygopharyngeus, 433 pubovesicalis, 497 rectococcygeus, 530 recto-uterinus, 535 salpingopharyngeus, 435 sphincter ani externus, 445, 497, 526-530, 534, 535, internus, 445, 53S f tertius, 445 pylori, 43S, 439 urethra membranaceae, 532 styloglossus, 410, 415, 417, 421, 425, 432, 433 stylopharyngeus, 410, 415, 432, 433, 435, 436, 440 suspensorius duodeni, 494 tensor veli palatini, 410, 417, 418, 433, 435, 436 thyreo-arytsnoideus (externus), 460, 461 + superior, 460 thyreo-epiglotticus, 460 thyreopharyngeus, 433, 466 INDEX 55Za Musculus, transversus linguae, 420, 421 periuei profundis, 527, 528, 5J1, 55^ superficialis, 527, 529, 532 uvulae, 418, 4j^ verticalis (linguae), 421, 422 vocalis, 460, 461 N. Xares, anterior, 412 posterior, 434, 435 Nasopalatine canal, see " Canal " Nasopharynx, 411, 434, 436 lateral wall, anatomy of, App., note * Navel, the, see " Umbilicus " Neck of the bladder, 496 and App., note " of the gall-bladder, 449 of the glans penis, 508 of the pancreas, 441 of tooth, 426, 430 of the uterus, 510-513, 518 divisions of, 511 and App., note '* Nerve, dental, inferior, 410, 425 dorsal, of the clitoris, 531 of the penis, 531 hypoglossal, 421, 425 inferior dental, 410, 425 laryngeal, inferior, 470 recurrent, 470, note superior, fold of, 434 and note, 461 lingual, 410, 414, 421, 424, 425 obturator, 533 pneumogastric, 470 vagus, 470 Nerves, suprarenal, 492 Nervus alveolaris inferior, 410, 425 dorsalis clitoridis, 531 penis, 531 hypoglossus, 421, 425 laryngeus inferior, 470 lingualis, 410, 414, 421, 424, 425 obturatorius, 533 vagus, 470 Nipple, 471, 4S6, 488, c;i7 Noduli lymphatici aggregati [Peyeri], 442 lienales [Malpighii], 450 solitarii, 407, 440, 442, 443, 445 Nose, base of, 412 bridge of, 412, note root of, 412 septum of, 414 cartilaginous, 411 tip of, 412 Nostrils, 412 Notch, cardiac, of the lung, 464 great median, of the thyroid cartilage, 458, note interarytenoid, 461 of the pancreas, 441 thyroid, 458 umbilical, of the liver, 446, 447 Xotochord, 46S Nuhn's gland, 420 and note, 421 Nymphae, 510, 514-516, 524, 529 CEsophagus, 40S, 411, 433, 434, 456, 461, 470, 471, 47S, 479, 487 pars abdominalis, 43S, 479, 494 cervicalis, 411, 470 thoracalis, 411, 470, 478, 479 Omenta, App., note " Omental sac, see " Sac, omental " tuberosity of the liver, 446, 447, 478 of the oancreas, 47S. 479 Omentum, cavity of, see " Sac, omental " gastrocolic, see "Omentum, great" gastrohepatic, see "Omentum, small" ga.strosplenic, 450, 477, 479, 480, 495 great, 456, 472-477. 481 Omentum, great, anterior layer, 456, 472, 486-488 free portion, 472-477 posterior layer, 456, 473-477 hepatocolic, 477 and App., note '" hepatoduodenal, 477 and App., note ■"", 478-4S0 lesser, see '" Omentum, small " majus, 456, 472-477, 481 t lamina anterior, 456, 472, 486-488 t posterior, 456, 473-477 t pars libera, 472-477 minus, 452, 456, 477, 480, 495, 522 t pars condensa, 477 )■ flaccida, 477 sac of, see " Sac, omental " small, 452, 456, 477 and App., note ^-, 480, 495, 522 thick portion, 477 and App., note '- thin portion, 477 and App., note " Opening, mesoniental, 479 and App., note " Organ of Cliraldes, 500, 502, 503, 520 of Rosenmiiller, 500, 512, 513, 520, 521 l.)rgana genitalia muliebria, 509-524 viriiia, 499-508 uropoetica, 489-498 (Jrgans, digestive, 409-456 genito-urinary, 489-524 reproductive, female, 509-524 male, 499-508 respiratory, 457-467 urinary, 4S9-49S urogenital, 489-524 Orifice, cloacal, 520 and App., note ", 524 Eustachian, cushion of, 434, 436 of the Eustachian tube, pharyngeal, 411, 436 of the Fallopian tube, abdominal, 500, 511, 512 uterine, 500, 512 mitral, 471 of the pulp-canal, 426, 427 tricuspid, 471 of the ureter (vesical), 498 of the urethra, external, in the female, 498, 510, 514-516, 529, 531 in the male, 506-508, .524 internal, 496, 498, 511, 533 vaginal, 514, 515, 529, 531 of the vermiform appendix, 444 Orifices of the uriniferous tubules, 492 and App., note "" Orificium externum uteri, 500, 511, 512, 516, 518 internum uteri, 511, 512, 518 ureteris, 49S urethrs externum (niuliebris), 498, 510, 514-516, 5^9. 