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CORNELL 

UNIVERSITY 

LIBRARY 




GIFT OF 

S. H. Gage 



r^.. — ^J^""" University Library 
QM 25.S67 1900a 



V.I 



Hand atlas of human anatomy, 
3 1924 003 110 347 




Cornell University 
Library 



The original of this book is in 
the Cornell University Library. 

There are no known copyright restrictions in 
the United States on the use of the text. 



http://www.archive.org/details/cu31924003110347 



HAND ATLAS 



OF 



HUMAN ANATOMY 



BY 

WERNER SPALTEHOLZ 

EXTRAORDINARY PROFESSOR OF ANATOMY IN THE UNIVERSITY 
AND CUSTODIAN OF THE ANATOMICAL MUSEUM AT LEIPZIG 

WITH THE ADVICE OF 

WILHELM HIS 

PROFESSOR OF ANATOMY IN THE UNIVERSITY OF LEIPZIG. 



TRANSLATED FROM THE THIRD GERMAN EDITION 

BY 

LEWELLYS F. BARKER 

PROFESSOR OF ANATOMY IN THE UNIVERSITY OF CHICAGO. 



WITH A PREFACE 

BY 

FRANKLIN P. MALL 

PROFESSOR OF ANATOMY IN THE JOHNS HOPKINS UNIVERSITY AT BALTIMORE. 



VOL. I. 

BONES, JOINTS, LIGAMENTS. 



LEIPZIG 

S. H I R Z E L 

1900. 
WILLFAMS AND NORGATE, G. E. STECHERT, 

14, Henrietta Street Covent Garden, LONDON Importers of Books and Periodicals, 

20, South Frederick Street, EDINBURGH Wholesale and Retail, 

AND 7, Broad Street, OXFORD. 9, East 16 th Street, NEW YORK. 



ALL RIGHTS RESERVED. 



Preface. 



The appearance of Spalteholz's Atlas a few years ago was welcomed 
alike by teachers and students of anatomy. So useful is this book to students 
who desire to study anatomy in the dissecting room that without any effort 
on my part it has become the favorite aid to the students of anatomy at the 
Johns Hopkins University. Its value to English and American students not 
acquainted with the German language is now greatly increased through the 
admirable translation of the text into English by Professor Barker. 

The main object of studying anatomy is to obtain a mental image of the 
human body rather than to memorize numerous terms as is too often the case 
in our medical schools, especially in America. When the study of anatomy is 
transferred from the lecture room, text book and quiz-compend to the dissecting 
room it becomes one of the best disciplinary studies for medical students and 
at the same time gives them most useful knowledge by the inductive method 
of study. In the dissecting room the student obtains the greatest aid from the 
instructor who teaches him the art of dissection and guides him in methodical 
studj^ Next in importance is a good text book which should always be at 
the student's side in order that he may study the dissection of the body 
as it proceeds. 

The study of anatomy would be relatively easy were the student familiar 
with the subject before he begins it. The rule that the student should acquire 
as much knowledge as possible of a region before he begins to dissect it 
is good but has its limitations because it is only through the work itself that 
the interest of the student, and thereby his instruction, can be kept up. Just 
at this time an Atlas proves to be of the greatest value. Pictures of dissections, 
true to nature, aid the imagination of the student enormously and thus guide 
his work from the known to the unknown. It follows that the illustrations 
of an anatomical atlas must be typical, giving all stages of the dissection of 
the body from its beginning to its completion. The Atlas of Spalteholz meets 
this requirement. In addition to the superior quahty of the illustrations it 
may be stated that they are all carefully marked with the new anatomical 
nomenclature. 



IV Preface. 

Making the anatomical terms uniform means much more than simply 
changing some of the names, for it brings us one step nearer to a know- 
ledge of the normal. In casting the new nomenclature the leading anatomists 
of the world occupied much of their time in determining the normal and for 
this reason if for no other the BNA should be adopted. In the translation 
where the terms used are very different from the old nomenclature the latter 
are inserted in brackets. 

The Atlas speaks for itself If its reception is as favorable generally 
as it has been at the Johns Hopkins University it will soon become the 
standard aid to our students of practical anatomy. 

Franklin P. Mall. 



Author's preface. 

As early as shortly after the appearance of the first part of this atlas, on 
various sides the wish was repeatedly expressed, among others by my friend 
Prof. F. P. Mall, to possess an English edition. After some hesitation the 
publishers have decided to this end, since so distinguished a specialist as Professor 
Barker has been found ready to prepare this. In order to secure the utmost 
conformity with the German work, the illustrations have been printed from the 
original plates, and for the translation, the text of the third German edition, under 
preparation, was submitted. I myself moreover, have superintended the proofreading. 

In accordance with the plan which I had laid as a foundation for the 
work, the atlas is intended to embrace the entire descriptive anatomy with the 
exception of histology, while including so far as possible the relations which are 
brought out by magnification with strong hand lenses. Thus, likewise, it is 
intended to have due regard for the field which lies between macroscopic and 
microscopic anatomy proper. The topographic relations of the organs and especially 
of the vessels and nerves have been given the utmost consideration attainable 
within the compass of a book which treats primarily of descriptive anatomy. 

In order to increase the clearness of the illustrations , a great part of 
them have been done in colors so that the parts whose portrayal in the 
sections is of importance, are brought into prominence by the colors. 

The number of drawings necessary is provisionally roughly estimated at 
about 800, but if necessary this number will be increased. 

It is intended , if possible, that the second volume , containing muscles 
and blood vessels, shall appear in the course of the winter, the third volume 
containig the viscera, brain, nerves, and sense organs, immediately after its 
completion in the German edition. 

At the end of the atlas a complete index is proposed. 

For all illustrations, with unimportant exceptions , new original drawings 
were made. To the choice of the objects and the production of the drawings 
the most thoughtful attention was devoted. With regard to the admission and 
manner of representation of an object, first and foremost, pedagogic principles 
gave me the decision; where an object appeared difficult a greater number of 
drawings were made, and vice versa. The illustrations, in all cases, have been faith- 
fully drawn from original preparations, but at the same time no copy of a definite 
individual case, but always a composite from several sections has been made. 

The preparations were made for the most part especially for this purpose 
and admitted only after many repetitions if the relations did not appear to me 



VI Introduction. 

clear enough. Thence it follows that in those cases in which I have given new 
delineations which departed somewhat from the customary, I did it with full 
consciousness on the strength of new preparations. 

All illustrations are taken from the right half of the body. 

As the basis for the technical terms, I have, throughout, made use of the 
new anatomical nomenclature, BNA, as unanimously adopted by the anatomical 
association at its IX. meeting in Basel on April 19, 1895 and published with 
introduction and explanations by W. His. I have held myself strictly to the 
terms there given and only in a few isolated cases added terms according to 
my own judgment. Also for the mass of quoted names, the compilation just 
referred to has served me as a standard ; only a few terms will be found missing. 

As to the process of reproduction, with a few exceptions the Half-tone 
was made choice of, because this mechanical method reproduces the original 
drawing far more accurately than the woodcut. 

The drawings of the attachments of muscles were completed from pre- 
parations which were made by the deceased Prof W. Braune himself 

As far as the text is concerned, I undertook only unwilKngly the writing 
of the same, since in my opinion this adjunct too easily permits the idea to be 
acquired by the student, that this text will suffice for the study of anatomy 
in general. I have determined ultimately on a supplement to the same if much 
desired, and then to devote to it the greatest care. My effort was, to give a 
clear description of the figure, and at the same time an explanation of all the 
descriptive terms made use of in the figure. In so doing it unintentionally 
turned out much more detailed than was really necessary in the accompanying 
text of an atlas, in which, indeed, the illustrations are the essentials; yet it 
resembles many text books in completeness. And yet again it differs from these 
in the main points : it is more incomplete in as much as I found it necessary 
to omit entirely all general matter, and occasionally, if place for the text was 
wanting, it was necessary that the illustration alone should speak for itself 
Consequently the text remains, for the most part, a guide; so it ought not 
and can in no way render a text book of anatomy unnecessary. 

In the part on articulations, I have provided a description of the pure 
anatomic relations only, and with the exception of the mandibular articulation, 
intentionally, have nowhere entered into the function of the same; for while 
the old classification of joints according to the form of the articulating faces 
has now only partial value, nevertheless a new classification according to the 
amount of motion possible in life is not yet applicable to all joints. 

For showing the soft parts, especially^ the muscles and viscera., for the 
most part, material carefully hardened in formalin was used. 

The data regarding the action of the individual muscles take into account 
only the influence which the muscles exert on those joints over which they pass. 

Werner Spalteliolz. 



I. 
BONES, JOINTS, LIGAMENTS. 



Bones of the Skull. 



Sulcus sagittalis 



Margo lambcloideu.4 



Protuberantia occipitalis 
interna 



Sulcus transversus 



Margo mastoideus 




_, Manama 
occipitalis 



Pars lateralis 



Processus jugularis 



^ Sulcus transversus 
Canalis condyloideus 
s Incisura jugularis 
\ Probe in canalis hypoglossi 
\ Processus intrajugularis 

Tuberculura jugulare 
Sulcus petrosus inferior 



Pars basllaris 

1. Occipital bone, os occipiiale, from in front. 

The impaired os occipitale (occipital hone) (see also Kgs. 2, 3, 55, 56 and 59 — 66) 
forms the posterior inferior part of the sknll. It is divisible into four parts ; an unpaired basilar 
part (pars basilarisj; an unpaii-ed squamo-oocipital part (squama occipitalis) and the paired 
lateral parts (partes laterales). These parts are so arranged around the large occipital 
foramen (foramen occipitale magnum) that the pars basUaris lies in front of the foramen, 
the squama occipitalis behind and above it, while the partes laterales lie lateral fi'om it. 
Through the great occipital foramen pass the meningeal rami of the vertebral arteries, the 
vertebral arteries themselves, the anterior and posterior spinal arteries, the basilar plexus, 
the nn. accessorii, the roots of the nn. cervicales I, and the medulla oblongata. 

The pars basilaris presents, up to about the twentieth year of life,' a rough surface 
in front correspontling to its attachment to the body of the sphenoid bone; the union is 
effected by a layer of hyaline cartilage which ossifies later (fissura and synchondrosis spheno- 
occipitalis). The two lateral slightly jagged edges lie upon the posterior angle of the petrous 
portion of the temporal bone (fissura and synchondrosis petroocipitalis) ; on the upper siu- 
face is situated the gi'oove, formed by the two bones in common, corresponding to the sulcus 
petrosus inferior (for the sinus petros. inf.). The posterior border, sharp in the middle, is 
smooth and concave, and forms the anterior cii-cimiferenoe of the for. occip. mag. The superior 
surface is smooth and slightly concave in a frontal direction; it helps to form the clivus in- 
asmuch as it is directly continuous with the posterior surface of the dorsum seUae of the sphenoid. 
The clivus gives support to the pons, the vertebral arteries, the basilar artery and their branches. 
The inferior surface presents in the median line a small projection, the pharyngeal tubercle (tuber- 
culum pharyngeum) (for the attachment of the lig. longitud. ant. and the m. constrictor 
pharyngis sup.), and also alternating ledges for the m. rectus capitis ant. and the m. longus capitis. 
Spalteholz, Atlas. \ 



Bones of the Skull. 



Planum occipitalc 



Protuberantia occipitalis externa / 



Linea nuehae siiprema 
, Crista occipitalis externa 
,'' , Linea nuehae superior 
' / Linea nuehae inferior 
Planum nuchale 




SquHina 
oeclpitallg 



Fossa condyloidea 
Canalis condyloideus 

Base of the processus jugularis 



Pars lateralis 



Probe in 

canalis 

hypogloBsi 



'^ Incisura jugularis 

Processus intrajugularis 
Condylus occipitalis 



Tuberculum pharyngeuni 



Pars basilarls 

2. Occipital bone, os occipitale, from behind. 

The partes laterales fonn by their medial edges the lateral borders of the great occi- 
pital foramen ; the anterior portion of the lateral margin is attached to the posterior angle of 
the petrous portion of the temporal bone and helps to form the fissura pefrooccipitalis ; it 
presents a smooth concavity , the incisura jugularis which is divdded by the small processus 
intrajugularis into a larger lateral, posterior, and a smaller medial, anterior fossa which with 
the corresponding notches of the petrous portion of the temporal bone help to form the simi- 
larly divided foramen jugutare. The lateral compartment of the jugular foramen gives passage 
to the internal jugular vein; the medial compartmept to the sinus petrosns inf., the n. glosso- 
pharyngeus, n. vagus, n. access., gangl. sup. n. glossophar., and the gang, jugul. n. vagi. The 
posterior part of the lateral border, mar go mastoideus is rough and unites with the occipital 
margin of the mastoid portion of the temporal bone (sutura occipitomastoidea) . At the lateral 
angle the processus jugularis projects upward , being surroimded medianward and behind by 
the sulcus transversus (for the sinus transversus). Medial from this lies the oblong, smooth 
tuberculum jugulare and at the corresponding spot on the inferior surface the oval occipital 
condyle (condylus occipitalis), which is covered with cartilage: it is curved so as to he convex 
in the sagittal and fi-ontal direction. The long dianu'ters of the right and left condyles converge 
in front. Between the jugular tubercle and the occipital condyle is si-cn thi^ short canalis hypo- 
glossi (0. T. anterior condyloid foramen); it extends from the great occijiital foramen obliquely 
forward and latcralward and gives passage to the rote canal, hypogl. and the n. hypoglossus. 
Behind the i-ondylc lies the condyloid fossa (fossa condyloidea) with an opening (sometimes 
absent) known as the canalis condyloidciis (0. T. postorior eoudyloid foramen); this canal leads 
to the sulcus transvoi-.^us and gives jiassagc t(j the emissarimu condyloidcum. On the inferior sur- 
face cnnvsiiondiug to the base of the jugular process is the site of iusi-rtiou of the m. rectus capit. 
lat. and simictinies a blunt projection, the jiroccssiis paramastoideus (not shown in the figure). 



Bones of the Skull, 



Planum oceipitale 
Liuea nuchae suprenia - 



Liiiea nuchae superior. 
Protuberantia occipitalis- 
externa 



Crista occipitalis externa- ■ 
Planum nuchale 



Linea nuchae inferior 



., Stinama occipitalis 




Processus jugularis 
1 Incisura jugularis 

Processus intrajugnlaris 



■ Pars basilaris 



Fossa condyloidea 



Tuberculum phaiyDgen]ii 



Canalis hypoglossi 
Canalis eondyloideus con^yjus occipitalis 

3. Occipital bone, OS oceipitale, seen from right side. 
(The direction does not correspond to that of the bone when the skull is m its ordinary position.) 

The sqnama occipitalis is curved so as to be convex backward in the sagittal and 
transverse direction. Its anterior border forms the posterior periphery of the foramen oceipitale 
magTimn; the free lateral and superior borders meet in the median plane, the lower portion 
of each lateral border being shghtly serrated as the continuation of the margo mastoideus 
(p. 2); the upper portion of tliis border is deeply and multiply serrated and is known as the 
margo lambdoideus for union with the occipital margin of the parietal bone (suiura lambdoidea). 
Projecting from the middle of the posterior surface is seen the external occipital protuberance 
(protuberantia occipitalis externa). Extending lateralward fi'om this protuberance on each 
side are the superior nuchal lines (lineae nuchae superioresj, convex upward, and above these 
the less constant supreme nuchal lines (lineae nuchae supremae). In the median plane 
extending toward the foramen magnum is seen the external occipital crest (crista occipitalis 
externa) which gives attachment to the ligamentum nuchae. From about the middle of the 
crest extend lateralward the two inferior nuchal lines (lineae nuchae inferiores), also convex 
upward. The area for the m. occipitaHs above the external protuberance and the supreme 
nuchal lines is called the occipital plain (planum oceipitale), while that below the same is 
designated the nuchal plain (planum nuchale) and gives attachment to the mm. trapezius, 
sternocleidomastoideus , splenius capitis, semispinalis capitis, obhquus capitis superior, recti 
capitis posteriores. On the anterior surface of the bone at the middle point of the eminentia 
cruciata nearly corresponding in position to the external protuberance is seen the internal 
occipital protuberance or protuberantia occipitaHs interna (for the eonfluens sinuuni; falx 
cerebri, and tentorium cerebelli). From the internal protuberance arise three well marked 
grooves: one in the median line passes upward, the sulcus sagittalis (0. T. superior longitu- 
dinal sulcus) for the sinus sagittalis superior and the falx cerebri: and one lateralward on 
each side, the sulcus transversus (for the sinus transversus; tentorimn cerebeUi). Of the two 
transverse sulci the right is usually wider than the left and it alone is continuous with the 
sulcus sagittalis. A fourth groove or (more often) ridge extends to the foramen magmmi and 
receives the sinus occipitahs. 

1* 



Bones of the Skull. 



Anguliis / 
parietalis 



Ala parva 

Y 

Corpus 

I 1 

Margo frontalis 



Sulcus chiasmatis 
^Tuberculum sellae 
/ Sella turcica 

Foramen opticuni 




Margo squamoau; 



;i^ Dorsuiii sellae 
Ala magna 



Fissura orbitalis superior 
Processus clinoideus anterio 
"Foramen rotuudum 
) ~ - Facies cerebralis 

Processus clinoideus posterio 
Foramen ovale 
Foramen spinosum 



Lingula sphenoidalis 



4. Sphenoid bone, os sphenoidale, from above. 

The unpaired OS sphenoidale (see also Kgs. 5, 6, 55, 56, 59, 60, 63—71) lies in the 
middle of the base of the skull. It is divisible mto a middle piece or body (corpus) and six 
processes, known as the two small wings or alae parvae, the two larp? wings or alae magnae, 
and the two pterygoid processes or processus pterygoidei ; of these the four former are directed 
lateralward, the two latter, downward. 

The corpus (body) is approximately cubical and contains within it two cavities lined 
by mucous membrane, the sinus sphenoidales (0. T. sphenoidal cells) which are separated from 
one another by the septum sinuum sphenoidalium. The superior surface presents a deep 
frontally placed groove, the sella turcica (for the sinus circularis; h)-pophysis) with the fossa 
hypophyseos (0. T. pituitary fossa) in the depth. Posteriorly, the sella is overhung by the 
dorsum sellae^ which at the angles of its upper fi'ee margin presents on each side a small 
processus clinoideus posterior (for the tentorium cerebelli); the posterior smo(jth surface of 
the dorsum sellae together with the superior surface of the pars basUaris oss. occipitalis forms 
the clivus (for the aa. vertobrales, a. basilaris and its branches; puns). In front of the sella 
lies the small tuherculum sellae or pommel; lateralward and backward therefrom are situated 
the middle chnoid processes or processus clinoidei medii (often absent). In front ot the tubercle 
extendiug transversely on each side to the foramen opticmn is the shallow sulcus chiasmatis 
(0. T. optic groove) behind which lies the chiasma opticiun. The anterior margin of the superior 
surface unites with the lamina cribrosa of the ethmoid bone to form the sutura spheno- 
ethmoidalis. On the lateral surface extending from behind forward, above the region of origin 
of the large wing is the sulcus caroticus ((). T. cavernous gro(Dve) for the a. carotis interna 
and the plexus caroticus iuternus. Just lateralward from the posterior extremity of this sulcus 
projects the lingula sphenoidalis. The posterior surface of the body unites with the pars 
basilaris oss. occipitaUs (See p. 1). The anterior and a part of the ulterior surface are formed 
by the thin, saucrr-shaped, curved conchae sphenoidales (0. T. sphenoidal tm-binated bones) 
which, embiyologically, properly belong to the ethmoid bone. Each pri'seiits lateralward and 
above an opening, the apertura sinus sphenoidalis and, lateralward from this, small depressions 
which help to close the posterior ethmoidal cells fi-om behind; the lateral border of each concha 
is connected above with the lamina pajiyr. oss. ethmoid, (sutura sphenoethmoidalis) ; below 
with the proi', orbit, oss. palat. (sutura sphenoorbitalisj. In the median plane the conchae 
and the septum in fi-ont form the projecting sphenoidal crest or crista sphenoidalis (0. T. 
ethinoiilid crest) for contact with the perpendicular plate of the etbnioid bono; this crest runs 
out below into a projection, the rostrum sphenoidale which is dii-ected downward and lies 
against the vomer. 



Concha sphenoidalis Fissura orbitalis superior 
Facies orbitalis 




Processus 
pteryeoideos 



Lamina luedialis . 
Sulcus hamuli 



Facies infra- 
tempo rails 
Spina angularia 
Foramen rotundum 
Facies spheiioniaxillaris 

- Lamina lateralis 



Flssura pterygoidea 
Hamulus pterygoidens 



5. Sphenoid bone, os sphenoidale, from in front. 

/ The alae niagnae ossis sphenoidalis (larffe wings of the sphenoid bone) arise from 
the lateral surface of the body of the bone and turn first lateralward, then upward and forward. 
Each possesses an upper, internal, concave surface or facies cerehralis and a much divided 
external surface. Of the latter the quadrangular part which, medianward, is directed forward 
into the orbit, is called the orbital surface or facies orbitaiis; its posterior border is smooth 
and together with the ala parva forms the fissura orhitalis superior (for the w. ophthabn. sup. 
et inf. ; nn. oculomot., trochlearis, ophthalm., abducens) ; the inferior border, also smooth, forms, 
along with the posterior border of the orbital surface of the maxilla the fissura orbitalis 
inferior (for the a. infraorbital. ; v. ophthalm. inf. ; nn. zygomat., infraorbit.) ; the lateral ser- 
rated border, margo zygomaticus , unites with the fi'ontosphenoidal process of the zygomatic 
bone to form the sutura sphenozygomatica ; the lateral superior angle, margo frontalis, unites 
with the orbital portion of the fi-ontal bone and thus helps to form the sutura sphenofrontalis. 
Below the orbital surface and encroaching upon the pterj'goid process hes the triangular facies 
sphenomaxillaris (sphenomaxUlai-y surface) which helps to form the fossa pterygopalatina. The 
rest of the external surface is divided by the crista infratemporalis (0. T. pterygoid ridge), 
passing from before backward, into an inferior, horizontal field or facies infratemporalis (for 
the m. pterygoid, ext.) which looks into the fossa infi-atemporalis, and a superior vertical field 
or facies temporalis (for the m. temporahs). The posterior border of the latter, margo squamosus, 
is serrated below, somewhat bevelled from without inward above, and seizes for apposition with 
the squama temporahs (sutura sphenosquamosa). The uppermost angle (angulus parietalisj, 
is bevelled from within and lies upon the angulus sphenoidalis oss. parietalis (sutura spheno- 
parietalis). Passing downward from the most posterior angle of the large wing is the spina 
angularis (0. T. spinous process of the sphenoid) (for the hg. sphenomandibulare ; m. tensor 
veil palatini). In addition, there extends from this point forward and medianward, a short, 
serrated margin for apposition with the angulus anterior of the petrous portion of the temporal 
bone (fissura and synchondrosis sphenopetrosa) . Perforating the root of the large wing are 
three foramina : passing forward from above and behind, to the sphenomaxUlaiy surface is the 
foramen rotundum (for the n. maxUlaris) ; passing downward, from above, to the infi-atemporal 
surface is the foramen ovale (for the rete foraminis ovalis; n. mandibul.); and the foramen 
spinosum (for tie a. mening. med., vv. meningeae mediae ; n. spinosus, plexus mening.) ; the 
latter foramen lies just in front of the most posterior angle and is sometimes incomplete. 



Bones of the Skull. 



Ala magna 



Processus clinoideus anterior 



Dorsum sellae 



1 Foramen rotundum 

I ■ Fissura orbitalis 
; ' ' superior 



Facies cerebralis 




Angulus 
parietalis 



Processus pterygospinosus^ ^ 
[Civinini' 

Processus 
pteryg^oidens 



Sulcus tubae auditivae 



Spina angularis 



Canalis pterygoid . 
Lamina medialis 
Hamulus pterygoideus 



^ Lingula sphenoidalis 
-Fossa scaphoidea 
Fossa pterygoidea 

^ Lamina lateralis 
' Fissura pterygoidea 
"~ Sulcus hamuli pterygoidei 



6. Sphenoid bone, os sphenoidale, from behind. 

The alae parvae ossis sphenoidalis (small wings of the sphenoid bone) arise from 
the anterior superior part of the lateral surface of the hody by two roots which surround the 
foramen opticum (for the a. ophthahnica ; n. opticus). They are smooth thin plates of bone 
which present a superior and an inferior surface; the inferior forms with the orbital surface 
of the \i\Tgc mng (cf. p. 5) the fissura orbitalis superior. The anterior margin, marfjo fron- 
talis, is serrated and lies upon the posterior margin of the pars orbitalis oss. fi-ontalis (sutura 
sphenofrontalis) ; the posterior margin is smooth and runs out medianward into the strong 
processus clinoideus anterior. 

The processus pterygoidei (pterygoid processes) extend from the pnint of union of 
the body and the large wing downward. They are composed of tn-o plates: the shorter and 
broader, lamina lateralis proc. pteryg. (lateral surface for the m. pterygoideus externus) ; the 
other narrower and longer, lamina medialis proc. pteryg.. The two plates unite anteriorly at 
an angle, in front of which there extends from above downward the sulcus pterygopalatimis ; 
behind, the plates diverge and form the deep fossa pterygoidea (for the m. pterygoideus in- 
ternus) ; between the two below is a notch with jagged borders, the fissura pterygoidea, in which 
is received the proc. pjTamidalis oss. palatini. The lamina medialis runs o\it below to form the 
hamulus pterygoideus (0. T. hamular process) which is cim-ed lateralward. This process is 
convave on its lateral surface and is covered with cartilage forming the sulcus hamuli ptery- 
goidei (for the tendon of the m. tensor veli palatini). Passing doATiward over the root of 
the lamina medialis on the posterior surface is the fossa scaphoidea (for the origin of the 
m. tensor veli palatini). Lateralward fi-om this, encroaching upon the meilial surface of the 
spina angularis lies the sulcus tubae auditivae (for the pars cartilaginea tubae auditivae). The 
lamina mediahs gives off fi-om its root the processus vaginalis, a small process which extwids 
methanward toward the body; on the inferior surface of this process, either as a closed 
canal or as a grnovr which is cIosihI by the proc. sphenoidalis oss. palatini is the canalis- 
pharyngeus (0. T. iiterygopalatine canal) (for a small branch of the a. sphenopala turn- rr nasal 
post. sup. lat. gangl. sphenopalat.) ; lietweon the mferior surface of th(- body of the bone and 
the processus vagmalis , a canal is sometmies present, the canalis basipharmuieus (fnr the 
rr. nasal, pnst. sup. lat. gangl. sphenopalat.). Constantlv pres.nit, passing through the ro.-t of 
the ]itcrygoid process m a sagittal direction, is the canalis ptcn/,/oidnis I fidii] iO T Vidian 
canal) (f„r the a. et yv. canal, pteryg. ; n. canal, ptery.,); its' pnstenor „,,ening lies below 
the hngula sphenoidalis, its anterior >,].eumg upon the s],br„„maxillarv surface , \uedianward 
and below the foramen rotundum. ■ ' 



Bones of the Skull. 



Margo 
parietaliy 



Squama temitoraliis 

^ F.aciuH temporalis 



Sulcus a. temporalis 
mediae 

Incisura parietalis 



Linea temporalis 



Fossa mastoidea 

Spina supra 
nieatum. 

Remains of the 
sutnra squamoso 

mastoidea 
Foramen mastoideum 

Pai-8 mastoidea 




Margo 
sphenoidal is 



Processus mastoideus 



rissura tympanomastoidea 

Meatus acusticus externus 



Processus 
zygomaticus 

Apex pyraraidis 

Tuberculum 

articulare 

Fossa mandibularis 



Fissura petrotympanic a [GlaseriJ 
Vagina processus styloidei 
Processus styloideus 
Pars tympanlca 



7. Right temporal bone, os temporale, from without. 

The paired os temporale or temporal bone (of. also Figs. 8—15, 55, 56, 63—66) lies 
between the occipital bone and the sphenoid bone, helping to foi'm both the base of the slnill 
and its lateral wall. Each bone is divisible into four parts; the squama temporalis, pars 
mastoidea, pars petrosa and pars tympanica. Around the meatus acusticus externus ((w- 
ternal auditory canal) which is open lateralward, these parts are so arranged that the squama 
is directed upward, the pars mastoidea baclvward, the pars tympanica forward and downward 
and the pars petrosa, medianward and forward. 

The squama temporalis consists essentially of a vertical plate, the fi'ee approximately 
semi-circular border of which is serrated only in its anterior inferior portion, being otherwise 
bevelled fi-om within; the anterior part of the margin, margo sphenoidalis , unites mth the 
large wing of the sphenoid bone to form the sutura sphenosquamosa , the posterior, margo 
parietalis, with the margo squamosus oss. parietalis to form the sutura squamosa. The 
lateral surface, fades temporalis (for the m. temporalis), is smooth : projecting fi-om the lower 
part of this surface in front of the external auditory canal is the processus zygomaticus (for 
the lig. temporomandibulare ; m. masseter) with two roots of origin; it passes at first horizon- 
tally outward , then , turning at a right angle , forward. Between the two roots , directed 
dim-nward, lies the fossa mandibularis (0. T. glenoid cavitjO with the fades articularis, 
limited in front by the fi'ontally placed tuberculum articulare , the lattrr being covered by 
cartilage. On the outer surface of the squama temporalis is seen, passing upward ia the 
posterior part, the sulcus arteriae temporalis mediae (for the a. temper, med.). Eunning 
out also from the posterior extremity of the zygomatic process is a ridge, the linea temporalis, 
which curves backward to become continuous with the linea temporalis inferior of the parietal 
bone. The medial surface of the squama, fades cerebralis, presents well marked juga cerebralia 
and impressiones digitatae as well as a deep sulcus arteriosus. 



Bones of the Skull. 



Sanama 
temporalis 



Facies cerebralis 
Sulcus arteriosus 



Margo 
parietal! s 



Margo 
sphenoidalis 




Fissura petrosquamosa 



Eminentia arcuata 

Incisura parietalis 

k-' Sulcus sigmoideus 



Foramen mastoideum 



Impressio trigemini -' 

Angiilus superior pyramidis 

Sulcus petrosus inferior ^/ / 
Facies anterior pyramidis / - 
Angulus posterior pyramidis' / 
Porus acusticus internus ' 

Apertura externa canaliculi coclileae 



^' Margo 
^ occipitalis 



// / ; ■ 

Facies posterior pyramidis / / / / Sulcus petrosus superior 
Fossa subarcuata ' / ' 
Processus intrajugularis / Apertura externa aquaeductus vestibuU 
Incisura jugularis 

k- ^ 

I I 

Pars petrosa Pars mastoidea 

8. Right temporal bone, os iemporale, from within. 

The pars mastoidea is a thick conical projection m^t well developed untU. adult life. 
Developmentally it is not an independent part of the bone, but a secondary outgrowth- from 
the lateral and most posterior part of the temporal bone and belongs actually in part to the 
pars petrosa and in part to the squama temporalis. Its posterior, serrated margin, margo 
occipitalis , comes into apposition with the margo mastoideus oss. occipitalis (sutura occipito- 
mastoidea) ; the short upper serrated margin forms with the margo parietalis of the squama 
temporaUs an ang-ular indentation, the incisura parietalis, in which is received thi^ angulus 
mastoideus oss. parietalis (sutura parietomastoidea) ; ahovi^ and in front it goes over into the 
squama temporalis, in front it adjoins the pars tympanica; thi^ site of jimction of the two 
components is iadicated (often very incUstinctly in the adult) by the siitura squamosomastoidea 
which runs lateralward, obliquely do\vnward and fnvwiird. The lateral surface is convex and 
shghtly roughened (tor the attachment of the imu. auricularis posterinr et occipitalis), and often 
presents behind one or se\i'ral foramina mastoidea (for the ramus mastoideus a. occipitalis, 
emissarium maHtoiileuiu) which hih'u on the medial surface in the sulcus sigmoideus. Projecting 
lateralward from the posti'rior superior margin of th(> porus acusticus exte^rnus there is fre- 
quently found a small spur, the spina supra meatmn : the surface behind it, ottem <lepressed, 
the fossa mastoidea, extends above as far as the Uuea. temporalis and below to the sutura 
squamosomastoidea, and is jierforatrd by nmnerous foramina fur IiInmI vessels. 



Bones of the Skull. 9 

A thick process extending domiward, the processus mastoideus (for the attachment 
of the mm. sternocleidomastoideus, splenius capitis, longissimus capitis) presents on its medial 
surface, a smooth depression, the incisura mastoidea (0. T. digastric fossa) for the attachment 
of the digastric mnscle, and, further medianward, a groove, the sulcus arteriae occipitalis 
(for the a. o(-cipitalis). The medial surface of the pars mastoidea is fused in fi-ont with the 
pars petrosa ; behind, it is free and there presents a deep groove, the sulcus sigmoidevs (0. T. 
fossa sigmoidea) (for the sinus transversus). Inside the process are mam' cavities hned by 
mucous membrane, the cellulae mastoideae (cf. Fig. 11). 

The pars petrosa (pyramis) is a three-sided pyramid, the base of which is directed 
lateralward, and is united with the pars mastoidea. It presents for examination three sur- 
faces, a fades posterior, a fades inferior and a fades anterior; at the jimctions of the 
surfaces are the anguhis posterior , the angulus anterior, and the angulus superior. The 
tip, or apex pyramidis , is directed median ward and forward, and is inserted in the angle 
between the occipital bone and the sphenoid bone, leaving, however, an irregular chink, the 
foramen lacerum which is fiUed by the fihrocartilago basalis. 

The fades posterior pyramidis almost vertical, is bounded above by the angulus 
superior with the sulcus petrosus superior (for the sinus petrosus superior ; tentorium cere- 
beUi), below by the angulus posterior; the latter is rough and unites with the lateral margin 
of the pars basUaris and the pans lateralis of the occipital bone ffissura and synchondrosis 
petrooccipitalis) , and contains above at the upper surface of this place of union the sulcus 
petrosus inferior (for the sinus petrosus inferior). At about the middle of the posterior sur- 
face a circular opening, the porus acusticus internus, leads into the short meatus acusticus 
intei-nus (for the a. and vv. auditivae internae ; nn. facialis and acusticus). Above and lateral- 
ward close to the superior angle hes the fossa subarcuata which, running below the superior 
semicircular canal, receives a process of the dura mater; this fossa, very well marked in the 
new-born (see Kg. 15), is usually only shghtly indicated in the adult. Still further lateral- 
ward and downward is seen the apertura externa aquaeductus vestibuli (for the ductus endo- 
lymphaticus); it is usually sHt-shaped, opening from a dorsolateral direction, and from it a 
gi-oove runs downward to the incisura jugularis. 

The fades inferior pyramidis is placed horizontally and is very uneven and 
rough. In front its boundary is formed laterally by the pars tympanica and medianward 
therefi'om by a ft-ee margin, the angulus anterior, which unites with the margin of the large 
wing of the sphenoid bone situated medianward from the spina angidaris, to form the fissura 
and synchondrosis sphenopetrosa. Behind it is bounded by the angulus posterior. A notch, 
sometimes scarcely noticeable, the incisura jugularis, close to the small processus intrajugu- 
laris, forms with the oon'esponding incisura jugularis of the occipital bone (p. 2), the foramen 
jugular e (lateral compartment for the v. jugularis interna; medial for the sinus petrosus in- 
ferior; nn. glossopharyngeus , vagus, accessorius, gangl. superius n. glossophar}Tigei , gangl. 
jugulare n. vagi). Just in fi-ont of this notch hes the broail fossa jugularis (for the bulbus 
v. jugularis superior) with a small hole, one of the openings of the canaliculus mastoideus, 
and a groove leading to this, the sulcus canaliculi mastoidei (for th(! r. auricularis n. vagi). 
Just medianward from the jugular fossa near the posterior angle, is seen a funnel-shaped 
depression, with the apertura externa canaliculi cochleae (for the v. canahculi cochleae). 



10 



Bones of the SkuU. 
Processus zygomaticus 

s^qnama temporalis 



Tiiberculum articulare 

Fossa mandibularis 

Processus styloideus 
Foramen stylomastoideum " 
Processus luastoideus ' 

Iiicisnra niastoidea 
Sulcus it. occipitalis 




Pars petrosal 

Canalie musculotubarius > 

Foramen caroticum internum 
' Angulus anterior pyramidis 

Apex pyramidis 

- Faeies inferior pyramidis 

Angulus posterior pyramidis 

Foramen caroticum externum 

- Canaliculus caroticotympanicus 

Fossula petrosa 

Apertura externa canaliculi cochleae 
~ - Canaliculus mastoideus 
Processus intrajugularis 

Fossa jugularis 
Incisura jugularis 



Pars luastoldea 

9. Right temporal bone, os iemporale, from below. 

Fades inferior pyramidis (continued). Situated almost exactly in front of the 
fossa jugularis is a largv round opening, the foramen caroticum externum, which forms the 
entrance to tlie canalis caroticus (for the a. cavntis interna, plexus venosiis carnticus intemus; 
plexus caroticus intemus). This canal is curved and passes obliquely from behind and lateral- 
wanl, forward and mcdianward through the pyramid, and emerges near the apex by an irre- 
gular opening, the foramen caroticum intenmm . partly on the inferior and partly on the 
superior surface. Near the I'xtrrnal carotid foramen can be seen, in the canal, the small 
openings of the canaliculi caroticotympanici (fur the r. caroticotyuipanicus a. carotis intemae: 
im. caroticnt3anpanici), which jiass upward tn the middle ear. Between the external carotid 
foramen, the jugular fossa and the ajiertura externa canaliculi cochleae lies a small di^pr(^ssinn. 
the fossula petrosa (for the gangl. pctmsum n. glosscpharviigci) with a small opening, the 
apertura inferior canaliculi tympanici (for the a. tympanica inferior; n. tynipanicus). Situated 
lateralward and j)rojecting downward and forward is the processus slijtoideus (for the lig. 
stjdomandihularc ; mm. stylohyoideiis, styloglossus, stylophavyugeus). variou-sly developed in diffi^ 
rent individiuils. .Inst lateral from this and behind it lies the foramen stylomastoideum (for 
the a, and v. stylomastoidi'a; n. facialis). Closely attiii-lied to the sfvloid proci>ss in front is seen 
the vagina processus slyloidci ((.». T. vaginal pl■o(■r^s), the lowest portion of the pars tMupanica. 



Bones of the Skull. 



11 



Squama 
temporalis 



Processus zygomaticus | 



Tuberculum articulare 

Pars tympauica- 

Vagina processus styloidei 



Processus mastoideus 




Facies cerebralis 



Incisura parietalis 

^ Fissura petrosquaniosa 
Eniiuentia arcuata 
Facies anterior pyramidis 

Hiatus canalis facialis 
/ ,Apertura superior caiialiculi tympanici 
/ Sulcus n. petrosi superficialis minoris 
. Sulcus n. petrosi superficialis majoris 

Tnipressio trigemiui 



-Apex pyraniidis 



Foramen caroticum internum 



Seniicanalis in, tensoris tynipani 
j ISeptum canalis nuisculotubarii 
Seniicanalis tubae auditivae 



- __ Processus styloideus 



10. Right temporal bone, os temporale, from in front. 

The facies anterior pyramidis is smooth and directed obliquel}-- from behind and 
above, forward and downward. Laterally it is fused with the squama temporahs through the 
fissura petrosquamosa , where it goes over gTaduaUy into the cerebral surface of the squama. 
The free, rough, anterior margin is the anguhis anterior; it forms an angle with the margo 
sphenoidalis of the squama in which fits thi> posterior angle of the large wing of the sphenoid 
bone. In this angle hes the opening of the canalis musculotubarius , directed forward and 
medianward; this canal is divided, usually incompletely, by means of a leaflet of bone, projecting 
fr'om its medial wall, the septum canalis musculotubarii, into a smaller upper part, the semi- 
canalis m. tensoris tympani (0. T. canal for tensor tympani muscle) and a larger inferior 
part, the semicanalis tubae auditivae (0. T. canal for the Eustachian tube). The anterior 
surface is bounded behind by the angulus superior (p. 9). Projecting at a point somewliat 
lateralward from the middle of the superior surface, near the posterior angle, is the cminc/itia 
arcuata (0. T. eminence for superior semicircular canal) caused by the canalis semicii-cularis 
superior. The smooth region a little lateral fi'om this is caUed the teijmen tympani since it 
covers the cavum tympani above. Stdl further forward two openings can be seen and two 
gi'ooves running forward from them: the medial opening, hiatus canalis facialis (0. T. hiatus 
Fallopii), leads through a short canal to the geniculmn canalis facialis and contains the r. 
petrosns superficialis a. mening. med. and the n. pctrosns superflc. maj., the latter passing 
further forward in the medial groove called the sulcus n. petrosi superficialis majoris; the 
lateral, smaller, opening, sometimes fused mth the medial, is known as the apertura superior 
canaliculi tympanici (0. T. opening for smaller petrosal nerve) through which rrai the a. 
tympaniea superior and the n. petrosns superflc. nun. in order to pass further on in the smaller, 
lateral, gToove, the sulcus n. petrosi superficialis minoris. On the ujiper surface near the 
apex of the p^Tamid lies the impressio triyemini (0. T. depression for (jasseriau ganghon) fur 
the n. trigeminus. 



12 



Bones of the Skull. 



Prominentia canalis 
semicircularis lateralis 



Fenestra veBtibuli 



Canalis facialis 
1 



Processus cochleariformis 

Septum canalis musculotubarii 

Apertura superior canaliculi 
/ tympanici 

/ Sulcus n. petrosi superficial 
ma j oris | 

Foramen, caroticum inter! 
Impressio trigemini| 




Prnbd 

canalicj 
tympad 

Semicanalis m. tensoris tymiaj 

Semicanalis tubae auditivae 

Foramen caroticum externum 

Probe in canaliculus tympanicus 



^ , i,T , Fossa jugularis 

Fenestra cochleae I 

Promontorium 



11. Right temporal bone, os temporale, cut open, 

lateral view of medial half of bone. Magnification 2:1. 

(The canalis facialis is opened in its entire length.) 

The canalis facialis (Fallopii) (0. T. Aqueduct of Fallopius) (for the a. and t. stylo- 
mastoidea, r. petrosus superiieialis a. meningeae mediae; n. faciaUs, n. intermedins) hegins in 
the floor of the meatus acusticus internus near the posterior surface of the pjTamid, thence 
passes lateralward, after a short course hends around at a light angle, forming the geniculum 
canalis facialis, and from this point passes hackward and then downward. In doing so it 
lies close to the mastoid wall of the cavity of the tjTiipanum and there forms the prominentia 
canalis facialis (not shown in the figure). It runs at first close beneath the facies anterior 
pjTamidis, then between the fenestra vestibuli and the prominentia canahs semicircularis 
lateralis, then behind the eminentia pyramidahs to terminate in the foramen stylomastoideum. 
From the geniculum canalis facialis which, in the new-bom (Fig. 15) lies free upon the anterior 
surface of the pyramid, a short canal jiasses medianward and foi-ward to the hiatus canalis 
facialis (0. T. hiatus Fallopii) (for the r. petrosus superfic. a. raening. med.; n. petrosus 
supcrfleialis major); another very delicate canal runs tu the upper part of the canaliculus 
tympanicus; behind the eminentia pyramidahs a Mttle lateral branch is given off to enter 
this eminence and lielniv it arises the canaliculus chordae tympani which leads into the 
middle ear (see ( »rgan of Hearing) , and receives the canaheulus mastoideus. 

The canaliculus tympanicus {\w\w\ for the a. t\Tnpanica inferior, above for the a. tym- 
panica superior; besides for the n. tjanpanicus and n. petrosus superficialis minor) begins with 
the apertura inferior in the depth uf the fossula petrosa, arrives in the cavum tympani on 
its inferior wall, runs nver the promontorimn in the sulcus promontorii , perforates the pro- 
cessiis cxjchlearifonuis and then passes in a curved direction in the bone, forward and upward 
to the apertura superior canaliculi tyrnpanici nu the ujipcr snrlaee of the pyramid- in this 
\i]i]ier part it receives a di'lii-ate canal coming from thi> geniculum canalis facialis. 



Bones of the Skull. 



13 



lucUui'a parietalis^ 
Sutura squamosomastoidea 



Canalis facialis 

Spina tympanica minor 
Spina tympanica major 




""- Entrance to the antrum 
tympanicum 



Spina tympanica major 
Spina tympanica minor 



Non- ossified area 



Sulcus tympanicus 



12. Right temporal bone, os femporale, at the 7th or 8th 

year of life, seen from without and somewhat from below. 

