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fQ 



HAND-ATLAS 



OF 



HUMAN ANATOMY 



BY 

wernp:r spalteholz 

EXTRAORDINARY PROFESSOR OF ANATOMY IN THE UNIVERSITY AT LEIPZIG 



EDITED AND TRANSLATED FROM THE FOURTH GERMAN EDITION 

BY 

LEWELLYS F. BARKER 

PROFESSOR OF THE PRINCIPLES AND PRACTICE OF MEDICINE, JOHNS HOPKINS UNIVERSITY, BALTIMORE 
FORMERLY PROFESSOR OF ANATOMY IN THE UNIVERSITY OF CHICA(,0 AND RUSH MEDICAL COLLEGE 



WITH A PREFACE 

BY 

FRANKLIN P. MALL 

PROFESSOR OF ANATOMY IN THE JOHNS HOPKINS UNIVERSITY AT BALTIMORE 

SECOND EDITION T\ ENGLISH 
VOL. II. 

REGIONS, MUSCLES, FAS CL4Z, HEART, BLOOD-VESSELS 

PHn.ADELPHIA AND LONDON ^^ 

J. B. LIPPINCOTT COMPANY ^ 



ALL RIGHTS RESERVED 



II. 



REGIONS, MUSCLES, FASCI/E, 
HEART, BLOOD-VESSELS. 



Regions of the Body. 



237 



Eegio orbitalis 
Regio palpebralis superior i Begio supraorbitalis 

Eegio palpebralis inferior 

Regio nasalis 



Regio frontalis 



- Regio temporalis 

- Regio parietalis 

- Regio auricularis 




Regio infraorbitalis 

Regio zygomatica 

Regio labialis superior 
Regio oralis __^ 
Regio labialis inferior , 

Regio buccalis 
Regio parotideo- 
luasseterica 
Regio nientalis 

Regio submaxlllaris 
Regio submentalis 

Regio hyoidea 
Regio subhyoidea 

Regio laryngea - 
Fossa carotica 

Regio thyreoidea - - 
Regio 
sternocleidomastoidea 

Regio 
suprasternalis 



Fossa jugularis 



Fossa supraclavicularis minor 



Trigonum omoclaviculare 



Fossa infraclavicularis 



Regno infraclavicularis 
Regio clavieularis 



281. Regions of the head and neck. 



Spalteholz . Atlas. 



16 



238 



^JlRogioDs (if the Body, 



It. aiitibracliii 
volaris 

Resio antibrachii 
ulnaris 
I{. antibrachii dorsalis 
llegio cubit i anterior -- 
Regio cubiti medialis''^^. 
i;egio cubiti posterior ' ,- 
Regio olecrani y 
Regio brachii anterior 
Regio brachii medialis 




Regio pudendalis 

Regio fenioris lateralis 
Kegio fenioris anterior 

Regio fenioris medialis 



Regio iiarietalis 

- Regio frontalis 

- Kegio temporalis 
Regio orhitalis 
" Regio nasalis 

Regio oralis 

Regio mentalis 
Regio colli anterior 

Regio sternocleidomastoidea 
Regio acromialis 
---Fossa iiifraclavicularis 
Regio infraclavicularis 
-Regio axillaris 
-Regio deltoidea 
-Kegio nianimalis 
-Regio sternalis 
--Regio iiifranjammalis 
--Regio brachii lateralis 
-- Regio brachii anterior 

- Regio cubiti lateralis 

- Regio cubiti anterior 

"-- Regio antibrachii volaris 

Regio antibraeliii 
radialis 

Regio antibrachii 
dorsalis 

Regio dorsalis nianus 

Kegiones dorsalcs 
digitorum 



Regio cruris anterior 

Regio cruris posterior 

Regio cruris lateralis 

Regio cruris medialis 

Regio rctronialleolaris medialis 

Regio malleolaris medialis 

Regio dorsalis pedis 

Regio calcanea 

Regiones ilorsales digitornin gJ-'-i- 



282. Regions of the body, viewed tKun in tVont. 



Kegions of the Body. 



239 



Kegio pariutalis 

Eegio temporalis . 

Eegio occipitalis-- 

Regio mastoidea 

Fovea iiuchae-- 

Eegio imchae-- 

Eegio siiprascapularis^ 

Eegio acroiiiialis, 

Eegio deltoidea 
Eegio mediana dorsi 

Eegio scapularis.. 

Eegio bracliii inedialis - 

Rcsjio bracliii posterior 
Eegio brac-hii lateralis 
Eegio culiiti lateralis. 

Eegio olecrani ._ 
Eegio cubiti posterior 
R. antibrachii dorsalis. 

E. antilirachii uhiaris., 
F!. antibrachii volaris - 

Eegio volaris maims .. 

Eegiones 
volares digitorvim 




-Eegio cubiti lateralis 
Eegio cubiti posterior 
Eegio olecrani 



- Eegio bracliii anterior 
Eegio bracbii lateralis 
Eegio bracbii posterior 
"Fossa axillaris 
Z^"''- Eegio interscapularis 
"---Eegio pectoris lateralis 

~~-Eegio infrascapularis 

Eegio liypocbondriaca 
'-- Eegio lumbalis 

"Eegio abdomiiialis lateralis 
Eegio coxae 
- Eegio satralis 
Eegio trochauterica 
Eegio perinealis 

Eegio glutaea 

-Eegio femoris niedialis 
_ Eegio femoris posterior 

. Eegio femoris lateralis 



Eegio genu posterior 



Eegio suralis 

Eegio cruris lateralis 

Eegio cruris posterior 

Eegio retronialleolaris lateralis 
Eegio malleolaris lateralis 

^ Eegio calcanea 

Eegio dorsalis pedis 
- Eegio plantaris pedis 
_ Eegiones jilantares digitorum 



283. Regions of the body, viewed from behind. 



16^ 



240 



Eogio 
urogenitalis 



Eegio analis 



Eegions of the Body. 

Regio pudendalis 




Kegio glutaea 



Eegio sacralis 



284. Regions of the male perineum, 



Eegio pudondalis 




Eegio 
urogenitalis ' 



Eegio analis 



Eegio sacralis 



Eegio glutaea 



285. Regions of the female perineum 



Muscles of thfr Head. 



241 



M. auricularis anterior 

M. auricularis 
superior 



Galea aponeurotica 



M. frontalis 




Ligamentuui 

palpebrals 

mediale 

M. orbicul. oculi . 

Caput 



angulare 

Caput 
infraorbit. 

Caput 
zygomatic. 



ui. 
<Hiadrati 

labii 
superior. 



Fascia parotideo 
ruasseterica 



M. sterno- 
cleidomastoideus 



M. caninus 



M. zygomaticus 



M. risorius 
M. quadratus 
labii iuferioris 

INI. triangularis 

M. traiisversus menti 



286.JVIuSCleS of the head and face, viewed somewhat from the right. 



242 



Muscles of the Head. 



Galea aponeurotica 




.nS;^"'f\v5..v~'^. 



JSr. frontalis 




M. procerus 



M. orbicularis 
oculi 



]sr. zygoniaficus 



Sulcus nasolabialis 



M. iiasalis 
(pai's transversa) 



Caput zygoniaticum, 

: Caput infraorbit ale , "'.-. I"'*'^'^"' . 

i labu superioris 

Caput angulai'e ' 



287. Muscles of the head and face, vioAved from in front. 

Miisciiliis cpicraiiiiis. Jmii-ih: Ihit, broad. Position : cuvers the roof of the skull. 

J'oskrior jxirl, ticsliy : in. occipitalis (see Fig. 296). Origin: lineae niichae supreniae 
OSS. occipitalis. Insertion: galea aponeurotica. Action: draws the galea backward. 

Middle portion, tendinoiis: galea aponeurotica, largo flat tendon inserted between 
ni. occipitalis and ni. frontalis: lodsoly and ninvably uniti'd with thi' jieriosteum, very firuily 
connected with the cutis. 

Antoior portion, fleshy: m. frontalis (see also Fig. 2S6). Origin: galea aponeurotica. 
Insertion: slcin of the eyebrows, ossa nasalia (latter portion callinl ni. procerus). Action: 
draws eyebrows u])ward, wrinkles forehead transversely; moves galea apdueurotioa. 

Innervation : n. facialis. 

31. <|iia(lratus labli superioris (see also Fig. 286). Form: Hat, triangular. Po- 
sition: lateral from the nose; origins partly covered by ni. orbicularis oculi. Caput angular e. 
Origin: proc. frontalis maxillae. Insertion: skin of the ala nasi and of the sulcus 
nasolal)ialis. Cajiut iiifraorhilalc. Origin : margo infraorhitalis. Insertion: sulcus 
nasolabialis. Caput zygoniaticum. Origin: facies malaris oss. zvgomatici. Insertion: 
sidcus nasolabialis. Action: draws ala nasi and upper lip outward and upward, Avidens 
nasal ojieniiig and decjiens the sulcus nasolabialis. Innervation: n. facialis. 



jVIusclcs of the Hea 



ead 



243 



Eyebrow 



Pars iirliitalis m. orbicularis ociili 

Pars paljicbralis 
in. orbicuUiris oculi 




M. corrusator 



Ligamentuiu jjalpe- 
brale luediale 




''^M \ 



Pars lacrimalis m. orbicularis oculi 
(The overlying parts of the pars orbitalis have only been di-awn to one side.) 



288. Muscles of the right eyelid, viewed from in front. 



8inus frontalis 



Pars lacrimalis 
lu. orbicularis 
oculi 



Cellulae 
ethiuoidales 



Cavuiii nasi 



M. corrugator 

The upper limit of the tarsus superior is 

igji^jSj^.^, _ '( indicated by the dotted lino 




Kaphe palpe- 
bralis lateralis 



The lower limit of the tarsus inferior 
is indicated bv the dotted line 



289. Muscles of the right eyelid, viewed from behind. 

M. orbicularis oculi (.see also Fig-s. 2S(i ami 2S7). Form: flat, elliptical. Position: 
ill the eyelids and at their periphery. Pars orbitalis. Origin: pars nasalis oss. frontalis, 
crista lacrimalis anterior maxillae, anterior limb of the lig. palpebrale mediale: the fibres 
surround the eyelids in flat, concentric arches anc! ffiterweave with one another lateralward fi-om 
the external angle of the eye or go to a thin, horizontal band of connectivi^ tissue (Raphe 
palpehralis lateralis) which extends from the external angle of the eye to the lateral margin 
of the orbit. Action: draws the eyebrow downward, the skin of^he cheek upward; helps to 
close the lids. Pars lacrimalis [ Horueri] . Origin: crista lacriuialis posterior oss. lacrimalis ; 
it runs lateralward l)ehind the tear-sac to the medial angle of the eye and spreads out thin 
within the lids corresponding in extent to about that of the tarsi. In the lids it forms the 
pars palpebralis. Action: widens tear-sac, closes eyelids. Innervation: n. facialis. 



244 



Muscles of the Head. 



M. eaU|imis ] M. incisivus labii superioris 

I I Pars transversa m. na1?alis 



Orbita 



M. zygomaticus 
Glandula parotis. 




M. depressor 

septi 

'^ Pars alaris 

m. iiasalis 



M. orbicularis 
oris 



M. inassetei 



M. buccinator ; 

M. triangularis 

M. incisivus labii inferioris 



M. nrentalis 



290. Muscles of the region of the mouth, 

viewed somewhat from the right side. 
(Platysma, mm. risorius, quadrati and orbicularis oculi havo Ijccn removed.) 



M. quadratus labii superioris jSi. incisivus labii superioris 
M. caninus ; ; ^j orbicularis oris 

M. buccinator ' ; ^ ^n-^H. 




M. triangularis 



M. nientalis 
Af. cjuailratus la)iii inferioris M. incisivus labii inferioris 



291. Muscles of the region of the mouth, viewed from behind. 

(The tissues about the uiuutli have been loosened from their bony substratum and the muscles 
liave l)een dissected out from the posterior surface.) 



Muscles of the Head. 245 

M. cornig'ator (see Figs. 288 289). Form: flat, narrow. Position: near the root 
of the nose, extending upward and lateralward. Origin: pars nasalis oss. frontalis. In- 
sertien: skin of the eyebrow. Action: causes longitudinal folds at the side of the rout 
of the nose. Innervation: n. facialis. 

M. nasalis. Form: flat, triangular. Position: lateralward from and helow the ala 
nasi," partly cdvered by the m. ([uadratus labii superioris. 

Pars transversa. Origin: jugimi alveolare of the upper canine tooth. Insertion: to 
the dorsum of the nose spreading out by a thin tendon to the muscle of the other side. 

Pars alar is. Origin: jugum alveolare of the upper lateral incisor tooth. Insertion: 
lateral and lower margin of the ala nasi. 

Action: draws ala nasi downward, narrows nasal opening. Innervation: n. facialis. 

M. depressor septi. Form: flat, quadrangular. Position: below the nose, just 
raedianward from the preceding muscle. Origin: jugum alveolare of the upper medial incisor 
tooth. Insertion: septum nasi. Action: draws nasal septum downward, narrows nasal 
openings. Innervation: n. facialis. 

M. risoriiis (see Fig. 286). Form: flat, triangular: very variable. Position: lateral 
from the angle of the mouth, upon the platysma. Origin: fascia parotideoraasseterica. 
Insertion: .unites at the angle of the mouth, or somewhat below it, with them, triangularis. 
Action: helps to draw the angle of the muuth lateralward; causes dimple. Innervation: 
n. facialis. 

M. zygomaticHS (see also Fig. 286). Form: oblong, flat-cylindrical. Position: 
lateralward from and above the angle of the mouth. Origin: facies malaris oss. zygomatici. 
Insertion: skin of the angle of the mouth ; some of the fibres go over into the 
m. orbicularis oris. Action: draws the angle of the mouth lateralward and upward. 
Innervation: n. facialis. 

M. caiiinus (see also Fig. 286). Form: flat, triangular. Position: in the fossa 
canina covered by i^a m. quadratus labii superioris; comes to the surface between the latter 
and the m. zygomaticus. Origin: fossa canina. Insertion: with converging fibres, partly 
to the skin of the angle of the mouth: partly the fibres go over arch-like into the lower 
lip. Action: draws the angle of the mouth upward; the muscles of the two sides together 
lilt the lower lip and help to close the mouth. Innervation: n. facialis. 

M. triangularis (see also Figs. 286 and 297). Form : flat, triangular. Position: below 
the angle of the mouth; covers the foramen mentale. Origin: just above the basis mandibulae 
below the foramen mentale. Insertion: with converging fibres to the angle of the mouth and, 
in largest part, arch-like into the upper lip. Single bundles sometimes connect the muscles of 
the two sides below the chin ; they lie upon the platysma as the m. transversus meuti (see 
Fig. 297). Action: draws the angle of the mouth dowmward ; the muscles of the two sides 
together draw the uppi-r lip down and help to close the mouth. Innervation: n. facialis. 

M. quadratus labii inferioris (see also Figs. 286 and 297). Form: flat, quadrangular. 
Position: IteLjw tlie lateral part of the mouth opening, for the most part covered bj' the 
m. triangularis. Origin: the upper part is a direct continuation of the platysma, the lower 
part arises from the basis mandibulae. Insertion: skin of lower lip. Action: draws the 
lower lip lateralward and downward. Innervation: n. facialis. 

M. incisiviis labii superioris (see also Fig. 293). Form: flat, triangular, narrow. 
Position: above the angle of the mouth, covered by the m. quadratus labii superioris, at the 
upper margin of the ni. orbicularis oris. Origin: jugum alveolare of the upper canine tooth. 
Insertion: arch-like to the angle of the mouth, interwoven there with the other muscles. 
Action: draws the angle of the mouth median ward and upward. Innervation: n. facialis. 

M. incisivus labii inferioris (see also Fig. 293). Form: flat, quadrangular, narrow. 
Position: below the angle of the mouth, covered by the m. quadratus labii inferioris, at the 
lower margm of the m. orbicularis oris. Origin: jugum alveolare of the lower lateral incisor 
tooth. Insertion: to the lower margm of the m. orbicularis oris, iirterweaving with it. Action: 
draws the angle of the m.outh medianward. Innervation: n. facialis. 

M. orbicularis oris, a muscle-plate situated in the lips which owes its formation to 
the fact that the muscles going to the mouth opening, at the angles of the mouth, partly 
radiate out into the upper or lower lip. The fibres run in the lips for the most part trans- 
versely, at the angles of the mouth also arch-like between the two lips and are attached in 
part to the external skin. In this way a sort of ring muscle is formed. Action: if it con- 
tracts alone it closes the mouth and points it. Innervation: n. facialis. 

M. mentalis. Form: thick, cyUndrical, short. Position: on the chin. Origin: 
jugum alveolare of the lower medial incisor tooth. Insertion: obhquely downward into the 
skin of the chin. Action: lifts the skin of the chin and wrinkles it. Innervation: n. facialis. 



246 



Muscles of the Head. 




Fascia Icniporalis 



292. Fascia 
temporalis and m. masseter, viewed from the right side. 

Fascia parotideomasseterica (see Fig. 286) covers the lateral (and medial) surface of 
the glandula parotis as a thick nieuibrane, the in. masseter as a thinner membrane, and becomes 
lost mrdianward 1)elow the m. zygomaticus, platysma and m. risoriiis. 

Fascia temporalis, very dense, covers the fossa temporalis externally, arises from the 
linea temporalis .superior, divides below into two layers, separated usually by fat, and goes to 
the medial and lateral surface of the arcus zygomaticus and the os zygomaticum. 

M. masseter. Form: Hat, (juadrangular, thick. Position: immediately upon the 
lateral surface of tlie raums mandibulae; behind partly covered over by the glandula parotis: 
in front and below covered by the platysma. It consists of two layers which are separated 
fmrn one another distinctly behind only ; the external layer is the longer and broader. Origin: 
external layer: anterior and middle part of tlie arcus zygomaticus (tendon of origin jagged, 
reaching far downward): internal layer: middli' and posterior part of the arcus zygomaticus. In- 
sertion: external layer: ohli(|uely backward and downward to the lateral surface of the angulus 
mandibulae and its periphery; internal layer: downward and somewhat forward to the lateral sur- 
face of tlif ranms mandibulae. Action : lifts the lower jaw. In ncM'vation : n. massetericus (V. 3). 



Muscles of the Head. 



247 




M. temporalis 

Tuberculuni articulare 

Os zygomaticum (sawed througli) 

Ductus parotideus 
(cut through) 

M. bucciuator 



293. 

IVI. buccinator 
and m. temporalis, 

viewed from the riglit side. 



]\I. incibivus labii sinjerioi is 

Mm. zygomaticus, caninus, triangularis 
(cut through) 



M. inq^ivus 
labii inferioris 



(The arcus zygomaticus has been sawed away at its origins, the joint of the lower jaw having 

been opened at the same time.) 

M. temporalis. Form: flat, triangular, broad and thin above, narrow and thick behiw. 
Position: covered by the fascia temporalis and the arcus zygomaticus; it fills up the fossa 
temporalis completely. Origin: the Avhole extent of the fossa temporalis and medial surface 
of the fascia temporalis Insertion: the anterior fibres run vertically, the posterior almost 
horizontally and markedly curved: all the fibres converge to the processus corunoideus mandibulae 
and descend deep to its medial surface. The tendon reaches in a jagged form as far as 
half the height of the muscle on its lateral surface. Action: lifts the lower jaw and draws 
it somewhat backward. Innervation: nn. temporales profundi (Y. 3). 

Fascia buccopharyiigea, very thin, covers the lateral surface of the m. buccinator; 
it becomes lost in front at the angle of the mouth, is stretched out as a denser cord between 
the hamulus pterygoideus and the posterior end of the crista buccinatoria [mandibulae] as the 
raphe pteryr/omandibularis (see Fig. 294) and goes over behind ujjon the outer surface of the 
nmscles of the throat. 



248 



Muscles of the Head. 




Tuberculum articulare 



'SI. pterygoideus externus 



M. pterygoideus internus 



Kaiibe pterygoniandibularis 

Ductus parotideus (cut through) 

M. buccinator 



294. Mm. pterygoidei of the right side, external view. 

(The arcus zj'gomaticus has been removed as m Fig. 293 : the processus coronoideus and an 
adjacent piece of bone have been chiselled out of the rannis mandibulae.) 

M. buccinator (see also Figs. 290, 291 and 293). Form: ilat, oblong-quadrangular, 
thin. Posit i<Hi: beneath all the other muscles of the mouth like a transverse, curved band ; 
close to the mucous membrane of the cheeks and lips, along the rows of teeth. Origin: rajihe 
pt^^Tj'goraandibularis , lateral surface of the i)rocssus alveolaris maxillae and the crista bucci- 
natoria (or corresponding portion) of the lower jaw bone. The fibres run partly parallel, 
partly they decussate into the upper and lower lip at the angles of the mouth and there 
go over into the fibres of the muscles of the other side. In the li])S it forms the deepest 
layer of the m. orbicularis oris. Action: it draws the angle of tln' mouth lateralward, closes 
the mouth opening, presses the lips and cheeks upon the teeth. Innervation: n. faciaUs. 



2iluscles of the Head. 



249 



Pars basilaris 
OSS. opcipitalis 
(sawed through) 



Vomer 
Fossa pterygoidea - 
Caviim nasi 

Palatum durum 
Hamulus pterygoideus 







Os temporale 
(awed tiirough) 

Arcus zygomaticus 



Processus condyloideus 
mandibulae 

M. pterygoideus externus 



M. masscter 



Eamus mandibulae 



M. pterygoideus intcrnus 



Corpus mandibulae 



295. Muscles of mastication on right side, 

viewed from behind and somewhat medianward. 
(The posterior half of the skixll has been removed.) 

M. pterygoideus externus (see also Fig. 294). Form: triangular, thick. Position: 
in the fossa infra temjioralis , covered lateralward by the m. temporalis, arcus zygomaticus and 
m. masseter. Origin: by two heads; upper head: flat, from the crista infratemporahs and the 
facies inft-a temporalis of the great wing of the sphenoid ; lower head : rounded, partly from the 
lamina lateralis proc. pteiygoidei and from the processus pyramidalis oss. palatini, partly from 
the tuber maxiUare. Insertion: the fibres run converging backward and lateralward to the 
fovea pterygoidea proc. condyloidei mandibulae, partly also to the anterior surface of the capsula 
articiilaris and of the discus artieularis of the joint of the lower jaw. Action: draws the 
niandibula forward, the proc. condyloideus and discus artieularis under the tuberculum articulare; 
when it acts on one side alone it draws it somewhat toward the other half of the body. 
Innervation: pterygoideus externus (V. 3). 

M. pterygoideus internus (see also Fig. 294). Form: oblong -quadrangular, thick. 
Position : on the medial side of the lower jaw, in a direction similar to that of the ra. masseter; it 
is covered lateralward partly by the m. pteiygoideus externus, m. temporalis, ramus mandibulae 
and m. masseter. Origin: fossa pterygoidea, by a small part also (lateralward fi'om the 
m. pterygoideus externus) fi-om the corpus maxillae. Insertion: by parallel libres downward, 
backward and somewhat lateralward to the medial surface of tbe angidus mandibulae and its 
neighbourhood. Action: hfts the lower jaw; when it acts on one side only it draws the jaw 
toward the opposite side of the body. Innervation: n. pterygoideus internus (V. 3). 



250 



.Mu8eL 



es 01 



the Head. 



Pi-dtuberamia 
occipitalis externa 

M. transversus 
nuchae 

Space for the passapo 
of IliP ii. and V. occi- 

liitalis and tliey" 
n. occipitalis majoi' 

M. semispinalis 
capitis 



M. splenitis capi- 
tis et cervicis . 




Galea aponeurotica 



, M. aiirictilaris 
superior 

]M. occipitalis 



M. auricularis 
posterior 



Auricula 



- M. sternocleiclomastoideus 



M. tra- 
pezius 



296. 

Right occipi- 
tal and cervi- 
cal muscles, 

viewed from behind. 

31. aiiricHlaris anterior (0. T. attralieiis aureni) (see Fig. 2S6). Form: flat, triangular. 
J'ositioii: ill fnnit of and above the ear. Origin: galea aponeurotica. Insertion: to 
the anterior end of the helix auriculae. Action: it draws the auricle fonvard and upward. 
I n n e r v a t i o n : n . i'acialis. 

M. .luriciilaris superior (0. T. attoUens aurem) (see also Fig. 28(i). Form: flat, triangular. 
Position: aliove the ear. O rigin : galea aponeurotica. Insertion: narrow, to the eininentia 
fossae triangularis auriculae. Action: it draws the auricle upward. Innervation: n. facialis. 

M. auricularis posterior (0. T. retrahens aurem). Form: oblong-quadrangular, single 
or divideii. Position: beliind the ear. Origin: pars mastoidea oss. temporalis, upon the 
tendon of the m. sternocleidoiuastoideus. Insertion: with parallel flbers to the eininentia 
conchae auriculae. Action: it draws the auricle backward and upward. Innervation: 
n. auricularis posterior (VII). 

M. transversus nuchae, inconstant. Form: oblong- quadrangular. Position: it 
lies suiierliciallv upon the linea nuc}iac supiM'ior, in the same layer as the mm. trapezius 
and sternocleidomastoideus. Origin: protuberantia occipitaUs externa. Insertion: tendon 
of the m. sternocleidomastoideus. 



Muscles of the NecTf. 



251 



M. quadratus 
labii inferioris^- 



a. truuigiihiris 



yi. transversu 
iiienti 




297. Right platysma, viewed from in front. 

Platysma (see also Fij^s. 286 and 291). Form: ol)lorig-(|uacli-angular, thin, very large. 
Position: just beneath the skin in the clavicular region, in the neck and in the lower part of 
the face. Origin: fasciajiecliii'alis. Insertion: the fibers run parallel, medianward and upward : 
the posterior fibers radiate out upon the fascia parotideomasseterica , the anterior go partly ti) 
the angle of the mouth, partly into the m. quadratus labii inferioris, partly to the basis 
mandibulae. Below the chJ^_tho fibers of the two sides often decussate. Action: it liits the 
skin of the neck""from the subjacent tissue; it draws the angle of the mouth to the side and 
downward. Innervation: ramus colli n. facialis. 



252 



Muscles of the Neck. 



Processus 
niastoideu 



Corpus ossis hyoidci 




M. tligaslricus 
venter anterior) 

M. mylohyoideus 



Carlilago thyreoidea, 
Glandula thvreoidea 



M. digastricus 
(venter posterior) 



M. stylohyoideus 

Loop for tlie 
111. digastricus 
]M. thyreohyoideus 

M. omoliyoideus 
(venter superior) 
M. cricothyreoideus 

M. sternohyoideus 



M. sternocloido- 
mastoideus 



M. trapezius 



C'lavicula 



M. ouioliyoideus 
(venter inferior) 

M. sternothyreoideus 



298. Muscles of the neck, (2"i layer), viewed from in front. 

(The head has hecn bent backward; the phitysma has been removed.) 

M. steriiocleidom.astoi(leus (see also Figs. 296 and 299). Form: long, flat-cylindrical, 
strong. Position: on the lateral and anterior surfixce of the neck, covered in its lower half by 
the platysnia. Origin: by two heads: medial head: by a long tendon from the airtau^r surface 
of the maniilitiuiLUsterni, partly covering the articulatio sternoclavicularis ; lateral head: by a 
short tendon Irom the upper surface of the sternal extriMiiity of the clavicle. Between the two 
heads there is usually a triangular space, which is broader below, and which corresponds to 
the fossa supraclavicularis minor (see P'ig. 2S1). Insertion: the lateral head passes under the 
medial; the two unite at about the middle of the neck and go obliquely upward, backward 
and lateralward to become attached by a short tendon to the lateral surface of the processus 
mastoideus and to tlio linea nuchae sui)renia. Action: the muscle of one side acting alone 
turns the head to the opposite side ami the face at the same time upward : the muscles of 
the two sides acting together draw the head obliquely forward and downward, or, if the head 
be fixed, they elevate the clavicle and sternum (and with them also the thorax). Innervation: 
n. accessorius. 



Muscles of tbe Neck. 



253 



Porus 
acusticus 
externus 

Processus 
mastoideus 

Pi-ocessu& _ 
styloideus 
M. masseter 



M. digastricus 
(venter posterior) 

M. splenius capitis 
M. styloliyoideus 



M. sternocleidoniastoideus 



M. levator scapulae 



M. scalenus posterior 

M. scalenus 
medlus 

il. scalenus 
anterior 



M. digastricus 
Corpus (venter 
ossis anterior) 
livoidei 



M. thyreohyoideus 




M. omohyoideus 
(venter superior! 



M. sternohyoideus 



Acromion 



M. omohyoideus (venter inferior) 



Clavicuhi 



299. Muscles of the neck {2^'^ layer), viewed from the right side. 

(The platysma has been removed.) 

M. digastricus (see also Tigs. 298 and 301). Form: two rounded bellies, venter pos- 
terior and venter anterior, with a long intermediate tendon. Position: below, behind and 
medianward from the mandibula. The venter posterior arises in the ineisura mastoidea oss. 
teraporaUs and goes over in front and below into an intermediate tendon, which is fastened 
by a loop -like strip of the fascia colli to the coi-pus oss. hyoidei; the venter anterior arises 
from this intermediate tendon and usually also from the corpus oss. hyoidei and goes to the 
fossa digastrica mandibulae. Action: when the hyoid bone is fixed, it depresses the lower 
jaw; when the lower jaw is fixed, it draws the hyoid bone upward. Innervation: venter, 
2>osterit)r : r. digastricus n. facialis; venter anterior: n. mylohyoideus (V. 3). 

M. styloliyoideus (see also Figs. 298, 300 and 301). F o r m : flat, oblong, thm. Position: 
behind and below the mandibula, just in front of and above the posterior belly of the m. tUgastricus. 
Origin: processus stjdoideus. Insertion: forward, downward and medianward to the corpus 
oss. hyoidei ; in the neighborhood of its insertion it surrounds the m. digastricus by two limbs. 
Action: it draws the hyoid bone backward and upward. Innervation: r. stylohyoideus n. facialis. 

Spalteholz, Atlas. 17 



254 



Muscles of the Neck. 




Processus niastoideiis 

M. nniohyoideus 
' M. stylohroideus 
Corpus ossis hyoidei -- 
M. splenius capitis 

M. longus capitis 
M. thyreohyoideus 
VM. steriioliyoideus 

H. omohyoideus (venter superior 
M. levator scapulae 

M. scalenus medius 
M. scalenus anterior 



M. scalenus posterior 

J M. steniothyreoideus 
M. omohyoideus 
(venter inferior 




Scapula 







i^^^% 






^ 




Clavicula (sawed through) 



300. Muscles of the neck {^^'^ layer), viewed from in front. 

(Like Fig. 298 ; in addition however the mm. sternocleidomastoidei, trapezii and digastrici have 
been removed ; the right clavicle has been sawed through close to the sternum and removed.) 

M. oniohjoidcus (see also Figs. 298, 299 and 301). Formf Hat, narrow, long; divided 
liy an intermediate tendon int(j two bellies, venter inferior and venter siijierior. Position: on 
the lateral and anterior surface of the neck, covered behind by the clavicula and the m. trapezius, 
in the middle by the m. sternocleidomastoideus. The intermediate tendon is ensheathed in the 
iascia colli and united with the anterior wall of the v. jugularis interna. Origin: margX)^sujierior 
sca])ulae and lig. transversiun scajjidae suj)erius. I n ser ti o u : runs in front'of the mm. scaloiii forward 
and upward to th(> intermediate tendon and thence, bends upward to the corpus oss. hj-oidei, where 
it lies laterally from the m. sternohyoideus and in frontof the in. thyreohyoideus. Action: it draws 
the hyoid bone downward and makes the fascia colli tense. I n u e r v a t i o n : r. descendens n. liy poglossi. 



Muscles of the Nook. 



255 



Porus 
aeuslious - 
extenuis 

Processus 

niastoideus 



Processus styloideus 

M. masscter 

M. digastripus 
(venter posterior 

M. splenius capitis 
M. stylohyoideus 



!M. levator scapulae 
M. trapezius (cut through) 

M. scalenus medius ~- 



M. scalenus posterior 



M. serratus 
anterior 
.M. supra- 
spinatu 



-- M. digastric 
Loop for the (ventr 
111. digastiicus antcric 
Corpus ossis hyoidei 




M. constrictor pliaryngis 
inferior 

^[. tlivreohvoideus 



1\[. sternothvreoidcus 



M. slernobvoideus 



M. omohvoideus 



v^^mtm^ 



V 



Acromion 



Clavicula 



301. Muscles of the neck [V^ layer), vieAved from the right side. 

(The platysma, m. sternocleidomastoideus and the anterior part of the m. trapezius 

have been removed.) 

M. sternohyoideus (see also Figs. 298 300). Form: flat, oblong-quadranguhir, thin. 
Position: on the anterior surface of the neck in front of the larj-nx and the tra(;hea, cove- 
red above by the platysma only , below by the m. sternocleidomastoideus ; the muscles of the 
two sides approach very close to each other and sometimes even touch in the median line. 
Origin: posterior surface of the manubrium sterni, of the articiilatio sternoclavicularis and of 
the first costal cartilage (see Fig. 313). Insertion: the fibers run parallel to one another 
upward, at first also somewhat medianward, and go to the corpus oss. hyoidei (bursa m. sterno- 
liijoidei, see P'ig. 302 and p. 257). A c t i o n : it draws the hyoid bone downward. Innervation: 
r. descendens n. hypoglossi. 

17* 



256 



Muscles of the Xeck. 



Muiulibula 



Corpus ossis liyoidei 



LigaimMiluni hyotliyreoi 
deiini nicdiuiu 



Cartilage thyreoidea 



M. styloglossus 

- M. hyoglossus 

- M. geniohyoideus 

Bursa m. steruohyoidel 

M. thyreohyoldeus 

Bursa subcutaiiea 
promiiientiae laryligeac 



Ligameiitum crjeo- 
thyreoideuiu [medium 



Cartilage cricoidea 



Glaiidula thyreoidea 



Clavifula - 




M. cricothyreoideus 



]M. sternothyreoideus 



Ligameiitum 
sternoclaviculare 



Ligamentuni interclaviculare 



302. Muscles of the hyoid bone 

(deep layer), viewed from in front. 
(The nun. stcrndhyoidei, oniobyuidei, digastrici and niylobyoideus have been removed.) 

M. steruothyreoideus (see also Figs. 298, 300 and 301). Form: flat, oblong-quadrangular, 
very tbin. Position: on tbe anterior surface of tbe neck, close to tbe glandnla tbyreoidea, covered 
by tbe mm. omobyoideus and sternobyoideus. Origin: posterior surface of tbe manubrium sterni 
and of tbe first costal cartilage (see Fig. 313). Insertion: upward and lateralward to tbe lamina 
cartilaginis tbyreoidoae (linea obli([ua); single fibers go over immediately into tbe m. tbyreobyoideus. 
Actinn : it draws tbe cartilago tbj'reoidea downward. Inni'rvation : r. descendens n. bjpoglossi. 

M. thyreohyoideus (see also Figs. 298301). Form: flat, quadrangular, very thin. 
Position: on tbe anterior surface of tbe neck, close to tbe cartilage tbyreoidea, covered by the m. omo- 
bycjidt'us. r i g i n : lamina cartilaginis tbyreoideae (linea obliqua) (see also above). I n s e r t i o n : cor- 
pus and cornu majus oss. byoidei {bursa m. t/tyreo/ii/oidei,seQ p. 257). Action: draws tbe byoid 
bone closer to tbe cartilago tbyreoidea and vice vcisa. Innervation: r. tbyreobyoideus n. bypoglossi. 



Muscles of the Xeck 



257 



Processus coronoideus 
mandibnlae 




/- 




Ramus mandibnlae 



Os hvoideum 



M. mylohyoideus 

M. geniohyoideus 



303. Muscles of the floor of the mouth, 

viewed from behind and above. 
(The imiscles of the tongue have been completely removed.) 

M. mylohyoideus (see also Figs. 298 and 300), unpaired. Form: flat, quadrangular, 
broad, above, hullo wed out, like a trough. Position: stretches between the lower jaw and 
the hyoid bone and thus forms the floor of the mouth; immediately adjacent to its lower 
surface lies the anterior belly of the m. digastricus. Origin: hneae mylohyoideae mandibnlae. 
Insertion: the fibers run parallel to one another on each side, backward, downward and 
medianward and are attached for the most part to a medially situated connective-tissue raphe; 
the posterior fibers go to the anterior surface of the corpus oss. hyoidei. Action: when the 
hyoid bone is fixed, it depresses the lower jaw; when the lower jaw is fixed, it draws the hyoid 
bone forward and ui)ward. Innervation: n. mylohyoideus (V. 3). 

M. geniohyoideus (see also Fig. 302). Fo'^rm:" flat-cylindrical, oblong. Position: on 
the upper (buccal) side of the m. mylohyoideus, completely hidden by it from below; the 
mm.-g'eniotiyoidei of the two sides are immediately adjacent to one another in the median plane. 
< ) r i g i n : by a short tendon from the spina men talis inandibulae. Insertion: the fibers, diverging 
a httle, extend to the anterior surface of the corpus oss. hyoidei. Action: when the hyoid 
bone is fixed, it depresses the lower jaAv; when the lower jaw is fixed, it draws the hyoid bone 
forward and upward. Innervation: n. h^'ijoglossus. 

Bursa [mucosa] subcutanea promineutiae laryugeae (see Fig. 302), often absent, 
usually found only in men and only in older individuals ; it is unpaired and lies in the sub- 
c\itaneous tissue in fi-ont of the upper part of the thyreoid cartilage. 

Bursa m. sternohyoidei (see Fig. 302), almost constant, is better developed in the 
male than in the female and lies, if unpaired, in the median plane or, if paired, close to the 
median plane upon the lig. hyothyreoidenm medium, between it on the one hand and the 
m. stemohyoideus and the fascia colli on the other; it extends upward behind the hj'oid bone. 

Bursa m. thyreohyoidei (not shown in the drawing), stQl more constant than the 
preceding, lies below the cornu majus oss. hyoidei, upon the membrana hyothjTeoidea, between 
it and the upper end of the m. thyreohyoideus. 



Muscles of the Neck. 

] Pars basilaris ossis occipitalis 



Processus transversiis atlanfis 

Processus transvcrsus epistrophei 



M. rectus capitis j 
lateralis 



"" M. rectus capitis anterior 
W. longus capitis 




Corpus vertebrae 
cervicalis VII 



M. scalenus 
posterior 



Costa I _ 



Corpus vertebrae thoracalis III 

304. Deep muscles of the neck, viewed from in front. 

(The sternum ami tlif anterior ends of the ribs with their muscles have been removed.) 
M. rectus capitis lateralis. V o r in : Hat, short. P o s i t i o n : in front of the articulatio atlanto- 

occipitiilis. Origin: proc. transversus atlantis. Insertion: inferior surface of the proc. jiigularis oss. 

occipit. Action: bends head to tlie side. Innervation: direct branch of the plexus cervicalis. 
M. rectus capitis anterior (0. T. rectus capitis anticus minor). Form: flat, short. 

Position: in front of the articulatio atlantooccipi talis. Origin: massa lateralis and proc. 

transversus atlantis. Insertion: pars basilaris oss. occipit. Action: bends head forward. 

Innervation: direct branch of the plexus cervicalis. 



Muscles of the Xeck. 



r> 



M. longus cai)itis 

(cut through and 

turned laterahvard) 



M. longus colli 



305. Anterior 

muscles of the 

cervical spine on 

the right side. 




259 



Processus transversus 
atlantis 



Corpus vertebrae cervicalis IV 



Corpus vertebrae 

cervicalis VII 



Corpus vertebrae thoracalis III 



M. longus capitis (0. T. rectus capitis anticus major) (see also Figs. 300, 301, 304). Form: 
flat, oblong-triangular. Position : just in front of the upper end of the cervical spine and in front 
of the merabrana atlantooccipitalis anterior. Origin: tubercula anteriora of the transverse processes 
of the 3rd 6th cervical vertebra. Insertion: upward and medianward to the pars basilaris oss. 
occipitalis. Action: bends the head forward. Innervation: direct branch of the plexus cervicalis. 

M. longiis colli (see also Fig. 304). Form: flat, oblong -triangular, broadest in the 
middle. P osition: close to the anterior surface of the cervical spine, in the groove between the 
bodies and transverse processes of the vertebrae ; it is partially covered above by the m. longus 
capitis. Two portions. Inferior, medial: from the bodies of the 3rd thoracic to the 5th cervical 
vertebra, goes to the bodies of the 5tii 2iid cervical vertebra and to the anterior tubercles of 
the transverse processes of the 6*^ and 5th cervical vertebra; superior, lateral portion : from the 
anterior tubercles of the transverse processes of the Gth 3rd cervical vertebra, goes to the 
tuberculum anterius atlantis. Action: bends the cervical spine forward and lateralward. 
Innervation: direct branches of the cervical and brachial plexuses. 



260 



Muscles of the Neck. 



..::i^ 



Processus spinosus 
epistrophei 



Tendinous slips of 

he in. levator scapulae 

(cut througli) 



[. scalenus raedius 



alenus anterior 



nus posterior 



i spino 
tebrae 
is VII 



scalenus 
inlmus 




Atlas 



306. Mm.scaleni 
of the right side, 

vieAved from the ri^ht. 



Corpus 

vertebrae 

cervicalis VH 



M. scalenus anterior (0. T. 

scalenus anticus) (see also Figs. 
299 301 and 304). Form: flat, 
oblong-quadi'angular. Position: 
close to the inferior part of the 
cervical spine. Origin: by four 
tendinous slips from the trans- 
verse processes of the 3'''3 to the 
6*11 cervical vertebra. Inser- 
tion: downward and forward by 
means of a short tendon to the 
tuberculura scaleni [Lisfranci] of 
the 1st rib. Action: when the 
cervical spine is fixed it elevates 
the 1st rib; -jvhen the l^t rib is 
fixed it bends the cervical spine 
forward and lateralward ; and 
when acting with its fellow of the 
opposite side the two bend the 
cervical spine directly forward. 
I n n e r V a t i n : direct branches of 
the cervical and brachial plexuses. 
M. scalenus medius (see 
also Figs. 299301 and 304). 
Form: flat , oblong- triangular. 
Position: close to the taferior 
part of the cervical spine, behind 
the m. scalenus anterior, sepa- 
rated from it at the pt rib by 
a triangular space. Origin: 
by 6 (7) slips from the trans- 
verse processes of the 6 (7) in- 
ferior cervical vertebrae. In- 
sertion: downward and lateral- 
ward to the lateral suiface of 
the l^t rib (behind the sulcus 
subclaviae). Action: when the 
cervical spine is fixed it elevates 
the 1 ^t rib ; when the 1 **t rib is 
fixed it bends the cervical spine 
lateralward and forward. I n n e r- 
V a t i n : direct branches of the 
cervical and brachial plexuses. 

M. scalenus posterior (0. T. 
scalenus posticus) (see also Figs. 
299301 and 304). Form: flat, 
oblong-quach'augular. Po si t i on : 
close to the inferior part of the 
cervical spine, bounded in front by the m. scalenus medius, behind by the m. iliocostalis cervicis, 
lateralward by the m. levator scapulae; usually fused with the m. scalenus medius. Origin: 
by 23 slips from tiie transverse processes of the 2 or 3 inferior cervical vertebrae. Insertion: 
downward and lateralward to tlie lateral surface of the 'l'^^^ rib. Action: is related to the 2c' rib as 
is tliat of the preceding muscle to the l^t rib. Innervation: direct branches of the brachial plexus. 
M. scalenus minimus (inconstant). P'orm: flatly rounded, narrow. Position: in 
the slit between the nun. scalenus anterior and medius; it separates the brachial plexus from the 
a. sulx^lavia. Origin: by 1 2 slips from the transverse processes of the 6ti or of the 
6'1> and 7"i cervical vertebra. Insertion: downward and forward to the lateral surface of the 
l*<t rib and to the pkuiral cupola. Action: makes the pleural cupola tense. Innervation: 
direc^t branches of the brachial plexus. 



Tuberculum scaleni 



. .. Costa I 



Costa II 



for the passage 
e a. subclavia 



Tuberositas eostae 




Muscles of the Neck. 



261 



Spatiuin suprasternale 



Trachea 



Oesophagus 



Fascia prae- 

vertebralis 



Corpus 

vertebrae 

cerviealis VII 



Foramen 
vertebrate 



Glandiila thyreoidea (lobus dexter) 

] M. sternohyoideus 

' I Fascia colli 

M. sternothyreoideus 

' M. omohyoideus 

A. oarotis communis 

E. dcscendens n. hypoglossi 

N. vagus 



T.yniphoglaudula 




N. synipathicus 
_ N. phrenicus 

__V. jugularis interna 

Mm. longi colli 
et capitis 
_ Plexus 
brachialis 

^^ M. sternocleido- 
mastoideus 

Mm. scaleni 

Platysma 

Fascia colli 

Fat 



.Muscles of 
the neck 



M. trapezins 



307. Transverse 
section through 
the neck, at the 
level of the uppermost cartilages of the trachea, 

viewed from above (after Fr. Merkel). 

The fascia praevertebralis is a thin but strong membrane which covers the anterior 
surface of the cervical spine and the deep muscles of the neck : part of it descends with these 
into the thorax, part extends upon the outer surface of the mm. scaleni and of the thurax: 
it covers directly all the muscles represented in Fig. 304. 

The fascia colli extends as a strong membrane from the hj'oid bone to the sterniun and 
clavicle in front of the larynx, laryngeal muscles and trachea. It is attached to the sternum 
by two leaves, which enclose the spatinm suprasternale and its fetty contents. Laterally it 
extends above in front of the m. omohyoideus and past it as far as the anterior surface of 
the bundle of blood vessels, where it becomes lost ; it forms a sheath for the intermediate tendon 
and the venter inferior of the m. omohyoideus. Behind, it becomes thinner and passes 
below the m. sternocleidomastoideus , upon the fat which helps to fill up the lateral cervical 
triangle, and below the m. trapezius to the lig. nuchae ; the external surface of the mm. stermi- 
cleidoinastoideus and trapezius is covered only by delicate muscle -fascia. 



262 



Muscles of the Chest. 



M. trapezius 



M. biceps 
biaehii 
(caput 
breve) 

M. biceps 

brachii 

(caput 

longuui) 

M. triceps 

brachii 

(caput 

hiteralc) 



Fossa infraclavienlaris 

Clavicula 
Acromion 



M. deltoideus 




M. 

sternocleido- 
niastoldeus 



M. pectoralis 
major (pars 
elaviiularis) 



+ Sternum 



M. pectoral 

major 
(pars stern 
costal is 



M. pectora 
major (pa: 
abdominal 



Vagina 

m. recti 

abdominis 



M. latissimus dorsi i 

M. serratus anterior 



M. obliquus externus abdominis 



308. Muscles of the right side of the chest, 

viewed from in front. 
(The platysma has been removed.) 

M. pectoralis major (see also Figs. 309, Slfi, 317 and 343). Form: flat, quadrangular, 
hniad, thick. Position: on each side it passes out from the median plane to the anterior 
surface of the thorax and of the axilla, above it is partly covered by the platysma. Origin: 
medial half of the clavicle (pars clavicidaris) , anterior surface of the sternum, and of the 
second to the seventh costal cartilage (pais sternocostalis) and the anterior leaf of the vagina 
m. recti abdominis (pars ahdominalis) . Insertion: see p. 263. 



Muscles of the Chest. 



263 



Pars clavicularis 



Crista 
tuborculi 
majoris ~ 

Posterior 
layer of the " 
teniiiiia) 
tfiidoii 

Anterior 
layer of ttie 
terminal 
tendon 



Corpus 
luiiiieri* 




Pars 
steriiocostalis 



Part of the jnuscle which passes to the 
posterior layer of the terminal tendon 



Pars abdominalis 



309. Right m. pectoralis major, 

semi - schematically. 



viewed from in front, 



(Two strips have been cut out of the muscle. The dotted black lines indicate the course of the upper, 
posterior margins of the muscle bundles, the dotted red lines that of the lower, anterior margins.) 

M. pectoralis major (continued). Insertion: the fibers converge, lateralward to 
the crista tuberculi majoris of the humerus. The fibers of the pars sternocostalis and of 
the pars abdominahs pass, at the lower margin of the tendinous attachment, to the posterior 
surface of the same and thence to the bone, without altering their direction, so that the fibers 
which arise lowest down are inserted highest up ; the tendon of insertion , accordingly , looks 
as though it were rolled up at its lower margin and consists of two layers, one anterior, thick 
(formed chiefly by the pars clavicularis), and one posterior, thin (pertaining especially to the 
pars sternocostalis and pars abdominalis) ; these layers are continuous below but can be separated 
from above (see Fig. 310). Between the posterior surface of the terminal tendon and the 
anterior surface of the caput longum m. bicipitis brachii there often lies an oblong bursal sack, 
l)iirsa m. pectoralis majoris (see Fig. 346). Action: it draws the upper arm medianward 
and forward, and rotates it inward. Innervation: nn. thoracales anteriores. 



264 



Muscles of the Chest. 



M. subclaviiis 



C'lavicula 



M. trapezius 
M. pectoralis minor 
Processus coracoideus 
Acromion 



M. sternocleidomastoideus 



M. deltoidcus 



subscapularis - 

M. coraco- 
brachialis . 



\l. teres major 



ndon of in- 
iertion of 
he m. pec- 
1 rails major 

M. biceps 

brachii 
aput breve 



M. biceps 
brachii 
put longum) 

M. triceps 

brachii 
iputlaterale) 




Costa I 



Sternum 



M. serratus anterior 



Mm. intercostales interni 



M. latissimus dorsi 



Costa V 



310. Muscles of the right side of the chest (2'"^ layer), 

viewed from in front. 
(The platysnia and the ni. pectoralis major have been removed.) 

M. pectoralis miuor. Form: flat, oblong - triangular. Position: oii thr anterior 
surface of the tliorax and (if th(> axilla, covered by the m. pectoralis major. Origin: by four 
or three digitations from the anterior surface of the 2^'^ or S^'i 5''' rib. Insertion: the fibers 
converge upward and lateralward to go by a short tendon to the proc. coracoideus scapulae. 
Action: it draws the lateral angle of the scapula downward and forward; when the shoulder 
blade is fixed it elevates the ribs to which it is attaclnMl. Innervation: nn. thoracales 
anteriori's. 

M. subclavius. Form: flat-cyhndrical, narrow, short. Position: hidden between the 
clavicle and the 1=** rib, covered by the platysma, the clavicle and the m. pectoralis major. 
Origin: tendinous, from the anterior surface of tlie \^^ custal cartilage, just lateralward from the 
lig. costodaviculare. Insertion: obliquely lateralward and upward to the inferior surface of the 
clavicle. Action: it draws the clavicle downward and forwar<l. Innervation; n. subclavius. 



Muscles of the (Ihest. 



265 



M. scalenus mediiis 
M. sealemis anterior 



Scapula 

I pulled forcibly 

backward 




M. serratus anterior 



Sternum 



Costa IX 



Mm. inter- 
costales extern! 

Miu. intercostales 
interni 



311. Right m. serratus anterior, 

viewed from the side and someAvhat from in front. 

(The mill, pootorales as well as the iiiu.?cles of the antei'ior and posterior scapular fossae have 
been removed: the clavicle has aho heen removed and the scapula drawn forcibly backward.; 

[Text see p. 267.] 



266 



Muscles of the Chest. 



A. intercostal is 



R-nius anterior [n. intcrcostalis] ii. tlioracalis V 



Mm. intercostales iutcrni 



Mm. intercostales 
externi 



Costa V 



M. 

subcostalis' 



Ligauientuni 
liiiubocostale 



Costa XI 



M. transversus 

abdominis 

(cut tlirougbi 




Processus trans- 

versus vertebrae 

thoracalis V 



Ligaiiientum inter- 
costale internum 



Processus transversus 

vertebrae 

thoracalis XII 



Processus trans- 
versus vertebrae 
lumbalis I 



Ligamentuni longi- 
tudinale anterius 



Fascia lumbodorsalis (anterior leaf) 



M. intertransversarius lateralis 



312. Right posterior wall of thorax with muscles, 



viewed from in front. 



(Diaphraj^ina, m. psoas and m. ijna<lratns ltuul)iiniin litive been removed.) 



Muscles of the Cliest. 267 

M. serratus anterior (0. T. serratus magnus) (see Figs. 308, 310, 311, 31(;, 317 
and 343). Form: flat, quadrangular. Position: on the lateral and posterior wall of the thorax, 
close to the ribs and mm. intercostales , covered in front and al)Ove by the ram. pectorales, 
behind by the m. subscapularis , by the scapula and its posterior muscles as well as by the 
m. latissiraus dorsi; lateralward and below, with its 4 5 inferior digitations, just beneath the 
skin. Origin: by 910 tieshy digitations from the 89 uppermost ribs (by 2 digitations 
from the 2ndrib); also from a tendinous arch between 1^' and '^^jj^- Insertion: uppermost 
2 digitations (from 1*^ and 2"^ rib) converging to the angulus medialis scapulae; 2^^ digitation 
(from 2iid rib) runs diverging to the margo vertebralis: 4"i 10<i digitations (from 3id gth 
rib) extend converging to the angulus inferior; the latter portion is the strongest. The 
fibers run as a whole curved so as to be convex and to follow exactly the curvature of the 
wall of the thorax. Action: it presses the scapula to the thorax, draws it forward and lateral- 
ward, acting with especial power upon the angulus inferior; at the same time it rotates the 
scapula so that the angulus lateralis is elevated. Innervation: n. thoracalis longus. 

Mm. intercostales externi (see also Figs. 311, 319 and 33G). Form: flat, short, 
thin. Position: in the intercostal spaces, from the tubercles of the ribs on, to about the lateral 
ends of the costal cartilages; behind they are continous with the mm. levatores costarura. 
Origin: lower margin of each rib, external fnim the sulcus costae. Insertion: the fibers run 
parallel downward and st(n-nalward to the upper margin of the next rib below. Medianward 
from the anterior end running in the same direction are glistening tendinous bands of connective 
tissue (ligamcnta intercostalia externa, not shown in the figure). Action: muscles of inspi- 
ration. Innervation: rami anteriores [nn. intercostales] of the nn. thoracales I XI. 