531 „ (virihs), 506-508, 524 internum, 496, 498, 511, 533 vaginae, 514. 5'S> 5^9. 53' Os tincae, App., note " Os uteri, App., note " externum, 500 and App., note ", 511, 512, 516, 518 internum, 511 and note, 512, 518 Ostium abdominale iuh^ uterine, 500, 511, 512 pharyngeum, tubae auditivae, 411, 436 uteri, 511 and note uterinum tuba- uterinae, 500, 512 venosum dextrum, 471 sinistrum, 471 Ovarium, 41,3, 500, 510-512, 518, 520, 535, 537 Ovary, 453, 500, 510-512, 518, 520, 535, 537 position of, App.. note " Oviduct, see " Tube, Fallopian " Ovulum, 512 Ovum, 512 Pad, incisive, 416 and note, 417 sucking, 414, note Palate, hard, 410, 411, 4'4. 4'''. 4>9. 425- 43° soft, 411, 416, 434 4.'?6 Palatum durum, 410, 411, 414, 416, 419, 425, 436 molle, 416 696- 5526 INDEX Pancreas, 441, 451, 452, 456, 46S, 478-480, 4S4, 495 accessorium, 441 lesser, 441, note rudiment of, 468 Winslowi, 441 of Winslow, 441 and note Papilla or papillas : circumvallate, 416, 419, 421, 423 conicae (lingua;), 419, 422 conical (of tongue), 419, 422 duodenal, 440 duodeni (Santorini), 440 filiform, 419, 422 filiformes, 419, 422 foliate, 419 foliatas, 419 fungiform, 419, 422 fungiformes, 419, 422 incisiva, 416, 417 lenticular, 419, 423 lenticulares, 419, 423 mammae, 471, 486, 4S8, 517 of mucous membrane, 404 palatine, 416 and note, 417 renal, 491-493 renales, 491-403 submaxillary, 419, 424 vallatae, 416, 419, 421, 423 Paradidymis, 500, 502, 503, 520 Parametric connective-tissue, 513 and App., note ", 535 *Parametrium, 513 and App., note ", S35 Paries membranaceus tracheae, 459, 461, 465 Paroophoron, 500, 520, 521 Parotid gland, retromandibular process of, 415, 425 Parovarium, 500, 512, 513, 520, 521 Part, nasopharyngeal, of nasal meatus, App., note * Partes genitales externae (muliebres), 514, 515 Passages, alveolar, 465 Patches, Peyer's, 442 Pavilion of the Fallopian tube, 500, and see also " Infundi- bulum of the Fallopian tube" and " Orifice, abdominal, of the Fallopian tube " Pectiniform septum of the penis, 506, 508 Pelvic fascia, tendinous arch of, 497 and App., note °', .532. 533 white line of, 497 and App., note '" , 532, 533 Pelvis of the kidney, 490-492 renalis, 490-492 Penis, 501, 506-508, 520, 522-524, 534 Pericardium, 410, 411, 456, 470, 471, 477, 482, 4S4, 528 Periglottis, 420 and App., note ', also App., note " Perimetrium, 535 and note Perineal region, 526 Perineum, 510, 514, 524, 534 obstetrical, 510, 514 Periosteum, alveolar, 426 and note dental, 426 and note Peritonjeum. see " Peritoneum " Peritoneal folds, ligaments and omenta, App., note " fossK and pouches, App., note ^' Peritoneum, 451-456, 500 parietal, 408, 452-456, 472, 473, 478-481, 485-48=;, 494, 495, 513, 522. 523. S33-S3S" * primary, 408, 453, 456 * secondary, 408 visceral, 40S, 445, 456, 511, 533-535 Petiolus epiglottidis, 45S Peyer's patches, 442 Pharynx, 432-436 arched summit of, 411, 436 laryngeal part, 411, 434, 470 nasal part, 411, 434, 436 oral part, 411, 434 + paries dorsalis, 436 + lateralis, 436 pars laryngea, 411, 434, 470 nasalis, 411, 434, 436 oralis, 411, 434 wall, lateral, 436 posterior, 436 Philtrum, 412 PiUar of the fauces, anterior, 415-419, 421 posterior, 415-418, 434, 436 Pillars, see " Crura " of diaphragm, 470 and App., note ^' Pinna, 424 Placenta, 5:8, 519 foetal (fcetalis), 519 maternal, 519 uterine (uterina), 519 Placental sinuses, 519 Plate of the cricoid cartilage, 458 Pleura, 477, 482-484, 4S7, 488 cervical, 467 and note, 470, 476-479, 4S3, 485, 487, 4S8 costalis, 467, 470, 471, 477-479, 482-487 diaphragmatica, 476, 477, 479, 484, 485, 494 mediastinalis, 470, 471, 478, 482 parietalis, 479, 484 pericardiaca, 471, 476, 477, 494 pulmonalis, 464, 477, 478, 484 Plexus, capillary, of renal cortex, 493 medulla, 493 cesophageus (posterior nervi vagi), 470 pampiniformis, 501-503, 522, 523, 533 t (venosus) ovaricus, 512, 513 pudendalis, 532 and App., note "^, 533 uterovaginalis, 512, 513 venous, ovarian, 512, 513 pampiniform, 501-503, 512, 513, 522, 523, 533 prostatic, App., notes " and '"* spermatic, 501-503, 522, 523, 533 uterine, 512, 513 and App., notes " and '"'' uterovaginal, 512, 513 and App., notes " and "^ vaginal, 512, 513 and App., notes " and '"' vesical, App., note '"^ of venous radicles surrounding the orifices of the ducts of Bellini, 493 Plica vel plies : adiposas (pleurae), 476, 494 aryepiglottica, 461 csecalis, 455 circulares [Kerkringi], 440, 442 duodenojejunalis, 454, 474 duodenomesocolica, 454, 474 epigastrica, 536, 537 fimbriata, 419, 421 gastropancreatica, 479 glosso-epiglottica lateralis, 419, 461 mediana, 419 gubernatrix, 521 and App., note " ileocaecalis, 455 longitudinalis duodeni, 440 mucosae ventriculi, 43S nervi laryngei, 434, 461 palatinas transversas, 416, 417 palmatae, 512 t pharyngo-epiglottica, 415, 434, 435, 461 recto-uterina [Douglasi], 510, 511, 535, 537 + rectovesicalis, 536 salpingopalatina, 436 salpingopharyngea, 434, 436 semilunares coli, 443, 444 serosa, 455 sublingualis, 414, 419, 424 transversalis recti, 445, 538 triangularis, 416, 419 tubariffi (ampuUares), 512, 513 tunicae mucosa vesica felleae, 440 umbilicalis lateralis, 472, 494, 522, 536, 537 media, 472, 494, 536, 537 ureterica, 498 ventricularis (laryngis), 461 vesicalis transversa, 535-537 villosae of the pleura, 476, 494 vocalis, 459, 461 Ponticulus hepatis, 446 and App., note ", 447 Porta hepatis, 447 Portal vein, 446, 480 Portio aryvocalis musculi thyro-arytenoidei, 460, note INDEX 55'2c Portio supravaginalis (cervicis), 511, 516 vaginalis (cervicis), 510, 511, 516 Portion of the cervix uteri, infravaginal, App., note " intermediate, App., note ''^ supravaginal, 511 and App., note '', 516 vaginal, 510, 511 and App., note '', 516 Post-nasal space, 411, 434. 436 Post-trigonal pnuch, 498 and App., note " Pouch or pouches : of the colon, 443 of Douglas, 510, note, 511, 513, 535, 537 inguinal, external, 536 internal, 536 middle, 536, note supravesical, 536 laryngeal, 460, 461 omental, see " Sac, omental " peritoneal, 454, note; and see " Fossa, peritoneal " post-trigonal, App., note °' rectovaginal, 510, note, 511, 513, 535, 537 rectovesical, 456, 534 rectocascal, 455 splenic, 477 and App., note ", 483 uterovesical, 511, 535, 537 Pracputium clitoridis, 498, 514-516 penis, 508, 524 Prepuce of the clitoris, 498, 514-516 of the penis, 508, 524 Process, muscular, of the arytenoid cartilage, 45S and App., note -" retromandibular, of the parotid gland, 415, 425 uncinate, of the pancreas, 441 and note vaginal, of the peritoneum, 455, 522, 523 vocal, of the arytenoid cartilage, 458 and App., note ", 459 Processus caudatus (lobi Spigeli), 447, 478 Ferreini, 493 muscularis (cartilaginis arytaenoideae), 45S papillaris (lobi Spigeli), 447 retromandibularis (glandulae parotidis), 415, 425 uncinatus (pancreatis), 441 vaginalis peritonjei, 455, 522, 523 vermiformis, 444, 455, 474, 475, 537 vocalis (cartil. arytaenoicleae), 45S, 459 Prominence, laryngeal, 411 • levator, 436 and App., note ' Prominentia laryngea, 411 Prostata, 445, 497, 498, 500, 504-506, 532534 Prostate, the, 445, 497, 498, 500, 504-506, 532-534 Pseudarteriae rectae, 493 and App., note '' Pubes, 514 Pudendum muliebre, 514 Pulmo (dexter, sinister), 463-465, 467, 471, 476-479, 4S2 488, 494 Pulpa dentis, 426 lienis, 450 Pulp-canal, 426, 427 Pulpovity. 426, 427 Pulp, dental, 426 of the .spleen, 450 Pulvinar of the epiglottis, 461 Pyloric region, 439 Pylorus, 43S-441, 482, 486. 487 Pyramid of the thyroid body, 46*), 467 Pyramides renales. 491, 492 Pyramids of Ferrein, 493 of Malpighi (renal), 491, 493 R. Radix (radices) dentis, 426, 430 linguae, 411, 4"J. 434. 4.3.';. 