(The pars tympanica has been shelled out and di-awn separately in the lower part of the 
figure; on the right it is seen fi-oni the outside, on the left from within.) 

The canaliculi caroticotympanici (for the r. caroticotympanicus a. carotis internae; 
nn. carotieotympanici superior et inferior) usually two in number, are openings or short canals 
which pass from the posterior wall of the canaUs caroticus immediately over the foramen 
caroticum externum to the cavum tjTiipani and open in the latter on its anterior wall (see 
Organ of Hearing). 

The pars tympanica, a platelet of bone hollowed out behind and above in the form 
of a groove, a nearly flat plate in front and below, presents normally, during the early years 
of life, a non-ossified portion. The pars tympanica foi-ms the whole inferidr anterior and a 
part of the posterior wall of the meatus acusticus externus as well as the porus acusticus 
externus. The posterior limb of the groove Kes upon the anterior surface of the proc. mastoideus 
and often forms there the fissura tympanomastoidea. The anterior limb of the groove is 
attached to the inferior margin of the squama temporalis just behind the fossa mandibidaris ; 
lateralward it is fused for a short distance with the squama, but medianward there exists 
between the two a narrow platelet of bone which proceeds from the anterior margin of the 
facies anterior pyramidis and which , with the pars tympanica , forms the fissura petrotym- 
panica [Glaseri] (0. T. Glaserian fissure). The latter presents several small openings for the 
a. tympanica anterior, w. tympanicae, chorda tympani and the lig. mallei anterius. Below, 
surrounding the root of the styloid process from in front hke a sheath, is a process called the 
vagina processus siyloidei (0. T. vaginal process). 

The superior posterior surface of the pars tympanica is smooth and contains near its 
anterior medial extremity a groove, bounded by two ridges, the sulcus tympanicus (for the 
membrana tympani), the plane of which is inclmed obliquely forward, downward and median- 
ward: at each of the upper angles of the pars tympanica it runs out into a small pointed 
extremity, the anterior being called the spina tympanica major, the posterior, the spina 
tympanica minor. The space between these two spines is not entirely filled up l)y the 
attachment of the pars tympanica to the squama temporalis; on the contrary, there remains 
an indentation called the incisura tympanica [Rivini] (see Organ of Hearing). 



14 



Bones of the Skull. 



Squama temporalis 




Foramen 
stylomastoideum 



Processus 
zygomaticns 

■Tuberculum articulare 

'- Fossa mandibularis 

Fissura petrotynipanica 
[Glaseri] 

\ Pars petrosa 

Annulus tympanicus 




Fenestra vestibuli Promontoriuni 



13 and 14. Right temporal bone, os lemporale, 

from the newborn child, seen from without. 

{13: complete, 14: squama temporalis and annulus tympanicus alone.) 



Squama temporalis 

Y 



Sulcus arteriosu' 



Geiiiculum canalis 

facialis et sulci 
nn. petros. auperf. 




Fissura petrosquamosa 

Tegmen tympani 
Incisura parietalls 
Eminentia arcuata 



/ 



.Pars petrosa 



Canalis caroticus 

Impressio trigemini ,' / / / j Apertura externa aquaefluctus vestiljnli 
Facies posterior pyramidis ; / / jncisura jugularis 

Porus acustieus interniis / Apertnra externa canaliciUi cochleae 
Fossa subarcuata 

15. Right temporal bone, os femporale, from newborn child, 

seen from within. 

The OS tempornle consists in the foetus (jf three parts, pars petrosa, squama temporalis 
and pars tympanica; in the newborn it is still divided into all three or into only two parts 
according as the squama temporalis and pars tympanica still remain separated or have united 
with one another. The pars tympanica in the newborn is a flat semicircle, the annulus tym- 
panicus; it is open above and contains in its concavity the sulcus tympanicus (see p. 13); 
out of it the pars tympanica ultimately develops in that it ijrows out chiefly in a lateral 
direction to form a jvniovi'. 

In the newborn no actual proc. mastoideus exists. The foramen stylomastoideum lies 
on thi; lateral surface of what is later to be the pars mastoidca. The pi'OC. styloideus is still 
cartilaginous. On the jiusterior and anterior surface of the p\Tamid the size of the fossa 
subarcuata (p. VI) ami the situ of the geniciilum canalis facialis (pp. 11 — 12) not vet bridged 
over by bone, are striking features; acrordingh, a hiatus canalis facialis, in the sense in winch 
it exists in the adidt, is absent in the newborn. 



Bones nf the ISkull. 



15 



Sqnauia frontalis 



l-'acies frontalis 



Tuber frontale 



Margo 
parietalis 




Facies 
temporalis 

Linea temporalis 



/ 


■ 1 


[-^^rV 


'■ \ • Processus zygomaticus 




\ 


L-iPr ' 


\ 1 Margo supraorbitalis 


Site of former sutura frontalis '' 




If 


i Foramen supraorbitale 
, Incisura frontalis 


Glabella 




^^--_ 


Arcus superciliaris 








-Spina frontalis 




L 


Margo 
nasalis —' 






Pars nasalis 





17. Frontal bone, os froniale, from in front. 

The unpaired os frontale (frontal hone) (see also Figs. 17, 18, 55 — 58, 61 — 66, 
68 — 71, and 73) closes the cerebral skull in front and lies above the facial sknU. It has four 
parts, the unpaired squama frontalis and ipars nasalis, and the paired -partes orhitates. 

The squama frontalis is curved sagittaUy and transversly so as to be convex in front. 
Its largest posterior serrated margin, margo parietalis , unites with the frontal margins of 
the parietal bone to form the sutura coronalis. The inferior boundary is formed in the middle 
by the pars nasalis, lateral from this on each side by the margo supraorbitalis; the latter 
runs out lateralward into the proc. zygomaticus , which unites, by means of a rough surface, 
with the proc. frontosphen. of the zygomatic bone to form the sutura zygomaticofrontalis. 

In the medial part of the margo supraorbit. there is often a shallow notch, incisura fron- 
talis (rarely a foramen frontale) (for the a. frontalis; r. frontal, n. frontal.) and lateralward 
from this a foramen supraorbitale or an incisura supraorbitalis . (for the a. supraorbit. ; 
n. supraorbit.). The anterior, convex surface, facies frontalis, is smooth and sometimes presents, 
in the median plane, signs of the sutura frontalis (always present at birth) ; lateralward from 
this on each side lies the tuber frontale (0. T. frontal eminence) and lateralward from this 
the linea temporalis, ascends backward and upward from the zygomatic process, boundhig the 
flat, nearly sagittally placed, facies temporalis (for the m. temporal). Close to the inferior 
border, near the median plane on each side, begins a ridge, arcus superciliaris (0. T. super- 
ciliary ridge), which passes upward and lateralward, flattening as it proceeds; the depressed 
surface lying between the medial ends of these ridges is called the glabella. 



16 



Bones of the Skull. 



Sulcus sagittalis 



"Facies cerebralis 



Squama ^ 
frontalis 




Pars orbitalls 



t 



\ \ Crista frontalis 
\ Foramen caecum 
Spina frontalis 



Processus zygomaticus 



Pars nasalis 

17. Frontal bone, os frontale, from behind. 

The concave posterior surface of the si^uama frontalis forms a part of the facies 
cerebralis (0. T. interaal surface) of the frontal bone. In the median plane in the upper 
part, is a shallow gToovo, sulcus sagitialis (for the sinus sagittalis superior ; fals cerebri) ; out 
of its lower end develops a narrow, usually markedly projecting sharp ridg-e, the fn^ntal crest 
or crista frontalis (fur the falx cerebri), which, below, forms the anterior boundary of the 
foramen caecum. 

The term pars nasalis is applied to the part projecting somewhat from the inferior 
margin of the squama fi'ontalis in the middle; it separates the two partes orbitales from one 
another. In front it is boimded by the shghtly serrated mar go nasalis, to which the nasal 
bone is attached on each side fsutura nasofrontalis) ; inmiediately adjacent is attached the 
proc. frontalis maxillae (sutura frontomaxillaris). The posterior free margin is the anterior 
part of the incisura ethmoidalis ; it unites wiih the anterior margin of the lamina cribrosa 
OSS. ethmoidalis and forms a part of the sutura frontoethmoidalis. Obliquely downward and 
forward from the inferior rough surface projects the spina frontalis (0. T. nasal spine). It 
is rough in front for the further attachment of the nasal bones and of the frontal processes 
of the maxillae; its posterior, jiartly smooth, partly rough, surface is applied medianward to 
the crista galli and lamina per])riidiculLiris uss. ethmoidalis, lateralward to the medial wall of 
the ethmoidal labyrinth; botwcrn these the posterior surface helps to form also the anterior 
wall of the nasal cavity. On the upper surface, close behind the inferior extremity of the 
crista fi'ontaUs , Ues the entrance (usually formed by the frontal boni> alone) to the foramen 
cai'cuin, a caiial which grows siualler as it descruds and ends blindly in the apex of the spina 
frontalis; it contains oidy a jimcess of thi^ dura mater. The sjjina frontalis is also perforated 
)]y a small canal which extends from behind and above, forward and downward, and gives 
passage to the n. ethmoid, ant.. 



Bones of the Skull. 



Glabella 
Spina frontalis / 



Arcns superciliaris 
Incisure frontalis 
Spina trochlearis 

Foramen supraorl)itule 
JVrargu supraorbitaliH 
Fossa glancUilae 
lacriiualis 




Fovea 
Jf^ trochlearis 



Pars orbitalis 



Incisura 
ethmoid alls 



Processus zygoniaticus 

Facies orbitalis 
Foramen ethmoidale anteriu^ 

^Foramen ethmoidale posterius 



18. Frontal bone, os frontale, from below. 

The partes orbitales pass at a right angle from the inferior margin of the squama 
frontalis backward and are separated fi-om one another by the quadrangular incisura ethmoidalis 
cutting in from behind. The anterior boundary is formed liy the marrjo supraorUtalis ; the 
lateral by the processus zygomaiicus. The posterior margin is slightly serrated medianward 
for union with the ala parva oss. sphenoid., and is continuous lateralward toward the proc. 
zYgomat. with a triangidar rough surface for contact ^^■ith the margo frontahs of the ala 
magna oss. sphenoid, (sutura sphenofronialis) ; behind this surface lies a variable, narrow, 
sickle-shaped, smooth field, which along mth the ala parva oss. sph(>noid. helps to form the 
middle fossa of the skull. The medial border, bounding the incisura ethmoidahs, is only 
slightly rough and fonns with the lateral margin of the lamina cribrosa oss. ethmoid, a part 
of the suiura frontoethmoidalis. Near this margin a rough ridge runs lateralward to which 
are attached in front the os laorimale by the sutura frontolacrimalis , behind the lamina 
papyi-acea oss. ethmoid, by a part of the sutura frontoethmoidalis. The oblong field lymg' 
between this ridge and the medial border is irregularly di-s-idcd by thin transverse ridges, h(?s 
upon the upper surface of the ethmoidal labyrinth and helps to cover the ceUulae ethmoidales 
from above; two grooves, running frontaUy, form with corresponding grooves of the ethmoidal 
labyiuith the foramen ethmoidale anterius (for the a. ethmoid, ant.; n. ethmoid, ant.) and 
the foramen ethmoidale posterius (for the a. ethmoid, post. ; n. ethmoid, post. , rr. orbital, 
gangl. sphenopalat.). The inferior surface of the pars orbit., facies orbitalis , is smooth and 
presents near its medial anterior angle a small depression, the fovea trochlearis (ami occa- 
sionally near it a smaU spur, spina trochlearis) (for the trochlea m. obHqm ocuh super.); in 
the lateral portion, bounded in front by the margo supraorbit., lateralward by the proc. zygomat., 
lies the fossa glandulae lacrimalis (for the glandula lacrun. sup.). The upper surfa<'p, facies 
cerebralis, presents strong juga cerebralia and impressiones digitatae. At the junction of the 
partes orbitales with the squama fi-ontalis the bone contains within it, the sinus frontales or 
frontal sinuses , cavities between the plates of the partes orbitales and the squama of varying 
width and hned by mucous membrane. They are subdivided liy the septum sinuum frontalium, 
which usually diverges somewhat ft'om the median plane; the entrances lie in the anterior 
medial angles of the partes orbitales. 

Spalteholz, Atlas. 2 



18 



Bones of the Skull. 



Facies parietalis , 



Margo occipitalis 



r~ 



Anguliis 
occipitalis 



Margo sagittalis 

Foramen parietale 
, Tuber parietale 
\ _ Linea temporalis inferior 



Linea temporalis superior 



1 




Angulus frontalis 



Margo frontalis 



Angulus mastoidcus 



_ Margo squamosus 



Angulus sphenoidal is. 



19. Right parietal bone, os parietale, from without. 

The OS parietale (parietal hone) (see also Figs. 20, 55, 56, 61 — 66) is paired and 
helps to form the ruof and lateral wall of the skuU. It is a quadrano-ular, flat, saucer-shaped 
bone with an external, convex facies parietalis and an internal, concave facies cerebralis. 

The hone has four margins, and four angles. The posterior convex margin, margo 
occipitalis, is deeply serrated and unites with the margo lambdoideus oss. occip. to form the 
sutura lambdoidea. The inferior margin, margo squamosus , is concave and bevelled from 
without; it is attached to the margo parietal, oss. temper, (sutura squamosa) . The anterior, 
shghtly concave margin, margo frontalis, is serrated and unites with the margo parietal, oss. 
front, to form the sutura coronalis, and thi^ upper straight, markedly serrated margin, margo 
sagittalis, forms with the same margin of the opposite parietal bone the sutura sagittalis. 
The anterior superior angle, angulus frontalis, lies in the middle of the sutura coronalis and 
adjoins the frontal hour; the posterior superior angulus occipitalis, adjoins the upper extre- 
mity of the squama oi'cipitalis. The posterior interior angle, angulus mastoideus, is inserted 
in the incisui'a parietal, oss. tenijior. and forms there with the upper margin of the pars 
mastoid, oss. temper., the sutura parieiomastoidea. The anterior inferior angli>, angulus 
sphenoidalis , is bevelled fi-oni irithout, attachcil to the angul. pariet. of the ala magna oss. 
sphenoid, and forms with this the sutura sphcnoparictalis. 



Bones of the Skull. 



19 



Margo sagittalis 

Sulcus sagittalis Facies cerebralis 



Angulus frontalis 



Sulcus arteriosus 




A.ngulus occipitalis 



Sulcus transversus 



Angulus 
spheuoidalis 



" ~ Margo squamosus- ■ 



..-J 



Angulus mastoideus 



20. Right parietal bone, os parietale. from within. 

The fades parietalis is more or less markedly bulged out in the middle; this pro- 
jection is called the tuber parietale. Below it nms the linea temporalis inferior, convex 
above, which begins at the margo frontalis as a continuation of the Unea temporalis oss. fi'on- 
talis and goes over at the angulus mastoideus into the linea temporahs oss. temporahs ; it 
itself and the field beneath give origin to the m. temporahs. Concentric with it runs generally 
a less marked linea temporalis superior, which ends at the margo occipitalis ; to it are attached 
the fascia temporahs and the galea aponeurotica. Close to the margo sagittahs there is often, 
near the angulus occipitalis, an opening, the foramen paiietale (for the r. meningeus a 
occipitalis, emissarium parietale). 

On the facies cerebralis along the margo sagittahs runs a groove, completed by 
apposition with the .parietal hone of the other side, the sulcus sagittalis (for the sinus sagit- 
tahs sup. ; falx cerebri), into which the foramen parietale usually opens. Over the inner siu- 
face of the angTdus mastoid, runs a short broad flat gr(.iove, the sulcus transversus (0. T. 
groove for lateral sinus) (for the sinus transvers.j. At the angulus sphenoid, is foimd a deep 
sulcus arteriosus, sometimes for a short distance an actual canal, otherndse sevi-ral shallower 
ones, for branches of the a. mening. med. In addition the facies cerehrahs presents im- 
pressiones digitatae and. juga cerebralia and also frequently, especially in older people, near 
the sulcus sagittalis, foveolae granularcs [Pacchioni] (0. T. Pacchionian depressions). 



20 



Bones of the Skull. 



Crista galli 

Processus alaris 
Lamina cribrosa 



Lamina 
papyi'acea 



IJabyrinthns 
ethmoidalis 




Lamina cribrosa 



Labyriiithns 
ethnioidalis 



Processus uncinatus 
Concha nasalis superiitr 



' Concha nasalis media 

Lamina perpendicularis 




^Foramen ethmoidale 
posterius 



• - Lamina papyracea 



-Foramen ethmoidale 
anteriua 



Crista galli 
Processus alaris 



^ Lamina perpendicularis 



21 and 22. Ethmoid bone, os ethmoidale. 

From behind, somewhat schematic. From above. 

The OS ethmoidale (ethmoid bone) (see also Fig-s. 23—25, 63, 64, 6S— 70, 73—75) 
is unpaired, helps in part to i-lnse the most anterior portion of the cerebral skull below, but 
reaehes with its main mass deep down into the faeial sknU and helps to fomi the nose and 
orbit. It consists above of a trans-iprsi'ly placed oblong plate, the lamina crihrosa; from the 
imder surface of this extending downward in the median plane is the lamina perpendicularis 
and from each of its two lateral borders hangs the lahjrinthus ethmoidalis. 

The lamiua cribrosa (cribriform plate) lies h(.>rizontally, fills the incisura cthmoidahs 
OSS. frontahs completely and thus forms at the antm-ii'r and the two lateral margins a part 
of the sutura frontoethmoidalis ; the posterior margin lies on the anterior border of the upper 
surface of the b(.Kly of the sphenoid bone (sutura sphenoethmoidalis) . The cribriform plate 
presents on its upper surface in the median plane a ridge which becomes elevated in fi'ont to 
form the oblong crista galli or cock's comli (for the falx cerebri); this is higher in front than 
behind and often contains bone-marrow s]iac(-s: it is attached to the pars nasalis and crista 
frontalis oss. &-ontalis, usually by means of the two small, laterally directed processus alares, 
and completes the entrance' to the foramen caecum oss. frontalis when this is incomplete. 
The cribriform plate is perforated liy nmneroiis Inraniina, the larger (if which are arranged 
chiefly in two I'ows, one medial and oni' lateral, and which are continued in small grooves on 
the laiimia jierjiendicularis and on the medial surface of the labyrinth; tlu-y give passage to 
the nn. olfa<'torii. .\ small sht laterah\ard from the anterior jiart o|' the erista galli receives 
the ,1.. and the n. ethmoidalis anterior. 



Bonos of the Skull, 



21 



Processus alaris 
rista galli 



Lamina cribrosa 



Concha nasalis media 

Concha nasalis .superior ,, ,, 

' I' oraiuen ethmoi- \ 

/ Recessus sphenoothmoid. *-^ale posterius \ 

/ I Concha nasalis suprema '■ ' 




Foramen ethnioidale anteriu 
Lamina papyracea 



Crista galli 




Concha 
nasalis media 



; Lamina 

J perpendicularis 

I^rocessus uncinatus 



Couclia nasalis inferior 
'Processus xmciiiatus 



23 and 24. Right ethmoidal labyrinth, labyrinthus 

From within. ethmoidalis. From without. 

Each labyrinthus ethmoidalis (0. T. lateral mass of ethmoid) is oblong and quadran- 
gular in shape and is connected only aliove and median ward with the lateral border of tln' 
lamina cribrosa. Inside it is divided hj delicate platelets of bone into the numerous cellulae 
ethmoidales (ethmoid cells) lined by mucous membrane. They conmiunicate with one another 
and are closed completely by the wall of the ethmoid bone only on the medial and lateral 
surface: otherwise they are partly open and become closed cavities only by the attachment of 
adjacent bones; in front the pars nasalis oss. frontalis and proc. fi'ontalis inaxillae, lateralward 
by the os lacriniale and corpus maxillae, behind by the proc. orbitahs riss. palatini, corpus oss. 
sphenoidaHs and conchae sphenoidales , above by the pars orbitalis oss. frontalis; spread out 
on the latter surface of union are the foramen ethmoidale anterius (for the a. ethmoid,, ant.; 
n. ethmoid, ant.) and the foramen ethmoidale posterius (for the a. ethmoid, post. ; n. ethmoid, 
post., rr. orbit, gangl. sphenopalat.). The lateral wall of the labjTinth, lamina papyracea 
(0. T. OS planum), is oblong, quadrangular, and unites ia front mth the os laorunale, below 
with the corpus maxillae (sutura ethmoideomaxillaris) , behind with the proc. orbital, oss. 
palat. (sutura palatoethmoidalis) and the corpus oss. sphenoid, (sutura sphenoethmoidalis), 
above with the pars orbital, oss. front, (sutura frontoethmoidalisj. The medial wall is vertical, 
is very rough, and much pei-forated. Its anterior margin is attached to the posterior surfVice 
of the spina frontalis oss. frontalis, its posterior border to the anterior surface of the concha 
sphenoidalis ; the inferior thickened border hangs dovra fi-ee, bends around somewhat lateral- 
ward, and thus forms the concha nasalis media (middle turbinated bone); above this in the 
posterior part is a deep notch (meatus nasi superior, upper nasal passage) and above this 
a similar, concha-like plate of bone, bent so as to be convex medianward, the concha nasalis 
superior (superior turbinated bone); further backward and upward lies usually still another 
turbinated bone, the concha nasalis suprema, separated from the preceding Ijv a groove, the 
recessus sphenoethmoidalis. Lateralward from the anterior extremity of the concha media, 
a sickle-shaped process, the processus uticinatus (0. T. unciform process), directed backward, 
becomes separated fi'om the inferior wall; at its extremity it rolls aroimd lateralward, and below 
or behind this place unites with the proc. ethmoidalis conchae nasalis ioferioris. 



22 



Bones of the SkuU. 



Os frontale 



Os nasale 



Crista galli 

Lamina perpendicularia 



Lamina cribrosa (in section); 

Corpus ossis sphenoidalis 



Concha nasalis -' 
inferior 




Lamina medialis processus 
Ijterygoidei ossis sphenoidalis 



A'onier 
Processus palatinus maxillae 



25. Ethmoid bone, os ethmoidale, lamina perpendicularis. 

from the left. 

Tho lamina perpendicularis or perpendicular iilatc is quadrangular with unequal 
sides; at its upper border in the median plane it is in largv part united to the inferior sur- 
face of the lamina eribrosa ; it hangs down perpendicularly and fi-ee between the two labyrinths 
and thus forms a part of the bony nasal septmn. At its upper margin it presents small 
grooves which are continuations of the medial foramina of thi^ lamina crilirosa. The upper 
border is attached in fi'ont to thi^ juisterior surface of the spina frontahs uss. ft'ontalis (sutura 
fronioeihmoidalisj ; the posterior margin unites with the crista sphenoidahs oss. sphenoidahs 
(s'uiura sphenoethmoidalis) , the inferior with tho anterior margin of the vomer, thi- anterior 
with the cartilaginous nasal septum. 

Di'viatidus of the lamina perpendicularis as a wholi^ or in single spots from the median 
plaur are very fi'equent. 



Bones of the Skiill. 



23 



LubyrintluiM ethmoidalis (medial surface) 

; Processus lacrimalig conchae nasalis iuferioris 
\ ,' ; Processus uncinatus ossis ethmoidalis 



Processus ethmoidalis conchae nasalis interior 




Processus ethmoidalis 

Processus lacrinuxlis 




Processus niaxillaris 



26 and 27. Right inferior turbinated bone, concha 

Above, fioin witliin. naSoHs inferior. Below, from without. 

The concha nasalis inferior (inferior turbinated bone) (see also Figs. 68, 73, and 
74) is paired; it lies on each side in the lower part of the lateral nail of the nasal cavity 
and is placed sagittaUy in its longest diameter. It is oblong, very porous, bent so as to be 
convex medianward, and hangs downward as a, free mass from its upper attached margin. The 
inferior border is much thickened and lateralward somewhat rolled. The upper thiimer margin 
is attached in front to the crista conchalis maxillae and gives ofl' close behind this point the 
processus lacrimalis, directed obhquely upward and forward, which unites with the inferior 
margin of the os lacrimale (sutura lacrimoconchalis) ; somewhat further backward the broad 
processus maxiltaris projects lateralward and dciwnward, so as to lie on the inferior circum- 
ference of the hiatus niaxillaris; above this broad process arises the narrower, more irregular 
processus ethmoidalis which passes upward to unite with tho processus uncinatus oss. ethmoi- 
dalis. The most posterior part of the upper margin is attached to the crista oonchahs 
oss. palatini. 



24 



Bones of the Skull. 



Os lacrimale 

Sulcus lacrimalis 



Crista lacrimalis 7, ^ 
posterior - - J. 



Processus frontalis 
maxillae 





28 and 29. Right lachrymal bone, os lacrimale. 

From without From within. 

The OS lacrimale (lachrymal bone) (see also Fiys. 68 — 70, 73, and 74) is a paired, 
oblong', quadrangular, thin platelet of bone, the size of >■ finger nail, and lies in the anterior 
part of the medial wall of the orbit. The upper margin unites with the pars orbitalis oss. 
frontalis (sutura froniolacrimalis); the posterior margin with the anterior border of the lamina 
papyracea oss. ethmoidaUs; the inferior margin behind with the medial margin of the fades 
orbitaUs of the corpus maxiUae (suttira lacrimomaxillaris) , in ft-ont with the proc. lacrimalis 
conchae nasalis infcrioris (siitura lacrimoconchalis) ; the anterior margin with the margo 
lacrimalis of the proc. fi-ontahs maxillae (sutura lacrimomaxillaris). The medial surface is 
tolerably flat, hes fi'om without on the anterior part of the lateral wall of the ethmoidal laby- 
rinth and so closes the anterior ethmoidal cells; the lateral surface is divided by a crest 
extending fi-om above downward, the crista lacrimalis posterior (0. T. lachrymal crest) (for 
the origin of the pars lacrimalis m. orbicularis oculi), into a smaller posterior level area and 
a larger anterior concave area, sulcus lacrimalis \ the latter forms with the sulcus lacrimalis 
of the proc. frontalis maxillae, the fossa sacci lacrimalis (for the saccus lacrimalis). Fi'om 
the inferior extremity of the crista lacrimahs posterior proceeds the somewhat variable hamulus 
lacrimalis (0. T. hamular process) lateralward, forward and downward; it is inserted in the 
iucisura laerunahs on the medial anterior margin of the orbital surface of the body of the maxilla. 



Bones of the Skull. 



25 



Union with the 
pars nasalis ossis frontalis 

r n 



Processus frontalis 
maxillae 




Probe in one 
foramen nasale 



/\ 




Union with the ',' 


A^ 


03 nasale of J . 


p 


the other side ^'A 


% 


^^BKSm 


Sulcus 


(^^' 


ethmoidal] 



Probe in one foramen na-^ale 



Processus zygomaticus | 
maxillae 



Corpus maxillae 



30 and 31. Right nasal bone, os nasale. 

From without From -within. 



The OS nasale (nasal hone) (see also Kgs. 57, 58, 68, 73—75) is paired and forms 
flith that of the other side the root of the nose and the upper part of the back of the nose. 
It is a small, oblong, quadrangular bone thicker and narrower above, thinner and broader 
below. The nasal bones of the two sides are attached to one another by their medial, slightly 
serrated borders to form the sutvra internasalis ; the upper serrated border unites with the 
margo nasalis of the pars nasaMs oss. frontalis to form the sutura nasofrontalis ; the lateral, 
somewhat bevelled margin foims with the anterior margin of the processus ffontahs maxillae 
the sutura nasomaxillaris ; the inferior, bevelled, irregularly serrated margin unites with the 
lateral nasal cartilage; in the macerated skull, however, it lies ft-ee and helps to bound the 
apertura piriformis. The anterior surface is smooth and usually slightly curved hke a saddle. 
The posterior surface in its upper portion is attached fi'om in front to the spina frontalis uss. 
frontalis; in its lower portion it is smooth and helps to form the bony part of the anterior 
wall of the nasal cavity; there is seen also the sulcus ethmoidalis (0. T. groove for nasal 
nerve) (for the n. ethmoidaUs anterior). The nasal bone is often perforated by one or several 
small openings, foramina nasalia. 



26 



Bones of the Skull. 



Squama frontalis 



Lamina perpendicularis 

ossis ethmoidalis Corpus ossis 
sphenoidalis 




Ala vomeris 



Ala vomeris 



Lamina medialis processus 
pterygoidei ossis sphenoidalis 



Groove for the 
attachment of the 
lamina perpendi- 
, '^cularis ossis eth- 
moidalis and the 
cartilage septi nasi 



Tomer 



Processus palatinus maxillae 



32 and 33. Plough -share bone, vomer. 

From the left. From in front. 

The vomer (ploughshare hone) (see also Kg. 75) is an unpaired, oblong quadrangular, 
flat bone whicb lies in the median plane and forms the posterior part of the nasal septum. 
It is usually bent somewhat to one side, but never at its posterior margin. Its upper margin 
is broad and is spht into two thick laterally directed leaves (alae vomeris), each of which is 
attached by its fi-i;e margin to the proe. vaginalis of thi,' proc. pterygoideus oss. sphenoidahs 
and to the proc. sphenoidalis oss. palatini. The two wings of the vomer leave a groove between 
them in which is placed the rostrum sphenoidale. The posterior margin is smooth, thin and 
lies free. The inferior margin is sharp and seri'ated, and adjoins thi.' crista nasalis of the 
miited palate bones and upper jaw bones. The anterior margin, which is also the upper, is 
snniewhat thickened and hollowed out to form a groove; it unites behind with the inferior 
margin of the perpendicular plate of the ethmoid bone, in fi'ont with the cartilaginous 
n;isal septum. 



Bones of the Skiill. 



2'y 



Corpus 



Facies orbitalis 



Sulcus infraorbitalis 
Facies infratemporalis 

Foramina alveolaria -:-■ 
Tuber maxillare 

Processus 
zygomaticus ' 




■^ Processus frontalis 

rista lacrimalis anterior 
Ineisura lacrimalis 



- - aiargo infraorbitalis 
Facies anterior 

Foramen infraorbitale 
Fossa canina 
Ineisura nasalis 
Processus palatinus 

-^ - Spina nasalis anterior 

Juga alveolaria 



Processus 
alveolaris 



34. Right upper jaw bone, maxilla, from without. 

The maxilla (0. T. svpcrior maxillary hone) (sof also Figs. 35, 36, 55—60, 67—75) 
is paii-ed, lies in the upper anterior part of the facial skull and is divisible into a corpus or 
body and four processes of which two . the processus frontalis and processus zygomaticns, 
belong to the upper part, whili- the two others, the processus alveolaris and the processus 
palatinus, belong to tho lower part. 

The corpus or body is quadrangular in shape and contains within it a large cavity, 
simis maxillaris (0. T. antrum of Highmore) lined by mucous membrane, the entrance to 
which, hiatus maxillaris, is situated on the nasal surface. The upper surface, facies orbitalis 
(planum orbiialej is smooth, triangular, dh-ected obliquely forward, outward and downward 
and fonns the floor of the orbit; its medial border unites behind with the lamina papyracea 
nss. ethnioid. fsutura ethmoideomaxillaris) , in front with the lachrymal bone (sutura lacrimo- 
maxillarisj; the anterior border is smooth medianward, lying free as the margo infraorbitalis, 
while lateralward it is serrated and goes over into the proc. zygomaticns ; the posterior border 
is for the most part smooth, lies fi-cc, and forms with the inferior margiu of the orbital surface 
of the large wing of the sphenoid running parallel to it, the fissura orbitalis inferior (for 
the a. infraorbit., v. ophthalm. inf.; mi. zygomat., infraorbit.). From this point forward on the 
upper surface extends a groove (sulcus infraorbitalis) closed by periosteum, which gTaduaUy 
becomes deeper and is continued into the canalis infraorbitalis (both for the a. nifi-aorbit. ; 
h. infraorbit.); branching off from this are the very minute canales alveolar es (for the aa. alveol. 
sup. ant.: rr. alveol. sup. medius et anteriores n. infraorbit.), which rim within the anterior 
wall of the body of the bone. Upon and beneath th(^ posterior medial angle of the facies 
orbitahs is attached the proc. orbital, oss. palat. (sutura palatomaxillaris) . The posterior 
surface, facies infratemporalis {(). T. zygomatic surface), looks into the fossa infi-atemporalis 
and pterygopalatina , is shghtly rough, often bulged out (tuber maxillare) and there gives 
origia to parts of the nmi. pterj'goideus extemus and internus; it presents from two to three 
small foramina alveolaria, which lead into canals passing forward, the canales alveolares 
(('•. T. posterior dental canals) (for the a. alveol. sup. post.: im. alveol. sup.). The anterior 
surface, facies anterior (0. T. external or facial surface), presents above the foramen infra- 



28 



Bones of the Skiill. 



Processus frontalis 

,-^ Union Tvith pai's 

nasalis ossis frontalis 



- Margo lacrimalis 



Union with os nasale 



Crista ethmoidalis' 



Crista conchalis-' 



Union with lamina papyracea 
OSS. ethmoidalis 



Spina nasalis anterior - 




Facies nasalis 
Incisiira nasali 



Hiatus maxillaris 

Surface for apposition with the 
- pars perpendicularis 

;.y ossis palatini 



;-'-- Corpus maxillae 

Crista nasalis 

Groove for the completion of 
the canalis pterygopalatinus 

■^ -- Processus alveolaris 



Processus palatinus 



Canalis incisivus 



35. Right upper jaw bone, maxilla, from within. 

The facies nasalis i.f the corpus maxillae is placed sagittally and helps te form the 
lateral wall of the nasal cavity. A large opening in it, the hiatus maxillaris, leads into the 
sinus maxillaris ((.). T. antrum of Highniore). The slightly rough field behind the hiatus 
has attached to it the facies maxillaris of th(.' pars perpentheularis oss, palatini and presents 
usually a smooth perpendicular gruovc for the completion of the canaUs pterygopalatinus. In 
front of the hiatus in the upper part passing doi^iiward from the posterior margin of th(^ proc. 
frontaUs is the sulcus lacrimalis which is closed tn form the canalis nasolacrimalis (0. T. 
lachl■J^nal groove) liy the attadunent to it medianward of the os lacrimale above and the proc. 
lacrimalis coiichai^ nasalis inferioris liclnw. In fi'ont of this the crista conchalis (for union 
with the upper border of the concha nasalis inferior) runs approxunately horizontally forward. 
The anterior margin, incisura nasalis, helps to Imuud the aperiura piriformis. 

The processus frontalis (0. T. nasal process) ascrnds in front fr-om the upper 
margin of the facies nasahs and facies anterior. Its upper, thick, serrated margin Ues upon 
thi.' pars nasalis oss. frontalis (siitura frontomaxillaris); the anterior, sharji. shghtly serrated 
margin unites with the os nasale (sutura nasomaxillarisj . The jiosterinr broad margui 
presents a groove, stilcus lacrimalis, which leads do^^■nward on the faci(-s nasahs of the body 
(vide supra); it is boimded medianward l)y the margo lacrimalis, to which is attached the 
anterior margin of the lachrymal lione (sutura lacrimomaxillaris) , lateralward by the sUght 
crista lacrimalis anterior, which g(jes over into the niargo infi-aorbitalis; behind this point 
of transition is situated the incisura lacrimalis, m which is placed the hamulus lacrimahs 
oss. lacruualis. The lateral surfaci' is smooth; ou 
is tile crista ethmoidalis (for ai)pii,'iition mth tl 
the labyrinth). 

The short, bivail processus zygomaUcus (0. T. malar process) jiv.Kreds from the 

lateral urmer lllC'lc f)f the liodv df fhi^ nm-i,.T imi- n^i,! ;.- ..-..i,,,...,ll.- l,..ll l ..^ :„ -.: i . e ., 



the medial, nmning 
anterior extremitv of 



from behind forward, 
the medial surface of 



Bones of tho Skull. 



29 



Sutnra intemiaxillaris , Foramen iiu-isivnni 

/ <»s incisivxiiii 




Processus palatinas _. -^' 



Sutui'a incisiva 

Sutura palatina incdiana 

Alveoli dentales 

Liiiibu8 alveolaris 
Sc'iitum interalveolare 



36. The two upper jaw bones, maxillae, united, from below. 

The processus palatinns is a transversely placed plate ef bone whieli goes off metHan- 
ward ft-om the inferior margin of the fades nasahs and helps to form the bony septum between 
the nasal and the buccal cavity. At the medial rough margin the two maxUlae imite with 
one another to form the sutura palatina inediana; above the same on each maxilla runs a 
ridge, crista nasalis , the union of the two ridges serving for the attachment nf the vomer 
and the cartilage of the septum of the nose. The posterior margin lies on the anterior border 
of the pars horizontalis oss. palatini (sutura palatina transversa). The upper surface is 
smooth and shghtly concave in frontal direction; the inferior surface is rougher and pn'snits 
near the posterior extremity usually two sulci palatini (for the branches of the a. palatina 
]najor) boimded by small ridges, sjyinae palatinae. 

The processus alreolaris is dependent in its development on that of the teeth and 
extends dowmward like an arch convex in front and externally, concave behiud and intemaUy, 
from the lower margin of the body. The broader, free, inferior margin, limbus alveolaris, 
contains eight tooth canities, alveoli dentales, which are separated fi-om one another by the 
sej}ta interalveolaria ; they have wide mouths and grow narrower in the depth; they are 
exact unpressions of the corre-sponding roots of the teeth. The anterior surface of the proc. 
alveolaris presents oblong projections, juga alveolaria, corresponding to the anterior five al- 
veoli. The portion of the bone lying most medianward including the most anterior two (in- 
cisor-teeth) alveoli and the corresponding part of the proc. palatums represents what is in the 
foetus a special bone (as incisivum) which fuses early with the rest of the bone; remains of 
the suture originally present at the site of union, the sutura incisiva, are usually distinct in 
the new-born, sometimes also in the adult; medianward th(^y extend, arch-like, backward to 
an unpaired opening, foramen incisivum, situated on the inferior surface of the combined 
proc. palatini ; from it proceeds upward the sj-nmietrically forldng canalis incisivus (for branches 
of the a. palatina major, branches of the n. nasopalatinus) and ends on the upper surface of 
each proc. palatinns by an opening on each side. The two processus alveolares unite in the 



30 



Bones of the Skull. 



Crista ettiinoidalis 
\ Processus orbitalis 




Incisura spbenopalatina 
Processus sphenoidalis 



Pars 
perpendicalaris 

Crista conchalis 



Facies nasalis 



Area for completion of 
the fossa pterygoidea 



Processus pyramidalis 
Spina nasalis posterior 



Maxilla 



Pars horizontalis 



37. Right palate bone, os palatinum, from within. 

The paired os palatinnm (palate bonej (see also Figs. 38, 39, 59, 50, 68—70, 72—74) 
lies in the pusti-rior part of the nasal cavity and there forms a part of the floor of the same 
(of the hard palate) and of the lateral wall. It presents for examination a pars horizontalis 
and a pars perpendiculai'is. 

The pars horizontalis (0. T. horizontal plate) is very similar to the proc. palatinus 
maxillae, only shorter; the upper surface (facies nasalis), is smooth and slightly concave; the 
lower surface (facies palatina), is somewhat rough and presents near the posterior margin a 
small sickle-shaped elevated surface f.>r the attachment of the m. tensor veli palatini. The 
anterior, slightly serrated margin lies on the posterior border of the proc. palatinus maxillae 
and forms with this the sutura palatina transversa. The medial margin unites with the 
corresponding border of the bone of the other side and forms the posterior part of the siitura 
palatina mediana; on the upper surface of this border the crista nasalis (for union with 
the vomer) projects upward and runs out behind into the spina nasalis posterior. The 
posterior margin is smooth and cuneavi'. 

From the lateral part of the posterior margin projects baclrsvard the strong processus 
pyramidalis. It is mserted fi-om in front into the fissura pterygoidea oss. sphenoidalis and 
helps, with a smooth area on its posterior surface, to complete the inferior part of the fossa 
pterygoidea. The external, rough sui-face unites with the posterior portion of the corpus 
maxillae just above the eighth alveolus. The medial, smooth surface looks into the nasal 
cavity. The inferior surface belongs to the lower surfiiee of the hard palate and contains 
usually throe openings, of which the foramen palatinum majus lies furthest forward, the others, 
foramina palatina tninora, lie further baclvward. These are the outlets of the canales 
palatini (for the aa. palatinae major et minores: nn. iialatinil which sotiietimos mien lnt-,.rnl- 



Bones of the Skull. 



31 



Processus orbitalis 

luciaura spheuopalatina 
Processus sphenoidalis 



Crista conchalis 
Crista nasalis 



Fades nasalis " 



Spina nasalis posterior 




Processus sphenoidalis 

Incisina spheuopalatina 

; Processus orbitalis 



l-'acies maxlllaris 



Sulcus pterygopalatinus 



Pars 
perpendicalaris 



Area com- 
pleting the fossa 
pterygoidea 
I 
Pars horizontalis 



Processus pyramidalis 




Sulcus 
pterygopalatinus ; 



j Foramen palatinum majus 

' Processus pyramidalis 
Area completing the fossa pterygoidea 



38 and 39. Right palate bone, os palatinum. 

From behind. From M'ithout. 

The pars perpendicnlarig (0. T. vertical plate) ascends as a thin leaf of bone verti- 
cally upward fi-om the lateral margin of the pars horizontalis. The medial fades nasalis is 
smooth and presents two ridges extending from before backward, an upper, shorter, crista 
ethmoidalis (0. T. superior turbinated crest), for the attachment of the concha nasalis media, 
and a lower, crista conchalis (0. T. inferior turbinated crest), for union with the concha 
nasalis inferior. The lateral surface, fades maxillaris, is for the most part rough and unites 
with the posterior, rough portion of the fades nasalis corporis maxiUae, so that it covers over 
a portion of the hiatus maxillaris from behind; it is attached behind to the anterior margin 
and the medial surface of the lamina medialis pr(jc. pterygoidei oss. sphenoidalis. Between 
these two areas, extending from above downwards, is the smooth, shallow sulcus pterygopala- 
tinus. Through the attachment of the fades maxillaris to the two bones mentioned this forms 
together with the sulcus pterygopalat. of the proc. pteryg. oss. sphenoidalis and a groove on 
the upper jaw bone, above, the fossa pterygopalatina , open lateralward (for the aa. maxill. 
int., palat. descendens, sphenopalat. ; nn. zygomat., sphenopalat., alveol. sup., infraorbit. ; gangl. 
sphenopalat.) , below, the canalis pterygopalatinus (0. T. posterior palatine canal) (for the a. 
palat. descendens; nn. palat., rr. nasal, post. inf. gangl. sphenopalat.), closed also externally 
by the proc. pterygoideus oss. sphenoid, and the upper jaw; it is continued below into the 
canales palatini (for the aa. palatinae major et minores ; nn. palat.) which usually run in the 
proc. pyramidahs alone. Prom the upper margin of the pars perpendicularis extend two pro- 
cesses, the processus sphenoidalis bent somewhat backward and markedly medianward, which 
lies on the inferior surface of the body of the sphenoid and on the ala vomeris, and the pro- 
cessus orbitalis forward and somewhat lateralward. The latter is bulged out and contains a 
small cavity whicli helps to close the posterior ethmoidal cells. Its lateral, smooth surface 
forms the most posterior part of the floor of the orbit ; in front and below it meets the fades 
orbitalis corporis maxillae (sutura palatomaxillaris), in front and above the lamina papyracea 
oss. ethmoid, (sutura palatoeihmoidalis) , behind and above the anterior margin of the latn-al 
surface of the body of the sphenoid (sutura sphenoorhitalis) ; behind and below it lies free 
and helps in part to form the medial portion of the fissura orbitalis inferior, in part it looks 



32 



Bones of the Skiill. 




5US zygomaticiis ^ e-. -iff'^/- --^ 
•As frontalis ^ < ' 



rocess^^s fronto 
sphenoidalis 



sus zygomaticns 

is temporalis y 



np oral is 
iiiatici 



Os 
lacrimale 



, Foramen 

' infraorbitaie 

Lamina papyracea 
ossis ethmoidalls 
Fnranieii zygomaticofaciale 



Processus frontosphenoidalis 

I 



Foramen 
zygomatico- 
orbitale '■■- 
Fades 

orbitalis 



Facies malaris 



Surface whicli 

lies upon the 

processus zygo- 

maticus maxillae 



Probe in 
foramen zygomati 
temporale 




Facies temporalis 



Os zysomaticnm 



40 and 41. 

From without 



Right yoke bone, os zygomaticum. 

From within. 