Mm. intercostales iiiterui (see also Figs. 310. 311, 313 and 321). Form: flat, short, 
thin. Position: in the intercostal spaces from the region of the angles of the ribs to the 
sternum: they lie more internally than the mm. intercostales externi, and are accordingly 
covered by the latter externally as far as the lateral ends of the costal cartilages; between 
the costal cartilages they are covered only by the ligg. intercostalia externa; behind they 
leave the anterior surface of the nun. intercostales externi free medianward from the angles of 
the ribs. Origin: inferior margin of each rib, internally from the sulcus costae. Insertion: 
the fibers run parallel doT\'nward and vertebralward to the upper margin of the next ril) 
below. Action: the portions extending between the ossa costalia are muscles of exspiration : 
those bundles running between the costal cartilages, mm. mtercariilaf/iiiei , act like the 
mm. intercostales externi. Innervation: rami anteriores [nn. intercostales] of the nn. 
thoracales I XL 

The ligamenia intercostalia interna are thin bands of connective tissue which are 
situated, partly in front on the inner side of the mm. intercostales interni, in connection with 
the m. transversus thoracis (not shown in figure), partly behind on the anterior surface 
of the mm. intercostales externi in connection with the nun. intercostales intemi and the 
mm. subeostales. 

Mm. subcostales, very variable. Form: flat, triangular, very thin. Position: on the 
internal surface of the ribs, usually only of the lower ribs, in the region of the anguli costarum. 
Origin: frum the inner surface nf the ribs. Insertion: the fibers run like those of the mm. 
intercostales interni, but jump over one or two ribs. Action: muscles of expiration. Inner- 
vation: rami anteriores [nn. intercostales] of the corresponding nn. thoracales. 

M. transversus thoracis (see Fig. 313). Form: flat, quadrangular, very thin. 
Position: directly upon the posterior surface of the anterior thoracic wall, below close to the 
diaphragm and bounding the m. transversus abdominis. Origin: posterior surface of the coi-pus 
sterni and of the proc. xiphoideus. Insertion: obliquely upward and lateralward to the 3"i 
(or also 2ndj_6th rib. Action: it draws the ribs downward on expiration. Innervation: 
rami anteriores [nn. intercostales] of the nn. thoracales III (or II) VI. 



268 



Muscles of the Chest. 



M steriiotliyreoideiis (cut tlirough) 

Mm. steriioh5-oidci (cut through) 



Olavicula 

Costa I 
V. niamniaiia interna 



A. niauiniaria .._ /, 
interna 



Mm. interoostales 
interni 




thoracis 



(On 



313. Anterior wall of thorax with muscles, 

viewed from beliincl. 
tho right side the fibres of origin of the tUniihragm have been removed.) [Text see p. 267.] 



Th(> Abilomiual Muscles. 

Foramen voiiao cavae . , p.,,.^ stornalis rliaphragniatis 



269 



Cms / 

laterals 



Crus 
mediale 




Pars costalis 
diaphragmatis 



Centrum 
tendineuiM 



Hiatus 
oesophageus 

Pais lunibalis 
diaphragmatis 



Hiatus aortieus 



Arcus Inniliocostali 
medialis 

Arcus lumbocosta 
lateralis 



. M. qiKidratus 
lumborum 

. M. traiisversus 
abdominis 

M. obliquus 
interims abdomin 

M. obliquus 
externus abdomin 

--M. iliai-us 



M. psoas major 



Corpus vertebrae lumbalis V 



M. psoas minor 



314. Diaphragm, viewed from beloAv and in front. 
(The muscles of the chest have been removed, the abdominal muscles have been cut through transversely.) 
Diaplirag"ma (diaphragm) (see also Figs. 313 and 315). Form and position: flat, 
broad , kidney-shaped , tendinous in the middle (centrum teadineumj, otherwise fleshy ; it is 
stretched out transversely between the abdominal and thoracic cavities; it bulges into the 
thorax, being convex above, markedly so lateralward, less so in the middle, so that to the right 
and to the left there arises a cupola-like elevation, those of the two sides being separated by 
a shallow median depression; in the adult on moderate expiration the right cupola reaches 
to close below the costocartilaginous junction of the A^^ rib, the left cupola to just above the 
costocartilaginous junction of the 5*^^ rib (see Fig. 410). Origin: from the posterior surface 
of the proc. xiplioideus sterni (jmrs sternalisj , from the internal surface of the anterior 
ends of the 7*1^ 12tii rib (pars cosialis) and from the lumbar vertebrae (itars lumhalis). 

Spalteholz, Atlas. 18 



270 



The Abdominal Muscles. 



Foramen 
venae cavae 



Centrum teudineum 
N. vagus sinister 

Oesophagus 

N. vagus dexter 




Aorta 

, Ductus 
thoracicus 



Cms 
laterale 



ntum 

)stalc 

terale 

'gos and 

lanchnici 

msversus 

i lumb. I 

us sympa- 

hicus 

srraedium ^ 1 

us medialo ! 

leaf of the fascia lumbodorsalis 



Crus 
intermedium 



Crus 
mediale 



- Costa XII 



M. transversus 
abdominis 



" ^ M. psoas major 

M. psoas minor 
Corpus vertebrae lumbalis III 



M. quadratus 
lumborum 



315. Diaphragm, pars lumbal is, vieAved from below and in front. 

(The dia2)lira<4in has been separated from the tipper ribs and from the sternum and drawn 
somewhat upward; on the right the mm. psoas and quadratus lumborum have been removed.) 

Diaphrag'uia (continued). The pars hmibalis arises from the lig. longitudinale anterius 
and is divided on each side by perforating vessels and nerves (somewhat variably) into three 
crwa: crus mediale from the anterior surface of the S^d and 4tii, crus intermedium, narrow, 
Irom the anterior surface of the 2"d and 3rd ctiis laterale, from the lateral surfaci> of the 
2nd (oj. 1st) lumbar vertebral body and from a strip of fiiscia which extends thence in front of 
the m. psoas to the transverse process of the 1^^ lumbar vertebra (arcus lumbocostulis mcdialis 
[Halleri]). "A second strip of fascia, between the point last mentioned and the r2tii rib (arcus 
lumhocostalis lateralis [Halleri]), forms a bridge over the m. quadratus lumborum and serves 
chiefly to give origin also to muscle fibers ; it is not rare to find a triangular space in the muscle 
over it. Tlie crura medialia of the two sides diverge somewhat above and in front and leave 
between them and the spine an oblong space, the hiatus aorticus (for the aorta and ductus 
thoracicus), which is closed above by a small tendinous arch. Over this, the right crus mt^liale 
diyides into two bundles which enclose a slit which reaches almost to the centrum teudiutnun, the 
hiatus oesopharieus (for the oesophagus and the nn. vagi); the left crus mediale sends only a few 
corresponding fibers to the right. Between the crus mediale and the crus intermedium run usually 
the V. azygds (or hemiazygos) and the nn. splanchnici : b(>tw(>en the crus intermedium and the crus 
laterale runs tlie truncus sympathicus. Insertion : on all sides radially td tlie centrum tendiaeum 
(O. T. central tendon), which has the shape of a clover-leaf and consists of interwoven tendon bundles. 
In its right half lies the foramen venae cavae, quadrangulary rounded (for the v. cava inferior 
and the raun' jiluvnicoabduniinales n. plirenici dextri). Action: it enlarges the thoracic cavity ; the 
cupolae de.scen( 1 markedly, the centrum teudineum descends less. I n n e r v a t i o n : nn. phrenici and 
the rami anteriores [nn. intercostalesj of the nu. thoracales VII XII (especially VII, VIU and XI) 



The Al)iiniiiinal Muscles. 



271 



^r. serratiis 
anterior 



M. latissimus 
dorsi 



M. obliquus 

externus 

abdominis 



Spina iliaca 
anterior 
superior 



Ligamentum 
inguinale 
IPouparti] 




_^r. pectoralis major 
"(pars stcrnocostalis) 

.M. pectoralis major 
(pars abdorainalis) 



Fossa ovalis 



Linea alba 

"Vagina m. recti 

abdominis 

(anterior leaf) 



Ligamentum 
- fundiforme 
penis 



Fascia lata 

Funiculus 
spermaticus 



316. Muscles of the abdomen, vieAved from the right side. 

[Text see p. 273.] 

18* 



272 



The Abdominal Muscles. 



Linea alba 




M. pectoralis ma 
(pars sternocosta 



]M. pectorali: 

major (pars 

abdominalis) 



M. serratiis 
anterior 



Vagina m. recti 
abdominis 

(anterior leaf) 



M. obliquiis 

externus 

abdominis 



Spina iliac 
anterior 
superior 

Ligament 
inguin 
[Poupai 



M. sartoiius 
Fossa ovalis 

Ligamentnm fundiformc penis 
Funiculus spermaticus 



317. Muscles of the abdomen, viewed from in from. 

I Text see p. 27:5. | 



The Abdominal Muscles. 
] Linea alba 



273 




Vagina ni. recti abdomin: 
(anterior leaf) 



^. 



Funiculus sperruaticus ^ 




Vagina m. recti 

abdominis (anteritJ 

leaf) (reflected) 

M. pyranjidalis 



__.Fibrae inter- 
crurales 

Aiinulus inguinalis 
subcutaneus 

Ligamentuni inguinale 
reflexum [Collesi] 

Crus inferius 



Crus superius 



I.iganientum suspensoriuni penis 



318. Mm. pyramid ales, viewed from in front. 

(The anterior leaf of the sheath of the rectus has* been partially dissected off and reflected.) 

II. obliqiius externus abdominis (see also Figs. 31fi, 317, 329 and 331). Form: 
tiat, i-[uadrangnlar, broad, much longer in front than behind. Position: on the anterior and 
lateral surface of the abdominal and inferior thoracic region. Origin: by 8 fleshy digitations 
from the outer surface of the 5*11 12'^ rib; the uppermost digitation is usually covered by the 
pars abdominalis m. pectoralis majoris (see Fig. 319); the 5 upper digitations are inserted between 
the digitations of the ra. serratus anterior; the 3 lower between those of the m. latissimus dorsi. 
Insertion: the upper fibers run more transversely, the lower more obliquely, forward and 
downward. The largest, upper part goes over medianward into a broad, tendinous sheath 
which runs in front of the m. rectus abdominis and helps to form the anterior leaf of the 
vagina m. recti abdominis (see p. 279); the next lower muscle bundles pass obliquely to tho 
/i;/amcntum inguinale [Pouparti] (0. T. Pouparfs ligament) (see p. 280) and leave medianward 
an open space (annuliis inguinalis sithcntanciis) (see p. 280) for the passage of the funiculus 
spermaticus; the muscle fibers arising farthest back are attached in fleshy masses to the external 
lip of the ihac crest. Action: it draws the thorax downward, bends the spinal column forward 
and toward the same side and rotates it toward the other side; when the thorax is fixed it 
elevates the pelvis. Innervation: rami anteriores [nn. intercostales] of the nn. thora- 
cales Till XII and the nn. iliohypogastricus and ilioinguinalis. 

M. pyramid.ilis, inconstant. Form: flat, oblong-triangular. Position: close to the 
median plane above the symphysis pubis, in front of the m. rectus abdominis, in a duplicaturo 
of the anterior leaf of the vagina m. recti abdominis. Origin: anterior surface of the ramus 
superior ossis pubis and of the symphysis ossium pubis. Insertion: the fibers run upward 
and medianward to the hnea alba. Action: it tightens the linea alba in the upright position 
and gives rise to the median groove below the navel when the abdominal muscles are relaxed. 
Innervation: r. anterior [n. intercostalisj of the n. thoracalis XII. 



274 



The Abdominal Muscles. 





jNI. pectoralis 

major (pars 

sternocostalis) 



1st digitation 
_the ra. obliqn 
externus 
abdominis 
-Costa VI 

_ M. serratus 
anterior 

- M. latissimus 
dorsi 

Mm. intercosta 
exterBl 



Mm. intercostales 
interni 




Costa X 



Vagina m. recti 

abdominis 
(anterior leaf) 
Insertion of the m. obi 
quus externus abdomin 

M. obliquus internus 
abdominis 



Linea alba 



Spina iliaca 
;unterior snperio: 



Ligamentum 
inguinale 
[Pouparti] 



^ Funiculus spermaticus 
Ligamentum suspensorium penis 

319. Muscles of the abdomen (2'"' layer), viewed from in front. 

[Text see p. 275.] 



The Abdominal ]\[uscles. 



275 



>[. rectus abdominis 



j\liu. intercostales 
interni 



Vagina 

m. recti 

abdominis 



posterior 
leaf 



anterior 
leaf 



M. transvcrsus. 
abdominis 




Vagina m. recti 

abdominis 

(anterior leati 



M. obliquus internus abdominis 



M. obliquus externus abdominis 
(cut through and reflected medianward) 



320. Transition of the tendon of the right 
m. obliquus internus abdominis into the sheath 

of the rectus. 

(The m. ohliquus externus abdominis has been complete!}" removed above; below, it has been cut 
through and reflected; the m. obliquus inteiTKis abdominis has been separated at its upper border from 
the costal cartilages; theanterior leaf ofthe sheath oftherectushasbeenremovedin the upperportion.) 

M. obliqmisiuternus abdominis (see also Figs. 3 19, 331 and 332). Form: flat, quadran- 
gidar, broad, in front considerably longer than behind. Position: on the anterior and lateral 
surface of the abdomen, completely covered by the m. obliquus externus abdominis. Origin: 
posterior surface of the combined leaves of the fascia lunibodorsalis (see p. 288), linea intermedia 
of the iUac crest, lateral two thirds of the lig. inguinale. Insertion: the most posterior fibers 
pass upward and forward to the inferior margins ofthe lOtii 12* rib. The other fibers coming 
from the iliac crest diverge and pass medianward so that the uppermost run parallel to the 
ends of the costal cartilages (connected with them only by loose tissue), the lowermost run 
transversely; the fibers Irom the lig. inguinale are somewhat curved as they run downward. 
All the muscle bundles not fastened to the ribs go over, lateralward from the m. rectus, along a 
curved line, into a tendinous plate. This divides in its upper two thirds into two lamellae, of 
which one passes in front of, the other behind, the m. rectus abdominis to go to the median 
plane and there form the basis for the corresponding leaf of the vagina m. 7-ecti abdominis 
(0. T. sheath of the rectus) (see also Fig. 322 and p. 279). In the lower third, all the fibers 
run in front of the m. rectus abdominis (see also Fig. 323 and p. 279); the posterior leaf of 
the rectal sheath is lacking here ; its lower margin is curved so as to be concave and is called 
the linea semicircularis IDouglasi] (see Fig. 324). The lower margin of the muscle forms in 
part the upper margin of the inguinal canal (see p. 281); in addition the m. cremaster goes off 
from it (see p. 281j. Action: it draws the thorax downward, bends the spinal column forward 
and toward the same side, rotates it toward the same side : when the thorax is fixed it elevates 
the pelvis. Innervation: rami anteriores [nn. intercostales] ofthe nn. thoracales YUI XII 
and the nn. iliohj-pogastricus and ilioinguinalis. 



270 



The Abdominal Muscles. 




M. pectoralis major 
pars sternocostalis) 



M. pectoralis major 

(pars abdominalis) 

(cut through) 

Costa V 



M. serratus 
aiitei ior 

M. latissimus 
dorsi 

Mm. iiitercostales 
exteriii 



Mm. intercostales 
interni 



-r Costa X 
Inseriptio tendiiica 



Linea alba 

M. transversus 
abdominis 



M. rectus abdominis 



Vagina m. recti 

abdominis (anterior 

leaf) (cut through) 

Spina iliaca 
anterior superior 



_Ligamentum inguinale 
[PoupartiJ 



Funiculus spermaticus 



321. Mm. recti abdominis, viewed from in front. [Text see p. 277. 



The Abdominal iMuscles. 



277 




Linea 



M. obliquus interims abdominis 

M. obliquus exteriius abdominis 



322. Transverse section through the abdominal 
wall above the linea semicircularis [Douglasi] 

(after W. Braune). 



Cutis 




Fascia transversalis 



M. obliquus externus abdominis ' 

323. Transverse section through the abdominal 
wall below the linea semicircularis [Douglasi] 

(after W. Braune). 

M. rectus abdomiuis (see Figs. 321 and 324). Form: flat, oblong-quadrangular, above 
broader and thinner, below narrower and thicker. Position: on the anterior surface of the 
abdomen close to the linea alba. In front it is covered by the anterior leaf of the vagina m. 
recti abdominis; behind it lies in its upper two thirds on the posterior leaf of the vagina m. 
recti, in the lower third directly upon the fascia transversalis. Origin: anterior surface of the 
5th 7tii costal cartilage, of the proc. xiphoideus and of the lig. costoxiphoideum. Insertion: 
its fibres run downward, parallel to one another, close to the linea alba. In its upper half it 
is interrupted by three intercalated tendons, inscriptiones tendineae ; the uppermost, usually 
incomplete, corresponds approximately to the inferior margin of the thorax, the lowermost runs 
transversely at the level of the navel, and the middle one, between these two, in the same direction ; 
these intermediate tendons oiten do not go entirely through the thickness of the muscle ; they 
are very intimately connected with the anterior leaf, but loosely with the posterior leaf of the 
rectal sheath. The number and extent of these tendons varies: usually there is an incomplete 
one below the navel at the level of the linea semicircularis | DouglasiJ. Below, the muscle fibers 
converge and are attached by a strong flat tendon to the ramus superior oss. pubis and to the 
anterior surface of the symphysis ossium pubis ; the fibers of the tendons are very much inter- 
woven. Action: it draws the thorax downward and bends the spinal column forward; when 
the thorax is fixed it elevates the pelvis. Single sections of the muscle can contract separately. 
Innervation: rami anteriores [nn. intercostales] of the nn. thoracales Y XTI. 



278 



The Abdominal Muscles. 



Cosla V 



^f^^sij^ 



^"^fe:-"^ 




N. serratus anterior 



Mm. intercostales 
iuterni 



Mm. intercostales 
externi 



Costa X 



Linea alba 



Vagina m. recti abdomin 
(posterior leaf) 



Linea semilunaris 

[Spigeli] 

M. transversus abdominii 



Linea semicircularis 
[Douglasi] 

M. rectus abdomin 
(cut through) 

Spina iliaca 
anterior superior 

Vagina m. recti 

abdominis 
[(anterior leaf) 

Lig. iirgninale 
fPouparti] 



Funiculus 
speriuaticus 



324. M USCleS of the abdomen (3^* layer), viewed from in front. 

(Mm. obliqui abdominis have been completely removed. The m. rectus abdominis and the anterior 
leaf of its sheath have been removed on each side in their upper two thirds.) 



The Abdominal Muscles. 279 

M. traiisversus abdominis (see also Figs. 313, 321 and 332). Form: flat, quadrangular, 
broad, much longer in front than behind. Position: on the anterior and lateral surface of 
the abdomen, completely covered by the mm. obliqui abdominis, partly also by the m. rectus 
abdominis. Origin: from the Lntemal surface of the 6tii 12*1^ costal cartilage, fi'om the union 
of the two leaves of the fascia lumbodorsalis (see Figs. 332 and 333), from the internal lip 
of the iliac crest and from the lateral two thirds of the hg. inguinale. Insertion: the fibers 
are paraleU, run transversely forward and go over into a tendon plate along a line which is 
concave medianward (Ihiea semihmaris [SpigeU]). This tendon plate (see also Figs. 322 
and 323) runs, in its upper two thirds, behind the m. rectus abdominis and strengthens the 
posterior leaf of the sheath of the rectus; in the lower third, where there is no posterior leaf 
of the rectal sheath, it goes in front of the m. rectus abdominis and fuses with the anterior 
leaf of the rectal sheath. The lowermost fibers arch downward and help to form the posterior 
wall of the inguinal canal (see pag. 282); they are attached partly to the upper surface of 
the pubis, partly to the hg. inguinale. Action: it pulls the ribs downward and diminishes 
the size of the abdominal cavity. Innervation: rami anteriores [nn. intercostales] of the 
nn. thoracales VII XII as well as the nn. Oiohypogastricus and ilioinguinalis. 

Vagina m. recti abdominis (sheath of the rectus) (see also Figs. 317, 319, 320, 
322 and 323) consists on each side of two broad tendinous leaves, which cover, dii'ectly, the 
anterior and posterior surfaces of the m. rectus abdominis and which are formed by the tendons 
of the mm. obliqui et transversus abdominis; medianward both leaves meet those of the other 
side in the linea alba. The anterior leaf covers the whole anterior surface of the m. rectus 
and is firmly fased with its inscriptiones tendineae. It is very thin above and there serves 
to give origin to the pars abdominalis of the m. pectoralis major; it becomes stronger lower 
down and consists of interwoven fibers. In its upper two thirds it is fonned by the anterior 
leaf of the tendon of the m. obliquus Latemus, with which is fused the tendon of the m. obliquus 
externus (see Fig. 322), in its lower third by the union of the tendons of the mm. obUqui 
and of the mm. transversus abdominis (see Fig. 323). The posterior leaf is much shorter, 
begins on the costal cartilages at the angulus infi-astemalis and ends, more or less sharply, 
somewhat below the navel in a margin, the H7iea semicircularis [ Douglasi] , which is concave 
below and stretches out lateralward from the linea alba ; it consists of the transverse tendinous 
fibers of the posterior leaf of the tendon of the m. obhquus internus abdominis and those of 
the m. transversus abdominis. 

Linea alba (see also Figs. 317, 318 and 321 323) is a tough connective tissue strip 
which extends in the median plane between the mm. recti abdominis fi'om the proc. xj'phoideus 
( to the symphysis ossiimi pubis. Below the proc. xyphoideus it gi-aduaUy broadens, being 
about twice as wide at the level of the navel as it is higher up, and again narrows below 
the navel to a thin cord whicJi is attached behind the tendons of the mm. recti abdominis 
to the hg. pubicum superius by means of a triangular expansion (adminiculum lineae albae) 
(see Fig. 328). The sheath of the rectus is attached to the linea alba; indeed it forms it, in 
a way, through the imion of the two leaves of the right side with the two leaves of the left. 
Approximately in its middle and about at the level of the body of the 4'ii lumbar vertebra the 
linea alba contains the navel, umbilicus. 

Ligamentum fundiforme penis (0. T. suspensory ligament) (see Figs. 316 and 317) 
(in the male) is a broad band, consisting essentially of elastic fibers; it arises, above the 
symphysis ossium pubis, from the anterior surface of the vagina m. recti and the hnea alba 
as weU as from the fascia supei-ficiahs abdominis. It surrounds the penis like a loop by 
means of its two Umbs and often radiates out into the scrotum. 

Ligamentum fundiforme clitoridis (0. T. suspensory ligament) (see also Fig. 675) 
(in the female) corresponds to the ligament just mentioned in the male. 



280 



The Abdominal .Muscles. 



Liganientum inguinale [PonpaHiJ 



Fibrae intercrurales 

M. obliquns externus abdominis 



Annulus 



inguinalis subcutaiieus 
I Crus superius 



^-> 




Funiculus 
spermaliciis 
(cut through) 

with 
ui. cremaster 



325. Right anterior abdominal ring and fossa 

ovalis in the male. 

Lig'amcutum inguinale [l^oupartij (0. T. Pouparfs ligament) (see also Figs. 316, 317, 
324, 328, 370 and 376) is a powerful, flatly rounded tendon, which extends from the spina iliaca 
anterior superior to the tubercidum pubicum. To its upper margin are attached the tendinous 
fibers of the m. obliquus externus, and from it arise part of the fibers of the m. obliquus iu- 
ternus and m. transversus abddininis ; to its lower margin the fascia lata is attached and this 
causes a convex downward bulging of the ligament. Medianward the ligament does not end at 
the tuberculum pubicimi alone but also sends diverging fibers to the pecten ossis pubis: the latter 
insertion is a small triangular ligament, lifiamctitum lacunare [Gnfiber/iati] (0. T. Girabernafs 
ligament) (see also i^'igs. 32S and 370), which bounds the annulus fenKjralis (see p. 32.5) with its lateral 
concave margin, and fused with the fascia pectinea, extends obliquely backward and upward. 

Caiialis inguinalis (inguinal canal) (see also Figs. 326328) is a cylindrical space 
filled up by the funiculus spermaticus in tlie male, by the lig. teres uteri in the female: it 
perforates the lowermost portion of the abdominal muscles obliquely from behind and above, 
forward, downward and medianward. The canal has two openings, one posterior, annulus 
in/iuinalis ulidominalis (0. T. internal abdominal ring), and one anterior, annulus inguinalis 
subculancus ((). T. external abdominal ring), and (somewhat schematically) four walls, one 
anteriiir, one inferior, one superior, one posterior. 

The annulus ingui/ialis subculancus (see also Fig. 318) lies somewhat laterally fi"om 
and a little above the tub(>rculum jjubicum. It is forme(l by the separation of the lowermust 
fibers of the tendon of the m. dbliquus extenms from one another giving rise to an acute-angled 
space, which is bounded below by fibers which go to the tuberculum pubicum ferns infcrius, 
0. T. external, pillar), above by fibers which run to the anterior surface of the symphysis ossiura 
pubis (crus superins, 0. T. internal pillar): the larger lateral portion of the space is filled up by 
curved fibers which run transversely, fibrae inter crur alt's (0. T. inters ihunnar fascia, external 
spermatic fascia). These fibers leave as a free opening only a small si)a<'e, convex laterally, 
whicii will permit the passage of the tip of the index finger. 



The Abdominal IMuscles. 



281 



M. obliquus iiitt'i'iius 
ahdoniiuis 



M. obliquus 
externus abdomiuis 

(cut through and " 
reflected downward) - 

Lateral origin of the 
in. creniaster 

Margo falciforinis 
(cornu superius) 



V. femoralis 




M. obliquus externus 

: abdominis (cut throug 

and reflected median- 
^ ward) 



Upper wall of the 
canalis inguinalis 
Posterior wall of th 
canalis inguinalis 



jNledial origin of 
the ni. creniaster 



Funiculus spermaticus 
with m. creniaster 



326. Right inguinal canal in the male (2"^ layer), 

viewed from in front. 

(The m. oliliquits externus abdominis has been cut tbrougb above the anterior abdominal rini;- 
and reflected partly medianward and partly d()wnward. The spermatic cord bas been pressed 

somewhat downward within the inguinal canal.) 

Canalis iugiiiualis (continued). 

Anterior wall: formed by the tendon plate of the m. obliquus externus abdominis, 
and also by the fibrae intercrurales. 

Lower wall: m. obliquus externus: the lig. inguinale [PoupartiJ and the fibrous bands 
of the crus inferius immediately adjacent do not extend in their medial jjortion in a straiglit 
line to the tuberculum pubicum but are curved somewhat downward so that they form a 
groove open above for the spermatic cord. 

Upper wall: m. obliquus internus: the lowermost fibers of this muscle, arising from 
the lig. mguinale, extend in curves medianward and downward, forming lateralward the mus- 
cular, narrow, upper wall of the inguinal canal and going over n^.edianward into the anterior 
layer of the sheath of the rectus; this medial part has its lower insertion sometimes farther 
lateralward and then passes close in front of and along with the fiilx inguinalis to the up])er 
surface of tlie os pubis. 

M. cremaster (see also Figs. '.V2b and 652) (in the nale) is a portion sejiarated 
from the lower margin of the m. obliquus internus. It arises by a thick lateral bundle 
from the upper margin of the lig. inguinale and by a weak, medial bundle from the anterior 
layer of the sheath of the rectus : the furmer lies on the lateral, the latter on the medial surface 
of the spermatic cord; both pass with the spermatic cord through the subcutaneous opening of 
the inguinal canal, spread out in common upon the tunica vaginalis communis of the testis and 
epididymis, and surround it like a loon. Action: it elevates the testis. Innervation: 
n. spermaticus externus. In the female this nuiscle consists of only a few fibers which go to 
the lig. teres uteri. 



282 



The Abdominal Muscles. 



M. obliquus interniis abdominis 
(cut tlirough and reflected mediaiiward) 



M. tiansversus abdominis 
I 



M. obllquns 

nterniis abdominis 

(cut tbrougli and 

reflected lateral- 

ward] 



M 



obliquus extern us 
abdominis 
(cut through and 
reflected downward) 



Margo falciformi: 
(cornu superius) 




M. obliquus 
externus abdominis 

(cut through and 

reflected median- 
ward) 



Posterior wall 
(thin spot) 

Falx inguinalis 

M. crem aster 
(cut away) 

Ligamentum 

inguinale 
reflexum 

ICollesi] 



V. femoralis 



Funiculus 
spermaticus 



327. Right inguinal canal in the male {3^^ layer), 

viewed from in front. 
(The mm. obli(iui abdominis have been cut through above the inguinal canal and reflected 
medianward and lateralward. The spermatic cord has been pressed somewhat downward within 

the inguinal canal.) 

Caiialis iu^uiualis (continued). Posterior wall (see also Fig. 328): m. transversus; 
the lowermost fibers of the m. transversus arch downward on the median side of the posterior 
abdominal ring, spread out in a divergent manner and become attached medianward to the 
upper surface of the os pubis, lateralward to the upper margin of the lig. inguinale. The triangular 
])late thus arising furms the posterior wall of the inguinal canal and varies in strength at 
different places. Medianward it contains a strip of strong tendinous fibers, faLv [ aponeurotica] 
i/iffuinalis, which extends from above downward and medianward to the upper surface of the 
jniltis, and becomes firndy attached by its medial border to the tendon of the m. rectus; m 
front it is not rarely covered and strengthened by fibers of the m. obliquus internus (see 
p. 281). In the lowermost portion of this strip tliere are also fibers which extend from the 
lateral margin of the m. rectus abdominis, in curves, downward and lateralward (see Fig. 328); 
not seldom they are more powerful than the others. The lateral part of the posterior wall is 
strengthened by the lig. interfoveolare (see p. 283). 

The ligamentum inguinale reflextim [CoUesi] (see also Fig. 318) is a thin band of 
fibers, one finger broad, which comes into view medial I'rom th^^anniilus mguinalis subcutaneus, 
between the two crura. It extends from the medial end of the lig. inguinale and lig. lacunare 
obliquely upward and medianward behind the crus superius to the anterior layer of th(> sheath 
of the rectus and in so doing lies partly in front of the lowermost portion of the falx inguinalis. 



\ 



The Abdominal Muscles. 



283 



A. and v. epigastrica Inferior 

Liganientum interfoveolare [Hesselbachi] 
L I 1 ^r. transTersus abdominis 



Linea 
semicircularis 

[Douglasi] 



Linea alba 

M. rectus 
abdominis 



M.interfoveolaris 



Thin spot in the 
posterior svall 



Falx 
[aponeiirotica] 

iugiiinalis 

Adiiiiniculum 

lineae albae 




A. and v. 
teslicularis 

-Ductus deferens 



A. femoralis 

V. femoralis 

M. iliopsoas 



\ Ligamentum inguinale 
[PoupartiJ 

Annulus femoralis 
Lig. lacunare [GimbernatiJ 
Direction of the plica umbilicalis lateralis 



328. Posterior wall of the right inguinal canal 

in the male, vieAved from behind, 

Canalis iuguiualis (continued). Posterior wall (continued): The lateral part of 
the plate connected with the m. transversus, which forms the posterior wall (see p. 2S2) is 
strengthened by a band of fibers markedly concave lateralward and upward, the lu/a?nenhim inter- 
foveolare [Hesselbachi]. This lies just in fi'ont of the a. epigastrica. It consists of fibers which 
bend directly downward from the m. transversus and of those which go off behind the same 
further up ; both kinds of fibers extend downward, bend around chiefly lateralward and upward, 
partly also medianward and downawar<l to the inner surface of the lig. inguinale and fuse with 
it. The falx inguinalis and the lig. interfoveolare vary greatly in strength and breadth. The 
thinner spot, situated between the two, which lies directly behind the subcutaneous abdominal 
ring, is broad, when they are narrow, and vice versa; it contains always single tendon fibers 
of the m. ti'ansversus , consists otherwise of irregularly and loosely arranged fibers, and is 
perforated by the a. spermatica externa and the n. spermaticus externus. On the posterior 
surface of the posterior wall there often run a few buntUes of muscle fibers, m. interfoveolaris, 
either directly behind the lig. interfoveolare, or somewhat more medianward; they arise like a 
fan behind the m. transversus (sqraetimes also ft"om it) and extend downward to the posterior 
surface of the lig. inguinale and .ihe lig. lacunare. 

The annulus ingninalis abdominalis (0. T. internal abdominal ring) lies somewhat 
medianward above the midtlle of the lig. inguinale, is bounded medianward and below by the 
lig. interfoveolare and flattens out gradually lateralward and upward. 



284 



Muscles of the Back. 






Processus spinosus 
vci'tebrae cervicalis VIT 



Spina scapulae 
Acromion 



Processus spinosus 

vertebrae tliora- 

calis XII 



M. splenius capiiis 

M. sternocleidomastoideus 

>I. trapezius 

Fascia infraspinata 



M. deltoideus 




M. triceps 
brachii 



Crista iliaca 



Fascia lumbodorsalis 
(posterior layer) 

JSr. obliquus exteruus 
abdominis 

Trigoiium lumbale 
Petitil 



Vl. glutaeus medius 



C utis 



M. glutaeus 
raaximus 



329. Broad muscles of the back, viewed from behind. 

[Text see pp. 285 and 2S6.] 



Muscles of the T5ack. 



!85 



Protulierantia occipitalis externa 



Processus spinosus vertebrae 
cerviealis VII 

Spina scapulae 
Acromion 



M. seuiispinalis capitis 

M. splenius capitis et cervicis 
M. levator scapulae 

M. rhomboideus minor 

JI, rhomboideus major 

Fascia infraspinata 

M. supraspinatus 

M. deltoideus 




Processus spinosus vertebrae thoraralis VI 



M. latissimus dorsi 

M. teres major 



M. triceps brachii 
M. teres minor 



330. Broad muscles of the back 

(2"'^ layer), viewed from behind. 
(The mm. trapezii and sternocleidomastoidei have been removed.) [Text see also pp. 286 287. J 

M. trapezius (see Fig. 329). Form: flat, triangular, broad. Position: in the neck and 
upper part of the back, just beneath the skin. Origin (see also Fig. 296): tendinous froin 
the linea nuchae superior, protuberantia occipitalis externa, lig. nuchae and lig. supraspinal 
as far as the 1211^ thoracic verteljra; the tendon fibers are connected with those of the other 
side, are longer in the neighborhood of the vertebra prominens, and there form, on each side, 
a triangular area. Insertion: the upper fibers extend oblicfuely downward and forward to the 
acrominal extremity of the claviel'-, the middle fibers transversely to the acromion and to the 
sjiine of the scapula: the luwev libers obii"'" - "i.'-.-..-r! nnH lateralward to become attached 
by a small, triangular, flat tendon to the ii le of the scapula. Action: it 

draws the shoulder-blade toward the spi'^t ..i.; >. .. .. _ ..lat the angulus inferior is dis- 

placed lateralward. the nngnlus later&li.s npwird: when, the .<U')Older-blade is fixed, it draws 
the head backward and r.'tiit<r ' along with tlie face, 6"i"ewhat toward the other side. 
Innervation: r. externus n. i\''\ssorii and .i branch of the plexus cerviealis. 

Spalteholz, Atlas. J9 



28G 



Muscles of the Back. 



Insertion of Ihe m. latissimus dorsi 
M. serratus posterior inferior 



Processus spinosus vertebrae thoracalis XII 
I M. latissimus dorsi 




II I I 

] I Tendon of origin of the ni. i I 

I j transversus abdominis Fascia lunibodorsalis ; 
I I M. obliquus internus (posterior layer) 

' Crista iliaca abdominis M. glutaeus maximus 

M. obliquus externus abdominis 



I 



I M. obliquus 

externus abdominis 
I Trigonum lumbale [Petiti] 
M. glutaeus medius 



331. Muscles of the lumbar region (l^Mayer), viewed from 

behind. (,(_)ii the left the m. latissimus dorsi has been removed.) [Text see also pp. 287 and 288.] 

M. latissimus dorsi (see also Figs. 316, 329, 330 and 343). Form: hat, triangular, 
thin. Position: in the lower part of the back and lateral region of the thorax, being partly 
covered above by the ra. trapezius. Origin: tendinous from the posterior layer of the fascia 
lumbodorsalis , from tbe proc. spinosus of the 6'^ thoracic vertebra on downward, from the 
crista iliaca and, by three or four fleshy digitations, from the external surface of the three or 
four lowermost ribs. Insertion: the fibers run, converging, lateralward, the upper fibers 
more transversely, the lower almost straight upward ; they lie on the lateral wall of the thorax 
close to the m. serratus anterior, fuse with the lower margin of the m. teres major, wind 
ardund it to its anterior surface and become attached by a flat tendon to the crista tuberculi 
niiniiris humeri. Between these two muscles, in this situation, Ues the bursa m. latissimi 
dorsi (see Fig. 345). Action: it draws the aim medianward and backward; it draws the 
shoulder-blade medianward and downward. Innervation: n. thoracodorsalis. 

M. rhoinboidcus major (see Figs. 329 and 330). Form: flat, quadrangular. 
Position: upper part of the back, covered by the m. trapezius. Origin: tendinous from 
spinous processes and interspinal ligaments of the pt 4th thoracic vertebra. Insertion: the 
fibres run parallel downward and lateralward to the margo vertebrahs scapidae. Action: it 
draws the shuulder-bladt^ medianward and u])war(l and rotates it at the same time so that 
the aiigulus inferior scapulae is turned medianward. Innervation: n. dorsalis scapulae. 

M. rhomboideus minor (see Fig. ?.30), often only indistinctly separable from the 
prt>ceding muscle. F(rm: flat, obl^.ig-quadrangular. Position: directly on the upper margin 
of the preceding muscle. Origin: tendinous from the lig. nuchae and the spinous processes 
of the two lower cervical vertebrae. Insertion: like that of the preceding muscle, just above 
the same. Action and innervation: same as for the preceding muscle. 



Muscles of the Back. 



287 



Diaphragma (pars costalis) 



Insertion of the ni. latissimus dorsi 



Costa XII 



Iu>;ertion of the 
m. serratus posterior inferior 




M. serratus posterior inferior 

I Mm. intercostales exteriii 

I I 

I I Mm. intercostales interni 





M. transversus abdominis I 
Crista iliaca 



Proc. transversus 
I 1 vert, lumbalis IV 
! M. sacrospinalis 
' (cut through) 

P'ascia himbodorsalis 
(anterior laj'er) 



1 J M. obliquus internus 

j I abdominis 

I Tendon of origin 

I of the m. transversus abdominis 

Fascia himbodorsalis (posterior layer) 



332. Muscles of the lumbar 

viewed from behind. 



region (2^ layer), 



(The mm. kitissimus dorsi and obhquus extemus abdominis have been removed on both sides: on the 
left side the mm. obliquus internus abdominis and serratus posterior inferior have also been removed.) 

[Text see also p. 288.] 

M. levator scapulae (O.T. levator ang-uli scajjulae) (see Figs. 299 301 and 330). Form: 
flatly roimded, oblong. Position: on the lateral surface of the neck, covered by the mm. sterno- 
cleidomastoideus and trapezius, in front coming in contact with the m. scalenus posterior, behind 
with the m. sjilenius capitis et cervicis. Origin: by four tendinous processus from the posterior 
tubercles of the transverse processes of the l^t 4th cervk'al vertebra (see Figs. 306 and 335). 
Insertion: the fibers run parallel downward, backward and lateralward to the margo vertebraUs 
scapulae. Action: it draws the shoulder-blade medianward and upward and rotates it so that 
the angulus inferior is turned medianward ; when the shoulder-blade is fixed, it bends the cervical 
portion of the spine to the same side and rotates it somewhat. Innervation: n. doi'saiifrscapulae. 

Trlgonum lumbale [Petiti] (O.T.Petit's triangle) (see Fig. 331), a triangular thiimer spot 
of the posterior abdominal wall, varying in size; below it is bounded by the crista iliaca, lateralward 
by the posterior margin of the m. o))liquus extemus abdominis, medianward by the lateral margin of 
the m. latissimus dorsi. In this triangle the muscle fibers of them, obliqims internus are visible; in 
front of them lies the tendon of origin of the m . tran sversus abdominis and of the m. quadratus liimborum. 

Fascia uuchae (not represented in the figure) is a thin membrane of connective tissue 
which lies just beneath the mm. trapezius aud rhomboidei; it goes off from the inferior surface 
of the squama occipitahs , covers the mm. splenii capitis et cervicis and seraispinalis capitis, 
is connected medianward with the lig. nuchae, is continued in front into the fascia colli and 
goes over below at the m. serratus posterior superior into the fascia lumbodorsalis. 

1<J* 



288 



Muscles of the Back. 



Fibrocartilago iutervertebi alls 
vertebrae liinibalis IJI et IV 



Cavum 
articulare 



M. obliquus externus abdominis 

M. psoas minor ji. obliquus iuternus abdominis j 

M. psoas major m. transversus ' < 



Processus transversus 
vertebrae lumbalis I\' 
Fascia iliaca 



abdominis 




fl 



''/ 



Cutis 



[ I\r. latissimus dorsi 

^inniculus adiposus 



Tendon of origin of tlie 
m. transversus abdominis 



Processus spinosus 
vertebrae lumbalis IV 



Ligamentnm 
supraspinale 



Anterior layer i 
Posterior laver I 



of the fascia lumbodorsalis 



1 Fascia superticialis 

M. sacrospinalis 



333. Transverse section through the muscles of 

the lumbar region, (after W. Braune). 

Thi> fascia lumbodorsalis consists of two layers. 

The posterior layer (see also Figs. 329, 331, 332 and 334) lies just below the 
mm. trapezius, rhomboidei and latissimus dorsi on the posterior surface of them, sacrospinalis, 
is thin at its beginning at the m. serratus posterior sujierior, where it is continuous with the 
fascia nucliae (see p. 2S7), forms a sheath below for the m. serratus posterior inferior and, 
becoming stronger, descends as far as the coccygeal region; on its way it is fused median ward 
with the spinous processes and supraspinal ligament of the thoracic and lumbar vertebrae and 
with the crista sacralis media ; below, it fuses Avith the posterior ligaments of the sacriun and 
with tlie crista iliaca, lateralward with the anguli costaruin and, below the ribs, between them 
and the crista iliaca, with the anterior layer. It consists above of transverse, below of oblique 
crossing fibers, mIucIi represent in part the immediate continuation of the mm. serratus posterior 
inferior iind latissinms dorsi arising from the fascia. 

The anterior layer (see also Figs. 312, 315, 332 and 340) is thinner, lies in front 
of the m. sacrospinalis, l)ehind tlie mm. (piadratus luraborum and psoas major and extends 
only from the 12t'i j-j]^ ^q ^jjg crista iliaca, being fastened to both. It arises by four processes 
from tlie transverse processes of the lst_4th lumbar vertebra, is connected below with the 
lig. iliolumbale and contnins, above, powerful curved fibrous bands Avhich extend from the 1 st 
and 2'"' lunil)ar vertebra to the \2^^^ rib, the lujameiitum lumbocpstalc (see Figs. 312, 315 
and 34ii). Tho tiliers of the anterior layer run essentially transversely, unite lateral from the 
111. sacrospinalis with th(> fibers of the posterior layer and thus together form the tendon of 
origin of the m. transversus abdominis; tlie m. obliquus iuternus abdominis arises in part from 
the posterior surface of the (combined layers. 



Muscles of the Back. 



289 



334. Broad muscles of the back (S'^kyer), viewed from behind. 

(The shoulder-blades and the muscles going to thera have been removed.) 
3E. serratiis posterior 

Protiiberantia 
occipitalis _ 



externa 



Processus 
iiiastoideus 



Processus spinosiis 
vertebrae oervicalis Vli 



M. semispinalis capitis 



]M. splenitis capitis 

et cervicis 



scaleni 



serratus posterior 
superior 



Processus 

spinosus 

vertebrae 

tlioracalis IV 



Costa VI 



superior (O.T. serratus ])usticu 
superior). Form: flat, qua- 
. drangular, very thin . Position: 
upper part of the back, covered 
by the mm. rhomboidei. Origin: 
by a flat tendon from the lig. 
michae or the spinous processes 
of the 6^li and 't^ cervical and 
1 St and 211'^ thoracic vertebrae. In- 
sertion: the fibers run parallel, 
obliquely lateralward and down- 
ward and terminate by four fleshy 
digitations on the 2nd 5th rib. 
Action: it elevates these ribs. 
Innervation: rami anteriores 
[nn. intercostales] of the nn. 
thoracales I IV. 

M. serratus posterior in- 
ferior (0. T. serratus posticus 
inferior) (see also Fig. 331). 
Form: flat, quadrangular, very 
thin. Position: lower part of 
the back, covered by the m. la- 
tissimus dorsi and partly also by 
the m. trapezius. Origin: po- 
sterid^- layer of the fascia lumbo- 
dorsalis in the region of the 
10tli_i-2tli thoracic'and the 1st 
and 2Jid lumbar vertebrae. In- 
sertion: the fibers run parallel 
obliquely lateralward and upw;ird 
tind terminate by lour fleshy di- 
gitations on the"^ 9<ii 12'h rib. 
Action: it draws these ribs 
downward and outward; it con- 
tracts on inspiration. Inner- 
vation: rami anteriores [nn. in- 
tercostales] of the nn. thora- 
cales IX XII. 

M. splenius capitis (see 
also Figs. 296, 301, 330 and 335). 
For m : flat, oblong-quadrangular, 
thick. Position: in the neck, 
partly covered by the mm. trajjc- 
zius and sternocleidomastoideus, 
serratus posterior superior ;nid 
rhomlx)idei. Origin: lig. nucbne 

at the level of the 3r'<i 7tii cervical vertebra as well as from the spinous processes of the 
1st and 2nd thoracic vertebrae. Insertion: the fibers converge somewhat and i>ass upward 
lateralward by a thick, short tendon to the proc. mastoideus and to the linea nuchae superior 
OSS. occipitahs. Action: it rotates the head so that the face is turned upward and toward thi' 
same side; the muscles of the two sides together bend the head backward. Innervation: 
rami laterales of the rami posteriores of the nn. cervicales II VIII. 

M. splenius cervieis (0. T. splenius colli) (see Figs. 296, 3;i0 and 335). Form: flat, 
'jlduug-quadrangular, narrow. Position: it forms in a way a continuation downward of the 
preceding muscle and is often indistinctly separable from it. Origin: procc. spinosi and ligg. 
interspinalia of the 3r'i 6*11 thoracic vertebra. Insertion: by 23 processes to the tubercula 
posteriora of the procc. transversi of the 23 uppermost cervical vertebrae. Action: it bends 
the neck backward and lateralward and rotates the atlas like the preceding muscle rotates the 
head. Innervation: like that of the preceding muscle. 



Processus 

spinosus 

vertebrae 

thoracalis' 

XII 



Costa XII 




Fascia 
Uimbn- 
dorsalis 

Mm. inter- 
costales 
extern! 



iSf. serratus 
posterior 
inferior 



I'ascia 
umbodorsali 

M. 
transversus 
abdominis 



290 



Muscles of the Back. 



M. semispinalis 
capitis 



Protuberantia 
occipitalis externa 



_, ._ _ Processus 

iiiastoideus 

J 4 M- splenius capitis 

7,, (cut. through) 

M. longissimus capitis 



M. semispinalis 
capitis 



M. scalenus posterior 



Nj M. levator 
scapulae 
(cut through) 



M. splenius cervicis 
(cut through) 

M. longissimus cervicis 



Mm. inter- 
costales 
extern i 




M. iliocostalis cervicis 



- M. scalenus posterior 



>I. iliocostalis cervicis 



_ M. iliocostalis 

dorsi 
M. longissimus 
dorsi 



335. Muscles of the neck (left: 2"'^ layer, right: 3^ layer), 

viewed from behind. 

(On botli sides the iiini. trapezius, sternocleidomastoideus and levator scapulae Lave Leeu removed, 
on the right side tlie nun. splenii have also been removed.) [Text see p. 289 and 291 293.] 



Muscles of the Back. 



291 



Protuberantia 
occipitalis externa 



Tiiberculum posterius 
atlantis 



Processus spiuosus ver- 
tebrae cervicalis VII 



M. iliocostalis 
cervicis 



336. Long muscles of the back (pMayer), 

(On the right sicb' thi> in. ihucostalis has heen pulled lateralward, on 

reflected.) [Text see also pp. 292 and 293.] 

M. sacrospinalis (O.T. erector 
spmae) (see also Figs. 332, 333 
and 337 340. Form: trian- 
gular-prismatic, long. Position: 
on each side along the median 
plane from the sacral region to 
the neck. r i g i n : fleshy in the 
depth, otherwise by lung tendons 
from the crista iliaca, posterior 
surface of the sacrum, spinous 
processes of the lumbar vertebrae, 
inner surface of the fascia lim]bo- 
dorsalis. The mass of fibers is divi- 
sible in the lumbar region into three 
separate mucles : m. iUocostalis, 
m. longissimus and m. spinalis. 
M. iliocostalis (0. T. external 
division of erector spinae), farthest 
lateralward, extends between the 
ribs or their homologues. 

M. iliocostalis lumborum 
(O.T. sacrolumbalis) .Insert! o n : 
by nine processes, the lower ones 
fleshy, the upper ones thin and 
tendinous, to the angles of the 

12*11 4tii rib. Action: it can 
depress the ribs. 

M. iliocostalis dorsi (0. T. 
accessory to the iUocostal). Ori- 
gin: covered by the preceding, 
it arises by six fleshy digitations 
from the angles of the \2^^ 7* 
rib. Insertion: by eight thin 
tendons to the angles of the 1^^ to 

1st ]-[i3 ami the transverse process 

of the 7tli cervical vertebra. 
M. iliocostalis cervicis (0. 

T. cervicalis ascendens) (see also 

Fig. 335). Position: it is bound- 
ed in front by the m. scalenus 

posterior, lateralward by the m. 

levator scapulae, medianward by 

the mm. splenius and longissimus 

cervicis. Origin: covered by 

the preceding muscle, it arises 

bv 4 6 fleshy processes from 

the angles of the 6tli 3i-'i (2"<i 

or 1^) rib. Insertion: by three 

narrow tendons to the transverse 

processes of the 6*^1 4fh cervical 

vertebra. Action: it bends the 

neck backward and toward the 

same side: it can elevate the ribs. 
Action of the whole m. ilio- 
costalis : it bends the spinal 

colunm backward and toward the 

same side. Innervation: rami 

laterales of the rami posteriores 

of the nn. cervicales III VIII, 

thoracales I XII and lumbalis I. 



viewed from behind. 

the left side it has been 



M. longissimus capitis 

M. interspinalis 
- M. longissimus cervicis 
M. spinalis cervicis 



M. iliocostalis 
cervicis 



Proc. 

spin.ver- 
tebrae 
thora- 

calis VI 

M. ilio- 
costalis 
dorsi 



Proc. spin. 

vertebrae 

thoracalis 

XII 

Costa XII 



Pelvis 




Mm. 

intercostales 

externi 



M. 

iliocostalis 
dorsi 



M. 

longissimus 

dorsi 



M. spinalis 
dorsi 



M. iliocostalis 
lumborum 



M. iliocostalis 
lumborum 



Ligamentum 
sacrospinosum 

Ligamentum 
sacrotuberosum 

Tuber ischiadicuni 



292 



Muscles of the Back. 



I'rotaberantiii 

occipitalis 

externa 



M. loDgissimus 
capitis 



M. loiigissimtis 
cervicis 



337. Long muscles of the back (2"^MaYer), viewed from behind. 

(The mm. ihocostiiles have been removed; the mm. longissimi dorsi have been reflected outward ; 

thi> m. long'issimus cervicis has been, on the right side, drawn hiteralward, on the left side, 

medianward; the m. longissimiis ca]iitis has been drawn medianward on the right side.) 

M. lougissimus (0. T. middle division 
of erector spinae) (see also Fig. 336) is the 
middle bundle of the m. sacrospinalis ; it 
extends (in the back only by its medial 
digitations) between the transverse pro- 
cesses or their homologues. 

M. lougissimus dorsi. Ori- 
gin: it receives medianward 
several short, accessory bundles 
from the transverse processes of 
the 12th 7th thoracic vertebra. 
Insertion: l^t, by thin, la- 
teral processes, fleshy below, 
tendinous above, to the transverse 
jirocesses of the 5th jst Imnbar 
vertebra and the angles of the 
12th 2nd i-ib (see Fig. 336); 
2"<J^ by medial processes, below 
fleshy, above tendinous, to the 
procc. accessorii of the 5th to 
1st lumbar vertebrae and the 
procc. transversi of all the tho- 
racic vertebrae. Action: it 
bends the spinal column back- 
ward and toward the same side. 
M. longissiniHS cervicis (see 
also Fig. 335). Form: flat, thin. 
Position: medianward from the 
m. iliocostahs cervicis, lateral- 
ward from the m. longissimus 
capitis. Origin: uppermost 4 6 
thoracic vertebrae. Insertion: 
the middle cervical vertebrae. 
Action: it bends the neck 
Itackward and to\\ard the same 
side. 

M. loiig'issimus capitis (0. 
T. tracbelomastoid) (see also Fig. 
335). Form: flat, oblong-(iua- 
drangular, thin: usually fused 
with the preceding muscle. Posi- 
tion: medianward from the m. 
longissimus cervicis, lateralward 
from the m. semispinalis capitis. 
Origin: procc. transversi of the 
3rd_list thoracic vertebra and 
procc. articulares of the 7th 3rd 
cervical vertebra. Insertion: 
thickened and tendinous to the 
proc. mastoideus. Action: it 
draws the head backward and 
toward the same side. 

Innervation: rami laterales 
of the rami posteriores of the 
nn. cervicales II VIII, thora- 
cales I XII, lumbales I V, and 
sacrales I and IT. 



Mm. 

intercostale 

externi 



M. 
semi- 
spinalis 
dorsi 




Muscles of the Back. 



293 



338. Short muscles of the back (P^ layer), viewed from behind. 

(The 111. seiiiispiiiahs eiipitis has been removed mi the left side.) 