47> mesenterii, 454, 474, 475, 522, 536 nasi, 412 penis, 507, 526 pulmonis, 4164, 465 Rami bronchiales (eparterialis, hyparteriales), 462, 465, 483, 484 pulmonum (tdorsales, fmedialis, +ven- trales), 462, 463 ductus hepatici, 44S lienales (arteria; lienalis), 440 Ramification, bronchial, 462, 463 Raphe of the palate, 416 of the penis, 524 of the perineum, 524 of the pharynx, 432 pterygomandibularis, 417, 433 scroti, 501, 524, 527 of the tongue, median, 419 Rays, medullary, of cortex of kidney, 493 Receptaculum chyli, 494 Recess, see " Fossa " and " Pouch" of the pharynx, lateral, 434, 436 mesial, 434 and note, 436 pyriform (pyriform sinus), 434 and note 461 Recesses, urethral, 506 Recessus duodenojejunalis, 454, 474 ileocaecalis inferior, 455 superior, 475 inferior omentalis, 476 intersigmoideus, 455, 522 lienalis (bursae omentalis), 479 paracolic!, 455 pharyngeus tKosenmuelleri], 434, 436 phrenicohepaticus, 454 piriformis, 434, 461 retrocaecales, 455 superior omentalis, 479 Rectum, 445, 456, 475, 486-4S8, 513, 530, 533-538 anal portion, 445, 538 Recurrent straight branches of arterial arches of kidney, App., note °° Regio perinealis, 526 pylorica, 439 trigoni vesicae, 496 Region, perineal, 526 pyloric, 439 Ren, 408, 479-481, 483-4S5, 4S7, 488, 490-495, 521 Reproductive organs, female, 509-524 male, 499-508 Respiratory organs. 457-467 Rete testis [Halleri], 503, 520 vasculosum testis, 503, 520 Reticular framework of the spleen, 450 Retinacula of the ileocaecal valve, 444, note Retzius, cavity of, 456, 534 Ridge of the palate, median longitudinal, 416 of the pyloric ring, 438 and App., note ' urethral, 514, 516 Ridges of the mucous membrane of the gall-bladder, 44Q Rima glottidis, 459, 461 pars intcrcartilaginea, 461 intermcinbrunacea, 461 oris, 411, 412 pudendi, 514 urrigenitalis, 514 vestibuli, 461 Ring, abdominal, deep, 533 external, 501 internal, i;33 superficial, 501 of the cricoid cartilage, 45S • haemorrhoidal, 445 and App., note '^ 538 lymphoid, faucial, 411, note • urethral, 498 and App., note °-, 506 Rivini, duct of, 424, ntAe Rivinus, duct of, App., note ' Root of the lung, 464, 465 of the mesentery, 454, 474, 475, 522, 536 of the nose, 412 of the penis, 507, 526 of the tongu;;,' 411, 419, 434. 435. 47' of tooth, 426, 430 552d INDEX Rosenmiiller, fossa of, 434, 436 organ of, 500, 512, 513, 520, 521 Rudiment of the caecum, 451 of the gall-bladder, 468 of the genital gland, 520 of the kidney, 520 of the lung, 468 of the pancreas, 46S of the reproductive gland, 520 of the scrotum, 520 of the spleen, 468 of the ureter, 468 (see Erratum, p. 552^) of the uterus, 520 of the vagina, 520 of the vaginal process of the peritoneum (canal of Nuck), 455 Rudimentum processus vaginalis, 455 Rugae of the bladder, 4gS of the duodenum, transverse, 440 of the hard palate, 416, 417 of the mucous membrane of the stomach, 438 of the small intestine, 440, 442 of the vagina, transverse, 516 vaginales, 516 Sac, omental, 452, 456, 468, 476-47S, 479 and App., note 4S0, 4S4, 495 divisions of, App., note ■** lesser, App., note '''' splenic fossa of, App., note "* superior fossa of, App., note " vestibule of, 452, 479, App., note ■", 495 yolk, 468, 518 Saccule, laryngeal, 460, 461 Saccules of the ampulla of the vas deferens, 504 of the colon, 443 Saccus lienalis, 477, 483 Sacs, dental, 431 Santorini, cartilages of, 458 duct of, 440-442 Scrotum, 500, 501, 520, 522-524, 526, 527, 534 Segment of the ileocascal valve, lower, 444 and note upper, 444 and note Seminal vesicle, 496, 497, 500, 504-506, 520, 532, 534 Septa of the testicle, 503 Septula testis, 503 Septum atriorum, 471 bulbi urethrte, 533 glandis, 508 of the glans penis, 508 interauricular, 471 interventricular, 471, 484 linguEe, 420, 421 mobile nasi, 411 ^ nasi, 414 cartilagineum, 411 of the nose, 414 cartilaginous, 411 pectiniforme, 506, 508 penis, 506, 508 scroti, 501, 523, 526 of the tongue, 420, 421 ventriculorum, 471, 484 Sinus or sinuses : costomediastinalis, 471 epididymidis, 502, 503 of the galactophorous ducts, 517 glosso-epiglottic, 419, 461 of the kidney, 491, 492 lactiferi, 517 of the larynx, 461 maxillaris (Highmori), 414 maxillary, 414 phrenicocostalis, 470, 479, 4S0, 482-488 placental, 519 pocularis, 498, 500, 504-506. 