The OS zygomaticum or yoke hone (0. T. malar bone) (see also Fijjs. 55 — 60, 69—72), 
is paired and Hes in the lateral part of the facial skull. It has thi-ee siufaces. The laterally 
directed facies malaris is quadrangular, fairly smooth, markedly convex and presents the 
foramen zygomaticofaciale (0. T. malar foramen). The concave facies orUtalis, directed 
medianward and forward, helps to form the lateral and inferior waU of the orbit and meets 
the facies malaris, forming a markedly (niry(^d concave margin, which below completes the 
mar go infraorhitalis , and above forms the lateral margin of the aditus orbitae. The medial 
inferior margin of the facies orbitalis unites with the lateral angle of the facies orbitalis cor- 
poris ma.xillae (sntura zygomaticomaxillaris) and forms in half the eases the lateral boundary 
of the fissura orbitalis inferior; the medial upper margin lies upon the margo zygomatieus of 
the ala magna oss. sphenoidalis (suiura sphenozygomaticaj. On the facies orbitalis can be 
seen the single or double foramen zygomaticoorbitale (0. T. temporo-malar canals), the entrance 
to a bifurcating canal (sometimes double from the beginning), the divisions of which perforate 
the lionc and end on the facies malaris and the facies temporalis (for the r. zygoma ticotacialis 
et r. zygoraaticotemporalis n. zj-gomatici). The facies temporalis looks downward and median- 
ward, is curved so as to be markedly concave and forms the anterior part of the fossa tem- 
poralis. Here the foramen zygomaticotemporale is visible; medianward it adjoins a rough 
surface fa- broad union with the proc. zygomatieus corporis maxillac> fsntura zygomatico- 
maxillaris). 

At the upper angle of the faeies malaris lies the pi'ocessus frontosplienoidalis (0. T. 
frontal pv(«•es^), m front for miion with the proc. zygomatieus oss. frontalis (suiura zygo- 
maticofrontalis), beliind with the larg(> wing of the sphenoid (vidi^ supra). From the posterior 
angle of the lione goes off the slim processus icmpor<i/is ((_>, T. zygomatic process), which 



Bones of the Skull. 



33 



Corpus mandibalae 



Spiua mentalis 
Fossa digastrica 



Fovea sublingualis 



Fovea submaxillaris 



Sulcus 
y mylohyoideiiy 
Angulus 
,' maiidibulae 




Proctssus condyloidei 



42. Lower jaw bone, mandibula, from below. 



34 



Bones of the Skull. 



Procesyus condyloideiis 

Y 



Collum 



("apituhiiii 



fncisura mandibulae 

Processus coronoideiis 




Angnhis mandilmlae 



Basis inandibnlae 



Corpus minndibalae 



ProtuberaDtia 
raentalis 



43. Lower jaw bone, mandibula, right half, from without. 

The mandibula (lower jaw hone), (0. T. inferior maxillary bone) (see also Figs. 42, 
44 — 50, 57, and 58) is impaired and forms the inferior anterior part of the facial skuU. It 
consists of the parabolically curved corptis, and two rami, which ascend from the ends of 
the corj)us. 

The corpHS mandibulae (body of lower jaw) consists orig-inally of two halves united 
with one another in the median plane , the union taking- place in the first year of life. The 
point of union is often indicated by a gi'oove. Each half represents a mass of bone which is 
higher than it is thick, and curved in fi'ont so as to be markedly convex exteraaUy. Its 
inferior margin, basis mandibulae, is somewhat thickened and roimded; close above this, near 
the median plane, is situated the somewhat roll-shaped, transversely placed protuherantia 
mentalis (0. T. mental process), which, lateralward, runs out into the tuberculum mentale. 
Somewhat lateralward and upward fi'om the latter a round foramen mentale (for the a. men- 
talis; n. mentahs) is visible; it is usually situated below the alveolus of the second praemolar, 
about half-way between the base and the upper margin. Beneath it, or somewhat further 
back, begins the linea obliqua (0. T. external oblique liuc) extending obliquely upward to the 
anterior margin of the rannis. The upper part of the body, pars alveolaris, dependent in 
development upon that of the teeth, is bounded abo\i" by a narrow border, the limbus alveolaris. 
It contains on each side eight, altogether then sixteen, alveoli dentales which are separated 
from (ine another by thin septa interaloeolaria ; the alveoli an- wide at the opening and 
beciime narrower in the depth, being exact impressions of the roots of thi^ tix^tli which they 
hold. Oblnug jirnjcctinus, 71/(70 alveolaria, usually caused by the three anterior alveoli only, 
are iiliservabb' on the outer surface. The medial s\irface of the corpus jireseiits, close to the 



Bones of the Skull. 



35 



Ijicisura luiindibulae 
Processus coronoideus \ 



Ramus mandlbnlae 

Lingula mandibulac 




pterygoidea 
Capitulum 
\ Processus coiidyloideus 

\ Y 



Angulus mandibulae 



Sulcus mylohyoideus 
I Fovea submaxillaris 
Linea mylohyoidea 



Fossa digastrk-a 



Fovea sublingualis 
.Spina mentalis ^ 

Corpus mandibulae 



44. Lower jaw bone, mandibula, right half, from within. 

Above the fossa digastrioa on each side begms the linea mylohyoidea (0. T. internal 
oblique line) (for the nim. mylohyoid., mylopharjTig.), which ascends obUquely backward to the 
medial surface of the ramus. Above the medial part of the latter lies the fovea sublingualis 
(0. T. sublingual fossa) (for the gland, subling.), usually distinctly marked; beneath the lateral 
portion, often less well indicated, the fovea submaxillaris (0. T. submaxillary fossa) (for the 
gland, submax.). Extending forward, just below the lateral part of the linea mylohyoid., is 
the sulcus mylohyoideus (for the r. mylohyoid, a. alveol. inf. ; n. mylohyoid.). 

The ramus mandibulae (0. T. perpendicidar portion) is a broad plate of bone which 
extends from the posterior end of the body perpendicularly upward or obliquely backward. Its 
posterior, thicker margin, foims with the basis corporis the angulus mandibulae; its anterior 
margin begins lateralward at the posterior end of the linea obliqua, medianward at the last 
alveolus, with a small triangular surface on which is often visible the crista huccinatoi-ia 
(for the m. buccinat.). The lateral surface is smooth, the medial presents about its middle 
an opening, foramen mandihulare (0. T. inferior dental foramen), which is bounded median- 
ward by a small leaflet of bone, the lingula mandibulae. Below the for. mandibul. begins 
the sulcus mylohyoideus and in it the canalis mandibulae (0. T. inferior dental canal) (for 
the a. alveol. inf.; n. alveol. inf) which extends, within the spongiosa of the bone, arch-like, 
doy\Tiward and fonvard as far as the median plane; before reaching this, however, it opens 
also on the external surface at the foramen mentale. The upper end of the ramus supports 
two processes separated from one another by the incisura mandibulae (0. T. sigmoid notch); 
the anterior, processus coronoideus, (for the insertion of the m. temporal.) is bent backward 
somewhat hook-like, the posterior, processus condylcAdeus, serves for articulation of the lower 
iaw with the rest of the skuU and supports a roller-like capitulum mandibulae, covered over 



36 



Bones of the Skiill. 



M. temporalis 




M. incisi"vus labii inferioris 



Platysma 
M. triangularis 
M. qiiadratus labii inferiori 



M. mentalis 



45. Lower jaw bone, mandibula, right half, 

from without, showing muscular attachments. 



Bones of the Skull. 



37 



M. pterygoideus externus 



M. temi^oraliy^ 




I M. digastricus 
/ M. geniohyoidens 
M. geuioglossns 



M. mylohyoideus 



M. pterygoideus internus 



46. Lower jaw bone, mandibula, rig-ht half, 

from within, showing muscular attachments. 



38 



Bones of the Skull. 




47. Newborn. 




4^. (i — 7 rear old chilil 



47—50. Lower jaw bones, mandibulae, 

at different ages of life, figures drawn to uniform scale. 



Bones of the Skull. 



3i> 




49. Ailult. 




50. Old 



4.T — f^O. I.nwfir iau/ hnnPR. mnndihulnp. 



40 



Bones of the Skiill. 




Cornu majus 
Cornu minus 




Corpus 



Corpus 



51 and 52. Hyoid bone, os hyoideum. 

From above. Right half, from the left. 



The OS hjoidenm (hyoid bone) lies as an unpaired, horse-slioe-shaped bone behind 
and below the Ljwer jaw between the muscles, without direct connection with the other bones. 
It is divisible mto a middle i)icc(^ or corpus, two cornua majora and two cornua minora. 

The corpus (body) is a transversely placed oblong plate with an anterior surface, bent 
so as to be cunY(^x in front and above, and a concave posterior surface. The anterior surface 
presents variably developed ridges for the muscular attachments, the posterior is smooth. At 
the lateral ends are small fnssae, below for union mth the cornua majora, aliove for the 
cornua minora. 

The cornna majora are thin, laterally Huttened plates of bone, longer than the body. 
They are placi'd horizontally or directed obliquely upward, are united in front with the body 
l)y means of a narrow plate of cartilage or by a small joint with a joint cavity and a tight 
capsule. Behind, each ends in a small button-like projection. 

The cornua minora are small pieces, sometimes reniainmg cartilaginous, which are 
attached abo\e near the point of union of the body and the cornua majora. either by means 
of a small jotut with joint cavity and loose capsule or by ligamentous vmion only. They are 
surrounded by the end of the Kgamentum stylohoideum (see Kg. 555), a thui round elastic 
fibrous ligament which extends ft-om the processus styloideus oss. temjior, int«rwoven in the 
deep layer of the cervical fascia. Sometmies it contains masses of lume, the single pieces 
liring more or li.^ss se]):irated from one another. The processus styl.jiileus, tlie lig. stylo- 
hoideum and the cornu minus oss. liyoid. arise fi-om the second branchial arch of the foetus. 



Bones of the SlaiU. 



41 




M. stylohyoideus 

M. omohyoideus 



M. mylohyoideuH 
M. sternohyoideus 



53. Hyoid bone, os hyoideum, from above, 

with muscular attachments. 



Magnification 3:2. 



M. geniohyoideus 

> M. constrictor 

; pliaryngis 

;' medius 




M. thyreoliyoidcus 



54. Hyoid bone, os -hyoideum, right half, from the left, 

with muscular attachments. 



42 



Bones of the Skull. 




55. Skull, from the rio- 



ight. 



Hones of tho Skull. 



43 



Linea temporalis inferior 
Linca temporalis superior 



Sutura squamosa 



Siitura coronalis 

Sutura spheiioparictalis 
/ Siilura sphenosquamosa 
; Sutura spheiiofrontalis 



Sutura sphenozygomatica 



Sutura zygomatico- 
fronlalis 




I. trapezius ^ 

M. occipitalis 
lispiiialls capitis i 
Sutura lambcloidea 
,ura occipitoiuastoldea 
Sutura parietomastoideii 



!M. spleiiius capiti: 

M. sternocleldomastoideu^ '• 
il. temporalis 
i\r. stylopharyngeus 

I\I. styloglossui 



M. corrugator 
. \ M. orbi- 
/cularis oculi 
M. quadr. hil.ii 
.. M. orbicular] 
oculi 



\ M. quadrat] 
/labii superio: 

M. zygomaticus 

M. caninus 

M. uasalis 



jM. depressor 
se])ti 



M. incisivu 
labil superio 



M. massctcr 



]\[. temporalis 

M. buccinator " 



Platysina ,' 

M. triangularis ,' / ' 

i ■■' M. mentalis 
M. quadratus labii inferioris / 

M. incisivus labii inferior 



56. Skullj from the riglitj with muscular attachments. 



44 



Bones of the Skull. 




57. Skull, from in front. 



Bones of the Skull. 



45 



M. cornigator,. 

^I. orbicularis oculi 

{Pars orbitalis) 

M. procerus 

!M. orbicularis oculi 

{Pars lacriraalis) 

M. orbicularis oculi 

(Pais orbitalis) 
quadrat, labii sup, 
(Caput angulare) 
quadrat, labii sup 
CJaput infraorbitale) 

M. zygomaticus -^ 

M. quadrat, labii sup 
(Caput zygomaticum) 

M. masseter ' 
M. caninus 
M. temporali; 
^l. buccinator 

,r ^^ ( Pars transv. 

JI. nasahs | p^^^ ^,^^.^ 



M. masseter-, 
M. incisivus labii superioris-- 
M. depressor septi 

M. buccinator 




Siitura coronalis 



Sutura splieu< 
frontalis 

^ Sutura naso- 
•".n/" frontalis 
Sutura zygomatic 
frontalis 

Sutura fronto- 
inaxillaris 
. Sutura naso- 
maxillaris 



''Sutura zygomatico- 
maxillaris 
Sutura intermaxillaris 



Platysma 

M. triaugLilai 
M. quadratus labii inferioris 

M. incisivus labii inferioris 

M. mental] s 



58. Skull, from in front^ with muscular attachments. 



46 



]!oUL'S of thi^ Skull. 




59. Base of the skull, fiom witlmnt. hasis cranii externa. 



Bones of the Skull. 



47 



Foramen incisivum 



jr. quadratus labii superiori.'- 
(Caput infraorbitale) 

M. cauiuus 
quadratus labii siiperioris 
(Cai>ut zygomaticuiii) 

M. zygomaticiis 



M. buccinator-. 



[. tensor 
i palatini 

3ryg. ext. 




M. 

laryngens 
rectus 
9 lateralis 

igastriciis 

ngissimus 
■apitis 



splenitis capitis 



ternocleidomastoideus 



Sutiiia palatiua niediana 

Sutura palatlna transversa 

Pars horizontalis ossis palatiiti 



iSiitura zygoniaticn 

niaxillarls 
. Fissura ovbitaliH 
inferior 

Sutura 

' sphcnofrontalis 

..Facies tempora 

OSS. sphenoidal 

Proc. pyrauiiilii 

OSS. palatini 

Fossa pterygoidc 

Sutura 

sphenosquaniosa 

Foramen ovale 

Foramen spinosi 

_Fiss. sphcnuiK-'ti 

... FisH. petrotymi 

Poru.'* acusticn;- 

CXtlTllllS 



M. obliqiius capitis superior 

M. semispinalis capitis 
M. rectus capitis posterior major 

M. rectus capitis posterior minor 



M. trapezius ! 

Fissura sphenooccipitalis 



P'oramen mastoidenni 

Sutura oecipitomastoidea 

Foramen stylomastoideum 
Processus styloideus 
i-^ossa jugularis 
'; ; ' ,'FossuIa petrosa 
', '; Foramen caroticum externum 

(.■ondylu:^ occipitalis 
: Fissura petrooccipitalis 
Foramen lacerum 



60. Base of the skull, from without, basis cranii externa, 

with muscular attachments. 



48 



Bones of the Skull. 



Behind 

Squama occipitalis Sutura sagittalis 

/ ." Sutura lambdoidea 

' / Foramen parietale 

Os parietale 




Squama frontalis 



In Front 

61. Skull, from above. 



Bones of the Sk\ill. 



49 



Behind 

Squiinia occipitnlis 



Siitnra, sagittalis 

Sutura lambdoidea 
/ 

Os parietale 




In front 



Squama frontalis 
Sulcus sagittalis 



62. Skull CaD, from within. 



50 



Bones of tbr Skull. 




63. Base of the skull, from within, basis cranii interna. 



Bones of the Skull. 



51 



Pars orbitalis 
ossis frontalis----. 



Ala parva ossie 
sphenoidalis 
Ala magna ossis . ...^ 
sphenoidalis '^'k~~I.. '^ 



Os parietale. 

Corpus 
aphenoidaliB 

Squama ^ 
temporalis*" 



basilaris ^ 
. occip. 

s petrosa 
is tempo-- 
ralis 



Pars 
iiastoidea ^ 

ossis 
emp oralis 



Squama 
occipitalis 



Foramen caecum 

Crista galli 

Lamina cribroaa 
ossis ethmoidalis 



^ Sutura sphenofrontal is 
Foramen optieum 



Sutura spheno- 
parietalis 




Foramen rotuudu: 
Sutura spheno- 

squaiuosa 
Foramen uvale 



F'oramen spino 

- Foramen lace 

Hiatus canali? 

facialis 

Fissura 

jietrooccipital: 

Apertura ext€ 

canal, eochle 

Sulcus sigmoii 

ossis teuiporn 

Sutura 

parietomastoid! 

Sutura 
occipitomastoid 



Sutura lambdoidea 
Sulcus transversus 



64. Base of the skull, from within, basis crartii interna. 

with names of various parts. 



52 



Bones of the Skull. 



*•■*•> ,- , 




65. Median section of the skull, from the left. 



Bones of tlie Skull. 



53 



Sutura sphenopaiietalis 
Ala magna oss. sphenoidalis i Sutura sphenosquamosa 
Sutura coronalis ■ ; ■ Sulcus arteriosus 



Ala parva oss. sphenoidalis 
Sutura sphenof rout alls 
Lamina cribrosa oss. ethmoidalis ! 
Para orbitalis oss. frontalis | ; 
Sutura frontoethmoidalis 



Squama frontalis 



Squama temporalis 
; Os parletale 
; . Sutura squamosa 



Sutura lambdoidea 



Sinus 
frontalis' 




Hamulus pterygoideus 



Protuberai 

occipital: 

externa 

Squama occipita 
Protuberantia 
; occipitalis interna 

Sulcus transversus 
j ;;!:;; | Sutura oecipitomastoidea 
; : i ' ' ; i Foramen occipitale magnum 
; i : ; ', i Foramen jugulare 
; i ; ; : Apcrtura externa aquaeductus vestibuli 
; ; ; I Apertura externa canaliculi cochleae 

; ! i Canalis hypoglossi 

; ; Sulcus petrosus inferior 
: Forus acusticus internus 
Sulcus petrosus superior 

Fissura spbenooccipitalis 

Sella turcica 
Lamina lateralis processus pterygfic^ei 



66. Median section of the skull, from the left, 

with names of various parts. 



54 



Bones of the Skull. 



Anguliis spheiioidalis ossis pariotalis 
Sqnania temporal]; 



iFacies temporalis alae magnae ossie sphenoidalis 
I iFacies temporalis ossis frontalis 



Fossa 
temporalis " 



Processus zygomatieuby''' 
ossis temporalis 

Crista infratemporalis-^ 

Fossa infratemporal is ^' 
Foramen sphenopalatinum '- 
Fossa pterygopalatina 
Fissura orbitalis inferior 



Lamina lateralis processus pterygoidei 

Tuber maxillarel 



Os lacrimals 
_0s uasi 




67. Right temporal fossa, fossa temporalis, from without. 

(The arcus zyt;niiiatii-us has heen partially sawed away.) 

The fossa temporalis lies on each side on the lateral surface of the sknU and is, for 
the most part, open lateralward. Its medial surface is fonned by the most inferior part of 
the facies parietal oss. pariet., liy the facies temper, squamae temper., the fades temper, oss. 
fi-ont., and the facies temper, of the ala magna oss. sphen. ; the anterior surface by the facies 
temper, oss. front, and the facies temper, "ss. zygom.; the external wall by the arcus zygom. 
Below and mecUanward it goes over mto the tlissa infratempor.. On the medial-'suiface nm 
the sutura squamosa (between squama temper, and margo squamos. oss. pariet.),! the suiura 
sphenosquamosa (between squama temper, and margo sq\iamos. alae magnae oss. sphen.), the 
sutura sphenoparielalis (between angul. sphen. oss. pariet. and angiil. pariet. alae magnae 
oss. sphen.), the suiura coronalis (betwei'U margo friait. oss. pariet. and margo pariet OSB. 
front.), the suiura sphenofrontalis (bi'twcen pars orbital, nss. fi-ont. and margo front, alae 
magnae oss. sphen.) and the suiura zygomaiicofronialis (between proc. zygom. oss. front, 
and proc. frontosphen. oss. zygom.); on thi> anterior surface, tln' suture last mentioned and 
the suiura S2>henozygomatica (between os zygom. and margo zygtjm. alae magnae oss. sphen.); 
on the lateral surface the sutui-a zygomaiicotemporalis (between proc. temper, oss. zygom. 
and proc. zygom. oss. temper.). On the anterior wall lies the foramen zygomaticotemporale. 

The fossa infrateinporalis (0. T. zygumatic fossa) lies on each side below and mediau- 
ward fi-ora the arcus zygom., goos ovor above into the fossa temper, and is open behind and 
below. Its upper wall is formed me<lianward by the facies infratemp. of the ala magna oss. 
sphen., the anterior obli(|ur wall by the liuies in&'atempor. maxillae and the facies tempor. 
nss. zygiini., the lateral wall by the ramus of the lower jaw and the medial by the lamina 
lat. proc. jitcryg.. On the anterior suvfaci.^ tlie suiura zijgomiilicomaxiUaris (between os 

ZV."'()I11_ and tu'oc /vt'iini mnvillafj"* i« vicihlo Af flip inm-finn of fli*:) imfpvior nnd medial Sur- 



Bonos of tbr Skull. 



55 



Sinus frontalis 



J-iiunina papyracea ussi.s (.'ilmioidalis 

Foramina <-'ilimoidalia 

Processus orbitalis ossis pa'atini i. 

(■(irpus ()ssis sphenoidalis ; ,' ■ 



Foramen opticuii 
Fissura orbitalis superior 
Sella turcica 



Probe in 
foramen ^ 
rotundum 




Foramen sphenopalatinum 

Fossa pterygopalatina 

"jamina lateralis prot-t'ssns ntcrygniaLi 

Processus pyramidalis ossis palaiijii 

Probe in canalis palatinus I'ars perpendicularis 
ossis palatini 



Spina trochlearis 
Pars orbitalis ossis 
frontalis 



Os lacrimale 

Fossa 

,'sai.'ci lacriraalis 

Os nasale 



acies orbitalis maxillae 

Processus imcinatus 
ossis ethmoidalis 

Processus ethmoidalis 
conchae nasalis inferioris 

Processus maxillaris 
conchae nasalis inferiorig 



38. Right pterygopalatine fossa, fossa pterygopalatina, 

from Avithout. 

(The main portion of the ala mag-na oss. sphenoid., ul the lateral part of the corpus 

maxillae and of the pars orbit, oss. front, have been removed by a sagittal section, 

so that the medial wall of the sinus maxillaris and of the orbit is visible.) 

The fossa pterygopalatina (0. T. sphenomaxillary fossa) lies, deeply concealed, between 
be bones medianward fi-om the fossa iofi-atemporalis. It is united mth the latter bv a sickel- 
haped space, broad above, narrow below, which is closed below and lateralward by periosteum, 
ts medial wall is formed b}- the lateral surface of the pars perpendicularis oss. palatini, its 
pper wall by the lateral portion of the inferior surface of the body of the sphenoid, the 
osterior by the sphenomaxillary surface of the ala mag-na oss. sphenoidalis and by the anterior 
-irface of the processus pterygoideus, the anterior by the most posterior margin of the corpus 
laxiLlae and by the processus orbitalis oss. palatini. Below it narrows to become the canalis 
terygopalatirms which is continued into tlie canales palatini oss. palatini and opens at the 
iramina palatina majus et minora on the imder surface of the hard palate ; in addition, dehcato 
mals pass betwei^n the fades maxillaris of th(.' pars perpendicularis oss. palatini and the fades 
asalis corporis maxfllae obUquely fonvard and downward into the misc. On the anterior wall 
)niiection is made with the orbit by means of the hssiira orbitalis inferior, with the anterior 



56 



Bones of the Skull, 




69. Right orbital cavity, orbita, from in front 



Magnification 5:4. 



The orbita (orbital cavity) lies on each side in the upper part of the facial skull and, 
above, adjoins the cerebral skull. It opens in front bj a wide mouth, aditws orbitae, behind 
this widens suddenly in its lateral half and then narrows gradually fi'om before backward. 
Its shape, in front, is that of a four-sided, behind, that of a three-sided, pyramid, since the 
medial and the inferior wall form in front an obtuse angle with one another, while further 
back, they lie almost in one plane. The axes of the two orbital ea\ities (fi-om the middle of 
the anterior opening to the middle of the foramen optieimi) converge behind to the region 
above the seUa turcica and are in addition inclined, in fi-ont, somewhat downward. 

The opening of entrance, aditus orbitae, is more or less quadrangular with rounded 
corners, The upper margin, margo sujiraorbitalis, is formed liy the margo supraorbitalis and 
pr(X'essiis zygomatiius oss. frontalis, the medial by the pars nasalis oss. frontalis and the pro- 
cessus frontalis maxiUae, the inferior, margo hifrnorbitalis , by the corpus maxillae and os 



Boues of the Skull. 



57 



Fissura orbiialis superior 
Ala parva o^nis spheiioidalis ; foramen opticum 
Foranieu supraorbitale 
Sutiii'aj;spheuofrontalis 



Facies orbitalis alae luagnae ossis sphenoidalis 
Facies orbitalis ossis frontalis ; 
Sutiira zygomaticofrontalis 




Sntura sphenoethmoidalis 
Foramen ethmoidale posteriiis 

Lamina papyracea ossis ethmoidalis 
Sutura frontoetbmoidalis 
Foramen ethmoidale anterius 

Sutura frontolacrimaliM 



Fossa aacei lacrimalis 



Os lacrimale 



Sutura laci'imomaxillaris 
Sutura ethmoideomaxillaria 
Facies orbitalis maxillae 
Sutura zygomaticom axillaris : Processus orbitalis os^is palatini 



Facies orbitalis ossis zygomatiei ■ 
Sutura sphenozygomatica 

Fissura orbitalis inferior 



Sulcus infraorbitalis 



70. Right orbital cavity, orbita, from in front. 

Outline drawing with explanation of Fig. 69. Magnification 5 : 4. 

The walls of the orbit go over into one another, usuaUj' with rounded angles, and are 
lined by a thin periosteum, the periorbita. 

The medial wall, paries medialis (see also Fig. 68), is placed nearly sagittally. It 
is composed of the os lacrimale, the lamina pap^Tacea oss. ethmoidalis and the lateral surface 
of the corpus oss. sphenoidalis. It presents the sutura lacrimomaxillaris (between os lacri- 
male and proc. frontaUs maxillae), the sutura frontolacrimalis (between os lacrimale and pars 
orbitalis oss. frontalis), the sutura frontoethmoidalis (between pars orbitalis oss. frontalis and 
OS ethmoidale) as well as the sutura sphenoethmoidalis (between os ethmoidale and corpus 
oss. sphenoidalis). Near the anterior margin lies the fossa saoci lacrimalis which is continuous 
below with the canaUs nasolacrimalis. At the junction of the medial with the upper wall go 
oif the foramina ethmoidalia anterius et posterius, of which the anterior leads constantly into 
the slvuU cavity upon the lamina cribrosa oss. ethmoidalis, the postei-ior also to the same 



58 



Bones of the Skull. 




Fossa glandiilae lacrimali 

Ala magna ossis splienoidalis 
Os zygomaticum 
Foramen zygomaticoorbilalo 



Fissnra orbitalis inferior 
Sulcus infra orbit alls . 
Corpus maxillae .. 



Sinus frontalis 




Fissura orbitalis 
superior 



Foramen rotundum 



Canalis pterygoideus 



Sinus maxillaris 



71. Right orbital cavity, Orbifa, lateral wall, from the left. 

(The medial part of the orbit has been removed by an approxunately sagittal section.) 

The upper wall of the orbit, paries superior, (see also Figs. 69 and 70) is horizontal 
and is formed by the pars orbitalis oss. frontalis and the ala parva oss. sphenoidaUs ; it is 
smooth and sUghtly concave. A part of the suiura sphenofrontalis is visible between these 
two bones. In addition it contains in front and lateralward the fossa glandulae lacrimahs, in 
front and medianward, the fovea and occasionally the spina trochlearis. 

The lateral wall, paries lateralis, is vertical and inclined from in fi-ont and lateral- 
ward obliquely downward and medianward. It is composed of the fades orbitahs oss. zygi> 
matici, the faeies orbitalis of the ala magna oss. sphenoidalis, jiartly also of the medial surface 
of the processus zygoniaticus oss. frontalis. Between these bones run the sntura sphenozygo- 
matica (between os zygomaticum and ala magna oss. sphenoidalis), the sutura zygomatko- 
frmitalis (between processus frontosphenoidalis oss. zygomatici and processus zygomaticus oss. 
frontalis), as well as the suiura spheno frontalis (bi'tweeu ala magna oss. sphenoidalis and 
l)ars orbitalis oss, ft'ontalis). Hi'ri> can be seen also the single or double foramen zygomatico- 
orbitale which leads to the facial surface and ti_i the fossa temporalis, and the fissura orbitalis 
superior {(). T. sphenoidal fissure or foramen lacerum antorius). The lattm- is found on the 
lioundai-y between the lateral and the superior wall and oecupii's the whole medial half of the 



it is uarvinv and iiente-au'ded Intcrnlwnvd nnd livnnd. 



iiQ merlinnwrivn iiannllv sii 



ddeiilv. 



Bones of the Skull. 



>^inus frontalis ■ 



Pars orbitalis 
(i^sis frontalis 



Lamina oribrosa '*"* 
O'^isis ethmoiclalls 



Corpus ossis 
sphenoidalis 



Os lacrimale 

Lamina papyracea ossis ethmoiilalis 

('orjius maxillae 
/ / Sulcus infraorbitalis 

/ / 

Os zygomaticum 




Processus orbitalis 
ossis palatini 



Corpus ossiv 
sphenoidalis 



Fissura orbitalis supcri 



jj- Foramen ovale 

Foramen rotundum 



72. Right orbital cavity, Orbita, inferior wall, from above. 

The inferior wall of the orbit, paries inferior, is inclined somewhat obliquely down- 
ward, forward and lateralward. It is formcil chiefly by the ;facies orbitalis corporis maxillae, 
besides, lateralward, by a part of the facies orbitahs oss. zygomatici, and behind by the pro- 
cessus orbitalis oss. palatini. At the boundary between the inferior and the medial wall one 
sees the sutura lacrimomaxillaris (between os lacrimale and corpus maxillae), the suiura 
ethmoideomaxillaris (between os ethmoidale and corpus maxUlae), the sutura palatoethmoidalis 
(between os ethmoidale and proc. orbitalis oss. palatini), the sutura sphenoorhitalis (Isetween 
corpus oss. sphenoidalis and processus orbitalis oss. palatini), besides, near the posterior angle, 
the sutura palatomaxillaris (between corpus maxillae and processus orbitalis oss. palatini) 
and near the lateral margin the sutura zygomaticomaxillaris (between processus zygomaticus 
maxillae and os zygomaticum). It is united by bone with the lateral wall only in the anteriof 
half, but is s(>parated from it in the posterior half by the fisswa orbitalis inferior (0. T. 
sphenomaxillary fissure). This slit, runniiig between the posterior margin of the facies orbitalis 
corporis maxillae and the inferior margin of the facies orbitalis alae magnae oss. sphenoidalis, 
is, lateralward, closed either by a small process of one of these two bones or by the os zygo- 
maticum. The slit is often broader lateralward than medianward and leads externally into 
the fossa infi-atemporalis , internally into the fossa pterygopalatina. It is connected at its 
medial extremity by a groove with the fissura orbitalis superior and is for the most part 
closed bv tousrh connective tissue and i)criosteum. At about its middle begins the sulcus 



60 



Bones of the Skull. 



Sinus frontalis 

Concha nasalis media 

I 

I Meatus nasi medius 

I I Concha nasalis superior 



Os nasale^ 



Meatus nasi superior 

Apertura sinus sphenoidalis 
i Sinus sphenoidalis 



Sella turcica 



Clivus 



Processus fron- 
talis maxillae 
Os lacrimale 




Lamina medialis processus 
pterygoidei 



Meatus nasopharyiigeus 



1 Concha nasalis inferior 
Meatus nasi inferior 



73. Nasal cavity, Cavum nasi; right lateral wall, from the left. 

The caTum nasi (nasal cavity) is unpaii'ed and lies iii the middle and upper part 
of the facial skiill. It consists of the nasal cavity proper and the accessory cavities which 
surround the former ahove, lateralward and liehind: these accessory cavities are the sinus 
frontales (in front and above), the cellulae ethmoidales (lateralward almost in the whole 
depth), the sinus sphenoidales (behind and above) and the sinus maxillares (lateralward). 

The lateral wall is nearly sagittal, but somewhat inclined fi'om above and medianward 
downward and lateralward. It is formed in fi'ont by the medial surface of the proc. frontahs 
maxillae, in front and in the middle by the facies nasalis corpor. maxiUae, further by the os 
lacrimale, by the medial wall of the labja'inthus ethmoidalis, by the concha nasalis inferior, by 
the facies nasalis of the pars perpendicidaris oss. palatini and by the mecUal surface of the 
lamina medialis of the proc. pterygoidcus oss. sphenoidalis. From these bones hang down 
free the three conchae nasales (turbinated bones) which cover over partially medianward three 
oblong fossae, the nasal passages. The meatus nasi superio?- (upper nasal passage), between 
the concha nasalis superior and media of the os ethmoid., is tlie shortest and narrowest, present 
only in the posterior half of the nasal cavity; it descends somewhat obliquely toward the upper 
circumference of the foramen sphenopalatinimi. The meatus nasi medius (middle nasal 
passage), between the concha media and the concha inferior, reaches from the anterior margin^ 
of the middle concha as far as the ri'gion of the foramen sphenopalatimun. The meatus nasi 
inferior (infei-ior nasal passage), li(-tween the concha nasal, inferior and the inferior wall of 
the nasal cavity, is the longest and at the same time the most capacious. Lateralward from 
the septum, medianward from the conchae there remains a slit-shaped space between which 
extends through the whole height of the nasal si)ace, the meatus nasi communis. The part 
of the cavity situated on each side belund the posterior ends of the conchae is called the 
meatus nasophanjngeus ; it is bounded above liy the inlerior surface of the body of the 
sphenoid, the ala vomeris, the jiroc. vagmalis of the proc. pteryg. oss. sphenoid, and the proc. 



Bones of tiv Skull. 



61 



Probe in eanalis nasolamtnalis 



On iiasale. 



Sinns frontalis 
Probo from siuus frontalis in the infundibulum ethmoidale 
Processus uncinatiis 
, Hiatus aemilimaris 
/ Bulla ethmoidalis 

Probe from sinus frontalis in the infundibulum ethmoidale 
Site of the actual opening of the siuua maxillaris 

Opening of the posterior ethmoidal cells 
/' Probe in the apertura sinus sphenoidalis 






Sinus sphenoidalis 



Os laerimale / 




Foramen sphenopalatinum 

Lamina medialis processus pterygoidei 

Pars perpendicularis ossis palatini 
Probe in eanalis nasoJacrimalis 



74. Nasal cavity, Cavum nasi, right lateral wall, from the left. 
(The middle and inferior turbinated bones have been partially removed.) 



In the meatus nasi inferior, near the anterior end, lies the lower opening of the 
eanalis nasolacrimalis. This goes out from the fossa saeci laerimalis and is formedj lateral- 
ward and in front by the sulcus laerimalis of the corpus and of the proc. frontalis maxillae, 
medianward and behind by the sulcus laerimalis oss. lacriniahs and the proc laerimalis conehae 
nasalis inferioris; it is directed from above downward and at the same time somewhat from 
before backward. 

Into the meatus nasi medius opens the sinus maxillaris. The opening does not corre- 
spond to the whole hiatus maxillaris of the upper jaw bone, for this is essentially narrowed 
by the overlapping of the neighboring bones, namely, by the pars perpendicularis oss. palatini 
from behind, the proc. maxillaris conehae nasalis inferioris from below, the proc. ethmoidalis 
conchas nasalis' inferioris and the proc. uncinatus oss. ethmoidalis in the middle. The actual 
opening lies lateralward from the proc. uncinatus at the bottom of a nanrow oblong fossa 
(mfundihilum ethmoidale), which extends along the proc. imcinatus upward and forward, 
widens like a funnel and opens above into the sinus fi'on talis, but in addition receives the 
openings from the anterior ethmoidal cells; besides this connection between the fi-ontal and 
nasal cavities there is also a second just medianward from the processus uncinatus. Projecting 
downward into the infimdibulum ethmoidale from the outside there is usually a vesicular eth- 

T>i,^nflol f^aW flio hifllft. ethmniflnlis • +.lip tinvrn-ar aiV-lflp-Hlia-npfl alif. hpf.wppii tbia aiirl +.lip m-inpT 



62 



Bones of the Skull. 
Sinus frontalis 
Crista galll 



LaiiiLna perpendicularis ossis ethmoidalis 
Sinus sphenoidalls 



Os nasale 



Sella turcica 

CUvns 



Concha 
iiasalis inferior 




\ Vomer 

Processus palatiniis maxillae 



75. Nasal cavity, cavum nasi. 

Bony nasal septum, septufn nasi osseum, from the left. 

The upper, narrowest wall of the nasal cavity is formed by tlie lamina cribrosa 
OSS. ethmoidalis; the lower, broader wall by the slightly concave upper surface of the pro- 
cessus palatini maxillae and the partes horizontalos oss. palatini. 

The anterior wall of the nasal cavity proper is bony above only and is there formed 
)iy the spina ft-ontalis of the pars nasalis oss. ft'ontalis and the ossa nasalia; below it presents 
the apertura piriformis (0. T. anterior nares), opening toward the facial siu-face. This is 
"pear-shaped'', narrow above, broad below and is sunwmded above by the free margins of 
the ossa nasalia, lateralward by the incisiirae nasales of the upper jaw bones, below by the 
ossa incisiva and the spma nasalis anterior. 

The septnm nasi osseum (hony nasal septum), which, within, subdivides the nasal 
cavity, lies in the median plane and is usually somewhat deflected toward one side or the 
other. This deviation, however, is never met with at the posterior margin. The septum begins 
in front, behind the apertura pii-iformis, by a deep notch which is filled up by the cartUago 
sopti nasi, ends free behind at the posterior boundary of the nasal cavity and otherwise extends 
without essential inteiTuption from thr upper to the lower wall. Its upper part is formed liy 
the lamina perpendicularis oss. ethmoidalis, the lower by th(^ vomer. Above it unites in front 
with the spina frontalis of the pars nasalis oss. frontalis and with the lamina cribrosa oss. 
ethmoidalis, behind with the crista sphenoidalis and the rostrum sphenoidale; below it lies on 
the crista nasalis of the united maxUlarj' and palate bones. 

Tlic nasal cavity is cnunccted on its upper wall by the openmgs of the lamina cribrosa 
with the skull cavity and ))y thi> foramina ethmoidalia with tlic orbit: on its lateral wall l)y 
the canalis naaolacrimalis with the orliit. bv the foramen snbpiiniialatinnni witb the fossa 



Bones of the Skull. 



63 



Fonticulus frontalis 



Foiitioulus fron 




Fonticulus sphenoic 



Fonticulus occii)italis 



76 and 77. Skull of the new born child, magnification i:2. 

View from above. View from the right. 

A part of tlie bones of the skull are originally laid dovni in cartilage and represent 
the primordial cranium (chondro-cranium) ; these are the os occipitale (without the upper part 
of the squama), the os sphenoidale, the os temporale (without the squama and the pars trai- 
panica), the os ethmoidale, the concha nasalis inferior, the os hyoideum and the small bones 
of the ear. AH other bones of the skuU arise as roof bones (bones of the vault) and parietal 
bones in that the bony substance forms in membrane, the membraneous skull-capsule surrounding- 
the brain above, in ft'ont, behind, and at the sides. At bu'th there are still non-ossified remains 
of this membrane in the regions in which the bones of the skuU meet, there being naiTower 
stripes along what are later to be the bony sutures, larger areas where several bones meet 
with one another. These latter regions are called the fonticuli (fontanellesj and are six in 
number; two unpaired and two paired. Of the unpaired the largest, quadrangular, fonticulus 
frontalis [major] lies at the junction of the suturae coronalis, sagittalis and frontalis, the 
small, triangular fonticvlus occipitalis [minor] at the apex of the squama ocoipitaHs, where 
the suturae lambdoideae and the sutura sagittalis meet. Of the paired fontaneUes, the anterior, 
oblong fonticulus sphcnoidalis lies at the apex of the large wing of the sphenoid, bounded 
by the angulus parietalis of the ala magna oss. sphenoidalis , by the squama temporalis oss. 
temporalis, the angidus sphenoidalis oss. parietalis, and the squama frontahs oss. frontalis: 

-flic i^i^o+ai-iriT mnTp TTTPo-nlfiT fnn.tir.ti.hi.s m.flstoidcil.S iq sitnatpd lipln^i' flip nncmliic m^afniilpiic 



64 



Bones of the Spine. 



Processus spiuosus 
Arcns vertebrae 




__ Processus 
transversiis 



Processus ariicu- 
laris superior 



Radix arcus vertebrae 



-- Corpus vertebrae 



from abovt 



78 and 79. Vertebra, 

vertebra (lOth thoracic ver- 
tebra, somewhat schematically- 
represented). 

The colnmiia yertebralis fver- 
iebral column or spine) extends from 
the base of the skull as far as the 
lower end of the tnmk. It consists 
of the single vertebrae superimposed 
upon one another; these are divisible, 
according to the regions in which they 
lie, into vertebrae cervicales, vertebrae 
thoracales, vertebrae lumbales, verte- 
brae sacrales, and vertebrae coccygeae. 
Each Tertebra is approximately 
ring-shaped and consists of an anterior,- 
thick body, corpus vertebrae, and a 
feebler, flat arch, arcus vertebrae; the 
two include between them a wide open- 
ing, the foramen vertebrate. The sum 
of all the vertebral foramina forms the 
canalis vertebralis (spinal canal). 

The corpus vertebrae (vertebi-al 
body) possesses an upper and a lower 
surface by means of which it is connected 
with neighboring vertebrae; these sur- 
faces are somewhat rough, flat or slightly 
depressed. The anterior and the lateral 
sm-faces are convex in the horizontal, 
somewhat concave in the vertical direc- 
tion ; the posterior surface, which forms 
the anterior boundaiy of the foramen 
vertebrate, is approximately flat and 
presents especially large foramina nu- 
tricia. 

The arcus vertebrae (vertebral 
arch) begins at the body by a nan-ow 
root, radix arcus verlebi-ae (0. T. 
pedicle): above this lies the shallower 
incisura verteh-alis superior, below it 
the deeper incisura vertebralis inferior; 
the intervertebral notches of two adjoining vertebrae miite to foiTa one foramen intervertebrale 
(for the passage of vessels and nerves). Close behind these, passing upward on each side is 
the processus articularis superior with the fades articularis superior, which generally looks 
backward, while passing downward is thi> processus articularis inferior with the fades 
articularis inferior which generally looks forward; between these, directed lateralward, is the 



Faeics 
articularis snperioi - 

Processus transversas; 



Processus articularis superior 
Incisura vertebralis superior 




Corpus vertebrae 
Incisura vertebralis inferior 

Processus articularis inferior 



Processus spinosus 



from the right 



Bones of the Spine. 



65 



Processus sphiosua 
Areas vertebrae 




Facies articularis 

superior 
Processus articularis 

superior 
Tubercuiuiu 

postorius 
.Sulcus nervi spinalis 
Tuberculuni auterlus 



Foramen transversariura 



Processus articularis superior 



Processus 
spinosus 




^ Sulcus nervi sp 

Tubereulum posterius 
I, 
Processus articularis inferior 



Corpus vertebrae 
Processus transversus 



80 and 81. Fourth cervical vertebra. 

From above. vertebra Cervicalis /I/. From the right. 



Each of the seven TCrtebrae cervieales (cervical vertebrae) (see also Fig. So) has a 
low body which, as seen from above, is quadrangular with rounded angles. The upper surface 
is concave in frontal, slightly convex in sagittal dii'ection, the lower exactly the reverse. The 
foramen vertebrate is -s'ery wide and triangular. The processus articulares superiores et 
iiiferiores are placed very ohliquely; their facies articulares are smooth or slightly arched, the 
superiores look backward and upward, the iiiferiores forward and downward. The processus 
spinosi are usually short and split into two spurs. The form of the processus transversi is 
especially characteristic for the cervical vertebrae. These arise in front of the processus articulares, 
are short and directed lateralward. On the upper surface, each presents a deep groove, sulcus 
nervi spinalis, which runs out from the inoisura vertebralis superior and separates, at the tip 
of the transverse process, the tubereulum anterius from the tubereulum posterius. In the 
region of the groove is situated also the foramen transversarium (in the upper six (/ervical 
vertebrae for the a. and v. vertebralis). The part of the processus transversus situated in 
front of the foramen transversarium with the tubereulum anterius is partially homologous i\'ith 
a rib and is accordingly also called the processus costarius; it may be so developed on the 
seventh cervical vertebra that it actually forms a cervical rib (see Fig. 96, No. 4). 