Protubcraiitia 

occipitalis 

externa 



Processus 
mastoideus 



M. semispiualis capitis 



semispinalis cervicis 



Processus spinosus verte 
brae cervicalis VII 

Costa I - 



( 



Processus 

spinosus 

vertebrae 

thorac. VI 



M. semi- 
spinalis 
dorsi 



M. spinalis (0. T. inner divi- 
sion of erector spinae) (see Y'vj^. 
336), very thin, lornis the metlial 
part of the m. sacrospinalis and ex- 
tends between spinous processes. 
M. spinalis dorsi. Orif,'in: 
tendinous from the two upper- 
most lumbar and the two (or 
three) lowermost thoracic verte- 
brae, intimately fused with the 
m. longissimus. Insertion: 
tendinous to the thoracic ver- 
tebrae from the %^^ (or 8th) to 
the 2"i inclusive; one vertebra 
(10^*1 or y'b) is' passed over 
without attachment. 

M. spinalis cervicis (0. T. 
s])inalis colli), very variable. 
Origin: two uppermost tho- 
racic and two lowermost cervical 
vertebrae. Insertion: A^^ to 
2"d cervical vertebra. 

Action: they extend the spi- 
nal column. Innervation : rami 
mediales of the rami posteriores 
of the nn. cervicales III VIII 
and thoracales I XII. 

M. spinalis capitis see under 
m. semispinalis capitis. 

M. semispinalis (see also Fig-. 
^37) is the superficial and most 
vertical layer of the fiber masses. 
which, running obliquely upward 
from the procc. transversi to the 
procc. spinosi, fills up the groove 
between the jirocc. spinosi and 
transversi as a triangular prisma- 
tic cord ; the fibers pass over more 
than four vertebral bodies before 
becoming attached. The muscle 
is absent in the lumbar region. 

M. semispinalis dorsi. Origin: procc. transversi of the six lower thoracic vertebrae. 
Insertion: j)rocc. spinosi of the six upper thoracic and two lower cervical vertebrae. 

M. semispinalis cervicis (0. T. semispinalis colli). Origin: procc. transversi of the 
six upper thoracic vertebrae. Insertion: procc. spinosi of the 5tii 2nd cervical vertebra. 

Action: they bend the spinal column backward and rotate it toward the opposite side. 

M. semispinalis capitis (0. T. complexus) (see also Figs. 296 and 335). Form: flat, 
oblong-quadrangular, thick. Position: bounded medianward by the lig. nuchae, lateral- 
ward by the m. longissimus capitis, covered in large part by the mm. splenii and trapezius. 
Origin: procc. transversi of tlie six upper thoracic vertebrae, procc. transversi et articulares 
of the 3 4 lower cervical vertelirae and procc. spinosi of the uppermost thoracic and lowermost 
cervical vertebrae. The fibers coming from the procc. spinosi are sometimes separated so as 
to form an independent muscle, the m. spinalis capitis. Insertion: the fibers run parallel 
upward and snmewhat medianward to the under surface of the si[uama occipitalis; they are 
interrupted, especially medianward, by one or several jagged intermediate tendons. Action: 
it draws the head backward and raises the face toward the other side. 

Innervation: rami mediales of the rami posteriores of the nn. cervicales II YIII 
and thoracales I XII. 



k 



Proc. spin. 

vertebrae 

thoracalis 

XII 

Costa Xn 



^V- 




294 



Muscles of the Back. 

339. Short muscles of the back 

(2"^^ layer 



c), viewed from behind. 



Protiiberantia 
occipitalis externa 



Processus mastoideiis 



multifidus 



Processus spinosus 

vertebrae 

cervicalis VII 



Costa II 



Processus 

spinosus 

vertebrae 

thoracal is VI 



Costa XI 



Processus spinosus 

vertebrae 

thoracalis XI T 



Pelvis 



Fascia 
mbodorsalis 
ut through) 




M. 

multifidus 



^ 



M. multifidus (see also 
Fig. 337) is the second layer 
of the muscular mass extending 
from the procc. transversi to 
the procc. spinosi ohliquely 
upward; it lies in the back 
and neck just below the m. 
seraispinalis, in the Imnbar 
region just below the m. longis- 
siraus dorsi; its fibers bridge 
over from two to four vertebral 
bodies . Origins: posterior 
surface of the sacrum, procc. 
mamillares and accessorii of 
the limibar vertebrae, procc. 
transversi of the thoracic ver- 
tebrae and procc. articulares of 
the 1^^ i^^ cervical vertebra. 
Insertions: procc. spinosi of 
the lumbar, thoracic and cer- 
vical vertebrae (with the ex- 
ception of the atlas). Action: 
it bends the spinal column back- 
ward and rotates it toward the 
opposite side (it bends the 
lumbar spine backward only, 
without rotating it). Inner- 
vation: rami mediales of the 
rami posteriores of the nn. cer- 
vieales III VIII, thoracales 
I XII and lumbales I \. 

The mm. rotatores (see 
Fig. 340) form the third, deepest 
layer of the fiber masses going 
oblitpiely tipward from the 
procc. transversi to the procc. 
spinosi; they are completely 
hidden by the m. multifidus. 
They consist of single, narrow, 
thin muscle bands. 

Mm. i-otatoros lougi 
bridge over one vertebra. 

Mm. rotsitores breves 
iro tn thi" next vertebra above. 
Both go to the root of the 
procc. spinosi or to the arcus 
vertebrae, are present from the 
sacrum as far as the 2"d cer- 
vical vertebra and, below, rim 
nearly vertically, above, more 
transversely. Action and 
i n n e r V a t i 1 1 n : same as for 
thi' m. multifidus. 



Muscles of the Back. 



295 



340. Short muscles of the back (S'^'^ layer), viewed from behind. 



Mm. levatores costarum. Form. Hat, tri- 
angular, thin. Position: behind the articulationes 



costotransversariae , covered by 
Origin: procc. transversi of 
the Tth cervical and 1st nth 
thoracic vertebra . Insertion: 
lateralward and downward to 
the next rib below (mm. leva- 
tores costarum breves) ; in the 
3 4 lower intercostal spaces 
also to the next rib but one 
below (mm. levatores costarum 
longi). The}' are directly ad- 
jacent to the mm. intercostales 
externi. Action: they extend 
the spinal column, incline it 
toward the same, and rotate it 
toward the opposite side. In- 
nervation: ramus posterior of 
the n. cervicalis Vni and rami 
anteriores [nn. intercostales] of 
the nn. thoracales I XL 
Mm. interspiuales, short 



the ni. 



longissimus 



Protuberantia 
occipitalis externa 

Processus mastoideus 

Tuberculum 
posterius atlant 



Processus spinosus 
vertebrae cervicalis VII 



_ Jr. rectus capitis 
posterior minor 



Costa 



- M. rotator 
brevis 



Costa VI 

Proc. spill, 
vertebrae ^ 
thoracf. VI 



bundles between every two 
neighboring spinous processes ; 
from the epistropheus to the 
saciHim. They are often double 
on the cervical vertebrae, are 
usually absent from the thoracic 
vertebrae but very powerful on 
the lumbar vertebrae. Action: 
they bend the spinal column 
backward. Innervation: 
, rami mediales of the rami 
posteriores of the nn. cervicales 
III VIII, thoracales I XII 
and lumbales I Y. 

Mm. iutertrausversarii 
(O.T. intertransversales), short 
bundles between every -two 
neighboring transverse pro- 
cesses. They are usually absent 
from the thoracic vertebrae. 
They are double on the cervical 
vertebrae, extending between 
adjacent tiibercida anteriora 
(mm. intertransversarii an- 
teriores) and also between 
adjacent tubercula posteriora 
(mm. intertransversarii poste- 
riores). They are double also 
on the lumbar vertebrae extend- 
ing between the procc. marail- 
lares (mm. intertransversarii 
mediales) and between the procc. 
(mm. intertransversarii laterales). 
they bend the spinal cohunn to 
Innervation: direct branches of the plexus 
cervicalis and brachialis; rami anterior(>s [nn. 
intercostales] of the nn. thuracales: rami la- 
terales of the rami posteriores of the nn. lum- 
bales I V. 



Processus 
spinos. vert, 
tliorac. XII 



Costa XI t 



-M. transversus 
abdominis 

M. iiiterspinalis 



Proc. 

spinosus 

vertebrae 

lumb. V 



Os sacrum 



transversi 
Action: 
the side. 




Pelvis 



M. rotator 
longus 

M. levati 
costae bn 



M. levati 
costae loii 



Ligamentun 
lumbocostal 

jSI. inter- 

transvers. no 

Fascia lumbc 

(Fusion of 

layers) 

M. iiifertrans 

lateralis 

Fascia luni 

~ fiorsalis 

(anterior la; 

JI. rotate 

longus 

M. rotate 
brevis 



296 



Muscles of the Back 

Linea nuchae inferior 
Liiiea nncliae superior 



Protnbevaiitia occipitalis externa 



Foramen 

niastoi- 

deuui 



Processus 
luastoideus 



Processus transversus 
atlautis 

A. vertebralis 



Tiibereulum posterius atlantis 




" ' .M.'obliquus capitis 
superior, 
""-^, M. rectus capitis 
postcrfor niiEor 
M. rectus capitis 
posterior major 

M. obliquus capitis inferior 



JM. intertransYersarius posterior 



Processus spinosus epistrophei 



- M. iutersjiiuiilis 



Processus spinosus verteijrae cerviealis III 



341. Short muscles of the neck, viewed from behind and below. 

M. rectus capitis posterior major (0. T. rectus capitis posticus major). Form: flat, 
oljlniio'-triiin^'ular. rusitioii: immodiati'ly upon the vertebrae. Origin: proc. spinosus 
opistni])hei. Jnscrtion: slii^htly diverging, upward and lateralward to the inferior surface of 
tlio squama occipitalis. Action: it draws the head backward, and rotates it toward the 
same side. Innervation: ranms ])osterior of the n. suboccipitalis. 

31. rectus capitis posterior minor (0. T. rectus capitis posticus minor) (see also 
''"ig. 340). Fnrm: Hat, triangular. I'osition: immediattdy upon the membrana atlantooccipitalis 
isti'riiir, rcacliiug as far as the median plane; lateralward it is partially covered by the 
.eceding muscle. Origin: tuberculum posterius atlantis. Insertion: slightly diverging, 
ii]iward t(> the inferior surface of the squama occipitalis. Action: it draws the head back- 
ward, lunervatidu: raiuus posterior of the n. suhoccipitahs. 

31. (l)li<|uus capitis superior. Form: flat, oblong-triangular. Position: lateralward 
and bacivward from the articulatio atlantooccipitalis. Origin: ])roc. transversus atlantis. In- 
sertion : slightly diverging, obliquely upward and medianward to the inferior surface t)f the squama 
nccipitidis. A r t i 1.11 : it draws tlir lic;id l):ickward. Inner v. : ramus posteriori if then. su1)occipitalis. 

31. obliquus capitis inferior. Form: flat, oblong. Position: immediately upon 
the vertebrae. Origin: proc. spinosus epistrophei. Insertion: lateralward and upward to 
the proc. transversus atlantis. Action: it rotates the atlas and the head toward the samo 
side. Innervation: ramus posterior of the n. suboccipitalis. 



Muscles of the Ann. 



29- 



342. Muscles of 

the right upper 

arm, 

viewed from the lateral 
side. 

M. deltoideus (see also 
Figs. 308, 310, 329, 330, 343, 
347 and 349). Form: flat, 
triangular, bent so as to be 
markedly trougblike , thicker 
in the middle than at the bor- 
ders. Position: just beneath 
the skin; it forms the fleshy 
projection of the shoulder. 
Origin: fleshy from the ex- 
tremitas acromialis claviculae 
and fhe acromion, tendinous 
from the spina scapulae, connect- 
ed with the fascia infraspinata. 
Insertion: the anterior and 
posterior fibers ruu in almost 
straight line downward and 
lateralward, the middle fibers 
curve downward over the tuber- 
culuni tnajus humeri (bursa 
suhdeltoidca see Fig. 345) ; the 
middle part of the muscle 
presents a markedly pinnate 
appearance ; all the fibers con- 
verge to the tuberositas del- 
toidea humeri, lateralward and 
below the insertion of the m. 
pectoralis major. Action: it 
lifts the upper arm lateralward 
in the shoulder joint. In- 
nervation: n. axillaris. 

Bursa subcutauea acro- 
mialis (see Fig. 349), often 
present, just beneath the skin, 
on the upper surface of the 
acromion. 



Acromion 



\i. triceps 
braciiii 


"" i 


(caput 
longuiu) 


/ 


H. triceps 
brachii 


il 


(caput 
laterale) 


f 




Clayicula 



M. 
deltoid 



W^ 



M. biceps 
braciiii 



M. bracliialis 



Septum 

intermiisculare 

laterale 



(_)lecraiii)n 



M. 
ancouaeus 



M. extensor 
carpi ulnaris 

JI. extensor 
digitorum 
comnuiiiis 



-%- 



/i^ 




.\[. brachioradialis 



Epicondylus lateralis 
humeri 



M. extensor jar 
radialis lor 



M. extensor carpi 
radialis brevis 



c* 



298 



Muscles of the Ami. 



M. pectoralis major 
M. deltoideus 



M. coracobrachial is 



M. biceps brachii 




M. serratus anterior 



M. triceps bracliii 



343. Muscles of the right axilla, viewed from below. 

(The upper arm has been lifted to the horizontal plane.) 

The axilla, when the upper arm is maintained in the horizontal plane, has the shape 
of a three-sided pyramid, the apex of which lies above, below the clavicle, and the base of 
which coiTesponds to the lower wall, covered only by skin and fascia. This inferior wall is 
bounded in front by the m. pectoralis major, behind by the mm. latissimus dorsi and teres 
major, median ward by the m. serratus anterior. The anterior wall is formed by the mm. pecto- 
ralis major and pectoralis minor, the posterior wall by the mm. latissimus dorsi, teres major 
and m. subscapidaris, the medial wall by the m. serratus anterior. Along the angle between 
the anterior and posterior wall lies the m. coracobrachialis ; in the groove behind the latter, 
between it and the muscles of the posterior wall, run the vessels and nerves. The axilla is 
filled with blood vessels, lymph vessels, lymph glands, nerves, and masses of fat. 



Muscles of the Ai-m. 



299 



A. and V. subscapularis 
M. deltoideus 



M. coracobrachialis 
M. biceps brachii 



M. pectoralis 
major 




Tendo m. latissimi 
dorsi 



INI. latissimus dorsi 



M. serratus anterior 



344. Fasciae of the right axilla, viewed from below. 

(The drawing corresponds to Fig. 343; the upper arm is in the horizontal plane.) 

Axilla (continued). The anterior surface of the in. pectoralis major is covered over 
by the thin fascia pectoralis. This is more powerful lateralward and extends, from the lower 
margin of the muscle to the lower margin of the mm. latissimus dorsi said teres major, trans- 
versely across the axilla to form the fascia axillai-is. The latter is multiply perforated and 
presents usually a more powerful, curved, fibrous band, the axillary arch, which varies much 
in form and curvature, not infrequently contains muscle fibers and extends from the region 
of the tendon of the m. pectoralis major to that of the m. latissimus dorsi: it is manifoldly 
connected with these tendons. The fascia axillaris goes over behind into the thin fascia of the 
mm. latissimus dorsi and teres major, in front into the thin covering of the m. deltoideus 
and lateralward into the somewhat stronger fascia brachii. This forms a sheath for the 
whole muscular mass of the upper arm and sends on each side a stronger strip to the margo 
medialis and the margo lateralis humeri, the septtim intermuscular e mediale (0. T. internal 
intermuscular septum) and the septum intermuscular e laterale (0. T. external intermuscular 
septum), the former passing medianward and the latter lateralward between the m. triceps 
brachii on the one hand and all the other muscles of the upper arm on the other. The 
medial septum (see Figs. 348 and 353) lies immediately behind the insertion of them, coraco- 
brachialis, behind the mm. brachialis and pronator teres and in front of the caput mediale 
111. tricipitis brachii. The lateral septum (see Figs. 342 and 351) begins behind the insertion 
of the m. deltoideus and runs behind the mm. brachiaUs, brachioradialis, extensor carpi radialis 
longus, in front of the caput laterale and caput mediale of the m. triceps brachii. The muscles 
mentioned arise in Darf from these septa. 



300 



Muscles of the Arm. 



Ligamentum acromioclaviculare 
Processus coracoideiis | 

Acromion 



Bursa liganienti coracoclavicularis 
Clavicula (cut through) 



Ligamentum 
coraooacromiale 

Bursa subacromialis 



Bursa m. 
coracobrachialis 

Bursa 
subdeltoidea 



Tondo m. latissimi dorsi 

(cut through and 

reflected) 

Bursa m. latissimi dorsi 



Crista tubei'culi minoris 



Humerus 




Angulus niedialis 



- M. subscapularis 



M. teres major 



345. Muscles of the right shoulder-blade, 

viewed from in front. 

M. subscapularis (see also Figs. 343 and 347). Form: flat, triangular. Position: 
hi^liind the ra. serratus anterior-, it fills up the fossa subscapularis and passes ininiediately in 
front of the shoulder joint. Origin: facies costalis scapulae and fascia subscapularis (see 
below), very penniforra. Insertion: the fibers converge upward and lateralwai'd and are 
attached by a short powerful tendon to the tuberculuni minus and crista tubereuli minoris of 
the humerus; on the posterior surface they are fused with the capsula articularis humeri; 
there the bursa m. siihscapu/aris is fuuntl (see p. ISO and Fig. 346). Action: it draws 
the arm nuMlianward and mils it inward. Innervation: nn. subscapulares. 

The fascia subscapularis (not shown in drawing) covers the anterior surface of the 
m. subscapularis, is connected lateralward with the continuation of the fascia brachii, which 
covers tlie m. coracobrachialis (see also Fig. 344). 

M. teres major (see also Figs. 329, 330, 343 and 346351). Form: flat-cylindrical. 
Position: at the margo axillaris of the shoulder-blade, in front covered by the tendon of the 
m. latissiums dorsi, behind and lateralward partly by the m. latissimus dorsi, partly by the 
ni. deltoideus and caput longum m. tricipitis brachii. Origin: facies dorsahs of the angulus 
inferior scapulae. Insertion: the fibers run parallel upward and lateralward and are at- 
tached by a strong tendon to the crista tubereuli minoris. There, between the tendon and 
the bone, lies tlic bursa m. teretis majoris (not shown in drawing). Action: it draws 
tht> arm mediauward and liackward. Innervation: nn. subscaptdares. 

Bursa ligameuti coracoolaricularis, small, often present, between the lig. trape- 
zoideum and the lig. cdnnidiMim ol' the lig. coracoclaviculare. 

Bursa subacroniialis, laige, almost constant, between the acromion and the lig. 
coracoacromiale on tlie one hand and the capsula articularis of the shoulder joint and the 
m. su])ras])inatus on tlie other. It often coramunicat(>s with the following bursa. 

Bursa subdeltiudea, large, almost constant, between the m. deltoideus and the tuber- 
culuni inajiis hunifri, often coiunuinicating with the preceding bursa. 

Bursa m. coracobrachialis, of moderate size, almost constant, situated in front of 
the upper part of the tendon of the m. subscapularis, between it, the proc. coracoideus and 
the tendon of the m. coracobrachialis. 

Bursa lu. latissimi dorsi, fairly large, oblong, constant, between the tendon of the 



m. latissimus dorsi and that of tlie m. teres 



major. 



Muscles of the Arm. 



301 



Bursa ni. subscapularis 



Processus coracoideus 



Ligamciituni trausvorsuiu scapulae siiperius 
yi. onioliyoideus (cut tlirough) 



Tendo capitis 
longi 111. liicipitis "" 

Capsula I 

articularis 



Vagina mucosa 
iiitertubercularis 

M. 
coracobrachialis *kt 

M. 
pectoralis major - 
(cut tlirough) 

Bursa 
111. pectoralis - 
majoris 

(caput 
breve ~ " 
uieeps . 
bracliii I caput 
I longum 




Scapula 



M. triceps M. teres major 

brachii 
(caput longum) 



- M. biceps brachii 



346. Muscles on the anterior surface of the right 

shoulder joint, viewed from in front. 
(The claviciila, mm. di'ltnideiis, pectoralis major and subscapularis have been removed.) 

Bursa m. pectoralis majoris see p. 263. 

M. biceps brachii (see also Figs. 308, 310, 342, 343, 347 and 348). Form: rounded, 
spindle-shaped, thick. Position: on the anterior surface of the upper arm; above, at its 
origins, it is covered by the mm. pectoralis major and deltoideus. Origin: by two heads. 
Caput longiun : from the tuberositas supraglenoidalis scapulae and from the labrum gienoidale 
liv a long, thin tendon, which extends first lateralward within the cavity of the shoulder joint, 
then curves markedly downward in the sulcus intertubercularis (see also Fig. 231) and is 
accompanied in its course by a prolongation of the joint -capsule, the varjhia mucosa iater- 
tuberculaiis (see also p. 180). Caput b'eve: by a narrow, flat, shorter tendon from the proc. 
coracoideus, at first fused with the m. coracobrachialis. Insertion: both heads extend down- 
ward and unite to form a spindle-shaped muscle-belly, the fibers of which, a little above the 
elbow joint, go over for the most part into a flatly roimded , thick tendon , partly , also , into 
a superficial thin tendinous plate. The latter, lacertus fibrosus (0. T. semilunar fascia), runs 
obliquely medianward and downward in front of the m. pronator teres and becomes lost in the 
fascia antibrachii; the tendon proper, bending into the depth, becomes attached to the tuberositas 
radii fbwsa bicipitoradialis and bursa cubitalis inter ossea see Fig. 348). Action: it lifts 
the upper arm forward, flexes the fore -arm and supinates it, especially, when it is flexed. 
Innervation: n. miisculocutaneus. 

Spaltebolz, Atlas. 20 



302 



Slnscles of the Arm. 
Processus coracoideus 



Claviciila (cut through) 



M. lU'ltoideiis 



!M. corato- ._ 
brachialis 

Caput brive 
ni. bicipitis -- 
brachii 

Caput longum 

ni. bicipitis 

lirachii 



M. triceps 
bratliii 



Sulcus 

bicipitalis 

lateralis 



M. 

bi':irlii(ir:iiliiilis 




Angulus" 
luedialis scapulae 



Marge 

vertebralis 

scapulae 

M. sub- 
scapularis 



M. teres major 



carpi 
adialis 



M. latissimus 
dorsi 



347. Muscles 
of the right upper 

a.rrn, viewed from in front. 

M. coracobraehialis (see Figs. 
310, 343, 340 ami 348). Form: flat, 
obloiig-qnadrang'ular. Position: in 
the axilla, covered in front by the 
m. pectoralis major, laterahvard and 
in front adjoining- the caput hreve 
m. bicipitis, behind adjoining the m. 
subscapularis and the tendons of the 
ram. latissimus dorsi and teres major: 
below on the medial surface of the 
upper arm, between the m. biceps and 
the caput mediale of the m. tricej)s. 
Origin: tendinous from the proc. 
coracoideus scapulae, being fused 
there with the caput breve m. bici- 
pitis (bursa m. coracobraehialis see 
Fig. 345). Insertion : the fibers run 
perpendicularly to the margo raedialis 
humeri, just Ixdow its middle, being 
often partially fused there with tlie 
m. brachialis. Action: it hfts the 
upper arm forward. T n ii i^ r v a t i (Ui : 
11. luusculocutanous. 



Caput humeri 



.Mux-b's of till' Ann. 
Pi-ocessus coracoideus 



303 



Caput breve 

m. bicipitis 

(cut through) 



M. 
coracobrachialis 



Tuberositas 
deltoidea 



Septum 

iutermusculare 

laterale 

Epicondylus 
lateralis 



Capsula 
articularis 



Bursa 
bicipitoradialis 

Tendo 

111. bicipitis 

(cut through) 



Radius 



Bursa 

tendon of tbr 




Scapula 



Epi- 
loudylus 
niedialis 



348. Muscles of the 
right upper arm 

(2"^ layer) , viewed from in 
front. 

M. brachialis (0. T. brachialis 
anticiis) (see also Figs. 342 and 347). 
Form: flat, spindle-shaped. Po- 
sition: on the anterior surface of 
the upper arm, covered for the most 
part hy the ra. biceps; the grooves 
left free in fi-ont of it, medianward 
and lateralward, near the m. biceps, 
are called the snlcus hicipitalis nie- 
dialis and lateralis (see Fig. 347). 
Origin: fleshy from the septa inter- 
muscularia and from the facies an- 
teriores humeri, siirrotmdmg, above, 
the insertion of the m. deltoideus like 
a horse-shoe and often fused with the 
insertion of the m. coracobrachialis. 
Insertion: the fibers converge and 
go by a short tendon to the proc. 
coronoideus and to the tuberositas 
ulnae. Action: it flexes the forearm. 
Innervation: n. musculocutaneus. 

Bursa bicipitoradialis, con- 
stant; between the tuberositas radii 
and the tendon of the m. biceps. 
cubitalis interossea, olten present in later life; adjoining, lateralward, the 
m. biceps, medianward, the ulna and chorda obliqua, behiud, the m. supinator. 

20=^ 



Tuberositas 
ulnae 

Bursa cubitalis 
interossea 
Chorda obliqua 

riua 



304 



Muscles of the Arm. 



M. 

supraspinatus 



Spina _ 
scapulae 



Clavicula 



Bursa sulscutanea 
acromialis 



M. infra- 
spinatus 



M. teres 
minor 



M. teres major 
]\r. triceps brachii (caput longura) 




M. 

cleltoideus 



M. triceps 
^__. ^m^^^j^m- ' l'i"'iclili (caput 

349. Muscles of the ^.^v m^Mmit lateraie, 

right upper arm, 

viewed from behind. 

Bursa subcutanea 
mialis see ]>. 2lt 

M. supraspinatus (see 

Figs. 350:111(1351). Form 
triangular, thick. Position: in the 
fossa siipraspinata scapulae, covered 
medianwani by the m. trapezius, 
lateralward hy the acromion , lig. 
coracoacroinialc and m. deltoideus. 
Orif^in: fossa supraspinata and 
fascia supraspinata. Insertion: 
the iihers ctinverye lateralward and, 
becoming tendinous, extend to the 
tuberculum majus humeri: there 
thoy become fused with the capsuli- 
of the joint. Action: it lilts the 
upper arm lateralward. Inner- 
vation: n. siqirascapularis. 

M. infraspinatus (see also 
Fig. 350). Form: flat, oblong- 
triangular , thick. Position: in 
the fossa infraspinata scapulae, par- 
tially covered iiiedianward by the 

m. trapezius, lateralward by the m. di'ltmcleus. Origin: fossa infraspinata and fascia infra- 
spinata. Insertion: the fibers converge as they pass lateralward to become inserted by a 
strong tendon at the tuberculum majus humeri (bursa m. inft-aspiuati see Fig. 351); they 
are there fused with the capsule of the joint. Action: it rolls the upper arm outward. 
Innervation: n . suprascapularis. 



M. bracbioradiali.s 

M. extensor carpi 
radialis longUM 

Ei)icondylus 

lateralis 



anconaeus 

M. extensor 
digitorum 
coraniuiiis 
JNI. extensor 
carpi uli;aris 



Muscles of the Arm. 



305 



Acromion 



M. supraspinatus 
Spina scapulae 

M. infraspinatus 




M. tei'cs minor 



M. teres major ,, 

triceps brachii 
(caput longuni 



M. 
triceps brachii 
(caput laterale) 



350. Muscles of the right 

upper arm, viewed from behind, 
the m. deltoideus haying been removed. 

M. teres miuor (see also Fig. 349). Foriu : 
flat, oblong-quadrangular. Position: just below 
the ui. infraspinatus, often fused with it; covered 
behind and lateralward by the m. deltoideus. 
Origin: facies dorsalis scapulae, close to the 
margo axillaris, and fascia infraspinata. Inser- 
tion: the fibers run , parallel to one another, 
lateralward and become attached to the tuber- 
culum majus humeri by a short tendon, which is 
fused with the capsule of the joint. Action: it 
rolls the upper arm outward. Innervation: 
n. axillaris. 

Fascia siipraspiuata (not shuwnin draw- 
ing) is a fascia, distinctly striated medianward, 

which covers the m. supraspinatus ; it is fused medianward with the margo superior, the margo 
vertebralis and the spina scapulae and. lateralward, becomes lost. 

The fascia iufraspiuata (see Figs. 329 and 330) is attached to the margo vertebralis 
and to the spina scapulae, is stronger medianward, covers the mm. infraspinatus and teres 
minor and becomes lost lateralward below the m. deltoideus. 

M. triceps brachii (see also Figs. 342, 343, 349 and 351). Form: flatly roimded, 
oblong -quadrangular. Position: it occupies the whole posterior surface of the upper arm. 
Origin: by three heads. Caput longurn: by a flat tendon from the tuberositas infraglenoidalis 
scapulae; it runs downward between the mm. teres minor and teres major, the fibers being- 
parallel, is partly covered above by the ra. deltoideus and overlaps the caput metUale, in part, 
i'rom behind and medianward; below it is attached to the medial border of the tendon of the 
caput mediale. Caput mediale: from the facies posterior humeri, medial to and below the 
sulcus n. radialis, as well as from the septa intermuscularia mediale et laterale; the fibers 
I'each, below close to the m. anconaeus and run, converging somewhat, to a large quadrangular 
flat tendon, which begins in the middle of the u])per arm (continued (.m p. 30(>). 



306 



Muscles of the Arm. 



Spina scapulae i sawed through) 
M. supraspinatus 



Scapula 



M. teres 
major 



351. Muscles of the 
right upper arm 

(deep layer), viewed from 
behind. 

(The acromion has been sawed 
through, the mm. infraspinatus and 
teres minor have been com])letely, 
the caput laterale m. tricipitis 
partially, removed.) 

M. triceps brachii (continued). 
Caput laterale: from tlie faeies 
posterior humeri, lateral from and 
above the sulcus n. radialis, as well 
as from the septum intei'miiscularc 
lat^'rale; the fillers run, iiarallcl, 
downward, bridging over the sidcus 
n. radialis (with tlio a. i)rofuiula 
brachii and the n. radialis) and 
extend j)artly over the pdstcrinr 
surface uf the caput mediale to tlie 
upjx'r and lateral margin of the 
t<Mid(in (if the same. Insertion: 
(decrannn ulnae (bursa olecraui 
see Fig. ;j(;0). Action: it adducts 
the upjier arm, and extends the fore- 
arm. Innervation: n. radialis. 

Bursa in. iiifraspiiiati, small, 
frenuently present, iictween the ten- 
don of insertion of tlie m. infra- 
spinatus and the e.ipsule nt the jiiint. 




Capsula articulari.? 



Bursa 
m. iufraspinati 



M. iiifra.?piratus 
(cut through) 



M. teres minor 
(cut through) 



>I. triceps brachii 

(caput laterale) 

(cut through) 



N. radialis 



Septum 

intermusculare 

laterale 

M. triceps brachii 
(caput laterale) 
icut throughi 



M. triceps brachii 
(caput mediale) 



- M. brachioradialis 



M. extensor 

carpi radialis 

longus 

jCpieoiiilylus 
lateralis 



M. anconaeus 

M. extensor 

cari)i radialis 

brevis 
_M. extensor 
digitonini 
communis 



j\l. extensor 
carpi ulnaris 



]\Iuscles of the Arm. 



307 



352. Muscles 
of the right fore- 
arm, 

viewed from in front. 



M. biceps brachii- 



M. brachialis 



Teiulo 
m. bicipitis - 
brachii 



:m 



. extensor 

carpi 
radialis 

longus 



J[. brachio 
radialis 



M. extensor 
carpi radialis 



brevis 



M. braehioradialis (0. T. 

supinator louyus) i^see also Figs. 
353, 357 and 358). Form: flat, 
in the shape of a long spindle. 
Position: superficial on the 
lateral surface of the upper arm 
and the volar surface of the fore- 
arm. Origin: margo lateralis 
humeri and septum interraus- 
culare laterale. Ins_e_rt_i_on : 
above, it runs between the m. 
triceps and the m. brachialis ; be- 
low, it is bounded behind by the 
m. extensor carpi radialis longus, 
ulnarward by the mm. pronator 
teres and flexor carpi radialis anil 
becomes attached by a long, thin, 
flat tendon above the proc. styloi- 
deus radii. Action: it flexes 
the forearm and brings the hand 
into a position midway between 
pronation and supination. In- 
nervation: n. radialis. 

M. palmaris loiigns (see 
als Fig. 362) (is frequently ab- 
sent). Form: spindle-shaped, 
narrow. Position: superflcial 
on the volar surface of the fore- 
arm. Origin: epicondylus me- 
dialis humeri and fascia anti- 
brachii, fused with its neighbors. 
Insertion: it extends above 
between the mm. flexor carpi 
radialis and flexor digitorum 
sublimis, then dowTiward and 
radialward upon the latter and 
goes over by a long, thin tendon, 
in front of the lig. carpi trans- 
versum, into the aponeurosis pal- 
maris. Action: it makes the 
aponeurosis paknaris tense and 
flexes the hand. I n n e r v a t i o n : 
n. medianus. 

M. pronator teres (0. T. 
pronator radii teres) (see also 
Figs. 353 and 355). Form: 
oblong - quadrangular. Posi- 
tion: flexure of the elbow and 
volar surface of the forearm. 
<-) r i g i n : partly from the septum 
intermusculare mediale and the 
epicondylus medialis humeri ^ 

fcaptit humerale) , partly from 

the proc. coronoideus ulnae (cuimt ulnare) ; the two heads are usually 
n. medianus. Insertion: the fibers run, parallel, obliquely radialward 
become attached by a short tendon to the facies volaris and lat^-alis ra 
pronates the forearm and flexes it. Innervation: n. medianus. 



M. abductor 
pollicis 

longus 



M. 

abductor 
pollici-i 
brevis 




Epi- 
Condylus 
medialis 

M. 
pronator 

teres 



Laeertus 
fibrosus 



M. flexor 
_ carpi 
radialis 



_ _ M. palmaris 
longus 



M. flexor carpi 
ulnaris 



Cutis 



:\[. flexor 
digitorum 
sublimis 



Os pisiforme 



Aponeurosis 
jialmaris 



M. p;ilniaris brevis 



separated by the 
and downward to 
dii. Action: it 



30S 



l\ruscles of the Arm. 



Opening 

in the septuiu 

iiiterniuscularo 

laterale lor the 

n.-radialis 



llunienis 



M. brachio- 
radialis 



jr. exten.sor 

carpi radialis 

;ongus 



M. extensor 

carpi radiali- 

brevis 



M. abiluctor 
polliii>s 
longus 

M. extensor 
pollicia brevis 

Prooessus 

styloideiis 

radii 



Process 

to tlie 111. 

abdnctor 

pollicis 

brevis 



I'l t 



^1 



//i 



/. 



fH 



Hi 



N. triceps 

brachii 

(caput 

longuni) 



JI. Iriceps 

brachii 

(caput 

)ncdiale) 

Septum 

iutcrmusculare 

niediaie 



I'picondylus 
medialis 



M. pronator 
. teres 



_ M. flexor 
carpi ulnaris 



U. flexor 
carpi radialis 



Hi 



M. flexor 

i~- digitoruni 

Ijnifundus 



Os pisiforme 



T.iganientum carpi 
traiisversuni 



353. Muscles of 
the right forearm, 

viewed from in front. 

(The mill. bieei)s, brachiaUs, paltnaris 

longus and flexor digitorum sublimis 

have been reraoTod.) 

M. flexor carpi radialis (see 
also Fig. 352). Form: flat, oblong- 
spindle-shaped. Position: super- 
flcial cm the volar surface of the fore- 
arm. Origin: epicondylus medialis 
humeri and fascia antibrachii, fused 
M'ith its neighbors. Insertion: the 
flbers go, at flrst diverging, between 
mm. pronator teres and palmaris lon- 
gus, radialward and downward, then 
converge and run by a long, powerful 
tendon between the mm. brachioradialis 
aud palmaris longus to the hand, where 
the tendon, covered by the lig. carpi 
transversum, lies in the groove of the 
OS multangulum majus ; finally, cover- 
ed by the tendon of the m. flexor 
l)ollicis longus, it goes to the basis 
OSS. metacarpalis II and III (see Fig. 
355). In the hand, the bursa ni. 
flexoris carpi radialis (see Fig. 366) 
lies between the bone and the tendon. 
Action: it flexes the hand and pro- 
nates the forearm. I n n e r \- a t i o n : 
11. medianus. 

M. flexor carpi uluaris (see 

also Figs. 352, 355, 358 and 360). 
Form: flat, oblniig-triangular ; above 
it forms, with its anterior surface, a 
groove, in which lies the ulnar part 
of the m. flexor digitorum profundus. 
Position: superficial on the ulnar 
margin of the forearm. Origin: 
partly Irum the epicondylus medialis 
liuineri and from the fascia antibrachii. 
fused Mith its neighbors (caput hione- 
raU) , i)artly liy a long, flat, thin 
tendon from the posterior surface of 
the olecriinon and from the niargo 
dorsalis ulnae (caput ulnare). In- 
sertion: it runs downward, coming 
in contact radialward with the m. 
flexor digitorum sublimis and is attach- 
ed by a long, powerful tendon to tlie 
OS pisiforme; the bursa ill. flexoris 
carpi ulnaris (not shown in figure) is 
lrei|uently to be found there. Action : 
it flexes and adducts the hand. In- 
111' rv a t i on : ii. ulnaris. 



% 



Muscles of the Arm. 



309 



354. Muscles 
of the right fore- 
arm (2'"^^ layer), 
viewed from in front. 

(The mm. bracliioradialis . pru- 
nator teres, flexor carpi radialis, 
palmaris longus and flexor carpi 
ulnaris have been removed; the 
lig. carpi transversum lias been 
cut through.) 

M. flexor digitoruin subli- 

mis (see also Fig. 352). Form: 
flat, spindle-shaped. Position: 
on the volar surface of the fore- 
arm ; above, it is covered by the 
mm. brachioradialis , pronator 
teres, flexor carpi radialis, pal- 
maris longus and flexor carpi 
ulnaris ; below, it lies between the 
mm. flexores carpi radialis et 
ulnaris, coming to the surface 
and overlapped only by the m. 
palmaris longus. Origin: partly 
fi'om the epicondylus medialis 
humeri and fi'om the proc. co- 
ronoideus ulnae , fused with its 
neighbors (caput humerale), 
partly from the facies volaris 
radii (caput radiale) and, 
between, from a tendinous arch, 
which bridges over the a: ul- 
naris and the n. medianus. 
Insertion: the fibers converge 
down^vard to form four, different, 
widely separated muscle -bellies, 
from the distal ends of which 
emerge four flat , long tendons ; 
these extend, so that those 
destined for the S^''^ and 4t'i finger 
lie superficially, beneath the lig. 
carpi transversum to the hand ; 
thence all diverge to the volar 
surfaces of the 2nd 5tti finger 
(see Figs. 363 and 364). On 
the volar surface of the first 
phalanx each tendon divides into 
two halves, which surround the 
correspondiiig tendon of the m. 
flexor digitorum profundus (chi- 
asma tcndiimm.) ; the two halves 
nnile again bebiud the same on 
the volar surface of the base of 
the second plialanx, where they 
become attached. Action: it 
flexes the 2"d phalanx of the 
2nd 5th finger. Innervation : 
n. medianus. 



Tendo lu, 
bicipitis 
braclui 



M. 
extensor 

carpi 
radialis 
longus 

Tuberositas 
radii 

M. 
supinator 



M. pronator 
quadratus 

M. flexor digi- 
torum profundus 

j\r. flexor 
car[)i radialis 
(cut through) 

Ligamentuni 

carpi 

transversum 

(reflected,! 



M. 

abductor 

pollicis 

brevis 

M. 
flexor 

digit. 

pro- 
fund. 




M. brachialis 



.Epicondylus^" 
medialis 



M. flexor 

digitorum 

sublimis 

(caput 
humerale) 

Space for the 

passage of the 

a. ulnaris and 

the n. medianus 



M. flexor 

digitorum 

sublimis 

(caput radiale) 



M. flexor 
digitorum 

sublimis 



xor 

Inaris 
(cut through) 



- Os pisiforuu' 



Ligamentum carpi 

transversum 

(reflected) 



M. abductor 
digiti quinti 



Tendines 
m. flexoris 
digitorum 

sublimis 



II III IV V 



310 



Muscles of the Arm. 



Ihunerus 



tiicips braehii 
raiiut medialei 

Scjitum 

inteniiusculaie 

niL'diale 



M. extensor carpi f _ ^ 
radialis longns ( 



pronator 

teres 



M. supinator- 



M. extensor earpi 
radialis ))revis 



Origin 

from the 

epicondjius 

niedialis 

hnineri 

M. flexor' 
digitornm 
profundus 



M. flexor pollicis , 
longus I 



M. iironator t 

<|iiadratus f 

'i 



M. alHluctiir pollicis i 
Idiigus 






f-oC carpi 
lig,dllis 



M.. !,-or _ 
poUii 1-- liiHvis" 

Teiulo 
ni. Ilcxoris .. 
pollicis loiii;! 



tlio mill. Ilexoros dij, 
the in. tiexor jiollicis 
it flexes the 2iid phal 



355. Muscles of 
the right forearm 

(.3-^ layerj, 

viewed from in front. 

(The mm. biceps, brachialis, brachio- 
radialis* flexor earpi radialis, pal- 
raaris longus and flexor digitorum 
sublimis have been removed; the 
lig. carpi transversum has also been 
removed.) 

M. flexor digitorum profundus 

(see also I'igs. 353, 354 and 356). 
Form: flat, spindle-shaped. Posi- 
tion: on the volar surface of the 
forearm, directly upon the ulna and 
ra. pronator- qiiadratus; completely 
covered by the mm. pronator teres, 
flexor car]u radialis, palmaris longus, 
flexor digitorum sublimis and flexor 
carpi ulnaris. Origin: facies volaris 
antl niedialis ulnae and membrana 
iuterossea antibrachii. Insertion: 
the fibers run parallel downward: 
from the muscle belly, from the middle 
of the forearm on, go off four long, 
flat tendons, which go beneath and 
along with the tendons of the m. 
flexor sublimis, under the lig. carpi 
transversum to the hollow of the 
hand and thence to the 2nd_5th 
finger: each tendon runs, at the 
level of the l^t phalanx, between the 
halves of the chiasma tendinum of 
the corresponding tendon of the m. 
flexor sublimis to the base of the 
3rd phalanx (see Fig. 364). Action : 
it flexes the 2"* and 3"i phalanx of 
the 2"d 5*1' finger. Innervation : 
ulnar half (for the 4''^ and S^ii finger i : 
u. ulnaris; radial half (for the 2"^ 
and 3rd linger) : n. interosseus volaris 
of the u. medianus. 

M. flexor pollicis longus isee 
also Figs. 354 and 356). F o r m : flat, 
oblong-triangular. Position: on the 
volar surface of the forearm, immedia- 
tely upon the radius and the m. pro- 
nator quadratus ; covered by the mm. 
liroiiatur teres, brachioradialis, flexor 
carpi radialis and flexor digitorum 
sublimis. Origin: facies volaris radii 
and usually, by a thin bundle, from 
the e])icondylus niedialis humeri. In- 
sertion: the fibers run to a long 
tendon beginning ulnarward; this 
extends, ahmg with the tendons of 
itorum, below the lig. carpi transversum to the hand, tlien in the groove of 
brevis to the base of the 2"d phalanx of the thumb (see Fig. 364). Action: 
anx of the thumb. I n n e r v a t i >' n : n. interosseus volaris of the n. medianus. 




il. Hex or 
carpi ulnaris 
(drawn aside) 



M. flexor 
earpi ulnaris 

Tendines ni. flexoris 
digitorum profundi 

- Os pisiforme 



Hamulus ossis liamati 



Insertion of the 

m. flexor carpi 

radialis to the basis 

iiss. metacarjialis 1 1 



Muscles of the Ann 



311 



Epicondylns 

latei'alis 



Epicondylus 
niedialis 



Tuberositas 
radii 



M. supiuator- 



Origin of the 
m. flexor pollicis 

longus from the 

epicondylus 
medialis humeri 



M. flexor digitorum 
profundus 



356. Muscles of the 

right forearm r :^^- Humerus 

(4*^^ layer), viewed from in front. 

(The mm. flexor digitorum profundus 

and flexor pollicis longus have been 

partialh', all the more superficial 

muscles completely, removed.) 

M. pronator qnadratus (see also 
Fig. 354). Form: flat, (juadrangular. 
Position: on the volar surface of the 
forearm near the wrist, immediately 
upon the radius, the ulna and the 
membrana interossea; covered by all 
the flexor muscles going to the hand. 
Origin: facies volaris ulnae. Inser- 
tion: the fibers run jiarallel, radial- 
ward and downward to the facies volaris 
radii. Action: it pr(5nates the forearm. 
Inn-ervation: n. interosseus volaris 
of the n. medianus. 

M. supiuator (0. T. supinator brevis) 
(see also Figs. 354, 355, 359 and 360). 
Form: flat, triangidar. Position: 
close below the elbow joint on the 
volar, radial and dorsal surface of the 
forearm, immediately upon the radius, 
covered by the mm. brachioradialis, 
extensores carpi and anconaeus. Ori- 
gin: epicondylus lateralis humeri, lig. 
collaterale radiale of the elbow joint 
and crista m. supinatoris ulnae. In- 
sertion: the fibers run obliquely 
downward to the facies dorsalis , late- 
ralis and volaris of the radius, partially 
surrounding this bone in a curve. 
Action: it supinates the forearm. 
Innervation: ramus profundus n. 
radialis. 

M. extensor carpi radialis longus 

(0. T. extensor carpi radialis longior) 
(see Figs. 352355, 357359 and 361). 
F or m : flat , oblong - spindleshaped. 
Position: usually superficial on the 
radial side of the forearm, bounded in 

front by the m. brachioradialis, behind Radius 

by the m. extensor carpi radialis brevis. 
Origin: septum intermuscidare late- 
rale , margo lateralis and epicondylus 
lateralis liimieri. Insertion: the 
fibers run downward and converge in 
the middle of the forearm to form a 

long, flat tendon, which extends upon the facies lateralis radii (there partly covered by the 
mm. abductor pollicis longus and extensor pollicis brevis) imder the lig. carpi dorsale (through 
its second compartment) to the dorsal surface of the basis oss. metacarpalis II; at the wrist 
the tendon of the m. extensor pollicis longus crosses over it. Action: it flexes the forearm, 
extends and abducts the hand. Innervation; ramus profundus n. radialis. 



M. flexor 

pollicis 1 

longus 



it. pronator quadratus 



'^,i 



- Tina 



312 



Muscles of the Arm. 



M. triceps 

brachii 



Epicoiidylus 
lateralis 



Olecranon 



IM. anconaeus 



isr. extensor 
carpi uliiaris 



M. extensor 
digitorum 
communis 



LigauHii 
carpi do 



M. extensor 
arpi radialis lirevis 

M. extensor 
tar]]i raili.alis longus 




M. biceps 
brachii 



braeliialis 



357. Muscles of the 
right forearm, 

viewed from the radial side. 



M brachio- 
radialis 



M. extensor 
-carpi radialis 
lonarus 



M. extensor 

carpi radialis 

brevis 



tcndinuiii. Ench 
hocdiiie attacbod 
ii.-md and tlio 2"'^ 



tendon presents 
mm. liimbricales 



M. extensor carpi radialis breyis 

(see also Figs. 352, 358 and 359). 
Form: spindle -shajwd. Position: 
usually superficial on the radial side 
of the forearm, coming in contact in 
front with th(> m. extensor carpi radia- 
lis longus, behind with the m. extensor 
digitorum communis. Origin: epi- 
condylus lateralis humeri and fascia 
antihrachii, fused with its neighbors. 
Insertion: the fibers go downward 
and converge, becoming attached in 
the middle of the forearm to a flat, 
long tendon which goes close behind 
that of the m. extensor carpi radialis 
longus through the second compartment 
of the lig. carpi dorsale to the dorsal 
surface of the basis oss. metacarpalislll: 
there, between the tendon and the bone, 
lies the bursa m. extensoris carpi 
radialis brevis (see Fig. 360), rarely 
absent. The tendon is partially crossed 
uver by the same muscles as is that of 
the m. extensor carpi radialis longus 
(see also Fig. 361). Action: it ex- 
tends the hand. In n e r v a t i o n : ramus 
profundus n. radialis. 

M. extensor digitorum commu- 
nis (see also Figs. 358 and 361). 
Form: oblong - spindleshaped. Posi- 
tion: superficial on the back of the 
forearm, radialwavd bounded by the 
ra. extensor car]i radialis brevis, ulnar- 
ward by the m. extensor carpi ulnaris. 
Origin: epicondylus lateralis humeri 
and fascia antihrachii, fused with its 
neighbors. Insertion: the fibers run 
parallel downward and in the middle 
of the forearm become separated into 
four single bellies. Each of these goes 
over into a long, flat tendon ; these pass 
together through the fourth compartment 
of the lig. carpi dorsale and then di- 
verge to go to the dorsal surface of 
the first phalanx of the 2"d 5th fin- 
ger; each becomes attached by three 
processes, one in the middle going to 
the base of the second plialanx and 
two at the side converging in frunt and 
going to the base of the third. The 
four tendons are connected -ndth on(^ 
another upon the ossa metacarpalia by 
means of three o\iYu{\whA\\A?,.JH)icturae 
a triangidar exj^ansion upon the first phalanx to which 
and interossei (see Fig. 368). Action: it extends the 



abductor pollicis 
longus 



extensor pollicis 
brevis 



M. extensor 
pollicis bi'evis 

M. abductor 
pollicis longus 

M. extensor 
pollicis 

loilKUS 



-5'''i finger. Innervation: ramus profundus u. radialis. 



Muscles of the Arm. 



313 



358. Muscles of 
the right forearm, 

viewed from behind. 



M. extensor dig'iti quiuti 
proprius (0. T. extensor iiii- 
nimi digiti). Form: oblong- 
spindlesbaped , narrow. Posi- 
tion: immediately on the ulnar 
side of the preceding muscle, 
fused with it above. Origin: 
in common with the preceding- 
muscle. Insertion: the long, 
thin tendon runs through the 
fifth compartment of the lig. 
carpi dorsale and fuses on the 
back of the hand with the tendon 
going to the little finger from 
m. extensor dig-itorum com- 



M. triceps 
braehii 



Epicondylus- 
medialis 

Olecranon.. 



anconaeus" 
Ulna- 



M. flexor 
carpi ulnaris 



M. extensor 
carpi ulnaris 



the 

munis (see also Fig. 361). Ac- 
tion: it extends the b^^ finger. 
Innervation: ramus profundus 
n. radialis. 

M. ancouaeus (see also Figs. 
351^357, 359 and 360). Form: 
flat, triangular. Position: 
superficial on the back of the 
forearm, hidden by the fascia 
antibrachii , above immediately 
adjacent to the caput mediale 
of the m. triceps, radial ward 
bounded by the m. extensor 
carpi ulnaris, idnarward by the 
ulna. Origin: epicondylus late- 
ralis humeri. Insertion: the 
fibers diverge to the facies dor- 
salis ulnae. Action: it ex- 
tends the forearm. Innerva- 
tion: n. radialis. 

M. exteiisoi' carpi iiluaris 
(see also Figs. 357, 359 and 361). 
Form: flat, oblong- spindle- 
shaped. Position: superficial 
on the back of the forearm, 
radialward bounded by the m. 
extensor digitorum communis 
and the m. extensor digiti Y 
proprius, ulnarward above by 
the m. anconaeus, below by the 
ulna. Origin: epicondylus 
lateralis humeri, lig. collaterale 
radiale of the elbow joint and 
fascia antibrachii, fused with its 
neighbors ; also by a thin , ten- 
dinous leaf from the facies dor- 
salis idnao. Insertion: the 
fibers run ulnarward and down- 
ward to the facies dorsalis ulnae 

and upon this go over into a long tendon, ^vhich runs through 
carpi dorsale to the basis oss. metacarpalis V. Action: 
Innervation: ramus profundus n. radialis. 




M. biceps braehii 



M. brachioradialis 



yi. extensor carpi 
radialis longus 

Epicondylus 
lateralis 



M. extensor 
carpi radialis 

brevis 



M. extensor 
digitorum 
communis 



M. extensor 
digiti V proprius 



M. abductor 
pollicis longus 



M. extensor 
pollicis brevis 



Processus styloideus ulnae 



Ligamentnm carpi dorsa 



Processus styloi 
radii 

M. extensor 

pollicis longui 

31. extensor c 

radialis bre\ 

M. extenso] 

carpi radiali 

longus 
M. extensor' 
pollicis brev 



lig. 
hand. 



the sixth compartment of the 
it extends and adducts the 



314 



]\ruscles of the Ami. 



51. biceps bracbii 



M. triceps 
bracliii 



]".picoudyhis. 
iiicdialis 

Olecranon 



M. 

aiiconaeus" 



rina 



M. Ilexor 
:irpi uliiaris 



\r. extensor 
cai'iji ulnaris 



Conipartinent for the 

iiiin. extensor (ligitorum" 

comniunis and extensor 

indicia proprius 



Processus styloidciis ulnae.. 

Conipartnient 
for the m. extensor 
dijiiti V propriu.s '' 

Tendo ni. extensoris.. 
carpi ulnaris 




. M. brachioradialis 



M. extensor 
arpi radialis 
longus 



Epicoudylus 

lateralis 



M. supinator 



M. extensor 

carpi radialis 

brevis 



M. abductor pollicis 
longus 



M. extensor pollicis 
brevis 



extensor pollicis 
longus 

extensor indicis 
proprius 



Proc. styloideus 
radii 



Lig. carpi dorsale 



M. extensor 
_ carpi radialis 
longus 

~-- M. extensor 
carpi 
radialis 
brevis 



Os nietacarpale II 



359. Muscles 
of the right fore- 
arm, 

viewed from behind. 

(The m. extensor digitorum com- 
munis has been removed.) 

M. abductor pollicis lou- 

gus (0. T. extensor ossis meta- 
carpi pollicis) (see also Figs. 3.52, 
3.57, 358, 360, 361 and 363). 
Form: flat, spindle-shaped. 
Position: on the posterior and 
radial side of the forearm; be- 
hind immediately upon the mem- 
brana interossea and the radius, 
covered by the mm. extensor 
carpi ulnaris and extensor digi- 
torum communis ; radialward 
superficial passing over the mm. 
extensores carpi radiales. Ori- 
gin: facies dorsalis ulnae, mem- 
brana interossea and facies dor- 
salis radii. Insertion: the 
fibers converge radialward and 
downward to form a flat tendon, 
which, at the radial side of the 
forearm, goes between the mm. 
extensores carpi radiales and 
tiexor carpi radialis through the 
first compartment of the lig. 
carpi dorsale, partly to the m. 
abductor pollicis brevis, partly 
to the basis oss. nietacarpalis I. 
Action: it opposes the thumb 
to the other fingers and abducts 
the hand. I n n e r v a t i o n : ra- 
mus jtrofundus n. radialis. 