520 prostatic, 498, 500, 504-506, 520 pyriform, 434, 461 Sinus or sinuses : rectales, 445 of the rectum, 445 and App., note " renalis, 491, 492 sphenoidalis, 436 tonsillaris, 415, 418, 419 urogenitalis, 520, 524 of Valsalva, App., note '° Skene's glands, 514 and App., note '", 516 tubules, 514 and App., note ", 516 Socket of tooth, 426 Space, Burns's, 410, note mediastinal, see " Mediastinum," footnote to p. 410, and App., note "' pleural, supplemental, costomediastinal, 471 and App., note " mediastinodiaphragmatic, App., note ■"' phrenocostal, 470 and App., note ^^, 479, 480, 4S2-485 pericardiophrenic, App., note '° pericardiosternal, 471 and App., note '^ post-nasal, 411, 434, 436 preperitoneal, 456, 534 retroperitoneal, 408, 456, 480, 4S1, 494, 495, 534 Spatiuni interaponeuroticum suprasternale, 410, note t prasperitonsale [Retzii], 456, 534 retroperitona;ale, 40S, 456, 480, 481, 494, 495, 534 Spermatic cord, 501, 502, 523 Sphincter of the anus, external or superficial, 445, 497, 526- 530. 534, S35> 538 internal, deep, or circular, 445, 538 third, 445 of the pylorus, 438, 439 vesicas, 498 and App., note ^-, 506 vesica externus, App., note '" internus, App., note °', 506 Spiral of the cystic duct, 449 Splanchnologia, 401 ei seq. Splanchnology, 401 et seq. general considerations, 404-40S Spleen, 450-453' 477, 479> 480, 482-484, 486, 487, 495. 5^2 accessory, 450 descriptive anatomy of, App., note ' Stensen's canal, 416 and note duct, 413, 416, 424, 425 Stomach, 438, 439, 451, 452, 456, 476-478, 480, 482-484, 486, 487, 495' 514 body, 43S, 480, 482, 484 cardiac portion, 438 curvature, great, 438, 450, 476, 478, 4S6 small, 43S, 439 fundus, 438, 477, 483, 4S4, 4S6 great cul-de-sac, 438, 477, 483, 4S4, 486 pyloric antrum, 43S portion, 438-440, 477, 482 small cul-de-sac, 438 wall, anterior, 438, 472 posterior, 478, 4S3 tStratum circulare (tunicas muscularis), 407, 452 granulosum (foUiculi oophori), 512 longitudinale inferius linguae, 421, note superius lingua?, 421, note f tunica? muscularis, 407, 452 perpendiculare lingua?, 421, note submucous fibrous, of the tongue, 420-423 transversum lingua, 421, note Striated border, 404 Stroma ovarii, 512 Substance, glandular, of the prostate gland, 505 Substantia adamantina, 426, 427 corticalis glandulas suprarenalis, 492 renis, 491-493 eburnea, 426, 427 meduUaris glandulse suprarenalis, 492 renis, 491, 493 ossea (dentis), 426 INDEX 552< Sucking-pad, 414 and note Sulcus, alar, 412, note t aorticus (pulmonis), 464 t dorsalis penis. 507 medianus (linguae), 419 mentolabial. 412 nasal posterior, App., note * nasolabial, 412 oesophageal, 447, note subclavius (pulmonis), 464 terminalis linguae, 419 Summit of the bladder. 494. 496, i;34, 536, 537 of the pharynx, arched, 411, 436 Suprarenal body, 4S3, 492, 494, 495, :;2i Surface of the arytenoid cartilage, articular, 45S and App., nore -' of the kidney, anterior, 490 posterior, 490 of the liver, inferior, 446, 447 posterior, 446, 447 superior, 446 of the lung, costal, 464, 4S6 diaphragmatic, 4G4 inner, 463, 464 lower, 464 mediastinal, 463, 464 outer. 464, 4S6 phrenic, 464 of the ovary, external, 511 internal, 511, 537 of the pancreas, anterior, 441 inferior, 441 posterior, 441 of the placenta, external. 