The first cerwcal vertebra, atlas, the second, epistroplieus , and the seventh, vertebra 



66 



Bones of the Spine. 



Tuberculnm posterius 
Arcus posterior 



Fovea dentis - 



Sulcus arteriae 
vertebral is 



Fovea 
articularis 
superior 
Processus 
trans versus 




Facies articularis posterior 

Facies articularis superior 
Groove for n. spinalis II 



I Foramen 
transversar'um 
Massa lateralis 




, Facies 
— ■ articularis 
anterior 



_ _ Dens 



Facies articularis inferior 



Processus transversvi: 



\ Arcus anterior 
Tnberculum anteriiis 



82. Atlas, 

from above. 



83. Epistropheus 

(0. T. axis), from the right. 



The atlas is especially characterized by the fact that it lacks the maiu mass of the 
body. The only representative of a body is a narrow mass of bone in front, arcus anterior, 
which presents, in the middle on its anterior surface, a small tuherculum anterius, on its 
posterior surface a fiat fovea derUis, covered with oartdage. The arch proper, here called 
arcus posterior, is narrow, roundish and presents, in the middle behind , in place of the pro- 
cessus spinosus, a small tuherculum posterius. Between the two arches lie the massae laterales; 
each lateral mass possesses above an oval, cnncave articular surface, fovea articularis superior, 
for articulation with the condylus occipitalis (uss. occipitalis), below a flat, rounded facies 
articularis inferior for articulation with the epistropheus. Lateral from each massa lateralis 
the processus transvcrsns projects far lateralward; it is devoid of sulcus, n. spinalis and of 
tubercles. Running out fi'oni the foramen transversarium is a groove which leads behind the 
massa lateralis on the upper surface of the arcus posterior to the foramen vertebrale, the 
sulcus arteriae vertehralis (for the a. and i. vrrtebralis; n. suboccipitalis). Incisurae verte- 
brates are absent in the form in which they occur in the dtlier cervical vertebrae (vide infra). 

The epistropLens (0. T. axis) is especially characteriz(Hl by a thick cone, dens (tooth) 
((). T. odontoid process), which ascends fi'om the upper surface of the body; this presents, 
both in front and behind, a small, flat surface, covered witli cartUage, facies articulai-is 
anterior and posterior and ends above in a blunt tip. Near the tonthshapi'd pn.ieess on the 
lateral part of the body lie the slightly convex fades articnliires supcriores, directed obliquely 
lateralward and ujiward. The jirdci^ssiis articvilares inferinres and spinosus show no especial 
drviatious; the jirnccssus transvi'rsi lack the tubercula anterius and pnslerius as well as the 
siilcus n. .spinalis. The incisura vertelu-alis inferior is present and situated as in the other 
cervical vi'rtebrae, i. o. in front of the processus articularis. An i^xactlv corresnonding incisui'a 



Bones of ttie Spine. 



67 




Processus spinoMis 

Processus articularis inferior 

Processus articularis superior 



Tuterculum posterius 

Sulcus uervi sjjinalis 
Tnberculum auterius 
P'oranien transversarium 



84. Seventh cervical vertebra, veHebra promimns. 

From above. 

The seventh cervical vertelbra is characterized by an especially long, powerful, 
non-bifurcated processus spinosus, which on palpation of the spine from above is usually 
the first to be distinctly felt; it is accordingly named the vertebra prominens. 
It has in addition longer processus transversi; its foramen transversarium is sometimes 
absent, it is nearly always small, is sometimes subdivided and often serves for the 
passage of the v. vertebralis. 

On the lower margin of the lateral surface of the body a fovea costalis is 
usually present for articulation with the head of the first rib. 

The part (processus costarius, see p. 65) situated in front of the foramen trans- 
versarium, is sometimes slightly movable, forming the so-called cervical rib, in which 
case its length may vary greatly (see Fig. 96, Xo. 4). 



68 



Bones of the Spine. 

Dens epistrophei 




Facies artictdaris inferior 
atlantis 
Facies articularis superior 
epistrophei 



Tuhercula anteriora 

of the 
processus transversi 



Tuherculuin caroticum 



Tubercuhini auterius processus 
transversi 
-< Fovea costalis 



85. Cervical spine, vertebrae cervicales, from in front. 

The jbodies of the cervical vertebrae gi-ow gradually broader from above downward. 
The adjacent surfaces of the same are so curved that the umler surface of each vertebra always 
fits into the upper surface of the next vertebra below. 

The processus transversi on the whole diminish gi-adually in length from the seventh 
upward as far as the second vertebra: then follow munediately the widely projecting processus 
transversi of the atlas. The tubercula anteriora of the jiroccssus transversi increase in size 
from the thii'd to the sixth vertelira: those of the sixth vertebra are called the tubercula 
carotica; on the seventh vertebra they are only feebly developed (see also Fig. 84). 

The nrocessn.q sninoRi are sliort from the second to tbe (fiftb or^ sivtli cer\'ieal vertebra. 



Bones of the Spine. 



69 



Processus spiiiosus 

1 L Processus transversus 



Processus articularia superior 
Fovea costalis superior 




86 and 87. Sixth thoracic vertebra, vertebra fhoracalis VI. 

From above. From the right. 

The twelve vertebrae thoracales (thoracic vertebrae, 0. T. dorsal vertebrae) possess 
broad bodies. The eonnectmg surfaces of the bodies are fiat and on the upper and lower 
vertebrae are described as bean-shaped, on the middle vertebrae as more heart-shaped. The 
foramen vertebrale is nan-ow and rounded. The processus articulares stand nearly frontally, 
their fades articulares are slightly curved and form parts of the mantle of a cylinder, the 
axis of which is situated in front of the body; the fades articulares superiores look back- 
ward, the fades articulares inferiores forward. The processus transversi arise between the 
processus articulares, are very powerful and directed obliquely backward and lateralward. 
On the anterior surface of their lateral extremity they present a small fossa covered with 
cartilage, the fovea costalis transversalis (0. T. facet for tubercle of i-ib) for articulation 
■with the tuberculum costae; they are absent from the eleventh and twelfth, sometimes also 
fi-om the tenth vertebra. The processus spinosi are long, triangular, apical and directed 
more or less markedly downward; the middle ones cover one another like tUes of a roof. 
The small articular surfaces which he on the lateral surfaces of the bodies of the vertebrae, 
just in front of the roots of the vertebral arches, are special pecuharities of the thoracic 
vertebrae. On the nine upper vertebrae two of these are present on each bone, one larger 
at the upper margin, fovea costalis superior (0. T. demifacet for head of rib) and one 
smaller on the lower margin, fovea costalis infei-ior; each fovea costalis inferior forms with 
the fovea costalis superior of the next vertebra below and with the intervertebral disc lying 



70 



Bones of the Spine. 



Fovea costalis superior 



'ertebra 

loracalis 

IX 




Processus 
mamillaris 



ijt::*? 



Vertebra luinbalis 
II 



88. Ninth thoracic to the 
second lumbar vertebra, 

vertebra thoracalis IX 
to vertebra lumbalis II, 

from the right and somewhat from behind. 

The lower two vertebrae 
thoracales approach in many parti- 
culars the form of the. vertebrae lum- 
bales, the twelfth thoracic vertebra 
especially. The processus articulares 
superiores of the latter are, like those 
of the other thoracic vertebrae, usually 
placed nearly frontally; their processus 
articulares inferiores on the contrary, 
like those of the lumbar 
vertebrae, nearly sagittally. 
This change in the direc- 
tion of the processus articu- 
lares may occur even at the 
eleventh thoracic vertebra. 
Further, on the poste- 
rior surface of the pro- 
cessus transversi and arti- 
culares superiores small 
projections are present 
■which resemble in form 
and position the processus 
mamillares and accessorii 
of the lumbar vertebrae; 
these are usually distinctly 
marked on the twelfth 
thoracic vertebra, less so 
on the eleventh and tenth. 
The processus transverei 
are short and directed 
markedly backward. 



Processus irausvcrsus 
Processus aecessorius 
Processus articularis inferior 



Bones of the Spiiie. 



71 



ProcoHsus spiijosus 

Processus articularis inferior 
I Processus articularis suim>i 
I ■ Processus mamillaris 




Processus Inmsversus 



89. Third lumbar vertebra, vertebra lumbalis III, from above. 

The five vertebrae lumbales (lumbar vertebrae) (see also Fit;-. SS) are higher and 
broader than the cervical and thoracic vertebrae Their bodies have flat connecting surfaces, 
varying from a bean-shaped to a transversely oval form. The foramen vertebrate is narrow 
and ti-iangular. The processus artictilares are vertical; their fades articulares lie nearly in 
sagittal planes ; the fades articulares stiperiores are concave behuid and hollowed out median- 
ward, the fades articulares inferior es are convex in fi-ont and laterahvard, so that the twn 
belong to a cylinder-mantle, the axis of which is situated behind the processus spinosus; every 
two processus articulares superiores surround the processus artioidares inferiores of the next 
vertebra above as an axle-box does an axle. On the posterior margin of the processus arti- 
cularis superior a blunt bony mass, the processus mamillaris, projects backward. The ^;ro- 
cessus spinosi are flat and high, pass straight, backward, end in a swollen extremity and are 
often bent hook-like, domiward. The /irocessiis transversi arise hi front of the processus 
articulares; they are thin, flat and directed only slightlj' backward. They are considered fi-om 
theii' largest part to be homologues of the ribs; the curri'spondmg part is accordingly also 
de,signated as the processus costarius; this is sometimes especially large on the first lumbar 
vertebra and united by a jomt with the rest of the i)riicess; it is then called a lumbar rib 
(see Jig. 96, No. 8). On the posterior surface of the root of the transverse process, lateral 
from and below the processus mamillaris, a small, varialily developed nodule, the processus 
accessorius, projects backward. 



72 



Bones of the Spiae. 



Basis ossis sacri 



Processus articularis siiperior 




Lineae 
trans versau 



_ Apex ossis sacri 



90. Sacrum, OS sacrum, from in front and below. 

The five vertebrae sacrales are distinctly separated from one another ia youth only: 
in the adult they are fused to a single bone, the os sacrum (sec also Figs. 91 — 93), which 
is situated helow the lumhar vertebrae and is the largest and broadest bone of the verte- 
bral column. 

The OS sacrum is wedge-shaped, broad above (basis), pointed below (apex): its sagittal 
diameter also diminishes essentially ft-om above downward. Its anterior inferior surface, fades 
pelvina, looKng into the pelvis, is concave, its posterior upper surface, fades dorsalis, is convex. 

The anterior inferior surface, facies pelvina, is in general smooth and concave. In 
the middle, four lineae iransversae are to be seen, lines corresponding to the places where 
the five individual bodies of the sacral vertebrae have grown together. Lateral from them 
on each side lying in a vertical series over one another an- the four foramina sacralia an- 
terior a , which behind and methanward lead into the canalis sacralis (see Fig. 92*), but, 
laterahvard, run out into grooves on the anterior surface of the partes laterales. The foramina 
sacralia anteriora diminish in size from above downward; below the last one, near the apex 
ossis sacri, is a notch which is closed by the processus transversus ossis coccygis and by the 
ligamentum sacrococcygcum laterale to form a fifth foramen sacrale. The opcx ossis sacri 



Bones of the Spine. 
Processus articnlaris superior 



73 




Tuberositas 
sacral is 



Facies 
anricularis 



Crista sacralis 

lateralis 

Crista sacralis 

articular is 

Crista sacralis media 



Foramen sacrale posterius 



~ -- Hiatus sacralis 
Cornu sacrale 

Apex ossis sacri 



91. Sacrum, OS sacrum, from behind and above. 

The facies dorsalis ossis sacri is very rough and convex from above downward. On 
it five rows of processes and projections run downward, almost parallel to one another. The 
middle row, crista sacralis media, has resulted fi-om the fusion of the processus spinosi; it 
is most marked, represents often an uninterrupted ridge, but is frequently incomplete. Lateral- 
ward on each side lie the cristae sacrales articular es ; they are to be considered as the pro- 
cessus articulares fused with one another and usually project only moderately above the surface. 
Lat«ralward fi'om these, separated from them by the foramina sacralia posteriora, are the 
cristae sacrales laterales; they arise from the fusion of the processus transversi and are 
usually more distinctly marked than the cristae sacrales articulares. The four foramina sa- 
cralia posteriora like the anterior, are situated on both sides in nearly parallel rows; they 
lead (see Fig. 92*) forward and medianward into the canalis saorahs, forward and doivnward 
to the foramina sacralia anteriora. 

Corresponding to the upper end of the cristae sacrales articulares two completely deve- 
loped processus articulares superiores pass vertically upward ; their facies articulares superiores 
are directed medianward and backward and articulate with the corresponding surfaces of the 
fifth lumbar vertebra. From the lower end of the cristae sacrales articulares the two small 



74 



Bones of the Spine. 



Caiialis sacralis 



Crista sacralis media 

/ Crista sacralis artieularls 

Processus articularis superior 
f'B .' ' Incisura vertebralis superior 

Pars lateralis 




92. Sacrum, os sacrum, from above. 



Foramen intervertebrale 
Foramen sacrale posterius \ 



_ Crista sacralis media 



Canalis sacralis 



Pars lateralis 




92^, Transverse section through the sacrum 

at the level of the second pair of foramina sacralia. 

The anterior upper sui-face of the saenun, basis ossis sacri, contains in the middle 
a somewhat projecting, transversely oval, flat surface with which the body of the fifth lumbar 
vertebra is connected by means of an intervertebral disc. Behind this lies the upper, triangular 
opening of the canalis sacralis which passes through the sacrum fi'om above downward and 
reaches its lower extremity in tlie hiatus sacralis on the posterior surface, a little above the 
apex; within the bone going off fi-om it on each side are four short canals (foramina inter- 
vcrtebralia) which are continued H-shaped into the foramina sacralia anteriora and posteriora. 
Lateralward from the upper opening of the canalis sacralis the processus articulares superiores 
(see p. 73) project upward; in front of them he the incisurae veriehrales superiores. The 
lateral portions of the basis ossis sacri are smooth, somewhat concave and form the anterior, 
upper limiting surfaces of the partes laterales ossis sacri. 

Through the union of the fifth lumbar vertebra with the sacrum there arises, at the 



Bones of the Spine. 



75 



Tuberositas sacralis 



Crista sacralis media 




Processus artieularis superior 



Basis ossis saeri 



Cornu sacrale - 
Cornii coecygeum 



93. Sacrum and coccyx, os sacrum and os coccygis. 

From the right. 

The portions which lie lateralward from the foramina sacralia are called the partes 
laterales ossis saeri; they have arisen through fusion of the transverse processes and of 
rudiments of ribs (on the upper three vertebrae). The partes laterales grow much narrower 
from above downward and present on the upper part of their fi'ee lateral surfaces an uneven 
joint surface, fades auricularis, covered with cartilage, for union with the hip bone; it is 
formed in the main by the first sacral vertebra, less by the second and least by the third. 
Behind the facies auricularis lies a markedly roughened surface, tuberositas sacralis, to which 
are attached the ligamenta sacroiliaca interossea. 

Sometimes the uppermost vertebra of the saonmi is fused laterally with the pars laterahs 
only in one-half, while on the other half it has a shape similar to that of a lumbar vertebra : 
such a transition form is called a lumbosacral vertebra (see Fig. 96, No. 11). 



76 



Bones of the Spine. 



Cornua coccygea 



Comua coccygea 





94 and 95. Coccyx, os coccygis. 

From in front. From behind. 



The OS coccygis lies as a small, triangular bone at the lower end of the vertebral 
column below the sacrum. It consists of from four to five rudimentary vertebrae 
coccygeae, of each of which the body only, as a rule, is present. The first possesses 
still two small, transversely directed processus transversi and in place of the processus 
articulares superiores two cornua coccygea directed upward. The succeeding vertebrae 
diminish in size from above downward and represent actually only small oblong or 
spherical pieces of bone.- 

The upper surface of the coccyx is united with the tip of the sacrum by the 
symphysis sacrococcygea (see p. 162). The first, second and third coccygeal vertebra 
are usually united with one another by a layer of fibro-cartilage, the third, fourth and 
fifth by bony substance. Deviations occur very often in that the connections between 
tlie first three or that between the coccyx and sacrum ossify. 



Bones of the Spine. 



77 



Tubcrculum post. 
ArcuB post. 
Site of exit 
of the n. cer- 
vicalis I 

Fovea articn- 
laris sup. 



ArcoB 
Proc. artic, sup.^ 
Proc, tranar,-. 

For. costo- 
trans v. 
CoRta , 
cervicalls 

Incls. 
vertebr. sup. Coi-pua ooetarius 



Proc, artic. 
inf. 



Proc. 
COBtarius 




Corpus 



tebr.sup. Corpus 



96, Collection of different vertebrae and vertebra] varieties to illustrate 
the morphological value of the single parts (after Quainj. 



78 



Bones of the Thorax. 



Crista capituli 
Tulterculum costae 



Corpus oostae 



Capitulum 
I costae 




Angulus costae 



97. Seventh rib of right side, casta VII, from within. 

The twelve costae (libsj (sec also Figs. 105 — 107) are thin, partly bony, partly cartfla- 
ginous masses which go out on each side from the lateral surfaces of the thoracic vertebrae 
and which, forming an arch which is convex lateral ward, help to boimd the thoracic ea\it\'. 
Each thoracic vertebra corresponds to a pair of ribs ; they are numbered from above downward. 

The upper seven (sometimes eight) pairs of ribs are fastened dii'ectly to the stemimi 
in front near the median plane and are distmguished as costae verae (true ribs) fi-om the 
lower live (sometimes four) pairs of ribs, the costae spuriae (false ribs), which are indirectly 
connected with the stemmn or else end fi'ee. 

Each rib consists of a longer posterior bony portion, os costale, and a shorter, anterior, 
cartilaginous portion, the cartilago costalis. 

Each rib is somewhat expanded at its vertebral end so as to form the capitulum costae 
(head of the rib); this possesses a small fades articularis caiiittiU costae, covered over with 
cartdage, which is divided, on the ribs fi-om the see(_ind to the tenth, by a transverse ridge, 
crista caidttdi, into an upper smaller and a lower larger surface. By means of these joint 
surfaces the heads of the ribs articulate with the foveao eostales of the bodies of the vertebrae. 
The portion of the bone adjoining the capitadum is somewhat narrowed, collum costae (neck 
of the rib), on tlie upper ribs mere distmctly than on the lower; the neck presents on its 
upper margin a longitudinal ridge, crista colli costae, which is contmued lateralward upon the 
shaft and is iibsent only from the first and the last ribs; at its lateral extremity a small 
nodule, tuberculum costae, projects baekw;ird and downward; this possesses a small facies 
articularis tuberculi costae, covered with cartilage, for articulation with the fovea eostjilis 



Bonos of the Thorax. 



79 



Facies articiilaris 
capituli costae 



Crista capituli - 



Collinn costae 

. Crista colli costae 




Capituliiiii costae 

Tuherculum costao -^ ' 



-\-i)gulus costae 



98. Eighth rib of right side, cosia \llll. from behind. 

The middle piece or shaft of the rib, corpus costae, forms lateralward fi-om the tuher- 
culum costae an. angle which is directed backward and downward, the angulus costae. This 
lies on the first rib close to the tubercle; on succeeding ribs it is situated ever more lateral- 
ward; it is most marked on the middle ribs and is absent from the last two ribs. The bodyl 
of the rib is a flat plate of bone with an internal and an external smooth surface; the externa 
surface is directed vertically in the middle ribs, markedly upward in the uppermost ribs, more 
downward in the lowermost (see Figs. 105 — 107). The Curvature of a whole rib is double, 
since in the first place the surface of the shaft is bent so as tn be convex lateralward and 
in the second place, its upper edge is curved so as to be concave nr OJ-shaped. On the internal 
surface near the lower margin runs the sulcus costae (for the v. and a. intereostalis) ; it begins 
at the tubercle, is most marked behind and becomes lost in front; on the first and last ribs 
it is absent or only slightly indicated. The anterior extremity is less broadened and ends in 
a rough depressed surface for the reception of the costal cartilage. 

The cartilage costalis (costal cartilage) (see Fig. 105) has in general the same shape 
as the i-ib. It unites in front with the sternum or is attached to the cartilage of the next 
rib above. The cartilages increase in length ft-om the first to the seventh; from this on they 
decrease so that the cartilage of the eleventh and twelfth ribs are only short pointed pieces. 
The first two costal cartilages only follow the same direction as the bony parts of their ribs, 
the others are more or less curved upward at their anterior extremities. 



80 



Bones of the Thorax. 



Capituliim costae 



Costa I 



Costa II 




Tuberositas costae II 



99 and 100. First and second ribs of right side, 

costae I et II, from above and without. 

The first two ribs present certain peculiarities. 

The costa I (see also Figs. 105 and 107) is on the whole directed equally 
obliquely forward and downward and possesses an upper surface directed somewhat 
lateralward and a lower directed somewhat medianward. On the upper surface a little 
in front of the middle, near the medial border is a small nodule (sometimes only a 
roughening), tuherculum scaleni [Lisfranci] (for the attachment of the m. scalenus 
anterior); a very sliallow furrow in front of this serves for the v. subclavia, a curve 
behind this, the sulcus subclaviae, for the a. subclavia is usually somewhat more distinctly 
marked. Behind the latter lies another roughened area for the m. scalenus raedius. 

The costa II (see also Figs. 105 and 107) resembles the other ribs in its form 
much more than it does the first rib. On its lateral surface, somewhat in front of the 



Bones uf the Thorax. 



81 




Capitula 



101 and 102. Eleventh and twelfth ribs of right 
side, costae XI et XII, from below. 

The COSta XI is like the costa XII (see also figures 106 and 107). a 
delicate bone in whicli there can be sharph- made out only a small capitulum behind 
without crista capituli ; the coUum costae and tuberculum costae are practically absent 
as are also the angulus costae and the sulcus costae. The two ribs are, in their 
whole length, directed nearl}' evenly obliquely downward and curved so as to be almost 
evenly convex lateralward and backward. The cross section shows rounded angles: in 
front the ribs become sharper and possess generally only a small cartilaginous tip. 
They form no joint union with the other ribs ; but end free between the abdominal muscles. 

The twelfth rib is very variable. 

Between every two adjacent ribs is an intercostal space, spatium illter- 
COStale (see Figs. 105 — 107). Its form resembles that of the adjacent ribs and 
varies with their shape and position. 



82 



Bones of the Thorax. 



Incisura jngularis 



Incisura clavicularis 



llIan1ll)riaIu>'^^\ %\ ,\ 
stcrni 




Incisura costalis I 



Incisura costalis II 



Incisura costalis III 



Incisura costalis VI 
Incisura costalis VII 



Processns _ 
xjphoideus 




Incisura costalis IV 



Incisura costalis V 



ID?? t:^rM^ inZL X^trr^^i^A- U^^« „i-. 



Bones of the Thorax. 83 



The steriinm fbinist bonej (see also iii^mvii 105 and 107) lies as an nnpaired oblong 
plati' of bone in the meilian plane and helps to form thi- anterior wall of tin" thorax. It 
extends in i;eneral somewhat obliquely from behind and above, forward and downward and 
corresponds in position tn the spine from the third to the ninth thoraeic vertebra. Three 
parts are distinguishable: manubrium sterni, coi-jnis sterni and processus xiphoideus , the 
parts being separated from one another by layers of cartilage which, however, in advanced ago 
may ossify and lead to fusion. 

The iiiauubriiiiu sterni is the broadest part, especially above; below it becomes 
somewhat nanvwer; its anterior surface is slightly convex, its posterior, Hat. At the upper 
margin in the midcQe is a flat notch , incisura jugularis (0. T. presternal notch) ; near this, 
at the upper angle on each side, is a somewhat deeper depression covered with cartilage, the 
incisura clavicularis, for articulation with the fades articularis sternalis claviculae. 

The corpus sterni (0. T. gladiolus) is the longest portion; above and below it is 
somewhat narrower than in the middle; its anterior surface, planum stentak, and its posterior 
surface are flat. The manubrium and corpus are somewhat movable upon one another where 
they are united at the synchondrosis sternalis; at the point of junction, whether the joint 
exists or even when it has become ossified, there is often an angle, angutus sterni, which 
can be felt as a transverse ridge projecting forward beneath the sldn. 

The processus xiphoideus (0. T. ensiform process) forms th(- lower extremity; it is 
thin, longer than it is broad, very irregular in shape, often bifurcated or perforated by an 
opening and remains for a long time wholly or partially cartilaginous. Only late in life does 
it begin to become ossified inside and to fuse with the body. 

On each lateral surface of the manubrium and corpus are seven (sometimes eight, see 
p. 78) notches, incisurac costales , for the upper seven (eight) ribs. The first is rough, the 
others are covered with cartilage. The first notch is in the manubrium just below the in- 
cisura clavioidaris ; the second at the point of union of manubrimn and corpus , each forming 
a haK of it ; the third on the corpus nearly in the middle of the whole length of manubrium 
-f coi'pus; the fourth to the seventh (eighth) in the lower half, so that the inferior notches 
are closer and closer together , the two lowest often being fused to one ; the seventh (and 
eighth) situated at the junction of tlie corpus with the processus xiphoideus may be situated 
partially in front of the latter. 

In the female, other things being equal, the corpus sterni is sh(jrter than in the male ; 
accordingly, the female sternmn is, on the whole, shorter and looks relatively broader and 
plumper. 



84 



Bones of the Thorax. 



•J"^?*. ''ji^ i^„ __ Vertebra thoracalis I 




105. Thorax, thorax, from iu front, 



Bonea of tlio Thorax. 



85 



Vertebra thoraealis I 




Bones ol wb 



Vertebra thoracalis I 



Steinun' 




Vevtetva __ ,-^ 
thoracalis XU 



Vertebra j-j< 

Uimbalis I 



107. Thorax 

ihorax. from tho x\% 



Bones of the Uiiiirr Extremity. 



Aiigulus medial i; 



Fades articularis acromii Foasa subscapularLs 
lueisnra scapulae ' iMiirij;!) siipcrioj- 



CulUini scapulae 
Cavitas glenoidalis , '*; 

Augulus lateralis' 
Tuberositas iufragleuoidali 




Marj^o axillaris-' 



Augulus iiiteriui- 



108. Right shoulder blade, scapula, from in front. 

The scapula (shoulder Made) (see also flt;\u-cs 109—112) is a broad, flat, thin, triangular 
bone which lies upon the upper part of the wall of the thorax so that the lateral angle pro- 
jects lateralward over the thorax ; its medial margin , when the arm is hanging down , runs 
nearly parallel to the median plane and extends from the second or third to the sen-nth or 
eighth rib. It lies freely movable between the muscles and is ennin'cted by joints lateralward 
Tvith the clavicle and mth the humerus nnly. 

The shoulder blade has three margins; the thin, shortest, ujiprr, margo superior, winch 
presents on its lateral extremity a notch, the incisura scapulae ((_). T. suprascapidar notch), 
the longest, medial margin, margo vertebralis ; the thick, lateral margin, mar/jo axillaris. 
These margins meet in three angles; the blunt, thick augulus inferior, the sharper, thinner 
angulus medialis (0. T. superior angle) and the augulus lateralis (0. T. anterior angle); 
the latter supports the surface for articulation with the humerus (see p. S'J). 

The anterior surface, facies costalis, is markedly concave in its upper lateral part. 



Bones of the Upper Extremity. 



AiiK'-ilii^ iiiedialis ' 



I^Iaigo superior 

Fossa snpraspinata Acromion 

Spina scapulae Processus coracoldeus ; 



Angulus lateralis 



Tuberositas infraglenoiLlalis 
Cdllum scapulae 
FoMsa infraspinata 



Margo 
vertebral is 




Margo axillaris 



Angiilus inferioi,' 



109. Right shoulder blade, scapula, from behind. 

The posterior smfacc of the sho\il(ler bladi', facies dorsalis scapulae, is convex and 
subdivided by a bony projection, sjrina scapulae, which ascends about at the junction of the 
upper with the middle third, into the iipper smaUer, deeper fossa snpraspinata and the lower, 
larf,nn', flatter fossa infraspinata. The spina scapulae is low where it begias at the margo 
vertebralis and develops gradually to a very powerful high plate of bone which possesses an 
upper surface, directed also somewhat forward, and a lower surface, looldng also somewhat 
liackward. The fi'cc margin is broad. A strung process (the acromion) gnes off from the side 
of it, first lateralward, then forward; it Ineks Hatti'ned out in its most anterior part and 
presents an upper and a lower surface; near its apex it presents mediauward a small oval 
facies articnlaris acromii for articidation with the facies articnlaris acromialis claviculae. 



Bones of the Fiipov Extrnnity. 



89 



Tubcrositiis siipiajjlenoidalis 
i Processus coracoicleiis 



Ciivilas glenoiclulis 



Tuberositas infragleiioitlalis 




110. Right shoulder blade, scapula, from without. 

The angulus lateralis scapulae becomes markedly broader externally and is marked 
off from the rest of the shoulder blade by a shallow groove or neck, collum scapulae. The 
surface which is turned lateralward, the cavitas glenoidalis , is somewhat concave and is 
covered with cartilage; it is nearly oval in shape and is broader below than above; there is 
a slight indentation in the upper part of the anterior margin. A roughness just above this, 
the tuberositas supraglenoidalis (0. T. aapraglenoid tubercle), gives origin to the caput longum 
m. bieipitis; another, larger, below it, at the uppermost end of the margo axillaris, tuberositas 
iiifraglenoidalis gives oiigin to the caput longimi m. tricipitis. 

Between the cavitas glenoidahs and the incisura scapulae, arising from the margo 
superior, is the processus coracoideus (crows leak process) ; it is thick, rounded, runs iirst 
forward and upward, and then, making a marked hook-like curve forward and lateralward, ends 
in a blunt tip. 



Bones of the I^^pper Extremity. 



M. biceps brachii {Caput breve) >I. sen-atus 

I\[. deltoideus *' M. eoracobrachialis anterior 

/ / !M. peetoralis minor 



Isl. triceps brachi, ,- 
I Caput longuiu 




M. subseapulari? .'- \\' 



31. serratus anterior^ 



111. Right shoulder blade, scapula, from in front, 

■\vith the muscular attachments. 



Bonos of the Upper Extremity. 



91 



INI. supnxspiuatus 



M. levator scapulae.. 



M. trapezius. 



M. deltoideus 
1st. rhomboi- 
deus minor - 



M. trapi 
M. biceps brachii 
{Caput longmii) 



"'SI. deltoideus 



!M. triceps brachii 
(Caput^longuui} 




-M. teres mino 



M. rhomboideus, 
major 



-M leres major 



112. Right shoulder blade, scapula, from behind, 

with the muscular attachments. 



92 



Bones of the Upper Extremity. 



Tuberositas coracoiclea 



Behind 




Kxtremltas 
acroniialis 



In front 



Extreniitas sternal is 



113. Right collar bone or clavicle, clavicula. from above. 



Facies articiilaris acroniialis 



In front 



Extremitas 
sternalis 




1 Tuberositas coracoidea 

I Behind 

Kxtremltas 

acroniialis 



Tuberositas costalis 



Faeies arlioularis stemalis 



114. Right collar bone or clavicle, clavicula, from below. 

The clavicula (key, clavicle or collar bonej is a hhnrt, strimij', oylindrical bone bent 
cc-hke which nms transversply in fi'ont of the first rib, i;'ninn' out on each side from the 
upper end of the stemmn, and is attached at its lateral I'xtrrmity h< the acromion scapulae. 

It is diviaible into a shaft and two extrcinitirs : that ihrected toward the sternum, 
extremitas stemalis, and that lonldug toward the scapida, exiremitas acromialis. 

The shaft is bent convexly forward in its metUal haK; in its lateral half convexly 
backward. It is triangular with rounded angles csiircially medianward. The extremitas 
sti.'rnalis ends with the approximately triangular, curved fades articularis stemalis covered 
with cartila.L;'!.', which lies in the incisura clavicidaris sterni. Somewhat lateralward from it, 
at the junction of the inferior with the ]«jstrri"r siirlace, the tuberositas costalis (0. T. Im- 
prrssiou fur rhomboid ligament) (for the hg. custi'claviculari") is visible. The extremitas 
acromialis is somewhat broadened and is flattened from above downward; at its extreme end 
it is turned somewhat forward and supports there the small, oval, flat facies articularis 
acromialis for articulation with the facies articularis acroiuii scap\ilai\ Just medianward, near 
this, on the lower surface lies the oblong, ro\igh tuberositas coracoidea (0. T. impression for 
conoid ligaiiient) (fir the lig. coracocla.viculare). 



Bones of tlie Up])er Extreimty. 



M. trapezius 



^I. .sternuelfiduniastdidc'Ui 




IM. deltoideus 



M. pectoralis major 



115. Right collar bone or clavicle, clavicula, from above 

■with the muscular attachments. 



:M. deltoideus 



if. pectoralis major 




ls\. trapezius 



I\I. sternohyoideus 



116. Right collar bone or clavicle, clavicula. from below 

with the miisculai" attachments. 



94 



Bones of the Upper Extremity. 



Tuberculum minu3 
C'ollum auatomicum 



Tuberculum 
ma jus 
Sulcus 
intertuberculari3 



Caput humeri 



Collum chirurgicum . 

Crista tuberculi 
minoris 

Crista tuberculi 
majoris 




Trochlea liunieri. 

Epicondylus niedialis 



117. Right humerus, 

humerus, from in front. 

The humerus (upper arm hone) (see 
also figures 118 — 122) is a long cylindrical bone 
which articulates above with the shoulder 
blade, below with the bones of the forearm. 
It is divisible into a body or shaft, corpus 
humeri, and two extremities. 

The corpus humeri (shaft) is more 
cyhndrical above, distinctly triangular below; 
its surfaces are called the fades posterior, 
the fades anterior medialis (0. T. internal 
sui-face) and the fades anterior lateralis 
(0. T. external surface); the posterior surface 
is separated from the two anterior surfaces 
by the margo medialis (0. T. internal border) 
and the m.argo lateralis (0. T. external 
border) both of these being especially sharp 
and prominent below. On the facies anterior 
lateralis somewhat above the middle is a broad 
rough surface, tuberositas deltoidea (for the 
m. deltoideus); behind this, on the posterior 
surface lies a shallow groove, the sulcus nerd 
radialis (0. T. musculospiral groove) (for the 
n. radialis), which begins on the medial margin 
and descends lilce a long di-awn-out spiral to 
the lateral margiu. A large foramen nutricium 
is often noticeable near the middle on the 
medial margin: it leads into a canalis nutridus 
directed distalward. 

The upper extremity is broadened 
and supports the caput humeri which is 
covered with cartilage; this is nearly hemi- 
spherical and directed upward and median- 
ward. It is separated fi-om the rest of the 
bone liy a constriction, the collum anatomicum 
(anatomical neck). Close to this he two 
eminences : directed exactly lateralward is the 
tuberculum majus (0. T. greater tuberosity), 
in front of this directed foi'W'ard, the tuber- 
culum minus (0. T. lesser tuberosity); running 
forward and downward ft'om both of these are 
ridges, the ci'ista tuberculi majoris (0. T. 
posterior bicipital ridge) and the crista tuber- 
culi minoris (0. T. anterior bicipital ridge). 
Between the tubercula and the cristao runs 
the deep sulcus intertubercularis (0. T. bici- 
pital groove) (for the tendon of the caput 
long-nm m. bicipitis). At the junction of the 
upper extremity with the <-iirpus humeri hes 
the collum chirurgicum (surgical neck). 



Bones of the Upper Extremity. 



118. Right humerus, 

humerus, from behind. 

The lower extremity of the 
humerus is somewhat thinner hut 
broader than the shaft. From each 
side of it projects a rough eminence, 
the epicondylus medialis (0. T. internal 
condyle) and the epicondylus lateralis 
(0. T. external condyle). These lie in 
the lines of continuation of the margo 
medialis and the margo lateralis and 
give attachment to muscles and liga- 
ments of the elbow joint. The epi- 
condylus medialis is the larger and 
presents on its posterior surface a 
shallow groove, sulcus nervi ulnaris 
(for the n. ulnaris). 

Between the two epicondyles lies 
a joint surface, covered with cartilage, 
for articulation with the bones of the 
forearm. It consists of a medial, roller- 
shaped surface, trochlea humeri (for 
articulation with the ulna), which extends 
also upon the posterior surface, and of 
a lateral, smaller capitulum humeri (0. T. 
capitellum or radial head) (for articula- 
tion with the radius) , shaped like the 
segment of a sphere, which is not con- 
tinued upon the posterior surface. Above 
the trochlea, both in front and behind, 
is a deep depression; that in front is 
called the fossa coronoidea, that behind, 
the fossa olecrani; between the two 
the bone is very thin and may be 
absent. On the anterior surface, above 
the capitulum humeri, lies the smaller 
fossa radialis. These three depressions 
are not covered with cartilage. 



Caput humeri 

CoUuin anatomiciim 



Tuberculum niajns 



Colluui chirurgicum 




96 Bones of the Upper Extremity. 

Behind 

Collum anatomicum 

for the mm. infraspinatus and teres^ 
minor ^ 

Tiiberculum majur ^~-*^f^^- '^ ^^^H ^^^P*^* humeri 

for the m. supraspinatu; - 

Sulcus intertuhercularis / 

Tuberculum minus y 

In front 

119. Right humerus, humerus, upper extremity, 

from above. 

Behind 

Facies posterior 




.■> \ 

Margo lateralis — 'j^^^B-' '' Margo medialis 



,-.-*<. 



I 

Facies anterior lateralis "^ V^ ^ 




Facies anterior medialis 
In front 



119^ Transverse section through the lower half 
of the right humerus- 



lu fVont 

Capitulum humeri 

I Trochlea humeri 



Epicondylus lateralis^ 




Epicondylus medialis 
Sulcus nervi ulnaris 



Behind 



120. Right humerus, humerus, lower extremity, 

from below. 



Bones of the I^i>iier Extivmity. 



97 



M. snpraspinat.ua ---7 
M. subscapularis - 



M. latiasinuis dorsi . 



M. teres 



major 



M. pectoralia major 



M. deltoideus- 



!M. coraeolnachialis- 






M. brachialis 



M. brachioradialis - 



M. extensor carpi 
radialis longus 



v'-J 



/ . 'i. 



M. esteiisor carpi 
radialis brevis ,JJi _ ' '/ 

M. extensor /^i' 1 ^ \\ ^ 

digitorum ~-V^f/!^^, 
communis, 
m. extensor / w, 

carpi [ . ; V--., 

ulnaris and \ ;ij ^^^ b " ■ V:j)V' """j 

m. supinator V ..o-"^^*^ ^fe^f^W 






ij:^:- 



•-- U. infraspinatus 
...M. teres minor 



M. flexor carpi 
ulnaris 



^y '' M. palmaris longus, m 
:J/ ,' flexor carpi radialis and m. 
/ flexor digitorum sublimis 
M. pronator teres 



_I\[. trici'ps brachii 
I Caput laterale- 

. M. deltoideus 




.M. bracbiali^ 



M. brachiorodialia 



iX. triceps bracbii 
(("'ni'Ut mediale) 



■M. aneonaeus 



121 and 122. Right humerus, humerus, 

with muscular attachments. 
Prom ill front. From behind. 



Spalteholz, Atlas. 



98 



Bones of the Upper Extremity. 



123. Right ulna, ulna, 

from in front. 



Incisura __ 
radialis 



Crista interossea _ 



Incisura semilunaris 



Processus 
coronoideus 



Tuberositas xilnae 



Foramen nutricium 



Margo volaris 



Facies Solaris 



Cj 



Capitulum ulnae 
Processus styloideus 
Circnmferentia articnlaris 



The ulna (see also Figs. 124, 
127—129, H6) is along, cylindrical 
iDone which is thicker at its upper than 
at its lower extremity. It lies on the 
side of the forearm corresponding to the 
little finger, is united above by a joint 
with the upper arm, below, only in- 
directly, with the carpus; it is united 
by joints with the radius both above 
and below. 

It is divisible into a shaft or 
corpus, and two extremities. 

The shaft, corpus ulnae, is 
bent slightly so as to be convex toward 
the side of the little finger and is 
triangularly prismatic. Of its three 
surfaces, the facies mediaUs (0. T. 
internal surface) on the side cor- 
responding to the little finger is narrow; 
it goes over at the rounded margo 
volaris (0. T. anterior border) in fi-ont 
and the margo dorsalis (0. T. posterior 
border) behind, into the broader facies 
volaris (0. T. anterior surface) and 
facies dorsalis (0. T. posterior surface). 
These meet radialward in the sharply 
projecting crista interossea (0. T. ex- 
ternal or interosseous border). A fora- 
men nutricium often lies near the crista 
interossea at the middle of the length 
of the volar surface and leads into a 
canalis nuiricius directed proximalward. 



Bones of tlic Upper Extremity. 



99 



124. Right ulna, ulna, 

from the radial side. 



The upper extremity of the 
ulna is thickened and ends with a 
rough strong process, the olecranon; 
beneath it, projecting from the volar 
surface, is the strong processus coro- 
noideus. Between these two processes 
lies a deep notch , covered with carti- 
lage, the incisura semilunaris (0. T. 
greater sigmoid cavity), in which the 
trochlea humeri is received. On the 
radial side of the proc. coronoideus the 
smaller, slightly concave, incisura ra- 
dialis (0. T. lesser sigmoid cavity) (for 
the capitulum radii) is visible. Passing 
obliquely backward and downward from 
this is a sharp bony ridge, the crista 
m. supinatoris (for the origin of the 
m. supinator). Somewhat below tlie 
proc. coronoideus lies a broad rough 
surface for the attachment of the m. 
brachialis, the tuberositas ulnae. 

The lower extremity is nar- 
rower and forms a small rounded head, 
capitulum ulnae. This is covered with 
cartilage on its distal surface as well 
as in the larger part of its circum- 
ference, the circumferentia articularis 
(for the incisura ulnaris radii). On the 
side corresponding to the little finger, 
the small blunt processus styloideus 
projects distalward. 



Margo dorsalis 



Facies dorsalis _ 



f Incisura semilunaris 



Processus 

coronoideus 

"Incisura radialis 

- Crista m. supinaioris 
_ Tuberositas ulnae 



- Crista mterossea 



.Capitulum ulnae 

Circumferentia articularis 
Processus styloideus 



100 



Bones of the Upper Extremity. 



Fuvea capituli radii 



Capitulum radiL>. 



Circumferentia 

articularis 

Collnm radii 



_ Tuberositas radii 



-Crista interossea 



Faciey Tolaris 



Margo volaris- 



Processus styloideus 



125. Right radius, 

radius, from in front. 

The radius (spoke) (see also 
Figs. 126 — 129, 146) is a long 
cylindrical bone, thickened at its lower 
end which occupies the side of the 
forearm corresponding to the thumb. 
It articulates above with the upper arm, 
below enters into the joint between the 
bones of the forearm and those of the 
wrist and rotates above and below on 
the ulna. 

It is divisible into a shaft or 
corpus and two extremities. 

The corpus radii or shaft is 
bent so as to be somewhat convex 
toward the thumb side and is triangu- 
larly prismatic. The narrowest of its 
three surfaces, fades lateralis (0. T. 
external surface) is directed toward the 
thumb side ; it adjoins at the rounded 
margo dorsalis (0. T. posterior border) 
behind and the margo volaris (0. T. 
anterior border) in front, the broader 
fades dorsalis (0. T. posterior surface) 
and fades volaris [0. T. anterior sur- 
face). The ulnar angle formed by these 
two surfaces is especially sharp and is 
called the crista interossea (0. T. 
internal or interosseous border). A 
foramen nutricium is often visible at 
a spot corresponding to that on the 
ulna ; the canalis nutricius is directed 
proximalward. 



Bojii>s of tHe Upper Extremity 



lo: 



126. Right radius, 

radius, from behind. 
The upper exti'emity of the 

I'adius supports the button - shaped 
capitulum radii (head) ; this is for the 
most part covered with cartilage and 
proxinialward presents a small flat 
depression, fovea capituli radii (for 
articulation with the capitulum humeri); 
its circular periphery covered with car- 
tilage, circumferentia ariicularis, mo- 
ves in the incisura radialis ulnae. Just 
below the capitulum the bone is narrowed 
to form a neck, collum radii, and close 
below this spot, projecting ulnarward and 
volarward, is the tuberositas radii 
(0. T. bicipital tuberosity) (for the 
attachment of the m. biceps brachii). 
The lower extremity is mark- 
edly broadened. Its anterior surface is 
smooth and slightly concave; its posterior 
surface is subdivided by several longi- 
tudinal ridges into grooves for tendons 
(see Fig. 129). The distal terminal 
surface, fades articularis carpea, 
covered with cartilage, is slightly con- 
cave and triangular; it is subdivided, 
usually distinctly, into a triangular 
radial part (for the os naviculare) and 
a quadrangular ulnar part (for the 
radial portion of the os lunatum). On 
the ulnar side is a small notch covered 
with cartilage, the incisura ulnaris 
(0. T. sigmoid cavity) (for the capi- 
tulum ulnae). Projecting distalward from 
the angle on the thumb side is the 
short blunt processus styloideus. 