M. extensor pollicis brevis 

(0. T. extensor jirimi iuternodii 
pollicis) (see also Figs. 355, 357, 
358, 360 and 361). Form: 
spindle-shaped. Position: 
just distalward from the pre- 
ceding muscle. Origin: mem- 
brana interossea and facies dor- 
salis radii. Insertion: it runs 
exactly as does the preceding 
nniscle and, close to it, goes 
upon the back of the os meta- 
carpale I to the base of the first 
phalanx of the thumb. Action: 
it abducts the thumb and ex- 
tends the first phalanx of the 
same. Innervation: ramus 
profundus n. radialis. 



Muscles of the Arm. 



315 



AI. triceps 
(cut through 

obliquely) 
Epicondylus 

medialis ^^ 
Bursa iiitra- 

tendiuea 

olecrani 

Bursa sub- 
tendinea 
olecrani 

Bursa sub- '- 
cutanea 
olecrani 

M. 

anconaeus 



M. flexor 

carpi 

ulnaris 



360. Muscles of 
the right forearm 

(deep layer), 

viewed from behind. 

(The mm. extensores carpi, digitorum 

communis and digiti V ])roprius have 

been removed.) 

M. extensor poUieis lou^us 

(0. T. extensor secundi internodii 
pollicis) (see also Figs. 357 359 
and 361). Form: long-spindleshaped. 
Position: ulnarward from and be- 
hind the two preceding muscles, im- 
mediately upon the ulna and radius, 
covered by the same muscles as are 
they. Origin: facies dorsalis ulnae 
and membrana interossea. Inser- 
tion: the fibers go over into a long 
tendon, which passes obliquely behind 
the tendons of the ram. extensores 
carpi radiales through the third com- 
partment of the lig. carpi dorsale and 
then tothe base of the second phalanx 
of the thumb, partly also fused with 
the fendon of the m. extensor pollicis 
brevis. A c t i o n : it extends the thuml) 
and draws it backward. Innerva- 
tion: ramus profundus n. radialis. 

M. extensor indieis proprius 
(0. T. extensor indieis) (see also 
Fig. 359). Form: oblong - spindle- 
shaped. Position: ulnarward from 
and behind the preceding nuiscle, im- 
mediately upon the ulna, covered by 
the mm. extensor digiti V pro]n'ius, 
extensor digitorum communis and ex- 
tensor carpi ulnaris. Origin: facies 
dorsalis ulnae and membrana inter- 
ossea. Insertion: the fibers con- 
verge to form a flat tendon which 
goes in common with the tendons of 
the m. extensor digitorum communis 
through the fourtli compartment of 
the lig. carpi dorsale and then fuses 
with the tendon of this muscle that 
goes to the index finger. Action: 
it extends the index finger. Inner- 
vation: n. interosseus dorsalis of 
the n. radialis. 

Bursa subcutauea olecrani, 
very frecpient. ujiun the olecranon. 

Bursa intratendinea olecrani, 
very ft-equent, in the tendon of the 
ra. triceps. 

Bursa sul)tendinea olecrani, 
jccasional, in front of the tendon 
of the m. triceps. 

Bursae subcutaneae epicondyli | humeri] late- 
ralis et epicondyli medialis (not shuwn in figure), 
the former occasional, the latter more frequent in 
the adult, upon the c*responding epicondylus humeri. 



- Humerus 




epicondylus lateralis 



Origin of the 
m. extensor 
carpi ulnaris 



__M. supinator 



liadius 



jM. abductor 

pollicis longus 



M. extensor 
pollicis iongus 



rina 



M. extensor 
indieis proprius - 



Compartment for the 
mm. extensor digitorum 
communis and extensor - 
indieis ]>roprius 

Ligainentum carpi dorsale 

Compartment 

for the ra. extensor- 

digiti V proprius 




M. extensor 
jiollicis brevis 



Compartment 
for the m. extensor 
carpi radialis longus 

Compartment 
for the lu. extenso: 
carpi radialis brevi: 

Bursa 

m. extensoris 

, carpi radialis 

brevis 

M. extensor 
- carpi radiali: 
brevis 

Ossa 
metacarpalia 



316 



M. extensor 
carpi ulnaris 



Processus 
styloideus ulnae 



Ligaiiionfum 
carpi (lorsale 



Muscles of the Arm. 

._ M. extensor pollicis brevis 

- - M. extensor digitorum comnuinis 



Attachment 

of the m. extensor 

carpi ulnaris 



M. abductor 
digiti V 
M. extensor 
digiti V proprius 
M. extensor 
digitorum 
communis 



abductor pollicis longus 
M. extensor pollicis brevis 

extensor carpi radialis longus 
M. extensor carpi radialis brevis 

M. extensor pollicis longus 



nterosseus 
,lis I 



Junctura 
tendinura 



Bursa 
subcutanea 
digiti dorsalis - 




361. Back of 
the right hand. 



Ligamentum carpi dor- 
sale (0. T. posterior annular 
ligament) (see also Figs. 357 
til 360) extends as a broad, 
powerful band of fibers, inter- 
woven in the fascia antibrachii. 
I'rom the facies lateralis and 
tlie proc. styloideus radii obli- 
(juely distalward to the proc. 
styloideus ulnae, os triquetrum 
and OS pisiforme. It is connect- 
ed by strong processes with the 
posterior surface of the radius 
and ulna; in this way six 
cyliadrieal C(im])artiiieuts are 
t'urnied fur the tendons of the 
' extensor musclt^s. The first 

compartment (numbered from 
the radial side) is for the nun. abdiu-tor pollicis Lmgus and extensor jHillicis brevis, the second for 
tlie mm. extensures carpi radiales, the third, ubli(pir|y lirhind the second, for the in. extensor pollicis 
longus, the fourth for the mm. extensor digitorum commimis and extensor indicis proprius, the 
fiftb f 'V tl)!' ni. extensor digiti V proprius. tho sixtii for the m. extensor carpi ulnaris. 



M.'palmaris loiigus 



Muscles of the Arm. 



317 

Ligamentum carpi vola 
Os pisifornie 



]SI. palmaris br 



Aponeuros 
jialmaris 




362. 
Fascia 
of the 

right 

palm. 

The ligameutum carpi vo- 

lare is a band of fibers riinniEu- 
transversely in the fascia anti- 
brachii just over the wrist; it 
covers the flexor muscles in that 
situation and is connected with 
tlip li<i'. carpi dorsale. 

The aponeurosis palmaris 
(<). T. palmar fascia) lies just 
beneath the skin in the palm : 
it is triangular being liarri iw at 
its beginning; it comes partly 
from the ligamentum carjii 
transversum. the largest part 
of it being a conthiuation of the 
m. palmaris longus; it goes by 
five diverging processes chiefly 
to the skin nf the fingers at tlu^ 

level of the capitula oss. metacarpalium , partly also 
into the depth to the ligamenta vaginalia : somewhat 
distalward frijm this insertion fasciculi transversi 

are stretched nut just beneath the skin between every two fingns from l:hf''2"J 5'li finger 
they are also partially connected with one another. The thenar and iv] i"t I i.uar eminences 
are covered only by thin fascia. Upon the hypothenar eminence tb<'rf' i' - ni additiun the 

M. palmaris brevis, flat, quadrangular. r i g i n : ulnar margin . ' ," >neurosis palmaris. 
I n s e r t i n : to the skin at the ulnar mnrgin of the hand. A c t i o n ; it wv'ukJes the skin, and deepens 
the hollow of the hand. Innervation: ramus superficialis "f the rjrius volaris manus n. ulnaris. 

Lig. carpi trausversura (0. T. anterior annular ligamein) (spi' also Figs. 363365) 
is a tough flbrous band which extends transversely bet^veenJ^^le eniinentiae carpi and tlie 
adjacent ligan.ents; it bridges over the sulcus carpi (see p. 1( ^^ 

Spalteholz, Atlas. .^Sl^Hi^HF 21 



Vessels an 
nerves 



r^ 




318 



Muscles of the Arm. 



M. Hfxor caii>i ladialis 
M. abductor pollicis longus. 

Liganientuin carpi transversuni 
M. abductor pollicis lirevis 

M. flexor pollicis brevis -- 



M. flexor carpi 
ulnaris 



I Is pisiforine 



M.~abductor 
(liL'iti V 



M. flexor 

digiti Y 

brevis 



jNI. addu('tor j)ollicis 



Mm. lunibricales .=-r^~^ 

M. flexor pollicis /L 

longus 



M. oppoiieus 
digiti V 



M. flexor 
digitorum 
sublimis 




363. 

Muscles of the 
right palm. 

M. abductor pollicis 

brevis (0. T. abductur polli- 
cis). Form: flat. Position: 

su])ei-ficial upon the ball of the 

thumb. ()ri<j;in: li<;'. carpi 

transversuni and tuberculum 

OSS. navicularis. Insertion: 

base of the first phalanx of 

the thumb and tendun of the 

m. exten.^or iinllicis longus. 

Action: it opposes the 

thumb; it fle.xes the first and 
extends the second ])halanx. 

ii;)nervatii II n. nedianws. 
JL. abdiictoi digiti 
qiilnti ro. T. abductor uuinimi digiti) (see also Fig 
3l>lj. Form: flat, ollong. Position: superfleia 
upon the ball n}' tlie ht^le tmger. Origin: lig. carpi 
transversuni and os pisi'/orrae. Insertion: base of 

the first plialanx of tlie 5 'i' finger a nd to its extensor tendi ms. A c t i o n : it abd\icts the 5*^ flnger and 
extends its 2"'^ and 3"'^ ph.vVmx. In nerva t. : ramus profundus of the ramus volarismauusn.nlnaris. 
M. flexor dijriti quinti. brevis (O.T. flexor brevis minimi digiti) (frequently absent). Form: 
flat, oblong. I'osi tiou: supeili'ial, on the radial side ofthe preceding muscle. Grig.: lig. cari>i trans- 
versuni and hamulus oss. hama^i. Insertion: base ofthe first phalanx of the 5<^ finger. Action: it 
flexes the first phalanx of tlielitti",fingeran<l abducts it. I nnervat.: like that ofthe preceding muscle. 



Ligameutuiii 

vaginale 

digiti 

Ligaiuentii 
annulare 
/ digiti 



Ligauientuiu 
cruciatum 

digiti 



^.jut-'*^ 



Muscles of till' Ann. 



M. flexor carpi radialis - 

M. flexor digitoruiu sublimis -- = 
M. abductor pollicis longus 



M. abductor pollicis brevls 
(cut off) 



M. opponens pollicis 



M. flexor pollicis brevis 



M. abductor pollicis 
brevis (cut off) 



/ 



M. flexor _ ,' -,. 

pollicis longus / 




Chiasma tendiuum 



5j four flat, 
Position: in 




JI. flexor carpi uluaris 



Os pisiforme 



M. abductor digiti V 
(cut off) 

Ligamentum carpi 
transversum 



Tendines 

m. flexoris 

digitorum sublimis 

iCUt off) 

M. opponens digiti V 



- ~s- Mm. lumbricales 



Tendines m. liexoris 
digitorum profundi 

M. abductor digiti V 

(cut oft) 

Lig. vagiuale 
(cut open) 

Tendo 
m. flexoris 
digitorum 

sublimis 

(cut off) 

Tendo 

m. flexoris 

digitorum 

profundi 



364. Muscles of 
the right palm 

(2'i layer). 

(The mm. abductor pollicis 
brevis, abductor digiti V and 
flexor digiti V brevis have been 
removed; a piece has been cut 
out of the tendons of the m. 
flexor digitorum sublimis.) 

Mm. lumbricales 

narrow muscles, 
the palm between the tendons 
of the m. flexor digitorum pro- 
fundus. Origin: two radial 
from the radial side of the cor- 
responding tendons, two ulnar 
each from two adjacent tendons 
of the m. flexor digitorum pro- 
fundus. Insertion: the flbers converge to form narrow tendons which run on the radial si4^' 
of the 2"'! 5'li finger, volarward from the lig. capitulorum transversum (see Fig. 241), to the 
posterior surface of the first phalanx and to the triangular expansions of the ti'nduns u^f tji:fn.i5" 
tensor digitorum communis (see Fig. 361). The tendon of the third muscle is frequentiv ."^^iK'cd 
and sends also a process to the ulnar margin of the Si'^^ finger. Action: tbev flex ^^--^ first and 
extend the second and third phalanx of the 2'l 5*^ finger. Innervation. "2( 3) radial from 
the n. medianus, 2( 1) ulnar from the ramus profundus of the ramus v^Iari.^t nianus u. ulnaris. 




\ 



320 



Muscles of the Arm. 



lyigaiuentum carpi tiaiisversiiii 
(cut through and turned back 



M. oppoiiens pollicis 



M. flexor pollicis brevis ._ 
fsuporticial headi 



Groove for the m. flexor 
pollicis longus 



M. flexor pollicis 
brevis (deep head 



M. adductor ^ 

pollicis 



Tendon" of the 

ni. flexor pollicis 

longus 

(turned down) 




Os pisiforme 
M. abductor 
digiti V 

y' (cut off) 

Opening for a 
branch of the 
' a. and n. ulnaris 

Ligamentum 
- - carpi transversum 
(cut through) 



M. opponens 
digiti V 



Mm. 
= . interossei 
volares 

Mm. 
-= interossei 
^. dorsales 



Ligamentum 

- capitulorum 

transversum 



Ligamentum 
vaginale 



365. Deep muscles of the ball of the right thumb. 

(The 111111. iifxorcs digituriiiii , tlexur jioUicis long'us, ahiluctor ixjUicis Itrevis, abduetur digiti V 
aud Hexor digiti V brevis have been removed ; the lig. carpi transversum has been cut through.) 

M. oppoiH'us pollicis (see also Fig. 364). Form: flat, oblong-quadrangular. Position : in 
the ball of the thuiiil), almost completely covered by the m. abductor pollicis brevis. Origin: lig. 
earpi transversum aud tuboreulum oss. multauguli majoiis. Insertion: corpus and capitulum oss. 
nietacarpalis I. Action: it opposes the thumb to the other fingers. Innervation: n. medianus. 

M. flexor pollicis brevis (see also Figs. 363 and 364). Form: oblong-quadrangular. 
I'usition: ulnar margin of the ball of the tbumb, in the depth, bounded radialward by the 
ni. op]i< 'liens pollicis, ulnarward by the m. adductor pollicis. Origin: by two beads; superficial 
head: lig. carjii transversum : deep head: ossa mullaugula, capitatum, metacarpale II. Insertion: 
superficial head to the radial sesamoid bone, deep head by two divisions (one narrower, radial 
and one thicker, ulnar) to the radial and ulnar sesamoid bones, both also to the base of the first 
phalanx of the thumb and ])artly to tlie tendon of the m. extensor pollicis longus. Between 
the two heads is a groove for the tendon of the m. flexor pollicis longus. Action: it flexes 
the first and extends the second phalanx of the thumb. Innervation: superficial portions 
by the n. medianus, dee]) by the ramus profundus of the ramus volaris manus n. ulnaris. 

M. adductor pollicis (see also Figs. 363 and 3()4). Form: fiat, triangular. Posi- 
tion: in the depth of the 2)alm, immediately upon the bones and the mm. interossei; covered 
by the tendons of the mm. fiexores digitorum , being bounded radialward by the preceding 
muscle. Origin: os mi'tacarpale HI. Insertion: ulnar sesamoid bone, base of th(> first 
pbalanx of the thumb and tendon of the m. extensor pollicis longus. Action: it adducts the 
thumb and opposes it to the other fingers; it extends the second jihalanx of the thumb. 
Innervation: ramus profundus of the ramus volaris manus n. tilnaris. 

M. oppoiieiis diu'iti quiiiti (0. T. o])ponens minimi digiti) (see also Figs. 363 and 364). Form : 
tla , u'k,l..ng '(uadranguliir. Position; in the ball of the little finger, almost completely covered by 
thv' Dam. aJxivvtor digiti V, aud flexor digiti V brevis. Origin: lig. earpi transversum and hamulus 
oss. liamati. Insertion: corpus and e;i]iitiilum oss. metacarpalis V. Action: it draws the fifth 
fi'iger toward tlil- thuii.'\ Innervation: ramus ])rofundus of the ramus volaris manus n. ulnaris. 



iluscles of the Arm. 



321 



Bursa m. flexoris carpi radialis - 



Vagina tendinis 
m. flexoris pollicis longi 



Vagina 

tendinis 

ni. flexoris 

pollicis longi 




Vagina tendinuni 

mm. flexorum 

commimiuiu 

Tendines 

mm. flexorum 

communium 

(cut off) 



Vagina 

tendinum 

mm. flexorum 

communium 



Vaginae tendinum digitales --^^ 



366. 

Sheaths of 

the tendons 

in the right 

palm, 

injected and colored 
red. 

Vag^ina [mucosa] 
tendiuum mm. flexo- 
rum eommuuium tuims 
a e<jmmun sheath fur the 
tendons of the mm. flexo- 

res digitorum communes ; it begins a little above the lig. carpi transversum and ends in the- 
middle of the palm; very often a special sheath entirely or partially separated from the main 
sheath is to be found, radialward, for the tendon of the index finger (see also p. 322). 

Vagina tendinis m. flexoris pollicis longi accompanies the tendon of the m. flexor 
pollicis longus frum the upper margin of the lig. carpi transversum as far as the second 
phalanx; it fretj^uently communicates with the preceding sheath. 



322 



^luscles 4^ the Arm. 



Radius 



Ulna 



~ Os pisiforiiic 




Os nietacarpale V 



Miu. interossei 
volares 

Mm. interossei 
dorsales 



Mm. 

^-lumbricales 
(cut away) 



Phalanx I 



367. Mm. interossei volares manus dextrae. 

The vaginae teiidiuuiii digitales (sec Fig. 366) are four long sheaths, which on the volar 
surface of the 2^^ 5*^ finger from the region of the capitulum oss. metacarpalis on, suiTound 
the tendnns of the mm. flexores digitorum conmumes in common as far as the third jihalanx: 
that of the 5'^ finger is connected in the adult with the vagina tendinum mm. fiexorum com- 
munium. Each of these tendinous sheaths for the fingers is attached, for some distance, by a 
('onn(>ctive tissue sheath, lirfamenUan vaginalc , firmh* to the underlying hones and ligaments 
(see also Fig. 241): in this sheath strung hands of fihers run, partly transversely, partly obliquely 
and crossed, lir/amenta annuUaria and Ufjamenia cmciata digitorum maims (see Fig. 363). 

Mm. interossei volares (0. T. i)almar interossei), three flat, triangular, small muscles. 
Position: in the depth of the pahn, in the mterspaces between the ossa metacarpalia IT ^V, 
covered by all tlie otlier muscles of the palm. Origin: on the lateral surfaces of the ossa 
metacarpalia the first on the idnar surface of the 2"^1 bone, the second and third on the 
radial surfaces of the 4*^ and 5th (gp^ jiigo Fig. 150). Insertion: each of the narrow 
tendons goes dorsalward from the lig. capitulorum transversum (see Fig. 241) on the same 
sidi' (if the finger to the back of the first plialanx and to the triangular expansion of the 
corresponding tendon of the m. e.xtensor digitorum communis (see Fig. 361). Action: they 
draw the 2"fi, 4*^^ ;,nd Sth fingers toward the middle finger, flex the first phalanx and extend 
the second and third phalanx of the 21^^ 4*^ and 5*^ finger. Innervation: ramus jtrofundus 
of the ramus volaris manus n. ulnaris. 



Muscles of the Arm. 



323 



Radius 



Processus styloideu 
ulnae 



Proeessiis stvloideus radii 



Ligameiita 
intercarpea dorsalia 



Os metacarpal e \ 



Mm. interossei _s; 
dorsales 



Tendines 

111. extensoris 

digitorum -= 

communis 

(cut off) 



Phalanx I ' 




368. Mm. interossei dorsales manus dextrae. 

Mm. interoissei dorsales (see also Figs. 361 and 367), four flat triangular, penniform, 
small muscles. Position: in the interspaces between the ossa metacarpalia, nearer the back 
of the hand. Origin: each comes from the neighboring surfaces of the ossa metacarpalia 
(see also Fig. 151). Insertion: each of the narrow tendons runs dorsalward fi'om the lig. 
capitulorum transversuin (see Fig. 241) the first and second each on the radial side of the 
2nd and 3rd finger, the third and fourth each on the ulnar side of the 3rd and 4*'! finger, 
to the back of the first phalanx and to the triangular expansion of the corresponding tendon 
of the m. extensor digitorum communis (see also Fig. 361). Action: the first and second draw 
the 2nd and 3'"d finger radialward, the third and fourth draw the 3rd and 4<'i finger ulnarward ; 
aU flex the first phalanx and extend the second and third phalanx of the 2nd 4th finger. 
Innervation: ramus profundus of the ramus volaris manus n. ulnaris. 

Yagina teudinuin mm. abduetoris longi et extensoris brevis polliois, ragiua 
tcndinum mm. exteiisoriim carpi radialium, Tagina tendinis m. extensoris pollicis 
longi (communicating constantly witli the preceding), vagina tendinis m. extensoris digit! 
quiuti and vagina tendinis m. extensoris carpi iiluaris fsee Fig. 369) surround thejj; 
corresponding tendons at the lig. carpi dursale and for varying distances b^'luw it. 

Vagina tendiuum mm. extensoris digitorum communis et extensoris in^icis 
(see Kg. 369) forms a sheath for the tendons of these muscles in common as far as the middle 
of the ossa metacai-paha. 



824 



Muscles of the Ann. 



Vagina tcndinuni 

mm. extensoris 

digitorum communis 

et extensoris indicis 



Liganientum 
carpi dorsale 



Vagina tendinis 
m. extensoris 
carpi ulnaris 

Vagina tendinis ni. ex- 
tensoris digiti V 

Vagina tcndinuni 
. mm. extensoris 
[digitorum communis 
et extensoris indicis 



Vagina tendinis m. ex- 
tensoris pollicis longi 



Vagina tendinum 
mm. abductoris longi et 
extensoris brevis pollicis 

Vagina tendinum mm. e.\- 
tensorum carpi radialium 

Vagina tendinis m. ex- 
^ tensoris pollicis longi 



Bursae 

subcutaneae. 

metacarpo- 

phalangeae - 

dorsales 

Bursae inter- 

nietacarpo- 

plialan^eae 





369. Sheaths 
of the tendons 
of the back of 
the right hand, 

injected and colored 

I-.mI. 

Bullae iatermeta- 
carpopkalangeae, livqiKiit, 

nue to three, are small, lie 
between two adjacent finojers 
at the level of the capitula 
OSS. nietacarp;iliuni, dorsal- 
ward from the ligg. capitu- 
liiriim transversa, between 
^~^ the 2"<i and tli(^ 5tli finger. 

Bursae subcutaneae 
metaearpoplialangeae dorsales are occasionally present and then usually only on the b^^ fingin-. 
JJursae subeutaueae rtig'itoruni dorsales (see Fig. 361), just beneath the skin on 
the liack of Wm- nrticulatiiiurs digitiiruin, usually small, occurring constantly or almost con- 
stantly on the first finger joints (between the first ami tlie second ]ihalanx), occasionally on 
the si>cond joint of the 2"d and 4*'' finger. 



Muscles of the Leg. 



325 



- Spina iliaca anterior superior 



Oi ilium 



Ligamentum inguinale [Pouparti] 

' Fascia iliopectinea 

Spina iliaca anterior inferior 

- M. iliopsoas 

Lacuna Tasorum 

-- N. femoralis 

A. femoralis 



Aceta- 
buUini 



Os iscliii 




Bursa iliopectinea 



V. femoralis 

Eminentia 
iliopectinea 



Annulus femoralis 
Ligamentum 

lacunare 
[GimbernatiJ 

Annulus 

inguinalis 

subcutaneus 

M. peetineus 

Tuber- 

culum 

pubicum 



Os pubis 



370. Section through the muscles of the right in- 
guinal region, parallel to and directly under the lig. inguinale [Pouparti]. 

Fascia iliaca (see also ri<r. 372). It covers the entire free surface of the m. iliopsoas, 
begins above on the bodies of the lumbar vertebrae and on the crista iliaca, is strongest below, 
and passes over medianward into the fascia pelvis. Below the lateral portion of the lig. inguinale 
[Pouparti] it extends downward with the ra. iliopsoas, is attached lateralward to the spina 
iliaca anterior superior and to the lig. inguinale, medianward to the eminentia iliopectinea and 
is named, from this puint on, the fascia iliopectinea. This divides the space under the lig. 
inguinale into two compartments, a lateral, lacuna musculorum, for the m. iliopsoas and 
n. femoralis, and a medial, lacuna vasorum; the latter contains lateralward the a. femoralis, 
medianward the v. femoralis and, between the latter and the lateral concave edge of lig. lacunare 
[GimbernatiJ, the annulus femoralis, which is closed by the fascia transversaUs (sejitum femorale 
[CloquetilJ and serves for the passage of lymph vessels. Below the lig. inguinale the fascia 
iUopectinea covers the floor of the fossa iliopectinea and forms at the same tune the deep 
layer of the fascia lata (see also p. 330). 



326 



Muscles of the Lee 



Costa xn 



M. quadratus 
lumborum 



M. psoas minor 

M. psoas major 



Costa XII 



Corpus vertebrae 
liimbalis I 

M. transversus 
abdominis 



Crus mediale 
diaphragmatis 

M. quadratus 
lumborum 

Origins of the 
m. psoas major 



bpina 

iliaea . -_^ 

anterior '^ 

superior 




Li game n- 
tuni ilio- 
lumbale 

Pro- 
montoriun 

M. psoas majo] 

(cut off and 

reflected) 

JI. iliacus 



Femur 



371. Lumbar muscles, 

\'icwed from in front. (The largest part of the 
left 111. psoas major has been removed.) 

M. (nuulratus liiniburiuu (see also Figs. 314, 315 ami 333). Form: flat, oblong- 
"piadrangular. Position: posterior wall of the peritoneal cavity, directly in front of the anterior 
layer of the fascia lumbodorsalis, covered partly in front hy the m. psoas major. Two, often slightly 
separated, layers. Ante7io?- layer. Origin: procc. transversi of the S*!" 2Dd lumbar vertebra. 
Insertion: inferior border of the 12tlM-ib and the liody of tlie 1 2 '^ thoracic vertebra. Posterior 
layer. Origin: labium internum cristae iliacae and lig. iliolumbale. Insertion: inferior margin 
of 12t'i rib and procc. transversi of the 4th jst lumbar vertebra. Action: it draws the last rib 
downward ; it bends the lumbar spine lat^^-alward. T n n (> r v a t i o n : rami musculares ])lexus lumbalis. 

M, iliopsoas cdiisists of in. psoas minor, m. psoas inajor and nt. iliacus. 

31. psoas minor (see also Figs. 314, 315 and 333), variable. Form: flat, long, narrow. 
Position: directly in front of the m. psoas major. Origin: lateral surface of the bodies of the 
12th thoracic and 1st lumbar vertebra. Insertion: fascia iliaea. Action: it bends the lumbar 
spine lateralward and makes the fascia iliaea tense. Innervation: rami musculares plexus lumbalis. 



Muscles of the Leg:. 



327 



M. psoas major 



M. fiuadratus lumboruia 



M. psoas minor 



Crista iliaca 



Fascia iliaca 

Spina iliaca 
anterior superior 

Fascia illopectinea 

Superficial layer of 

the fascia lata 

^reflectedj 

Fascia lata - 



Fossa ; 

illopectinea i 



A. and v. 
femoralis 

Margo falciformis 
(cornu inferius) 




Ligamenturo 

ongitudinale 

anterius 



Corpus vertebrae 
lumbalis IV 



- Promontorhim 



Symphysis ossium pubis 



Fascia pectiuea 



372. Fascia iliaca dextra. [Text see p. 325 and 330.] 

M. psoas major (see Figs. 314, 315, 333, 370, 371 and 376). Form: round, oblong- 
triangular. Position: posterior wall of the peritoneal cavity, directly in fi'ont of the mm. 
quadratus luraborum and iliacus, just lateral from the lumbar vertebrae and the apertura pelvis 
superior. Origin: lateral surfaces of the bodies and intervertebral discs of the r2th thoracic 
to the 5th lumbar vertebra as well as the procc. transversi of the lumbar vertebrae. In- 
sertion: converging downward, forward and lateralward and with a narrow tendon to the 
trochanter minor femoris. Action: it bends the lumbar spine lateralward, flexes the thigh, 
and rotates it somewhat outward dr, when the latter is fixed, it bends the pelvis and the 
body forward. Innervation; rami musculares plexus lumbalis. 

M. iliacus (see also Figs. 314, 370. 371 and 376). Form: flat, triangular. Position: 
in the fossa iliaca and anterior to the hip-joint, covered medianward by the m. psoas major. 
Origin: fossa iliaca, spina iliaca anterior superior and inferior; the latter origin (see Fig. 377) 
is also designated as the third head of the m. iliopsoas. Insertion: the fibers converge 
downward in front of the hip-joint (buisa iliopectinea see Fig. 377), then backward in common 
with the m. psoas major to the trochanter minor femoris (bursa iliaca subtendinea see Fig. 378). 
Action: it flexes the thigh and rotates it sniue-nhat outward or, when this is fixed, it draws 
the pelvis, together with the body, forward. Innervation: rami musculares n. femoralis. 



328 



Fossa iliaca 



Muscles of the Leg. 

Os sacrum 



M. piriformis 




coccygis 



M. coccygeus 



Faoics syniphyseos 
ossis pubis 



UKamentum sacrotuberosuin 



('aiuilis obturatorius 

FcTiiiir -_x 



M. obturator internus 



373. Muscles of the true pelvis on the right side, 

viewed from witliiii. 

M. obturator iiiteruus (sec also Figs. 374 and 385). Forni: flat, triangular. Position: 
in the small or true pelvis, on its lateral wall and close behind the hip-joint. Origin: medial 
surface of the os coxae and of the memhrana obturatoria. Insertion: tlii^ tibt,n's converge to 
the incisura ischiadica minor; tli(>r(> they Ijend lateralward (bursa m. obturutoris intend see 
Fig. 380) ;it a right angle and becoming tendinous pass between the two mm. gemeUi to tbe fossa 
trochanteri<-a femoris. Action: it rotates the thigh outward. Innervation: n. til)ialis. 

M. coccygeus (see also Figs. 374, 670 and 671). Form: quadrangular, thin. Po- 
sition: on the anterior surface of tlie lig. sacrospinosum, fornn'ng with it a common mass of 
variable composition (see p. 194); it projects beyond it, esi)ecially l)elow. Origin: spina 
ischiadica. Insertion: lateral edge of lower sacral and upper coccygeal vertebrae. Inner- 
vation: branches of the plexus ]iii(liMidus. 



Muscles of the Leg. 



329 



Os sacrum 
Ligamentum saerospiuosum j 
with the m. coccygeus 



M. piriformis 



Os ilium 





Ligamentum 
sacrotuberosum 



M. obturator 
interuus 



Tuber 

ischiadicum 



-^Capsula articularis 



Trochanter major 



Crista intertroclianterica 



Troclianter minor 



Femur 



M. obturator externus 



374. Muscles of the small or true pel- 

vis on the right side, viewed from without and below. 

M. obturator externus (see also Figs. 378 380). Form: triangular, thick. Posi- 
tion: anterior surface of the small pelvis and beneath the hip-joint. Origin: anterior surface 
of the I is coxae and of the memhrana obturatoria . Insertion: convt^'ging lateral ward ti > the fossa 
trochanterica femoris. Action: it rotates the thigh outward. Innervation: n. obturatnrius. 

M. piriformis (see also Figs. 373, 385 and 386). Form: Hatly roimded, triangular. 
Position: behind the hip-joint. Origin: facies pelvina oss. sacri. Insertion: the fibers 
run, converging, thi-ough the foramen ischiadicum majus lateral ward to the tip of the trochanter 
major femoris (bursa m. piriformis see Fig. 386). Action: it rotates the thigh outward and 
I'xtends it somewhat backward and lateralward. Innervation: ranu' musculares plexus sacralis. 



330 



Muscles of the Leg. 




Spina iliaca anterior superior 



Ligamentum inguinale [Poupartij 
Fossa ovalis 




Tractns 
iliotibialis 
[MaissiatiJ 




Cutis 



?treiigtlieniiig 

band 

(see text) 



liursa 

pracpatellaris 

subfiutanea 



Bursa 
infrapatell. 
'subcutanca 
Bursa 
subcut. 
tuberosit. 
tibiae 



375. 

Fascia of 
the right thigh, 

viewed from in front. 



Fascia lata [anterior lialf| 
(see also Fios. 325 and 372) 
covers the free surface of the 
muscles of the thigh and is 
stronger lateralward and above. 
From near the knee a fibrous 
process runs upward and lateral- 
ward : a furrow in the skin 
corresponds to this when the 
knee is extended and the muscles 
are relaxed. The fascia also 
forms a sheath for the m. sar- 
torius behind and dindes above 
into a deep and a superficial 
layer. The deep layer covers 
the fossa iliopecliuea. This (see 
Figs. 372 and 376) possesses a 
triangular entrance, comes in 
ri^ation above with the lig. ingui- 
nale and ends below under the 
m. sartorius; lateralward it is 
bounded by the m. iliopsoas, 
medianwanl by the m.pectineus: 
above it is continued into the 
lacima vasoriun. It is the lateral 
part of the larger, triangular, 
trigoimm femorale [fossa Scar- 
pae major] ((). T. Scarpa's tri- 
angle), which is limited above 
by the hg. inguinale, laterally 
by the m. sartorius, and me- 
diauly l)y the medial edge uf the 
m. adductor longus. Lateralward 
the deep layer is identical with 
the fascia iliopectinea (see p. 
325), and medianward, upon 
tlie m. pectineus, it is called the 
fascia pec tinea. The super- 
ficial layer partially covers 
the fossa iliopectinea and passes 
from the upper edge of the m. 
sartorius to the lower edge of 
the lig. inguinale. It ends median- 
ward with a concave edge, margo 
falciformis (0. T. falciform liga- 
ment) which arises below from 
the faseia pectinea (cornu in- 
ferius), is often indistinctly 
oiitliiUHl in its middle portion 
and, above (cornu siiperius), 
runs medianward to the lig. in- 
iiiiLuale and the liii'. lacimare. 



Muscles of the Leg. 



;i.si 



M. 

slutaeus 
inedius 



31. tensor 

fasciae 

latae 



Ciiti 



376. 

Muscles of the 
right thigh, 

viewed from in front. 

Fascia lata (continued). 
The fossa bounded by the 
marii^o falciformis is called 
the fossa ovalis; it is covered 
by the fascia cribrosa, a deep 
layer of the fascia super- 
ficialis which extends from 
the margo falciformis to the 
fascia pectinea and presents 
openings for lymph glands 
and vessels. The space fi'om 
the annulus femoralis as far 
as the entrance to the fossa 
ovalis is called also the 
canalis femoralis. 

Biirsae praepatellares 
see p. 214. 

Bui'sa iufrapatellaris 
subcutauea (see Fig. 375), 
frequently present, just be- 
neath the skin, in front of 
the lig. patellae. 

Bursa siibeutanea tu- 
berositatis tibiae (see Fig. 
3T5), frecjuently present, in 
front of the tuberositas tibiae. 

M. sartorius (see also 
Fig. 388). F r m : flat, narrow, 
very long. Position: super- 
ficial, in a long spiral above 
on the anterior, below on 
the medial surface of the 
thigh. Origin: by a short 
tendon from the spina iliaca 
anterior superior. Inser- 
tion: the fibers run parallel, 
at first medianward and 
downward in front of the 
ra. iliopsoas and in front of 
the groove l)etween the m. 
(puulriceps and the adductors, 
then downward medial from 
the m. vastus mediahs in front 
of the m. gracilis, then be- 
hind thf- epicondylus medialis, 
and thence obliquely forward 
with a flat, diverging tendon 
to the tubei-ositas tibiae and 
fascia cruris; the tendon 
covers the insertions of the 

mm. gracilis and semitendinosus and fuses with 
(bursa m. sartorii propria see Figs. 377 and 
Action: it flexes the thigh a'i the hip -joint and the leg 
at the knee, at the same time rotating the leg mward 
and the flexed thigh outward. Innervation: n.femorahs. 



Spina iliaca anterior superior 
M. iliopsoas 



M. vastus 
lateralis 




Lig. inguinale [Pouparti] 

Lig. lacunare [GimbernatiJ 
Tuberculum pubicum 



Fossa 
hi '"^ iliopeetinea 



M. 

peclineus 



M. 

adductor 

longus 



M. gracilis 



M. adductor 
luagnus 

M. rectus 
femoris 



M. sartorius 



M. vastus 
juedialis 



Tractus iliotibialis. 
[ilaissiati 

Eetinaculum 
patellae laterale 

Ligamentnm patellae 



them 
378). 



Retina- 
culum 
patellae 
ruediale 



Tendo 
m. sartorii 

Tuberositas 
tibiae 



332 



Muscles of the Leg. 



Spina iliaca anterior superior 
,M. sartorius (cut off) 



M. 

glutaeus- 
medius 



/Spina iliaca anterior inferior 

M. iliacus (tliird liead) 
/ (see p. 327} 

Bursa iliopectinea 
M. pectineus 



M. rastus lateralis 




Tuberculuni pubicuni 



M. 

adductor 

longus 



;M. cfracilis 



Hiatus 

tendineus 

[addiic- 

torinsl 



M. rectus 
femoris 



.M. vastus 
niedialis 



Patella 



Ligamcntum patellae 



Tuberosiias tibiae 



Tendo 
ni. <rracilis 



JUirsa 

ni. sartorii 

propria 

M. 

sartorius 

(cut off) 



377. Muscles of 
the right thigh, 

viewed from in front. 

(The mm. sartorius and tensor ' 
fasciae latae have been com- 
pletely, the m. iliopsoas, for the 
most part, removed.) 

Bursa iliopectinea (see also 
Fig. 370), constant, large, be- 
tween the m. iliopsoas and the 
lig. iliofemorale ; it is frequently 
connected with the cavity of the 
hip-jomt. 

M. pectineus (see also Figs. 
370 and 376). Form: flat, 
(iblong-quadrangular. Position : 
medial from and l3elow the hip- 
joint, boimded lateralward by 
the m. iliopsoas, medianward by 
the m. adductor longus, behind 
by the mm. adductor brevis and 
obturator i>xternus. Origin: 
from the rnmus superior oss. 
pubis, pecten oss. pubis and li- 
gamentum pubicum superius (see 
p. 197). Insertion: parallel 
downward, lateralward and back- 
ward to the linea pectmea femoris 
(biirsa m. 2)ectinci see Fig. 378). 
Action: it adducts and flexes 
the thigh, and rotates it outward. 
Innervation: n. fcmoralis. 

M. gracilis (see also Figs. 
376, 384, 386 and 388). Form: 
flat, long, thin. Position: super- 
ficial , on the medial surface of 
till' thigh, medianward from the 
mm. adductores; behind it is 
bounded by the m. semimembra- 
nosus. Origin: by a broad 
tendon from the ramus inferior 
oss. pubis. Insertion: paraUid 
downward, bebind the epicoudy- 
lus niedialis femoris and tbenct^ 
forward by a thin tmidon to 
tbe tuberositas tibiae, just beluw 
th(^ tendon of the m. sartorius 
(bursa aiiscrina see p. 378). 
Action: it adducts the thigh, 
flexes tbe leg and rotates if 
inward. Innervation: ramus 
anterior u. obturatorii. 



Muscles of the Leer, 



333 



378. Muscles of the 
right thigh, 

viewed from in front. 

(The nmi. sartorius, tensor fasciae 
latae, pectineus and oTacilis have 
been removed; the knee joint has 
been opened on tlie medial side.) 

M. (quadriceps feinoris, consists 
of four muscles, which are more or 
less distinctly separated above, but 
inseparably united at their insertion: 
m. rectus femoris, in. vastus late- 
ralis , m. vastus intermedins and 
m. vastus medialis. 

M. rectus femoris (see also Fij^-s. 
376 and 377). Form: spindle-shaped, 
thick, penniform. Position: on the 
anterior surface of the thigh, covered 
above by the m. sartorius, otherwise 
superficial. Origin: tendinous, part- 
ly from the sphia iliaca anterior in- 
ferior, partly arch-like above the ace- 
tabulum (bursa m. recti femoris see 
Fig. 379). Insert. : the fibers diverge 
from the middle downward, where its 
flat tendon goes over above the patella 
into the conunon tendon. Action: 
it flexes the thigh and extends the 
leg. 1 n n e r v a t i o n : n . fem orahs . 

M. adductor longus (see also 
Figs. 376 and 377). Form: flat, 
oblong-triangular, thick. Position: 
on the anterior surface of the thigh, 
bounded laterally by the m. pectineus, 
medianly by the m. gracLUs, behind 
by the ram. adductores brevis et mag- 
nns ; in front, below , it is covered 
by the m. sartorius. Origin: by 
a thick tendon from the anterior 
surface of the ramus superior oss. 
pubis. Insertion: di vergmg down- 
ward and lateralward to the labium 
mediale of the Unea aspera femoris. 
Action: it adducts and flexes the 
thigh and rotates it outward. Inner- 
V a t i n : ramus anterior n.obturatorii. 

Bursa iliaca subtendiuea, very 
frequently present, between the m. 
iliopsoas and the trochanter minor. 

Bursa m. pectinei, very fre- 
'juently jiresent, between the m. pecti- 
neus and m. iliopsoas, just below 
the trochanter miuoi'. 

Bursa m. sartorii propria (sc 
also Fig. 377), between the tendon 
of the m. sartorius and the tendons 
of the mm. gracilis and semimembra- 
nosus ; not rarely connected with the 

Bursa auserina, constant, large, 
between the tendons of the mm. graci- 
lis and semitendinosus and the tibia. 
Spaltebolz, Atlas. 



- --- Spina iliaca anterior superior 



Spiua iliaca anterior inferior 



!M. rectus femoris (cut away) 
M. pectineus 



...Ligamentum 
iliofemorale 

-il. obturator 
extern us 

Bui-sa iliaca 

subtendinea 
__M. iliopsoas 
(cut aw'ay) 

Bursa ni. pectinei 




yi. adductor longus 
M. adductor magnus 



Hiatus tendineus 
[adductorius] 



-- M. semimembranosus 
_- M. vastus intermcdius 

^. ]\I. vastus lateralis 



Tendo m. recti femoris 
(cut away) 



>I. vastus medialis 



Patella 



Ligamentum 
patellae 



1 Kctinaculum 
I patellae mediale 

._ Meniscus medialis 

Ligamentum 

collaterale tibiale 

Hill, gi-acilis et semi- 

teudinosus (cut away) 

. Bursa anserina 



M. sartorius 
(cut away) 
.. Bursa m. sartorii 
propria 



22 



334 



M. rectus femoris 
(turned back) 

Bursa 
m. recti femoris 



Trochanter 
major 




Muscles of the Leg. 

379. Muscles of the right thigh, 

viewed from in front. 



Spina iliaca anterior superior 



Spina iliaca anterior inferior 

Ligamentum iliofemorale 

Tiiberculum pubicum 



(Like ..^. 



:-''^*2S^ 




, M. obturator 
externus 

M. quadratus 
femoris 



.M. adductor 
brevis 



M. adductor 
magnus 

M. adductor 
longus (cut off) 

Hiatus 
tendineus 
idductorius] 

M. vastus 
intermedins 

M. semi- 
membranosus 



M. vastus 
medialis 



T'Tendo m. 
recti femoris 
(cut off) 



M. 



M. vastus lateralis 



articularis 
genu 



Patella - 
Meniscus lateralis. - 

Ligamentum collaterale - 
fibulare 

Ligamentum patcllae-- 



Mcniscus 
medialis 

Ligamentum 
collaterale 
tibiale 
Tibia 



Fig. 378 ; in addition the ni. 
adductor longus has been entirely, 
the mm. vasti medialis et lateralis 
have been partial!}- removed; the 
knee-joint has been opened.) 
M. adductor brevis. Form: 
triangular, tbick. Position: in front 
covered by the mm. adductor longus 
and pectineus, above adjoining the m. 
obturator externus, behind the m. ad- 
ductor minimus. Origin: anterior 
surface of the rami ossis j)ubis. In- 
sertion: diverging downward and 
lateralward to the labium mediale of 
the linea aspera femoris. Action: 
it adducts and flexes the thigh and 
rotates it outward. Innervation: 
ramus anterior n. obturatorii. 

M. adductor minimus (0. T. 
upper iiortii)n of adductor magnus) 
(see Figs. 380 and 385387). Form : 
triangular, thick. Position: behind 
the preceding, bounded above by the 
mm. obturator externus and quadra- 
tus i(>moris, below by the m. adductor 
magnus , behind by the latter and 
the m. glutaeus maximus. (>rigin: 
anterior surface of the rami inferiores 
ossis pubis and ossis ischii. In- 
sertion: diverging lateralward and 
downward to the labium mediale of 
the linea aspera femoris. Action: 
it adducts and flexes the thigh and 
rotates it outward. Innervation: 
ramus posterior n. obturatorii. 

M. adductor magnus (see Figs. 
376, 378, 380, 384, 386 and 387). 
Form: triangular, thick. Position : 
on the medial sule of the thigh, 
in front covered by the mm. adduc- 
tores brevis et longus and sartorius, 
bounded above and in front by the 
m. adductor minimus, median ward 
by the m. gracilis and posteriorly by 
the mm. semimembranosus, semitendi- 
nosus and biceps. r i g i n : anterior 
surface of the ramus inferior oss. 
ischii and tuber ischiadicum. In- 
sertion: the anterior fibers diverge 
lateralward and downward to the 
labium mediale of the linea aspera 
femoris (see also p. 336), the posterior 
fibers converge downward to a thick 
tiMidon, which runs to the epicondylus 
medialis. Action: it adducts the 
thigh. Innervation: ramus poste- 
rior n. obturatorii and n. tibialis. 
Bursa m. recti femoris, freipiently 
present, between the tendon of origin of 
the m. rectus femoris and the acetabulum. 



Muscles of the Leg. 



335 



380. Muscles of the 
right thigh, 

viewed from in front. 

(The muscles have been removed with 

the exception of the nun. obturator 

externus, adductores minimus et 

magnus and vastus intermedins.) 

M. vastus intermedius (0. T. 

crureus) (see also Figs. 378 and 379). 
Form: flat, oblong. Position: on 
the anterior side of the thigh, directly 
upon the bone; in fi'ont covered by 
the m. rectus femoris; at the sides 
covered over by the mm. vasti media- 
lis et lateralis, being fused with them. 
Origin: anterior surface of the corpus 
femoris. Insertion: the fibers run 
parallel downward, covered in front by 
a thin, fiat tendon, and go, above the 
patella, into the common tendon (see 
p. 336). 

M. articularis genu (0. T. sub- 
crureus) (see Figs. 379, 390 and 392) 
forms, in a sense, the deepest layer 
of the preceding muscle. Form: flat, 
thin. Position: directly upon the 
lower third of the femur, covered by 
the preceding muscle. Origin: an- 
terior surface of the corpus femoris. 
Insertion: upper and lateral surface 
of the capsule of the knee-joint. 
Action: it makes this capsule tense. 

M. vastus lateralis (0. T. vastus 
externus) (see Figs. 376379, 387 and 
389). F r m : flat, spindle-shaped, thick. 
Position: on the lateral surface of 
the thigh, chiefly supei-ficial, covered 
only by the m. tensor fasciae latae and 
the tractus iliotibialis, bounded behind 
by the m. biceps femoris. Origin: 
linea intertrochanterica, lateral surface 
of the trochanter major and labium 
laterale of the linea aspera femoris. 
Insertion: the fibers run parallel, 
in a curve, medianward and downward 
and are attached partly to the m. vastus 
intermedius, partly, above and lateral- 
ward from the patella, to the common 
tendon (see p. 336). 

Bursa m. glutaei minimi, almost 
constant, fairly large, between the 
tendon of tbe m. glutaeus minimus 
and the trochanter major femoris. 




Trochanter 

major 

\B.''m. glutaci 
minimi 

M. glutaeus 
minimus 



Spina iliaca anterior superior 

Spina iliaca anterior inferior 

Ligamentum iliofemorale 

Tuberculum pubicum 




M. obturator 
externus 



M. adductor 
minimus 



iSI. adductor 
magnus 



M. vastus; 
intermedius 



Tendo m. adductoris 
magni 



Patella 
Meniscus lateralis 

Ijigamentum . 

collaterale fibularc \ 

Ligamentum patellae - - 
Fibula 



Insertion of the 

m. vastus] 
medialis (cut off) 

Meniscus 
medialis 

Ligamentum 
ollaterale tibiale 



22* 



336 



Muscles of the I.e<>-. 



M. glutaeus medius with its covering of fascia Crista iliaca 



M. glutaeus 'luaxiuius 





Spina iliaca 
anterior 
>- superior 



\ 



\ 




M. sartorius 



]M. 'tensor 
fasciae latae 



Situation of the 

trochanter major 

femoris 




Sulcus glutaeus ' 



-il. rectus femoris 



Cutis 



M. somitendinosiis 










M. vastus 
lateralis 



M. biceps femoris 



Tractus iliotibialis [MaissiatiJ 



381. External muscles of the right hip, 

viewed from the lateral surface. 

M. vastus niedialis (0. T. vastus internus) (see Figs. 376379, 387 and 3S8). Form : 
flat, spindle-shaped, thick. Position: on the medial and anterior surface of the thigh : covered 
at its origin by the m. sartorius; otherwise superficial; comes into contact behind with the 
mm. addiu'tores longus ot magnus. Origin: labium mediale lineae asporae femoris. Insertion: 
the fibers go. parallel, in a curve, latoralward and downward, partly to the m. vastus inter- 
mcdius, partly, above and medianward from the patella, to the common tendon. From the 
anterior surface of the m. adductor magnus, approximately from the lower margin of the 
m. addiu'tor longus on, a tendinous ])late goes to the medial surface of the m. vastus juedialis; 
this bridges over a triangular vascular canal, which extends obliijuely baclxward and downward, 
the caiialis adcbictorius iHimteri] (0. T. Hunter's canal), the anterior entrance to which is 
called tlie hiatus icndineus /addiictoriusj. 

The connnon tendon of the m. quadriceps femoris is attached to the upper and tv the 
lateral margins of tht; ])atella and partly goes over in front of it, directly into the lig. patellae. 
Some of the tendon fibers of the mm. vastus medialis and vastus lateralis run however 
downward beside the patella to the anterior surface of the condyli tibiae and thus form the 
1-etinacnl.a patellae jnediule et laterale (sih^ Figs. 376 and 3SS), of wliicli the medial one is 
the broader and the more distinct; to these are also to be added other ligamentous bands which 
extend from the epicondyli forward to the patella and into whidi also bands of muscle are inserted. 

Action of the mm. vasti: thev (^xtend the leg. Innervation of the same: n. femoralis. 



Muscles of the Leg. 



337 



M. ghitaciis nicdius with its covering ot fascia 



Crista iliaca 



J[. glutaeus niaxiinus 



Sulcus fflutae 



M. seraitendi 




iSpina iliaca 
anterior superior 



M. sartoriiis 



. tensor fasciae latae 



Insertion of the 
m. glutaeus maximus 
o the tractus iliotibialis 



Cut surface of the 

superficial layer of the 

tractus iliotibialis 

M. rectus femoris 

Insertion of the 

m. glutaeus maxinuis 

to the femur 



M. vastus lateralis 



M. biceps femoris . 



I Tractus iliotibialis [Maissiati] 



382. External muscles of the right hip, 

viewed from the lateral surface. 

(In order to show the varying mode of attachment of the m. ghitaeiis maximus, a piece has been cut 
out of the superficial layer of the tractus iliotibialis and the deeper layer has been disected out.) 

M. tensor fasciae latae (0. T. tensor vaginae femoris) (see also Figs. 376 and 381). 
Form: flat, oblong-quadrangular, thick. Position: on the lateral surface of the hip, just 
beneath the skin; bounded in front by the mm. sartorius and rectus femoris, medianward and 
behind by the m. glutaeus medius. Origin: tendinous from the spina iliaca anterior superior 
and from the fascia lata. Insertion: the fibers riui parallel downward and go over, at the 
junction of the upper with the middle third of the thigh, into the tractus iliotibialis [Maissiati] 
(iliotibial band). Tbe muscle is covered on its lateral surface by a thin fascia, on its medial 
surface by a thicker layer of fascia : these can be looked upon as a superficial and a deep layer 
of the fascia lata. Action: it makes the fascia lata tense, especially the tractus iliotibialis; 
it flexes the thigh and rotates it somewhat inward. Innervation: n. glutaeus superior. 

M. g-lutaeus maximus (see also Figs. 329, 381, 384, 385 aud 387). Form: flat, 
quadrangular, very thick. Position: just beneath the skin of the buttock, the fleshy basis 
of which it forms. Origin: lateral surface of the ala oss. ilium behind the linea glutaea 
posterior, the posterior surface of the sacrum and coccyx and their ligaments, the ligg. sacro- 
iliaca posteriora and the lig. sacrotuberosum. Insertion: the fibers run, nearly parallel, lateral- 
ward and dowTiward : those of the upper jiortion go, in the form nf a broad tendon, over the lateral 
surface of the trochtmter major femoris fb. troclianlerica m. glutaci maximi see Figs. 385 387 
and p. 343), curve downward and pass over into the deep layer of the tractus iliotibialis, hidden 
by the superficial layers of the same; the fibers of the lower portion are attached by ;i thick, 
flat tendon to the tuberositas glutaea femoris (biirsae glutaeofemorales see Figs. 386 and 387. 
iind p. 343). Action: it extends the thigh backward and rotates it somewhat outward. 
Innervation: n. glutaeus inferior. 



338 



Muscles of the Les?. 







383. Fascia of 
the rightthigh, 

viewed from behind. 