519 foetal, 519 internal, 519 maternal, 519 uterine, 519 of the prostate gland, anterior, 50^ basal, 496, 505 posterior, 505, 506, 532 pubic, 505 rectal, 505, 506, 532 vesical, 496, 505 of the spleen, basal, App., note " gastric, 450, 479 phrenic, 4^0 renal, 450 of the suprarenal capsule, anterior, 492 posterior, 492 and App. note '-' of teeth, buccal, 428-430 of contact, 430 labial, 430 lingual, 42S, 430 masticatory, 42S, 429 posterior (premolar and molar), 428, 429 of the testicle, e.xternal, 502, ^21 internal, 502 of the tongue, inferior, 419-421 superior, 411, 416, 417, 419 of the uterus, anterior, 511, 537 intestinal, 511, 513, 535 posterior, 5.1, 513, 535 vesical, 511, 537 Sustentaculum lienis, 474, note, App., note *' tSyndesmosis arycorniculata, 450 corniculo-arytenoid, 459 and App., note " T. Taenia libera, 443, 444, 475, 474 mesocolica, 443, 444 omentalis, 444, 473, 478 Taeniae coli, 443, 444 Tail of epididymis, 502, 503, 521, 522 of the pancreas, 441, 480, 483 rudimental, ^24 Taste-buds, 425 Teeth, 426-431 Teeth, absorption of temporary, 428 bicuspid, 427, 429-431 canine, 426-431 deciduous, 427, 42S, 431 developmental stages, 431 grinders, 427-431 incisor, 426-431 lower, 427 milk, 427. 42S, 431 molar, 427-431 multicuspid, 427-431 permanent, 427-431 premolar, 427, 429-431 temporary, 427, 428, 431 upper, 427 wisdom, 429, 430 Tela subcutanea, <^oS submucosa, 405-407 subserosa, 407 Tendinous intersection between the cricothyroid muscle and the inferior constrictor of the pharynx, 433 and note Tendon, central, cordiform, or trefoil, of the diaphragm, 446, 485 Testicle, 456, 500-507, 520-523 appendix of, 500, 502 and App., note ", 520, 521 descent of, 522, 523 Testis, 456, 500-507, 520-523 Theca folliculi, 512 Thoracic viscera, projection-outlines of, 486-4S8 Thymus (gland), 410, 411, 456, 466, 467, 476 Thvroid body, 40S, 411, 434, 466, 467, 470 Tip of the coccyx, 529 and note of the nose, 412 of the tongue, 415, 419, 420 Tissue, areolar, of mucous membrane, 404-407, 422, 423 submucous, 405-407 subserous, 407 erectile, of the female urethra, 535 and App., note '"' subcutaneous areolar, of the penis, 50S Tongue, 419-425 body of the, 414, 419 edge of the, 419-421 lower surface of the, 419-421 root of the, 411, 419, 434, 435, 471 upper surface of the, 411, 416, 417, 419 Tonsil (amygdala), 411, note, 434-436 lingual, 411, note, 416 and note, 419 Luschka's, 411 and note, 434-436 palatine, 411 and note, 434-436 pharyngeal, 411 and note, 434-436 Tonsilla lingualis, 416, 419 palatina, 415-419. 424. 4J4-436 pharyngea, 411, 434-436 Tooth, see " Teeth " Topographical anatomy, see " Anatomy, topographical " Torus tubarius, 434, 436 Trabecule lienis, 450 of the spleen, 450 Trachea, 408, 411, 433, 456, 462, 463, 465-471, 47S, 479 bifurcation of, 411, 462 Tricuspid orifice, 471 Trigone of the bladder, 496, 498 and App., note "' boundaries of, 498 and App., note " Trigonum vesicae [Lieutaudi], 498 Tuba uterina [Falloppii], 455, 500, 510-513, 518, 520, 521, 535, 537 pars uterina, 512 Tube, Kustachian, 410, 411, 434436 bony portion of, 435 membranous portion of, 433, 436 Fallopian, 455, 500, 510.513, 518, 520, 521, 535, 537 uterine portion, 512 subtracheal, App., note ' Tuber omentale hepatis, 446, 447, 478 pancreatis, 478, 479 papillare, 447 Tubercle of the epiglottis, 461 genital, 520, 521, 524 552/ Index Tubercle of the thyroid cartilage, inferior, 458 superior, 458 of the upper lip, median, 412, 419 Tubercles of the crown of the teeth, 427-429 Tubercula (corona?), dentis, 427-429 Tuberculum corniculatum [Santorini], 461 cuneiforme [Wrisbergi], 460, 461 epiglotticum, 461 labii -superioris, 412, 419 thyreoideum inferius, 45S superius, 458 Tuberosity, omental, of the liver, 446, 447, 478 of the pancreas, 478, 479 Tubule or tubules : of the epoophoron, longitudinal (duct of Gartner), 512, 520, 521 transverse, 512 of the kidney, 492, 493 ascending (of Henle), 493 and App., note ■" collecting, 493 and App., note "'^ convoluted, first, 493 second, 493 and App., note "''' descending (of Henle), 493 and App., note ''' excretory, 492 and App., note ^', 493 irregular, 493 junctional, 493 looped (of Henle), 493 and App., note ^' straight, 493 and note zigzag, 493 mesonephric, 520 SchiiUer's, 514 and note, 516 seminiferous, convoluted, 503 straight, 503 Skene's, 