('ircumferentia,_ 

articularis 
Collum radii 



Tuberositas _ - 
radii 



-^ -Capitulum radii 



Foramen nutricium 



Crista inierossea 



Faeies dorsalis 



. Margo dorsalis 



Incisura ulnaris 



Processus styloideus 



102 



Bones of the Upper Extremity. 



Behind 



Facies dorsalie^ 
Facies dorsalis 



Margo dorsalis ^ 



Facies .ateralis-. 



Radius 



Margo volaris 




Margo dorsalis 



.Facies medialis 



-< Ulna 



Margo volaris 



Facies volaris 



In front 



127^ Transverse section through the middle of 
the bones of the right forearm. 



Behind 

Facies dorsalis radii 



Pruce^:jus styloideua ulnae 



Ulna 




Facies articuiaris carpea 

Processus styloideus radii 
< Radios 



Facies volaris radii 



Capituluni ulnae 

In front 

127. Lower extremity of the bones of the right 

forearm, from below. 

The lower extremity of the bones of the forearm (see also Fig. 146) 
which forms the articulation with the carpus, presents on its distal surface the facies 
articuiaris carpea radii and the cqpitulum ulnae. The former articulates directly 
with the OS naviculare manus and the radial part of the os lunatum. The capitulum 
ulnae on the contrary does not touch the ulnar part of the os lunatum and the os 
triquetrum, situated distalward from it, directly, but is separated from them by a discus 
articuiaris. 

On the sides of this surface the two processus styloidei are visible. 



Bones of the Upper Extremity. 



103 



M. flexor carpi ulnaris . 
M. flexor digitoruiu sublimis 
M. pronator teres^ 



^i^-- 



M. bracliialis ,_^ 

M. supinator, _ 
M. extensor carpi ulnaiis.., 
M. biceps bracliii— /- 
M. flexor digitoruiu sublimis - 

M supinator.- 



>-. # 



^[. pronator teres.. 



M. flexor digitonim 
sublimis 



M. flexor djcfitorum, 
profundus 



&[, flexor poUicia longus. 



M. pronator quadratus^--/ 



M. brachioradialis-i 



. M. tric«pg bracliii 

M. flexor carpi ulnaris 
M. anconaeus 



^ M. extensor carpi ulnaris 

_ M. flexot digitorum profundus 
-M. supinator 



~-,M. abductor pollicis longus 

M. pronator teres 
— .M. flexor carpi ulnaris 

_M. flexor digitorum sublimis 
.31. extensor pollicis longus 

..JT. extensor pollicis brevis 



. _. M. extensor indicis proprius 



7 



\ ■ 



. M. pronator quadiatus 

..M. atiduct. poll. loufi. 
. M. extens. poll. brev. 
dM. extens. poll. long. 

, M. extensor carpi 
3§\ radialis longus 
^ m. extensor carpi 
radialis brevis 

M. extensor digitorum communis 



' A'-r^ M. extensor carpi ulnaris 

128 and 129. Bones of the right forearm, 

with the muscular attachments, 

from tlie surface corresponding to the fr-om the side corresponding to the 

hollow of the hand. liack of the hand. 



104 



Bones of the Upper Extremity. 



Os lunatum 



<.)s naviculare manus 



Os triquetrum 



Tu"berculnm ossis navicularis 
Tuberculnm ossis 
multanguli majoris 



Os multaugulum 
raajns 




Os pisiforme 



Os multangulum minus 



Hamulus ossis hamati 
Os hamatum 



Os capitatum 



130 — 137. Bones of the right carpus, ossa carpi, 

shown singly, from the volar surface. 

The eight ossa carpi fwrist hones) (see also Fiij;s. 138 — 146, 148, 149) are arranged 
in twu transverse mws of four eaeh ; the proximal (numhered from the thmnh side) consists 
of the OS naviculare manus, os lunatum, os triquetrum, os pisiforme; the distal of the 
OS rmiltang^ihim majus, os mnltanrjuhim minus, os capitatum, os hamatum. 

The OS naviculare manus (0. T. scaphoid bone) presents proximally a convex articular 
surface (for the radius), on its distal surface, a convex articular surface (for the ossa miiltangula 
majus et minus), ou the ulnar surface distalward a concave surface (for the us capitatvun) and 
proxunalward a small flat articular surface (for \\v' os limatum). On the volar surface lies the 
tuberculum ossis ndricvlaris. 

The OS lunatum ((>. T. semilunar bone) presents proximally a markedly convex articular 
surface (for the radius and for the discus articularis of the joint formed by the forearm with 
the hand), ilistally, a markedly concave articular surface (for the os capitatum and the os 
hamatum); radialward and ulnarward lie small fiat articular surfu-es for the os na%'iculare and 
the OS triquetrum. • ' 

The OS triquetrum ((_). T. cuneiform hone) has proximally a small, convex articular 
surfac'.' (for the dis(.-us articularis of the joint formed by the forearm with the hand), disbiUy, 
a laryc cuncave-eniivex siirface (for the os hamatum), radialward, a small flat one (for the os 
lunatum) and on tlie volar surface a smaD, flat, rounded articular surface (for the os pisiforme). 

Tlir OS pisiforme is a small, env-shaped bon.' which dorsalward pri'srnts a small, flat, 
I'dutided articular surface (for tlie os triiiuetrmn). 



Bones of the Uppur Extremity. 



lot 



Oa luuatum 



Os triqnetrnni 



* *s iiaviculare maiius 




Os hamatum 

Haimilus ossis hamati 



Os capitatuni ' 

Os nmllangulum minus 



Os multangulum majus 



138—145. Bones of the right carpus, ossa carpi, 

shown singly, from the surface. 

The OS multangulum majus or large multangular bone (0. T. trapeziimi) ,has 
proximally a slightly concave articular surface (for the os naviculare), distalward a sadcUe- 
shaped surface (for the os metacarpale I), ulnarward a small surface (for the os metacarpale II) 
and a somewhat larger, concave surface (for the os multanguhun mmus). On the volar surface 
is a small projection, iuberculum ossis multanguli majoris , and ulnarward from it a groove 
(for the tendon of the m. flexor cai-pi radiahs). 

The OS multangnlnm minus or small multangular bone (0. T. trapeznid bone) 
presents proxhnally a shghtly concave articidar surface (for the os naviculare), distalward a 
flat saddle- shaped surface (for the os metacarpale II); on the radial surface lies a slightly 
convex articular surface (for the os multangulum majus), ou the ulnar a feebly concave surface 
(for the OS capitatum). 

The OS capitatum (0. T. os magnum) is inserted in its proximal part mto the deep 
concavity formed by the os naviculare and the os lunatum. It supports there a markedly 
convex articular surface (for the os lunatum), distalward a tripartite, flat, articular surface (fir 
the ossa metacarpaha 11, HI, IV); radialward are convex articular surfaces for the os navi- 
culare and the os multangTdum minus, ulnarward a flat articidar surface for the os hamatum. 

The OS hamatniu or hook bone (0. T. unciform bone) presents a large, convex-concave 
articular surface (for the os lunatum and the os triquetrum) directed proxiniaUy and at the 
same time ulnarward; distaUy is a double articular surface (for the ossa metacarpalia IV, V) 
and radialward a single, flat, articular surface (for the os capitatuni). On the volar surface a 
.flat somewhat curved process projects upward, the hamulus ossis hamati (0. T. unciform process). 



106 



Bones of the Ujiper Extremity. 



Kadi us 



Os uaviculare manus ---- 



Os multaiigulum -- 
maju3 



Os multanguluni 
minus 




_ Os haraatuni 



Ossa metacarpalia 



146. Right wrist and neighboring bones, 

in transvei'se rows, separated from one another, from the volar surface. 



Bones of tho Upper Extremity. 107 



The first carpal row (see also Fig. 240) , considered as a whole , has ])roxmialward 
an elongated oval, markedly convex, articular surface, in the formation of which participate 
the OS naviculare and the os lunatum especially, the os triquetrura to a less extent; the os 
naviculare and the radial part of the os lunatum articidate with the fades articularis carpea 
radii, the ulnar part of the os lunatum and the os triquetrum with the discus articularis 
situated below the capitulum ulnae. The os pisiforme takes no part in the articulation with 
the bones of the forearm nor in that with the second carpal row, but is simply attached, 
volarward, to the os triquetrum. Distalward the first carpal row is bounded by a surface, 
the radial portion of which (formed by the os naviculare) is convex and projects markeiily 
distalward, and its ulnar portion (formed by the ossa naviculare, lunatum, triquetrum) 
represents a depression markedly hollowed out proximally. 

The second carpal row (see also Fig. 240) ends proxiraalward in a surface, the 
radial portion of which (formed by the ossa multangula majus et minus), is concave and its 
ulnar part (formed by the os capitatum and os hamatum) represents a head projecting markedly 
proxiraalward. These proximal surfaces are impressions of the corresponding distal surfaces of 
the first carpal row. The distal boundary of the second row is formed by a wury surface in 
which the ossa metacarpalia are deposited; fui'thest radialward lies the saddle - shaped surface 
for the OS metaoarpale I (formed by the os multangulum majus) after this comes the surfai-e 
for the OS metaoarpale 11 (formed by the ossa multangula majus et minus , os capitatum) ; 
then the surface for the os metaoarpale HI (formed by the os capitatum), then the surface 
for the OS metacarpale IV (formed by the os capitatum and the os hamatum) and finally, the 
surface for the os metaoarpale V (forjned by the os hamatum). 

The carpus (wrist) (see Figs. 148 and 149) is on the whole almost quadrangular, 
and narrower proxunaUy than distaHy. It is besides curved so as to be somewhat convex 
dorsalward and, accordingly, volarward forms a groove which is made deeper by the fact that 
the radial and the ulnar sides are somewhat elevated; radialward are the tuberculum ossis 
navicularis and the tuberculum ossis multanguli majoris which together form the eminentia 
carpi radialis; ulnarward the os pisiforme and the hamulus ossis hamati project upward and 
form the eminentia carpi ulnaris. The groove bounded by the two enrinentiae carpi is called 
the sulcus carpi; it is converted uito a complete canalis carpi by the ligamentum carpi 
transversum which extends between the eminentiae : through this canal go the tendons, vessels 
and nerves to and from the fingers. 



108 



IJdiK's of the U])]>fr Extivmity. 

__ Processus styloidens 



(!5a1 



..Basis 



Os metacarpale 



_ _ Corpus 



^ Direction of the eanalis nutricius 



^ Capitulum 



Phalanx I 




Basis 



Corpus 



Phalanx II 



Phalanx III 



y^ Direction of the eanalis nutricius 

Trochlea 

^^ . Basis 
."^" Corpus 

"^ Direction of the eanalis nutricius 

Trochlea 

Corpus 

Direction of the eanalis nutricius 

Tuberositas 
uuguicularis 





147. Metacarpal bone and phalanges of the third 
finger of the right hand, os metacarpale III et phalanges 

aigltl III, from the dorsal surface. 



Biincs of the rpju'i- Extveiiiity. 109 

The five ossa metacarpalia (see also Fij^-s. 146, 148 — 151) are short cylindrical 
boni>s, each of wliioli is divisible into a shaft, or corpus, a proximal extremity, basis, and a 
distal extremity, a/jiiiidiim. Tlie \vhole bone is curved, so as to be sli,i;htlv convex toward 
thi- back of the hand. 

The corpus or shaft is triangular so that one side looks dorsahvard, the other two 
radial- and iilnarward; the latter surfaces meet in an angle directed volarward. (Jii the volar 
snrface is a lart;-e foramen nuiricium, which Icails mto a canalis nutricius directed m the 
thumb distalward, in the second to the fifth finger, proxiraalward. 

The basis is somewhat broadened and prcsi'nts on its proximal surface an articukir 
snrface for connection with the carpus, between the second and the fifth finger also small 
articular surfaces on the radial and ulnar surface for the neighboring metacarpal bones. The 
basis ossis metacarpalis I, has a saddle-shajuMl joint surface (for the os multangulum majus) 
but no lateral articular surfaces. On the basis ossis nietai'arpahs III, from the radial part of 
the dorsal surface, a blunt proc(<ss, the processus styloideus ossis metacarpalis III, projects 
toward the carpus. The basis ossis nictacarpahs Y presents proximalward a slightly sadtUe- 
shaped articular surface and a flat articular surface on the radial side. 

Each capihilum possesses a spherical articular surface, covered with cartilage, which 
extends upon the volar more than upon the dorsal surface. On the two sides there are 
depressions and roughened areas for the ligaments of the joint. 

The four sjiaces lying bt'tween the ossa metacarpaha (see Kgs. 148 and 149) are 
called sjmtia interossea metacarpi. The first, between thumb and index finger is the broadest. 
They are all fiUed out b\' the mm. interossei. 

The phalanges digitorum (see also Figs. 148 and 149) are three in number from the 
second to the fifth finger; while on the thumb there are two; they are called ^;Aaterex /??7'm«, 
secunda , iertia. Each phalanx is a short cvUndrieal bone which is dirigible mto a shaft or 
corpus, a proximal end, basis, and a distal end. 

The corpus is flat volarward and curved dorsahvard so as to be convex in transverse 
tlii-ection. A ku-ge foramen nuiricium on its volar surface leads iuto a canalis nutricius 
directed distalward. The basis is somewhat broad(nied and possesses a deep articular surface, 
covered with cartQage, which on the first phalanx is simple, on the others is divided by a 
ridge. The distal end of the first phalanx of the thumb and also of the first and second 
lihalanx of the remaining fingers has a trochlea, a small transverse roller surface covered with 
cartilage, with a gi'oove in the middle; on the sides lie small depressions for the attachment 
of the ligaments of the joint. On the terminal jihalanx the distal end is transformed to a 
broad flat rough area, the tuberositas unguicularis. 

Ossa sesamoidea (sesamoid bones) (see Fig. 148) are small masses of bone which, 
embedded in tendons or ligaments, lie upon the other bones. There are constantly five or 
almost constantly five such on the volar surface, two at the metacarpophalangeal jouit of the 
thumb, one at the interphalangeal joint of the thumb and one each at the metacarpophalangeal 
joint of the second and of the fifth finger. 



no 



Bones of the Upper Extremity. 



Os naviculare maims 
Os capitatum 
On raultanguluin majus ^ 
Oh miiltanguhim minus ^ 



Phalanx III - 



Os lunatum 
Os triqnetrum 



Os pisifornie 
Os hamatum 



Spatia interossea 
melacarpi 




148. Bones of the right hand, ossa manus. 

from the volar surface. 



Bonos of the Upper Extremity. 



Ill 



Os uaviculare luamis 
_ Os capitatum 

Os niiiltangulum minus 
Os mnltanguhim raajus 



Os hamat 




Phalanx III 



149. Bones of the right hand, ossa manus, 

from the dorsal surface. 



112 



Bonos of tlip U])!!!'!' Extremity. 



M. flexor carpi radialis 



y\. flexor carpi ulnaris 



M. opponens pollicis ../. ^ 



M. abductor digiti V 
__^1N[. extensor carpi 



M. abductor .. 
pollicis brevis / 

M. flexor ; 

pollicis brevis ' 



j\I. adductor 
IJoUicis 



... M. flexor digiti V 
^^.31. opponens digi 



flexor pollicis - 
longus 




Mm. interossei volarcs .-■ 



M, flexor digitorum sublimis^:: 



]\[, flexor digitorum profundus 



150. Bones of the right hand, ossa manus, 

from the volar surface, with the muscular attachments. 



Bones of tlin Upper Extremity. 



113 



M. extensor carpi radialis brevis 

M. extensor carpi radialis longus 



M. extensor carpi iilnaiis. 




M. abductor pollicis longus 



M. adductor pollicis 



M. extensor 
pollicis brevis 



---^.^^ M. extensor 
f^T ^ '^ V" pollicis longus 



Mm. interossei dorsales 



M, extensor digitorum 
communis 



151. Bones of the right hand, ossa manus, 

from the dorsal surface, with the muscular attachments. 



Spalteholz, Atlas. 



114 



Bones of the Lower Extremity. 



Labium externum 
...^^^'w^w— ^^ / Linea intermedia J Crista iliaca 



Ala ossis ilium 



Linea 

glutaea , 
posterior 



Spina iliaca | ^* 
posterior superior 'i^. 



Spina iliaca 
anterior superior 



Linea glutaea inferior 

Spina iliaca anterior inferior 
[ Corpus ossis ilium 




Spina iliaca posterior inferior ^^^"^^^ glutaea' ^ «-'' 



Spina ischiadica 

Incisura ischiadica minor .y \ 

Corpus ossis ischii 

Os ischii - >- j 



Tuber ischiadicum 



Incisura acetabuli 

Crista obturatoria 
Pecten ossis pubis 
Tuber culum 
pubicum 



J Ramus superior ossis pubis 

Ramus inferior ossis pubis 
Ramus superior ossis ischii Ramus inferior ossis ischii 



152. Right hip bone. 



OS coxae, from without. 



Bonrs of the Lower Extremit\ . " j j 5 



The OS coxae (hip bone) (0. T. os innommatuin) (src also Fio-s. 153— Ifii) is paired, 
hos in the Ljwermest part of the trunk, and forms then- with th(> same bono of the otlier side 
and with the sacrum a firm hroad l)ony ring upon which tlie vertel.ral cohunn rests above 
and with which, externaUv, the bon(>s of the thigh are eonneeted. 

Each OS coxae is composed of three jiii^vs, s.'parated until about the age of ]nd.ei-tv: 
the OS ilium which is directed upward and backwavtl, th.' os ischii, wliich is dire<-ted (lown\iard 
and the os pubis whieli is directed forward and dol^■nward. These thi-ee constituents meet 
somewhat below the middle of the hip bone. At this spot on the external surface lies a wide 
de(>p fossa, the acetabulum. This is surrounded by a high Ijony wall which presents below 
a broad notch, the incisura acetabuli; in the bottom of the acetaljulum a large rough spot 
is visible, the fossa acetabuli, whicli is surrounded in fi-ont, above and behind by a h. .rse-shoe- 
shaped concave surface, the fades lunata, covereil mth cartilage. The acetal)ulum ser\'es fjr 
articulation with the femur. In youth the plac(-s where the threi^ bimes unite are visible as 
a Y-shaped seam, the middle point of which is situated in the fossa acetabuli. 

The 09 ilium helps to form the acetabulum Ijy means of its thick and liroad lower 
part, the corpus ossis ilium (vide supra); the upper part is n l)road, in places very thin, 
somewhat wavy bony plate which bends backward, upward and laterahvard and is called the 
ala ossis ilium. The oorjius and ala are separated from one another by the linea arcuata 
a curved rounded bony ridge descending obliquely from behind and aljove, forward and down- 
ward. The fre(^ margin of the ala ossis Oiimi is curved like the letter S, being cnncave in 
front and medianward and behind and lateralward, besides it is markedly broadened; it is 
called the crista iliaca (iliac crest). On it the places of attachment of the abdominal muscles 
are marked as ridges, namely as labium exteriimn and labium intei-num on the external and 
internal angle of the crest and as linea intermedia between these two. The crest ends in 
front in a blunt ]irojection, spina iliaca antei-ior superior ; below this the margin is narrower, 
somewhat concave and presents a second less marked projection, spina iliaca anterior inferior ; 
below this it goes over into the corpus ossis pubis and then^ forms with the latter the eminentia 
iliopectinea. The iliac crest ends behind at the spina iliaca posterior superior ; below it, 
separated by a small notch, lies the spina iliaca posterior inferior (sometimes indistinct), 
and stOl lower is a deep notch involving also the corpus ossis ischii , the incisura ischiadica 
major (0. T. great sacro-soiatic notch). The medial surface of the ala is for the most part, 
smooth, slightly concave, the fossa iliaca : behind it is an uneven portion, the anterior S-shajicd 
haK of which, fades auriculai-is , covered with cartilage, unites with the fades auricularis 
ossis saeri, while its posterior vcu-y rough half, tuberositas iliaca, serves chiefly for the 
attachment of the ligamenta saeroihaca interossea. The facics auricularis is not inire((uent]y 
partially surroimded in front and behind by a groiive, the sulcus paraglenoidalis, which servi^s 
for the attachment of the deep fibrous bands of the ligamenta saeroihaca. The external surface 
of the ala is fairly smooth, and c\irveil so as to be partly concave, partly convex. It presents 
three rough ridges, convex upward and backward, the shortest of which, the linea glutaea 
inferior (0. T. inferior curved Une), hes just above the acetabuhun ; above and behind this is 
the linea glutaea anterior (0. T. middle curved hne) which is the longest of the ridges and 
extends from the incism-a ischiadica major to the spina ihaca art^rior superior; and abo\- 
this the shorter linea glutaea posterior (0. T. superior curved line) runs fi-om the spina iliaca 
posterior inferior to the crista ihaca. 



116 



Bones of the Lower Extremity, 



Spina iliaca 
anterior superior 



Fossa iliaca 



Sulcus paraglenuidalis -,J- 



Spina iliaca anterior inferior -.. 
Linea arcuata 



Eminentia iliopectinoa 




Crista iliaca 



Tuberositas iliaca 



Spina iliaca 
posterior superior 



Facies auricularis^ 



Spina iliaca posterior 
inferior 



Incisnra ischiadica major 
Corpus ossis ilium 
Corpus ossis ischii 



Corpus ossis pubis _ 

Pecten ossis pubis 

Sulcus obturatorius ...._4tj£^ 



Ramus superior ossis pubis- - 



Os pubis ' 

Facies symphji-seos 



Spina ischiadica 
Incisura ischiadica mino 



Ramus superior us6is 
ischii 



Os ischii 



Ramus inferior ossis pubis 



Ramus inferior os^is ischii 



153. Right hip bone, os 



coxae, from M'ithin. 



Bonos of the Lower Extremity. H'] 



The OS ischii (0. T. ischium) helps • by its thicker upper part or body, the 
corpus ossis ischii, to form the acetabulum. At the anterior margin of this, below 
the incisura acetabuli, there is not infrequently a small projection, tuherculum obtura- 
torium posterius ; from its posterior margin the strong, sharp spina ischiadica (0. T. 
spine of ischium) projects backward and somewhat medianward. The deep notch between 
the spina ischiadica and the spina iliaca posterior inferior is called the incisura 
ischiadica major (0. T. great sacro - sciatic notch); a second notch,, the incisura 
ischiadica minor (0. T. lesser sacro-sciatic notch), below the spina ischiadica, between 
this and the tuber ischiadicum, is flatter and covered with cartilage. 

Extending backward and downward from the body or corpus is the triang-ularly 
prismatic ramus superior ossis ischii; the surface of this, directed backward and 
lateralward, is rough and much tliickened; it forms the tuber ischiadicum (0. T. tube- 
rosity of the ischium). From the lower end of the ramus superior in front the thinner 
flat ramus inferior ossis ischii (0. T. ascending ramus) goes off, nearly at a right 
angle ; it extends forward and upward and fuses with the inferior extremity of the ramus 
inferior ossis pubis. 



18 



J^niirs uf the Lower Kxtremity. 



0» iliiini 



Labium interuum 
., Linea intermedia [ Crista iliaca 
Labium externum 

Spina iiiaca anterior superior 



Ala ossis ilium — 



Corpus ossis ilium 



Corpus ossis pubis 



Pecten ossis pubis 

Ramus superior ossis pubis 
, Tuberculum pubicnm 




Acetabulum 

Facies lunata - 
Fossa acetabuli 



Corpus ossis ischi 



Ramus superior ossis ischii 



Tuber ischiadicum 



OS 

pabis 



Ramus inferior ossis pubis 



Ramus inferior ossis ischii 



Os ischii 



154- Right hip bone, OS coxae, from in front and below. 



Bones of the Lowit Extivinity. 119 



Tho OS pubis helps, with its thicker upper lateral portion, the corpus ossis 
pubis, to complete the acetabulum. Medianward and somewhat in front of this portion 
lies a rough projection, eminentio, iUopectinea, formed by the os pubis and the os ilium 
in common. Extending forward, downward and medianward from the corpus (body) is 
the ramus superior ossis pubis. It is triangular and grows narrower from the out- 
side in. Its posterior surface is smooth and somewhat concave. Its superior, somewhat 
convex surface is directed at the same time obliquely lateralward and forward, is broad 
at its beginning at the acetabulum and at the eminentia iliopectinea and is narrow, 
where it ends , medianward ; the posterior margin of this surface , pecten ossis pubis, 
jirojects in part to form a ridge, is continued behind and lateralward into the linoa 
arcuata ossis ilium and forms with it and the projection between the facies pelvina and 
basis ossis sacri the linea terminalis of the pelvis ; the anterior border arises from the 
incisura acetabuli, is rounded, slightly concave and ends near the median plane at a 
small rough projection, the iuberculum pubicum (0. T. spine of os pubis). The lower 
surface looks medianward at the same time forward and is continued lateralward into 
a groove, sulcus obturator ius , which ascends obliquely lateralward, backward and up- 
ward on the lower surface and ends on the inner surface ; the sharp bony border 
below by which this surface and groove are bounded medianward is called the crista 
obturatoria and presents a small projection, tuberculum obturatorium anterior. Tlie 
ramus superior ends medianward with an oval rough surface, facies symphyseos (0. T. 
symphysis pubis), for connection with the pubic bone of the other side. 

The ramus inferior ossis pubis is the narrow, flat piece of bone which extends 
from the medial end of the ramus superior downward and lateralward and unites with 
the upper end of the ramus inferior ossis ischii. 

The foramen Obturatuili is a large triangularly oval opening which is bounded 
by the os ischii and the os pubis on all sides. Its margin is everywhere sharp, except 
in the upper lateral angle where the sulcus obturatorius is situated. The foramen 
obturatum is closed in the fresh pelvis by a thin membrane, membrana obturatoria 
(see Fig. 246) whose uppermost transverse bands are stretched out between the two 
tubercula obturatoria ; the space thus left behind corresponds in its course to the sulcus 
obturatorius and is called the canalis obturatorius (for the a. and v. obturatoria ; 
n. obturatoriusj. 



120 



Bones of the Lower Extremity. 



:>r. glutaeus medius. 



M. obliquus externiis 
abdominis 



M. tensor 
fasciae latae 



^M. sartorius 




M. glutaeus 
maxim us 



M. semimembranosus 

M. biceps fcraorls,. 
M. quadratus fenioris.. 



■'31. adductor brevis 

M. gracilis 
M. adductor minimus 



M. semitendinoaus 



M. adductor magnus 



155. Right hip bone, OS coxae, trom behind and without, 
witli the muscular attachments. 



Bones of the Lower Extremity 



121 




M. quadralus fcmoris, 



M. semi- 
membranosus 



M. pectineus 



M. rectus 

abdominis 

M. pyramid alls 



M. adductor longus 
M. adductor brevis 



M. semitendinosus 



'. M. gracilis 
M. adductor minimus 



M, adductor inagnus 



156. Right hip bone, OS coxae, from in front and without and 
somewhat from below, mth the muscular attachments. 



122 



Bones of the Lower Extremity. 



yi. tranversus abdominis 



^[. obliquus 
intermis abdomini: 



M. quadrati 
M. obliq 



M. sartoriiis 




^_ M. coccygeu 



^^.... M. gemellus ii 



^[. obturator intern 



M. transversus perinci pro 



157. Right hip bone, os coxae, from withii 

with the muscuhir attachments. 



Bonos (if till' LowLT Extrciiiitv. 



123 




158. Male pelvis, pelvis, from in front and below. 




159. Female pelvis, pelvis, from in front and below. 



124 



Bones of the Lower Extrcmit)'. 




160. Male pelvis, pelvis, from in front and above. 




161. Female pelvis, pelvis, from in front and above 



Bones of the Lower Extrriiiitv. 



125 




162. Male pelvis, pelvis, from below and behind. 




163. Female pelvis, pelvis, from below and behind. 



126 



Bones of thr Lower Extremity. 




164. Male pelvis, pe/vis, median section, 
rio'lit half, from the left. 




165. Female pelvis, pelvis, median section, 
right half, from the left. 



Bones of the Lower Extremity. 



127 




Diameter transversa 



Diameter obliqua 11 



Diameter obliqua I 



Conjugata 



166- Female pelvis, pelvis, from in front and above, 
with pelvic diameters. 



Vertical 



DiagoiialcoDJugata j, 

Conjugata (anatomica).... 

Conjugata gynaecologica._ 
Axis pelvis.... 



Inclinatio pelvis / 




Diameter recta of the broadest 
part of the pelvis 



Diameter recta of the narrowest 
part of the pelvis 

Horizontal plane 

Diameter recta of the outlet of the 
pelvis 



- Horizontal plane 



167. Female pelvis, pelvis, median section, right half, 
from the left, with pelvic diameters. 



128 



Bones of the Lower Extremity. 



Fovea capitis 

Caput femoris 

Collum femoris 
Linea intertrochanteric a 
Trochanter minor 




168. Right thigh bone, 

femur, from in front. 

The femur (sec also Figs. 169—177) 
(thitjh heme) is the longest cyUndrical bone 
of the human body and hes in the thigh ; 
it articulates above with the aci'tabuhmi 
of the hip bone, below with the tibia and 
is so situated that its long axis is oblique 
in that the two thigh bones C(jn verge toward 
one another at their lower rxtn.'niitics. 

The thigh bone is divisible into a shaft 
or corpus, and two rxtremitics. 

The corpus femoris (shaft) is ciu-vihI 
so as to be slightly convex in front and 
is nearly triangiilarly prismatic. Its an- 
terior surface is ^ery convexly cuiTed in 
transverse dii'ection and goes 'jver without 
sharp limit into the two lateral surfaces 
which are also directed backward; these 
latter meet in the uiiddl(:> behind in a 
rough ridge, linea aspera, on which two 
lips are distinguishable, an external, labium 
laterale, and an internal, labium mediale. 
Below and above. th(>se two lips diverge: 
below they go to the two condyles and 
leave between them a flat, triangiilar field, 
planum popliteum [0. T. pophteal space). 
Above, the medial lip extends jiartly toward 
the trochanter minor and forms a tolerably 
(.Ustinct ridge, linea pectinea, in part it 
bends below the trochanter minor foi'ward 
and \ipward and is continued into the linea 
intertrochantcrica : the lateral lip turns 
outward and goes over into an oblong 
rough field, tuberositas glutaea, which 
sometimes projects like a comb as the so- 
called trochanter tertius. 

In the middle of the linea aspera 
can be seen usually one large or several 
smaller foramina nutricia, which lead into 
canales nutricii, directed proximalward. 



Bones of the Lower Extremity. 



129 



169. Right thigh bone, 

femur, from behind. 

The upper extremity of the 
femur supports the caput femoris 
(head), covered with cartilage, which is 
directed obliquely inward and upward 
and possesses medianward a small rough 
depression, the fovea capitis femoris. 
The head includes about three -fourths 
of the surface of a sphere. It sits 
upon the coUum femoris (neck) which 
looks flattened out from before back- 
ward; -the long axis of the neck is 
directed obliquely medianward and up- 
ward. At the place where the neck is 
united with the shaft there are two 
large projections from the posterior sur- 
face, the trochanter major and the 
trochanter minor. The trochanter major 
projects directly backward and upward 
and possesses on its medial surface, 
below the blunt tip which is bent median- 
ward, a deep fossa, fossa trochanterica 
(0. T. digital fossa). The trochanter 
minor is situated lower down and looks 
also medianward. The crista inter- 
trochanterica (0. T. intertrochanteric 
line), in part very markedly projecting, 
connects the two trochanters on the 
posterior surface. The much less pro- 
minent linea intertrochanterica (0. T. 
spiral line) runs on the anterior surface 
of the bone obliquely downward and 
medianward from the trochanter major, 
turns backward below the trochanter 
minor and becomes lost in the labium 
mediale of the linea aspera. 



^j|||B||^ Fossa trochanterica 


'"""'""""Qlkli 


. _ Trochanter 
jjL major 


^^^^^^B^ - • i' !■ .9 


U 


Crista intertrochanterica ^J^d±j(Bm2 


r 


-"— -^ 


f 


T„„.„„ „„,... MM 





Linea aspera 



Labium laterale 
Labium mediale _ 



Foramen nutrichim 



Ai 



Planum popliteum _ 



Condylus .. 
medialis 



,^B 



m^\ 



[.^Eplcondylns 
lateralis 

Condylus 
lateralis 

Linea intercondyloidea 
Fossa intercondyloidea 



Spalteholz, Atlas. 



130 



Bones of the Lower Extremity. 



Collum feraoris 



-- Fovea capitis 

Trochanter major 

Fossa trochanterica 



Crista 

intevtrochant erica 



faB-. Trochanter minor 




170. Right thigh bone, 

femur, from within. 

The inferior extremity of the 
femur is thickened and runs out into 
two strong condyli (condyles), covered 
witli cartilage, which are especially de- 
veloped backward, where they are, how- 
ever, separated from one another by a 
deep notch, the fossa inter condyloidea. 
The condylus tnedialis (0. T. inner 
condyle) is larger than the condylus 
lateralis (0. T. outer condyle); both, 
on account of the oblique position of 
the thigh bone, are situated in the same 
horizontal plane in the body; the lateral 
condyle projects further forward in front 
than does the medial. Both are covered 
with cartilage behind, beneath, and in front, 
run together in front to form a common 
surface, the uppermost part of which, 
fades patellaris, is hollowed out in 
the middle like a groove and receives the 
patella when the knee is extended. The 
surface, covered with cartilage, is curved 
so as to be markedly convex in the 
sagittal direction. The lateral surfaces 
of the condyles are rough and each 
presents a prominent nodule, the epi- 
condylus medialis (0. T. inner tube- 
rosity) on the condylus medialis and 
the epicondyliis lateralis (0. T. outer 
tuberosity) on the cond3-lus lateralis. 
The fossa intercondyloidea is rough and 
bounded above toward the planum po- 
pliteum by the Unea intercondyloidea. 



Bones of the Lower Extremity. 



131 



Epicondylus lateralis - 




, Epicondylus medialis 



Condvlus lateralis 



Facies patellaris Condylus medialis 



171. Right thigh bone, femur, inferior extremity, 

from in front. 



In front. 

Facies patellaris 



Epicondylus lateralis - 



Condylus lateralis 




- Epitondylus medialis 



Condylus medialis 



Behind. 



172. Right thigh bone, femur, inferior extremity, 

from below. 



132 



Bones of the Lower Extremity. 



Behind. 



Linea aspera 



Labium laterale 



Lateral surface 




Labium mediale 



Medial surface 



Anterior surface 
In front. 



172^. Transverse section through the middle of 
the right thigh bone. 



Trochanter major 



^^^ 




Fovea capitis 
femoris 



._ Caput femoris 



Collum femoris 
Linea intertrochanterica 



Trochanter minor 



173. Right thigh bone, femur, upper extremity, 

from in front. 



Bones of the Lower Extremity. 



133 




M. obturator Internus 



'M. glutaeus medius 

M. glutaeus raedius 



M. obturator 
externus 



M. piriformis 



]M. quadratus 
f em oris 



M. vastus medialis 



M. pectineus 



glutaeus maximus 
, adductor minimus 
adductor brevis 




174 and 175. Right thigh bone, femur, upper extremity, 

with the muscular attachments. 
From behind and within. From in front and without. 



134 



Bones of the Lower Extremity. 



M. obturator externns 
M. gUitaeus medius 



M. glutaeus minimus 
M. vastus lateralis 

E- M. vastus medialis 



M. vastus 
intermedius 



0-~::;V.Vi M. articularis 
genu 



/ P 



M. gastrocnemius 
(Caput laterale) 



).\ u 



M. adductor minimus 



M. adductor magnus 



M. adductor longus J. fM///jW--.^^- "vastus 

1 nmimn n intermedius 




M. vastus medialis 



il. adductor magnus 

M. biceps fenioris_ / 
(caput breve) 

M, vastus lateralis _.j 



M. gastrocnemius 



M. adductor 
magnus 



M. plantaris 
M. popliteus 



176 and 177. Right thigh bone, femur. 

with the muscuhir attachments. 
From in front. Ti-om behind. 



Bonos of the Lower Extrciiiitv. 



135 



Basis patellae 

1 



Basis patellae 




Facies articularis 




Apex patellae 



178 and 179. 

F.rom ia front. 



Apex patellae 



Right patella, patella. 

From behind. 



The patella (knee-cap) is a fiat, rounded bone, which is inteiralated as a laryf' sesamoid 
bone in the terminal tendon of the m. iiuadriceps femoris, and is situated in fi-ont of the hjwer 
extremity of the femur. The upper end is th(> broader, basis patellae, the lower end is some- 
what pointed, apex patellae, the margins are but little sharpened. The anterior surface is 
rough. Tlie posterior surface is for the most part covered with cartilage, facies articularis, 
and divided by a longitudinal projection into a somewhat larger lateral and a somewhat smaller 
medial part; when the knee is extended it lies on the facies pateUaris femoris and in movements 
of flexion at the knee joint glides downward and backward lietween the two joint-cond3ies of 
the femur in front of the fossa inter(.-(jndvl"idea. 



Crista lateralis 
Fibula — >- 



Facies lateralis 



%, 



Behind. 

Facies posterior 

Crista meclialis 

/ ^Facies medialis 

^/ '' Facies posterior 

I 
^ Margo medialis 



Crista anterior 
Cristas interosseae^'' \\ 



Facies lateralis - 




<.--- Tibia 



-Facies medialis 



Crista anterior 



In front. 



180^ Transverse section through the middle of 
the bones of the right leg. 



136 



Bones of the Lower Extremity. 



Margo 

infraglenoid. 
Condylus 
medialis 




180. Right shin bone 
and calf bone, 

tibia and fibula, from in front. 

The tibia (shin hone) (see also Figs. 1 80 », 
181 — 185) is a long, strong cylindrical bone 
and lies in the medial portion of the leg; 
it articulates above with the femur, below 
with the tarsus and also, above and below, 
with the fibula. It is divisible into a shaft 
or corpus and two extremities. 

The corpus tibiae (shaft) is trian- 
gularly prismatic, possesses a posterior, 
nearly flat surface, fades posterior, a smooth, 
somewhat convex surface looking forward 
and medianward, fades medialis, and a 
sUghtly concave surface directed forward 
and lateralward, fades lateralis. Of the 
three borders where the surfaces meet, the 
anterior, crista anterior, is the sharpest; 
the laterally directed crista interossea is less 
sharp, whUe the medial, margo medialis, 
is rounded off. At the uppermost p£^rt of 
the posterior surface a rough ridge, linea 
jmplitea (popliteal line), extends obliquely 
from above and lateralward, downward and 
medialward. At the junction of the upper 
and middle thirds there is behind usually 
a large foramen nutricium which leads 
into a distaUy directed canalis nuiricius. 

The upper extremity of the tibia 
is broadened markedly to form on the two 
sides the tibial condyles, condylus medialis 
(0. T. internal tuberosity) and condylus 
lateralis (0. T. external tuberosity). Each 
of these possesses a proximally directed, 
triangularly oval, somewhat depressed /aa«i 
articularis superior, covered with cartilage; 
between the two lies a rough surface, 
broader in fi'ont and behind, which is 
elevated in the middle to form the eminentia 
intercondyloidea (0. T. spinous process) 
where it ends in two small spurs, the 
tuberculu?n intercondyloideummediale and 
the tubei'culum intercondyloideumlaterale. 
The area in front of the eminence is called 
the fossa intercondyloidea anterior, that 
behind it the fossa intercondyloidea poste- 
rior. The surface covered with cartilage 
is contmued on each side for a certain 
distance upon the endnenee. On the outer 
eii'cumference of the faeies articularis supe- 
rior the bone falls suddenly as the margo 
infraglenoidalis. Below this, at the upper 
end of the crista anterior, a rough broad, 
projecting spur is visible, the tuberositas 
libidc ((_). T. tubercle); at about the same 
levid on the piwteriov lateral part of the 
condylus laterahs lies a small, flat, oval 
artiindar surface for the capitulura fibulae, 
fades articularii fibularis. 



Bones of the Lower Extremity. 



13/ 



181. Right shin bone 
and calf bone, 

tibia and fibula, from behind. 

The inferior extremity of the libia 

is quadrilateral, hut not much broadened; 
the lateral surface is somewhat concave 
below, incisura fibularis. for the attachment 
of the malleolus lateralis fibulae;- median- 
ward a strong blunt process passes down- 
ward, malleolus medialis (0. T. internal 
malleolus), which on its medial surface is 
somewhat rough, on its lateral surface (fades 
articularis malleolaris), is covered with 
cartilage ; on the posterior surface near the 
malleolus a shallow furrow extends down- 
ward, sulcus malleolaris (for the tendon 
of the m. tibialis posterior). The surface 
directed distalward, fades articulai-is in- 
ferior (for the talus) is shghtlj' concave, 
quadrangular, and covered with cartilage. 

The fibula (calf hone) (see also Figs. 1 80*, 
180, 182—185) is a long, thin eylmdrical 
hone situated in the lateral part uf the leg 
and connected above with the tibia, below 
with the tibia and the tarsus. It is divi- 
sible into a shaft or corpus, an upper 
extremitj', capitulum and a lower extremity, 
malleolus lateralis. 

The corpus flbnlae or shaft is nearly 
triangularly prismatic in shape, but appears 
at the same time twisted on its long axis. 
It presents a posterior surface, fades poste- 
rior, an anterior medial, fades medialis, 
and an anterior lateral, fades lateralis. 
They are separated fi-om one another by 
three borders; the sharpest looks forward, 
crista anterior, the second is directed 
medianward, crista medialis and the third 
lateralward, crista lateralis; further, runn- 
ing down over the medial surface is the 
crista inierossea, of markedly variable de- 
velopment. In the middle of the posterior 
surface a foramen nutridum leads into a 
canalis nutricius which rims distalward. 

The capitulum fibulae (head) is 
somewhat thickened, runs out proximaUy 
into a blunt tip, apex capituli fibulae, and 
supports on its medial anterior surface a 
small flat joint surface, fades articularis 
capituli. 

The malleolus lateralis (0. T. external 
malleolus) is thickened, projects further 
downward than the malleolus medialis and 
ends in a blunt tip. On its medial surface 
it is covered with cartilage, fades articu- 
laris malleoli, and, above this surface, lies 
in the incisura fibularis tibiae. The other 
surfaces are rough ; on the posterior surface 
a shallow furrow for the tendons of the 
mm. peronaei is visible. 




Sulcus 
malleolaris 



Malleolus 
medialis 



138 



Bones of the Lower Extremity.' 



In front. 



Tuberositas tibiae 



Eminentia intercondyloidea 



Facies articiilaris superior 



Fossa intercondyloidea anterior 
JIargo infraglenoidalis 

- Capitulum fibulae 



Tuberculum iiitercondyloideum mediale 

Fossa intercondyloidea posterior Tuberculum intercondyloideum laterale 

Behind. 




182. Right tibia and fibula. 



from above. 



In front. 



Fibula — V 

Malleolus lateralis 



Facies articularis malleoli 




- Malleolus medialis 
< — Tibia 



Facies articularis malleolaris 
Facies articularis inferior 

Behind. 



183. Right tibia and fibula, 

from below. 



Bones of the Lower Extreiiiitv. 



139 



M. yemiinenibranosus 



M. biceps femoris ( 



M. extensor 
digitorum --v" 
loiigus 



M. peronaeus 
longus 




' '!, 11/1 _:m. quadriceps 
femoris 
SSi. sartorius 

M. gracilis 

M. semitendinosiis 



M. pe]'uitaeus_ 
bi'evis 



mm./ 



..M. popliteus 

IM. biceps femoris 
-M. soleiis 



M. tibialis posterior 

M. peronaeus 
longus 



M. flexor 
-— digitorum 
longus 



M. flexor 
(T"" hallucis longus 



'A \\ 



M. tibialis posterior ■ i 

M. flexor digitorum longus ; 

M. flexor hallucis longus 



M. peronaeus brevis 
M. peronaeus longus 



184 and 185. Right tibia and fibula, iibia et fibula, 

with the muscular attachments. 
From in front. From behind. 



140 



Bones of the Lower Extremity. 