Bursa 

trochanterica 

subcutanea 




1 



k 




strengthen- 
ing band of 
the sulcus 
ghitaeus 



Tractus 
iliotibialis 
IMaissiatil 



Fascia lata (posterior half) 
(see also Figs. 381, 382 and 
389) is, upon the posterior 
surface of the m. glutaeiis 
maximus , in general thin ; 
distalward it is somewhat 
thicker. Interwoven in the 
fascia , along the lateral sur- 
face, from the lower end of 
the m. tensor fasciae latae.on, 
is a broad, thick, glistening, 
tendinous strip of parallel 
fibers, the tractus iliotibialis 
[Maissiati] (0. T. iliotibial 
band), which is attached below 
to the condylus laterahs tibiae. 
This strip consists above (see 
Fig. 382) of a deep layer, 
which is the direct con- 
tinuation of the tendinous 
fibers of the m. glutaeus 
maximus, and of a superficial 
layer, which consists partly 
of tendinous fibers of the m. 
tensor fasciae latae, partly 
of fibers which descend from 
the thick fascial covering of 
the m. glutaeus medius. From 
the latter region comes also 
a thicker, flat bundle which 
crosses the insertion of the 
m. glutaeus maximus and 
extends in a curve from above 
downward and modianward 
to the tuber ischiadicum. 
This strand, cutting deep intii 
the muscle, corresjionds to the 
sulcus glutaeus (O.T. gluteal 
groove), which is visible as a 
furrow, running transversely 
in the skin when the m. glu- 
taeus maximus is relaxed. 
A less marked strengthening 
band, in the pupliteal space, 
extends fr<im above and la- 
teralward downward and me- 
dianward and corresponds 
also to a similarly directed 
furrow in the skin. 
Arising from the fascia lata are septa of connective 
tissue which extend between the individual muscles 
and gi-"U])s of muscles; the strongest of these pass 
beliind the origins of the mm. vastus niedialis an<l 
vastus lateralis to tht> iahiuui uiediale and labium laterale of the linea aspera femoris, forming 
the septuin intermuscidai c /fo/ioris] riwdialc and septum intermusculare [femoris] laterale 
(see Fig. 387): they serve ]irtly fur tln' attachment of the neighboring muscles. 

Bursa trochantoriea siibcutanoa, frequently present, small, just beneath the skin, 
u])on the lati'ral surfaci' oC the tniclianti'v major. 



Cutis 



Fascia lata 






-** 




strengthening band 
(see text) 



Muscles of the Le<i 



339 



384. 

Muscles of the 
right thigh, 

viewed from behind. 

M. semiteudinosus (see 

also Figs. 385 and 388). 
Form: triangular, long, ta- 
pering below . Position: 
on the posterior surface of 
the thigh; behind, in large 
part, superficial, covered only 
above by the ra. glutaeus 
maximus: lateralward it is 
bounded by the caput longum 
m. bicipitis, medianward by 
the iiim. adductor mag-nus and 
semimembranosus , in front 
by the m. adductor magnus. 
Origin: tendinous from the 
tuber ischiadicum. in common 
with the caput longum ra. 
bicipitis f bursa m. bicipitis 
femoris supei'ior see Fig. 386 
and p. 34|). Insertion: it 
nms converging downward, 
then lies with a long tendon 
in a furrow of the m. semi- 
membranosus and extends 
from there behind the tendon 
of the m. gracilis and in 
common with it , in a curve, 
forward to the tuberositas 
tibiae (see ra. sartorius p. 331) 
(bursa anserina see Fig. 378). 
Action: it extends the thigh 
backward, flexes the leg and 
rotates it at the same time in- 
ward. Innervation: n. ti- 
bialis. 

M. semimembranosus 

(see also Figs. 379, 385, 386 
and 388). Form: flat, oblong- 
quadrangular. Position: on 
the posterior surface of the 
thigh ; below, partly just be- 
neath the skin, otherwise 
covered by the ra. seraitendi- 
nosus; lateralward below it 
is bounded by the m. biceps, 
in fi-ont by the mm. quadra- 
tus femoris, adductor magnus 
and gracilis. Origin: by a 
flat, long, strong tendon from 
the tuber ischiadicum (bursa 
m. bicipitis femoris stiperior 
see Fig. 386 and p. 343). 
(Continued on p. 340.) 



M. 

adductor 
magnus 



M. gracilis 



M. 

semimem- 
branosus 



M. 

semimem- 
branosus 

M. semi- 
teudinosus 

M. gracilis 
M. sartorius 




M. glutaeus medius 



M. glutaeus 
maximus 



Situation o 
the trochant 
major 



Cutis' 



Traetus iliotibial 

[Maissiati] 



M. biceps femoris 
(caput longum) 



!^^. semiteudinosus 



M. biceps femoris 
(caput breve) 



M. planlaris 

Tendo m. bicipitis femoris 
-^l. gastrocnemius 



340 



Muscles of the Le"-. 



Ligamentuni sacro 

tuberosum / 

M. pirifortnis 

Mm. gemelli 



liiirsa ischiadica 
111. glutaei maxiiui 



M. obturatn 
internus 



>[ quadratus feniovis 
M. gracilis 

M adductor magnus 




M. glutaeiis uiedius 



M. glulaeus 

raaxinius (superior 

"portion, going to the 

tractus iliotibialisj 



Bursa 

troohanterica 

ni. glutaei 

inaxlmi 



M. glutacus 

_maxinius (inferior 

portion, going to 

tiie femur) 



Insertion to the femur 
Traetus iliotibialis [Maissiati] 



.M, :idduelor minimus 



M. seniimembrauosus 

M. semitendiuosus 



M. biceps femoris (caput longumj 



385. Muscles of the right buttock (2"Mayer), 

viewed from behind. 
(The m. ^'hitaeus maximtis has been cut through and reflected laterahvard.) 

M. seniimembrauosus (continued). Insertion: the tendon reaches downward on the 
Literal surface of tlie muscle as far as its lower half; from its medial surface fibers go luediau- 
ward and downward to a tendinous strip, which begins in the upper half, runs downward on 
the medial surface and goes, behind the epicondylus medialis femoris between the tendons of 
the mm. gracihs and semitendiuosus (see Fig. 3 S8), to the condylus medialis tibiae; it is there 
partly attached to the bone, in part it bends around into the lig. poplitetira obliquum and in 
part it goes over into that portion of the fascia cruris wltich covers the posterior surface of the 
m. popliteus (see Fig. 258) (bursa m. scminievibranosi see Figs. 387, 393, 394 and 390 and 
\). 348). Action: it extends thi^ tliigh backward and flexes the leg. Innervation: n. tiliialis. 

M. glutaeus medius (see ako Figs. 329, 376, 377, 381, 382 and 384). Form: flat, 
triangidar, thick. Position: on the lateral surface of the hij): in its upper and lateral parts 
superflcial, covered only by the fascia htta , wliicli is liere very thick: in front it is over- 
lapped by the m. tensor fasciae latae, behind by the m. glutaeus maxinnis, being bounded 
medianward by the m. glutaeus minimus. Origin: lateral surface of the ala oss. ilium, 
between the linea glutaea anterior and posterior; fascia lata. Insertion: the fibers converge 
downward and become attached by a short tendon to the lateral surface of the trochanter 
major, near its apex fbiirsa troc/ianiericae m. (/Iniaei mcdii see Fig. 3Sr) and p. 343). Action : 
it abducts the thigh. Innervation: n. glutaeus superior. 



Musck's of the Leji-. 



341 



Ppiiiii iliaca 
posterior infe 



Ligament um 
sacrotuberosnm 

B. m. obturatoris / 
intern! 
Mm. gemelli 

I'., ischiadiea m. 
ghitaei aiiaximi -' 
Tuber 
ischiadieuni 
yi. quadratus / 
femoris 
?.. m. bicipitls / 
femoris superior 

M. adductor ] 

niagnus 



M. gracilis 



^[. adductor - 
magnus 



M. semimem 
branosus 



^r. 



J[. gracilis 



;M. sartorius 




-M. piriformis 



yi. glutaeus minimus 

Bursa m. piriformis 

Bursa trochanterica m. glutaei medii posterior 

Bursa trocbanteriea ni. glutaei medii anterior 



M. glutaeus maximus 
(upper portion] 



J[. glutaeus medius 
(cut off) 



Bursa trochanterica 
ra. glutaei maximi 



M. glutaeus maximus 
(lower portion) 



Bursae glutaeofemorales 
Tuberositas glutaea 



386. 

Muscles of the 

right thigh, 

viewed from beliind. 

(The mm. glutaeus maximus, 
<;iutaeus medius and semi- 
tendinosus have been largely, 
the m. obturator intei'nus 
has been completely, removed .) 
Mm. gemelli superior et 
inferior (see also Fig. 3S5). 
Form: fiat, quadrangular, 
narrow. Position: on the 
posterior surface of the os 
coxae and the hip joint, 
bounded above by the m. 
piriformis, belovr by the m. 
ipiadratus femoris , behind 



yi. biceps femoris 

(caput breve) 



M. plantaris 

Tendo m. bicipitis feinoris 

gastrocnemius 



I'overed by the m. glutaeus 



semitendinosus - | 
(cut off) 

maximus. Origin: superior: 
from the spina ischiadiea: 
inferior: from the tuber 
ischiadicum. Insertion: the 
two muscles form together a 
groove in which rims the 
tendon of the m. obturator 
internus (b. m. ohturatoris 
intei'ni see p. 343) ; the fibers 
run, parallel, lateralward partly to the tendon oi the m. obturator internus, partly with this to the 
fossa trochanterica femoris. Action: they mtatethe thigh outward. Innervation: n. tibialis. 



342 



Muscles of the Lea-. 



f Spina iliaca 
posterior inferior^ 



Foramen 
isehiadicum uiaju 



Ligamentum 
sacrotuberosum 

Bursa ischiadica 
m. glutaei maximi ' 

Tuber isehiadicum 

M. adductor 
minimus 



M. adductor magnus 



M. vastus medialis 



M. adductor magnus if 



M. semi- 
membranosus -- 
(cut oft) 

Bursa 
m. semimembranosi 




M. glutaeus minimus 



Trochanter major 



Bursa 

trochanterica 

m. glutaei 

maximi 

M. quadratus 

ffmoris 

31. glutaeus 
niaximus 

(cut off) 

Bursa glutaeo- 
femoralis 



Septum iuter- 
musculare 
laterale -' 



M. vastus 
lateralis 



M. biceps femoris 
(caput breve) 



M. biceps femoris 

(caput longum) 

(cut off) 



;sr. plantaris 

Tendo 
ni. bicipitis femoris 

M. gastrocnemius 



Bursa ischiadica m. glutaei luaximi (see also Figs 
present; upon the posterior surface of the tuber isehiadicum and 
and seniitcndinosup, between these and the ni. glutaeus maxiuu 



387. 

Muscles of the 
right thigh, 

viewed from behind. 

(The mm. glutaei maximus et 
niedius, piriformis, obturator 
internus, gemelli, semitendi- 
nosus and semimembranosus, 
as well as the caput longum 
ra. bicipitis, have been re- 
moved.) 

M. glutaeus minimus 

(see also Figs. 380 and 3S6). 
Form: flat, triangular. Po- 
sition: on the lateral surface 
of the hip, just above the hip- 
joint; covered by the m. 
glutaeus medius , in front 
partly fused with it : bounded 
in front by the mm. rectus 
femoris and tensor fasciae 
latae, behind by the m. piri- 
formis. Origin: lateral 
surface of the ala oss. ihum 
between the linea glutaea 
anterior and inferior. In- 
sertion: the fibers converge 
downward and lateral ward 
and go with a strong tendon 
to the anterior surface of 
the trochanter major femoris 
(b. irocliauterica m. glutaei 
minimi see Fig. 380). Action: 
it abducts the thigh. Inner- 
vat i o n : n. glutaeus superior. 

M. quadratus femoris 

(see also Figs. 379, 385 and 
386). Form: flat, quadran- 
gular. Position: behind 
and below the hip -joint, 
bounded in front by the m. 
obturator externus, below by 
the m. adductor minimus, 
behind by the mm. semi- 
membranosus , biceps and 
glutaeus maximus, above by 
the m. gemellus inferior. 
(Origin: tuber isehiadicum. 
Insertion: the fibers run 
para,llel lateralward to the 
crista intertrochanterica fe- 
moris. Action: it rotates 
the thigh outward . Inner- 
vation: n. tibialis. 

385 and 386) very frequently 
of the origins of the mm. biceps 

IS. 



M. sartorius i 
I 



Muscles of the Leg. 

^r. gracilis 



343 



M. rectus femoris 



M. vastus medialis _ , 



Retinaculum 
patellae med 



,n f 
iale I 



Patella _ _ . 

Ligamentum patellae 

Tuberositas tibiae ^ 

388. 
Muscles of the 

viewed from the 




M. semimembranosus 



^L semitendinosus 



_ M. semimembranosus 
_ M. semitendinosus 
M. gracilis 

-- M. sartorius 



M. gastrocnemius 



right knee, 

medial siu'face. 



Bursa trochauterica m. glutaei niaximi (>ee Fig. 385 387), e(mstant, very large, 
upon the posterior and lateral surface of the trochanter major as well as upon the origin of 
the m. vastus lateralis, between these and the upper portion of the m. glutaeus raaximus. 

Bursae ghitaeofemorales (see Pigs. 38() and 387), constant, two or three small bursae 
below the preceding; partly lateral, partly medial frum the attachment of the m. glutaeus 
maximus to the femur. 

Bursa trochanterica m. glutaei medii anterior (see Fig. 386), constant, sometimes 
double; between the tendon of the m. glutaeus medius and the apex of the trochanter major. 

Bursa trochauterica ni. g^lutaei medii posterior (see Fig. 386), very frequently 
present, between the ti-udon of the m. glutaeus medius and the tendon of the m. piriformis. 

Bursa ni. pirif(h'mis (see Fig. 386), frequently present, in front of and below the 
tendon of the m. pirifirniis, between it. the bone and the m. gemellus superior. 

Bursa m. obturatoris iuterni (see Fig. 386), constant, between the incisura ischiadica 
minor and the m. obturator internus; it is very often continued into the gi-oove formed by 
the mm. gemelli. for which it forms a lining; the latter part is very rarely independent. 

Bursa m. bicipitis femoris superior (see Fig. 386), inconstant, between the tendons 
of the mm. biceps and semitendinosus on the one hand and the tendon of the m. semimem- 
branosus on the other. 



344 



]\Iuscles of the Leg. 



.M. biceps femoiis 
(caput longiim) 



M. biceps femoris 
caput breve) 



M. semimembi'aiiosus 

'J'endo ui. bieipitis femoris 
M. gastrocnemius - 




-Tractus iliotibialis 
piaissiati] 



31. vastus lateralis 



- Patella 



Ligameut\im 
(ollaterale fibulare. 



Capitulum fibulae 



Tuberositas tibiae 



-M. soleus 



389. IVIuscles of the right knee, 

viewed from the lateral surface. 
(The fascia lata with the exception of the tiactus iliotibialis has beeu removed.) 

M. biceps femoris (see also Figs. 384 387). Form: triangular-prismatic, long with 
two heads. Position: on the posterior surface of the thigh, chiefly superficial, covered only 
above by the ni. glutaeus maximus: bounded niedianward by the mm. scmitendinosus and 
semimembranosus, lateralward by the m. vastus lateralis, in front by the mm. quadratus femoris 
and adductor magiius. Origin: caput lompim: by a short, strong tendon from the tuber 
ischiadicum , in connnon with the m. scmitendinosus (bursa m. bicijiitis fcinoris superior see 
Fig. 3S(i and p. 343); the tendon is continued on the medial surilice tif the muscle as lar as 
its inferior half: from it muscle fibers run out lateralward and downward to a tendon which 
b(>gins on the lateral surface in the upper half of the muscle: caput brcoe: fleshy, from the 
labium laterale of the linen aspera femoris: the fibers go backward and downward to the tendon 
of tlie caput longum. Insertion: the lowermost, common part extends downward behind the 
epicondylus lateralis femoris (b. bici}ntorjastrocnemialis see Fig. 3'J3) and goes by a strong, 
rounded tendon to the capitulum fibulae: in so doing it spans the lig. coUaterale fibulare from 
l>ehiud and lateralward by two limbs (bursa m. bieipitis femoris inferior see Figs. 390 and 3911. 
Action: it extends the thigh backward and rotates it outward: it flexes the leg and rotates it 
outward. Innervation: caput loiujuni: n. tibialis: caput breve: n. peronaeus communis. 



^[usclos or the Li'<r. 



345 



M. articularis 
enu 



M. plautaris 



Liganieutuin 

eoUaterale 

ftbulare 

M. biceps 

(cut off) 

B. lu. bicipitis 

femoris inferior 



M. quadri- 
ceps femoris 
icut off) 



Patella 



iiiirsa infra- 
patollaris 
profunda 

- Tuberositas 
tibiae 




Retinaculum mm. 
peronaeorum superius 

Bursa subcutanea _ 
malleoli lateralis 

Retinaculum mm. 
peronaeorum inferius' 

M. peronaeus _ 
brevis 

M. peronaeus 
longus 



390. Muscles of the 
right leg, 

viewed from the lateral surface. 

Tberetiuacula mm. peronaeorum 

are strong bands uf the fascia cruris 
and fascia dorsalis pedis tthich hold 
the mm. peronaei firmly in their bony 
grooves. The superius (see Figs. 393, 
395 and 409) goes, from the malleolus 
laterahs, partly into the deep layer of 
the fascia cruris, partly to the lateral 
surface of the calcaneus. The inferius 
(see also Figs. 264 and 4U9) forms a 
bridge over the mm. peronaei on the 
lateral surface of the calcaneus, is 
fastened to the bone above and below 
them and sends a septum in front 
between the two to the proc. trochlearis 
calcanei. Above it is connected with the 
superhcial layer of the lig. crueiatum. 

Bursa m. bicipitis femoris in- 
fer 'or (see also Fig. 391), almost con- 
stant, on the capitulum fibulae between 
the tendon of the m. biceps feiiioris and 
tbe lig. eoUaterale fibulare. 

M. tibialis anterior (0. T. tibiaUs 
anticus) (see also Figs. 391, 401, 402 
and 405). Form: triangular-prismatic, 
oblong. Position: superficial on the 
anterior surface of the leg: bounded 
medianward by the tibia, lateralward 
above by the m. extensor digitorum 
longus, below by the m. extensor hal- 
lucis longus. Origin: condylus lateralis 
and facies lateralis tibiae, membrana 
interossea cruris and fascia cruris. 
Insertion: the fibers converge down- 
ward to a flat tendon, which extends 
medianward, from the lower third of 
the leg on. in fi-ont of the tibia and 
articulatio talocruralis through the me- 
dial compartment of the lig. transversum 
and of the lig. crueiatum cruris, to the 
plantar surface of 
the OS cuneiforme I 
(b. siihleudiuea in. 
lihiatis anterioris 
see Figs. 402 and 
406) and to the 
])lantar surface of 
the basis oss. me- 
tatarsalis I (ee 
also Fig. 268). 
Action: it flexes 
the foot dorsal- 
ward. Inner- 
vation: n . pe- 
ronaeus profun- 
dus. 



- Ligamentum transversum cruris 

Ligamentum crueiatum cruris 

Ts\. peronaeus tertius 

M. extensor 
digitorum longus 

M, extensor 
- diijitoruni brevis 



346 



Muscles cf the Leg. 



Tendo m. bicipitis 
femoris 



Bursa m. bicipitis 
femoris inferior 



i / \ 



M. peronaeus 
longus 



M 



>r. peronaeus _ t-.-VU i M 



brevis 



'\'!M\ 



Fibula 



Ligamentum 
traiisvLTsum cruris" 



Malleolus lateralis '"1 



Ligamentuni 
cruciatum cruris 

!M. peronaeus 
tertius 
M. extensor / 

digitorum longus - , - 



"^hh 



vl/ 



M. vastus 
medialis 



- Patella 

^Meniscus 
niodialis 

Ligamentuni 
collaterale tibiale 
Ligamentuni 
patellae 

Tuberositas tibiae 

Mm. sartorius, 

gracilis et 

seniitendinosus 

(cut off) 

M. 
Ljastrocnemius 



-_ M. soleus 



Facies medialis 
tibiae 



-. M. tibialis anterior 



M. extensor hallucis 
longus 



M. extensor digitorum 
longus 



-iSIalleolus medialis 



M. tibialis anterior 



M. extensor 

lialhieis longus 



391. Muscles of 
the right leg, 

viewed from in front. 

M. extensor digitorum longus 

(see also Figs. 39U, 401 and 402). 
Form: flat, oblong. Position: 
just beneath the skin, on the lateral 
surface of the leg; bounded median- 
ward above by the m. tibialis an- 
terior, below by the m. extensor 
hallucis longus, lateralward above 
by the ni. peronaeus longus, below 
by the m. peronaeus brevis. rigin : 
fleshy, from the condylus lateraUs 
tibiae, capitulum and crista anterior 
fibulae, septum intermusculare an- 
terius [fibulare], membrana interossea 
cruris and the inner surface of the 
fascia criiris. Insertion: the fibers 
extend downward and forward to a 
tendon beginning medianward in the 
middle of the leg, which runs, 
through the lateral compartment of 
the lig. transversum and of the lig. 
cruciatum cruris, forward and down- 
ward and becomes subdivided into 
five tendons ; of these, the four me- 
dial tendons diverge to the heads 
of the ossa metatarsalia 11 Y, unite 
at the 2nd 4th toe with the cor- 
responding tendons of the m. extensor 
digitorum brevis, pass forward upon 
the dorsal surface of the phalanges 
of the toes, and each becomes at- 
tached by a middle process to the 
second, and by two lateral processes 
to the third, phalanx. Upon the first 
phalanx each tendon forms, as in 
the fingers (see p. 312), a triangular 
expansion, into the lateral processes 
of which the mm. lumbricales and 
interossei are inserted. The fifth 
tendon, that situated farthest lateral- 
ward, and the muscle belonging to it, 
usually incompletely separated above, 
namely the m. peronaeus tertius 
(see also Figs. 390, 401 and 409) 
extends to the dorsal surface of the 
OS metatarsale V. Action: it 
flexes the foot dorsalward, lifts the 
lateral margin of the foot, and 
draws the 2"d 5tli toe dorsalward. 
Innervation: n. peronaeus pro- 
fundus. 



Muscles of the Leg-. 



347 



Cavuiu 
articulare 

Tendo 
m. poplitei- 

Ligamen- 
tum col- _ 

laterale 

fib ul are 

Capituluiu ._ 
fibulae 

Space for 
. the n. 
peronaeus 
profundus 

Membrana 

interossea- 

cruris 

Septum 

inter- 

musculare 

anterius 

[fibulare] 



392. Muscles of the right leg 

(2^^ layer), viewed from in front. 

(The mm. tibiaHs anterior, extensor digi- 

toram lougus, and peronaeus longus have 

been removed; the lig. cruciatum cruris 

has been partially cut open.) 

M. extensor liallucis lougus (0. T. 

extensor proprius hallucis) (see also Figs. 
390, 391, 401, 402 and 405). Form: flat, 
oblong. Position: on the anterior surface 
of the leg, below just beneath the skin, 
above overlapped by its two neighbors: 
bounded lateralward by the m. extensor digi- 
torum longus, medianward by the m. til)ia- 
lis anterior. Origin: membrana in terossea 
cruris and facies m3dialis fibulae. Inser- 
tion: the fibers run parallel forward and 
downward to a flat tendon Ijeginniug median- 
ward in the inferior third: this extends, 
through the lateral compartment of the lig. 
transversum and thi-ough the middle com- 
partment of the lig. cruciatum criuis, for- 
ward and medianward to the dorsal surface 
of the OS metatarsale I and, after partial 
union with the tendon of the m. extensor 
hallucis brevis. to the base of the second 
phalanx of the great toe; with the first 
phalanx it is connected by short bands. 
Action: it flexes the foot dorsal ward, it 
elevates the medial margin of the foot, it 
extends the first toe dorsalward. Inner- 
vation: n. peronaeus profundus. 

The fascia cruris covers the free sur- 
face of the muscles of the leg. It is con- 
nected at the knee with the fascia lata, is 
stronger on the anterior surface above than 
below and, near the ankle-joint, is streng- 
thened by a broad band of transverse fibers, 
the iigamentum transversum cruris (0. T. 
broad part of anterior annular ligament) 
(see Figs. 391, 401 and 402). This is attached 
at its ends to the fibida and tibia and 
is divided, by a septum going to the 
tibia, into two compartments: one medial 
for the m. tibialis anterior, one lateral for 
the mm. extensor hallucis longus and ex- 
tensor digitorum longus : the lower margin 
of the ligament is connected medianward 
with the upjjer medial limb of the lig. cru- 
ciatum cruris. On the back of the leg the 
fascia covers not only the m. triceps surae 
fi-om behind, but also, passing in front of 
it, covers the mm. flexores longi and tibialis 
posterior: it thus forms a superficial and 
a deep layer. Medianward, upon the facies 
raedialis tibiae, the fascia is fused with the 
periosteum. Lateralward it sends a striji 
to the fibula, in front of and behind the 
mm. peronaei. septum intermuscular e an- 
terius ffibularej and septum intermuscu- 
lare posterius [fibulare] (see also Fig. 396), 
form which the muscles arise in part. 



M. articularis 
genu 

Tendo m. 
quadricipitis 

femoris 
~ (cut off) 

Ligamentum 

collaterale 

tibiale 

Meniscus 
medlalis 

Ligamentum 
patellae 

Tuberositas 
tibiae 



Crista anterior 
tibiae 



M. 
peronaeus 
brevis 



. M. extensor 
hallucis longus 



Malleolus 
lateralis 

M. extensor 

digitorum 

brevis 




Malleolis 
medialis 

Ligamentum 
cruciatum 



M. extensor 
hallucis 
longus 



348 



Muscles of the Leg. 



Tendo m. 

adductoris 

iiiagni 



M. semimem- 
branosus 
(dran aside) 



Bursa m. semi 
membranosi 



Planum 
popliteum 

i'enioris 
M. biceps 
(drawn aside) 

B. bicipito- 
gastrocnemialis 
M. plantaris 



gastrocnemius 



soleu> 



393. Muscles of the 
right leg, 

viewed from beliind. 

M. ti'iceps surae, consists of two 
muscles, m. gaslrocnemins and m. 
soleus , which are separated at their 
< irigins, but are inserted by means of 
a common tendon, lendo calcaneus 
[Achillia], into the posterior surface 
of the tuber calcanei (b. tendinis cal- 
canei [AcliiUisj see Fig. 395). 

M. gastrocnemius (see also Tigs. 
258,384,388391). Form: flat, long, 
with two heads . Position: superficial 
on the back of the leg; it forms the 
main mass of the calf. Origin: tendi- 
nous, from the planum popliteum fe- 
moris, fused with the capsule of the 
joint: caput laterale: above thecondy- 
lus lateralis (b. m. (jastrocnemii Catc- 
ralis see Fig. 395) ; it frequently con- 
tains a small sesamoid cartilage-; caput 
mediate: above the condylus medialis 
(b. m. (jastrocnemii medialis see Fig. 
394). Insertion: fibers for each 
head arise also fi'om a tendinous strip 
lying on the surface; they diverge 
below to form a broad tendon, which 
begins high up on the anterior surface 
of the muscle, becomes narrower and 
thicker below and goes over into the 
tendo calcaneus; the two heads con- 
verge, from their origins on. downward 
and are separated below only by a 
narrow groove: the belly of tlie medial 
head extends somewhat farther distal- 
ward. Action: it flexes the foot 
plantarward and supinates it. Inner- 
vation: n. tibialis. 

Bursa m. semimembrauosi. 
constant, double: one between the m. 
semimembranosus and caput mediale 
m. gastrocnemii, in front coming in 
contact with the capsule of the joint 
(it very frequently comnmnicates with 
the joint cavity) : the other, between 
the tendon of the m. semimembrandsus 
and the condvlus medialis tibiae (see 
Fig. 396). 

Bursa bicipitogastroonemialis, 
very rare, between the tendon of the 
ni. biceps on the one side, the caput 
laterale m. gastrocnemii and m. plan- 
taris on the other side: it is bounded 
medianward and behind by the n. pero- 
naeus communis. 

Bursa subcutauea caleanoa (not illustratiMl). constant, in tlu' sole of the foot, just 
beneath tlie skin on tlic inferior surface of the tuber calcanei. 

Bursa suboutanea tendinis calcanei [Achillis] (see also Fig. 409), frequently present 
on till' I'ostin'ior surface of the tuber calcanei. 



M. flexor 
digitorum longus 



Malleolus 
medialis 

Tendo 
calcaneus 
lAchillisJ 

Tuber calcanei 




M. soleus J 



Cutis 



peronaeus longus 

M. peronaeus brevis 
^lalleolus lateralis 

Retinaculum 
mm. peronaeorum 
superius 

Bursa subcutanca 

tendinis calcanei 



Muscles of the Lei. 



349 



394. Muscles of 

the right 1 eg (2"'^ layer), 
viewed from behind. 
(The in. 



I'laiiuiii ijopliteuin 
fenioris 



"aput niediale 
111. gastrocneinii _. 
(^cut away) 

Bursa m. 

gasTocnemii 

medialis 

yi. seniimein 

branosus 



/I 



Bursa m. senii- 
niembranosi 



M. popliteus 



Caput laterale 

m. gastrooiieiuii 

icut away) 



p]antaris 



peionaeus 
loiigus 



INf. soleus 



gastrocnemius has been 
removed.) 

M. soleus (see also Figs. 3S9 to 
391 and 393). Form: flat, spindle- 
shaped, thick. Position: on the 
posterior side of the leg. almost 
completely covered by the m. gastro- 
cnemius, bounded above bv the m. 

.., ,, . . f. -,, . memoranosi n 

popliteus. Urigm: from the capi- ^ 

tulum and facies posterior fibulae, 
linea poplitea tibiae and from a tendi- 
nous arch between the twci. Inser- 
tion: backward and do\mAvard to 
a broad superficial tendinous strip, 
which becomes narrower and thicker 
belo^- and goes over into the tendo 
calcaneus. Action: it fle.xes the 
foot plantarward and supinates it. 
IninTvat ion: n. tibialis. 

M. plautaris (see also Figs. 3S4, 
390 and 393). Form: flat, short- 
spindleshaped. Position: on the 
back of the leg, bounded lateral ward 
Ijy the caput laterale m.gastrocnemii, 
in front by the capsule of the ji'int 
and the m. popliteus. Origin: 
planum popliteum femoris above the 
condylus lateralis, fused with the 
capsule of the joint. Insertion: 
inedianward and downward to a long, 
narrow tendon which passes upon 
tlie posterior surface of the ni. soleus, 
in fi'ont of the m. gastrocnemius, on 
the medial side of the tendon of tiie 
latter and goes over into the tendo 
calcaneus ; in addition some fibers 
go to the fascia. Action: like the 
m. gastrocnemius : it makes the fascia 
tense. Innervation: n. tibialis. 

M. popliteus (see also Figs. 258, 
261. 392. 395 and 396). Form : flat, 
triangular. Position: on the back 

of the knee-joint and of the tibia, '?"^".*... " T'lll ifl 

covered by the mm. plantaris and 
gastrocnemius, bounded below by 
the m. soleus. Origin : by a narrow 
tendon fi-om the epicondylus lateralis 
femoris fb. m. poplitci see Figs. 261 
and 396). in addition by a fleshy 
origin from the lig. popliteum arcua- 
tum. Insertion: diverging me- 
dianward and downward to the facies 
posterior tibiae. Action: it flexes 
the leg and rotates it inward. In- 
nervation: n. tibialis. 

Bursa m. gastrocuemii medialis, almost constant, between the uppermost part of 
the capsule of the knee-joint, the femur and the caput mediale m. gastrocneinii: it very 
frequently communicates with the cavity of the knee-joint. 

Spalteholz, Atlas. 23 



I 



\i -. ' 



M. Hex or digitoruiii 

]ongus 
yi. flexor halliieis 
longus 
M. tibialis 
posterior 

Malleolus medialis 

Tendo calcaneus _ 
[AchillisJ 

Ligamentum ,^' 
laciniatum 
Tuber calcanei 



Tendo 

ni. gastrocneinii 

(cut away) 

jr. peronaeus 
longus 



.M. 



^^- 



peronaeus 
brevis 



^/ 



Malleolus lateralis 

Retinaculum 

mm. peronaeorum 

superius 



i- 



350 



Muscles of the Le"'. 



Planum 
'popliteum femoris 
B. m. gastrocneniii 
lateralis 



395. Muscles of the right leg 

(3''^^ layer), viewed from behind. 
(The mm. gastrocnemius, plantaris and soleus 



have been removed.) 



M. semi- 
membrano- 
sus (cut off) 



M. popliteus 



N>^1 



Wi 



M. tibialis 
posterior 



_ Caput laterale 
ni. gastrocneniii 

Lig. collaterale 
fibulare 
Lig. popliteum 
arcuatuni 
Ketinaculum 
ligamt-nti 
arcuati 
- Capitulum 
fibulae 
Opening 
for the 
n. peronaeus 
communis 



M. 

peronaeus 
longus 



M. flexor 
digitorum longus 



l> 



M. tibialis 
posterior 

Malleolus 
mcdialis 

Capsula 
articular is 

Ligamentuni 
laciaiatum 

Tuber 
calcanei 



Ji 



rri 



%.r--% 



hallucis, in the solephmtarwanl in ]i;irt liy the 

phintarward and sii]>inatrs it: it draws the 1^' 

Bursa m. gastrocnoinii lateralis, 

capsule of the knee-joint and 
with tlio cavity of the joint. 



M. flexor digitorum loug-us (see also 
Figs. 393, 399, 400, 405 and 406). Form: 
iiat, oblong, penniform. Position: on the 
back of the tibia and of the ra. tibialis poste- 
rior, bounded laterally by this muscle and 
by the m. flexor hallucis longus, covered by 
the m. soleus. Origin: facies posterior tibiae 
and the deep layer of the fascia cruris (see 
]). 347). Insertion: obliquely downward to 
a tendinous strip, which goes over above the 
malleolus into a roimded tendon ; this extends, 
behind and below the tendon of the m. tibialis 
])osterior, mcdianward near the sulcus m. flexor 
hallucis longi of the talus and at the medial 
margin of the sustentaculum tali of the calca- 
neus (see p. 141) to the sole of the foot, being 
held fast by the deep layer of the lig. laciniatum 
(see also Figs. 268 and 269). It then crosses, 
plantarward, the tendon of the m. flexor haUucis 
longus, receives from it a tendinous bundle and 
breaks up into four diverging tendons : these 
go to the 2"d 5th toe, perforate the tendons of 
the m. flexor digitorum brevis and become fasten- 
ed to the base of the 3id phalanx. The tendon 
is covered on the medial border of the foot by 
the m. abductor hallucis, in the sole plantarward 
by the m. flexor digitorum brevis. Action: 
it flexes the foot plantarward and supinates it : 
it draws the 3rd phalanx of the 2"^ 5th toe 
plantarward. Innervation: n. tibialis. 

M. flexor hallucis loiig'us (see also 
Figs. 394, 399, 400 and 405-407). Form: 
rounded , oblong , peunif\)rm. Position: on 
the posterior surface of the flbula and of the 
m. tibialis posterior; it is bounded medianward 
by the m. flexor digitorum longus, lateralward 
by the mm. peronaei, covered by the m. soleus. 
Origin: facies posterior fibulae, septum inter- 
innsculare posterius and the deep layet of the 
fascia cruris (see p. 347). Insertion: the 
fibers converge downward to a tendinous strip. 
Behind the malleolus medialis begins the round- 
ed tendon, which goes in the sulcus m. flexoris 
hallucis longi of the talus and calcaneus, held 
in position by the deeplayerof the lig. laciniatum 
(see also Figs. 268 and 269), behind the tendon 
of the m. flexor digitorum longus, to the sole of 
the foot. There it crosses dorsalward the tendon 
of the latter muscle, gives off a process to it, 
which goes especially to the tendon bundle for 
the 2n>i toe and extends between the bellies of 
the m. flexor hallucis brevis tn the base of 
the 2"*! phalanx of the l^t toe. At the margin 
of the foot it is covered by the m. abductor 
in. flexor digitorum brevis. Action: it flexes the foot, 
;ind 2"d toe ])lantarward. Innervation: n. tibialis. 
(iften present l)(>tween the uppermost part of the 
the caput laterale m. gastrocneniii: it frequently communicates 



M. flexor 
ballucis 
longus 



M. 



peronaeus 
brevis 



Malleolus 
lateralis 
^/' Ketinaculum 

mm. peronaeo- 

rum superius 

H. tendinis 

eak-anei 

Tendo 

calcaneus 

(cut off) 



Muscles of the Jjes. 



351 



396. Muscles of the right leg 

(4*^ layer), viewed from behind. 

(All the muscles have been removed with the 

exception of the mm. tibialis posterior and peru- 

naeus brevis.) 



iii 



Planum popliteuu 
feiuoris 



Ligamentum 

collaterale 

tibiale 

Bursa 

m. seiiiiiufiu- 

branosi 
M. semimem- 
branosus 
(cut off) 



\\ 



M. popliteus 

(cut off) 



Facies posterior 
tibiae 



M. tibialis posterior 



M. perouaeus lougus (see Figs. 390, 391, 
393395, 400, 407 and 409). Form: flat, 
oblong, penniform. Position: superficial on 
the lateral surface of the leg, above upon the 
fibula, below upon the m. peronaeus bre\'is; 
bounded in front by the m. extensor digitorum 
lungus, behind by the m. soleus. Origin: capi- 
tulum and facies lateralis fibulae, fascia cruris 
and septa intermuscularia [fibularia]. Inser- 
tion: the fibers go obliquely downward to a 

tendinous strip; the flalf'tendon extends down- ')\Wf /' 

ward at first on the lateral, then on the poste- ' ' 

rior surface of the m. peronaeus brevis in a curve 
behiaid and below the malleolus lateralis, upon 
the lig. calcaneofibulare to the sulcus m. peronaei 
[longi] of the calcaneus and is held in place by 
the retinacula mm. peronaeorum (see p. 345); 
thence it runs in the sulcus m. peronaei [longi] 
upon the tuberositas oss. cuboidei to the sole of 
the foot and there, covered plantarward by all 
the muscles and by the lig. plantare longum, it 
goes obliquely forward to the medial border of 
the foot; it is attached to the os cuneiforme I and 
OS metatarsal I (see Fig. 268). In front of the 
tuberositas oss. cuboidei it often contains a sesa- 
moid cartilage, rarely a sesamoid bone. Action: 
it flexes the foot plantarward and pronates it. 
Innervation: n. peronaeus superficialis. 

M. tibialis posterior (see also Figs. 395 
and -405407). Form: flat, oblong, penniform. 
Position: directly upon the posterior surface of 
the bones of the leg and of the membrana inter- 
ossea cruris, above between the mm. flexor digi- 
torum longus and flexor hallucis longus, covered 
below by these, above and below also by the m. 
soleus. Origin: facies posterior tibiae, mem- 
brana interossea cruris and facies raedialis fibulae. 
Insertion: the fibers run obliquely downward 
to a tendinous strip situated on the medial mar- 
gin : the round tendon, going out of it above the 
malleolus niedialis , extends , directly upon the 
tibia in front of the m. flexor digitorum longus, 
downward and medianward to the sulcus malleo- 
laris tibiae. It is there held in place by the 
lig. laciniatum, goes in a curve to the medial 
side of the ligg. talotibiale posterius and calcaneo- 
til)iale, thence on the medial and inferior surface 

of the lig. calcaneonaviculare plantare to the sole ^ , . 

of the foot and, lying directly upon the bones nnVanAi \ i, j'JI^^F^- 

and ligaments, it sends strong processes to the 
tuberositas oss. navicularis and to the os cunei- 
forme 1, and feebler processes to the ossa cunei- 

formia II and III, metatarsalia II, III, IV and cuboideum (see also Figs. 203 and 268). Action: 
it flexes the foot plantarward and supinates it. Innervation: n. tibialis. 
Bursa m. poplitei (see also Fig. 261) se,e p. 214. 

Bursa teudiuis calcanei [Acliillis] (see Fig. 395). constantly present, large, between 
the posterior surface of the tuber calcanei and the tendo calcaneus [Achillis^. 

23* 



Ligamentum 

coUaterale 

flbulare 

Tendo 
m. poplitei 

Bursa 
m. poplitei 

Capitulum 
fibulae 



Septum 

inter- 

musculare 

posterius 

M. 

peronaeus 

breyis 

Facies 

posterior 

fibulae 



Facies 

posterior tibiae 

M. tibialis 

posterior 

Malleolus 

medialis 

^I. flexor digi- 
torum longus 

M. flexor hal- 
lucis longus 

Ligamentum 
laciniatum 

Tuber 
calcanei 



:m 



\ 



peronaeus long 

Malleolus lateralis 

Retinaculum 
~ mm. peronaeon 
superius 

,__ Articulatio 
talocruralis 



352 




of the lieg. 



397. Fascia of the sole of the right foot. 




Fasciculi 
ransversi 



Bands 
^^ going to 
the depth 

(see text) 



M. peroiiaeus brevis (see 

Figs. 390 :59(i, 401 , 402 and 
409). Form: Hat, oblong, penni- 
1 orin . Position: on th e latera 1 
side of the leg upon the fibula, 
partly superficial, partly covered 
by the m. j^eronaeus longus ; 
bounded in Iront by the mm. 
extensor digitorum longus and 
l)eronaeus tertius, behind by the 
m. flexor hallucis longus. Origin: 
fades lateralis fibulae and septa 
intermuscularia [fibularia]. In- 
sertion: the fibers converge 
downward to a tendinous strip; 
the muscle extends medianward 
and in front of the tendon of the 
m. peronaeus longus, in a curve 
behind and below the malleolus 
lateralis (in a groove on the same) 
and then forward, directly upon 
the lig. calcaneofibtdare and above 
the proc. trochlearis calcanei; it 
is held in place by the retinacula 
ram. peronaeorum; thence the 
rounded tendon goes downward 
and forward to the tuberositas 
OSS. metatarsalis V; it gives off, 
usually, also a process to the 
tendon of the m. extensor digi- 
torum longus going to the little 
toe. Action: it flexes the foot 
plantarward and pronates it. 
I n u e r v a t i o n : n . peronaeus 
superficialis. 

The aponeurosis plantaris 
is a thick layer of glistening 
tendinous fibers just beneath the 
skin; it covers the inferior sur- 
face of the muscJes of the sole 
(if the foot. It begins at the 
tuber calcanei, extends forward, 
diverging, with five processes, 
and there becomes attached partly 
to the skin beneath the heads 
of the ossa metatarsalia , but 
especially by means of bundles 
branching off into the depth to 
go to the ligg. vaginalia. It is 
strongest in the middle and feebler 
over the muscles of the great too 
and of the little toe; it sends 
tough septa into the depth near 
the m. flexor digitorum brevis; 
anei otherwise it is connected behind 

with the fascia cruris and at the 
sides with the fascia dorsalis 
pi'ilis. Between its cutaneous insertions, there are 
stretched out, as in the hand (see p. 317), three bands of 
fibers whicJi run transversely, the fasciculi t ransversi. 
Bursa subcutaiioa calcanea see p. 348. 



A])oneurosis 
plantaris 



Cutis 



'I'ubcr 



]\Iuscles of the Le"'. 



;^5:-5 



398. Muscles of the sole of the right foot. 



Ligamentui 
anmilave 



Ligaiueiitnm ^. 
cruciatuiu 



M. flexor digito- 
ruiii brevis (see also 
Figs. 399 and 400). 
F r ra : oblunj,' - qua- 
drangular, thick. Po- 
sition: in the solo 
ot the foot, covered 
only by the aponeu- 
rosis plantaris ; bound- 
ed niedianward by 
the m. abductor hal- 
lucis, laterahvard by 
the m. abductor di- 
o'iti V, dorsalward by 
the m. (juadratus 
plantae and tendo 
in. flexoris digitorum 
longi. Origin: pro- 
cessus raedialis tu- 
ber's calcanei and 
aponeurosis i^lantaris. 
Insertion: the fibers 
diverge in front int(.> 
four muscular bellies 
and flat tendons which 
go to the 2iid 5th 
toe; the tendons sub- 
divide at the level of 
the first phalanx into 
two processes , per- 
mitting the corre- 
sponding tendons of 
the m. flexor digi- 
torum longus to pass 
throughbet ween them , 
and become attached 
to the second phalanx. 
Action: it draws 
the second phalanx 
of the 2c^ 5th toe 
planta rwa rd . Inner- 
vation: n. plantaris 
raedialis. 

M. abductor di- 
git! quiuti (0. T. 
abductor minimi di- 
giti) (see also Figs. 
399, 402 and 409). 
Form: flatly rounded, oblong. Po- 
sition: on the lateral margin of the 
foot, covered only by the aponeurosis 
plantaris, bounded m'edianward by the 
mm. flexor digitorum l)revis and qua- 
dratus plantae. Origin: inferior surface 
of the calcaneus, aponeurosis plantaris. 
Insertion: forward and lateralward 
partly to the tuberositas oss. meta- 
tarsalis V, partly h\ a half-tendinous 
insertion to the base of the first pha- 
lanx of the 5*ii toe. Action: it draws the first 
plantarward. Innervation: n. plantaris lateralis. 



Mm. 

lumbricales 



M. flexor 

digiti V 

brevis 



Tuberositas 
OSS. iiieta- - 
tarsalis V 

Band 

strengthening - 
the aponeuro- 
sis plantaris 



M. abductor digiti Y 




Ligameutuni 
vaginale 



Processes of 
the aponeu- 
rosis plan- 
taris to the 
ligg. vaginalia 

lendo m. flexo- 
ris hallucis 
longi 



.,, M. flexor 

^ hallucis brevis 



M. flexor digitorum 
brevis 



M. abductor hallucis 



Tuber cakanei 



phalanx of the little toe lateralward ami 



354 



Muscles of the Leg. 



399. Muscles 

(The 



Tendines 
m. flexoris 
digitorum """ 
brevis 

Liganientum 
vaginale (cut - 
open) X 



Mm. 
himbricales 



M. flexor 

digit! V 

brevis 



Tuberositas 
OSS. meta- 
tarsalis V 



Cliiasnia 
tendinuni 



of the sole of the right foot (2''i layer). 

ni. flexor digitorum brevis has been removed.) 

M. quadratns plau- 

tae (0. T. accessorius or 
flexor accessorius digito- 
rum pedis) (see also Fig. 
400). Form: flat, qua- 
drangular. Position: 
in the sole of the foot, 
bounded plantarward by 
the m. flexor digitorum 
brevis, dorsalward by the 
lig. plantare longum and 
caput obliquuni m. ad- 
ductoris hallucis, lateral- 
A^ard l)y the m. abductor 
digit! V. Origin: by 
two processes from the 
inferior and medial sur- 
faces of the calcaneus. 
Insertion: forward to 
the lateral margin of the 
tendon of the in. flexor di- 
gitorum longus. Action: 
it draws the third pha- 
lanx of the 2nd 5tli toe 
plantarward. Inner- 
vation: n. plantaris la- 
teralis. 

Mm. liiniliricales, 
four. Form: sjiindle- 
shaped, narrow. Posi- 



M. abductor 
-digiti V 




M. flexor 

hallucis 

brevis 



. flexor 
ueis longus 



Process to the 

ni. flexor 
igitoruni longus 



flexor 
orum longus 

adratus 
antae 



uctor hallucis 



calcanei 



draw the first phalanx medianward. 
three lateral: n. plantaris lateralis. 



1. I nn crva t ion : one 



tion: between the ter- 
minal tendons of the m. 
flexor digitorum longus, 
bounded plantarward by 
the m. flexor digitorum 
])revis, dorsalward by the 
mm. adductor hallucis 
and interossei. Origin: 
parti}' from the medial 
margin, partly from the 
opposed margins of the 
tendons of the m. flexor 
digitorimi longus. Inser- 
tion: small tendons ex- 
tern! forward, jjlantarward 
ironi the ligg. capitulorum 
[oss. metatars.] trans- 
versa, and go over, at the 
medial surface of the first 
phalanx of the 2"<i 5tii 
toe, into the triangular 
(Expansions of the tendons 
of the mm. ex'tensores di- 
gitorum (as in the hand, 
see p. 319). Action : 
they flex the first phalanx 
of the 2"*^ to the 5th toe, 
and extend the second 
and third phalanx: they 
medial muscle: n. jdantaris medialis: 



Muscles of the Leij 



355 



400. Muscles of the sole of the right foot (s-^d layer). 

(The mm. tiexores digitorum, abductor halhicis and abchictrn- digiti V have been removed.) 

M. flexor halhicis 
brevis (see also Figs. 
398, 399 and 404). 
F r ni : oblong. Po- 
sition: in the sole of 
the foot, partly super- 
ficial, behind and me- 
dianward covered by 
the m. abductor halhi- 
cis, lateralward pai'tly 
fused with the caput 
obliquum m. adductoris 
hallucis. Origin:plan- 
tar surface of the ossa 
cuneiformia I III and 
hg. calcaneocuboideum 
plantare. Insertion: 
it forms two diverging 
rounded bellies which, 
becoming tendinous, run 
to the two sesamoid 
bones and to the base 
of the first phalanx of 



Temlines 

ni. tioxoris 

digitorum 

longi 



the great toe ; 



Tendines 
111. flexoris 
d^igitorum 
hrevis 
Ligamentum 
capitulorum 
transversuiu 
M. adductor 

hallucis 
(caput trans- 
versuni) 
M. abductor 
digiti V 
(cut off) 
Mm. inter- 
ossei 
M. flexor 
digiti V 
brevis 



between the two bellies 
lies the tendon of the 
m. flexor hallucis longus. 
Action: it draws the 
great toe plantarward. M 
Innervation: medial 
belly : n. plantaris nie- 
dialis ; lateral belly: n. 
plantaris lateralis. 

M. adductor hfil- 
lucis (see also Fig. 404). 
Form: two heads. Po- 
sition: in the sole of 
the foot, bounded dor- 
sal ward by the mm. in- 
terossei, plantarward by 
the mm. flexores digi- 
torum. Origin: caput M. 
obliqmim : bases of the 
ossa metatarsalia II to 
IV, OS cuneilbrme III, 
OS cuboideiim and lig. 
plantare longum ; the 
fibers converge to a 
rounded belly, which is 
fused medianward with 
the m. flexor hallucis 
brevis ; caput trans- 
vcrsum: capsular liga- 
ments of the articula- 
tiones metatarsophalan- 
geae II V and ligg. capitulnrum transversa 
the fibers converge medianward. Inser 
tion: the two heads become inserted into 
the lateral sesamoid bone and the l)ase of the'' first phalanx 
draws the great toe plantarward and lateralward. Inner vat 



. opponens - 
digiti V 

Tuberositas 
OSS. meta- ^ 
tarsalis V 

Tendo 
m. peronaei 

lougi 
M. abductor 
digiti V 
(cut off) 
Ligawentum 
plantare lougum 



quadratus plantav 
(cut off) , 




Tendines 

in. flexoris 

digitorum longi 

(cut off) 

Tendo 

m. flexoris 

ballueis longi 

(cut off) 



Cbiasnia 
tendinuiii 



Processes of th( 

aponeurosis 
jilantaris to tbc 
ligg. vaginalia 



M. abductor 
hallucis (cut off 

M. 
adductor hallucis 
(caput obliquum) 



jr. flexor 'hallucis 
brevis^ 



Process to the m. flexo 
digitorum longus 



Tendo m. flexoiis 
hallucis longi 

Tendo iii. flexoris 
digitorum longi 



Origins of the 
m. abductor hallucis 



Deep layer of the ligamentun 
laeinialum 



-Tuber calcanei 



of the great toe. Action: it 
ion: n. plantaris lateralis. 



356 



Muscles of tbe Leg. 



401. Muscles of the back of the right foot. 



Fibula 



M. tibialis aiiterioi' 



Tibia 



Ligamemum 
traiisversTiii) cruris* 



M. extensor digitoniin 
longiis 



Malleolus lateralis 



Liganieiituiii 
cruciatuni cruris 



Malleolus 
luedialis 



M. extensor 
liallucis loiigus 



M. extensor 

digitoruiii 

brevis 



M. pero- 
iiacus tertius 



Tuberositas 

ossis nieta- r* 

tarsalis V 



M. extensor 
dlgitoruni < 
brevis 

JI. abductor 
digiti V " 




M. extensor 

liallucis 

brevis 

Strengthen- 
- ing band 
(see text I 



M. abductor 
hallucis 



The fascia dorsalis 
pedis is stretched out in 
the form of a membrane, inr 
the most part thin, over the 
tendons and nniscles of the 
back of the foot : above it is 
connected with the fascia 
cruris, at the sides with the 
aponeurosis plantaris. Inter- 
woven in it, at the junction 
of the foot with the leg, is 
situated the powerful li//(i- 
mentum cruciaium cruris 
(0. T. lower part of anterior 
annular lio'ament) (see also 
Figs. 392, 4 02, 405 and 409). 
This usually has the shape 
of a Y. Its lateral, strongest 
limb consists of two layers, 
of which the more superficial 
arises on the lateral surface 
of the calcaneus (connected 
with the retinaculum mm. 
peronaeorum inferius), the 
deep one arising in the sinus 
tarsi. Both extend median- 
ward, the former in front of, 
the latter behind the tendons 
of the m. extensor digitorum 
longus, unite on the medial 
side of the same and divide, 
then, into two medial limbs. 
The inferior medial, more deli- 
cate, limb runs in front of the 
tendons of the mm. extensor 
hallucis longus and tibialis 
anterior to the os naviculare 
and OS cuneiforme I. The 
superior medial, stronger limb 
goes to the anterior surface 
of the malleolus medialis (see 
also fascia cruris p. 347); it 
consists likewise of two layers, 
which run in front of and 
behind the mm. extensor 
hallucis longus and tibialis 
anterior: the main mass of 
fibers usually runs in front 
of the m. extensor hallucis 
longus and behind the m. 
tibialis anterior. Going off 
from the medial surface of 
the OS cuneiforme I and os 
metatarsale I is a curved 
strengthening band of fibers 
which passes m front of 
the nun. extensores hallucis 
to the basis oss. metatar- 
salis II. 



Muscles of tlio Leu'. 