514 and note, 516 uriniferous, 492 and App., note °', 493 of the Wolffian body, transverse, 520 Tubuli renales (contorti, recti), 503 seminiferi (contorti, recti), 503 Tubus digestorius, 438-445 'I'ulpius, valve of, 444 and note Tunica adiposa of the kidney, 479, 481, 4S4, 485 * adventitia (duodeni), 407 pharyngis, 432, 466 and App., note ^* albuginea corporum cavernos6rura, 506, 508 of the kidney, 491, 493 lienis, 450 testis, 503 dartos, 501 fibrosa (renis), 491, 493 mucosa, 406, 407 muscularis, 406, 407, 452 ductus deferentis, 501 intestini ilei, 407 recti, 445 urethrse, 498 uteri, 512, 518, 519 ventriciili, 439 vesicae (urinaria), 496-498 propria of the spleen, 450 serosa, 407, 408 vaginalis, 456, 501-503, 523 communis testis et funiculi sperm.), 501-503, 523 propria testis, 456, 501-503, 523 U. Umbilical cord, 51S, 519, 521, 522 loop of intestine, 451 and note, 521 vesicle, 46S, 518 Umbilicus, 481, 4S8, 523 Uncinate process of the pancreas, 441 and note Urachus, 496, 497, 520, 533 Ureter, 490-492- 494. 495. 497, 513, 520-522, 532-536 abdominal portion (pars abdominalis), 494 pelvic portion (pars pelvina), 496, 513 Ureter, rudiment of, 468 (see Erratum, p. 552^) Urethra, female (muliebris), 498, 500, 510, 511, 535 male (virilis), 48S, 500, 505-508, c^-f membranous or muscular portion (pars mem- branacea), 498, 504-506, 531, 534 penile or spongy portion (pars cavernosa), 504, 506, 50S prostatic portion (pars prostatica), 498, 504 5,. 6 ^Urethral ring, 498 and App., note "-, 506 Urinary organs, 489-498 Urogenital organs, 489-524 sinus, 520, 524 Uterus, 500, 510-513, 520, 521, 535, 537 gravidus, 518 masculinus, 498, 500, 504-506, 520 Utricle, prostatic, 498, 500, 504-506, 520 Utriculus prostaticus, 498, 500, 504-506, 520 Uvula of the bladder (uvula vesicae), 498, 504 of the palate (uvula palatina), 416, 417, 435 Vagina, 500, 510, 511, 516-, 520, 521, 531, 534 anterior wall (paries anteriorV 511, 516 posterior wall (paries posterior), 511, 516 Vaginal process of the peritoneum, 455, 522, 523 Vallecula epiglottica, 419, 461 Vallum, circular, of circumvallate papilla, 423 Valsalva, sinuses of, App., note " Valve or valves : aortic, 482 of Bauhin, 444 and note of the cystic duct, spiral, 449 Eustachian, 4S2 Houston's, App., notes " and '"", and see also " Fold of the rectum, transverse " ileocaecal, 444 and note ileocolic, 444 and note of Kerkring, 440, 442 mitral, 471, 482 * pyloric, 438 and App., note * semilunar, 482 spiral, of the cystic duct, 449 tricuspid, 471 of Tulpius, 444 and note of the vermiform appendi.x, 444 Valvula vel valvule : bicuspidalis, 471, 4S2 coli, 444 conniventes, 440, 442 processus vermiformis, 444 pylori, 438 semilunares aorts, 482 spiralis [Heisteri], 449 • tricuspidalis, 471 venae cava? [Eustachii], 4S2 Vas aberrans (of epididymis), inferior, 502 and App., note ", 503. 520 superior, 502 and App., note ", 503 afferens (glomeruli renis), 493 deferens, 494, 496, 500-504, 520, 522, 523, 533, 536 efferens (glomeruli renis), 493 Vasa aberrantia hepatis, 446-44S recta spuria, 493 and App., note " vera, App., note "' Vater, diverticulum of, 440 and note, 442 Vein or veins : azygos (right, or large), 471 capsular, 492 central, of the liver, 448 of the clitoris, dorsal, 531 of the corpus cavernosum, 532 dorsal, of the clitoris, 531 of the penis, 508, 531, 53a epigastric (deep or inferior), 53.^ facial, 424, note anterior, 424, note common, 424, note posterior, 424, note INDEX bb'Ag Vein or veins : hepatic, 446. 447. 404 hypogastric. App., note '" iliac, common, f^ 33 external. 1^33 internal. 533 and App.. note "' interlobular of the kidney, 41)3 of the liver, 448 intralobular, of the liver, 44S of the kidney, interlobular, 493 radiate, 493 stellate, 403 of the liver, central, 44S interlobular. 