Facies articularis navicularis 



Facies articularis 
calcanea anterior "^ 



, Articular surface 

1 for the fibrocarti' 

lago navicularis 



Facies articularis 
calcanea media 



Processus _ 
lateralis tali 



Facies articularis 
calcanea posterior 




Facies articularis navicularis 

I 



_ _ Caput tali 



. CoUum tali 



Processus posterior tali 



Sulcus 
m. flexoris hallucis longi 




Trochlea tali 



Sulcus m. flexoris 
hallucis longi 



Processus posterior tali 



186 and 187. Right ankle bone, talus (O. t. astragalus). 

From below. From above. 

The tarsus (root of the foot) (see also Figs. 198—203) is composed of the seven ossa 
tarsi: talus, calcaneus, os naviculare pedis, ossa cuneiformia primum, secundum, tertium, 
OS cuhoideum; the four last mentioned He cUstalward close to one another; the three first 
mentioned proximalward partly over one another, so that the bones of the leg are not united 
with several hones of the tarsus, but only with that situated uppermost, namely, the talus. 

The talus (ankle bonej (0. T. astragalus) (see also Figs. 198 — 203) is divisible into 
a body, corpus tali, and a head, caput tali, attached in front; between the two lies a con- 
stricted part, the collum tali. 

The corpus tali supports on its upper surface the broad trochlea tali; this is covered 
with cartilage above, facies superior, curved so as to be markedly convex from before backward 
and slightly concave in transverse direction; it possesses a largo, triangular, lateral surface, 
facies malleolaris lateralis (see Fig. 198) covered with cartdage, from which a process. 
processus lateralis tali, passes off lateralward and downward : the medial surface of tlie 
trochlea has above only a narrow facies malleolaris medialis (see Fig. 199); it is covered 
with cartUage. The lower surface of the ankle bone possesses three articular surfaces, covered 
with cartilage , for the calcaneus : a posterior, largest , markedly concave , facies articularis 
calcanea posterior, as weU as (separated therefrom by a deep, rough groove, sulcus tali) two 
nearly flat, smaller, facies articulares calcaneae media et anterior, of which the most anterior 
lies upon the caput taU. On the posterior margin of the body a blunt process, processus 
posterior tali, is visible which is divided by a groove, sulcus m. flexoris hallucis longi (for 
the tendon of the m. flexor hallucis longus) into a smaller, medial and a larger, lateral projection: 
the latter is sometuues an independent bone (os trigomim) and then is connected by connective 
tissut^ only with the remaining bone (it is nut shown in the figure). The head presents in front 
an oval, transversely directed, markedly convi^x articular surface, facies articularis navicula7-is 
(for the US naviculare); adjacent to this, beluw and medianward, is another oblong surface for 
the hg. calcaneonaviculare plantare, or the Hlirucartilago navicularis. 



Bones of the Lower Extremity. 



141 



Facios articularis 
I cuboidea 



Faeies articularis 
anterior 



Faeies articularis 
media 



SusteutacnUim 
tali 



Suk-us calcanei-^ 



Farirs articuli 
poster 




Corpus calcanci^ ', 



188. Right heel bone, calcaneus, from above. 



The calcaneus fheel bone, 0. T. os calcis) (see also Figs. 189, 190, 198—203) 

is the largest tarsal bone, lies below the ankle bone and at the same time projects 
beyond it behind. It possesses a quadrilaterally prismatic body, corpus calcanei, and 
an anterior extremity. 

The corpus calcanei becomes thickened behind to form the tuber calcanei, from 
which two rough broad projections pass downward, the processus medialis tuberis cal- 
canei, and the processus lateralis tuberis calcanei (see Fig. 201). The upper surface 
has three articular surfaces covered with cartilage for the talus ; about in its middle an 
oblong, markedly convex, fades articularis posterior, in front and medianward two 
smaller, almost flat, fades articulares media et anterior ; the latter are separated from 
the posterior by a rough deep groove, sulcus calcanei; the middle rests upon a medially 
projecting piece of bone, sustentaculum tali, which presents on its inferior surface a 
groove, the sulcus m. flexoris hallucis longi (for the tendon of the m. flexor hallucis 
loDgus). The margin of this projection directed medianward is usually rough, sometimes, 
however, partly smooth or hollowed out like a groove; on it glides the tendon of the 
m. flexor digitorum longus on its way to the sole of the foot. On the lateral surface 
of the heel bone there is often a small projection, processus trochlearis ; below which 
iTins a groove, the sulcus m. peronaei [longi] (for the tendon of the m. peronaeus 
longus). The anterior surface of the calcaneus is directed also medianward, is quadri- 
lateral with rounded corners, curved so as to be saddle-shaped and covered with cartilage 
to form the fades articularis cuboidea (for the os cuboideum). The sulcus calcanei 
and sulcus tali form together the sinus tarsi, a canal which, open lateralward, grows 
markedly narrower as it extends medianward. 



142 



Bones of the Lower Extremity. 



Facies articularis media 
Facies articularis anterior i 



Facies articularis posterior 



Facies articularis 
cube idea 




Sustentaculum tali 



Sulcus m. flexoris hallucis longi 



, Tuber calcanei 



Processus medialis tuberis calcanei 



189. Right heel bone, calcaneus, from within. 



Sulcus calcanei 
Facies articularis posterior 



Facies articularis media 



Tuber calcanei- 




Facies articularis anterior 



Facies articularis 
cuboldea 



Processus trochlearis 
Sulcus ni. peronaei [longij 



Processus lateralis tuberis calcanei 



190. Right heel bone, calcaneus, from without 

and somewhat from above. 



Bones of tho Lower Extremity. 



143 



P'or the OS cuneiforme III 



For the os cuneiforme II 

For the os cuneiforme I 




Tuberositas ossis navlcularis 



191. Right scaphoid bone, os navicu/are pedis, from in front. 



The OS navicul are pedis (scaphoid bone) (see also Figs. 198 — 203) is oval, 
flattened from before backward and lies in front of the talus on the medial side of the 
tarsus. It possesses proximally a markedly concave articular surface covered with cartilage 
for the caput tali, distalward a convex surface covered with cartilage and divided by 
two ridges into three parts for the three cuneiform bones. The lateral surface supports, 
usually, a small articular surface for the os cuboideum. The upper surface is rough, 
convex and slopes markedly toward the medial side. Medianward on the lower surface 
the broad rough tuberositas ossis navicularis projects downward. 



144 



Bones of the Lower Extremity. 



Os cnnelformc I 



Os cnneiforme II 




Os caneiforme III 



for the OS naviculare 



for the for the 

-OS cuiiei- OS cunel- 
forme III forme II 




for the OS uaviculare 



for the 03 naviculare 



192—194. The three cuneiform bones of the right 
side, ossa cuneiformia primum, secundum, tertium, from behind. 

The ossa cuneiformia primum, secnndum, tertium (wedge hones) (see also 
Kgs. 198 — 203) are -wedge-shaped; they lie distal from the os naviculare and are numbered 
beginning at the medial border of the foot. 

The OS cuneiforme primum (0. T. intcraal cuneiform bone) is the largest with the 
base of the wedge directed plantarward; it has more the form of an inverted comma. The 
posterior surface is triangularly rounded, and covered with cartilage (for the os naviculare). 
The medial surface, turned also upward, is rough and possesses in front and below an oblique 
flat groove in which lies the tendon of the m. tibiahs anterior being separated from the bone 
by the bursa subtendinea m. tibialis anterioris. The anterior surface is covered with cartilage, 
bean-shaped (for the os metatarsale I); the lateral surface has an anterior, small articular 
surface (for the os metatarsale 11) and a posterior (for the os cuneiforme 11). 

The OS euueiforme secundum is the smallest with the base of the wedge dii-ected 
dorsalward. The posterior triangidar surface, covered with cartilage, serves for the attachment 
of the OS naviculare, the anterior surface, covered with cartilage, for the os metatarsale II; 
on the medial and lateral surfaces are small articular surfaces for the neighboring cuneiform bones. 

The OS cuneiforme tertium has the base of the wedge looking dorsalward. Its 
posterior, rounded surface, covered with cartilage, is attached to the os naviculare, the anterior 
to the OS metatarsale 111; medianward it possesses a small, anterior articular surface for the 
OS metatarsale II and a larger, posterior for the os cuneiforme 11; lateralward it supports a 
small artioilar surface for the os cuboideum. 



Bones of the Lower Extremity. 



145 



For the os metatarsale V 



For the 

facies articularis 

cuboidea 

ealcanei 



Tuberositas ossis cuboidei 




For the ossa meta- 
tarsalia IV et V 
Sulcus m. pcronaei [longi] 




For the os metatarsale IV 



For the os 
" cuneiforme III 



Sulcus ra. peronaei [longi] 



195 and 196. Right cuboid bone, os cuboideum. 

From the side. From in front. 

The OS CUlJOideum (cuboid hone) is very irregularly cuboidal in shape and 
lies in front of the calcaneus and on the lateral side of the tarsus. It is longer 
medianward than lateral ward. 

Its posterior surface, covered with cartilage, is directed also lateralward, is quadran- 
gularly rounded, curved so as to be saddle-shaped (for the facies articularis cuboidea 
ealcanei) ; its distal surface supports two rounded quadrangular articular surfaces (for the 
ossa metatarsalia IV et V) separated by a slight' ridge ; its medial surface shows a small 
articular surface for the os cuneiforme III and usually also one for the os naviculare. 
The upper and lateral surface is rough. The lower surface presents an oblong bulging, the 
tuberositas ossis cuboidei, above the anterior smooth portion of which, covered lateralward 
with cartilage, (sulcus m. peronaei [longiJJ the tendon of the m. peronaeus longus glides. 
In front of the tuberosity is a rough groove extending obliquely medianward and forward. 



Spalteholz, Atlas. 



10 



146 



Bones of the Lower Extremity. 



Phalanx HI 




Phalanx II 



^ 
^ 



Tuberositas 
unguicularis 



- _Basis 



-Trochlea 



Phalanx I 




. Corpus 



Trochlea 



Corpus 



, Capituluiu 



Os metatarsale 



. Corpus 



197. Metatarsal bone and 
phalanges of the second 
toe of the right side, os 

metatarsale II et phalanges digiti 

SeCUndl, from the plantar aspect. 

(The ari'ows indicate the direction of the canales 
nutricii.) 

The five ossa metatarsalia (metatarsal 

hones) (see also Kgs. 198 — 203) are short cylin- 
drical bones in which can be distingiiished a shaft 
or corpus, a proximal end, basis, and a distal 
end, capitulum. On the whole they are curved 
so as to be somewhat convex dorsalward. 

The corpus is triangularly prismatic so that 
one side looks dorsalward, the other two lateral- 
and medianward; the latter meet in the border 
directed plantarward. A foramen nutricium 
situated plantarward corresponds tu the one m 
the hand (see p. 109). 

The basis is somewhat broadened, supports 
on its proximal side an articular surface for con- 
nection with the tarsus and from the second to 
the fifth toe also small articular surfaces at the 
sides for the neighboring metatarsal bones. The 
basis ossis metatarsalis I possesses a large con- 
cave , bean -shaped articular surface (for the os 
cuneiforme I), but no lateral articular surfaces; 
on the plantar surface a blunt nodule, tuberositas 
ossis metatarsalis J, projects lateralward (see 
Fig. 201). Projecting from the side of the basis 
ossis metatarsalis V backward is a strong pro- 
cess, the tuberositas ossis metatarsalis F (see 
Figs. 198, 200, and 201). 

The capitnlam is flattened laterally, pos- 
sesses a spherical articular sm-face, covered with 
cartilage, which extends further upon the plantar 
than upon the dorsal surface. At the sides are 
rough areas for the articular ligaments. 

The four spaces between the ossa metafcir- 
salia, spatia iiiterossca metatarsi, (see Figs. 200 
and 201) correspond to the spatia interossea meta- 
carpi (see page 109). 

The phalanges digitornm correspond in 
number, arrangement and form as well as in the 
relations of theii' foramina nuti-icia entirely to 
thi'se of the hand (see p. 109), except that they 
are all essentially shorter. 

As to ossa sesamoidea (sesamoid hones) 
(see Pig. 201), two are constantly found at the 
metatarsophalangeal joint of the gTeat toe, a third 
less constant, at the interphalangeal joint of the 
same toe; a fourth is situated in the tendon of 
the m. pcronaeus longus m front of the lateral 
angiii (if tbe tuberositas ossis cuboidei and a fifth 
souietiiues in the tendon of the m. tibiahs poste- 
rior below the flbrocartilago navicularis. 



Bonos of the Lower Extremity. 



147 



Facies malleolaris lateralis 



Talus 



Calcaneus 



Sinus tarsi 

Oa uaviculare 

Os cuneiforme III 
, Os cuneiforme II 

Os cuneiforme I 




Processus 
,' trochlearis / 
Sulcus m / I Tuberositas oss. metatarsalis ^ 

peronaei [longi] / Tuberositas oss. cuboidei 
Processus lateralis Qs cuboidcum 

tuberis calcanei 



198. Bones of the right foot, ossa pedis, 

from the lateral aspect. 



Os naviculare 



Os cuneiforme II 
Os cuneiforme I 



Facies superior trochleae 
' Facies malleolaris 

medialis 



Calcaneus 




Ossa sesamoidea 



Processus medialis tuberis calcanei 



199. Bones of the right foot, ossa pedis, 

from the medial aspect. 



10* 



148 



Bones of the Lower Extremity. 



Phalanx II __ 



Os metatarsale I 



Os cuneiforme I 
Os cuneiforme II 
Os cuneiforme III 

Os naviculare _ 




Tuberositas ossis 
metatarsalis V 



Os cuboideum 



200. Bones of the right foot, ossa 

viewed from the back of the foot. 



S, 



Boucs of the Lower Extremity. 



149 



Tuberositas ossia 
metatarsalis V 



Sulcus m. peronaei [longi] 
Os cuboideum 



Calcaneus 



„ , f Processus medialia wrf^iiiil* 

Tuber ) ' Vf/i^V 

caleanei 1 „ , , ,. WjwII, T 
I Processus lateralis 




Ossa seaamoidea 



Tuberositas ossis metatarsalis I 



Os cuneiforme I 
Os cuneiforme II 



Os cuneiforme III 



Os naviculare 



Talus 



Sustentaculum tali 



Tuber cal*anei 



201. Bones of the right foot, ossa pedis, 

viewed from the sole of the foot. 



Bones of the Lower Extremity. 



Mm. extensores hallucis ^^' 
longus et 1310713 



M. aljductor hallucis - 




Mm. extensores 
.^digitorum longus et brevis 



_M. abductor digiti V 



Mm. interossei dorsales 



M. peronaeus III 



V .M. peronaeus brevia 



M. quadratus plantae 



Tendo calcaneus 



202. Bones of the right foot, ossa pedis. 

with the muscular attachments, viewed from the back of the foot. 



Bones of the Lower Extremity. 



151 



M. flexor digitoruin longus 
>r. flexor digitorum brevis 



31m. interossei plantares ^- 



JI. oppouens digiti V. 



M. flexor digiti V brevis -■ 



M. peronaeus longus 



M. abductor digiti V i 




■M. flexor ballucis lougus 



-M. abductor hallucis 

.M. adductor ballucis 
(Caput transversum) 

.M. adductor hallucis 
(Caput obliquum) 



-,1.-, M. flexor ballucis brevis 



il.... M. tibialis anterior 
M. abductor hallucis 



, ^N ' M. tibialis posterior 



M. quadratus plantae 
M. abductor hallucis 



M. flexor digitorum brevis 



203. Bones of the right foot, ossa pedis, 

with the muscular attachments, viewed from the sole of the foot. 



152 



Joint of the Jaw. 



Tuberculum articulare 

Discus articularis ', 
Fossa mandibularis • 



Arcus zygomaticus 




; Capsula 
articularis 
' Meatus acusticus 
' ^ '-. externus 

Processus mastoideus 



-< ~ ' Ramus mandibulae 



204. Jaw joint of right side, 

from without. 



articulaiio mandibularis, 



(The arcus zygomaticus and the processus condyloideus mandibulae have been partially removed ; 
the parts have been somewhat separated from one another.) 

By moans of the articulatio mandibularis (joint of the jaw) (0. T. temporo-maxil- 
lary articulation) (see also Figs. 205 — 207) the lower jaw is movably connected -n-ith the rest 
of the skuU. The capitulum of the processus condyloideus mandibulae on each side rests on 
the posterior slope of the tuberculmn articulare in the fossa mandibularis ossis temporalis. 
The facies articularis extends into the fossa mandib\ilaris not quite as far as the fissura petro- 
tympanica where it is fur the most part covered by connective tissue and only in its most 
anterior portion covered with cartilage; in front it goes over upon the tuberculmn articulare 
which is covered with cartilage and does not end \mtil its anterior slope is reached. Between 
the processus condyloideus on the one side and the fossa mandibularis and tuberculum articu- 
lare on the other is inserted a connective tissue disc, discus articularis (0. T. interartioular 
flbrocartUage) , which is thinner in the middle, thicker in ft-out and behind and about of the 
shape of a l)ie(incave transversely placed plate. The capsula articularis (0. T. capsular liga- 
ment) is loose and is stretched from the circumference of the facies articularis of the fossa 
mandibularis and of the tuberculum articulare to the upper margin of the discus articularis, 
as well as from the lower border of the latter to the coUvmi (neck) of the process\is condyloi- 
deus mandibiilae. In this way two joint cavities, completely separated from one another, are 
formed, an iijiper and a lower, which are separated from one another by the articular disc. 



Joint of the Jaw. 



152 



^. 



Ligamentuni 
teraporomandibiilare 



Ligamentuni styloraandibulare 




205. Jaw joint of right side, articulatio mandibularis, 

from without. 



PassiDg obliquely from in front and above backward and downward, as a streng 
thening ligament of the capsula articularis, is the Ugamentum temporomandibular e. 
It arises on the lateral surface (0. T. External lateral ligament) by a broad base at 
the root of the processus zygomaticus ossis temporalis and is fastened to the collum 
(neck) of the processus condyloideus mandibulae; medianward a weaker fibrous band 
proceeds from the region of the fissura petrotyrapanica to the collum processus condy- 
loidei mandibulae (see Fig. 206)- 



154 



Joint of the Jaw. 



Ligamentum 
temporomandibulare 




Ligamentum temporomandibulare 



Ligamentum spheno mandibular e 



Ligamentum stylomandibulare 



206. Jaw joint of right side, articulatio mandibularis, 

from within. 

On the medial side of the jaw joint the ligamentum sphenomandibulare proceeds 
from above and behind, downward and forward. It arises from the spina angularis ossis 
sphenoidalis and from the fissura petrotympanica ossis temporalis and ends with a broad 
insertion at the lingula mandibulae. It is separated from the medial fibrous band of 
the ligamentum temporomandibulare and from the processus condyloideus mandibulae by 
a space through which runs the a. maxillaris interna with the veins accompanying 
it (see page 449) and the n. auriculotemporalis. 

The ligamentum stylomandibulare (0. T. Stylo-maxillary ligament) arises in 
common with the ligamentum stylohyoideum (see p. 40) from the processus stj'loideus, 
runs obliquely forward and downward and is fastened by broad attachment to the inner 
side of the angulus mandibulae. It is only a band of the fascia buccopharyngea (see 
p. 247) and has nothing to do with the joint of the jaw. 



Joint of the Jaw. 



15; 




207. Jaw joint of right side, articulatio mandibulans, 

from without; somewhat schematic. 

The position of the lower jaw when the mouth is shut is indicated in black; when the 

mouth is wide open in red. 

When the mouth is closed the capitulum of the processus condyloideus is in contact 
with the posterior slope of the tuberculum articulare and the anterior portion of the fossa 
mandibularis; when the mouth is wide open it stands somewhat in front of the deepest 
point of the tuberculum articulare; in both cases, however, the capitulum is separated 
from the points of the temporal bone mentioned by the discus articularis. 



156 



Joints of the Spine. 



Corpus vertebrae 



Fibro cartilage intervertebralis 




208. Intervertebral d'xsc, fibrocartilago intervertebralis, 

with the adjacent vertebral bodies, from in front. 

The ligamenta columnae yertebralis (spinal ligaments) consist of the 
fibrocartilagines intervertebrales between every two vertebral bodies, of the capsulae 
articular es , which unite the processus articulares inferiores of each vertebra with the 
processus articulares superiores of the next vertebra below, and of ligaments which are 
stretched out between the arches and between the processes of the same name of everj- 
two adjacent vertebrae, namely: ligamenta flava, ligamenta intertransversaria, liga- 
menta interspinalia ; besides the latter there are still a number of ligaments present 
which extend over the whole spinal collum or at least over the largest part of the 
same: ligamentum supraspinale, ligamentum longitudinale anterius and ligamentum 
longitudinale posterius. 

The fibrocartilagines intervertebrales (intervertebral discs) (see also 
Figs. 209 — 210) are flat fibrocartilaginous discs which lie between the adjacent surfaces 
of every two successive vertebrae; to these surfaces they are very firmly attached by 
a thin layer of hyaline cartilage. They have tlie shape of the adjacent vertebral body 
but are somewhat larger so that at the edges they project somewhat over this. 

In the cervical and lumbar part of the vertebral column (see Fig. 210) they are 
somewhat higher in front than behind. The total number of intervertebral discs present 
down to the sacrum is 23; the uppermost is situated between the second and third 
cervical vertebrae, the lowermost between the fifth lumbar vertebra and the sacrum 
(see also page 162). 

On the five lower cervical vertebrae there is usually, on each side, between tlie bent 
up lateral part of the upper surface of each vertebral body and the adjoining portion 
of the intervertebral discs, a small joint cavity with a capsula articularis (see Fig. 215). 



Joints of the Spine. 



157 




209. I n te r ve rte b ra I disc, fibrocartilago infervertebralis. 

cut through horizontally. Magnifleation 3 : 2. 

Each fibrocartilago intervertebralis consists of a firmer external portion, 
anniilus fibrosus, and a softer centre, nucleus pulposus. 

The annnlus fibrosus is composed of concentric layers of connective tissue 
fibres which are arranged like the leaves of an onion; inside each layer the fibre 
bundles cross one another in network-like fashion (see Fig. 208); in the depth the 
connective tissue layers are less sharply separated from one another and alternate with 
layers of very soft fibrocartilago. 

The nucleus pulposus consists essentially of a very soft mass of fibrocartilage 
with irregular connective tissue bands and contains the remains of the embryonic 
chorda dorsalis; it is separated but not sharply from its surroundings and lies nearer 
the posterior circumference of the intervertebral disc (see Fig. 210). In the uninjured 
spinal column its constituents are under high pressure so that on cutting through the 
disc they project markedly. 



158 



Joints of the Spine. 



Ligamentum longitudinale posterius 



Foramen intervertebrale 

Ligamentum flavum 



Nucleus pulposus^ 



Fibrocartilago 

intervertebralis 

Ligamentum 
longitudinale — 
anterius 



Ligamentum interspinale 

I Processus spinosus 



Ligamentum 
'supraspinale 




Ligamentum supraspinale 



210. Median section of a piece of the lumbar 

spinal column, right half of sections, viewed from the left. 

A median section of a fibrocartilago intervertebralis permits the excentric position 
of the nucleus pulposus to he especially distinctly recog-nized and besides shows that the 
connective tissue layers which compose the annulus iihrosus are bent so as to be somewhat 
convex forward; behind, on the other hand, they are much stronger and are shai-ply bent 
backward; in the middle of the disc the ilirection of curvature can be variable. 

The capsulae articulares (see Fij;-. 220) are stretched out between the borders of each 
adjacent pair uf processus articulares. Tbry are looser on the cervical than on the thoracic 
and lumbar vertebrae. 

The ligamenta interspinalia are flat bands of tissue which extend between the borders 
of each adjacent pair of processus spinosi. They are most strongly devi^loped on the limibar 
vertebrae, feeblest on the cervical vertebrae. In general the fibres are directed from above 
downward and backward. 

The ligamenta intertransversarla (see Pigs. 223 and 224) are rounded, thinner bands 
which run between the borders uf e\ery adjacent pair of processus transversi. They are sti'ongest 
in the lumbar and tlmracic spine, feebler, sdmetimes doubled on the I'orvical vm'tebrae; they 
may hr entirely absent from the latter. The tilires are directed ft'om abuve downward. 



Joints of the Spine. 



159 



Processus spinosus 
I 
\ Processus articularis superior 




Processus transversus 



Processus articularis inferior 



211. Vertebral arches with ligamenta flava, 

from in front. 



(The vertebral arches have been sawed off at their roots and the vertebral bodies removed.) 

The ligamenta flava (see also Fig. 210) are broad flat bands stretched out 
between the arches of every two adjacent vertebrae and always proceed from the front 
surface of the higher arch to the upper edge of the lower. They are especially strong 
and long on the lumbar and become feebler towards the cervical vertebrae. Their fibres 
run in a vertical direction ; in the median plane they are divided into two halves by 
a narrow groove. They consist almost exclusively of elastic fibres and are accordingly 
of a yellow color; hence the name. The band is not present in this form between the 
occipital bone and the atlas, nor between atlas and axis; at the former place is the 
membrana atlantooccipitalis posterior (see page 164), at the latter a thin membrane 
of connective tissue, which is strengthened only by isolated yellow stripes of elastic 
fibres (see Fig. 216). 



160 



Joints of the Spine. 



Processus articularis superior. 
Processus transversus 



Fovea costalis transversalis 



Lig. costotransTersarium 
anterius 
Lig. capituli costae radiatum 



Ligamentum loiigitudiaale anterius 

Corpus vertebrae 



Fibre cartilage 
intervertebralis 




212. Spinal column with ligaments, from in front. 

The ligamentum longitudinale anterius descends on the anterior and 
lateral surfaces of the hodies of the vertebrae. It begins as a narrow tough band at 
the tuberculum pharjmgeum ossis occipitalis (see Figs. 215 and 221), is fastened to 
the tuberculum anterius atlantis, then goes to the anterior surface of the epistropheus 
and thence to all of the bodies of the vertebrae as far as the upper part of the facies 
pelvina ossis sacri, where it becomes lost in the periosteum. Prom the epistropheus on, 
it becomes ever broader as it passes downward, is intimately connected with the vertebral 
bodies and the fibrocartilagines intervertebrales and is divisible more or less distinctly 
into three stripes, a broader one in the middle and a narrower one on each side. On 
the lumbar spine there arise from it the (tendinous) crura of the pars lumbalis dia- 
phragmatis (lumbar portion of the diaphragm). 



Joints of the Spiiie. 



161 




Fibrocartilago intervertebralis 



Kadix arcus vertebrae 



Ligamentum longitndinale posterius 



213. Vertebral bodies with ligaments, from behind. 

(The vertebral arches have been sawed off at their roots.) 



The ligamentum longitndinale postering (0. T. posterior common ligament) (see 
also Figs. 220 and 221) runs on the posterior surface of the vertebral bodies down inside the 
canalis vertebrahs. It begins as an extraordinarily thin, broad layer upon the clivus and is 
imited as far as the third cervical vertebra with the membrana tectoria, behind which it 
descends, and with the dura mater. From the third cervical vertebra on it becomes narrower 
and stronger behind each vertebral body but at each flbrocartUago intei'vertebraUs broader, 
and is at the same time especially firmly connected with the latter. It ends in the upper 
part of the canahs sacrahs. In it can be made out deeper bands, lying near the vertebral 
bodies, which are short and connect the vertebrae which are close to one another, and super- 
ficial, long bands which extend over long distances; it is the latter alone which form the 
uppermost part of the hgament behind the membrana tectoria (see p. 168). 

The ligamentum supraspinale (0. T. supraspinous hgament) (see Kg. 210) is a 
powerful, narrow hgament. It extends downward behind the tips of the spinous processes, 
becomes narrower between the same and fuses there with the hgamenta interspinalia. At the 
tips of the processus spinosi it is separated from the bone by a thin layer of fibrocartilage. 
The hgamentum supraspinale begms at the processus spinosus of the seventh cervical vertebra 
where it is connected with the hgamentum nuchae, and ends below at the crista sacrahs media. 
Spalteholz, Atlas. 11 



162 



Joints of the Spine. 



Processus transversiis vertebrae 
coccygeae I 




- - Apex ossis sacri 



Lig. sacrococcygeum laterale 
Lig. sacrococcygeum posterius 
superficiale 
Lig. sacrococcygeum posterius 
profundum 



214. Ligaments between the sacrum and the 

coccyx, from behind. 

The connection between the sacrum and the coccyx (symphysis sacrococcygea) is 
mediated hy a thin fibrous disc ; simUar fibrous discs are usually present also between the first, 
second and third coccygeal vertebrae ; the connection , however , can also be bony here as is 
the rule between the third, fourth and fifth coccygeal vertebrae. 

A number of ligaments also are present which are to be considered as modifications of 
those of the other vertebrae. 

The Ugamentum sacrococcygeum, anterius (= lig. longitudinale anterius) (see Figs. 243 
and 670) consists of two thin fibrous bands which extend on the anterior surface from the 
tip of the sacrum to the coccygeal vertebrae, crossing over one another in part; below it is 
attached to the m. levator ani (see page 608). 

The Ugamentum sacrococcygeum laterale {= lig. intertransversarium) runs on each 
side from the lower end of the crista sacralis lateralis to the processus transversus of the first 
coccygeal vertebra, boimds externally the notch situated lateral from the apex of the sacrum 
and so helps to form a fifth foramen sacrale. 

The Ugamentum sacrococcygeum j>osterius profundum 1^= lig. longitudinale posterius), 
lies as a thin plate immediately upon the posterior surface of the combined bodies of the sacral 
and coccygeal vertebrae and is connected in part with the following ligament. 

The Ugamentum sacrococcygeum ■posterius superficiale consists of several fibre-bands 
which extend on the one hand from the lower end of the crista sacralis media downward to 
the posterior surface of the coccyx and at the same time close the hiatus sacralis more or less 
comiilctcly ; on the other hand, the fibre-bauds extend between the conma sacralia and the 
cornua cuciygca. Narrow spaces between the single bands serve for the passage of the n. 
sacralis V and tho n. cuccvgi.'us. The ligament corresponds partly to the liganieuta flava, 
partly to the capsulnc articulares. 



Joints of the Spine. 



163 



Membraiia atlantooccipitalis antei 



Tuberculum pharyngeum 

Pars basilaris ossis occipitalis 
Caiialis hypoglossi 



Capgula articularis 



Capsula articularis 



Joint cavity between corpus 
vertebrae and fibrocartilago 
intervertebralis (see p. 156) 




Fibrocartilago intervertebralis 



Articulatio atl9,ntooccipitalis 



Processus transversus 
atlantis 



Processus transversus 
epistrophei 



Processus transversus 
vertebrae cervicalis III 



Ligameutum longitudinale anterius 



215. Occipital bone and first three cervical 
vertebrae with ligaments, from in front. 

(The joints have been partially opened.) 

The articulatio atlantooccipitalis {occipital joint, 0. T. articulation of the 
atlas with the occipital bone) (see also Figs. 216 and 219) is fonned so that the con- 
dyli occipitales move in the foveae articulares superiores atlantis. Between the borders 
of these cartilaginous joint surfaces are stretched the loose capsulae articulares (0. T. 
capsular ligaments). The interspaces between the arches of the atlas and the occipital 
bone are filled up by the membranae atlantooccipitales. 

The meinl)rana atlantooccipitalis anterior (0. T. anterior occipitoatlantal 

ligaments) extends as a flat, tough band between the pars basilaris ossis occipitalis and 

the arcus anterior atlantis ; its fibres run essentially vertically. In the middle it is fused 

with the uppermost part of the ligamentum longitudinale anterius, at the borders with 

the capsulae articulares. 

11* 



164 



Joints of the Spine. 



Os occipilale 



MemT>rana atlantooccipitalis 
posterior 



A. vertebralis - ' 
Capsula articularis,' 




Processus 
■ transversus atlantis 



Processus transversus 
epistrophei 



216. Occipital bone, first and second cervical 
vertebrae with ligaments, from behind. 

The memlbrana atlantooccipitalis posterior (0. T. posterior occipito- 
atlantal ligament) (see also Fig. 221) goes from the posterior circumference of the 
foramen occipitale magnum to the arcus posterior atlantis. Its middle, veiUcally running 
part is extraordinarily thin and firmly fused with the dura mater. Its lateral part con- 
sists of stronger fibrous bands ; tliey extend obliquely lateralward and are fastened tliere 
to a fibrous arch which bridges over the sulcus a. vertebralis and transforms it into 
a canal, through which pass the a. and v. vertebralis and the n. suboccipitalis. 



Joints of the Spine. ^55 



Tuberculum posterius atlantis 




Ligamentum transversum atlantis '' 

Capsiilae articulares ^' 

Dens epistrophei ' 



Tuberculum auterius atlantis 



217. Atlas and epistropheus, with ligaments, 

from above. 

The articulatio atlantoepistrophica (joint for rotation of head, 0. T. arti- 
culation of the atlas with the axis) (see also Figs. 218 — 221) is formed in that the 
facies articulares inferiores atlantis move uioon the fades articulares superiores epistrophei 
and that, at the same time, the dens epistrophei turns with its two facies articulares, 
like an axle in its axle-box, in the cylindrical space which is bounded in front by the 
arcus anterior atlantis, behind by the powerful ligamentum transversum atlantis. All 
the joint surfaces mentioned, though widely separated from one another, belong therefore 
to one and the same joint. Between the border of each inferior joint - surface of the 
atlas and the upper joint-surface of the epistropheus are stretched loose capsulae arti- 
culares (0. T. capsular ligaments); there is also a similar joint-capsule between the 
border of the fovea dentis atlantis and the facies articularis anterior epistrophei, as 
well as between the circumference of the facies articularis posterior epistrophei and the 
anterior surface of the ligamentum transversum atlantis. 



166 



Joints of the Spine. 



Pars basilaris ossis occipitalis 

Canalis hypoglossi 
Ligamentum alare 



Articulatio 
atlantooccipitalis 



Capsula artlcularis 




Ligamentum cruciatum atlantis 



Deepest layer of the 
mombrana tectoria 



Ligamentxim transversum atlantis 



218. Occipital bone, first and second cervical 
vertebrae with ligaments, from behind. 

(The part of the occipital bone situated behind the middle of the foramen occipitale magnum 

and the arches of the cervical vertebrae have been removed; most of the membrana tectoria 

has been removed. The joint shts are partly opened.) 

Among the essential constituents of the articulatio atlantoepistropMca, the 
ligamentum transversum atlantis (0. T. the transverse ligament) may first be men- 
tioned. This tough, flat ligament (see also Figs. 217 and 221) goes behind the dens 
epistrophei, has a broad origin from the medial surface of one massa lateralis atlantis 
and is similarly fastened on the other side ; it is curved so as to be convex behind and 
contains in the middle fibrocartilaginous deposits. On its anterior surface it is separated 
by a small joint cavity from the odontoid process; on its posterior surface it is united 
loosely with the membrana tectoria. From the middle of its upper margin a thinner 
bimdle of fibres runs vertically upward to the anterior circumference of the foramen 
occipitale magnum and from the inferior margin one runs downward to the posterior 
surface of the body of the second cervical vertebra. These fibre -bands together witli 
the ligamentum transversum atlantis mal;e up the ligamentum cruciatum atlantis 
(0. T. cruciform ligament). 



Joints of the Spine. 



167 



Pars basilaris ossis occipitalis 



Capsulae ,--•' 
articnlares ~~'- 



^ Ligameiitum apicis dentia 
Canalis hypoglossi 

^ Ligameiitum alare 




Processus trausversiis 
atlantis 



Corpus epistrophei 



219. Occipital bone, first and second cervical 
vertebrae with ligaments, from behind. 

(The part of the occipital bone situated behind the middle of the foramen occipitale magnum 
and the arches of the cervical vertebrae have been removed; the membrana tectoria and the 
ligamentum crueiatum atlantis have been completely removed. The right joiut slits are opened.) 

The articulatio atlantoepistropMca is strengthened by the Ugamenta alaria 
(0. T. odontoid or check ligaments) (see also Fig. 218). These consist on each side 
of a strong, flat-rounded fibre bundle which extends from the lateral surface of the dens 
epistrophei obliquely upward and lateralward to the medial surface of the condylus 
occipitalis where it is attached. They are situated therefore, in front of the ligamentum 
crueiatum atlantis. 

Also in front of the ligamentum crueiatum atlantis, in front of its upper vertical 
limb, a thin rounded band, ligamentum apicis dentis, (0. T. ligamentum suspensorium) 
extends in the median plane from the tip of the odontoid process to the anterior circum- 
ference of the foramen occipitale magnum (see also Fig. 221). It is mechanically in- 
significant and only important because it arises from the uppermost part of the embryonic 
chorda dorsalis. 



Joints of the Spine 



^ Pars basilaris ossis occipitalis 



^Canalis hypoglossi 

,Membrana tectoria 



Capsulae articulares 




Processus trans- 
versus atlantis 



..-Epistropheus 



Ligamentum longitudinale posterius 



220. Occipital bone and first three cervical 
vertebrae with ligaments, from behind. 

(The part of the occipital bone situated behind the middle of the foramen occipitale magnum 
and the arches of the cervical vertebrae have been removed; the most superficial, thin layer 
of the ligamentum longitudinale posterius has also been removed. The right joint slits are opened.) 

The articulatio atlantoepistropliica is covered behind bj the membrana 
tectoria (0. T. occipito-axial ligament) (see also Fig. 221). This lies as a broad, 
quadrangular fibrous plate behind the ligamentum cruciatum atlantis, is loosely connected 
with it and is separated from the dura mater of the canalis vertebralis by a very thin 
fibrous layer which is considered as a continuation of the superficial long bands of the 
ligamentum longitudinale posterius, while the membrana tectoria itself is looked upon as 
the especially strongly developed uppermost part of the deep, short-fibred layer of the 
ligamentum longitudinale posterius (see p. 161). The membrana tectoria arises from 
the posterior surface of the clivus as well as from the anterior and lateral circumference 
of the foramen occipitale magnum where it is broadest; its fibres converge downward 
and become fastened in several strands to the jxistorior surface of the body of tlie epi- 
stropheus. Short bands of fibres between the atlas and the epistropheus are attached 
in the depth, lateralward, to the membrana tectoria (slxi Fig. 218). 



Joints of the Spine. 



169 



Jlembrana tectoria _ 

Ligameiitum cruciatum _ 
atlantis 
Ligamentum apicig dentis - 

Arcus anterior atlanti3 _ 
Dens epistrophei - 
Caviiui articiilare - 

Ligamentum transversum 

atlantis 
Ligamentum longitudinale 

anterius 



Epistropheus 



Fibrocartilago inter- 
vertebralls 



Corpus Tertebrae 
cervicalis III 



Ligamentum longitudinale posterius 
(superficial layer. See page 168) 



Canalis hypoglossi 

Os occipitale 




Membrana atlantooccipitalis 

posterior 
A. vertebralis 

-- Arcus posterior atlantis 



-- - N. suboccipitalis 
_ Foramen intervertebrale 



Ligamentum flavum 



Ligamentum longitudinale posterius 



221. Median section through the occipital bone 
and first three cervical vertebrae with ligaments; 

right half of section, viewed from the left, somewhat schematic; 

magnification: 4:3. 

(The ligamentous masses have been partially separated from one another.) 

Enumerated from before backward the ligaments of the articulatio atlanto- 
occipitalis and the articulatio atlantoepistropliica lie behind one another as 
follows: ligamentum longitudinale anterius with the membrana atlantooccipitalis anterior, 
ligamentum apicis dentis, ligamentum cruciatum atlantis, membrana tectoria, ligamentum 
longitudinale posterius (superficial layer), membrana atlantooccipitalis posterior. 



170 



Joints of the Thorax. 

Ligamentum capituU costae interarticulare 



Costa X 



Ligamentum costotransTersarium^,^- ^ 
anterius i \ 



Fibrocartilago 
intervertebralis 




222. Tenth and eleventh ribs and corresponding 
vertebral bodies with their ligaments, 

viewed from the right. 

(The most anterior layer has been sawed off from the heads of the ribs; the parts have been 
somewhat separated from one another. The ligamentum longitudinale anterius has been removed.) 

The articulationes costoTCrteljrales (^articulations of the ribs with the 
vertebrae) (see Fig. 225) are the moveable connections between the ribs and the thoracic 
vertebrae. Each rib is articulated at two points; the capitiilum costae moves in the 
foveae costales of the bodies of the vertebrae (articulationes capitulorum) and at the 
same time the tuberculum , costae rotates in the fovea costalis transversalis (articula- 
tiones costotransversariae). Both together form mechanically one joint. 

In the articulationes capitulorum (articulations between the heads of 
the ribs and the vertebrae) (see also Figs. 212, 223 and 225) each capituhim costae 
lies with its facies articularis in the corresponding foveae costales of the vertebral bodies, 
so that, for example, the capitulum of the sixth rib rests in the fovea costalis inferior 
of the fifth thoracic vertebra, in the fovea costalis superior of the sixth thoracic vertebra 
and in a depression in the intervertebral disc lying between the two. On the second 
to the tenth rib, a ligamentum capiiuli costae interarticulare (0. T. interarticular 
ligament) extends from each crista capitiili to tlie fibrocartilago intervertebralis, and 
usually separates two special joint cavities, with their capsulae articidares from one 
another. The eleventh and twelfth ribs unite each with one vertebral body only and 
accordingly possess always only one capsula articularis each. 



Joints of the Thorax. 



17] 



Processus articularis superior 
Fovea costalis superior 



Fovea costalis transversal: 



Ligamentum eostotransversarium 

aiiterius 
Ligamentum inter trans versarium - 

Costa 




. Ligamentum capituli 
costae radiatum 

Fibrocartilago 
"intervertebralis 



Ligamentum lougitudinalo 
anterius 



Fovea costalis inferior 
Processus articularis inferior 



223. Ribs and corresponding vertebrae, 

with ligaments, viewed from the right. 

(The lateral portion of the ligamentum longitiidinale anterins has been removed.) 

On the anterior surface of each of the articulatlones capituloruni , the 
broad fiat ligamentum capituli costae radiatum (0. T. anterior costovertebral or stellate 
ligament) (see also Pigs. 212 and 225) extends from the head of the rib to the lateral 
surfaces of the corresponding vertebral bodies and fibrocartilago intervertebralis; the 
fibres diverge medianward and are partly covered over by the lateral portions of the 
ligamentum longitudinale anterius. 



172 



Joints of the Thorax. 

Processus articiilaris superior 



/^7' \ 



Processus transversus 



Ligamentum tuberculi costae 



Ligamentum costotrans- 
Tersarium posterius 

Ligamentum inter- . 
trausversarium 



Processus spinosus 
(apex removed) 




Ligamentum costotransversarium. anterius 
Costa 



224. Ribs and corresponding vertebrae with 

ligaments, viewed from behind and somewhat from the right. 

The articulationes costotransversariae (see also Figs. 212, 222, 223, 

225) are formed on the first to the tenth rib by the apposition of each fades articu- 
laris tuberculi costae to the fovea costalis transversalis of the vertebra pertaining to 
the rib, so that for example, the tubercle of the sixth rib is connected with the trans- 
verse process of the sixth thoracic vertebra. The margins of the cartilaginous joint 
surfaces are connected by capsulae articulares. Extending as a strengthening ligament 
from the under surface of the next transverse process above is the strong, quadrangular 
ligamentum costotransversarium anterius, which passes obliquely downward and 
median ward to the crista colli; behind this the feebler, triangular ligamentum costo- 
transversarium posterius runs from the root of the processus spinosus and from the 
root of the processus transversus of the next vertebra above obliquely lateralward and 
downward to the posterior surface of the coUum costae and to the region above the 
tuberculum costae. 



Joints of the Thorax. 



173 



Ligamentum colli costae 

Ligamentum tubercuU costae 



Tuberciilum costae 




Ligamentum capituli costae 
radiatum 



\ Ligamentum lougitudinale anterius 

I 

Corpus vertebrae 



225. Ribs and corresponding vertebra with 

ligaments, from above. 

(The body of the upper of the two vertebrae connected with the rib has been sawed through 
transversely. On the right side the joint slits have been opened.) 

The following strengthening ligaments of the articulationes costotransver- 

sariae have yet to be considered: — the ligamentum tubercuU costae, which extends 
as a quadrangular ligament behind the joint from the tip of the processus transversus 
to the posterior surface of the tuberculum costae (see also Fig. 224), as well as the 
ligamentum colli costae. The latter is short, broad, and stretched out horizontally 
between the posterior surface of the collum costae and the anterior surface of the pro- 
cessus transversus of the coiTesponding vertebra. The fibres run obliquely bakward and 
medianward from the rib. This ligament fills the space between the anterior surface of the 
processus transversus and the posterior surface of the collum costae, the foramen costo- 
transversarium, almost completely except for chinks in the anterior and posterior part. 
On the eleventh and twelfth rib the tuberculum costae does not touch the pro- 
cessus transversus of the vertebrae, and the joint cavity of the articulatio costotrans- 
versaria is absent as is also the capsula articularis; corresponding to this the two 
ligaments of this joint are somewhat modified. 