35- 



402. Muscles of the back of the right foot i^'"^ i? 



aver 



(The mm. tibialis auterinr 
and extensores longi as well 
as the inferior limb of the 
lig. cruciatum cruris have 
been removed.) 



M. 



M. extuiisor lia 
loiigus 

extensor digitoruni 
longus 



_ TibiH 



Malleolus lateralis 



Llgamentum 
cruciatum cruci 

Retinaculum mm. 

peronaeorum 

inferius 



M. peronaens 
brevis 

M. extensor 
fligitorum 
brevis 



M. extensor digitoriim 
brevis (see also Figs. 390. 
401 and 409), Form: 
Hat, triangular. Position: 
upon the Ijack of the foot. 
directly ujjon the bone, 
partly covered b}' the ten- 
dons of the m. extensor di- 
gitoruni longus. Origin: 
lateral and superior surface 
of the cori)us calcanei, in 
front of the entrance into 
the sinus tarsi, covered by 
the, lateral limb of the lig. 
cruciatum cruris. Inser- 
tion: the fibers diverge 
forward and form four small 
muscular bellies , which, 
upon the ossa raetatarsalia, 
go over into flat , delicate 
tendons. Of these, the three 
lateral run to the first 
phalanx of the 2"cl 4ti 
toe, fuse with the corre- 
sponding tendons of the m. 
extensor digitoruni longus 
and go with the latter tn 
the second and third pha- 
lanx. The medial, strongest 
tendon , along with the 
muscle belonging to it, is 
given a special name, being 
called the m. extensor 
Lallueis brevis; itextends 
obliquely medianward and 
becomes attached partly to 
the base of the first pha- 
lanx of the great toe; partly 
it becomes united with the 
tendon of the m. extensor 
hallucis longus. Action: 
it draws the 1st 4111 ^q^ 
dorsalward and lateral- 
ward. Innervation: n. 
peronaeus profundus. 

Bursa subteudinea m. 
tibialis anterioris (see 
also Fig. 406), very frequent- 
ly present between the me- 
dial surface of the os cunei- 
forme I and the tendon I'f 
the m. tibialis anterior. 

Bursae intermetatarsophalan^eae, 
four, l)etween the heads of the ossa nieta- 
tarsaha ; the three medial ahiiost constant, 
the fourth only occasionally present. 



M. peronaeus longus 



M. peronaeus 
lertius (cut off) 



yi. abductor 
digiti V 

Jim. 
interossei = 
dorsales 



Tendines 
m. exteii- 
soris digi- 
toruni longi 




Ligamentum 
transvcrsum cruris 



Compartment for 
m. tibialis anteric 



IMalleolus medial 

Compartment foi 

m. tibialis antei 

Compartment fo) 

m. extensor hall 
longus 

Compartment fc 
the ra. extenso: 

dlgitorum longi 

Tendo m. tibis 

anterioris 

M. extensor 

hallucis brevir^ 



B. subtendinei 

m. tibialis 
anterioris 

Tendo 

m. extensoris 
hallucis longi 



M. abductor 
hallucis 



^^^^ 



Bursa( 
intermel 

tarso- 
phalang( 



358 



]\Iuscles of the Leg. 



Os cuboideuni 



Tuberositas ossis 
raetatarsalis V 



Mm. iiiterossei dorsales -, 



Phalanx I 



Tendons of the nnu. extensores 

digitorum j. j, 




Os naviculare 



Ossa cuneiformia 



Os nietatarsale I 



Teiido m. extensoris 
hallucis brevis 



Phalanx I 



II 



403. Mm. interossei dorsales pedis dextri, 

viewed from the dorsal surface of the foot. 

Mm. interossei dorsales (see also Fig. 404), four. Form: oblong-triaugitlar, penni- 
form, small. Position: in the interspaces between the ossa metatarsalia, projecting somewhat 
].lantarward; covered dorsalward by all the muscles of the back of the foot, plantanward by 
all the muscles of the sole of the foot. Origin: from the adjacent sides of each pair of 
ossa metatarsalia. Insertion: the fibers of each muscle rtm converging forward to a small 
tendon; this extends dorsalward from the lig. capitulorum [oss. metatars.] transversum to the 
dorsal surface of the first phalanx and goes over into the triangular expansion of the tendons 
of the mm. extensores digitorum situated there. The tendon of the first (most medially 
situated) muscle runs on the medial side of the 2"d toe. while the tendons of the second to 
the fourth muscle lie on the lateral surface of the 2d_4th t(3e. Action: the first draws the 
2"<1 toe medianward, the others draw the 2ud 4tii toe lateralward; all flex the first phalanx 
and extend the second and third of these toes. Innervation: n. plantaris lateralis. 



]kluscles of the Les 



359 



Origin of the 
in. abductor hallueis 



Os naviculare - 



Origin of the ni. flexor 
hallueis brevis 



Origins of the ni. adductor ^'^ 
halhicis (caput obliquuni) 



Os metatarsalo I x % 



Mm. interossei dorsales 



Insertions of the 
m. flexor hallueis brevis 



Insertion of the "^ 
ni. adductor hallueis 



Phalanx I 




^- Liganu'iUuiii i)lantare_longuni 



Tendo ni. peronaei longi 



Origin of the ni. flexor 
digiti V brevis -(cut off) 



Mm. interossei plantares 



Insertion of the 
ni. flexor digiti V brevis 



404. Mm. interossei pedis dextri, 

viewed from the plantai' surface. 

M. flexor digiti quiiiti brevis (0. T. flexor brevis minimi digiti pedis) (see also 
Figs. 398 -100). Form: rounded, narrow, small. Position: in the sole of the foot, on the 
plantar surface of the os metatarsale V, partly covered plantarward by the m. abductor digiti V, 
otherwise only by the aponeurosis plantaris. Origin: basis oss. metatarsalis V and lig. 
plan tare longum. Insertion: the fibers nin converging forward and, becoming tendinous, 
go to the base of the first phalanx of the little toe. Action: it draws the 1^* i:ihalanx of 
the little toe plantarward and lateralward. Innervation: n. plantaris lateralis. 

M. opponens digiti quinti (see Figs. 400 and 409). Form: flat, triangular, small. 
Position: directly upon the plantar surface of the os metatarsale V, covered plantarward by 
the m. abductor digiti V, bounded medianward by the m. flexor digiti V. Origin: lig. plan tare 
longum, fused with the m. flexor digiti V brevis. Insertion: the fibers run lateralward and 
forward to the os metatarsale V. Action: it draws the little toe plantarward and median- 
ward. Innervation: n. plantaris laterahs. 

Mm. interossei plantares, three. F o r ra : oblong - spindleshaped, small. Position: 
in the interspaces between the ossa metatarsalia 11 V, plantan\"ard from the mm. interossei 
dorsales ; projecting somewhat toward the sole of the foot and covered there by all the muscles 
of the sole of the foot. Origin: from the medial surface of the ossa metatarsalia III V. 
Insertion: the fibers of each muscle go, converging, forward to a narrow tendon, which (like 
the tendons of the mm. interossei dorsales, see p. 358) go to the back of the first phalanx and 
to the tendons of the mm. extensores digitonun. The three muscles run on the medial side 
of the 3rd 5th toe. Action: they draw the 3rd 5th toe medianward, flex the first phalanx 
of each and extend their second and third phalanges. Innervation: n. plantaris laterahs. 



3 60 



Muscles of the Leg. 



M. solcus 



Faeies medialis tibiao 



M. flexor diiiitoruiii lonsus 



M. tibialis iiosterior 

M. flcxoi' hallucis loiigus 

Tc'iido calcaneus fAcbillisi 
Liganicntniu cruciatum cruris 




Malleolus medialis 
Ligamentuiii cruciatum cruris 

Fascia cruris (cut off) 
Tendo m. tibialis anterioris 

Tciido 111. extensoris ballucis 



Os mctatarsale I 



M. abductor ballucis 



Ligameiitiim laciniatum 
(supertioial layer) 



Partition- wall I 
Ligamentum laciniatum (deep layer) 



Bursa tendinis 
calcanei [.\cbillis] 



405. Muscles of the right foot, 

viewed from the medial surface. 

M. abductor hallucis (see also Figs. 39S 401 aud 404). Form: tiat, (ibknig-tnangiilar. 
Position: superficial ou the medial margin of the sole of the foot; bounded lateralward by 
the mm. flexdr digitorum brevis and flexor hallucis brevis. Origin: medial surface of the 
tuber calcanei, supei'ficial layer of the lig. laciniatum and malleolus medialis ; also from the 
tuberositas oss. navicularis aud the plantar surface of the os cuneiforme I. Insertion: the 
fibers converge to a tendinous strip, lying in the muscle, which goes over into a flat strong 
tendon : this is fused in front with the medial belly of the m. flexor hallucis brevis and goes 
to the medial sesamoid bone and to the base of the first phalanx of the great toe. Action: 
it draws the first phalanx of the great toe medianward aud plautarward. Innervation: 
n. 2)lantaris medialis. 

Ligamcufuin laciniatum (0. T. internal annular ligament) (see also Figs. 2()8, 394. 
395, 400, 406 aud 4UTj is a strengthening band in the luwer part of the fascia cruris, below 
and behind the malleolus medialis. It goes off from the posterior and inferior margins of the 
malleolus medialis, covers the tendon of the m. tibialis posterior and becomes attached to the 
subjacent bone; it then divides into two layers. The superficial layer is stretched out from 
there to the medial surface of the tuber calcanei and goes over above into the superficial 
layer of the fascia cruris, frequently with a sharp concave margin, sometimes without sharp 
limit (continued on p. 361). 



Muscles of tlip Let 



361 



M. fli'xor iligitoruiii loiigi;s 

TiMulo calcaneus [Acliillis 

M. tibialis anterior 

Facies niedialis tibiae 
Liganientiini traiisversuni cruris 
Vagina tendinis ni. tibialis jjosteriuris 

Vagina tendinis m tibialis anterioris 
Liganicntuni eruciatum cruris 

Bursa subcutanca malleoli medial is 



Vagina tendinis m. tibialis anterioris 
Ligamentuni eruciatum cruris 

Vagina tendinis ni. extensoris hallucis long! 



Tendo m. tibialis anteriori> 



Bursa subtendinea 
ru. tibialis anterioris 




Vagina tendinuni 
Vagina tendinis ui. flexoris ni. flexoris digitorumi 
Mm. abductpr hallucis longi longi | 

et flexor 
hallucis brevis (cut off) 



Vagina tendinis m. tibialis posterioris 



Ligamentum Vagina tendinis 
laciniatum m. flexoris 

(cut off) liallucis longi 



406. Bursae and sheaths of tendons of the right 

foot, injected (sheaths of tendons stained red), vieAved from the medial surface. 

(The mm. alxluetor hallucis ami tiexuv hallucis hrevis have been removed.) 

Ligamentum laciniatum (continued). The deep layer passes just behind the tendons 
of the mm. flexor digitoriiin longus and flexor hallucis longus to the medial surlace of the 
calcaneus, is firmly attached to the margins of the corresponding bony grooves and holds the 
ti'ndons firmly upon the bones; it reaches above as far as the malleolus and is continuous 
with thf deep layer of the fascia cruris. Between the two layers is a canal for the aa.. vv. and 
nn. ])Liutares: a septum, rarely absent, se]iarates the medial branches from the lateral. 

Bursa sulieutanea malleoli niedialis (see also Fig. 408), frequently present, upon 
the malleolus niedialis. 

Vagina tendinis m. tibialis posterioris (see also Fig. 407) begins over the medial 
malleolus and ends at the os naviculare; it fre(|uently communicates above with the following. 

Yagina tendinum m. flexoris digitorum pedis longi (see also Fig. 407), begins 
Ijelow the preceding and ends in tlie sole of thi' foot, at the point where its tendon crosses 
that of the m. flexor hallucis longus, below the os naviculare: above it conununicates sometimes 
with the preceding sheath, below sometimrs with the following. 

Vagina tendinis m. flexoris hallucis longi (see also Fig. 407) begins below the 
jireceding and ends at or in front of the point where the tendon of the m. flexor digitorum 
longus is crossed, below the os naviculare; there it sometimes communicates with the preceding. 



362 



Muscles of the Leg. 



Tuber calcanei 



Ligament am 

lai-iiuatuiu 

(cut off) 



Vagina tendinis 
in. tibialis 
posterioris 
A'^agina tendinis 
m. flexoris 
ballucis longi 

Vagina tendinnm 

ni. flexoris 

digitorum longi 

Bursa 

subtendiriea 

m. tibialis 

posterioris 

Vagina tendinis 

)u. perouaei 
longi plantaris 



Tendines 

ni. flexoris 

digitorum 

longi 

M. 

abductor 

hallucia 



Vaginae 

teudinuiii 

digitalcs 

pedis 



407. Bursae and sheaths of tendons of the sole 

of the right foot, injected; sheaths of tendons stained red. 
(The short muscles of the !* and 2^^ layer have been for the most part removed.) 

Bursa subtendi- 
nea m. tibialis po- 
sterioris, frequently 

present , oblong- 
troughshaped , be- 
tween the lateral ten- 
dinous process of the 
m. tibialis posterior 
(see Fig. 268) on one 
side, the ossa navicu- 
lare and cuneiforme II 
on the other side. 

Vagina tendinis 
m. peronaei longi 
plantaris begins at 
the sulcus m. peronaei 
[longi] of the os cu- 
boideum and ends at 
about the medial mar- 
gin of the lig. plantare 
longum; it communi- 
cates only rarely with 
the vagina tendinum 
ram. peronaeorum com- 
munis. 

Yagiuae tendi- 
nnm digitales pe- 
dis, five, one on the 
volar surface of each 
toe: they begin be- 
hind, at the great 
toe ui the neighbor- 
hood of the base, on 
the other toes in the 
neighborhood of the 
heads of the ossa me- 
tatarsalia , and ter- 
minate near the ter- 
minal phalanx; they 
are surrounded like 
those in the fingers 
(see p. 322) by the 
ligg. vaginalia with 
tile ligg. cruciata and 
annularia ; they never 
commimicate with the 
sheaths which lie 
more proximalward. 

Bursae mm. lum- 
briealium pedis, 
four, lying on the an- 
terior extremities of 
the mm. lumbricales, 
between tliem and the 
ligg. capitulorum [oss. 
metatars.] transversa ; 
the three medial bursae are almost con- 
stant, the fourth occurs in half the cases. 




Retinaculum 
mm. peronaeorum inferius 

-M. abductor digiti V 
_ , M. quadratus plantae 



Vagina tendinum 

mm. peronaeorum 

communis 



Tendo 
m. peronaei longi 

M. abductor 
digiti V 



Tuberositas 

- ossis meta- 

tarsalis V 

M. flexor 

digiti V brevis 



M. interosseus 
plantaris III 

M. opponens 
digiti V 
M. flexor 
' digiti V brevis 

M. abductor 
digiti V 



Bursae mm. 
-" lumbricalium 
pedis 



., Uiirsae intermeta- 
tarsoplialaiigcae 



Muscles of the Leg. 



363 



408. Bursae and 
sheaths of tendons 
of the back of the 

right foot, injected; sheath 
of tendons stained red. 



Vag^ina tendinis 
m. tibialis antorio- 

ris (see also Fig. 406) 

begins somewhat 
above the lig. trans- 
versura cruris and 
ends usually some- 
what above the articu- 
latio talonavicularis. 
Yagiua tendinis 
m.'extensoris hal- 
lucis loug'i (see also 
Kg. 406) begins as 
the most deeply si- 
tuated of the anterior 
tendon sheaths, below 
the lig. transversum 
cruris and ends farth- 
est forward in the 
region of the articu- 
latio tarsometatarsea 
of the gi'oat toe, 
distalward from the 
strengthening band 
situated there (see 
p. 356); the distal 
end often has the 
appearance of being 
pinched off. 

Vagina tendinum 
m. extensoris digi- 
torum pedis longi 
(see also Fig. 409) 
forms a sheath for 
the tendons of the 
m. extensor digitorum 
longus and of the m. 
peronaeus III; it be- 
gins somewhat above 
the preceding below 
the lig. transversum 
cruris and ends over 
the middle of the os 
cuneiforme III. 



Ligamentum 
transversum cruris 



Bursa subcutaiiea. 
malleoli lateralis 



Liganientum 

cruciatum 

cruris 



Vagina 

tendiuum 

111. extensoris 

digitorum 

longi 



Bursae inter- 
metatarso- 
phalangeae 




_ Bursa subcutanea 
malleoli medialis 



Vagina tendinis 
111. tibialis anterioris 



A'agina tendinis 
m. extensoris 
hallucis longi 



Strengthening 

band of the fascia 

dorsalis pedis 

(see p. 356) 



364 



Muscles of tbe Leg. 




M. tibialis anterior 
Tibia 
M. extensor digitorum longus 

^r. peronaeus brevis 

yi. peronaeus longus 

Ligament mil transversum cruris 

Fibula 

Tenclo calcaneus [Acliillis] 
Ligamentum cruciatuni cruris 

A'agina tendinum m. extensoris digitorum longi 



M. peronaeus III 
i 

Tendines m. extensoris digitorum longi 



Bursa subculanea -"^ , Tuberositas ossis 

tendinis oalcanei I , -M. abductor i metatarsalis V 

[Achillis] Calcaneus ' 'ligi'i ^ jj peronaeus brevis 

Retinaculum mm. peronaeorum ' lielinaculum mm. perouaeoruni inferins 

superius r.ursa subcutanea malleoli lateralis 

Vagina tendinum mm. peronaeorum communis 



I M. opponens digiti V 

M. abductor digiti V 



409. Bursae and sheaths of tendons of the 

right foot, 

injected (sheaths of tendons stained red), viewed from the lateral surface. 

Bursa siilnMitanca malleoli lat<'ralis (^oe also Tiii's. 390 ami 40SX very iiV(Hbnitly 
preseiit, ii|inii till' nialli'<ilus lati'i'alis. 

Vagina tciidinuni mm. peronaeorum communis (stf also Fig. 407), sunouiids the 
tt-ndons of tln' inni. iJcvoiiaci ami liifurcatos, at its proximal I'lid for a shurtfr, at its distal 
end fur a lunger, distance into two parts, cue for each tendon. It begins above the malleolus 
lateralis and ends at thi^ beginning of the tuberositas oss. cuboidei ; it communicates there 
only rarely with the vagina tendinis m. peronaei bingi i)lantaris. 



The Heart. 



365 








410. Position of the 
heart in the thorax, 

viewed from in front. 

(The level of the diaphragm un moderate expiration is shown hy the black dotted line: the 
outlines of the heart are indicated in red.) (In part after W. Braune.) 

The heart (cor) is an almost wedge-shaped, hollow, muscular body. It lies asym- 
metrical to the median plane in the thorax, so that the smaller part belongs to the right 
half of the body and the larger part of it to the left. The basis cordis (base of the heart) 
formed by the atria is directed backward and somewhat to the right, the apex cordis (apex 
of the heart) (belonging to the left ventricle alone) looks forward and to the left and comes 
into direct contact with the wall of the thorax in the 5tli intercostal space, somewhat medial 
from tiie costocartilaginous junction. The ostium arteriosum dextrum (0. T. pulnionaiy orifice) 
lies usually at the sternal end of the 3"d left intercostal space, or behind the 3rci costal cartilage ; 
the ostium arteriosum sinistrum (0. T. aortic orifice) lies somewhat more medianward and 
downward, close below the middle of the left halt of the iernum at the level of the 3rd inter- 
costal space. The middle point of the ostium venosum deictrum (0. T. right auriculoventricular 
opening) Hes behind the right half of the sternum at' the level of the sternal end of the 
4tii intercostal space: the ostium venosum sinistrum (0. T. left auriculoventricular opening) 
lies behind the sternal end of the Si^d left intercostal s-pace. 

Spalteholz. Atlas. 24 



366 



The Heart. 



A. anonyma 



V. cava superior 



Aorta ascendens 



-A. subclavia sinistra 
- - A. carotis sinistra 

Arcus aortae 



Auricula dextra 



Conus 
arteriosus" 



Atrium _ 
dextrum 




Position of reflection of the 
pericardium 

~" Ligamentum arteriosum 



A. pulmonalis 



Auricula sinistra 
Atrium sinistrum 



Sulcus 

longitudinalis 

anterior 



Sulcus 
coronarius ' 



Veutriculus 

sinister 



Ventriculus dexter 




Apex cordis 



Incisura [apicis] cordis 

411. I ne__nea.rt, moderately distended, viewed from above and in front. 

(Fades sternocostalis.) 

The heart is intercalatod as a pressure pump in the circulatory system and consists of 
two fore -chambers, atrium dexlrum (0. T. rigth auricle) and atrium si/iistnan (0. T. left 
auricle) and of two ventricles, veutriculus dexter (right ventricle) and ventriculus sinister 
(left ventricle). It presents for examination an inferior, almost plane surface, lying upon the 
dia]ihragm, the fades diaphraf/maiica (0. T. posterior surface) and a markedly curved surface 
looking u]>ward and forward, the fades sternocostalis ((). T. anteric>r surface) ; the latter lies 
partly just behind the sternum and behind the anterior ends of the 3i"<i to the %^^ pair of 
ribs, in part it is overlapped by the margins of the lungs. 



The Heart. 

Arcus aortae Eamus dexter a. piilmonalis 



367 



Ventriculus . 
sinister 




Basis cordis 



Bamus sinister a. pulmonalis _ 

Vv. pulmonales sinistrae __ - "M-^ 



Ligamentum 
V. cavae sinistrae 



V. cava superior 



-^ Vv. pulmonales dextrae 



Position of reflection 
of the pericardium 



V. cava 
"inferior 

Sulcus 
terminalis 

Appendix 
auricularis 
posterior 

A trium 

dextrum 



Sulcus 
coronarius 



_ Ventriculus dexter 



Sulcus longitudinalis posterior 



^ 



Apex cordis 



Incisura [apicis] cordis 



412. Th6 heart, moderately distended, viewed from below. 

(Fades diaphragmaiica.) 

The heart: the fore -chambers or atria are separated from the ventricles by a groove, 
the sulcus coronarius (0. T. auriculoventricular groove) which is usually filled up with blood- 
vessels and fat; it runs nearly perpendicular to the long axis drawn from the apex to the 
middle of the base and is in part hidden on the sternocostal surface by the beginning of the 
a. pulmonalis and aorta. The sulcus lonr/itudinalis posterior (0. T. posterior interventricular 
groove) runs fairly straight on the inferior surface, corresponding to the septum between the 
two ventricles ; the sulcus longitudinalis anterior (0. T. anterior interventricular groove) runs 
on the upper surface, twisted so as to be somewhat S - shaped from the base toward the apex. 
The latter sulcus begins, covered by the left auricle (0. T. auricular appendix), on the left 
side of the a. pulmonahs and meets the former at the right of the apex of the heart in 
a shallow groove, the incisura [apicis] cordis. 

24* 



368 



V. pulmonalis dextra 



The Heart. 

Atrium sinistruni 



V. cava superior 



Atrivim 
dextrum" 



Auricula . 
dextra 




.Auricula sinistra 



icular opening of the atrivim sinistrimi 



Aorta ascendens. 



Conus arteriosus 




s-^w. _ Ventricular opening 

^N of the atrium dextrum 



r\.. pulmonalis 



Ventriculus dexter 



/ 
Incisura [apicis] cordis 




Sulcus 

longitudinalis 

anterior 



i j_ -Ventriculus 
sinister 



Apex cordis 
Vortex cordis 



413. Superficial muscle layer of a maximally 

contracted heart, viewed from above and in front. 

(The fore-eliainl)ers or atria have boon (lissccted off. The (Hithnes of the dihited ventricles of 
the heart are indicatt'd in red, the position of the ostium arteriosum sinistrum being assumed 

to be fixed. [Text see pp. 370, 371 and 373.]) 



The Heart. 



369 



V. pulmonalis 
sinistra 



Auricula sinistra 



v. pulmonalis dextra 

Basis cordis 1 

I V. cava superior 

Atrium sinistrum Y ' 




Sinus coronarius 



-V. cava inferior 



Atrium dextrum 



Septum ventriculorum 



Ostium venosum 



Ventrioulus, 
sinister 




Ostium 

venosum 

^ dextrum 



VentriculH^ dexter 



Sulcus,k)ngitudinalis posterior 



Apex cordis 



414. Superficial muscle layer of a maximally 
contracted heart, vieAved from below. 

(The fore - chambers or atria have been dissected off. Two windows have been cut into the 

superficial muscle layer in order to show the deeper bands of fibers. The outlines of the dilated 

ventricles of the heart are indicated in red, the position of the ostium arteriosum sinistrum 

being assumed to be fixed. [Text see pp. 370, 371 and 373.]) 



370 



The Heart. 



Ostium arteriosum clextriiin 



Ostium Tenosum sinistrum 



Ventriculus_ 
sinister 






Ostium 

-venosum 

dextrum 




Ventriculus dexter 



415. The musculature of the ventricles of the 

heart, dissected free from one another; drawn apart; viewed from below. 

SomcAA^liat scliematically represented. 
(On the right the superficial muscle layer is showTi, on the left tJie middle layer is represented.) 

The heart is covered on its outer surface by the visceral layer of the pericardium, the 
epicardium, on its inner surface by the e?ulocardium ; the main mass of the wall is formed 
of muscle, the myocardium (see Y\g. 421). 

The musculature*) of the fore-chambers, or atria (0. T. auricles) (see Figs. 413 and 414) 
is very thin and irregular. On the posterior and especially on the anterior surface fibers go trans- 
versely from the wall of one atrium to that of the other; otherwise the fibers run chiefly in rings 
around the mouths of the veins and around the points of origin of the auricles (0. T. auricular 
appendices); in the auricles themselves the fibers are irregularly arranged. In addition, fibers 
go over into the radial fiber layer of the valvulae tricuspidalis and bicuspidalis. In the right 
atrium another, inner muscle layer, the mm. pectinati (see p. 376), exists. Between the mus- 
culature of the atria and that of the ventricles of the heart there is in general no connection. 

The musculature of the ventricles (see also Figs. 413 and 414, 416419) is common 
in its most superficial layers, but otherwise separated. The most superficial layer of muscle 
(see Figs. 413 and 414) runs obliquely, in front fi-ora the right and above to the left and 
downward, behind from the left and above to the right and downward ; the fibers can be 
followed in their course, behind jtartly as far as the annulus fibrosus sinister, otherT^-ise, how- 
ever, they cannot be distinguished, for long distances, from the other bands of muscle. 

The musculature of the riffht ventricle (see also Figs. 420 and 424) is thin and 
presents in general two lajers. The ]>ortion containing the ostium venosum presents, especially 
distinctly in the distended heart, an external, thin, connected layer and an internal, thicker 
layer arranged in the form uf a network. In the external layer the fibers run, in the main, 
obliquely, behind from the left and above to the right and downward and come partly from 
the annulus fibrosus dexter (see p. 373), partly from the upper surface of the left ventricle, 
partly from the annulus fibrosus sinister (seep. 373), partly from the septum ; in front they go 
partly to the upper surface of the left \-entricle, partly into the septum ; following upon these 
oblique fibers are fibers running more or less transversely. (Continued on p. 371.) 

*) In the description of the musculature (pp. 370 and 371) the heart is thought as 
being plac(>d with the base upward, the facies diaphragmatica backward and the apex downward. 



The Heart. 



371 



Fibers arising from the 
annulus fibrosus sinister and going to the right ventricle 



Superficial . 
muscle layer 



Middle (circular), 
muscle layer 




Superficial oblique 

-bands of muscle going 

to the right ventricle 



Deep muscle_layer_- 



Vortex cordis 

416. Course of the principal layers of muscle 
of the left ventricle of the heart, 

viewed from below. Partly schematic. 
(Parts of the -wall of the heart have been removed above and on the left side below.) 

Musculature of the right ventricle (continued). The irmer layer is formed of short 
bands of fibers which arise partly at the upper margin of the septum, go toward the apex, 
turn at varying levels toward the external wall and run upward in this again, in part to 
end as the musculi papillares , in part to reach the annulus fibrosus as trabeculae carneae ; 
between these columns are others which are stretched out transversely^ The conus arteriosus 
possesses an external layer of circular muscle and an internal longitudinal layer at right angles 
to it; the latter forms longitudinal ridges in the contracted heart. 

The musculature of the left venti-icle is much thicker than that of the right and is 
divisible into three layers of fibers, which, however, are not sharply separable from one another. 
The supei'ficial layer is thin; its fibers arise at the annulus fibrosus sinister (see p. 373) or 
at the ostium arteriosum sinistrum and run (the superficial more steeply than the deeper fibers) 
in front from the right and above downward and to the left, for the most part to the apex 
of the heart to form the vortex cordis: there they bend around into the interior and form 
the deep innermost layer of muscle. The thick, middle layer (see Fig. 415) consists of fiber 
bands which form closed circles, run essentially perpendicular to the axis of the heart, on the 
outer surface however also a little obliquely, in front from the right and above to the left 
and downward; on the inner surlace they are an-anged in the reverse direction; in their course 
the bands of fibers are manifoldly interwoven with one another. The deep, innermost layer is 
the continuation of the fiber bands of the superfcial layer entering into the vortex cordis. Its 
fibers are arranged in g(^ntle spiral turns but nearly parallel to the long axis of the ventricle 
and end either in the papillary muscles or at the annulus fibrosus sinister and at the ostium 
arteriosum sinistrum. As the trabeculae carneae they form, in general, numerous longitudinal 
ridges, of varying tliickness, which are connected with one another by thinner transverse beams ; 
only the septum below the ostium arteriosum is entirely smooth. 



372 



Large 

papillary 

muscle 



Large 

pap'l- I 

|lary 
muscle 



The Heart. 

Septum musculare ventriculorum 




Ventriculus dexter I 



I Ventriculus sinister 
Septum musculare ventriculorum 



Wiitrieulus tloxtcr | 



\ entnculus sinister 



Posterior 

"papillary 

muscle 



Anterior 

"papillary 

muscle 




Posterior 

.papillary 

muscle 



Anterior 

-papillary 

muscle 



417 and 418. Cross-sections of two hearts between the 

upper and middle third of the ventricles, perpendieukir to the long axis. 
The upper heart has been fixed in systole, the lower in diastole. (After L. Krebl.) 



The Heart. 



373 



Valvula semilunaris anterior a. pulmonalis ' 



I Conns arteriosus 



Valvula semilunaris 
sinistra a. pulmonali 



Valvula semi- / 

lunaris sinistra /_ 

aortae / 

I 

Trigona fibrosa ^ -/ 



N'alvula semilunaris 
'^ dextra a. pulmonalis 



Valvula semilunaris 
dextra aortae 




Valvula semilunaris 
posterior aortae 



Cuspis ante- 

rior valvulae__/. 

bicuspidalis / 

[mitralisj / 



Cuspis poste- I 

rior valvulaej 

bicuspidalis r 

fmitralisl ' 



valvulae 
tricus- 
pidalis 



Cuspis 
anterior 



_ Cuspis 
> medialis 

Cuspis 
posterior 



1 Annulus fibrosus 

' dexter 



Annulus flbrosus sinister 



>Ventriculus dexter 



419. Base of the contracted ventricles, 

after removal of the fore -chambers or atria. The valves are closed. 

(The outlines of the distended ventricles are indicated in red, the position of the ostium 

arteriosmn sinistruni being assumed to he fixed.) 

The anuiili flbrosi are dense, narrow bands of connective tissue, which surround the 
ostia venosa at the base of the ventricles. They serve for the attachment of the nniscular fibers 
of the atria and of the ventricles, and from them arise in largest part the valvulae tricuspidalis 
and bicuspidalis. The right surrounds the ostium venosum dextrum in the form of an oval 
closed ring. The left is horseshoe- shaped surrounding the right, posterior and left sides 
of the ostium venosum smistnuu; it begins right and left at the root of the aorta in a nodular 
thickening on either side, the trigona fibrosa ; between these the anterior cusp of the valvula 
bicuspidalis arises directly from the membranous wall- of the root of the aorta. 

The differences between the contracted and dilated ventricles are as follows 
(see also Figs. 413. 414, 417 and 41 S): 

In the dilated ventricles the diameter of the base is nearly the same as that of the 
long axis; the form approaches that of a hemisphere. The conus arteriosus projects markedly, 
the lower surface bulging much less than the upper, the ostia venosa and arteriosa are large, 
the cavities of the ventricles are wide open; the trabeculae cameae extend partly tbrough the 
lumen of the ventricles, and the musculi papillares stand out partly free in the ventricular cavities. 

On maximal contraction of the ventricles, the diameter of the base is markedly shortened, 
while that of the long axis diminishes only slightly; the form is wedge-shaped. The conus 
arteriosus shortens and sinks in: the facies diaphragmatica is slightly flattened, the s\ilcus 
longitudinalis anterior has a more marked spiral twist, the ostia venosa are markedly diminished 
in size, the ostia arteriosa less markedly, the cavities of the ventricles are represented only by 
a slit (with the exception of a s]>aee situated above the apices of the papillary muscles); the 
trabeculae cameae and the musculi papillares lie close to the walls and form ridge-like projections. 



374 



The Heait. 



Aorta ascendens 



Valvula venae cavae 
[inferioris, Eustachii] 



Musculi pectinati_ 

Foramen venae 
minimae [Thebesii]'^ ^ 



Septum I 

membranaceum i 

ventriculormn [ 



Cusp is 
posterior valvuhie 
tricuspidalis ~ 
Cuspis 
medialis valvulae 
tricuspidalis 



\ 




Atrium sinistrum 



Valvula semilunaris 

sinistra aortae 



'?m~ 


Valvula semilunaris 


posterior aortae 


%nk 


Cuspis anterior 

valvulae bicuspidalis 

[mitralis 


^^5 


Cuspis 
L posterior valvulae 
k bicuspidalis 
^ [mitralis] 



Large 
papillary muscle' 



Anterior 
-papillary muscle 



Posterior 
papillary muscle 



Septum musculare 
ventriculorum 



>- / Ventriculus sinister 



Trabeculae carneae 



420. Transverse section through a distended heart 

approximately parallel to the facies diapliragmatica. 
(Inferior half of the section, viewed from above.) 

The septum Tentriculorum (inierveniriadar septum) (see also Figs. 415, 417 and 
418) separates the two ventricles from one another completely. It is nuiscidar in by far its 
largest part (septum musculare ventriadornm) , is formed by a corresponding portion of the 
musculature of each of the two ventricles and can be divided into its two components only by 
artificial means. On contraction it thickens and the distance between the two sulci longi- 
tudinales diminishes. The septum membranaceum ventriculorum (0. T. undefended space) is 
a small area of pure connective tissue sitiuited just between and in front of the opposed margins 
of the valvulae semilunarcs dextra et posterior aortae (see also Fig. 426); its right surface is 
divided into two parts by the cuspis medialis valvulae tricuspidalis arising from it; the posterior 
part looks xUto the right atrium, the anterior into the right ventricle. 



Cuspis anterior 



The Heart. 

Cuspis posterior 



375 



Chordae tendineae 



Posterior papillary muscle^ 




-Aunulus fibrosus 



Endocardium 



-Myocardium 



Epicardiuni 



421. Transverse section through the valvula 

bicUSpidalis [mitral is]. The valve is set. 
(Inferior lialf, viewed from above.) 

The musculi papillares (impillary muscles) (see also Figs. 417, -118, 420, 424 and 425) 
are more or less isolated, bluntly wedge-shaped elevations of the internal muscular layer of the 
ventricles. They vary much in size and in dilferent hearts present considerable differences in 
appearance. From the tip of each muscle there go off one or several tendinous threads (chordae 
tendineae) of variable strength, which become attached partly to the fi-ee margins (chordae 
tend, of the I order), partly to the ventricular surface (chordae tend, of the II order) of the 
cusps of the valves guarding the ostia venosa ; tlie insertion is m the form of a triangular flat 
expansion. Each papQlary muscle gives off chordae usually to two adjacent cusps. In addition 
other tendinous threads (chordae tend, of the III order) arise directly from the muscidature 
of the ventricles and become attached in the same way also to the ventricular surface of the 
cusps of the valves. The chordae tendineae are of unequal length and are so arranged that 
the valve is set when they are all put upon the stretch, and vice versa. 

The ralvula tricuspidalis and valvula bicuspidalis [7nitralisJ (see also Figs. 419 and 
420) consists each of a tube-like membrane, which is attached to the annulus fibrosus (also 
partly to the wall of the root of the aorta on the left side) and is divided at its free margin 
by deep incisures into large sails or cusps fcuspides) and by less deep incisures into variably 
developed, smaller, intemiediary cusps. They are covered on both sides by endocardium and 
in their peripheral halves contain circular and radial muscle libers which are connected with 
the musculature of the fore-chambers or atria. At the end of the diastole of the ventricles, the 
central portions of the atrial surfaces of the cusps become applied to one another (the valves 
become set); the closure is water-tight and during the systole becomes gradually ever more 
complete, since the ostia venosa are markedly duninished in size and thus ever larger sections 
of the cusps of the valves are applied to one another. 



376 



The Heart. 



Aorta ascendens 



Auricula dextra 

Conus arteriosus 



Arteria pulmonalis 



Vena cava superior 



Crista terminalis 

Sinus venarum, ^ 
[cavaruml 

Basis cordis -V 

Venae 
pulinonales< 
dextrae 



Atrium 

sinistrum 




Tubcrculum 

intervenosum 

[Loweri 

Limbus fossae 
ovalis [Vieusseuii 

Fossa ovalis 



Yentriculus dexter 



Vena cava inferior 



\ Musculi pectinati 

Ostium venosum ventriculi dextri 



Valvula venae cavae [inferioris, Eustachiii\ \ Valvula sinus coronarii [Thebesii] 



422. Right fore-chamber (atrium dexlrum) 

of a markedly distended adult heart, viewed from the right. 

(A part of the wall of the atrium has heen removed.) 
The atrium dextrum (right fore- chamber, 0. T. right auricle) (see also Figs. 4 11 -114 
and 420) is of the shape of an irregular short cylinder. A groove, variably developed, running 
perpendicularly over the posterior e.xternal surface, the sulcus terminalis atrii dextri, and a 
ridge on the corresponding spot of the inner wall, the crista terminalis, mark off a posterior, 
medial portion, the sinus oenarvm [cuvarum] which is derived from a part of the sinus reuniens 
of the embryonic heart (see also p. 3S4). It contains in its lower and upper walls the mouths 
of the v. cava superior and inferior and in general has smooth walls. Between the opening of 
the V. cava inferior and the sidcus coronarius to the left of the sulcus terminalis there is often 
visible on its outer surface an irregular lumpy projection (appendix auricularis posterior). 
The posterior wall of the sinus is bounded partly by the atrium sinistrum, being slightly shoved 
forward by the same and presents there a transverse ridge, the tuberculum intervenosum [Loweri] 
(0. T. tubercule of Lower). The left wall is formed by the septum atriorum (0. T. interauricular 
septum), which consists partly of muscle, partly (pars memhranacea septi atriorum) of pure 
connective tissue. The latter spot lies in the lower part of the wall, is somewliat deepened 
(fossa ovalis) and is surrounded in front and above by a strong ridge of muscle (limbus fossae 
ovalis (Vieusseuii IJ. Starting at the anterior limb of the limbus, and arising from the inferior 
wall, is a thin, often partially perforated, fold of connective tissue which surrounds the mouth 
of the V. cava inferior from in front and sometimes also from the riglit (valvula venae cavae 
[inferioris, Eustachii] (0. T. Eustachian valve). .Tust in front of it, in the angle between 
the inferior, left and anterior walls, lies the mouth of the sinus coronarius ; it is only imperfectly 
closed from below by the sickleshaped valvula sinus coronarii [ Thebesii] (0. T. coronary valve 
or valve of Thebesius), whicii is often perforated. The anterior wall of the atrium contains 
the ostium venosum of the right ventricle. The right wall presents niuuerous muscular ridges 
projecting on the inner surface (musculi pectinati) (see also Fig. 420) ; these arise from the 
crista terminalis and ext>nd ap]iriiximately in the direction of the long axis of the heart as 
far as the sulcus coronarius; between them the wall is translucent when the heart is distended. 



The Heart. 



377 



Aorta ascendens 



Auricula dextra 

('onus arteriosus 



Arteria iiulnionali 



Vena cava superior 



Atrium sinistrum - 



Foramen ovale 



Valvula 
foraminis ovalis 



Vena cava inferior 




Ventriculns dexter 



I Ostium veuosum ventriculi dextri 

Valvula venae cavae [inferioris, Eustachii] Valvula sinus coronarii [Thebesii] 



423. Right fore -chamber (atrium dextnim) of a foetal 

heart iS"' month), viewed from the right. 

(A part of the wall of ihf^ atrium lias been removed. Magnification: 2:1.) 

From the upper wall of the atrium dextriim projects the bluntly wedge-shaped auri- 
cula dextra (right auricle of the heart) (0. T. right auricular appendix). It curves around 
the first portion of the aorta ascendens to the left, is notched above and below but otherwise 
smooth; it presents inside numerous irregular erossmg muscular columns, trabecnlae curneue. 

During foetal life the two atria commimicate with one another through an opening, the 
foramen ovule situated at the spot which later is the fossa ovalis. At its margin in front 
and al)Ove it is surrounded b_v a horseshoe-shaped, powerful band of muscle, which later becomes 
the limbus fossae ovalis, and behind and below it is bounded by the concave margin of the 
valvula foraminis ovalis, which rises as a thin connective tissue plate from behind and below 
and projects, gToove-like, uito the left atrium. Just after birth, as soon as the pressure in 
the left atrium becomes higher than in the right, this valve is pressed upon the lunbus and fuses 
with it almost completely, often, however, leaving a small slit open. The valvida foraminis 
ovalis becomes accordingly later the floor of the fossa ovalis; the anterior concave margin of 
the valve is often retained and is visible inside the left atrium on the septal surface. 

The yeutriculus dexter (right ventricle) (see Figs. 411 415, 417420 and 424) 
has the shape of a wedge ; its left concave surface is attached to the right side of the left 
ventricle: its apex does not reach the apex of the heart. The base of the wedge is hidden 
by the attacbment of the right atrium ; the inferior, the right and the superior anterior surfaces 
lie free ; the latter goes veiy gradiuilly over into the arteria pulmonalis and, in the distended 
heart, projects markedly convexly forward (conus arteriosus). On the inside, marking off the 
conus arteriosus from the venous portion of the ventricle, is a muscidar projection (crista 
supraventricularis) which extends, arch-like, from the base over the septum toward the apex 
and then to the right to the superior anterior wall and becomes lost in the roots of the large 
papillary m\iscle. The venous portion presents at the septum a fairly smooth wall, but else- 
where very many trabecidae carneae (see p. .371). The ostium venosum can be closed by the 
valvula tricuspidalis (tricuspid valve) ; this presents (see Fig. 419) a large cusp adjoining 
the interventricular septum (cuspis medialis), further a small cuspis anterior corresponding 
about to the conus arteriosus, a large cuspis posterior turned toward tlie right fi'ee wall, and, 
usually, between the cuspis medialis and cuspis posterior an additional small intermediary cusp. 



378 



The Heart. 

Aorta ascendens 



Ostium venosum ventriculi sinistri 



Cuspis anterior valvulae tricuspidalis 
Ostium venosum ventriculi dextri 



Cuspis 
posterior 
valvulae ~ ~ 
tricuspidalis 



'Large 
papillary muscle 



Trabeculae 
carneae 




Arteria 
pulmonalis 



_ Valvulae 
semilunares 



. Conus 

arteriosus 



Crista 
supraventricularis 



Sulcus longitudinalis 
anterior 



Yentriculus sinister 



424. Right ventricle (venfriculus dexter) of a markedly 

distended heart, viewed from the right and above. 
(The largest part of the right and anterior wall has been removed ; the atria have been removed.) 

Yentriculus dexter (continued) : the chordae tendineae of the anterior and posterior 
cusps come from a large pajiillary muscle which stands up free from among the trabeculae carneae 
at the junction of tht> conus arteriosus with the venous portion; besides this there is usually 
one smaller papillary muscle between the septum and the inferior wall, as well as a very small 
one on the septum just below the crista supraventricularis; the medial cusp receives many 
chordae directly from the septum itself. The conus arteriosus is more tubular, has a fairly 
smooth wall and goes over through the ostium arleriositm into the a. pulmonalis; at the 
entrance to the latter are situated the valvulae semilunares arteriae pulmonalis anterior, 
dextra, sinistra (semilunar valves of the pulmonary artery) (see p. 380). 



The Heart. 



379 



Arrow in the ostium arteriosiim 

^ 



Aorta ascendens 



Cuspis anterior valviilae 
bicuspidalis [mitral is] 



Arteria pulmonalis 



Ostium venosum ventriculi sinistri 



Conus 
arteriosus" 



i 



Yeutriculus 
dexter 




Sulcus longitu-_ 
dinalis anterior 




Cuspis posterior 
_ valvulae 
bicuspidalis 

[mitralisj 

Chordae tendineae 

of the anterior 
- papillary muscle 
(out through) 



Posterior papillary muscle 



Trabeculae carneae 



425. Left ventricle (venfriculus sinister) of a distended heart, 

viewed from in front and somewhat from the left. 

(The anterior wall has been almost entirely removed, the left wall partially ; the atria have been 
cut away. An arrow has been mtroduced into the ostium arteriosum.) (Text see p. 380.) 

The atrium sinistrum (left fore-chamher), (0. T. left auricle) (see Figs. 411 414 
and 427) is wedge-shaped, broad behind, narrower in front. At the junction of the posterior 
with the lateral surfaces, right and left, lie the openings of the venae puhnonales. The right 
wall, formed partly by the septum atriorum, shows frequently the concave margin of the valoula 
foraminis ovutis (see p. 377). The anterior wall contains the ostium venosum ventriculi sinistri. 
lYom the junction of the right with the superior wall goes off the zigzag curved auricula 
sinistra (left auricle of the heart), (0. T. left auricular appendix) which curves around the 
a. pulmonalis from the left and reaches as far as its anterior surface. This left auricle contains 
inside it numerous interlacing trabeculae carneae; otherwise the wall of the atrium is smooth inside. 



380 



The Heart. 



'l]- 
I h 



Lunula valvulae seiuilunaris 

Septum meinbranaceum ventriculoruni 
A. coronaria [cordisl dextra 



Nodulus valvulae semilunaris [Arantii] 

Valvula semilunaris posterior 

A. coronaria ] cordis] sinistra 



Valvula 

semilunaris 

dextra 



Septum 

musculare 

ventriculoruni 




Valvula semilunaris 
sinistra 



Cuspis anterior 

valvulae bicuspi- 

dalis fmitralisj 



Mvocardiuni 



426. Valvulae semilunares aortae, opened up. 

(The left ventricle and the aorta have heen opened hy a cut passing between the right and the 

left valve; the walls have been spread apart.) 

The TCntriculus sinister fief I ventricle) (see Figs. 411 421 and 425) has the shape 
of an egg, the large end of which is directed toward the right and backward and contains the 
ostia venosmn et arteriosmn ; the other end forms the apex of the heart. As regards the inner 
surface see also p. 371. The ostium venosum is guarded by the valvula bicuspidalis [jnitralix] 
(bicuspid or mitral valve). This consists of two large cusps and usually two small intermediary 
cusps : of the larger cusps, the cuspis posterior, situated to the left and behind, arises from 
the annulus fibrosus sinister; the cuspis antei'ior, situated to the right and in front, conies 
however only partially from the annulus fibrosus sinister, having its origin chiefly from that 
connective tissue portion of the root of the aorta which extends between the trigona fibrosa, 
S(j that the ventricular surface of this cusp goes over directly into this-part of the wall of the 
aorta (see also Figs. 420 and 425). The chordae tendineae come from two papillary muscles, 
each of which caii in turn be divided into several wedges; both muscles are developed from the lett 
wall and correspond in their position approximately to the intermediary cusps. The ostium arterio- 
sum contains the valvulae semilunares aortae dextra, sinistra, poste?-ior: the posterior portion 
of the left valve and thi' postcrinr valve arise from the membranous part of the root of the aorta. 

Each valvula semilunaris presents just below the middle of its concave free margin 
a small nodular thickening, nodulus valvulae semilunaris [Arantii], and on both sides of 
this, near the margin, a sickle-shaped, thinner portion, lunula valvulae semilunaris, by means 
of which it lies against the neighboring valve. 

The small or pulniouary circulation consists of the a. pulmonalis, the vv. pulmonales 
and their branches. 

The a. pulmonalis (see Figs. 411-413, 427, 62S and 029) extends on the left side of 
the aorta ascendens obli([uely to the left and backward and divides below the arcus aortae uito 
a ramus dexter and a ramus sinister. The former goes below the arcus aortae behind the 
aorta ascendens and v. cava su})erior, in front of the bronchus dexter to the hilus of the right 
lung; the r. sinister runs in front of the bronchus sinister and the aorta thoracaUs to the left 
lung. In the prolongation of the main stem a band of elastic connective tissue, the ligainentum 
arteriosum, extends to tlie concave anterior wall of the end of the arcus aortae. 

The vv. pulmonales (see Figs. 427, 619, 620, 628 and 629) come from the hilus pul- 
monalis on each side and open into the atrium sinistrum. They run on both sides in front of 
the main branches of the a. ])ulm(inalis and in front of th(> bronchi; in addition the right veins 
go behind the v. cava superior and the atrium dextrimi, the left in front of the aorta thoracahs. 



The Heart. 



381 



Costa I 



V. thyreoidea iiiia V. auoiiyma sinistra 
1 j Trachea 

V. azygos I I I 

Ramus dexter a. pulmonalis ' I | ' 

V. jugulavis interna j ' | 

A. subclavia | | 
V. subclavia i 



Arcus aortae 
I Liganientum artcriosum 

Ramus sinister a. pulmonalis 
V. subclavia 




Pulmo dexter 

Vv. pulmonales dextrae 



Pulmo sinister 
Vv. pulmonales sinistrae 



V. cava superior I 

Atrium sinistrum 



I A. pulmonalis 

Aorta ascendens 



427. Position of the heart and great vessels, 

viewed from in front. 

(Pieces have been cut out of the v. cava superior, aorta and a. pubnonalis; the heart has been 
turned downward, so that the apex luiks downward.) 
Spalteholz, Atlas. 25 



382 



The Heart. 



A. anonyma 



A. subclavia sinistra 



-A. carotis communis sinistra 



Arcus aortae 



V. cava superior 



Aorta ascendens 



Atrium dextrum , 



A. coronaria 
[cordis] dextra" 



Conus 
arteriosus ~" 

Sulcus 
coronarius- 



Ventriculus dexter 




Atrium sinistrum 



A. coronaria [cordis] 
sinistra 



.liamus circumflexus 



Ramus des- 
\ cendens anterior 



Sulcus 

-longitudinalis 

anterior 



_Ventriculus 
sinister 



>^ 



428. The arteries of the heart, viewed from above and in front. 

(The ostium arteriosuni doxtruin and the a. pnhnonalis have been removed.) 

The a. coronaria [cordis] dextra (ri-^ht conman arterv) (see also Fig. 429) arises 
ui the right sinus aortae [Valsalva(>J (see Figs. 426 and 433), runs at first between the right 
auricle and the conus arteriosus, then in the sulcus coronarius first to the right and then upon 
the facies diaphragmatiea to tli(^ left; finally it bends around into the sulcus longitudinalis 
posterior and, as the ramus dcsccadens posterior, arrives cl(is(> to the apex of the heart. It 
gives off larges branches to the right ventricle, small branches to the right atrium and (from 
the r. descendens posterior) to tlie loft ventricle. 



The Heart. 



383 



Ramus dexter a. pulnionalis 



Arcus aortae 



Raiims sinister 
. a. pulmonalis 

Atrium sinistrum - - 



Vv. pulmonales 

sinistrae 



V. cava superior 



r '~'_s~-~- Vv. pulmonales dextrae 



itrium dextrum 



.V. cava 
inferior 



Ligameutum 
V. c^vae sinistrae" 

Mouth of 

the sinus 

coronarius 

A. coronaria 
[cordis] sinistra 



Ventriculus 
sinister 




A. coronaria 
[cordis] dextra 



Ramus descendens 

posterior 

_ Ventriculus dexter 



Sulcus longitudinalis posterior 



< i / 



Ramus descendens anterior a. coronariae [cordis] sinistrae 

429. The arteries of the heart, viewed from below. 

The a. coronaria [cordis] sinistra (left coronary artery) (see also Fig. 428) arises from 
the left sinus aortae [Valsalvae] (see Figs. 426 and 433)/ is usually larger than the right, and 
divides just after its origin into two branches. The ramus descendens anterior extends at first 
behind the a. pulnionalis, then to the left from it, covered by the left auricle, to the sulcus 
longitudinalis anterior, in which it runs as far as the incisura [apicis] cordis, usually going over 
to a certain extent upon the facies diaphragmatica : it gives off larger branches to the septimi 
ventriculorum and the left ventricle and smaller branches the right ventricle. The ramus ciixum- 
flexus, hidden below the left auricle, goes in the sulcus coronarius first to the left, then upon 
the facies cUaphragmatica to the right and does not reach the sulcus longitudmalis posterior; 
it gives off larger branches to the left ventricle and smaller ones to the left atrium. 

Both aa. coronariae anastomose manifoldly with one another by means of minute branches 
(larger than capillaries), usually inside the muscle, more rarely on the surface just beneath 
the epicardium. 

25* 



384 



The Heart. 
Ramus dexter a. pulmonalisi 



Arcus aortac 



Eamus sinister 
a. pulmonalis 

Atrium sinistrum - 



Vv. pulmonales^. 
sinlstrae 



,V. obliqua 

atrii sinistri-. 

[MarshalliJ 

V. cordis magna- 



V. posterior, 
ventriculi 

sinistri 



Sinus 
coronarius' 



^ Y. cava superior 



~^Vv. pulnionales 
dextrae 



Atrium dextrum 



v. cava 
inferior 



Ventriculus- 
sinister 




V. cordis 
parva 

V. cordis 
anterior 

Ventri cuius 
dexter 



_ V. cordis media 



Eamus descendens posterior 
a. coronariae [cordis] dextrae 



Sulcus longitudinalis posterior 



430. The veins of the heart, viewed from below. 

Most of the veins of the heart open into the sinus coronarius. This lies in the lower 
part of the sulcus coronarius, extends to the left as far as the opening of the v. obliqua atrii 
sinistri [Marshalli] and opens at the right into the right atrium (see Fig. 422); it arises from 
one part of the embryonic sinus reuniens (see also p. 376) and, as such, possesses cross-striped 
(cardiac) muscle-fi))('rs. The veins opening into the sinus are partly closed at their mouths b_y' 
valves, which, elsewhere, are absent. All the veins of the heart anastomose with one another. 