448 intralobular, 448 peripheral, 448 sublobular, 448 mesenteric, inferior, 454 superior, 479, 495 obtvrrator, 532 ovarian, i;ii of the penis, dorsal, 508, 531, 532 peripheral, of the liver, 448 portal, 446, 480 pudic, internal, 532 and App., note '" pulmonary, 464, 46:;, 470, 471 radiate (of the kidney), 493 renal, 490, 494 spermatic, 494, 522 splenic, 441 stellate (of the kidney), 493 suprarenal, 492 temporomaxillary. 424. note umbilical. 519, 521, 1522 uterine, ^19 uteroplacental, ^19 Velum palatinum (velum pendulum palati), 411, 416, 434-436 \'ena vet venae : arciformes (renis), 493 azygos, 471 cava inferior, 446, 471, 479-481, 494, 495, 521 superior, 471, 477, 478, 482, 486 centralis (hepatis), 448 dofsalis clitoridis, 531 penis, 508, 531, 532 epigastriciE inferiores, 533 hepatica, 446, 494 hypogastrica, 537 iliaca communis, 533 externa, 533 interlobulares hepatis, 448 renis, 493 lienalis, 441 mesenterica inferior, 454 superior, 479, 495 obturatoria, 533 ovarica, 511 portae, 446, 480 profundae penis, 532 t pudenda interna, 532 pulmonales, 464. 465, 470, 471 renalis, 4C)f), 494 spermatica interna, 494 stellatSL- (renis), 493 sublobularis (hepatis), 492 suprarenalis, 492 testicularis, ^22 thyreoideac inferiores, 411 umbilicales, ^19, 521, 522 t uteroplacentares, 519 Venous arch, jugular, 410 and note Venous arches of kidney, 493 Ventricle of the larynx. 461 left, 471. 4S4 right. 471. 4S4 Vcntriculus, 43S, 43<), 4i;i, 4^2. n<{f\ 472, 4-6 47S. 4S0, 4S2-4S4, 48(1, 4S7. 49S. 514 paries anterior, 43S, 472 posterior, 47S, 483 pars cardiaca, 43S pylorica, 438-440, 477, 482 Ventriculus cordis dexter, 471, 484 sinister, 471, 484 laryngis [Morgagnii], 461 Venulae rectje (renis), 493 \'ertex vesica;, 494, 496. 534. Si^^ 537 X'erumontanum, 49S and App., note "', 505, 506 X'esica fellea, 446, 449, 453, 476-478, 482, 485, 486, 495, 522 urinaria, 456, 486, 487, 496-498, 500, 504, 510, qii, ■;i3, S^t>-523. 533-537 „ , Vesicle, prostatic, i;o4-5o6, 520, and App., note ; see aiso " I'tricle, prostatic " seminal, 496, 497, 500, 504-506, 520, 532, 534 umbilical, 468, 518 Vesicula seminalis, 496, 497, 500, 504-506, 520, 532, 534 umbilicalis. 468 Vessel, afferent, of renal glomerulus, 493 efferent, of renal glomerulus, 493 Vessels, aberrant, of the liver. 446-44S, and App., notes '* and " Vestibule, bulb of the. 515 and App.. note °', 535 of the larynx. 411, 461 of the mouth. 411. 414-417 of the omental sac. 452, 479, 495, and App., note " of the vagina, 498, 500, 510, 514 and App., note ", 515, 520, 524, 529 of the vulva, 498, 500, 510, 514, and App., note ", 5'5. 520. 524. 529 " Vestibulum burs^ omentalis. 452, 479, 495 laryngis, 411, 461 oris, 411, 414-417 vagina;, 49S. 500. 510, 514, 515, 520, 524, 529 Vestige of the Milllerian duct. 521 ; see also " Hydatid of Morgagni " Villi, chorionic. 519 foetal, 519 intestinal. 407, 432 Viscera, abdominal, projection-outlines of, 4S6-488 capitis et colli, 411 cephalic and cervical. 411 general considerations, 403-408 relations of, to body-wall, 40S thoracic, projection-outlines of, 4.%-488 Vulva, the, 514 W. Wall, membranous, of trachea, 459, 461, 465 Walther, duct of, App., note ' Wharton's duct, 414, 424, 425. and App., note * Wilson's muscle, App., note "" Winslow, foramen of, 47S, 479 pancreas of, 441 and note Wirsung, duct of, 440-442 Wisdom-teeth, 429, 430 Wolffian body, 468, 520, 521 duct, 46S, 520, 521 Wrisberg, cartilages of, 460 Y. *Vellow spot (of the larynx), App., note " \'olk-sac, 46S, 518 ERRATUM In the letterpress of Fig. 797, p. 4C8, right-hand column, " Rudiment of the uterus " is a misprint lor " Rudiment of the ureter." — Tr. i COLUMBIA UNIVERSITY LIBRARIES This book is due on the date indicated below, or at the expiration of a definite period after the date of borrowing, as provided by the library rules or by special arrangement with the Librarian in charge. DATE BORROWED DATE DUE DATE BORROWED DATE DUE — nf^T t ■ : iv, ■ C2e(3.S2)IOOM j 1 1 j COLUMBIA """'ffJ^'.ViiM' 1010236473 roidt T572 1919 v.3-4 c.Z Atlas of human anatomy. OCT 20