174 



Joints of the Thorax. 



■ J^'i- Vm Ligamentum sternocostale interarticulare 




11Q. Sternum and ribs with ligaments, from in front. 

(In the left half of the figure th(> most anterior layer has been removed and the joint slits 
have been opened; the parts are soparat(id somewhat from one another on the left side.) 



Joints of the Thorax. 175 



The anterior extremities of the seven upper costal cartilages are attached directly 
to the incisurae costales of the sternum, articulationes sternocostales (articu- 
lations of the cartilages of the ribs with the sternum); the cartilage of the fii'st 
rib fuses usually directly with the sternum, while for the cartilages of the second to 
the seventh rib there are usually present slit-shaped joint cavities and capsulae articu- 
lares. A ligamentum sternocosfale interarticulare (0. T. interarticular chondrosteraal 
ligament), which extends from the medial end of the second costal cartilage to the car- 
tilaginous (or bony) junction of the manubrium with the corpus sterni, makes constantly 
two separate joint cavities for this joint. In the other joints there are often similar 
fibrous strands, which, however, lead usually only to incomplete division of the joint 
cavities. The joint capsules are strengthened on the anterior surface by strong, on the 
posterior by weak, ligamenta sternocostalia radiata (0. T. anterior and posterior 
chondrosternal ligaments), which extend from the ends of the costal cartilages, diverging 
to the sternum ; the anterior of these interweave with those of the other side to form 
a tough layer. This layer, ensheathing the sternum in front and behind, is called the 
memhrana sterni. 

The eighth and ninth rib are attached usually (see p. 78) each with the anterior 
end of its cartilage to the cartilage of the next rib above. In these places as well as 
sometimes at other places on the fifth to the ninth costal cartilage, where contact 
between the cartilages or cartilaginous processes takes place, small joint slits and joint 
capsules are present, the articulationes inierchondrales. 

The anterior extremity of the tenth costal cartilage is united by a loose liga- 
mentous band with the ninth; no such connection of the eleventh with the twelfth 
rib exists. 

From the lowermost end of the corpus sterni and from the anterior surface of 
the sixth and seventh costal cartilage strand-like bands go off obliquely medianward to 
the anterior surface of the processus xiphoideus , the ligamenta costoxiphoidea (0. T. 
chondroxiphoid ligaments). They are connected with the anterior leaf of the vagina 
musculi recti abdominis. 



176 



Joints of the Upper Extremity. 



Ligamentum coatoclavicnlare 




Costa I 



^ Manubrium sterni 



227- Clavicle, sternum and first rib, with liga- 
ments, from in front. 

(On the left half the most anterior layer has lioen removed: the parts forming the joints are 
somewhat separated from another.) 

The articulatio sternoclavicularis (sternoclavicular joint) arises from the 
fact that the extremitas sternalis claviculae with its facies articular sternalis, covered 
with cartilage, lies in the incisura clavicularis sterni which is also covered with carti- 
lage, the two being separated only by the discus articularis (0. T. interarticular fibro- 
cartilage) ; the latter is thickened above, medianward and behind, and separates two special 
joint cavities with capsulae articulares from one another. On tlie anterior surfaces ot 
the joint the broad ligamentum sternoclaviculare extends from the clavicle down to 
the sternum. In addition, the rounded, unpaired ligamentum interclaviculare, concave 
above, stretches out between the medial extremities of the two clavicles over the incisura 
jugularis sterni. The ligamentum costoclaviculare (0. T. rhomboid ligament), a power- 
ful ligament, consisting of several layers, goes from the tuberositas costalis clavicular to 
the upper margin of the first costal cartilage. 



Joints of the Upper Extremity. 



177 



Ligamentum coracoacromiale 
Ligamentum acromioclaviculare ' 

Acromion 



Ligamentum trapezoideum | Ligamentum 

Lig. conoideum j coracoclaviculare 



Ligamentum transversum 
scapulae superius 



M. biceps (Caput 

longum) (Tendon 

cut through) 




Labrum _.. .1 * 

glenoidale 



Capsula articularis 



228. Right clavicle and shoulder blade with liga- 
ments, from without and somewhat from in front. 

(The medial half of the clavicle has been sawed off. The shoulder joint has been opened and the 
head of the humerus removed. Of the shoulder blade only the lateral portion has been drawn.) 

The thr-ee ligameuts of the shoulder blade extend between segments of bone which 
are not moveable upon one another ; they accordingly serve only as a supplement of the 
bony structure. 

The ligamentum coracoacromiale (coracoacromial ligament) is strong, broad, oblong, 
quadrangular and extends above the shoulder joint from the anterior surface of the acromion 
to the posterior surface of the processus coraooideus. 

The ligamentum transversum scapulae superius (see also Figs. 229 and 231) is thin 
and flat; it is stretched out over the incisura scapulae and transforms this into a foramen 
through which pass the v. transversa scapulae and the n. suprascapularis (the a. transversa 
scapulae generally runs over the same). 

The ligamentum transversum scapulae inferius (see Kg. 230) is thin and round; it 
extends fi-om the root of the acromion to the posterior margin of the oavitas glenoidahs, over the 
coUum scapulae. Thi'ough the space between ligament and bone runs the a. transversa scapulae. 

In the articnlatio acromioclavicnlaris the facies articularis acromiahs claviculae is 
united with the facies articularis acronui (rarely with intercalation of a disc of fibro-cartQage, 
discus articularis). From the margins, of the joint surfaces stretches out a capsula articularis, 
strengthened on the upper surface by 'the broad ligamentum acromioclaviculare. 

Between the tuberositas coracoidea claviculae and the upper surface of the processus 
coraooideus scapulae extends the broad, powerful ligamentum coracoclaviculare ; its anterior, 
lateral, quadrangular part is called the ligamentum trapezoideum, its posterior medial, trian- 
gular part, broader above, more apical below, the ligamentum conoideum; between the two 
there is often a bursa, bursa hgamenti coracoclavicularis (see Fig. 345). 

Spalteholz, Atlas. 12 



178 



Joints of the Upper Extremity. 



Processus coracoideus 



Ligamentum coracohumerale 

M. snbscapularis '\ 

(cut off near its insertion) 



Ligamentum 
transversum scapulae superius 




229. Right shoulder joint, arficu/atio humeri, 

from in front. 

(The bursa m. subscapiilaris is not shown. Of the shoulder blade only the lateral part has 

been di'awn in.) 

The articulatio humeri (shoulder joint) (see also Figs. 228, 230 and 231) is formed 
in that the caput humeri moves upon the ca vitas glenoidalis scapulae. The articular surface 
of the shoulder blade is enlarged by means of a fibrocartilaginous ring, labrum glenoidale 
(0. T. glenoid ligament), which is attached to the margin of the ca vitas glenoidalis. From 
the outer side of this fibrocartilaginous projection a wide and loose capsula articularis extends 
to the ooUum anatomicum humeri and bridges over the upper end of the sidcus intertuber- 
cidaris. The mm. subscapularis , supraspinatus, infraspinatus, ruuning elnse by the joint, are 
firmly attached to the capsule nrar their insertions to the hmnerus. The stratiun fibrosum 
of the capsule consists essentially of laterally direiAed libre bands which form somewhat thiclicr 
layers in front and below. 



Joints of tho Upper Extreniit}'. 



179 



Acromion 
(sawal off) 



Processus coracoideus 

I Ligixmentum coracohniiicrale 



Spina scapulae 




Ligament um 

transversum 

scapulae inferius 



Scapula 



230. Right shoulder joint, articulafio humeri, 

from behind, 

(The acromion has been sawed off. Of the shoulder blade only the lateral portion has 

been drawn in.) 

The Ugamentum coracohumerale (see also Fig. 229) is shown as an especial 
strengthening ligament of the artlculatio humeri. This arises from the lateral 
border of the processus coracoideus below the ligamentum coracoacromiale, is there sepa- 
rated from the capsule by loose tissue, but then sinks into the capsule and radiates 
out into its upper and posterior wall toward the tuberculum majus. 



W 



180 



Joints of the Upper Extremity. 



Capsula articulaiis 



Processus coracoideiis 

[ 



M. biceps (Caput longum) 



Liganientum transver- 
sum scapulae superius 



Spina scapulae 
{sawed off at its origin) 




231. Right shoulder joint, articulaiio humeri. 

Frontal section through the same, from behind. 

(The vagina mucosa intertubercularis has not been opened in its whole length. Of the shoulder 
blade only the lateral portion has been drawn.) 

The arliculatio humeri possesses regularly two bulgings of its capsula articularis. 
The one bulging, bursa m. subscapularis (see also Fig. 346) lies between the upper part of 
the m. subscapularis and the joint capsule, is ovale and extends to below the root of the 
processus coracoideus; it is connected with the joint caWty by an opening situated a little 
below the ligamentum coracohumerale. 

The second bulgiug of the capsula articularis is tlie vagina mucosa intertubercularis 
(see also Kg. 346). It surrounds the tendon of the caput longum m. bicipitis as a tubular 
cylindrical canal, is in free conununication at its upper extremity with the joint cavity and 
lies close to the bone in the region of the sideus intertuberc\ilaris whicli is covered with carti- 
lage above; it ends in the form of a blind sac in the region of the coUuni chirurgicum where 
the stratum synoviale of the capsule is reflected upon the teiuloii of the m. biceps, covering 
over part of tli(,' sam(> as it runs inside the joint caN'ity. 



Joints of the Upper Extremity. 



181 



232. 
Right elbow joint, 

articulatio cubiti, 

from in front. 

The articulatio cubiti 

(elbow joint) (see also Figs. 233 
to 236) is the articulation between 
the humerus and the bones of 
the forearm. Here three different 
joints are included in one common 
capsula articularis: — (1) the 
incisura semilunaris ulnae glides 
upon the ti-ochlea humeri (articu- 
latio humeroulnaris) ; (2) the 
fovea capituli radii rotates on the 
capitulum humeri (articulatio 
humeroradialisj ; (3) the circum- 
ferentia articularis radii moves in 
the incisura radialis ulnae (articu- 
latio radioulnaris proximalis). 
The articulatio humeroulnaris 
takes part in the movements be- 
tween the upper arm and the fore- 
arm only, while the articulatio 
radioulnaris proximalis serves ex- 
clusively for the movements be- 
tween the two bones of the fore- 
arm; the articulatio humeroradialis 
on the other hand, takes"part in 
both movements. 




Membrana 
inlei'ossea 
antibrachii 



182 



Joints of tlie Upper Extremity. 




Ulna 



Ligamentum collaterale iiluare 



233. Right elbow joint, articulaiio cubiti, 

from the ulnar side. 

The capsula articularis of the articnlatio culbiti is tolerably wide and proceeds from 
the humerus in front and behind in a line conyex above ; this place of origin lies in the middle 
in front close above the fossa coronoidea and fossa radiahs, behind in the upper part of the 
fossa olecrani; on the sides it runs distalward from the two epicondvH. On the ulna the 
capsule is attached in the whole circumference of the incisura semilunaris and incisura radialis 
beyond the margin of the surface covered with cartilage; to the radius it is fastened around 
the coUum radii, about in the middle between the lower margm of the capitulmn and the 
tuberositas radii. The narrow bulging of the capside between the incisura radialis ulnae and 
the oii'cumferentia articularis radii extending distalward is called the recessus sacciformis. 

The powerful, flat, triangular ligameninm collaterale ulnare (0. T. internal lateral 
ligament) (see also Figs. 232 and 235) is to be mentioned as an especial strengthening Hga- 
ment on the ulnar side; it extends from the epicondj'lus medialis humeri, its fibres diverging 
to the ulnar margin of the incisura semilunaris idnae. 



Joints of the Vmirr Extremit}-, 



183 



Membrana interossea aiitibrachii 




Capsiila articularis 



234. Right elbow joint, articulatio cubiti, 

from the radial side. 



The articulatio cubiti possesses as a second strengthening ligament on its radial side 
the Ugamentum collaterale radiale (0. T. external lateral hgament) (see also Fig. 232). 
This arises as a strong bundle on the epicondylus lateralis humeri and divides into two diverg- 
ing fibre bands of which one goes in fi'ont of, the other behind the capitulum radii; they 
are attached to the ulna partly in front of the incisura radialis, partly behind it and to the 
radial margin of the incisura semilunaris; cUstalward they reach as far as the level of the 
collum radii. The space between the diverging limbs of this hgament is filled up by fibres 
which surround the capitulum and coUum radii circularly and which partially unite with the 
limbs mentioned, partially are fastened separately to the ulna in fi'ont and behind the incisura 
radialis; these circular fibre hands are most markedly developed at the distal part and are 
grouped together there especially, under the name, Ugamentum annulare radii (0. T. orbicular 
ligament) (see also Fig. 237), but they are only artificially, not sharply, separable fi'om the others. 



184 



Joints of the Upper Extremity. 



Capsula articularis 



Epicondylus medialis 



Ligamentum collaterale ulnare 




.Epicondylus lateralis 



235. Right elbow joint, articulatio cubifi, 

from behind. 
(The foreaiin is flexed at a, right angle on the upper arm.) 

The capsula articularis of the articulatio cubiti reaches on the upper arm 
behind, in the middle as far as the upper part of the fossa olecrani, on the sides as 
far as the lower part of the epicondylus medialis and lateralis. Especial strengthening 
ligaments in the posterior wall of the fibrous capsule will not be described. The upper 
part of the fossa olecrani contains a thick mass of fat close to the capsule between it 
and the tendon of the m. triceps brachii. 



Joints of the Upper Extremity. 



1S5 



Fossa coronoidea 



Epiphyseal junction — 



Trochlea humeri ■: 



Processus coronoideus ulnae 




Fossa olecrani 



Capsxila articularis 



Olecranon 



'.f^^i- ■- Epiphyseal junction 



Radius 



Chorda ohliqua 



236. Right elbow joint, aHiculatio cubiti, 

cut through at right angles to the axis of the trochlea humeri, from the 

ulnar side. 

(The joint cavity on the anterior surface is not struck at the spot in which it extends furthest 
upward; the latter corresponds about to the dotted hne leading into the fossa coronoidea.j 

In the articulatio cubiti the olecranon ulnae comes to lie in the fossa olecrani humeri 
when the forearm is extended ; when the forearm is flexed, on the contraiy, the processus 
coronoideus ulnae enters the fossa coronoidea humeri and the capituhim radii enters the fossa 
radialis. During life, however, it is unusual to have the movements of extension and flexion 
go so far that the projections of the forearm hones mentioned touch the corresponding depressions 
of the humerus ; the movements are checked before this occurs. 



186 



Joints of the Upper Extremity. 



Ligainentum annulare radi 



Tendo m. bicipitia 
(cut through) 



Chorda obliqna 




Discus articularis 
rocessu8 styloideus radii 



237. 
Bones of the rightfore- 
arm, with ligaments, 

from the volar surface. 

The joint union between the two bones 
of the foreami, the articulatio radionl- 

naris is divisible spatially into two portions : 
these are the articulatio radioulnaris 
proximatis (0. T. superior radioulnar ar- 
ticulation) between the circninferentia ar- 
ticularis of the capitulum radii and the 
incisura radiaUs ulnae (see p. 181) and the 
articulatio radioulnaris distalis ((). T. in- 
ferior radioulnar articulation), between the 
incisura ulnaris radii and the circninferentia 
articularis of the capitulum ulnae. The 
latter joint is surrounded by a loose cap- 
sula articularis. This arises on the radius 
and ulna from the margin of the carti- 
laginous surfaces and fuses distalward with 
the margin of the discus articularis, a 
triangular plate of fibrocartilage which has 
a broad attachement to the ulnar margin 
of the incisura ulnaris radii and becoming 
narrow is fastened to the tip of the pro- 
cessus styloideus ulnae (see also Fig. 240). 
The bldnd-sac-like bulging of the joint cap- 
sule extending proximalward between the 
cii-cumferentia articularis of the capitulum 
ulnae and the incisura ulnaris radii is called 
the recessus sacciformis (see Kg. 240). 
The articulationes radiouLnares proximalis 
et distalis, in a mechanical sense, form to- 
gether one joint. The space between the 
two bones of the forearm is almost comple- 
tely fiUed up by the memhrana interossea 
antibrachii (interosseous membranej. This 
powerful fibrous sheet is stretched out be- 
tween the cristae ihterosseae of the radius 
and of the ulna, is separated proxunal- 
ward by a large, distalward by a naiTow 
space from the corresponding joint, and 
possesses several irregular openings for the 
passage of vessels and nerves; the fibre 
bands run in the main obhquely and ex- 
tend from the radius distalward toward 
the ulna. In addition the cJiorda obliqua 
(0. T. oblique ligament) (see also Figs. 232 
and 233) extends as a thin rounded iibrous 
band from the region of the tuberositas 
ulnae obliquely downward to the region 
of the tuberositas radii. 



Joints of the Upper Extremity. 



1S7 



Radius ._ 



Iiigamentuni radiocarpeiim volare 

Ligamentum coUaterale carpi 
radiale 



Tuberculum ossis uavicularis 
Ligamentum carpi radiatum 



Articulatio 
carpometacarpea poUicia 



Os capitatum---r " 




Articulatio radioulnar is 

distalis 
Processus styloideus ulnre 



Ligamentum collaterale 

carpi uhiare 
Os lunatum 



Os pisiforme 



Ligamentum pisohamatum 

Ligamentum 
pisoraetacarpeum 
Hamulus ossis hamati 
Ligamentum carpometa- 

carpeum volare 
_ Ligamentum hamato- 
metacarpeura 
Ligamenta basium 
ossium metacarpalium] 
volaria 



II III 

Ossa metacarpalia 



238. Joints of the right hand, articulatio mams, 

from the volar surface. 

The articulatio manus fjoint of the hand) (see also Figs. 239 and 240) is (.livisible 
into the articulatio radiocarpea and the articulatio intercarpea. 

In the formation of the articulatio radiocarpea (wrist-joint) the proximal joint surfaces of the 
ossa naviculare, lunatum, triquetrum move upon the facies articularis carpea of the radius and 
upon the distal surface of the discus articularis. Its wide loose capsula articularis is attached to 
the circumference of the articular surfaces. It is strengthened by the ligamentum collaterale carpi 
radiale (0. T. external lateral ligament) which extends from the processus styloideus radii to the 
OS navicnlare, and by the ligamentum collaterale carpi ulnare (0. T. internal lateral ligament) 
which extends from the processus styloideus ulnae to the os triquetrum. On the volar surface 
runs also the broad ligamentum radiocarpeum volare (0. T. anterior ligament) which arises 
from the processus styloideus and from the volar margin of the facies articularis carpea of the 
radius and goes in several bundles to the ossa naviculare, lunatum, triquetrum, capitatmn. 

The articulatio intercarpea connects and permits motion among the bones of the wrist; the 
individual bones are connected among one another by small capsulae articulares. On the volar 
surface there are several strengthening hgaments, short, flat, almost transversely dii-ected, liga- 
menta intercarpea volaria (0. T. pahnar ligaments); of these, those which radiate out from the 
os capitatum to the adjoining bones are grouped together as the ligamentum carpi radiatum. 

In the formation of the articulatio ossis pisiformis, the dorsal surface of the os pisiforme 
ghdes upon the volar surface of the os triquetrum ; a small, loose capsula articularis connects the 
borders of these surfaces. From the os pisifoi-me, the powerful ligamentum pisohamatum goes 
to the hamulus ossis hamati ; the ligamentum pisometacarpeum to the basis ossis metacarpahs 
TTT — V, both Hgaments being really continuations of the tendon of the m. flexor cai'pi ulnaris. 



Joints of the Upper Extremity. 



Radius 



Articulatio 
radioulnaris distalis 

Processus styloideus_ 
ulnae 

Ligamentum coUaterale 
carpi ulnare 

Os triquetruDi. 

Os pisiforme. 

Ligamenta intercarpea^. 
dorsalia 

Os haraatam— . 
Ligamenta carpo- 
metacarpea dorsalia*" 



Ligamenta basium 

[ossium meta- - 
farpaliuin] dorsal is 




Ligamentum radiocarpeum 
dorsale 



Ligamentum coUaterale 
carpi radiale_ijj 

._0s naTiculare 

Os capitatum 



Os multangulum niajua 

Articulatio carpo- 

metacarpea pollicis 
Os multangulum 
minus 



III 
Ossa metacarpalia 



239. Joints of the right hand, articulatio manus, 

viewed from the back of the hand. 

Articulatio manus (continuation). On the dorsal surface, tlie capsule of the articu- 
latio radiocarpea is strengthened by the ligamentum radiocarpeum dorsale (0. T. posterior 
ligament) which goes from the dorsal margin of the facies articularis carpea radii in different 
divisions to the bones of the first row of the carpus, 

The articulatio intercarpea possesses on the dorsal surface several short strengthening liga- 
ments, lir/amenta intercarpea dorsalia (0. T. dorsal ligaments), which run usually transversely. 

The articulationes carpometacarpeae (carpometacarpal articulations) are formed on the 
one side by the distal surfaces of the bones of the second row of the carpus, on the other 
side by the proximal surfaces of the ossa metacarpalia. Several short perpendicular and oblique' 
ligaments on the volar and dorsal surfaces, ligamenta carpometacarpea dorsalia et volana 
(0. T. dorsal and palmar hgaments) serve to their capsulae articular es as strengthening ligaments ; 
of the latter, that situated furthest ubiarward extends from the hamulus ossis hamati to the 
basis ossis metacarpalis V and is called the ligamentum hamatometacarpeum (see Fig'. 238). 

The articulationes intermetacarpeae (articulations of the metacarpal hones with one 
another) have their origin in that the proximal ends of the second to the fifth metacarpal 
bones can move upon one another by means of their lateral surfaces which are covered with 
cartilage. Their capsulae ariiculares are strengthened by short transversely directed fibre 
bands, ligamenta basium [ossium metacarpalium] dorsalia et volaria of which there are four 
on the back of the hand, but only three in the hollow of the hand (the ligament between the 
OS metacarpalo I and II is absent) (see also Kg. 238). 



Joints of the Fpin'r Extremity. 



189 



Ulna 



Epiphyseal junction 

Recessns sacciformis 

articulation is radio -i>Vr*5*- — 

ulnaria distalis 



Discus articularis 
Processus 
styloideus ulnae ~ 
Os triquctruni- 
Articulatdo 
ossis pisiforrais' " 
Os pisiforme - 

Os capitatum _ 

Liganieutum inter- 
carpeum interosseuni 
Os haniatuni 



Liganientum basiuni 

[oss. metacarp.] 

interosseuni 

Articulatio inter- __ 

metacarpea 



__ — Epiphyseal junction 



Articulatio radiocarpea 
-Os lunatum 
_0s navlculare 




Articulatio intercarpea 

_ Os multangulum minus 

Os multangulum majus 

_ , Articulatio carpo- 
metacarpea pollieis 
-Articulatio carpometa- 
carpea 



III 
Ossa metacarpalia 



240. Joints of the right hand, arficulatio mams, 

from tlie back of the hand. 

(The surface of a frozen hand has been filed off until the joint cavities have been opened.) 

Articulatio maniis (continuation). The joint cavity of the articulatio radiocarpea 

is connected neither with that of the articulatio radioulnaris distalis nor with that of the 
articulatio intercarpea. 

The shts between the individual joint surfaces of the bones which together form the 
articulatio intercarpea are usually all connected not only with one another, but also with 
the joint cavities of the articulationes carpometacarpeae and iutennetacarpeae of the second 
and third fingers. Short, strong ligamenta intercarpea interossea extend in the depth in a 
transverse direction between the neighboring wrist bones of the same row. 

The joint cavity of the articulatio ossis pisiformis is usually separated fi-om the others. 

In the articulationes carpometacarpeae of the second and third finger the joint slits 
are usually connected not only with those of the articulatio intercai'pea , but also with those 
of the articulationes intermetacarpeae between the second, third and fourth finger ; the articu- 
lationes carpometacarpeae and the articulatio intermetacarpea of the fourth and fifth fingers 
are usually separated from the others, the articulatio carpometacarpea pollieis always. 

The three articulationes intermetacarpeae possess, in the depth, short, transverse 
ligamenta hashtm [ossium metacarpalium] interossea. The joint capsules go off from the 
margins of the surfaces covered with cartilage. 



190 



Joints of the Upper Extremity. 



Tendo ni. flexoris digitorum profundi 
Tendo m. flexoris digitorum sublimis \ 



Os metacarpale II, 



Ligamentum vaginale 



Ligamentuni capitulorum 
transversnm 

M. lumbricalis II 




_ Os metacarpale V 



Ligamentum 
""^accessorium volare 
._ Ligamentum 
collaterale 



Ligamentum vaginale 



Ligamentum capitulorum 
trans versum 

Ligamentum vaginale 



Tendo m. himbricalis III (cut off) 
M. interosseus volaris II 



241. Metacarpal bones and first phalanges of the 
second to the fifth finger of the right hand with 

ligaments, from the volar surface. 

In the formation of the articulationes nietacarpoplialangeae tlie base of 
each phalanx I moves upon the capitultim of the os metacarpale. A tolerably loose 
capsula articularis connects the margins of the surfaces covered with cartilage. 

Between the heads of the second to the fifth os metacarpale a flat powerful 
ligamentum capitulorum [ossiitm metacarpalium] transversum (0. T. transveree meta- 
carpal ligament) stretches out transversely over the distal end of the corresponding 
spatium interosseum nietacarpi on the volar surface. It is partially fastened to the 
lateral surface of the capituluni; in part it goes over into the volar portion of the 
joint capsule and there connects with the ligamentum accessorium volare; in part it 
helps to form the ligamenta vaginalia for the flexor tendons of the fingers. The liga- 
ment separates the distal portions of the mm. interossei from those of the mm. lumbri- 
cales in that the former run dorsalward from it, the latter volarward. 



Joints of the Upper Extremity. 



191 



Capsula 
articularis 




rrocessua 
styloideua 



nietacarpale 



Ligamentum 
accessorium volare 
Ligamentum 
collaterale 



Capsula 
articularis 



Ligamenlnm 
collaterale 



Phalanx II 



Ligamentum 
collaterale 



Phalanx III 



242. 
Metacarpal bone and 
phalanges of the third 

finger of the right 
hand with ligaments, 

from the radial side. 

The articulationes metacarpopha- 
laugeae possess a ligamentum coUatei'ale 
((_>. T. lateral ligament) as a strengthening 
ligament, une on the radial and one on 
the ulnar side which extends from the 
lateral surfaee of the capitulum ossis meta- 
earpalis obliquely distahvard and volarward 
to the base of the first phalanx. In addi- 
tion, a ligamentum accesso7-ium volare 
((.). T. transyin'se metacarpal ligament) with 
one lunb on each side to the capitulum 
ossis mi'tacarpalis just volarward from the 
hgamentuni collaterale runs arch-hke to 
the volar surface of the jomt, broadening as 
it goes ; there the two limbs unite so that 
the whole ligament resembles a loop; on 
the volar surface it is united ndth the 
ligamentum capitulorum transversum (see 
Pig. 241). 

In the formation of the articulationes 
digitorum uianns (finger joints) the 
base of each phalanx IE is moveably con- 
nected with the trochlea of each phalanx I 
and in the same way the base of each 
phalanx III with the trochlea of each pha- 
lanx II. In the first finger (thiimb), only 
one such joint is present; in the second 
to the fifth iiuger always two. Loose cap- 
sulae articulares connect the margms of 
the cartilaginous joint surfaces mth one 
another and are strengthened by powerful 
ligamenia collateralia (0. T. lateral liga- 
ments) which run to the rachal and ulnar 
side in a manner entirely analogous to 
that in the articulationes metaearpo- 
phalangeae. 



192 



Joints of the Lower Extremity. 



Processus transversus vertebrae lumbalis IV 



Ligamentum iliolumbale 



Fossa iliaca 




Ligamentum 
longitudinale anterius 



Spina iliaca 
anterior superior 



Spina iliaca anterior inferior 



Eminentia iliopectinea 



Corpus vertebrae 
lumbalis V 



Promontorium 

Ligamenta sacroiliaca 
anteriora 



Foramen ischiadicum 
majus 



Ligamentum sacro- 

spinosum 

Ligamentum 
~ sacrococeygeum anteriuR 
Linea terminalis 

Foramen iscbiadicum 

minus 



Ligamentum sacrotuberosum 



Ligamentum pubicum superius 



Symphysis ossium 
pubis 



243. Ligaments of the right half of the pelvis, 

from in front and somewhat from above. 



Ji lints of the Lower Extremity. 193 



The pelvic bones are connected by means of two joints: — the paired arti- 
culatio sacroiliaca and the nnpaired symphysis ossium pubis. 

In the articulatio sacroiliaca (see also Fig's. 244 and 245) the fades 
auricularis ossis sacri and the facies auricularis ossis ilium of each side are in contact. 
A short, tight capsula articularis connects tlie margins of the cartilaginous surfaces ; 
it is strengthened on the anterior surface by the Ugamenta sacroiliaca anteriora, 
which, considered as a whole, run as broad thin fibre plates from the upper and anterior 
surface of the pars lateralis ossis sacri transversely to the inner surface of tlie ilium 
and are there attached in the periphery of the linea arcuata, eventually also in the 
sulcus paragienoidalis. 

The ligameiitum Uiolunibale (0. T. iliolumbar ligament) (see also Fig. 244), 
must also be regarded as a strengthening ligament (in the wider sense) for tliis joint. 
This forms a powerful flat fibre band which has its origin from the processus transversus 
of the fifth (partially also, as in Fig. 243, of the fourth) lumbar vertebra; one part 
of the fibres extends from there to the posterior portion of the crista iiiaca, another 
larger part broadens out on the inner surface of the ala ossis ilium and on the upper 
surface of the pars lateralis ossis sacri. 



Spalteholz, Atlas. 13 



194 Joints of the Lower Extremity. 



The articulatio sacroiliaca is strengthened on the posterior surface by the 
ligamenta sacroiliaca interossea (see also Fig. 245) and the Ugamenta sacroiliaca 
posterior a breve et longum. The latter form the broad mass of fibre bands, only 
indistinctly separated from one another, which ascend obliquely from the region of the 
crista sacralis lateralis of the sacrum toward the ala ossis ilium ; they are attached there 
chiefly to the spina iliaca posterior superior; of these the fibrous bands which come 
from the region of the second and third sacral vertebra are called the ligamentum 
sacroiliacum posterius breve, those from the region of the fourth sacral vertebra, the 
ligamentum sacroiliacum posterius longum. These ligaments cover over the ligamenta 
sacroiliaca interossea completely from behind and lie close upon them. 

Of great importance for the form and firmness of the pelvis are also the liga- 
mentum sacrotuberosum and the ligamentum sacrospinosum (see also 
Fig. 243). 

The ligametitum sacrotuberosum (0. T. posterior or great sacrosciatic ligament) 
arises broad and thin from the spinae iliacae posteriores superior et inferior as well as 
from the lateral margin of the sacrum and of the two upper coccygeal vertebrae; it is 
accordingly intimately connected in its upper part with the ligamenta sacroiliaca posteriora. 
The fibres converge to form a strong flat ligament which extends obliquely forward, 
downward and lateralward and becomes attached to the medial surface of the tuber 
ischiadicum where it again broadens out ; a narrow band which extends as a continuation 
of some fibre bundles from this point along the medial margin of the ramus inferior 
ossis ischii, is called the processus falciformis (0. T. falciform ligament). 

The ligamentum sacrospinosum (0. T. anterior or lesser sacrosciatic ligament) 
is essentially thinner than the preceeding; it arises on the lateral margin of the lower 
portion of the sacrum and of the upper coccygeal vertebrae, extends past the anterior 
surface of the ligamentum sacrotuberosum forward and lateralward, narrowing as it goes, 
and is attached to the spina ischiadica ; at the point where it crosses the ligamentum 
sacrotuberosum, it fuses with it. The ligamentum sacrospinosum forms, with the 
m. coccygeus (see p. 328), a common mass of variable composition; sometimes the 
connective tissue structures predominate, sometimes the muscle bundles. 

The ligamentum sacrotuberosum, as well as the ligamentum sacrospinosum, stretches 
out medianward from the two incisurae ischiadicae (or between them) so that these 
notches are transformed into foramina which are surrounded partly by bone, partly by 
ligaments; the incisura ischiadica major becomes the rounded quadrangular foramen 
ischiadicum majus (0. T. great sacrosciatic foramen), the incisura ischiadica minor 
the triangular foramen ischiadicum minus (0. T. lesser sacrosciatic foramen) (see 
also Fig. 243). 



Joints of the Ijnvor Extremit3^ 



19f 



Processus traiisversiis vertebrae lumbalis IV 
■ Ligamentum ilioluinbale 

/ Spina iliaca posterior superior 



Processus spiiiosus 
vert, lumbalis V 

Ligamantum 
interspinale 



Ligamentum 
sacroiliacum - 
posterius breve 



Ligamentum 

sacroiliacum 

posterius longum 



Cornu sacrale 



Cornu coccygeum 

Ligamentum 

sacro coccygeum 

posterius 

superficial© 



Os coccygis 



Ala ossis ilium 



Crista iliaea 




Processus falciformis 



Spina iliaca 
posterior 
inferior 



Foramen ischiadicum majus 



Ligamentum sacrospinosuni 
Acetabulum 

Foraroeu iscbiadicum minus 



/__ _ Ligamentum sacrotuberosum 



Tuber ischiadicum 



244. Ligaments of the right half of the pelvis, 

fi'om behind. 



IS'' 



196 



Joints of the Lower Extremity. 



Ligameuta 
sacroiliaca posteriora 



Ligamenta sacroiliaca 

interossea 



Os ilium 




Canalis saeralis 



_ Os sacrum 



Cavum articulare 



Ligamenta sacroiliaca anteriora 



245. Articulatio sacroiliaca dextra, frontal section. 

Posterior half of section, from in front. 



The articulatio sacroiliaca possesses an unevenh' curved joint slit; the 
adjoining articular surfaces are completely covered by cartilage and smooth, but they 
present several irregular projections which fit in to corresponding depressions of the 
other bone. 

On the dorsal surface there are present, as strengthening ligaments, the ligamenta 
sacroiliaca interossea. Under this name are included the mass of short fibre bands 
which are covered over completely behind by the ligamenta sacroiliaca posteriora aud 
which extend obliquely upward and backward from the tuberositas saeralis [ossis sacri] 
to the tuberositas iliaca [ossis ilium], eventually, also to the sulcus paraglenoidalis ; Uiey 
fill completely the irregular depression which is situated behind the joint cavity between 
these two rough surfaces, and are not visible in tho uninjured joint. 



Joints of the Lower Extromitv. 



197 



Spina iliaca anterior inferior 

Canalis obturatorius 



Tuberculum pubicuni 

Ligamentuni pubicvim superius 
i Lamina 

i librocartilagineu interpnbica 




Acetabulum 



Ligamentum trans- 
Tcrsum acetabuli 



Ligamentuni arcuatum pubis 



Membrana obturatoria 



Tuber ischiadicum 



246. Symphysis pubis and right half of pelvis 

with ligaments, from in front and below. 

(Only thuse fibres of the labrum glenoidale which form the hgamentum transrersum acetabuh 

have been retained.) 

The membrana obturatoria is nsually a thin fibre plate which almost completely 
closes the foramen obturatum. The fibres arise from the margins of the foramen, coming in 
the lower and posterior part from the posterior surface of the same. The direction of the 
fibres is usually transverse. The uppennost bands stretch nut below the sulcus obturatnrius 
between the tubercula obturatoria and transform this groove into the short canalis obturatorius 
(for the a. and vv, obturatoriae ; n. obturatorius). 

In the unpaired symphysis ossium pubis (see also Fig. 247), the two inibic bones 
are united with one another in the median plane. Between the opposing rough facics sympby- 
seos, which are covered over with a layer of hyaline cartilage, is intercalated a tiljrocartilagi- 
nous disc (lamina fibrocartilaginea interpubicaj (0. T. interpubic disc). This projects some- 
what on the posterior surface as a narrow ridge; in fi-ont it broadens essentially and is covered 
by a layer of decussating fibres which are connected with the tendons of the mm. recti ab- 
dominis. The uppermost, transverse fibre layer stretches out between the upper margins of 
the rami superiores of the pubic bones or rather between the tubercula pubica, and is called 
the ligamentum pubicum superius; lateralward it is continued like a ridge irpon the pecten 
ossis pubis (see Fig. 243) and there gives origin to a^ part of the m. pectineus. The sharp- 
angled triangular fibrous band which extends from the ramus inferior of one pubic bone to 
that of the other on the lower margin of the symphysis and which, above, is fused with the 
fibrocartilaginous disc, is called the ligamentum arcuatum pubis (0. T. subpubic hgament). 



198 



Joints of the Lower Extremity. 



Ligamentum pubiciim superius 



Os pubis - 




Cavum articulare 



Lamina fibrocartilaginoa 
interpubica 



247. Symphysis pubis, opened by a frontal section. 
Posterior half, viewed from in front. 



The symphysis ossium pubis contains in most cases within its lamina 
fihrocartilaginea interpubica a small medianly situated joint slit which lies nearer the 
posterior margin than the anterior and extends almost over the upper half of the fibro- 
cartilaginous mass. The strands of fibrocartilage run in the depth, mostly transversely, 
between the two layers of hyaline cartilage and are seen on median section ' to consist 
of concentrically arranged circular layers. Cartilage and fibrocartilage are very firmly 
united with one another. 



Joints of the Lower Extremity. 



199 



Spina iliaca anterior inferior -\:^+ 



Ligamentuin iliofemorale ,._. 
Trochanter major 



Eminent! a 
iliopectinea 

Ligamentum 

pubo- 

capiulare 




Linea inter- 
trochanlerica 



248. Right hip joint, aHiculatio coxae, 

from in front. 

In the formation of the articulatio coxae (hip joint) (see also Figs. 249 — 252) 
the caput femoris moves upon the fades lunata of the acetabulum. The latter is enlarged by 
means of a high three-cornered fibrocartilaginous ring, labrum glenoidale (0. T. cotyloid liga- 
ment) (see Kgs. 250 and 252) which sits with its broad base upon the border of the aceta- 
bulum and bridges over the incisura acetabuli as the ligamentum transversum acetabuli; this 
has also a broad attachment to the margins of the incisura acetabuli and is connected with 
the fibres of the membrana obturatoria (see Fig. 246). 

The capsula articularis (see Fig. 252) is strengthened on the anterior surface by the 
strong triangular ligamentum iliofemorale. It arises below and near the spina Uiaca anterior 
inferior, broadens gradually and is fastened to the linea intertrochanterioa in its whole length. 
The ligamentum piibocapsulare (0. T. pubofemoral ligament) hes on the medial, inferior side 
of the joint, comes from the corpus and ramus superior ossis pubis and runs partly to the 
upper margin of the trochanter minor, partly to the capsule in the same region. 



200 



Joints of the Lower Extremity. 



Ligamentum iliofemorale 

Trochanter major 




Crista inter- 
trochanterica 



249. Right hip joint, articulatio coxae. 

from behind. 

(The joint capsule, except for the strengthening lig;iments, has been removed.) 

The articulatio coxae pussesscs, as a strengthening ligament of the posterior waE of 
the capsnle, the ligamentum ischiocapsulare. This broad, thick ligament aris(^s externally 
along the margin of the acetabulmn in the whole extent of the corpus ossis ischii: its fibres 
converge smnewhiit. run obliquely upward and lateralward and become attached for the most 
part to the zona orbicularis ; part of them reach even U< the anterior margin of the trochanter major. 

Between the ligaraenta iliofemorale, piibocapsnlare and ischiocapsulare, the capsule is 
essi'utially thinner in three places; these pbices cnrrespimd to the points where the bones 
forming tiie acetabulmn fiise A\ith one another. 



.loints of the Lowor l-Ativitiitx , 



201 



■^— 1_^^._ ()s ilium 



Spina ischiadicii 



Labruin glenoidale 



Zona orbicularis 

Trochanter major 




JV Crista intLT- 
~|".V trocliantcrica 



250. Right hip joint, arficu/atio coxae. 

from behind. 
(The superficial layer of the capsule and the ligamentum ischioi-apsulare have been removed.) 

The capsule of the articulatio coxae is strengthened in the depth by the zona orbi- 
cularis (see also Fig. 252). This l.iand of fibres, eoven^d over completely by the other hgaments, 
but connected with thorn, is strongest and most distmct aliovo, behiud and below; it surrounds 
the neck of the femur like a ring and is connected al)ove with the bone below the spina iliaca 
anterior inferior. It extends therefore, essentially hke a loop, from this point, downward in 
front of the neck, then behind the same and thence, back again, upward to its starting point: 
its lateral margin is formed of fibres which run purely circularly. 



202 



Joints of the Lower Extremity. 



SpiBa iliaca — ! 
anterior inferior 



Fovea capitis femoris 
Caput femoris 



Ligamentum teres 
femoris 



Ligamentum 
transversum acetabuli 



Ramus superior 
ossis pubis 




*_ Spina ischiadica 



Tuber 
isehiadicum 



Facies symphyseos 



Corpus femoris 



251. Right hip joint, articulatio coxae, 

from the medial side. 

' (The bottom of the aoetabnlum has been chiselled away suffieiently to mate the head of the 

femur visible.) 

Hidden inside the articulatio coxae is the ligamentum teres femoris (see 
also Pig. 252). This flatly rounded ligament arises by a broad origin in the neigh- 
borhood of the incisura acetabuli and from the ligamentum transversum acetabuli, 
becomes narrow above and is attached in the fovea capitis femoris. It lies in the 
fossa acetabuli between its floor and the medial inferior surface of the head of the 
femur so that the posterior margin of the ligament, when the body is upright, is ap- 
proximately vertical in direction. The ligamentum teres is covered over by the stratum 
synoviale of the capsula articularis. 



.ri>iiits of the L(jwi.'r Extremity. 



203 



Epiphyseal junction 



Trochanter major 



Epi- 
physeal r- 
junction ^ 




Fovea capitis femoris 



Caput femoris 



Liganientum teres 
femoris 



^ Ligaraentum trans- 
versum acetabuli 



252. Right hip joint, articulatio coxae. 

Frontal section through the same. Posterior half of section, 
viewed from in front. 

(The joint surfaces have been somewhat pulled apart.) 

The^ capsula articularis of the articulatio coxae arises at the margin of the aceta- 
bulum, chiefly outside the labrum glenoidale so that this lies more or less completely within 
the joint ca^aty. The capsule is attached to the femur in front close above the linea inter- 
trochanterica , behind to the neck of the femur medianward from the crista intertrochanterica 
in a line parallel to the latter so that somewhat more than the medial half of the posterior 
surface of the neck of the femur looks into the joint capsule. The stratmn synoviale of the 
capsule is continued upon the hg-amentum teres and encloses this like a sheath. The fossa 
acetabuli is almost completely filled up by masses of fat, synovial villi and the hgamentum teres. 



204 



Joints of the Lower Extremity. 



Meniscus inedialis 



Ligamentum trausversum genu 
! Tuberositas tibiae 




Meniscus lateralis 



Ligamentum cruciatum anterius 
Ligamentum cruciatum posterius 



253. Right knee joint, articulatio gem. 

Tibia with cartilaginous discs, from above. 

In the formation of the articillatio gemi (knee joint) (see also Figs. 254 — 261) 
the two condyli femoris move upon the condyli tibiae. Within the capsula articularis 
enclosing the joint, between the two bones, two sickle-shaped fibrocartilaginous discs are 
intercalated, the meniscus lateralis and the meniscus medialis (see also Figs. 255 — 257 
and 260). These are firmly connected at their extremities, by connective tissue strands, 
with the tibia. Each meniscus is triangular on cross section (see Fig. 260); its 
narrowest side looks outward and is fused with the capsule, the two other smooth sides 
lie one on the condylus tibiae, the other on the condj-lus femoris ; these two sides meet 
in a sharp concave margin. 

The meniscus lateralis (0. T. external semilunar fibrocartilage) is somewhat 
shorter and more circular; it arises anteriorly close in front of the eminentia inter- 
condyloidea tibiae, directly in front of the tuberculum intercondyloideum laterale, and is 
fastened by its posterior extremity to the posterior slope of the eminentia intercondyloidea, 
chiefly to the tuberculum intercondyloideum mediale. 

The meniscus medialis (0. T. internal semilunar fibrocartilage) is longer, broader, 
and more sickle -shaped; it arises anteriorly in front of the fossa intercondyloidea anterior 
from the margo infraglenoidalis and is attached behind in the fossa intercondyloidea 
posterior. 