The V. cordis parva opens from the right into the sinus ; it runs in the sulcus coro- 
narius and comes ])artly from the right ventricle, partly from the right atrium. 

The V. cordis media extends in the sulcus longitudinalis posterior from the apex of the 
heart to the base; it receives its branches from both ventricles and opens from the right 
into the sinus. 

The V. ohlvjua atrii sinistri [Marshalli] (0. T. obli((ue vein of Marshall) runs downward 
as a small branch on the left side of the left atrium in iront of the pulmonary veins giving 
rise to a more or less distinct fold of the epicardium (Ikj. venae cavac sinislrae) (see Fig. 412); 
it opens from the left into the sinus and is a remnant of the embryonic v. cava sinistra. 



The Heart. 



385 



A. anojiviiia 



~ A. subclavia sinistra 



A. carotis communis sinistra 



Arcus aortae 



V. cava superior 



* Aorta ascendens 



Atrium 
dextrum 



V. cordis 
anterior 



A. coronaria 
[cordis] 
dextra 



V. cordis 
anterior 



Ventriculiis 
dexter 




Hamus sinister a. pulmonalis 



A. pulmonalis 



"^ Ati'ium sinistrum 



-V. cordis magna 



Ramus descen- 
dens anterior 
a. coronariae 

[cordis] sinistrae 



Sulcus 

longitudinalis 

anterior 



Ventriculus 
sinister 



431. The veins of the heart, viewed from above and in front. 

The yeius of the heart (continued) (see also Fig. 430). 

The V. poslei-ior ventriculi sinisti-i, on the left side of the heart, receives branches 
fi"om the left ventricle and opens into the v. cordis magna or into the sinus coronarius. 

The i\ cordis mafjim ari,ses at the apex of the heart, runs at first in the sidcus longi- 
tudinalis anterior toward the base, then in the sidcus coronarius around the left surface to 
the sinus coronarius; -it collects its blood partly from the right, but chiefly from the left 
ventricle. 

The vv. cordis anteriores, varying in ntmiber, upon the right ventricle, open at the 
sulcus coronarius directly into the right atrium. 

The vv. cordis minimae open directly into the cavities of the right and left heart by 
means of the foramina venarum minimarum [Thehesii] (see Fig. 420). 



386 



The Heart. 



- Aorta asceudens 



Vena cava superior 



Site of reflection of the pericardium 



- - Coiiiis arteriosus 



Sinus transversus 
pericardii 



Venae 
pulmonales '^ 
dextrae 



Atrium dextrum 



VenaVcava' inferior 




Sulcus longi- 
tudinalis anterior 



Ventriculus dexter 



Apex cordis 



432. The heart, viewed from the right and in front, showing" 
the place where the pericardium is reflected. 

(The hirgc arteries have been drawn away somewhat from the atria.) 
The pericardium (see also Figs. 626631) is a serous sack, closed on all sides, which 
presents a visceral layer, the epicardmm, firmly attached to the heart muscle, and a parietal 
layer. Between the two layers is a small slit-like space in which are contained several grams 
of a clear, serous fluid, the liquor pericardii. 

The epicardium (see also Figs. 411 and 412) covers completely the free surface of the 
ventricles of the heart and contains deposits of fat of variable size along the vessels. The 
atria are also covered on their free surface in large part by the epicardium, only the posterior 
surface of the li>lt and a narrow strip of the right atrium remaining free from it; the v. cava 
superior is covered by it for a distance of one little finger's bn^adth; the v. cava inferior and 
vv. pulmonales are covered by it only at the point where they open into the heart. The 
a. ptdmonalis and aorta ascendens are connected with one audther by connective tissue, are 
covered in common by the eiticardium and are separated i'rom the anterior wall of the atria 
by a slit, the sinus transversus pericardii, which is closed above and below but open to the 
right and to the left. The epicardium is reflected into the parietal layer of the pericardium 
along the junction between the aort;i ascendens and the arcus aortae, as well as over the 
bifui'cation of the a. pulmonalis. 



The Aorta. 



387 



A. subolavia 
dextra 



A. carotis communis dextra 



A. subclavia sinistra 



A. carotis communis sinistra 



Aorta aseendens 



Bulbus aortae 



A. coronaria [cordis] dextra 




Isthmus aortae 



Aortic spindle 



Aorta 
thoracal is 



A. coronaria 
[cordis] sinistra 



"^^^ 



Sinus aortae [Valsalvae] 

433. Aortic arch with its branches, 

viewed from the left and in front. 

(Aftm- a plaster mould.) 

The parietal layer of the pericardium (see Kgs. 432, 626 631) is fused, on its lower 
surface, firmly with the diaphragm, on the posterior surface loosely with the oesophagus and 
the aorta thoracahs ; to the right and left it is intimately united with the pleura pericardiaca. 
In front it is partly covered by the thymus and loosely connected with it; it lies in part just 
behind the corpus sterni and is fastened to it by several powerful, tendinous bands of fibers, 
the ligameiita sternopericardiaca (not illustrated), as well as by loose connective tissue. 

The aorta runs, from the ostium arteriosum sinistrum, at first, upward (aorta aseendens) ; 
it then bends around backward (arcus aortae), and goes finally downward, above, in front of 
the thoracic spme (aorta thoracalis), below, in front of the lumbar spine (aorta abdominalis) . 
It ends in front of the 4tii lumbar vertebra, a Kttle below the navel. 

The beginning of the aorta aseendens (see also Figs. 410, 411, 427 and 42S) lies 
behind that of the a. puhnonalis and presents a flask-like swelling (bulbus aortae) with three 
smaller bulgings (sinus aortae [Valsalvae]), of which each corresponds to one valvula semi- 
lunaris aortae. Thence the aorta passes upward and turns only a little to the right and 
forward; it lies behind the right auricle of the heart and behind the corpus sterni, on the 
right side of the a. puhnonalis and on the left side of the v. cava superior; behind, it adjoins 
the left atrium and the ramus dexter a. pulmonalis. The only larger branches given off by it 
are the two aa. coronariae [cordis] (see also Figs. 428 and 429). 



388 



Arteries of the Neck. 



y 



A. maxillaris interna 



A. temporalis superticialis' I 

I I 



A. transversa faciei 



K. occipitalis _ . 

Branch to the skin 

A. auricularis post. 

M. digastricus . 

(venter posterior) 

A. occipitalis 

' M. sternocleidomast 

A. sternocleidomast 

R. descendens n. XII 

V. jiigularis interna 

A. carotis externa- 

A. carotis interna 




A. infra- 
orbitalis 



A. cerviealis ascendens 



Ramus spinalis 

M. scalenus medius 

M. scalenus anterior 

A. cerviealis 
superficialis 



A. mentalis 

'4 A. maxillaris 

'^ externa 

- A. sub- 

mentalis 

-~^N. hypo- 
glossus 
^ ~ - _ A. lingualis 
i;. Iiyoideus 
R. hyoideus 
-A. larjngea superior 

-A. thyreoidea superior 

-R. sternocleidomastoideus </^ 

A. carotis communis 

,A. thyreoidea inferior 

A. transversa scapulae 
' ^Truncus thyreocervicalis 
V. jugularis 

interna 



Rete acromiale 



I I I 

Ramus aeromialis A. axillaris . A. thoracoacromialis 



Ramus cutaneus a. niammariae 
internae 



434. Superficial arteries of the neck, 

viewed from the riglit and somewhat from in front. 

(The head i.s beut somewhat backward; tlie parotid ji-hind lias been coiiiiiletely removed: the mm. 
pectoralis major, sternocleidomastoideus and the muscles of the Aice have been partially removed.) 

The arciis aortae (aortic arch) (sec Figs. 427, 433, 629 and 630) arches upward, being 
(!onvex from before backward, and at the same time somewhat to the left, crossing the point of 
division of the a. pulmonalis and the bronchus sinister: on the right it lies upon the trachea just 
abov(^ its bifurcation, below it ends on tlu^ left side of the body of the A^^ thoracic vertebra. 



Arteries of the Neck. 389 

At the jiincticn of the arciis aortae with the aorta thoracalis there is frequentl}' a cou- 
striction, the isthmus aortae, and, just beyond this, an oblong expansion, the aortic spindle 
(see Fig. 433). Both formations are especially well marked when the vessel is much curved. 

From the upper wall of the aortic arch go oft': a. anonyma, a. carotis co??imimis 
sinistra and a. subciavia sinistra. 

A. anonyma (innominate artery) (see Figs. 427 and 429) runs obliipiely in front of 
the trachi'a from the leit and below to the right and upward, covered in front by the venae 
anonymae: it divides behind the articulatio sternoclavicularis dextra into the a. carotis corn- 
munis dextra and the a. subciavia dextra. 

A. carotis communis (common carotid artery) (see also Figs. 435, 441 and 449) 
runs behind the articulatio sternoclavicularis, at first on the right somewhat further forward, 
on the lateral surface of the trachea, tlion behind the lobe of the thyreoid gland, in front of the 
mm. scaleni and longus colli, upward and somewhat backward and divides near the cornu superius 
of the cartilago thyreoidea into the a. carotis externa and the a. carotis interna. It is ac- 
companied in front and lateralward by the v. jugularis interna, behind by the n. vagus, and 
is partially covered by the mm. sternothyreoideus, sternocleidomastoideus and omohyoideus. 

A. carotis externa (external carotid artery) (see also Figs. 438, 439 and 441) 
passes almost straight upward, partly covered by the venter posterior of the m. digastricus 
and by the m. stylohyoideus, runs along the posterior margin of the ramus of the lower jaw 
on its medial surface, surrounded on all sides by the glandula parotis, and divides at the collum 
mandibulae into its two terminal branches: a. temporalis sitpcrficialis and a. maxillaris interna. 
It is partly covered by the v. facialis communis and by the n. hypoglossus. Branches: 

1. A. thyreoidea snperior (superior thyreoid artery) (see also Figs. 435, 441 and 
449) . arises from the antericir wall of the pomt of division , sometimes even somewhat more 
deeply; runs in a curve forward and downward to the upper end of the lateral lobe of the 
thyreoid gland, covered partly by the \ enter superior of the ra. omohyoideus. Branches: 

a) Ramus hyoideus upward to the hyoid bone. 

b) Rainus sternocleidomastoideus lateralward and downward to the m. sternocleidomast. 

c) A. laryngea superior perforates the membrana hyothyreoidea , being covered by the 

m. th\Teohyoideus, and anastomoses on the lateral surface of the laryngeal muscles 
with the a. laryngea inferior (a. thyreoidea inferior) and with a branch of d). 

d) Ramus cricot/iyreoideus runs just in front of the m. cricothyreoideus and the Ug. 

cricothyreoideum medianward: it anastomoses with that of the other side. 

e) and f) Ramus anterior and ra7tiiis posterior, to the anterior and posterior surface of 

the glandula thyreoidea ; both break up into numerous rami ylandulares (to the gland). 

2. A. lingualis (lingual artery) (see also Figs. 435 and 441), goes off, at the level of 
the gTeater conni of the hyoid bone, from the anterior wall, extends in a curve upward upon 
the m. constrictor pharyngis raedius, tlien, parallel to and above the hyoid bone, forward upon 
the m. longitudiualis inferior and the m. genioglossus, covered by the m. hyoglossus. Branches : 

a) Ramus hyoideus downward to the lateral surface of the hyoid bone. 

b) Rami dorsales linyuae, double or single, on the medial surface of the m. hyoglossus, 

upward to the region of the root of the tongue and the tonsil. 

c) A. sublingualis arises at the anterior border of the m. hyoglossus. runs between the 

ra. mylohyoideus and the m. genioglossus below the glandula sublingualis forward, 
supplies the floor of the mouth and the gums of the anterior teeth; it anastomoses 
through the m. myloliyoideus with the a. submontalis. 

d) A. profunda linynae {(). T. ranine artery), very tortuous, runs upward and forward 

between the m. longitudiualis inferior and the m. genioglossus ; it anastomoses above 
the frenulmn linguae with that of the other side. 

3. A. maxillaris externa (external maxillary artery) (0. T. facial artery) (see also 
Figs. 436 and 441) arises, close above the a. lingualis, from the anterior wall, covered by the 
venter posterior of the m. digastricus and by the m. stjdohyoideus ; it runs forward in a curve 
on the medial and upper surface of the glandula submaxillaris, between it and the lower jaw, 
then bends around the basis mandibulae at the anterior margin of the m. masseter and passes, 
very tortuous, upon the mm. buccinator and caninus to the side of the nose. In the face it is 
covered by the platysma, mm. risorius. zj'gomaticus and quadratus labii superioris. Branches : 

a) A. palatina ascendens (0. T. ascending or anterior palatme artery) (see Fig. 441) arises 

near the origin of the vessel (frequently from the a. carotis externa or a. pharyngea 
ascendens), runs upward upon the m. stylophar^'ngeus, then between this muscle and 
the m. styloglossus, then upon the m. constrictor pharyngis superior to the medial 
surface of the m. tensor veli palatini: it supplies the soft palate and the pharynx. 

b) Ramus tonsillaris (see Fig. 441), frequently a branch of a), runs upon the m. con- 

strictor phar\iigis superior to the tonsilla palatina and to the soft palate. 



390 



Arteries of the Neck. 



M. styloglossus 



A. palatina ascendens 
A. carotis externa | 



A. occipitalis 

A. pharyngea ascendens, 
A. stemocleidomastoidea^ 

A. luaxillaris externa - - 
A. carotis interna -- 
Kami dorsales linguae ^_ - 

A. lingualis , - - 

E. hyoideus 
A. thyreoidea superior 

A. laryngea superior _ 
A. carotis communis... 



Branch of the ramus 
cricothyreoideus of the 
a. thyreoidea superior 

A. laryngea inferior. 



A. cervicalis 
ascendens 

A. thyreoidea 
inferior 




A. profunda 

linguae 
M. longitudinalis 

inferior 
M. genioglossus 



Mandibula 



A. submentalis 
A. sublingualis 
M. geniohyoideus 
M. hyoglossus 

Os hvoideum 




Cartilage 
thyreoidea 



Cartilage 
cricoidea 



435. 
The arteries of 
the larynx and 
of the tongue, 

viewed from the right. 

(The lamina dextra of the cartilago thyreoidea, the 

right half of the lower jaw and the m. hyoglossus 

have been jiartially removed.) 

3. A. maxillaris externa (continued). 
c) A. submentalis (see Fig. 434) runs under the m. 
mylohyoideus, between it and the glandula 
submaxillaris, forward to the region of the 
chin ; it anastomoses with the a. sublingualis. 

d) Rami glandular es, arising partly from c), to the glandula submaxillaris. 

e) A. labialis inferior (0. T. inferior coronary artery) (see Fig. 436) arises below the angle 

of the mouth , runs medianward in the lower lip in the m. orbicularis oris , close to 
the mucous membrane, and forms a broad anastomosis with that of the other side. 

f) A. labialis superior (0. T. superior coronary artery) (see Fig. 436) arises at the angle 

of the mouth, runs in the upper lip like e) in the lower; branches to the nasal septum. 

g) A. awjularis (see Fig. 436), the terminal branch, ascends almost vertically along the lateral 

margin of the nose and anastomoses with the a. dorsalis nasi (from the a. ophthahnica). 

4. A. temporalis superflcialis (sui)erficial temporal artery) (see Figs. 434, 436 438) 

ascends behind the proc. condyloideus mandibulae, in front of the tragus, over the root of the 

zygoma; it is covered at first by the glandula parotis, and then, very tortuous, lies upon 

tiie fascia temporalis ; it divides above the ear into its two terminal branches. Branches : 

a) Rami parotidei, in part also directly from the a. carotis externa, to the parotid gland. 

b) A. transversa faciei (0. T. transverse facial artery), runs forward to the cheek directly 

upon the m. masseter, just below the zygoma, covered behind by the parotid gland. 

c) Rami auriculares anteriores, 3 4 , to the auricle and to the external auditory canal. 

d) A. temporalis media (medial temporal artery) (see Fig. 438) perforates the fascia tempo- 

ralis just above the root of the zygoma, runs upward in the sulcus a. temporalis 
mediae of the temporal bone and is distril)uted in the m. temporalis. 

e) A. zygomalicoorbitalis, above the zygoma, to the upper margin of the orbit. 

f) Ramus frontalis ((). T. anterior terminal branch), is tortuous and extends first for- 

ward and upward, then backward upon the m. epicranius- 

g) Ramus liar ietalis (0. T. posterior terminal branch), tortuous, backward and upward, 
f) and g) form a rich anastomotic network with one another, with the aa. frontales and occipitales. 



Arteries of the Head. 



391 



Ramus 
parietalis ' 



. temporalis 

uperflcialis 

Bamus 
occipitalis 

Ramus 
aurieiilaris 



Rami auriculares - 
anteriores 

A. occipitalis 



Branch of the a. auri 
cularis posterior 




A. frontalis. 

_A. supraorbitalis 

- - Ramus frontalis 



A. zygomatico- 
orbitalis 

A. dorsalis nasi 



A. transversa 
faciei 

^ A. infra- 
orbitalis 



A. angularis 

A. labialis superior 

A. labialis inferior 



A. submentalis 



Glandula parotis A. maxillaris externa 

436. Superficial arteries of the face, viewed from the right. 

(The platysma, m. risurius and m. quadratus labii siiperioris have been removed.) 

5. A. sternocleidomastoidea (see Fig. 434) arises, at the same level as the a. maxillaris 
externa , from the posterior wall and goes in a curve, in front of the n. hypoglossus and the 
v. jugiilaris interna, lateralward and downward to the m. stemocleidomastoideus. 

6. A. occipitalis (see Fig. 438), somewhat above the previous artery, from the posterior 
wall, runs at first upward upon the v. jugularis interna, covered by the venter posterior of the 
m. digastricus ; then it goes backward in the sulcus a. occipitahs between the m. rectus capitis 
lateralis and the m. iongissimus capitis, then between the m. semispinaUs capitis and the 
m. splenius capitis; finally it bends upward and arrives between the insertions of the mm. trapezius 
and stemocleidomastoideus at the linea nuchae superior upon the m. epicranius. Branches: 

a) Rami musculares to the m. sternocleidomast. and neighboring muscles; among these 
aa) Ramus descendens, downward between the mm. splenius capitis and semispinalis capitis. 

b) Ramus mastoideus through the foramen mastoideura to the dura mater (see also Fig. 439). , 

c) Ramus auricularis obliqueh' upward and forward toward the ear. 

d) Rami occipitules, very tortuous, upward: those of the two sides anastomose with one 
another and with the a. temporalis superficialis. A small branch, the ramus meningeus, 

goes through the foramen parietale to the dui-a mater. 

7. A. auricularis posterior (posterior auricular artery) (see Figs. 434 and 438), above 6) 
from the posterior wall, runs, covered by the glandula parotis, on the_ upper margin of the venter 
post. m. digastrici, upward and in front of the proc. mastoideus behind the ear. Branches : 



392 



Arteries of the Head. 

A. supraorbitalis A. frontalis 



Ramus frontalis a. tern- 
poralis superficialis 



Ramus 

parietalis 

a. temporalis 

superficialis 



# 



Bamus meningeus 
a. occipitalis 




Rami occipitalcs a. occipitalis 



437. Arteries of the roof of the skull, vieAved from above. 

a) A. siylomastoidea (see Figs. 4-11 and 442) goes through the foramen stj'lomastoideum into 

the canalis facialis, there gives off branches backward to the cllulae mastoideae (rami 
mastoidei), forward to the m. stapedius (ramus stapediusj and througli the canaliculus 
chordae tynipani into the middle ear (a. ti/mpanica posterior); it anastomoses at 
the hiatus canalis facialis with the ramus petrosus superficialis (from the a. meningea 
media). 

b) Ramus au7-icularis (0. T. anterior terminal branch) to the medial surface of the ex- 

ternal ear, and partly, perforating it, to the lateral surface of the same. 

c) Ramus occipitalis (O.T. posterior terminal branch) behind the ear, upward; it anasto- 

moses with the a occipitalis and the a. temporalis superficialis. 



Arteries of the Head. 



393 



A. temporalis profunda posterior 
A. temporalis media 



A. masseterica 



A. temporalis profunda anterior 



Ramus 
occipitalis 

Bamus - - 

auricularis 

A. temporalis ^ 
superfieialis 
A. tympanica 
anterior 
-A. auricularis _ 
profunda 
Ramus mastoideus 

A. maxillaris interna _ 
A. auricularis posterior ._ 



Ramus muscularis 
Ramus descendens 

A. occipitalis 

M. semispinalis capitis 

M. splenius cervicis 




,A. maxillaris 
interna 



A. alveolaris 
sup. post. 
Ramus 
pterygoideus 
A. infraorbitalis 

-A. meuingea 
media 

A. buccina- 
toria 

A. alveolaris 

inferior 



A. mentalis 



A. sternocleidomastoid ea 

A. carotis interna 
A. carotis externa 



A. maxillaris externa 



438. Deep arteries of the face, viewed from the right. 

(The parotid gland has been entirely removed, the zygoma, the ramus of the lower jaw and 
the muscles of the lower jaw have been partially removed [see Fig. 294J ; the canalis mandibulae 

has been chiselled open in a part of its course.) 

8. A. maxillaris interna (internal maxillary artery) (see also Figs. 439441) runs 
forward on the medial surface of the collum mandibulae (l^t portion), then, tortuous, forward 
and upward, usually on the lateral surface of the m. pterjgoideus externus between it and the 
m. temporalis (2d portion) to the fossa pterygopalatina, in which (S'd portion) it divides into its 
terminal branches. Not infrequently it lies on the medial surface of the m. pterygoideus externus 
and arrives between the two heads of this muscle into the fossa pterygopalatina. Branches: 
1 "t portion : 

a) A. auricularis profunda backward to the joint of the jaw, auditory canal , and tym- 

panic membrane. 

b) A. tympanica anterior upward through the fissura petrotympanica [Glaseri] into the 

middle ear (see also Fig. 442). 

c) A. alveolaris inferior (0. T. mandibular or inferior dental artery) runs downward and 

foi-ward between the ramus mandibulae and the m. pterygoideus intemus to the 
foramen mandibularc; it passes through the canalis mandibulae, giving off branches 
to the roots of the teeth, gums and bone. 

ca) Ramus mylolnjoideus goes off before the entrance of the arteiy into the canalis , 

mandibulae and runs, in the sulcus mylohyoideus, forward and downward. 

cb) A. mentalis leaves the canal through the foramen mentale and goes to the chin. 



394 



Arteries of the Head. 

lA. meningea media 

I 



A. meningea anterioi 



A. ethmoidalis 

anterior 

A. ethmoidalis 

posterior 




y 

Ramus mastoi- 
^,deus a. occipitalis 
A. occipitalis 



a. nasales posteriores latcrales ^ 
A. palatina major 



\ . jugularis interna 
A. anricularis posterior 

(A. temporalis superficialis 
\ A. auricularis profunda 
A. tympanica anterior 
A. meningea media 

niaxillaris interna 

Kamus nieningeus accessorius 

\ 1 M. pterygoideus extcrnus 

' A. alveolaris inferior 

A. canalis pterygoidei [Vidii] 

Kamus mylohyoideus 

spiienopalatina 
I 
Aa. palatinae major et minores 



439. Arteries of the skull and of the nasal cavity, 

right half, viewed from within. 
(The canalis pterygoideus and the eanales palatini have heen partly chiselled open.) 

8. A. luaxillaris interna (see al?o Figs. 438, 440 and 441) (continued): 
2nd portion: 

d) A. meningea media (middle meningeal artery) bends under the m. pterygoideus externus 

upon its medial surface, ])asses upward to the foramen spinosum and is distributed 
inside the skull, at first imbedded in the sulci arteriosi of the sphenoid bone and the 
parietal bone, to the dura mater of the frontal, temporal and parietal region.' Branches : 

da) Ramus meninrjens accessorius goes off outside the skuU, often directly from the 
a. niaxillaris interna, to the mm pterygoidei, tuba auditiva and its neighborhood. 

db) Ramus petrosus superficialis (0. T. petrosal branch) (see Pig. 442) arises just above 
the foramen spinosum, runs lateralward and backward to the hiatus canalis facialis 
and anastomoses there with the a. stylomastoidea (from the a. auricularis posterior). 

dc) A. tympanica superior (see Fig. 442) arises like the preceding branch, goes through 
the apertura superior canalictdi tympanici and canaliculus tympanicus into the middle 
ear and ujion the })romontoriuin. 

e) A. masseterica goes lateralward through the incisura mandibulae to the m. masseter. 



Arteries of the Head. 

A. ethmoidalis posterior 



395 



A. ethmoidalis 
anterior 




Aa. nasales posteriores septi 



Anastomosis with the a. palatina major in the canalis incisivus 



440. Arteries of the nasal septum, viewed from the left. 

8. A. maxillaris interna (see also Figs. 438, 439 and 441) (continued). 

f) Aa. temporales "profuadae posterior et anterior (posterior and anterior deep temporal 

arteries) upward in the ni. temporalis, the posterior close upon the squama temporalis, 
the anterior upon the ala magna ossis sphenoidalis. 

g) Rami pterygoidei, vaiying in number, often from f) or h), to the mm. pteiygoidei. 

h) A. huccinatoria (0. T. buccal branch), .downward and forward to the m. buccinator, for 
muscles of the face, mucous membrane of the mouth and gums of the upper jaw. 

i) A. alveolaris superior posterior (posterior dental or alveolar branch) arises near the fossa 
pteiTgopalatina, forward and downward, passes through the foramina alveolaria maxillae 
in fhe canales alveolares to the sinus maxillaris, upper molar teeth and their giuns. 
3rd portion: 

k) A. infraoj-bitalis , forward through the fissura orbitalis inf. to the sulcus and canalis 
infi-aorbitalis, gives off branches to the orbital contents, and also the aa. alveolares su- 
pe?-iores anteriores (0. T. anterior dental branch) in the canales alveolares to the anterior 
teeth and theii- gums : terminal branches through the foramen infraorbitale to the face. 

1) A. palatina descendens (0. T. posterior or descending palatine branch) passes downward 
to the canalis pterygopalatinus. Above it gives off the a. canalis pterygoidei [ Vidii] 
(0. T. Vidian artery) which goes through the canalis pterygoideus backward to the roof 
of the phar}-nx. Below it divides into the aa. palatinae minores et major, which 
run through the canales palatini and emerge from the foramina palatina minora et 
majus ; the minor branches go to the soft palate and its surroundings, the major branch 
goes to the inferior surface of the hard palate as far forward as the gums, 
m) A. sphenopalatina (0. T. sphenopalatine or nasopalatine artery) , thi'ough the foramen 
sphenopalatinum mto the nose; it supplies the lateral wall of the nose and the pharjTix 
by means of the aa. nasales posteriores laterales, runs at the inferior surface of the 
body of the sphenoid to the nasal septum and breaks up into the aa. nasales poste- 
riores septi which anastomose in the canalis incisivus with the a. palatina major. 

9. A. pharyngea ascendens (ascending phaiyngeal arteiw) (see Figs. 441 and 442) from 
the posterior surface, near the a. lingualis. ascends, at first between the a. carotis externa 
and interna, then in front of the latter between it and the lateral wall of the pharynx, medial 
from the mm. styloglossus and stylophar\T]geus , as far as the base of the skull. Branches: 

a) Rami pharyngei, 2 3. partly descending, partly ascending, to the pharynx and palate. 



396 



Arteries of the Neck. 



A. temporalis profunda posterior 
Ramus meningeus accessorius i 
A. meningea media i | 
A. tyrnpanica anterior 
A. temporalis superficialis ' 
A. auriculai'is profunda ' ! 



A. niaxillaris interna 

A. temporalis profunda anterior 

I A. lacrimalis 

I 




A. styloniastoidea - 

A. auricularls posterior 

Eamus tonsillaris 

A. palatina ascendons 

A. meningea posterior 

A. pharyngea asceudens 

Eamus pharyngeus 

A. maxillaris externa 
A. carotis interna 
A. lingualis 
A. carotis externa 



Ramus profundus 
a. cervicalis ascendentis 



A. cervicalis profunda 

M. semispinalis - 
cervicis 

"^' A. vertebralis - 

A. thyreoidea 

inferior 
,' Truncus 
^costocervicalis 

A. intercostalis _ 
suprema 

A. subclavia - 
Costa I -.._ 




A. supraorbitalis 
. A. frontalis 

.A. dorsalis 
nasi 

A. infra- 
orbitalis 

A. alveolaris 

sup. post. 

A. buccinatoria 

M. tensor veli 
palatini 

M. constrictor 

pharyngis 
superior 

- M. buccinator 

^ M. stylo- 
glossus 

M. stylo- 
pharyngeus 



M. liyoglossus 
icanius hyoideus 

" A. thyreoidea superior 

A. laryngea superior 
Ramus sternocleidomastoideus 

Ramus posterior 
Ramus anterior 

Glandula thyreoidea 

A. carotis communis 
Truncus thyreocervicalisv^~ 

A. mammaria interna \y' 
A. anonvma 



441. Deep arteries of the neck, viewed from the right. - 

(The muscle.s cif tlu' neck and face have been in h\r<.;f jtart removed; the bones of the face 

have been })artially removed.) 

b) A. meningea posterior ascends upon the hiteral surface of the a. carotis interna and 

goes throuL;li tlit^ foramen jiifTuIare to the dura mater (see Fii^'. 447). 

c) A. tyynpanica inferior (see Fig. 442) passes through the fossula petrosa and the 

canalicuhis tympanicus into the middle -ear and upon the promontorium. 



Arteries of the Head. 



397 



V. ophtlialmica superior 



Ramus pctrosus superficialis 
A. tyiiipanica 
superior (from the 
a. meningeamcdia) 



Sinus eavcruosus 



A. tyiiJpanica 
posterior(from~ " 
the a. slylo- 
mastoidea) 

Rami _- 
mastoidei 

Cellulae 
mastoideae 

A. stylomastoidea 




^:^x 




- - Plexus venosus 
caroticus intemus 



Ramus 
caroticotympanicus 
-A. tympanica inferior(from 
the a. pharyngea ascendens) 



Fossa jugularis 
M. longus capitis 
A. tympanica inferior 

A. carotis interna 

A. pharyngea ascendens 



Atlas 



442. A. carotis interna and the middle ear, viewed from the right. 

(The temporal b(jne has been cut open and drawn as in Fig. 1 1 ; the plexus venosus caroticus 
internus has been introduced after N. Kiidinger. Magnification : 3:2.) 

A. carotis interna (internal carotid artenj) {?,ee a\9,oY\<<:,^ am, i\\, Ai'i im^\.A.A.^), 
curved slightly like the letter S, runs in front of the mm. longus colli and longus capitis to the 
base of the skull, bounded medianward by the lateral wall of the pharynx; lateralward and be- 
hind, it adjoins the v. jugularis interna ; in front and lateralward it adjoins below the a. carotis 
externa, above the glandula parotis and the mm. styloglossus and stylopharyngeus ; the latter 
muscles separate it Irom the a. carotis externa. It then enters the canalis caroticus, and passes 
through it going first upward , then horizontally medianward and forward , rims through the 
foramen lacerum in a groove of the fibrocartilago basalis, turns upward and goes, slightly curved, 
in the sulcus caroticus of the body of the sphenoid bone to a position below the processus 
clinoideus anterior; there it bends sharply backward and upward, medial from the proc. clinoideus 
anterior and behind the foramen opticum , perforates the dura mater and breaks up into its 
terminal branches lateral from the chiasma opticuru, below the substantia perforata anterior. Inside 
the canalis caroticus it is surrounded by the plexus venosus caroticus internus, in the sulcus 
caroticus by the sinus cavernosus (see also Fig. 482). In tlie neck it gives off" no branches, 
in the canalis caroticus it gives off the ramus caroticotympanicus , in the sinus cavernosus 
small branches to the surrounding parts and during its course behind the foramen opticum, 
from the convexity of its last curve, the a. ophthalmica. 

1. Ramus caroticotympanicns (0. T. tympanic branch), a fine branch which passes 
through one of the canaliculi caroticotympanici to the mucous membrane of the middle ear. 

2. A. ophthalmica (see Fig. 443), at the lateral inferior surface of then, opticus, goes 
through the foramen opticum into the orbit, then bends somewhat upward and passes trans- 
versely over the n. opticus, between it and the m. rectus superior, to the junction of the medial 
with the upper wall of the orbit; there it passes, below the m. obliquus superior, forward and 
divides between the trochlea and the ligamentum palpebrale mediale into its terminal branches : 
aa. palpebrales mediales, dorsalis nasi and frontalis. Branches: 

Spalteholz, Atlas. 26 



398 



Arteries of the Head. 



A. supraorbitalis 



A. meningea 
aftterior 

A. frontalis . 



M. obliquus 
superior 

A. ethmoidalls ^ 
anterior 

A. ethmoidalis 
posterior 

Aa. ciliares 
posterlores 



Bamus y. 

muscularis / 

Nervus opticus 



A. ophthalmica 



Chiasma opticum 



A. lacrimalls 




A. carotis interna 



Processus clinoideus anterior 



b) 



443. Arteries of the right orbit, viewed from above. 

Magnification : 10:7. 
(The bdiiy roof and the contents of the orbit have been partially rentoved.) 

2. A. ophthalmica (contimted): 

a) A. centralis retinae (central artery of the retina) (not illustrated) often arises in common 
with c), perforates the medial inferior surface of the sheath of the optic nerve and 
passes in the axis of the same to the retina. 
A. lacrimalis (lachrymal artery) runs forward over the m. rectus lateralis at the lateral 
wall of the orbit: it gives off several aa. ciliares posteriores, and small branches into 
the foramen zygomaticoorbitale, perforates the lachrymal gland, supplies it and ends 
at the lateral angle of the eye in aa. palpehrales laterales, one for each eyelid. 

c) Aa. ciliares posteriores breves et lonr/ae (short and long posterior ciliary arteries), 
4 6, partly from neighboring branches, divide manifoldly, perforate the sclera in 
the neighborhood of the n. opticus and are distributed in the timica vasculosa oculi. 

,d) Rami musculares ., partly from neighboring branches, several in number, among them 
fretjuentlj' <ine large, lateral, superior and one medial, inferior to the eye muscles. 

e) Aa. ciliares anteriores (see Eye) arise usuallj' from th(^ anterior ends of the rami 

musculares, run forward in the tendons of the eye muscles and pass partly upon the 
scl(M-a to the margin of the cornea (aa. episclcrales). ])artly to the conjunctiva 
(aa. conjunctivales anteriores), partly perforating the sclera to the m. ciliaris. 

f) A. snpraorhitales (see also Figs. 436, 437 and 441) passes just l)elow the roof of the 
orbit to the foramen supraorbitale and through this to the forehead. 

A.ethmoidalis posterior (see also Figs. 439 and 440) through the foramen ethraoidale post, 
to the posterior ethmoidal cells and to the postei-ior superior part of the nasal cavity. 



g) 



Arteries of the Head. 



399 



A. cerebri anterior' 



A. communicans anterior 



Lobus frontalis 



A. cerebri media 

A. carotis- - 
interna 

A. ciiorioidea 

A. coi^municans -- 

posterior 
X. ociilomotorius " 



A. cerebelli - _ 
superior 

A. cerebri- - 
posterior 
A. basilaris- - 




Lobus occipitalis' <*' " 

A. auditiva interna^ / 
A. cerebelli inferior anterior 

A. vertebralis 
A. spinalis anterior 



\ Ramus 
\ ad pontem 

^N. abducens 

N. facialis 

^A. cerebelli inferior 
\ posterior 

A. spinalis posterior 

Cerebellum 



444. Arteries of the base of the brain. 

(The pole of the right temporal lohe and the right side of the cerebellum have been cut away.) 
2. A. ophthalmica (continued). 

h) J. eihmoidalis anterior (see Figs. 439, 440 and 443) passes through the foramen 
ethmoidale anterius upon the lamina cribrosa, there gives off the a. meuingea anterior 
upward to the dura mater, then ])prforates the lamina cribrosa and supplies the 
anterior part of the wall of the nasal cavity. 

i) Aa. palpebrals mediales (not illustrated), one in each eyelid lateralward ; they form by 
anastomosis of each medial artery with one a. palpebralis lateralis (from the a. lacri- 
malis), the arcus tarseus superior and inferior, situated near the free margin of 
the eyelid , in front of the tarsus. They give off fine branches to the conjunctiva 
(aa. cortjunctivales posteriores). 

k) A. dorsalis nasi (0. T. nasal branch) (see Figs. 436 and 441) perforates them, orbi- 
cularis oculi above the ligamentum palpebrale mediale, passes downward and anasto- 
moses with the a. angularis (from the a. maxillaris externa). 

1) A. frontalis (see Figs. 436, 437, 441 and 443) goes through the incisura frontalis to 
the forehead and supplies the muscles and skin in that situation. 

26* 



400 



Arteries of the Head. 



I' 



Lobus froiitalis 



A. cerebri media _ 

A. chorioidea 

Tractus opticus _ 
Insula 



Corpus genl- 
culatum laterale 

Corpus geni- 
calatum mediale 



Pulvinar 



Pars centralis 
ventriculi lateralis 




A. cerebri anterior 



A. coiiiniunicans anterior 



A. carotis interna 

A. communicans 
posterior 

A. basilaris 
A. cerebri posterior 



Corpora 
quadrigemina 



Lobus occipitalis 



445. 
A. cerebri media 



and 
a. cinorioidea, 



on the right side, viewed iVom beh)w. 

(The teiii])oral lobe and the occipital lobe have been removed to open up the cornu inferius 

ventriculi lateralis and to permit the ibssa cerebri lateralis [Sylvii] to come into view; the 

cerebellum and the pons have been cut off just in front of their anterior margin.) 

3. A. conimiiiiicaiis posterior (posterior communicating arterv) (see also Figs. 444. 
446 448) passes backward over tlie sinus euvernosus, below tlie tractus opticus and the pedun- 
culus cerebri, lateralward fmiu the tuber cinereum and the corpus mamillare, gives off small 
branches to the parts named and opens into the a. cerebri poslJerior (from the a. vertebralis). 

4. A. cerebri anterior (see also Figs. 444, 446448) runs medianward above the 
n. opticus, sends branches to the cerebral ganglia through the substantia perforata anterior and 
to the chiasma opticum. approaches closely the vessel of the same name of the other side and 
forms a broad anastomosis with it by means of the a. communicans anterior. It next goes 
into the fissura longitudinalis cerebri forming a loop u])ward around the anterior surface of 
the genu corporis callnsi, lying directly upon it, and passes backward upon the corpus callosum. 
It supplies the corpus callosum, the medial surface of the frontal and parietal lobes almost as 
far as the fissura parietooccipitalis , the gyrus rectus , the lobus olfactorius , the gyri orbitales 
as far as the medial limb of the sulci orbitales and the gyri frontales superior et medius. 



Sulcus cingnli 



Arteries of the Head. 

Corpus callosum 



401 



Fissura parietooccipitalis 



Cuneus 




A. cerebri anterior 



N. opticus 



A. communicans anterior 

A. carotis interna 



Fissura calcarina 



A. cerebri posterior 
A. communicans posterior 



446. Arteries of the medial surface of the right 

cerebral hemisphere. 

5. A. chorioidea ((). T. anterior choriuid artery) (see Figs. 444 and 445), delicate, goes 
between the tractus opticus and the gyrus hippocampi backward and lateralward to the cornu 
inferius of the lateral ventricle and breaks up in the plexus chorioideus ventriculi lateralis 
into branches ; it sends besides small branches to the surrounding parts. 

6. A. cerebri media (middle cerebral artery) (see Figs. 444, 445, 447 and 448) runs 
lateralward to the fossa cei"ebri lateralis [Sylvii] and in this to the lateral surface of the 
frontal, parietal and temporal lobe; it supplies the island and the gyri frontalis inferior, cen- 
trales anterior et posterior, the lobuli parietales superior et anterior, the gyri supramarginalis, 
angularis and temporalis superior. 

A. SUbclavia (see Figs. 427, 434, 441 and 449) arises on the right side from the a. 
anonyma, on the left side dii-ectly from the arch of the aorta (see p. 389) ; the riglit is therefore 
shorter than the left, which ascends at first behind the v. anonyma sinistra, on the left side 
of the trachea. The artery runs on each side lateralward in a curve over the pleural cupula 
and over the first rib, being convex upward. In front it is bounded at first by the v. sub- 
clavia, then by the m. scalenus anterior, behind by the m. scalenus medius and comes to lie 
in the triangular space between these two muscles in the sulcus subclaviae of the first rib. 
From there on it goes, in the depth of the fossa supraclavicularis major, downward and lateral- 
ward to the axilla, behind and below the middle of the clavicle; it is covered by lymph glands 
and adipose tissue and is bounded in front by the v. subclavia and the a. transversa scapulae, 
behind and above by the plexus brachialis. From the lower margin of the m. subdavius on, 
its continiiation is called the a. axQlaris. Arising from it medianward from the m. scalenus 
anterior are the following branches : a. vertebralis, a. mammaria interna and the truncus thjreo- 
cervicalis, which again divides in a variable manner into the a. thyreoidea inferior, a. cervi- 
calis ascendens , a. cervicalis superficialis and a. transversa scapulae ; beliind the m. scalenus 
anterior the truncus costocervicalis is given off, which divides into the a. intercostalis 
suprema and the a. cervicalis profunda: in the space between the mm. scaleni the a. trans- 
versa colli arises. 



402 



Arteries of the Head. 



A. cerebri posterior 
A. cerebelli superior 



A. communicans posterior 



auditiva interna 
A. cerebelli inferior posterior 
A. spinalis posterior 
I A. meningea posterior (from the a. pharyngea ascendens) 
' I Tentorium cerebelli 



A. cerebri , 
media 



A. cerebri 
anterior 
A. com- 
municans ~ 
anterior 

Hypophysis - 




- Dura mater 

Ramus meningeus 
A. yertebralis 



Ramus spinalis 
a. vertebralis 

N. cervicalis II 



Ramus ad pontem 
A. cerebelli inferior anterior 



A. spinalis anterior 



^\ 



447. Arteries of the base of the brain in their 
relation to the base of the skull 

after removal of the brain ; right half of the skull, viewed from the left. 

(The falx cerebri has been completely removed, the tentorium cerebelli partially. The a. meningea 
posterior and the ramus meningeus a. vertebralis have been drawn upon the dura mater.) 
1. A. vertebralis (see also Figs. 441, 444, 448 and 449) arises from the upper circum- 
ference of the a. subclavia and passes, at the lateral margin of the m. longus colli, lateralward 
and behind the a. carotis communis, curved slightly backward to the foramen transversarium 
of the 6th cer\acal vertebra, then through the foramina transversaria of the 5*^1 2^^^ cervical 
vertebra, in front of the emerging cervical nerves, almost perpendicularly upward; it is next 
curved markedly lateralward to the foramen transversarium of the atlas and goes medianward 
in the sulcus arteriae vertebralis (see Kgs. 216, 221 and 341) in a curve behind the massa 
lateraMs atlantis, bridged over by fibers of the membrana atlantooccipitalis posterior and then 
passes backward covered directly by the mm. obliquus capitis superior and rectus capitis posterior 
major. Between the atlas and os occipitale it then perforates the dura mater, bends upward, 
furward and medianward in front of the medulla oblongata to the upper surface of the clivus 
and unites with the vessel of the same name of the other side approximately in front of the 
posterior margin of the pons to form the unpaired a. basilaris. This goes upward and forward 
upon the clivus in the sulcus basilaris of the pons and, at the anterior margin of the pons, 
below the substantia jierfurata posterior and at the upper margin uf the dorsum sellae, divides 
into its two terminal branches, the aa. cerebj'i jjostcriores. Branches of the a. vertebralis: 

a) Rami spinales, from tlae cervical portion, go through tlie foramina intervertebralia to the 

canalis vert<>bralis and its contents. They give off lirancjies to the neighboring muscles. 

b) Ramus meningeus arises a. littl<^ in front of the point where the vessel passes through 

the dura mater and extends, through the foramen magnum, upward to the dura mater 
of the posterior fossa of the skull. 



Arteries of the Head. 



403 



A. communieans anterior 



A. cerebri anterior 



A. chorioid 



\ . ophthalniica 
A. earotis interna 



communieans 
posterior 




A. cerebri media 



Ramus ad pontem 

A. basilaris 
A. cerebelli inferior ' 
posterior 
A. spinalis anterior 



^ A. cerebri 
posterior 

A. cerebelli 
superior 

auditiva interna 

cerebelli inferior 
anterior^ 

nalis posterior ' 



Tentorium cerebellij 



A. Tertebralis 



448. Arteries of the base of the brain in their 

relation to the skull after removal of the brain; viewed from above. 

(On the right side the a. earotis interna has been exposed in its course in the sinus cavernosus.) 
1. A. yertebralis (continued) (see also Figs. 444 446): 

c) A. spinalis posterior, delicate, bends around the lateral margin of the medulla oblongata 

and runs downward, forming anastomoses with that of the other side, in the sulcus 
lateralis posterior of the spinal cord, in fi-ont of and lateralward from the posterior 
roots; it imites with branches of the rami spinales of the a. vertebralis, aa. inter- 
costales, lumbales and sacrales laterales and supplies the spinal cord and its membranes. 

d) A. spinalis anterior, delicate, unites with the artery of the opposite side at the upper 

end of the spinal cord and runs downward, impaired, in front of the fissura mediana 
anterior as far as the filum terminale ; like the preceding artery it receives a variable 
number of branches of the rami spinales, and supplies the spinal cord and its membranes. 

e) A. cerebelli inferior posterior (posterior inferior cerebellar artery) turns backward to 

the posterior part of the inferior surface of the cerebellum : it gives off branches to 
the plexus chorioideus ventriculi quarti. 



404 



x\rteries of the Arm. 



1. A. vertebralis (oontiimed) see Figs. 444 448): 
BraiK'hes of the a. basilaris: 

f) J. cerebelli inferior anterior, paired, runs lateralward to the anterior part of the in- 

ferior surface of the cerebeUuiu. 

g) A. miditiva interna (0. T. internal auditory artery) goes lateralward to the nn. facialis 

and acusticus and with these into the meatus acusticus internus ; it supplies the in- 
ternal ear by means of a delicate branch. 

h) Rami ad pontem (0. T. transverse 'or pontal arteries), numerous small branches, to 
the substance of the pons. 

i) A. cerebelli superior, paired, arises shortly before the terminal subdivision, extends, at 
the anterior margin of the pons, lateralward and backward, forms a loop around the 
pedunculus cerebri so as to arrive upon the upper surface of the cerebellum and supplies 
mainly this region; it gives oft' branches to the plexus chorioideus ventriculi tertii. 

t) A. cerebri posterior (posterior cerebral artery), paired, at first parallel to the preceding 
artery, separated from it by the n. oculomotorius and further lateralward by the 
tentorium cerebelli; it goes at the anterior margin of the pons around the pedunculus 
cerebri to the inferior surface of the occipital lobe. It gives off branches through the 
substantia perforata posterior to the cerebral ganglia, branches to the cerebral pen- 
duncles and to the plexus chorioideus ventriculi lateralis and supplies the whole occipital 
lobe and the temporal lobe with the exception of the gyrus temporaUs superior. 

The a. cerebri posterior receives near its origin the a. communicans posterior (from 
the a. carotis interna) ; in this way arises the circidus arlrriosus / ff'illisij (0. T. circle 
of Willis) which lies over the sella turcica and the diaphragma sellae and surrounds 
the chiasma opticum, the tuber cinereum and the corpora niamillaria. 

2. Truiicus thyreocervicalis(O.T. thethjToid axis) (seealsoFig. 434), arises from the an- 
terior wall of the a. subclavia : it divides in a somewhat variable manner into the following branches : 

a) A. thyreoidea inferior, runs, in front of the m. scalenus anterior, at first upward and 
then bends behind the a. carotis communis medianward and forward to the posterior 
surface of the glandula thyreoidea, into which it penetrates by means of its rami rjlan- 
dulares- it gives oft' on its way the rami phari/uf/ei, oesop/iar/ei tracheules, as 
well as the a. larynr/ca inferior (see Fig. 435), which goes below the ni. crico- 
phar\Tigeus into the larynx and anastomoses iipon the lateral surface of the internal 
laryngeal muscles with the a. laryngea superior (from the a. thyreoidea superior). 

Vj A. cervicalis ascendens, ascends upon the origins of the mm. scaleni and levator scapulae, 
at first medianward from the n. phrenicus, behind the v. jugularis interna often going 
as far upward as the base of the skull ; it gives off below several rami spinules into 
the foramina intervertebralia as well as J-ami musculares to the surrounding muscles ; 
one of the latter branches, ramus profundus (see also Fig. 441), runs between the 
transverse processes of the 4tli and o^^ cervical vertebra backward to the deep mus- 
cles of the neck; it can take the place of the a. cervicalis profunda. 

c) A. cervicalis super fcialis, goes behind the m. omohyoideus transversely through the 

fossa supraclavicularis major, in front of the mm. scaleni, levator scapulae and plexus 
brachialis, becomes hidden beneatli the m. trapezius and supplies this and adjacent muscles. 

d) A. transversa scapulae (0. T. suprascapular or transversalis humeri) (see also Fig. 452), 

bends downward and forward, in front of the m. scalenus anterior, to the posterior 

surface of the clavicle and runs along this bone over the lig. transversum scapulae 

superius to the fossa supraspinata; it then runs behind the coUum scapulae in front 

of the lig. transversum scapulae inferius to the fossa infraspinata, and there forms a 

broad anastomosis with the a. cireumflexa scapulae. Near the incisura scapulae arises 

the ramus acro7nialis, which goes through the m. trapezius to the rete acromiale. 

3. A. mammaria interna (internal mammary artery) (see also Fig. 450) goes from 

the inferior wall of the a. subclavia medianward and downward behind the v. subclavia directly 

upon the pleura and then vertically downward just behind the cartilages of the V^ T'h rib. 

It runs nearly parallel to the lateral margin of the sternum , is s(>parated from it, increasing 

from above downward, one to two cm. and is covered behind by the pleura and by the 

m. transversus thoracis. In the region of the ett intercostal space it divides into its two 

terminal branches: a. musculoplircnica and a. epir/aslrica superior. Branches: 

a) Aa. jnediastinales anleriores, delicate branches, backward to the structures lying in 

the spatiura mediastinale anterius. 

b) Aa. thijmkae (not ilhistratiMi), partly from neighboring vessels, backward to the thymus. 

c) Rami broncldales (not illustrated), " to the lower end of the trachea and the bronchi; 

often absent. 

d) A. pericardiacophrenica, with the n. phrenicus in front of the root of the lung on th(> 

pericardium downward to the diaphragm; it supplies the pericardium and the diaphragm. 



Arteries of the Neck. 

A. vertebralis 



405 



M. semispinalis cervicis 



Os hvoideimi 



Vertebra ceivicalis IV 
R 



Ramus profundus P - - 

. '.-if ; --'' \Jf_ 'r,.l - 

Ramus ascendens a. transversae colli "- 



M. scalenus medius 

M. scalenus anterior (cut through) 
M. levator scapulae 
Ramus spinalis 
Ramus muscularis 
A. cervicalis ascendens 

A. cervicalis superficialis 

A. vertebralis -- 

^^I'runcus costocervicalis 
Rauius ascendens 



X. transver! 



r 



ansversa colli 

Ramus 
acromialis 



Rete 
acromiale 

Ramus 
acromialis 

M. infra- 
spinatus 

M. biceps 

(caput 

longum) 




Ramus hyoideus 

A. thyreoidea superior 
- A. carotis communis 

~ Ramus cricothyreoideus 
Ramus posterior 

Ramus anterior 
A. thyreoidea inferior 
Ramus oesophageus 
Ramus trachealis 

Trunciis thyreocervicalis 
A. subclavia 

A. transversa scapulae 

mammaria interna 



A. axillaris 



A. thoraco- 
acromialis 



A. thoracalis 
lateralis 

A. mammaria 

interna 

Ramus 

pertorans 

Ramus. 

muscularis 



A. circumtlexa humeri anterior 
A. circumflexa humeri posterior 



449. A. subclavia dextra, viewed from the right. 

(Most of the clavicle has been removed, as have been the muscles attached to the clavicle, 
the m. scalenus anterior and the mm. pectorales and deltoideus.) 

3. A. mammaria interna (continued) (see also Fig. 450): 

e) Eatni steraales, medianward to the posterior surface of the sternmu; there they form 

a network of anastomoses with the vessels of the same name of the other side. 

f ) Rami perforantes, 6 7. the uppermost usually between the two heads of the m. sterno- 

cleidoraastoideus (see Fig. 434), the others through forward the uppermost 6 inter- 
costal spaces. They supply the m. pectorahs major and the skiu of the frc>nt of the 
chest (rami muscxiiares, rami cnlanei). Among the latter that which comes i'rom the 
2nd intercostal space is usually very large, bends downward to the mamma and supphes 
it by means of the rami mammarii. The branch perforating the 'o^^ intercostal space 
is also large and supplies the skin in front of the m. rectus abdominis as far as the navel. 

g) P\.ami iutercnstales, two for each intercostal space, arise separately or in common. They 

run lateralward in the six upper intercostal spaces close to the ribs, supply the 
muscles and the pleura and anastomose with the aa. intercostales. The branch 
running at the lower margin of each rib is the larger. 



406 



Arteries of the Neck and Arm. 



3. A. mammaria interna (continued): 

h) A. musculophrenica, extends behind the cartilages of the T^h lO^h (or 11 1^) rib, just 
over the origins of the pars costalis of the diaphragm, lateralward and downward; it 
gives off 7'ami intercostales for the 7*^ 10th (or 11^^) intercostal space and is 
distributed also in the diaphragm and in the abdominal muscles. 

i) A. epigastrica superior, passes between the processus xiphoideus and the 7th costal 
cartilage forward into the substance of the m. rectus abdorainis,_runs downward in this and 
anastomoses in the region of the navel with the a. epigastrica inferior; it gives off 
several small branches wbieh go forward to the skin in the neighborhood of the navel. 