Between the most anterior points of the two menisci is stretched out the thin 
rounded ligamentum transversum genu (see also Fig's. 255 and 256), which is 
composed of connective tissue. 



Joints of the Lower Extrrniitv. 



205 



Tuberositas tiljiae 




Condylus lateralis 



Ligamentuiii cruciatiim 
anterius 



Eminentia intercondyloidea 



Condylus lateralis tibiae 



254. Right knee joint, ariiculatio gem. 

Sagittal section at about the middle of the joint. Lateral half, viewed 
from the medial side ; somewhat schematic. 

(The meniscus lateralis has been removed.) 

The articnlatio genu has inside it the linamenia cruciata genu anterivs et posterms. 
Each of these goes from the surface turned toward the fossa mtercondyloidea of one oond^dus 
femoris downward to the region of the eminentia intercondjloidea tiliiae ; in the extended 
position the anterior ligament is directed obhquely forward, the posterior somewhat obliquely 
backward. Together they assume the form of an X and are connected by loose ciinnective 
tissue and fat not only with one another, but aJso with the posterior wall of the capsula arti- 
eularis. They are ensheathed by synovial membrane. 



206 



Joints of the Lower Extremity, 



Epicondylus lateralis - 



Condylus lateralis — 



Meniscus lateralis - 



Ligamentum 
collaterale fibulare 



Ligamentum 
cruciatiim anterius 

Ligamentum 
capituli fibulae 




Ligamentum cruciatum poaterius 



Corpus fibulae \- »- 



Epicondylus medialis 

Condylus medialis 



Ligamentum 
collaterale tibiale 



. Meniscus medialis 



Ligamentum 
transversum genu 

Tuberositas tibiae 



Corpus tibiae 



255. Right knee joint, articulatio genu, 

from in front. 
(The knee is flexed at a right angle ; the patella and the cinisule of the jomt have been removed.) 

In the articulatio genu the ligamentum cruciatum anterius (0. T. anterior 
or external crucial ligament) (see also Figs. 253, 254, and 257) has a broad origin 
on the non- cartilaginous, medial surface of the condyles lateralis femoris, near its 
posterior margin. From there on it becomes narrower, passes as a flath' rounded 
bundle obliquely forward, downward, and medianward and is attached especially to the 
tuberculum intercondyloideum mediale and in the fossa intercondyloidea anterior tibiae. 



Joints of the Lower Extremity. 



207 



Epicondylus ^. 

lateralis / 



Coudylus lateralis __ 



Meniscus lateralis- 



Ligamentum 
collaterale fibulare" 



Cut surfaces 
lig. cruciatum 



Ligamentum capituli _ _, 
fibulae 



Corpus fibulae 




of the .^^ > ^ '' *v^^^'v;t 

anterius 'l/V'S' * * i '^'i' d.'U} 



Ligamentum cruciatum posterius 



Epicondylus 
medialis 



Condylus -medialis 

Ligamentum 
~ collaterale tibiale 



Meniscus medialis 



Ligamentum transversum 
genu 

Tiihcrositas tibiae 



Corpus tibiae 



256. Right knee joint, ariiculatio genu, 

from in front. 

(The knee is flexed at a light angle; the patella and the capsule of the joint have been 
removed, the ligamentum cruciatum anterius has been cut off short at its poiats of attachment.) 

The ligamentum cruciatum posterius (0. T. posterior or internal crucial ligament) (see 
also Pigs. 253, 255, and 257) of the articulatio genu lies behind the ligamentiun cruciatum 
anterius, crosses the same and is somewhat stronger. It has a broad origin fi-om the lateral 
surface of the condylus medialis femoris close to its anterior and mferior margin, narrows to 
a flatly rounded cord and passes somewhat obliquely downward, backward, and lateralward to 
the fossa intercondyloidea posterior tibiae and to the posterior surface of the tibia; one band 
of flbres, arising in the medial portion, runs behind the ligament obliquely lateralward to the 
posterior part of the meniscus lateralis (see Fig. 257). 



208 



Joints of the Lr.wiT Extremity. 



LigEimeutum cruciatuni 
poster ill 3 




Epiroiidylus 
medial is 



Condyliis iuedialis__ 



Meniscus medialis , 



Li g amen turn 
eollateralc tibiale 



Corpus fem^oris 

Ligamentum cruciatum anterius 







. Epicondylus lateralis 
Condylus lateralis 



Ligamentum 
■ collaterale fibulare 



..Meniscus lateralis 



Articulatio tibio- 
fibularis 



--^^ Ligamentum 
capituli fibulae 

■-- Capitulum fibulae 



Corpus tibiae. 



Corpus fibulae 



257. Right knee joint, articulatio genu, from behind. 

(The capsule, except for the strengthening ligaments, has heen removed.) 

Articulatio genu (continuation). The ligaments which serve to strengthen the capsule 
laterally are called the ligamenta collatei-alia fibulai-e et tibiale (see also Figs. 255, 256, 258, 261). 

The ligamenium collaterale fibulare (0. T. long external lateral ligament) is a rounded 
fibrous conl , which , when the knee is extended, is stretched out tight from the epicondylus 
lateralis feraoris to the lateral surface of the capitulum fibulae. It is separated by iiitty tissue 
from the cajisule of the joint and from the meniscus lateralis. 

The liffamentum collaterale tibiale (0. T. internal lateral ligament) is a broader, flat 
ligament which extends from the epicondylus nunUalis feraoris to the medial portion of the 
margo iTilraglciioiilalis and tbciice further downward. It is interwoven in the wall of the capsule 
and is p;irtly atta(-bcd also tn the meniscus medialis. Below, it covers over the a. genu inferior 
uicdialis, wbiili lies (hrectl)' upon the bone. 



Joints of the Lower Extremity. 



209 



Corpus feiiioris 



TeDdo m, adductoris magn 
(cut tlu-ough) 



Caput mediale m 
gastroonemii 
(cut through ) 



Ligameiitum 
collaterale tibiale 

Ligamentum 
popliteum obliquuni 

Tendo m. semi- 
mcuibranosi 
fcut through) 



M. popliteu3 (cut through]. 




^[. jilantaris et 

caput laterale n\. 

gastrocncniii 

(cut through) 



Tjigamentuin 

collaterale fibulare 

Ligamentum 
popliteum arcuatum 

Retinaculum liga- 
menti arcuati 

M. popliteus 
Ifut through) 



Capitulum 
libulac 



i ' 



258. Right knee joint, articulatio genu, from behind. 

(The muscles partially fused with the capsule have been cut oft', close to their attachment.) 

The articulatio genu has, on the posterior surface, the following strengthening ligaments : 
The powerful, flat ligamenium popliteum, obliquum (0. T. posterior ligament) extends 
from the region of the oondylus lateralis femoris obliquely medianward and downward ; its fibres 
become lost, partially descending in the wall of the capsule and in the fascia of the m. pophteus, 
partially by bending around upward and going over into the tendon of the m. semimembranosus. 
The ligamenium popliteum arcuatum is a horse-shoe shaped band of fibres, concave 
above, which arises in the region of the epicondylus lateralis and becomes lost in the middle 
of the posterior wall of the cajisule below the ligamentum popliteum obhquum. From the convex 
circumference of the hgament the retinaculum ligamenti arcuati goes off with two converging 
limbs ; it has a narrow attachment to the capitulum fibulae ; from the same place, also, a part 
of the m. popliteus arises. 

Spalteholz, Atlas. 14 



210 



Joints of the Lower Extremity. 



Position of reflection 

of capsula articularis 

upon the bone 



Condyliis lateralis 




Bursa suprapatellar! s 



Ligamenta cruciata genu 



_ Condylus medialis 



Plica synovialis 
patellaris 



=-•' Plicae alares 



Faeies articularis 
patellae 



Position of reflection 

of capsula articularis 

upon the posterior 

surface of the m. 

quadi'iceps femoris 



Bursa suprapatellaris 



Posterior surface of the 
m. quadriceps femoris 



259. Right knee joint, articulatio gem, from in front. 

(After cutting through the capsuhi articularis close to the bone the tendinous expansion of 
the jn. (luailriei'ps femoris along with the jiatella have been turned down in ft-ont; the knee 

is flexed.) 



Joints of the Lower Extremity. 211 



The capsula articularis of the articulatio genu extends over the posterior 
surface of the common tendon of the m. quadriceps femoris in front close above the 
patella and goes over at the border of the patella upon the latter so that the whole 
facies articularis patellae looks into (he joint cavity. Thence the capsule runs as a 
loose membrane separated by abundant fatty tissue from the ligamentum patellae and 
from the adjoining parts of the retinacula patellae (see Figs. 260 and 261) to the 
upper margins of the two menisci and to the inferior attachment of the ligamentum 
cruciatum anterius. It then encloses the two ligamenta cruciata genu in a common 
sheath and goes over at the posterior margin of the ligamentum cruciatum posterius 
into the posterior wall ; thus the two ligamenta cruciata genu form with the surrounding 
synovial membrane a sort of wall of separation which is shoved in from behind into 
the joint cavity, dividing this, behind, into a medial and a lateral compartment. From 
the medial and lateral margin of the facies articularis patellae project two prominent, 
fatty, synovial folds, plicae alares (0. T. ligamenta alaria) which converge below. At 
the angle of union of the same there arises a simple, larger fold, the plica synovialis 
palellaris (0. T. ligamentum mucosum), which extends backward, in a sagittal direction, 
free through the joint cavity to become attached at the lowermost margin of the fossa 
intercondyloidea femoris; this ligament is extraordinarily different in individual cases; it 
often contains fat lobules inside it. 

The joint cavity is continued upward in the majority of cases directly into the 
bursa [mucosa] suprapatellaris. This large bursa lies between the anterior surface 
of the lower end of the femur which has only a slight covering of fat and the posterior 
surface of the common tendon of the m. quadriceps femoris (see Figs. 260 and 261); 
it is intimately fused with the latter and separated from the joint cavity, usually only 
incompletely and indistinctly, by a projecting fold (see Fig. 261); in rare cases it is 
completely shut off and then no connection exists between the two cavities. 



14' 



212 



Joints of tlie Lower Extremity. 



Bursa suprapatellaris 



Tendo in. quadricipitis femoris 
Capsula articularis 




Coiidylus lateralis tibiae -''C" 
Epiphyseal junct 



Patella 



. Cavum articulare 
Plica alaris 



. Ligamontum, 
patellae 

,, .Bursa infrapatellaris 
profunda 



.Tuberositas tibiae 



Corpus tibiae 



260. Right knee joint, articulatio genu. 

Sagittal section through the condylus lateralis femoris. 
Medial half of section, from the lateral side. 

(The lini'r is slifjhtly flexed; the joint surftiees have Ihtu pulled a little apart.) 



Joints of the Lower Extremit)'. 213 



The capsula articularis of the articulatio genu passes in front from the 
posterior surface of the tendon of the ni. quadriceps femoris (see p. 211) to the anterior 
surface of the femur above the joint tuberosities, covers their cartilaginous surfaces 
completely and goes over at the sides only a little beyond the margin of the cartilage 
so that it leaves the region of the epicondyli free (see Fig. 261). 

To the tibia the capsule is attached around the margo infraglenoidalis , a little 
below the margin of the cartilaginous joint surfaces ; thence it goes to the lower margin 
of each of the two menisci, lines its lower and upper surfaces and from its upper 
margin passes upward, partly to the posterior surface of the patella and of the tendon 
of the m. quadriceps femoris (see p. 211), partly to the point of reflection on the femur. 

The ligamentum patellae (see also Fig. 261) is a flat, very strong ligament, 
which goes off from the lower margin and the anterior surface of the patella and, 
narrowing slightly, becomes attached to the tuberositas tibiae; it is separated from the 
capsula articularis by thick masses of fat. The ligament is partially a direct continuation 
of the tendinous fibres of the m. quadriceps femoris running over the patella and can 
accordingly be considered as the terminal tendon of this muscle; in this sense the 
patella itself has to be thought of as a large sesamoid bone intercalated in this tendon. 



214 Joints of the Lower Extreraitj'. 



The cavum articulare of the articulatio genu is in open communication 
regularly with the bursa [mucosa] musculi poplitei. This tube -like pocket extends 
downward and bactovard on the lateral side in front of and below the tendon of origin 
of the m. popliteus ; it opens into the joint by a narrow slit above the meniscus lateralis, 
between this and the tendon of the m. popliteus, but possesses usually in addition a 
second communicating opening below the meniscus; it is sometimes connected also with 
the articulatio tibiofibularis. 

For the bursa suprapatellaris see p. 211. 

In front of the patella are three bursae: the bursa praepatellaris subcutanea 
in the subcutaneous connective tissue in front of the fascia lata (see also Fig. 375), 
the bursa praepatellaris subfascialis behind the fascia lata (not figured), between 
it and the tendinous expansion of the m. quadriceps femoris, and the bursa praepatellaris 
subtendinea between the tendon of the m. quadriceps and the anterior surface of the 
patella (not figured). In most cases only one of these three bursae praepatellares occur; 
sometimes two or three exist over one another in which event they usually communicate 
freely with one another; the size of these bursae dififers much. 

The bursa infrapatellar is profunda (see also Fig. 260) lies between the posterior 
surface of the ligamentum patellae and the anterior surface of the tibia. It is separated 
from the cavity of the knee joint by masses of fat and communicates with it only 
very rarely. 



Joints of the I.ower Extremity. 



215 



Tendo m. quadricipitis femoris 
— Bursa snprapatcllaria 



Cavum articularc 



Epicoudylus lateralis — ^ 




Ligamentum 
collaterale fibulare 

Tendo ra. poplitei . 
Bursa m. poplitei _ 

Capltulum fibulae 



Bursa 

praepatellaris 

sub cutanea 



-Meniscus lateralis 
— Ligamentum patellae 



-Bursa iufrapatellaris 
profunda 



Tuberositas tibiae 



Corpus tibiae 



261. Right knee joint, ariiculatio gem, 

from the lateral surface. 

(The joint cavity and several bursae have been injected with a stiffening medium and then 

dissected out.) 



216 



Joints of the Lower Extremity. 



Ligamentum 
capitiili fibulae 'p^-r==~"*"i; — ~ ^ ' \ YA 



Corpus fibulae 



Mcmbrana inter- 
ossea cruris 




Liganientum ^ 

juallcoli lateralis . _ .A 

anterius ^ 



262. Ligaments of the 

right leg, from in front. 

The tibia and fibula are united 
by two joints, one above and one below, 
besides throughout nearly their whole 
length by the raembranainterossea cruris. 

The articnlatio tibioftbularis 
(0. T. superior tibiofibular articulation) 
(see also Figs. 255 — 257) arises through 
the apposition of the faeies articularis 
eapituli fibulae and the fades articularis 
fibularis tibiae. The tight capsula 
articularis arises fi'oni both bones 
generally close to the margin of the 
cartilaginous surface. On the anterior 
surface and often also on the posterior, 
a sti-engthening ligament, the liga- 
mentum eapituli fibulae, (0. T. anterior 
and posterior superior tibiofibular liga- 
ments) runs transversely or somewhat 
obliquely lateralward and doT\-nward. 
In addition the ligaiuentum coUaterale 
fibulare " and the retinaculmn ligamenti 
arciiati of the knee joint are to be 
regarded as strenj^lhening hgaments (in 
the wider si.'iisr) for the articulatio 
tibiofibularis. Thi> joint communicates 
sometimes with the bursa [mucosa] 
m. poplitei and through this indirectly 
with the knee joint. 

The meiubrana iuterossea cruris 
(0. T. middle tibiofibular ligament or 
interosseous membrane) is stretched out 
as a liruad lamella between the cristae 
intcrusscac of the tibia and fibula. The 
fibres usually assume a cuurse descend- 
ing toward the fibula. Above, between 
the membrane and the articulatio tibio- 
fibularis, there remains a large opening 
fur the passage of vessels and nen'es. 

The syndesmosis tibioflbnlarls 
(<>. T. inferior tibiofibular articulation) 
(see also Figs. 263, 264 and 271) is 
the moveable union between the medial 
surface of the malleolus latorahs (above 
the facii's articularis malleoli) and the 
incisura fibularis tibiae. The bony sur- 
faci's (_ij)p(.isiHl to one another are not 
cijveri'd by jiiint i/artilage, but only by 
periosteum -n-ith a fatty substratum in 
parts; between the two. projecting 
upward from the articidatio talocruralis 
is a small slit-shaped pocket. In front 
and behind a strong ligament runs 
trausversily over the joint, the liga- 
menta iinillcoli lateralis. The liga- 
mciitiim malleoli lateralis anterius 
I'xti'iiils as a flat cord from the region 
in fnnit of the incisura fibularis tibiae 
obliijuely downward to the anterior 
surface of tin- malleolus lateralis. 



Joints of the Lower Kxtrnnitv. 



21: 



Fibula 



Trochlea talU- 



Ligaraentum 
talotibiale posterius 

Ligamentum 
calcaneotibiale 

Ligamentum 
talocalcaneum mediale 




Sulcus m. flexoris halhicis long: 



Ligamentum mallcoU 
lateralis posterius 



Ligamentum talo- 
iibulare posterius 



Ligamentum talo- 
calcaneum posterius 



Ligamentum 
calcaneotibulare 



Tuber calcanei 



263. Joints of the right foot, ariiculationes pedis, from behind. 

(The capsulae articulares have been removed except for the strengthening ligaments.) 

Syndesmosis tibiofibniaris (continuation). The lifjamentum malleoli lateralis poste- 
rius has a broad origin fi'om the region behind the incisura flbnlaris tibiae and fi'om the 
posterior margin of the faeies artieiilaris inferior tibiae and goes oblit|uely downward t'j the 
posterior surface of the malleolus lateralis; its lower fibres help to enlarge and deepen the 
joint cavity for the trochlea tah. 

In the formation of the articulatio talocruralis (ankle-joint) (see also Figs. 264 and 
265) the trochlea tali moves in the joint cavity formed by the distal end-pieces of the tibia 
and fibula ; here the faeies superior tali glides upon the fa<'ies artic\ilaris inferior tibiae, the 
faeies malleolaris laterahs tali upon the faeies articularis malleoli fibulae and the faeies maUeo- 
laris mediahs tali upon the fades articularis malleolaris tibiae; the two malleoli thus embrace 
the trochlea tali from two sides. Thi' capsula articularis arises everywhere close to the margin 
of the cartilaginous surfaces; only in front of the faeies articularis superior tali does it cover 
also a part of the collum tali which is fi-ee from cartilage; at the sides the capsule is tight; 
in front and behind it is looser. Lateralward and metUanward very powerful strengthenmg 
ligaments, ligamenta talofibularia et calcaneophidare and ligamentum dcltoideum., go froin 
the two malleoli to the ankle bones (see pages 218 and 219). 



218 



Joints of the Lower Extremity. 



Ligamentum 

malleoli lateralis- 

posterius 



Ligamentum 

talofibulare 

posterius 



Ligamentum malleoli lateralis antcrius 

Ligamentum talofibulare anterius 

Ligamentum talonaviculare [dorsale] 
I 
I Pars calcaneocuboidea"! Ugamenti 

/ Pars calcaneonavicul. / bifurcati 

^ Ligamentum cuboideonaviciilare 




Ligamenta navi- 
--■3-- cularicuneiformia 
dorsalia 



Ligamentum 

cuneocuboldeum 

dorsale 



Ligamentum. cuneocuboideum 
interosseum 



Ligamentum calcaneofibulare 
Retinaculum mm. peronaeorum inferius 



Ligamentum calcaneocuboideum dorsale 

Ligamentum talocalcaneum laterale 
I 
Ligamentum talocalcaneum interosseum 

Ligamentum talocalcaneum anterius 



264. Joints of the right foot, articulationQ.s pedis, 

from the lateral surface. 

(The metacarpal bones have been removed as well as the capsiilae articulares with the exception 

of their strengthening ligaments.) 

Articulatio talocruralis (continuation). The ligamentum talofibulare posterius 
(0. T. posterior fasciculus of external lateral ligament) (see Fig. 263) arises at the 
malleolus lateralis [fibulae] behind the fades articularis malleoli and extends, flat, 
obliquely medianward and downward to the region of the lateral projection fi-om the 
processus posterior tali. The ligamentum talofibulare anterius (0. T. anterior fasciculus 
of external lateral ligament) goes from the anterior surface of the malleolus lateralis 
medianward to the lateral surface of the collum tali. The ligamentum calcaneofibulare 
(0. T. middle fasciculus of external lateral ligament) (see also Fig's. 263 and 266) runs 
as a flat-rounded cord from the tip of the malleolus lateralis obliquely downward and 
backward to the lateral surface of the calcaneus; its outer surface forms a shallow 
groove in which glide the tendons of the mm. peronaei. 



Joints of the Lower Extremity. 



219 



Ligamentum talotibiale anterius 

liiganientum tibionaTicularc, 
Lig. talonaviculare [dorsale] ^ '^, 




..^^igamentum deltoideum 



Ligamentum 
talotibiale posterius 



Ligamenta naviculari- 
cuneiformia dorsalia 



Ligamentum calcaneotibiale 

Ligamentum 
talocalcaneum posterius 
Loop for the attachment of tlial 
tendon of the in. flexor hallucis 
longus in the sul- 
cus ni. flexoris 
hallucis longi 



Lig. navicularicuneiforme plantare i 

Ligamentum calcaneonavicularo plantare 

Ligamentum plantare longnm 



Ligamentum talocalcaneum mediale 



265. Joints of the right foot, ariiculationes pedis, 

from the medial surface. 

(The specimen has been prepared as for Fig. 264.) 

Articulalio talocraralis (continuation). The ligamentum deltoideum (0. T. deltoid 
or internal lateral ligament + the anterior and posterior tibiotarsal Ugaments) is an unequal-sided 
quadrangular ligamentous mass which has a naiTow origin on the medial surface of the malleolus 
medialis [tibiae] and has a broad attachment to the talus, calcaneus and os naviculare. This 
ligament is composed of several layers and is divisible, according to the lower attachment of its 
fibres, into the ligamenta talotibialia, the ligamentum calcaneotibiale and the ligamentum tibio- 
naviculare. The ligamentum talotibiale posterius (0. T. posterior tibiotarsal Ugament) (see also 
Fig. 263) is a thick, broad band of fibres which arises behind the tip of the malleolus medialis 
and is attached to the talus close behind and below the facies malleolaris medialis of the trochlea, 
in fi'ont of the medial projection of the processus posterior tali. The ligamentum talotibiale 
anterius (0. T. anterior tibiotarsal ligament) for the most part hidden below the hgamenta cal- 
caneotibiale and tibionaviculare, is short and narrow and goes off from the tip of the malleolus 
mechalis just in front of the preceding and has a somewhat broad attachment below the anterior 
portion of the facies malleolaris mediahs of the trochlea tali. The ligamentum calcaneotibiale 
(0. T. internal lateral ligament) (see also Fig. 263), the most supei-ficial part of the ligamentimi 
deltoideum, has a broad origin on the medial surface of the maUeoIas mediahs and runs do'miward 
to the posterior margin of the sustentaculum tali of the calcaneus. The ligamentum tibionaviculare 
has a broad attachment to the medial surface of the malleolus mediahs just above the ligamentum 
talotibiale anterius and, broadening, goes to the dorsal and medial surface of the os navicidare as 
well as to the medial margin of the ligamentum calcaneonavicularo plantare : at its origin and be- 
hind it is partially hidden beneath the Ugamentum calcaneotibiale. The ligamenta talotibiale poste- 
rius and calcaneotibiale form, medianward, a groove for the tendon of the m. tibialis posterior. 



220 



Joints of the Lower Extremity. 



Ligamenta tarsometa- 
tarsea dorsalia 



Ligamenta inter- 
cuneiform ia 



Ligamenta naviculari- 
cuneiformia dorsalia 



Ligamentiim talonavi- 
culare [dorsale] 



Ossa metatarsalia 
I II 

" III 




Ligamenta basium 

- [oKsium nietatar- 

saliumj dorsalia 



Ligamentnni cnneo- 
" ciiboideum dorsale 



Tendo m. peronaei 
brevis {cut tbxough) 
Ligamentura cuboideo- 
naviculare dorsale 



Pars ealcaneo-) 

cuboidea [ ligamenti 
Pars calcaneo- ( bifurcati 



navicularis 



Ligamcntum calcaneo- 
cuboidenm dorsale 

Liganientum talocalcaiieum 
laterale 

Retinaculum mm. peronaeorum 
inferius 



Ligamentum calcaneofibulare 
(cut through) 



Ligamentum talocalcaneum posterins 



266. Joints of the right foot, articulationes pedis, 

viewed from the back of the foot. 



(The ossa metatarsalia have lieen sawed through in the middle, the eapsulae articulares have 
been remuved except for the strengthening ligaments.) 



Joints of the Lower Extn.'inity. 221 

. In the formation of the articniationes intertarseae (0. T. articidations of the tarsus) 
each mdmdual ankle bone can move with its eartaaginous joint surface upon the corn ■s]„,u, lino- 
surfaces of the nciybboring tarsal Ijoues. The capsulae articulares of the individual joints 
thus arismg (see Pig. 271) are strengthened usually by short fibrous bands. 

Between the talus and the calcaneus are foun<l five ligamenta talocalcanea (0 T 
hgamcnts coimeeting the os calcis and the astragalus): (1) the ligamentum talocakaneum 
postenus (0. T. posterior calcaneoastragaL.id ligament) (see also Figs. 263 and 26.5), ge.'s 
fi-om the lateral projection of the processus posterior tali to the ujjper surface of the calcaneus 
immediately behind the fades artioularis posterior: (2) the ligamentum talocakaneum anterius 
(see Figs. 264 and 267) is a broad band of fibres which is stretched out in the sinus tarsi behind 
the hgamenta talocalcanea laterale et interosseuni. on the anterior side of the articulatio talo- 
calcanea (see p. 222 Text), between the lower surface of the talus- and the upper siu-face of the 
calcaneus, immediately in fi-ont of the facies articularis posterior; (3) the ligamentum talo- 
calcaneum mediate (0. T. internal calcaneoastragaloid ligament) (see Figs. 263. 265, and 269) 
is a narrow- bundle which extends from the medial tuljercle of the processus posterior tab 
almost horizontally to the posterior margin of the sustentaculum tali of the calcaneus: (4) the 
ligamentum talocakaneum laterale (0. T. external calcaneoastragaloid ligament) (see also 
Figs. 264 and 267) has a broad origin from the lateral and inferior surface of the celimn tali 
and runs at the entrance into the sinus tarsi obUquely dow-nward, forward and lateralward to 
the upper surface of the calcaneus; (5) the ligamentum talocakaneum interosseuni (0. T. 
interosseous Ugament) (see Figs. 264 and 267), fills up the sinus tarsi and consists of several 
broad, usually short, bands of fibres which go from the sulcus tali to the sulcus cal<-anei; in 
front it is partially covered over and sometimes only indistinctly separable fi'om the ligamentum 
talocalcaneum laterale. The sinus tarsi contains also masses of fat and in these, near the 
ligamentum talocalcanem-n, there is often a bursa, the bursa sinus tarsi (not figured). 

On the back of the foot are the following ligamenta tarsi dorsalia : the ligamentum 
talonavicular e [dorsale] (0. T. superior astragalonavicular Ugament) (see also Figs. 264 and 
265) extends as a broad hgament from the upper surface of the coUum tali to the upper 
surface of the os naviculare; the ligamentum Ufurcatum (see also Figs. 264, 267, and 271) 
has a broad origin near the anterior margin of the dorsal siu-face of the calcaneus in front 
of the ligamentum talocalcaneum laterale and divides fork-hke into the stronger pars cakaneo- 
navicularis (0. T. superior or external calcaneonavicular ligament), reaching wide Into the 
depth, which is attached to the posterior lateral angle of the os naviculare, and into the 
pars calcaneocuboidea (0. T. internal calcaneocuboid ligament) which goes to the upper sur- 
face of the OS cuboideum; the ligamentum cakaneocuboideum dorsale (0. T. external cal- 
caneocuboid ligament) (see also Figs. 264 and 267) runs lateralward from the preceding from 
the upper surface of the calcaneus to the upper surface of the os cuboideum: the ligamen- 
tum cuboidconaviculare dorsale (see also Figs. 264 and 267) stretches out between the upper 
surfaces of the os naviculare and the os cuboideum; the Hgamenta navicularicuneiformia 
dorsalia (see also Figs. 264 and 265) are fi-om four to five fibrous bands which exti'ud 
from the dorsal surface of the os naviculare to the upper surfaces of the three cunei- 
foi-m bones ; the two Hgamenta inter cuneiformia dorsalia, sometimes stUl further subdivided, 
pass transversely fi-om the dorsal surface of one cuneifoi-m bone to that of the adjoining bone; 
the ligamentum cuneocuboideum dorsale (see also Fig. 264) is a ligament (fi-ei|uently di-vided) 
extending fi-om the upper surface of the third cuneiform bene to that of the cuboid bone. 

The articniationes tarsometatarseae [Lisfranci] (0. T. tarsometatarsal articulations) 
are strengthened by six (or more) short Hgamenta tarsometatarsea dorsalia; these extend 
upon the dorsal surface of the ossa cuneiformia and from the os cuboideum straight or obliquely 
forward to the bases ossiiun metatarsaUum ; in this way the second metacarpal bone is eonneited 
with all three cuneiform bones. 

The articniationes intermetatarseae (0. T. articulations of the metatarsal bfiues 
with each other) possess three Hgamenta basium fossium metatarsaUum] dorsalia which are 
stretched out transversely between the dorsal surfaces of the proximal ends of the second to 
the fifth OS metatarsale. 



222 Joints of the Lower Extremity. 

Ligamentam ciiboideonaviculare dorsale. 



Ligamentuni calcaneo- 
naviculare planlare 



Sustentaculum 




Pars calcaneo- ] 

' navicularis [ ligamenti 

Pars calca- [ bifurcati 

neocuboidea J 



Os cuboideum 



Ligamentum 
calcaneo cuboideum dorsale 



Ligamentum talo- 
calcaneum laterale 

*, _ LigamenUim talocal- 
caneum interosseum 
Ligamentum talo- 
calcaneum anterius 



cut through 

close to 
attachment 



- Fades articularis posterior 
calcanei 



267. Joints of the right foot, articulationes pedis. 

viewed from the back of the foot. 

(The talus has heen removed as have also the cuneifoiin hones and the metacai-pal hones, the 
capsulae articulares have heen removed except for the strengthening ligaments.) 

The talus is moveably united vrith the calcaneus and with the os nancidare with constant 
formation of two separate joint cavities (see also Fig. 271). The posterior joint cavity is 
situated between the fades articularis calcanea posterior of the talus and the fades articularis 
posterior of the calcaneus; this union is called the articulatio talocalcanea ; its capsula 
arliculuri.1 goes off from the bone usually near the margins nf the cartilaginous surfaces; the 
strengthening ligaments belonging hero are the ligamenta talocalcanea posterius, anterius et 
mediale (see p. 221). The anterior joiut cavity lies between the facies articulares calcaneae 
media et anterior of the talus and thr fades articulares media et anterior of the calcaneus 
as well as between the facies articularis navicularis of the talus and the proximal joint surface 
of the OS naviculare; besides, the joint cnucavity is made still more complete for the caput tali 
by means of tlie ligamentum ealcaneuuavictdare plantare (see ]>. 224) and the fibrocartilago 
navicularis enclosed in this, as well as by the pars calcaneiaiavirularis ligamenti bifurcati (see 
p. 221); this antrriiu- joint union is known as the articulatio talocalcaueouavicularis ; 
its most anterior portion is also loiown separately as the articulatio talonavicularis ; its 
capsula articularis leaves the bones fnr the most part near the margins of the cartilaginmis 
surfaces ; lying close upon thi> capsule, as a strengthening ligament of tht^ same, is the liga- 
nientuni talonaviculare [dorsale] (see p. 221) while the ligamenta talocalcanea laterale et inter- 
ussi'uui (see j). 221) are seiiarated from it by masses of fat; in addition, the ligamentimi 
calcauronaviculare plantare and the pars calcaneouavieularis ligamenti bifurcati have to be 
designated as streiigthcniug ligaments. 



Jointf? of the Lower Extremity. 



223 



Ligamenta basium 

[ossium metatarsalium 

plautaria 



Tendo in. peronaei longi 



Ligamentum plantare longu 




— Tejido 111. peronaei longi 

_ Tendo ni. tibialis ant, 
(cut through) 



— Os cuneiforme I 

—Ligamentum naviculari- 
ouneiforme plantare 

--Tendo m. tibialis 
posterioris 

--Os naviculare 

.__ Ligamentum cuboideo- 

naviculare plantare 
_Ligamentum calcaneo- 

naviculare plantare 
- Ligamentum calcaneo- 

cuboideum plantare 

_Tendo m. flexoris digitorum 
longi (cut through) 

.- Tendo m. flexoris hallucis 
longi (cut through) 

. Tendo m. tibialis posterioris 
(cut through) 



Deep layer of the ligamentum 
laciniatum 



268. Joints of the right foot, arficulationes pedis, 

viewed from the sole of the foot. 

(The ossa metatarsalia have been sawed through in the middle, the capsulae articiilares with 
the exception of the strengthening ligaments have been removed.) 

Of the ligamenta tarsi plantaria in the soli> of the foot the strnngost is the liga- 
mentum plantare longum (0. T. long calcaneocuboid or long plantar ligament) (see also 
Fig. 269). It is very broad and powerful, arises from the lower surface of the calcaneus in 
front of the tuber calcanei and extends with its main mass to the tuberositas ossis cuboidei. 
As a continuation of its most superficial bundles it sends thin diverging fibrous strips to the 
proximal ends of the ossa metatarsalia which bridges over the groove for the tendon of the 
ra. peronaeus longus. 



224 



Os cuboideum. 



Sulcus 111. peronaei 
[longij 
Tuberositas ossis 
cuboidei 



Deep layer of the 

ligaraentum plantare 

loiigum 



Calcaneus 



Joints of the Lower Extremity. 

Ligamentuin calcaneoeuboideum plautare 

Ligaiuentum cuboideonaviculare plantare 

'A, 

-^ -Os naviculare 



Groove for the tendo 
m. tibialis posterioris 

Fibrocartilago navicularis 

Ligamentum calcaneo- 
naviculare plantare 

Talus 




__ Sulcus ni. flexoris hallucis 
lougi 
Groove for the tendo 
''' m. flexoris digitorum longi 

'-_'' .._ Ligamentum talocalcaneum 
mediale 



269. Joints of the right foot, articulationes pedis. 

viewed from the sole of the foot. 

(The cuneiform bones and the metacarpal hones have been removed, the supei-ficial Liver and 

the most anterior processes of the ligamentimi plantare longum have been cut off, the capsulae 

artionlares except the strengthening ligaments have been removed.) 

Ligamenta tarsi plantaria (continuation). The ligamentum calcaneoeuboideum plan- 
tare (0. T. short calcaneocuboid or short plantar ligament) (see also Fig. 2(i8) is a broad band 
of short fibres which go from the anterior end of the lower surlace of tlie calcaneus to the 
lower surface of the os cuboideiun; they are partially covered by the ligamentum plantare 
longum which lies more superficially and is more or less intimately fused with it. 

The ligamentum calcanconaviculare plantare (0. T. inferior calcaneonavicular ligament) 
(see also Figs. 265, 267 and 268) arises as a thick, broad mass of fibres from the anterior 
and medial margin of the sustentaculum tali of the calcaneus and is fastened to the posterior 
end of the inferior and medial surface of the (js navicidare. The ligament, the bands of which 
extend essentiall}' from behind forward and comiect dorsalward with the ligamentmn tibio- 
naviculiire, fonns a trough which is cnucave upward and latcralward (see Fig. 26'): its upi>er 
coucave siirliuT is lined by synovial membrane, belongs to the articulatio talocalcaueonavicularis 
and forms a part of the socket for the caput tali (see p. 222). At the junction of the inferior 
with the medial surface a slightly curved tiliro-cartilagiuous disc, fibrocartilago navicularis, is 
eiicliised. The medial, inleriur sui'fa<'e of the ligament is hollowed out to form a shallow groove 
and servi's for the receptiuu of the tendon of the m. tibialis posterior. 



Joints of the Lower Extremity 



22: 



Ligaiiieiitinii 
cuneoiuetatarseuin iiiterosseum 



Ligameuta basium 
[ossium metatarsalium] -vVf- 
plantaria 



Ligameuta tarso- 
metatarsea plantaria 



Sulcus m. peronaei — 

[longij 

Tuberositas ossis cuboiclei- 



Os cuboideum — 




Os cuneifornie I 



Tagamenla intereunei- 
lormia plantaria 

Ligamenta Daviciilari- 
I'uneiformia plantaria 



-- t)s naviculare 



Ligiimentum cuueocuboideum plantare 



Liganientum cuboideoiiaviculare plantare 



270. Joints of the right foot, articulationes pedis, 

viewed from the sole of the foot. 

(The calcaneus and talus have been removed at the so-called articulatio tarsi ti-ansversa 

[Chopai-ti]. The os metatarsale I has been completely excised, the ossa metatarsalia n — V 

have been sawed through in the nriddle; the capsulae articulares, with the exception of the 

streng-thening ligaments, have been removed.) 

Ligamenta tarsi plantaria (continuation). The Ugamentum cuboidconaviculare plan- 
tare (see also Figs. 268 and 269) stretches out between the plantar surfaces of the os cuboidemn 
and the os naviculare. The ligamenta navicnlaricaneiformia plantaria (see also Figs. 265 
and 268) are three short bands of fibres passing directly or obliquely forward, which extend 
fi'om the plantar surface of the os naviculare to the plantar surfaces of the ossa cuneiformia. 
The two ligamenta intercuneiformia plantaria run as short fibre bimdles transversely between 
the plantar surfaces of the ossa cuneifomiia. The Ugamentum cuueocuboideum plantare goes 
as a broad band from the under surface of the os cuneifoi-me III obliquely lateralward and 
backward to the plantar surface of the os cuboideum. 

The articulationes tarsometalarseae [Lisfranci] have a large number of strengthen- 
ing ligaments, ligamenta tarsometaiarsea plantaria, which, partly shorter, partly longer, run 
on the plantar surface from the ossa cuneiformia and fi-om the os cuboideimi to the bases 
ossium metatarsalium. 

The articnlationes intermetatarseae are strengthened by three ligamenta basium 
[ossium metatarsalium] plantaria (see also Fig. 268) which spread out on the plantar sur- 
face transversely between the proximal ends of the second to the fifth metatarsal l)oue. 

Spalteholz, Atlas. 15 



226 



Joints of the Li.iwer Extremity. 



Ossa metatarsalia 



Ligameiitum 
cuneometatarseum -, , ^ 
, _ interosseum ^ 

Artie ulati ones 
tarsometatarseae —---T 
[LisfranciJ 

Ligament um 
intercuneiforme^-- 

interosseum 
Os cuneiforme I .-_ 

Articulatio 
cuneoiiavicularis — - 



Os iiaviculare_. 



Articulatio 
talocalcaneoiiaviculari 



Ligamentum deltoideum 



Ten do t_^, 

111. tibialis postcrioris '" V*» 




Ligamenta basiiiiii 

---■"s-loss, metatars.] inter- 
ossea 



Articulationes 
intermetatarseae 



Ligamentum cuneocxi- 
boideum interosseum 



_0s cuneiforme III 



. . _ Os cuboideum 



Pars calcaneonavicularis 
ligamenti bifurcati 

Articulatio calcaneocuboidea 



. Ligamentum talocalcaneum 
iuterosbeum 

,- Calcaneus 
Articulatio talocalcanea 

- Articulatio talocruralis 

. , Ligamentum calcaneofibiilare 

- Syndesmosis tibiofibularis 



271. Joints of the right foot, articulationes pedis. 

from the back of tlie foot. 



(Thi' Kill-face of a frozen foot has been filed oil' until the joint cavities have been ojieneil.) 



Joints of the Lowrr Extremity. 2'Ti 



Articulationes pedis. The joint cavities of the articulatio talocalcanca and of the 
articulatio talocaicaneomwiculans (see p. 222) are comiik'trly closed off not only from one 
another, hut als,, from the neighboring joint cavities; th(.- articulatio ialonavicalaris is ...nly 
a part of the articulatio talocalcaneonavicularis. 

In the formation of the articulatio calcancocuboidea the facies articidaris cuhoidea of 
the calcaneus moves upon the proximal joint surfac- of the os cuhoideum; its capsula arti- 
cidaris arises cLjse to the margins of the cartilaginous surfaces: the joint i-avity is not 
connected witli adjoining ones. The articulatio calcaneoeuboidea and the articulatio talonavi- 
cularis are also designated in common by the name articulatio tarsi transversa [Choparti]. 

The articulatio cunconavicularis is the joint lietwcm the distal surface of the os 
navieulare and the proximal surfaces of the ossa cuneiformia ; the capsula articularis sniToamh 
these joint surfaces b\it in addition also those by which the ossa cuneiformia articulate with 
one another and those by which the os cuhoideum glides upon the os cuneiformc III and on 
the OS navieulare; the capsule is attached everywhere close to the margin of tlje cartilaginous 
surfaces. The joint cavity is connected as a rule, between thi^ first and second cuneiform 
bones with the cavity of the articulatio tarsometatarsea of the os metatarsale II (and thr..ugh 
this also with that of the os metatarsale III); short ligaments extend in the de])th lietwecn 
the cuneiform bones and also between the third cimeifbrm bone and the culioid lione ; two 
ligamcnta intercuneiformia interossca and one lijamentum cuneocuboideum interosseum. 

In the fonnation of the articulationes tarsometatarseae [Lisfranci] the proximal joint 
surfaces of the bases ossium metatarsaliura are in contact with the distal joint surfaces of 
the ossa cuneiformia and of the os cuhoideum. The places of junction form, in general, a 
surface convex from the medial toward the lateral side, which suffers interruption at the os 
cuneiforme II, in that the os metatarsale II reaches further proximalward than the othei-s. 
Usually three separate joint capsules are present: The first between the os cuneiforme I and 
OS metatarsale I, the second between the ossa cuneifnrmia II et III and the ossa meta- 
tarsaha 11 et III, the third between thi^ os cuhoideum and ossa metatarsalia IV et V; the 
joint cavity of the second is usually connected with that of the articulatio cum'imavicularis. 
From the lateral surface of the os emieiforme I and fi'om the medial sm'face of the ns cunei- 
forme in short ligamcnta cuneometatarsea interossea (see also Fig. 270) run in the depth 
to the adjoining surfaces of the basis ossis metatarsalis II. 

The articulationes intermetatarseae are formed in that the proximal ends of the 
second to the fifth os metatarsale are in contact, with the cartilaguious surfaces opposed 
to one another. The joint slits communicate with those of the corresponding articulatio tarso- 
metatarsea; the capsulae articulares arise from the bone close to the margin of the carti- 
laginous surfaces. Four ligamcnta basium [ossium metatarsalium] interossea extend, in the 
depth, between the neighboring surfaces of the bases ossium metatarsalium. 

The articulationes metatarsophalangeae and the articulationes digitorum pedis (0. T. 
articulations of the phalanges) present as regards their capsules and ligaments, essentially tlie 
same relations as do the corresponding joints in the hand (see Figs. 241 and 242). 



lb" 



228 



Structure of the Bones. 



Above 



Behind 




Inifront 



Bel on' 



272. Lumbar vertebra, vertebra lumbalis, 

ground sagittal section, from the side. 



Above 



Right 




Below 



lieft 



273. Lumbar vertebra, vertebra lumbalis, 

ground frontal section, from in front. 



structure of the Bones. 



229 



Behind 



Right 




I/eft 



In front 



274. Lumbar vertebra, vertebra lumbalis, 

ground horizontal section, from above. 



230 



Structure of the Bones. 




275. Right upper arm bone, humerus, upper extremity, 

ground frontal section, from in front. 



.StriR-tm-i' of the Donps. 



23 




276. Right thigh bone, femur, upper extremity, 
ground frontal section, from in front. 



232 



Structure of the Bones. 



Epiphyseiil_ 
junction 




277. Right thigh bone, femur. 

inferior extremity, 
ground frontal section, from in front. 



Stnictmv of the Bones. 



233 



Epiphyseal 
junction 




278. Right shin bone, tibia, upper extremity, 

ground frontal section, from in front. 



^34 



Structure of the Bones. 




. _ Epiphyseal 
junction 



279. Right shin bone and calf bone, 

tibia and fibula, inferior extremity, 
ground frontal section, from in front. 



Strufture of the Bonos. 



235 




280. Right heel bone, calcaneus, 

ffround sagittal section, viewed from the side. 



Printed by Fischer & Wittig, Leipzig.