4. Truucus costocervicalis (see also Figs. 441 and 461), from the posterior wall, di- 
vides after a short, upward course into two terminal branches: 

a) A. cervicalis profunda (deep cervical artery), backward between the l^t rib and the 

jiroc. transversus of the 7tli cervical vertebra, runs upon the m. semispinalis cervicis as 
far as the epistropheus. It supplies the muscles of the neck and, by a descending 
branch, the long muscles of the back ; several branches into the intervertebral foramina. 

b) A. iniercostalis suprema (first intercostal artery) bends doi;\Tiward and backward in front 

of the neclc of the first rib to the l^t intercostal space and also usually in front of the neck 
of the 2"d rib to the 2"d intercostal space. It gives oft" rami posteriores to the muscles 
and skin of the back and rami spinales into the foramina intervertebraUa ; in these 
branches and in its further course it behaves quite hke the aa. intercostales (see p. 419). 

5. A. transversa colli (0. T. transverse cervical artery or transyersalis colli) (see Figs. 
449 and 452), from the upper wall of the ST'sulicla^ia, runs among the branches of the plexus 
brachialis, 'directly upon the lateral surface of the m. scalenus medius, lateralward and back- 
ward and divides beneath the m. levator scapulae into its two terminal branches. It gives off 
a branch to the fossa supraspinata and supplies the muscles in the neighborhood of the same. 

a) Ramus ascendens, extends upward between the m. levator scapulae and the mm. splenii 

in the neck to supply these muscles. 

b) Ramus desce/ideiis, passes "downward between the mm. rhomboidei and the m. serratus 

posterior superior along the margo vertebralis of the scapula; it supplies these and 
the adjacent muscles and sends branches to the skin. 

A. axillaris (axillary artery) (see Figs. 434, 449 and 451) runs distalward from 
the lower margin of the m. subclavius along the lateral angle of the axilla ; it is covered at 
first by the proc. coracoideus, then lies in the groove behind the m. coracobrachialis and is 
bounded behind by the mm. subscapularis, latissimus dorsi and teres major, medianward by the 
m. serratus anterioi-. Superficially (in front and mediauMard) it is covered by the v. axillaris ; 
on the lateral, posterior and inferior and partially also on the anterior surface it is directly 
surrounded by the long branches of the plexus brachialis. From the lower margin of the m. 
pectoralis major on, its continuation is called the a. brachialis. Besides small branches to the 
m. subscai)ularis, ia7ni subscapulares, it gives off the following branches: 

1 . A. thoraealis suprema (0. T. superior thoracic artery)(not illustrated) arises behind the 
m. subclavius and runs downward, partly in front of and partly behind the m. pectoralis minor to 
the muscles of the chest ; it is usually absent and substituted by a branch of the a. thoracoacromialis. 

2. A. thoracoacromialis (0. T. acroraiothoracic or thoracic axis) (see Figs. 434, 449 
and 451) arises at the up})er margin of the m. pectoralis minor and ends in rami pectorales 
between the muscles of the chest. Branches : 

a) Ramus acromialis, transversely beneath the mm. pectoralis major and deltoideus, inft-ont 

of the proc. coracoideus, lateralward, supplies these muscles, perforates the m. deltoideus 
and ends in the retc acromiale, situated upon the upper surface of the acromion. 

b) Ramus deltoideus goes downward in tbe slit between the mm. pectoralis major and 

deltoideus; it su})plies especially the latter muscle and the skin over it. 

3. A. thoraealis lateralis (0. T. long thoracic artery) (see Fig. 449 and 451) arises 
behind the m. pectoralis minor and runs upon the m. serratus anterior downward as far as the 
5th or fi'h intercostal space ; it supplies (^specially the m. serratus anterior. Several branches 
[rami mammarii extend) go through the m. pectoralis major to the skin of the mannnary region. 

4. A. subscapularis (see Figs. 451 and 452), arises at the lower margin of the m. 
subscapularis, goes downward and soon divides into two terminal branches: 

a) A. circumflexa scapulae (0. T. dorsalis scapidae), bends backward between the mm. sub- 

scapularis and teres major and then, medial from the caput longum of the m. triceps, 
goes upward, ])artly in front of, partly behind the m. teres minor, into the fossa 
infras})inata. It su]ij)lies the neighboring muscles and skin and anastomoses freely 
with file a. transversa sca])ulae. 

b) A. tlwracodorsalis, between the mm. latissimus dorsi and serratus anterior along the margo 

axillaris scapulae downward and backward, supplies the neighboring muscles and skin. 



Arteries of the Wall of the .Trunk. 



407 



A. carotis commu 



A. subclavia sinist 

A. mediastlnalis 
anterior 



A. maiuniaria 
interna 



Ramus 
perforans 

Ramus 
sternalis 



Kamus , _ 

intercostal is i 



A.'. 

pericardiaco- 

phrenica 



A. musculo- 
phrenica 



A. epigastrica 

superior 



A. anonyma 



M. rectus 
abdominis 



M. obliquus 
internus 
abdominis 




A. circumtlexa 
ilium profunda 



A. epigastrica 
inferior 



A. iliaca externa 



f M. transversus 
thoracis 



A. pericardiaco- 
phronica 



Diaphragma 



M. transversus 
abdominis 



Vagina m. recti 

abdominis 
(posterior layer) 



Linea 

seniicircularis 

[Douglasi] 



A. circumtlexa 
ilium profunda 



450. Arteries of the anterior wall of the trunk, viewed from behind. 

(The aa. epigastricae are drawTi upon the surface of the m. rectus abdominis.) 



408 



Arteries of the Arm. 

A. thoracoaciomialis 



Kamus aoromialis 



A. axillaris 

V. axillaris 



Kamus deltoideus 



N. inusculocutaiievis 
Aa. circiimflrxae humeri 



M. coracobrachialis 
M. deltoideus 



I\r. ])ectoralis 
uiajor 






t 
1 


A.bra- 
chialis 


( 
N. 
medianus 


R. deltoideus 




a. profuudae 
brachii 


ulnaris , 


V. brarhialis 


Kn. cutanci 


brachii 




ct aiitibrachli 


inediales 
N. axillaris 



Costa III 



A. thoracalis 
suprema 

', M. pectoralis minor 

I 

Rami pectorales 



A. subscapularis 
M. latissimus dorsi 

A. circumflexa scapulae 



I 



A. thoracalis lateralis 
\. thoracodorsalis 



451. Arteries of the right axilla, viewed from in ftont. 

(The ami is lifted, the m. pectoralis major has been completely, tln' m. pectoralis minor 

partially, removed.) 

5. A. cirt'Uinflexa humeri anterior (0. T. anterior circumflex artery) (see Fi*?. 449) 
goes , directly on the anterior surface of the coUum chirurgicnm hunn'ri , covered by all the 
muscles, first lateralward , then backward. It supplies these muscles, the shouldi'r joint and 
by means of 1-2 liranclu's fa^. luiiriciae humeri) the superior epiphysis. 

6. A. circumflexa humeri posterior (0. T. posterior circumtiex artery) (see Figs. 44'.), 
452 and 454) arises at the same level as the preceding artery, sometimes in common with it. 
passes backward thmugli the space between the huuKn-us , mm. teretes and caput longum 
m. tricipitis and surrounds the coUura chirurgicum from. behind and lateralward, lying always 
upon the bone and covered by all the muscles. It supplies these muscles, the shoulder joint 
and the skin over the ra. deltoideus; it usually gives off two branches (^(3. nuiriciae hiinici-i) 
to the superior epiphysis of the humerus. 



A. trausversa colli 



Ramus ascendens 
Eainiis dc'scendeiis 1 



Arteries of the Ann. 



Ligamentiim transversum scapulae superius 



, A. trausversa scapulae 

'1 



409 



Acromiou 

Ramus acromialis 



M. deltoideus 




M. infraspinatus 



31. teres minor 

I A. circumflexa humeri posterior | 

' M. triceps (caput longum) 

M. teres major 



M. triceps (caput laterale) 



452. Arteries of the right shoulder blade, 

viewed from behind. 
(The mm. supraspinatus, infraspinatus, teres minor and deltoideus have been partially removed.) 

A. brachialis (brachial artery) (see Figs. 451, 453, 455 and 456) extends from the 
inferior margin of the m. pectoralis major onward, at first just behind the m. coracobrachialis, 
in front of the caput longum and caput mediale of the m. triceps, then in the sulcus bicipitalis 
medialis almost straight downward; it then passes upon the m. brachialis, covered by the 
lacertus fibrosus, to the depth of the elbow, there to divide at the level of the proc. coronoideus 
ulnae into the a. radiulis and the a. ulnaris. Superficial to it medianward and in front of it 
run the vv. brachiales; on its lateral anterior surface above descends the n. medianus, which, 
however, above the elbow passes in front of the artery to its medial side; on its medial, 
]>osterior surface above, lie the n. ulnaris and radialis; these, however, soon diverge from it. 
Besides several small branches to the neighboring muscles and skin, it gives off the following : 

1. A. profunda brachii (0. T. superior profunda artery) (see Figs. 453 and 454), 
arises from the upper portion of the vessel, bends backward and downward and follows a spiral 
course along with the n. radialis in the sulcus n. radialis aroun<l the posterior surface of the 
humerus downward and lateralward: in its course it runs between the origins of the caput 
laterale and mediale m. tricipitis and is covered by the former. Branches: 



410 



Arteries of the Ann. 



Bete acroniiale 




Ramus acromialis 
a. thoracoaeromialis 



M. deltoideus 

M. pectoralis major 
(cut through) 



'^ 






M. sub- 
scapularis 



M. coraco- 
brachialis 

Ramus 
deltoideus 

-A. profunda 
brachii 

M. triceps 
brachii 

(caput longuni) 



. A. collateralis 
ulnaris superior 



M. biceps brachii 



A. brachialis 

. M. triceps brachii 
(caput mediale) 

Septum iiiter- 
musculare mediale 



M. brachialis 



A. collateralis 
ulnaris inferior 

ulnaris 



VY 



i 



Kpicondylus 
mcdialis 

Lacertus 

flbrosus 





. A. recurrens 
radialis 

A. ulnaris 

A. radialis 

M. pronator 
teres 

M. brachio- 
radialis 



453. Arteries of the 
right upper arm, 

viewed from in front. 

1. A. profunda Ibracliii (continued) 
(see also Fig. 454): 

a) Ramus deltoideus (see also Fig. 451), 

goes off immetliately below the origin 
of the artery or arises from the 
a. brachialis or from the a. collate- 
ralis ulnaris superior; it runs lateral- 
ward, transversely over the anterior 
surface of the humerus, covered by 
the mm. coracobrachialis and biceps, 
to the m. deltoideus and gives oft' 
branches to these and to the m. 
brachialis. 

b) y4. coliateiYilis media, runs downward 

in the substance of the caput me- 
diale of the m. triceps and some- 
times reaches the rete articulare 
cvibiti, which it then helps to form. 

c) A. collateralis radialis (0. T. articu- 

lar branch of the superior profunda), 
appears somewhat below the middle 
of the upper arm between the caput 
laterale and the caput mediale of 
the m. triceps (with the n. cutaneus 
antibrachii dorsalis of the n. ra- 
dialis), runs jtist behind the septum 
intermusculare laterale as far as the 
epicondylus lateralis and there 
opens into the rete articulare cubiti. 
It supplies the neighboring muscles, 
the skin' over the m. triceps and 
partly also that over the ram. bra- 
chialis and biceps. 

d) A. nutricia humeri (not illustrated), 

arises sometimes also from a muscu- 
lar branch or from the a. brachialis 
itself; it passes through the canalis 
nutricius to the bone and marrow 
of the diaphysis. 

2. A. collateralis ulnaris superior 

(0. T. inferior profunda artery) (see also 
Figs. 454456), arises usually a little below 
the preceding artery, runs downward with 
the n. ulnaris on the medial surface of the 
caput mediale m. tricipitis (behind the septum 
intermusculare mediale) and enters into the 
rete articulare cubiti near the olecranon. It 
supplies the neiglibdring muscles aud skin. 

3. A. collateralis ulnaris inferior 

(0. T. anastomotica magna artery) (see also 
Figs. 454 457), goes off somewhat above 
the epicondylus medialis humeri, runs me- 
dianward in front of the ra. brachialis, 
perforates the septum intermusculare me- 
diale, bends directly uptm tlie bone back- 
ward and lateral ward and enters into the 
rete articulare cubiti : it gives off branches 
to the adjacent muscles. 



Arteries of the Arm. 



411 



454. Arteries of the right upper arm, viewed from behind. 



(Tlie 111. triceps has been partially 
removed, the other muscles, of the 
upper arm have been completely 
removed.) 
A. radialis (radial artery) 
(see also Figs. 453, 455460), ex- 
tends radialward, slightly curved, 
upon the in. supinator and then runs 
almost straight to the wrist between 
the m. brachioradialis on one side, 
the mm. pronator teres, flexor carpi 
radialis and flexor digitoruni subli- 
mis on the other side ; it is covered 
over in its upper portion by the 
margin of them, brachioradialis and, 
below, lies free, covered only by the 
fascia antibrachii; above it lies, in 
its course, upon the insei-tion of the 
m. pronator teres, below upon the 
ram. flexor poUicis longus and pro- 
nator quadratus, and is accompanied 
on its radial side by the ramus 
superficialis n. radialis. Distalward 
from the proc. styloideus radii it bends 
to the back of the hand, covered 
by the tendons of the mm. abductor 
pollicis longus and extensor poUicis 
brevis, then runs distalward beneath 
the tendons of the m. extensor pol- 
licis longus, passes between the bases 
of the ossa un'tacarpalia I and II 
into the palm and ends in the arcus 
volaris profundus. Branches : 

1 . A. reciirrens radialis (ra- 
dial recurrent artery) (see Fig. 456) 
goes off directly after the arteiy 
arises, bends upward and backward 
like a hook along the n. radialis di- 
rectly upon the ni. supinator; it sup- 
plies the adjacent muscles and the 
skin lying over them and sends off 
a branch beneath the origin of the 
m. brachioradialis thi-ough the sep- 
tum intermusculare laterale back- 
ward into the rete articulare cubiti 
(see Fig. 457). 

2. Rami musciilares (see Fig. 
455) in the forearm, numerous, to 
the adjacent muscles and to the skin. 

3. Ramus volaris superficia- 
lis (superficial volar branch) (see 
Fig. 459), arises at the level of the 
proc. styloideus radii, runs distal- 
ward upon or partly between the 
bundles of the m. abductor pollicis 
brevis, otherwise covered only by 
the thin fascia of the ball of the 
thumb, and goes over usually in 
the form of a curve into the arctis 
volaris superficialis. It gives off 
branches to the muscles and skin 
of the thumb. 



Acrninion 




A. circumfiexa 
humeri posterior 
^ M. triceps brachii 
(caput longum) 
M. triceps brachii 

(caput laterale) 
A. profunda brachii 



A. coUateralis media 



N. radialis 



M. triceps brachii 
(caput laterale) 

A. coUateralis radialis 

A. coUateralis 
ulnaris superior 

A. coUateralis media 

A. coUateralis 
ulnaris inferior 

Rete articulare cubiti 



N. ulnaris _ 



A. recurrens ulnaris 

A. interossea recurrens 
Olecranon 




412 



Arteries of the Arm. 



M. biceps brachii 



t| 




A. collatcralis uliiaris superior 



M. triceps brachii 
(caput mediale) 

A. brachialis 

Septum intermusculare 
mediale 



K. ulnaris 

A. collatcralis 
ulnaris inferior 



M. brachialis 

Kpicoudylus medialis 
humeri 

A. recurrens radialis 



Aa. rei'urrentes 
uhuires 



M. brachioradialis 

A. interossea 
communis 

A. mediana 



455. Arteries of the right forearm, 

viewed from in front, V^ layer. 

(The mm. pronator teres, palm;iris longus, 

flexor carpi radialis and tlexor digitonira 

subhmis have been partially removed from 

their origins on.) 

4. Ramus carpeus volaris (0. T. 

anterior radial carpal) (see Figs. 456 and 
460), delicate, goes iilnarward at the distal 
margin of the m. ])ronator (luadratus, di- 
rectly upon the bone ; it helps to form the 
rete carpi volare. 

5. Kamus carpeus dorsalis (0. T. 
posterior radial carpal) (see Figs. 457 and 
458), arises from the portion of the artery 
situated in the back of the hand, extends 
ulnarward directly upon the bones and 
ligaments and helps to form the rele 
carpi duvsale. 

6. A. metacarpea dorsjilis I (0. T. 
dorsalis indicis or dorsal artery of the 
first finger) (see Fig. 458), goes off shortly 
before the passage of the artery through 

j^\ ^A ^^^ ' iiiterosseus dorsalis I, divides soon 

5? '^JH afterward and supplies the adjacent margins 

oj the index finger (as far as the second 
phalanx) and thumb. A small branch to 
the radial margin of the thumb usually 
arises separately. 

A, ulnaris (ulnar artery) (see also 
Figs. 453, 456 4<)(y) goes into the depth 
at the upper margin of the m. pronator 
teres and then turns ulnarward beneath 
this as well as beneath the mm. flexor carpi 
radialis and flexor digitorum sublimis, di- 
rectly upon the m. flexor digitorum pro- 
fundus ; it then runs along the volar margin 
of the m. flexor carpi ulnaris, between it 
and the mm. flexores digitorum sublimis et 
profundus to the wrist. It is hidden in its 
course beneath the margins of the neigh- 
boring muscles, is accompanied ulnarward 
for part of the way by the n. ulnaris and 
rests upon the m. flexor digitorum pro- 
flexor digitorum profundus fundus. In the hand it runs beneath the 

lig. carpi volare, then upon the lig. carpi 
transversum on the radial sitle of the os 
pisiforme and ends in the arcus volaris 
suporficialis. Branches : 

1. Aa. recurrentes ulnares (ulnar 
recurrent arteries) (see also Fig. 454) single 
or in a conmion trunk from the beginning 
of the artery; they run in a recurrent di- 
rection, that is, proxim'alward ; one runs 
usually u]i( m the ;niterior surface I'f the m. brachialis towards 
the a. collatcralis ulnaris inferior, the other runs backward 
between the origins of the mm. flexor carpi radialis and 
flexor digitorum sublimis to the sulcus n. ulnaris of the epi- 
coiulylus mcdialis humeri and there enters into the rete arti- 
culare cultiti. It supj)lies the surrounding muscles and skin. 
2. Rami musculares, in the forearm, numerous 
branches, to the surroundinu' muscles and to the skin. 



M. pronator teres 

superticialis 
radialis 



Earn us 
n. 



A. radialis 

Eanius muscularis 
a. radialis 

- N. medianus 

A. ulnaris 

Kamus muscularis 
a. ulnaris 

N. ulnaris 



flexor pollieis longus 



INI. flexor carpi radialis 
M. ])almaris longus 
flexor carpi ulnaris 
exor digit.onini sublimis 



Ramus volaris 

superticialis 

a. radialis 



Ligamentum 
carpi volare 



Arteries of the Arm. 



413 



456. Arteries of the right forearm. 



viewed from in front, 2"^ layer. 

(The mm. brachioradialis, pronator teres, 

flexor carpi radialis and flexores digi- 

torum sublirais et profundus have been 

removed.) 

3. Ramus carpeus volaris (O.T. 
anterior uhiar carpal) (see also Fig. 4tiO), 
usuall}' double, delicate, goes radial- 
ward in the neighborhood of the wrist, 
directly upon the bone, to the rete 
carpi volare. 

4. Ramus carpeus (lorsalis(O.T. 
posterior ulnar carpal) (see Figs. 457, 
458 and 460) runs, directly upon tbe 
bone, around the ulna to the back of 
the hand and to the rete carpi dorsale. 

5. Ramus volaris profuudus 
(0. T. deep ulnar artery) (see Figs. 459 
and 460) arises close to the os ])isi- 
fomie, goes into the depth between the 
origins of the mm. flexor digiti V brevis 
and abductor digiti V and helps to 
form the areas volaris profundus ; it 
gives ofi' small branches to the muscles 
of the ball of the little finger. From 
this liranch, or from the stem of the 
a. ulnaris itself, an artery passes beneath 
the m. palmaris brevis upon the muscles 
of the ball of the little finger (giving 
branches to these and to the skin) to 
the ulnar margin of the 5th finger. 

6. A. interossea communis (com- 
mon interosseous artery) (see also 
Fig. 455) goes off a little below thi' 
tuberositas radii and divides imme- 
diately into two branches: 

a) A. interossea volaris (0. T. ante- 
rior interosseous artery) runs distal- 
ward directly upon the volar sur- 
face of the membrana interossea, 
covered by the m. flexor digitorum 
profundus ; it supplies the nniscles 
of the volar surl'ace and sends a 
series of branches through the mem- 
brane to the muscles of the posterior 
surface; it also sends branches to 
the radius and ulna. It reaches the 
dorsal surface of the membrana 
interossea at the upper margin of 
the m. pronator quadratus and runs 
distal ward upon it to the rete carpi 
dorsale (see Figs. 457 and 458); a 
small branch remains upon the volar 
surface and goes to the rete carpi 
volare (see also Fig. 460). Branch : 
aa) A. mediana (0. T. median artery 
or arteria comes nervi mediani) 
(see Fig. 455), comes off from the 
first portion of the artery, is slender 
and accompanies the n. medianus 
distalward, finally to reach the palm. 

Spalteholz, Atlas. 



M. biceps brachii 




M. tricep.s brachii 
(caput mediale) 

A. brachialis 



A. coUatefalis 
ulnaris superior 

A. collateralis 
ulnaris inferior 

M. brachialis 



A. recurreus 
radialis 



Aa. recurrentes 
ulnares 



A. interossea 
communis 



M. extensor carj)! 
radialis longus 

>I. flexor pollicis longus 
- A. radialis 
A. ulnaris 

Eamus muscularis 
A. interossea volaris 
Membrana interossea 
. - Ulna 

M. flexor carpi ulnaris 

Ramus muscularis 

31. pronator quadratus 

Ramus carpeus volaris 
J -- Ramus carpeus volaris 

_ Ramus volaris superficialis 
Rete carpi volare 

27 



414 



Arteries of the Aitu. 



457. Arteries of the right forearm, viewed from behind. 



A. collateralis media - 

A. collateralis radialis - 
" A. recurrens radialis. 



A. collateralis ulnaris 
inferior 



l!ete articulare cubiti 
Olecranon, 



N. ulnaris . 
A. recurrens. 
ulnaris 



M. iiexor 
carpi ulnaris 

A. interossea 
recurrens 

M. supinator 

A. interossea- - 
dorsalis 

;M. extensor carpi 
radialis longus 

M. abductor pollicis 
longus 



Ulna 



M. extensor 
pollicis longus 



M. extensor carpi 
ulnaris 



.M. extensor pollicis bvevis 



Terminal branch of the 

a. interossea volaris 



A. interossea dorsalis 

Radius 
M. extensor indicis proprius 



Rete carpi dorsale 

Ramus carpeus 
dorsalis a. ulnaris 




Ramus carpeus dorsalis a. radialis ' 
M. extensor carpi radialis longus 



(The lu. extonsor digitorura communis has been 

completely removed, the mm. extensores carpi, 

indicis proprius, digiti V proprius partially.) 

6. A. interossea communis (continued): 
b) A. ititei'ossea dorsalis (0. T. posterior 
interosseus artery), perforates the mem- 
brana interossea a little below the chorda 
obhqua, appears at the lower margin of 
the origin of the m. supinator and then 
runs almost straight distalward upon the 
ulnar origins of the mm. abductor pollicis 
longus, extensor polhcis longus and ex- 
tensor indicis proprius. It is distributed 
to the adjacent muscles and skin and 
ends in the rete carpi dorsale. Branch : 
bb) A. interossea recurrens (O.T. interosseus 
recurrent or posterior interosseus re- 
current), runs upward upon or near the 
m. supinator (covered by the m. an- 
conaeus), gives off branches to both 
muscles and to the skin covering them 
and goes to the rete articulare cubiti. 
Rete articulare cubiti (see also Fig. 454) 
is a wide vascular netw(jrk, situated especially 
on the dorsal surftice of the elbow joint, in part 
more superficially' upon the olecranon and the 
tendon of the m. triceps, in part deeper between 
this tendon, the humerus and the elbow joint. 
Opening into it from above are the aa. collate- 
rales ulnares superior et inferior, collateralis 
media and collateralis radialis, from below large 
branches from the posterior a. recurrens ulnaris 
and the a. interossea recurrens and small branches 
from the a. recurrens radialis. A little above 
the capsule of the joint there is usually a large, 
transverse anastomosis, which is fed especially 
by the a. collateralis ulnaris inferior. Branches 
go off from the network to the surroiuiding 
bones, joints, muscles and skin. 

Rete carpi dorsale (0. T. posterior carpal 
rete) (see also Fig. 458), lies upon the back of 
the wrist and is an-anged in two layers: one 
more superficial, consisting of finer vessels, upon 
the lig. carpi dorsale and one deeper, directly 
upon the ligaments and bones of the wrist. The 
rete is formed by the rami carpel dorsales of 
the a. radialis and of the a. ulnaris, as well as 
by the terminal branches of the aa. interosseae 
volaris et dorsalis. From the deep part of the 
network arise 3 aa. metacarpeae dorsales (0. T. 
dorsal interosseous arteries), which run distalward 
upon the mm. interossei dorsales II, III and IV. 
one upon each, each dividing at the level of the 
heads of the ossa metacarpalia into 2 aa. digi- 
lalcs dorsales (dorsal digital arteries) for the 
adjacent margins of the 2"<i to the 5th finger. 
The latter vessels are short and end in the 
region of the first joint of the finger. A vessel 
arises usually directly from the network for the 
ulnar margin of the little finger. The aa. meta- 
carpeae dorsales receive the rami perforantes of 
the aa. metacarpeae volares. 



Arteries of the Arm. 



415 



M. extensor digitoruni 
communis 



M. extensor digit! V 
piO])rius 

M. extensor carpi uluaris 



Processus styloideus ulnae 



Rete carpi dorsale 



Ramus carpeus dorsalis 
a. uluaris 



Rami perforantes 



Aa. metacarpeae_ ^ 
dorsales II IV 



M. extensor pollicis brevis 



Terminal branch of the 
a. interossea volaris 

.- Ligamentum carpi dorsale 



M. extensor pollicis brevis 
_ A. radialis 



Ramus carpeus dorsalis 
a. radialis 

^y .v- M. extensor pollicis longus 



s A. metacarpea dorsalis I 



Aa. digitales 
dorsales 



Branches of the 

aa. digitales 
volares propriae 




458. 
Arteries 



(The tendons of the extensors of the 
lig. carpi dorsale as far as 



of the back of 
the right hand. 



2nd 5th fin<Ter have been removed from the 
the heads of the ossa metaearpalia.) 

27* 



416 



Arteries of the Arm. 

^I. flexor digitoruin'subliinis 



M. palinaris loagus - 
M. flexor carpi radialis 

A. radialis 



Ramus volaris superflcialls 



M. abductor pollicis brevis 



Ligamentum carpi 
transversum 



M. flexor pollicis brevi: 




M. flexor cai7>i ulnaris 
Ligamentum carpi volare 

Os pislforme 
_ A. ulnaris 

Kamus volaris profundus 
il. palmaris brevis 



cus volaris 
uperficialis 

iVa. digitales 

volares 
communes 



Aa. metacarpeae 
volares II IV 



Aa. digitales 
__ volares 
propriae 



459. Arteries 

of the right 

palm 

superficial layer. 

(The aponeurosis palmaris 
has been removed. 

The arcus volaris super- 
flcialls (0. T. superficial 
palmar arch) lies just beneath 
the aponeurosis palmaris 

upon the tendons of the "***" 

m. flexor digitorum sublimis ; its convexity is dircct^^d distalward. It is formed chiefly by the 
termination of the a. ulnaris. which unites usually with the delicate ramus volaris superflcialls 
of the a. radialis. It gives off small branches to the surrounding muscles and skin as well as 
three aa. dif/itales volares communes (0. T. palmar digital arteries), which extend distalward 
upon Ihe 2nd 4**1 m. lumbricalis, receive the aa. metacarpeae volares II IV (see also Fig. 460) 
and divide at the metacarpophalangeal joints, each into two aa. dif/itales volares propriae 
(0. T. collateral digital arteries) for the adjacent surfaces of the 2"d 5th finger. 



Arteries of the Arm. 



417 



Radius 
A. radialis 
Ramus earpeus volaris 



Branch of the a. interossea volaris 

Ulna 

- . A. ulnaris 



Ramus rolaris superflcialis 



51. opponens pollicis 



Areus volaris profundus 



A. metacarpea _ 
volaris I 




- Ramus earpeus dorsalis 
_ ^ Ramus earpeus volaris 

Rete carpi volare 

M. abductor digiti V 



Ramus volaris 
profundus 

^ M. flexor digiti V 
brevis 



Rami perforantes 



Aa. metacarpeae 
volares II IV 



Aa. digitales 

volares 

communes 



Aa. digitales 

volares 

propriae 



460. Arteries of the right palm, deep layer. 

(All the structures have been removed with the exception of the mm. interossei, the muscles of the 
baU of the little finger and the insertions of the mm. opponens poUicis and flexor pollicis brevis.) 

The aa. digitales volares propriae (see also Fig. 459) supply the volar surfaces and. 
from the region of the first joint of the finger on, also the dorsal surfaces of the fingers. 

The arcus volaris profuiidus (0. T. deep palmar arch) lies directly upon the proximal 
ends of the ossa metacarpalia and the mm. interossei, covered by the tendons of all the fiexors 
of the fingers and by the ra. adductor pollicis. It forms a flatter curve than the superficial arch; 
its convexity looks distalward. In its formation is chiefly concerned the termination of the 
a. radialis, which anastomoses with the ramus volaris profundus of the a. idnaris. Proximalward 
it gives olf branches to the rete carpi volare, distalward four aa. metacarpeae volares (0. T. 
princeps pollicis, radialis indicis and palmar interosseous arteries) which run upon the mm. inter- 
ossei. The first goes to the two margins of the thumb and to the radial margin of the index 
finger. The 1^^, 3rd and 4th artery gives off, close to its origin, a ramus perforans, which 
passes through the mm. interossei to the corresponding a. metacarpea dorsalis ; the arteries finally 
anastomose, close to the heads of the ossa metacarpalia, with the aa. digitales volares communes. 

The rete carpi volare (0. T. anterior carpal rete) (see also Fig. 456) lies directly upon 
the volar surface of the wrist and consists of several fine branches from the a. interossea volaris, 
from the rami carpei volares of the aa. radialis and ulnaris and from the arcus volaris profundus. 



418 



A. intercostalis suprema 
Truncus costocervicalis 

A. bronchlalis \ 

A. intercostalis VII 



Arteries of the Trunk. 

A. carotis communis dextra 



A. subclavia dextra 



A. bronchialis 



Aorta thoracalis 



Ramus posterior 
Eamus anterior 




461. Aorta thoracalis, viewed from in front. 

(On the left side the nun. iut(>reustales interui and subcostales have been removed ; the dia- 

])hra^'m has been cut away at its origins.) 

The aorta tllOracalis (thoracic aorta) (see also Figs. 556, 629631) runs, from 
the left side of the body of the 4^h thoracic vertebra on, downward and somewhat to the right 
and passes in front of tlie lower margin of the 12"i thoracic vertebra, a little to the left of 
the median plane, through the hiatus aorticus of the diaphragm and there goes over into the 
aorta abdominalis. On the left side it is directly adjacent to the v. hemiazygos and is covered 
by the }>leura mediastinalis (and is accordingly in dii'ect contact with the cavum pleurae); on 
the riglit side it adjoins th(> ductus thoracicus and the v. azygos, above also the oesophagus, 
which I'urther down lies on its anterior surface; in front it comes into relation also with the 
bronchus sinister and with the pericardium in the region of the left atrium. It gives off branches 
to the thoracic viscera, rami viscerales, and to the waUs of the thorax, rami parietales. 



Arteries of the Trunk. 



419 



Ramus posterior ^ ; Ramus spinalis 



N. lumbalis II 



M. sacrospinalis 



Processus 
transversus 

vertebrae " 
lumbalis III 



M. inter- 

traiisversarius- 

lateralis 




Aorta 
abdomiiialis 



.A. meseuterica 
inferior 



462. Branches of the arteriae lumbales dextrae. 

(A piece of the himbar spine with its mnscles, viewed from the right and somewhat from above.) 

A. Eanii riscerales: 1. Aa. broucliiales (see Fig. 461), 23, from the anterior wall 
of the first part of the vessel, very frequently (especially on the right side) from the a. inter- 
costalis in. They go forward to the right and left bronchus and along with these into the lungs. 

2. Aa. oesophageae (not illustrated), 3 7, from the anterior wall at different levels, for- 
ward and ti) the right to the oi^sophagus ; the lowermost anastomoses with the a. gastrica sinistra. 

3. Rami pericardiaci (not illustrated), delicate, to the posterior wall of the pericardium. 

4. Rami inediastiuales (not illustrated), arising partly in common with the preceding, 
slender, going to the contents of the spatium mediastinale posterius; the lowermost spread 
out also upon the pars lumbalis of the diaphragm as the aa. phrenicae xuperiorcs (not illustrated). 

B. Rami parietales: Aa. intercostales (see also Fig. 461), fi-om the posterior wall 
of the vessel, ten on each side for the 3^3 lltii intercostal space and the lower margin of 
12^11 rib. The upper arteries run upward in a recurrent direction, the lower ones more horizon- 
tally; those on the right side are the longer. All of them lie upon the lig. longitudinale anterius, 
behind the n. sympathicus and behind the v. azygos or hemiazygos, the right also behind the 
oesophagus and behind the ductus thoracicus. Each arrives at the lower margin of a capitulum 
costae and there divides. 

a) Ramus posterior gives off a ramus spinalis, which goes through the foramen inter- 

vertebrale into the canalis vertebralis to the spinal cord and its surroundings. It 
then goes backward, medianward from the lig. costotransversarium anterius, gives off 
ra)ni miisculares, and divides into two branches. One of these runs between the 
mm. semispinalis and longissimus, appears between two procc. spinosi and turns lateral- 
ward to the skin (ramus cutaneus medialis) ; the other lies between the mm. longis- 
simus and iliocostalis and goes often (especially in the lower segments) also to the 
skin (ramus cutaneus lateralis). 

b) Ramus anterior runs forward in the spatium intercostale beneath the v. intercostalis 

(see p. 455), at first covered only by the fascia endothoracica and the pleura, then 
also by the mm. intercostales interni or the m. subcostalis; it gives off a branch to 
the upper margin of the next lower rib and also many rami miisculares. In front 
it anastomoses with the corresponding ramus intercostalis of the a. mamraaria interna. 
In the region of the digitations of origin of the m. obliquus abdominis e.xternus 
rami cutanei laterales [pectorales et abdominalesj (not illustrated) go, some back- 
ward (ramus posterior) to the lateral, some forward (ramus anterior) to the anterior 
wall of the trunk : small rami mammarii laterales go from the latter to the mammary 
gland. Only in the 4th 6''! intercostal space, as a rule, small branches pass to the 
skin medial from the nipple (raini cutanei anteriores [pectorales et abdominalesj) 
(not illustrated) and some to the mammary gland (rami mammarii mediales). 



420 



Arteries of the Trunk. 



Oesophagus I | A. phrenica inferior 
A. coeliaca\ ! I 



A. mesenterica superior 



Aoiia abdominali> 
A. lumbalis III 



Diaphragma 



Ramus suprareiialis superior 
/ A. suprarenalis media 
' / A. renalis 

' A. suprarenalis inferior 



A. spermatica interna 
/ (a. testicularis) 
A. mesenteriia 
inferior 




Ramus iliacus / 

Ramus lumbalis ^ 

A. circumflexa '' / 

ilium profunda / 

A. saeralis media 

A. epigastrica inferior 



A. iliaca externa 



A, hypogastrica I 



I lA. iliolumbalis 
I A. lumbalis inia 
A. saeralis lateralis 



463. Aorta abdominalis, viewed from in front. 

(On the right side the kidnc^v and the iniu. psuas and (juadratus Uimhorum have been removed.) 



Arteries of the Trunk. 421 

The aorta abdoniinaliS (see also Figs. 499 and 033) runs downward on the 
anterior surface of the lumbar vertebrae, a little to the left of the median plane. It is directly 
covered in front by the corpus pancreatis, the pars inferior duodeni and the peritonaeum, lies 
on the left side of the v. cava inferior and divides in front of the lower margin of the 4tii lumbar 
vertebra into the aa. iliacae communes dexti-a et sinistra. Its branches are divisible into rami 
parietales (to the walls of the abdomen) and rami yisccrales (to the abdominal viscera). 

A. Rami parietales: 

1. A. phreuica inferior, paired, arises in front of the 12tii thoracic vertebra, separated 
fi-om, or in 'common with, that of the other side, goes upward, forward and lateralward on 
the inferior surface of the pars lurabalis diaphragmatis (on the right side behind the foramen 
venae cavae) and helps to supply the diaphragm. Branches: 

a) Rami suprarenales superiores, from the first part of the artery, to the adrenal. 

2. Aa. lumbales I IV (0.,T. lumbar arteries) (see also Fig. 462), paired, go off, usually 
at a right angle, from the posterior wall, one in fi-ont of in body of each of the 1st _ 4111 
lumbar vertebrae ; they run backward on the lateral surface of the same, covered by the crura 
diaphragmatis and the origins of the m. psoas major, and pass through the m. quadra tus lumborura 
to the muscles and to the skin of the lateral wall of the abdomen. Eacli gives off one branch : 

a) Ramus posterioi-, corresponds exactly to the r. posterior of an a. intercostalis (see p. 419); 
it gives oft' a ramus spinalis and goes to the muscles and skin of the lumbar region. 

3. A. sacralis media (middle sacral artery) (see also Figs. 470 and 471), impaired, from 
the posterior wall of the aurta a little above the bifurcation, extends downward, somewhat tortuous, 
in the median plane in front of the Sth lumbar vertebra, sacrum and coccyx. It gives off branches 
to the neighboring bones, muscles, nerves and to the rectum and ends in a vascular skein, the 
glomus coccyfjeum (not illustrated), situated beneath the tip of the coccyx. Branch: 

a) A. lumhalis ima runs lateralward and downward, one on each side, upon the body of 
the 5th lumbar vertebra to the mm. psoas major and iliacus. 

B. Rami riscerales: 

1. A. suprareiialis media (middle suprarenal artery), paired, arises a little below the 
a. coeliaca tmd runs directly in front of the crus mediale diaphragmatis to the adrenal. 

2. A renalis (renal artery), paired, arises nearly at a right angle at the level of the 
1st lumbar vertebra (or somewhat lower), rims transversely in front of the crus mediale dia- 
phragmatis (on the right side behind the v. cava inferior) behind the v. renalis and sends its 
branches in fi-ont of and behind the pelvis of the kidney to the substance of the kidney (see also 
Ilg. 638). Variations in the origin and number of the renal arteries are fi-erpient. Each, by 
means of small branches to the tunica adiposa of the kidney, anastomoses with the aa. phrenica 
inferior j^ lumbales, suprarenales, spermaticae intemae and mesentericae. Each gives off also: 

a) A. suprareiialis inferior to the adrenal. 

3. A. spermatica interna (0. T. spermatic artery) (see also Figs. 464 and 465), paired, 
arises, at an acute angle, at the level of the 2id lumbar vertebra, runs downward, lateralward 
and forward (on the right side in front of the v. cava inferior) upon the mm. psoas major and 
minor, in front of the ureter, behind the peritonaeum, gives off in its course fine branches to 
the tunica adiposa of the kidney, to the ureter and to the lymph glands and approaches the 
lateral margin of the pelvic inlet. Thence it is distributed differently in the two sexes. 

In the male, as the a. testicularis (see also Figs. 467, 499 and 650) it goes upon the 
m. psoas major, in fi-ont of the a. and v. iUaca externa to the annulus inguinalis abdominalis and, 
surrounded by the plexus pampiniformis, in the spermatic cord to the epididymis and testicle. 

In the female, as the a. ovarica (see Figs. 471, 472 and 503) it crosses the a. and 
V. iliaca externa, nearly in ft-ont of the ureter, enters mto the lig. suspensorium ovarii, surrounded 
by the plexus pampimformis, runs along the anterior margin (margo mesovaricus) of the ovary, 
gives off branches to it and forms a broad anastomosis with the ramus ovarii of the a. uterina. 

4. A. coeliaca (0. T. coeUac axis) (see also Fig. 464), unpaired, from the anterior wall 
between the \2^^ thoracic and the l^t lumbar vertebra, is short, and divides at the upper 
margin of the corpus pancreatis into three branches. 

a) A. gastrica sinistra -{0. T. gastric or coronary artery) (see Figs. 464 and 465), bends 

forward and '.upward in the plica gastropancreatica to the right side of the cardia 
and runs in the omentum minus, along the curvatura minor of the stomach, to the 
right and downward. Small branches to the oesophagus (rami oesophagei), larger 
ones to the anterior and posterior walls of the stomach and to the omentum minus. 

b) A. hepatica (hepatic arteiy) (see Figs. 464 and 465) runs upon the right crus mediale 

diaphragmatis at the upper margin of the pancreas behind and below the vestibulum 
bursae omentalis to the left posterior surface of the pylorus. Branches: 
ba) A. gastrica dextra (0. T. pyloric artery) arises at the pylorus and runs between the layers 
of the omentum minus along the curvatura minor to the left; it unites with the a. 
gastrica sinistra and gives off branches to the anterior and posterior walls of the stomach. 



422 



Arteries of the Trunk. 



/ 



A. gastrica dextra (cut off) 

Ramus sinister a. hepaticae propriae ^ 

A. gastroduodenalis , | 

Ramus dexter a. ' [ 

hepaticae propriae .' \ 



Hepar 
(lobus \ 
dexter) \ 



A. hepatica 



A. gastrica sinistra 
A. lienalis 



A. gastroepiploica sinistra 
A. gastrica brevis 



/ Ramus 
/ lienalis 




'' ' '' / 

Duodenum f / / ^ 



A. gastroepiploica dextra 

A. pancreaticoduodenalis/ 



A. pancreaticoduodenalis inferior' / 



A. mesenterica superior 



/ 



/ 

Aorta 
abdominalis 



^A. colica sinistra 
A. mesenterica inferior 



^ Colon descendens 
^ ^Intestinum jejunum 

^ A. spermatica interna 



464. Arteries of the abdominal viscera, 

deepest layer, viewed from in front. 

(The left lohe of the liver, the largest part of the stomach, the small intestines and the colon 
transversum have been removed; the peritonaeum has been, in large extent, dissected off.) 

bb) A. hepatica propria ascends between the layers of the lig. hepatoduodenale, to the left 
of tlie ductus choledochus and in front of the v. portae (see Fig. 497), to the porta 
hepatis and there divides into a ramus dexter (0. T. right terminal branch) to the 
right half and a ramus sinister (0. T. left terminal branch) to the left half of the 
liver (see also Fig. 581). The former gives off the a. cystica to the gall bladder, 
be) A. gastroduodenalis (gastroduodenal artery) runs downward to the left of and behind 
the pars superior duodeni and divides into two branches : 

) A. pancreaticoduodenalis superior extends downward and to the left on the concave 
side of the pars descendens and pars inferior duodeni, between it and the caput 
pancreatis, unites with the a. pancreaticoduodenalis inferior and supplies, with its 
rami pancreatici, the caput i)ancreatis, and with its rami duodenalcs, the duodenum. 
/?) A. f/astroepiploica dextra (right gastroepiploic artery) arrives at the lower sur- 
face of the pars superior (hiodeni between the two anterior layers of the omentum 
majus, runs to tlie left along the curvatura major of the stomach and unites with 
the a. gastroepi])loica sinistra. It gives branches to the anterior and posterior 
walls of the stomach, as well as rami epiploici to the great omentum, 
c) A. lienalis (0. T. splenic arter\) bends to the left and extends to the left at the upper 
margin of the pancreas or behind it, as well as behind the bursa omentalis, in front 
of the left adrenal and kidney, in a tortuous course to the hilus of the spleen. 
Branches (see p. 424): 



A. pancreaticoduodenalis inferior 
A. gastroepiploica dextra 
A. pancreatico- 
duodenalis superior 



Arteries of the Trunk. 
A gastrica dextra 



423 



A. hepatica 



\ . LTHstrica sinistra 



A. gastroepiploica sinistra 




Colon ascendens / / 

A. colica dextra 

A. mesenterica superior 



Colon descendens 
A. colica sinistra 



A. mesenterica inferior 



A. ileocolica 



A. sigmoidea 
\A. haemorrhoidalis superior 



Aorta abdominalis 



465. Arteries of the abdominal viscera, 

more saperlicial layer, viewed from in front. 

(The left lobe of the liver, the small intestines and the colon transversum have been removed ; 
the mesenterium and mesocolon have been dissected off.) 



424 Arteries of the Trunk. 

ca) Rami panci-catici, numerous, to the corpus and to the cauda pancreatis. 

cb) A. gastroepiploica sinistra (left g-astroepiploic artery) (see also fig. 465) runs forward 

in the lig. gastrolienale, goes to the right, between the two anterior layers of the 
omentum majus, along the curvatura major of the stomach, and unites with the 
a. gastroepiploica dextra ; its branches are like those of the latter artery. 

cc) Aa. (jastricae breoes (vasa brevia) (see Fig. 464). in the lig. gastrolienale to the 

fundus ventriculi. 
cd) Rami lienaUs fmni the hilus to the substance of the spleen (see Fig. 586). 

5. A. meseuterica superior (superior mesenteric artery) (see also Figs. 463 465, 498 
and 584), unpaired, arises just below the a. coeliaca, separated from it by the v. lienalis, in front 
of the 1st lumbar vertebra; it goes downward at first behind the caput pancreatis, then passes 
through the incisura pancreatis in the groove on the anterior surface of the processus uncinatus 
and in fi-ont of the pars inferior duodeni between the layers of the mesenterium and runs in 
a curve, slightly convex to the left and forward, as far as the first portion of the large intestine. 

a) A. pancreaticoduodcnalis inferior (see Fig. 464) goes off from the right side, runs to 

the right on the concave surface of the pars inferior duodeni between it and the 
pancreas, supplies both organs and unites with the a. pancreaticoduodenalis superior. 

b) Aa. intesiinates (0. T. vasa intestini tenuis), about sixteen, fi'om the convexity of the 

arch, pass between the layers of the mesenterium to the loops of the jejunum (aa. 
jcjunaks) and ileum (aa. ileae). Each artery bifurcates and forms arch-like anasto- 
moses with the branches of neighboring vessels ; the branches arising from these form 
further anastomoses and so on until two to five series of anastomoses follow upon 
one another (see Fig. 496). From the last -iiumerous branches of nearly equal sife and 
almost equidistant from one another go to the small intestine. Small branches go 
also to the contents of the mesentery. The last a. ilea unites with the a. ileocolica. 

c) A. ileocolica, from the right side, runs behind the peritonaeum to the right and 

downward to the end of the small and beginning of the large intestine, anastomoses 
with the last a. ilea and with the a. colica dextra. A small branch, the a. ajrpen- 
dicularis (not indicated), goes behind the ileum "to the vermiform process. 

d) A. colica dextra (right colic artery), fi-ora the right side, very often a branch of the 

preceding arteiy, goes to the right behind the peritonaeum to the colon ascendens; 
it anastomoses with the a. ileocolica and with the a. colica media. 

e) A. colica media (middle colic artery), from the right side, in frunt Lif the pancreas; 

it extends to the right and forward in the mesocolon transversum to the colon trans- 
versum; it anastomoses with the a. colica dextra and with the a. colica sinistra. 

6. A.mesenterica iuferior (see Figs. 462465), unpaired, arises between the 3rd and 
4th lumbar vertebra and runs downward and to the left, beneath the peritonaeum. Branches: 

a) A. colica sinistra (left colic artery), beneath the peritonaeum to the left to the colon 

descendens; it anastomoses with the a. colica media and with the aa. sigmoideae. 

b) Aa. sigmoideae, often single, run downward and to the left to the colon sigmoideum: 

they anastomose with the a. colica sinistra and with the a. haemorrhoidalis superior. 

c) A. haemorrhoidalis superior (see also Figs. 470 and 471) bends downward in fi-ont 

of the a. and v. iliaca communis sinistra and in front of the promontorium and goes 

downward between the two layers of the mesorectum, in front of the sacrum and 

behind the rectum, and then divides into two branches, which run right and left to 

the intestinum rectum; it anastomoses above with the aa. sigmoideae, below witli 

the aa. haemorrhoidales mediae (from the a. hyppgastrica). 

A. iliaca communis (iliac artery) (see also Figs. 463, 467, 468, 470, 471 and 499) 

paired, goes downward, lateralward and forward, slightly curved, in front of the bodies of 

the 4th and 5th Uimbar vertebra at the medial margin of the m. psoas major; it is covered by 

jieritonaeum and runs, on the left side, behind the ureter and the a. haemorrhoidalis superior. 

It lies in front of and somewhat to the left of the v. iliaca communis. It divides in front of 

the articulatio sacroiliaca into the a. liypogastrica and the a. iliaca externa. 

A. liypogastrica (see Figs. 463, 467, 468, 470 and 471) turns downward and 
somewhat backward into the small pelvis and divides, after a short course, usually into a 
posterior and an anterior branch. The posterior branch bends markedly backward to the upper 
part of the foramen ischiadicum majus (above the m. piriformis), gives off the aa. iliolumbahs. 
obturatoria and sacralis lateralis and ends as the a. glutaea superior. The anterior branch 
runs in ft'ont of the m. piriformis to the inferior portion of the foramen ischiadicum majus, 
gives off the aa. umbilicalis (or aa. vesicales superiores), vesicalis inferiur. deferentialis (in the 
male), uterina (in the female) and haemorrhoidalis media and bifurcates into the aa. glutaea 
inferior and ]Hulenda interna. The subdivisions of the posterior branch (and the a. glutaea in- 
ferior) go chiefly to the walls of the pelvis as rami parietales, those of the anterior branch 
(with the exception of the a. glutaea inferior) chietly to the viscera as rami yiscerales. 



Arteries of the Trunk. 



425 



A. colica media V. mesenterica superior 
Colon transversuni ' ' A. mesenterica superior 



Duodenum 



.Aa. jejunales 




Colon ascendens / 

A. colica dextra ^ 
A. ileocolica 



lutestinum ileum 



Aa. ileae 
Colon sigmoideum 



Intestinum ileum 



466. Branches of the a. mesenterica superior, 

viewed from in front. 

(The small mtestinc has been cut away at the mesentery with the exception of two loops, 

the transverse colon has been drawn upward, the g'reat omentum cut off, and the mesentery 

reflected to the left. The mesentery and mesocolon have been partially dissected away.) 



p 



426 



Arteries of the Trunk. 
M. transversus abdominis 



A. epigastrica inferior 
I 
M. rectus altdominis 



Ductus 
deferens 

Ligamentum 

interfoveolare 

[Hesselbachi] 




i 



Kamus 
obturatorius - 

Eamus pubicus 

a. epigastricae 

infcrioris 

Adniiniculum lineae albae 



Ligamentum lacunare 
[Gimbernati' 

Ramus pubicus 
a. obturatoriae 

Vesica urinaria 
Symphysis ossium pubis 

V. dorsalis penis 



V. iliaca communis 

A. iliaca communis 

A. testioularis 

A. iliaca externa 

A. circumtlcxa 
ilium jirofunda 

A. hypogastrica 
A. iliolumbalis 

A. glutaea superior 
V. iliaca externa 
N. obturatorius 
A. obturatoria 



A. glutaea 
inferior 

A. pudenda 
interna 

A. haemor- 

rhoidalis 

media 



Penis 



Prostata 



I lutesliiuim rectum 
Ductus deferens 



467. Right a. obturatoria and a. epigastrica in- 
ferior, in the male, viewed from tlie left. 

A. Rami parietalos: 

1. A. iliolumbalis (0. T. iliolumbar artery) (see also Figs. 463 and 468) turns lateral- 
ward and upward beliind the n. obturatorius, between the basis ossis sacri and the m. psoas 
major, and divides into two ))ranches: 

a) Ramus Inmhalis corresponds to the ramus posterior of an a. lumlialis (see Fig. 462) and 

gives ofi'a ramns spinalis to the spinal canal: it supplies the neighboring muscles and skin. 

b) Ramus iliacus runs l)ehind the m. psoas major along the crista iliaca, gives off branches 

to the bones and muscles; it unites with the a. circumflexa iliimi profunda. 



Arteries of the Trunk. 



427 



Ductus deferens 
A. testicularis ' | 



I M. transversus abdoiuinis 

, A. circumflexa ilium profunda 



A. epigastrica inferior 
^^. rectus abdominis 



A. iliaca communis 




Ramus iliacus 
a. iliolumbalis 



Ligaiuen- 

tum iuter- 

foveolare 

A. sperma- 
tica externa 
A. obturatoria 
(abnormal) 

Lig. lacunare 
[Gimbernati 

Falx [aponeurotica] 
inguinalis 

Eamus pubicus a. _ , 
epigastricae inferioris 

Eamus pubicus _ 
a. obturatoriae 

Ramus internus 



Symphysis ossium pubis 



A. iliolumbalis 
A. iliaca externa 



A. hypogastrica 

V. iliaca externa 

bturatoria (normal, 
rudimentary) 
bturatorius 

A. glutaea inferior 

- A. haemorrhoidalis media 
- Ligamentum sacrospinosiJru 
A. pudenda interna 

- -M- levator ani 



Trigouum (diaphragma) urogenitale' 



A. penis 



468. Abnormal a. obturatoria dextra in the male. 

(A wiinlow has been cut out of the mm. obturator internus and levator ani.) 

2. A. sacralis lateralis (lateral sacral artery) (see Fig. 463) downward, single or 
double, upon the facies pelvina of the sacrum, gives off rami s\)inales through the foramina 
sacralia into the canalis sacralis, and branches to the muscles and to the skin of the back. 

3. A. obturatoria (obturator artery) (see also Pigs. 467, 469471 and 476), frequently 
arising from the anterior branch, extends fonvard and downward beneath the linea terminalis of 
the pelvis and beneath the n. obturatorius to the canalis obturatorius, inside which it divides 
into its terminal branches. In the pelvis, small branches to its surroundings, as well as : 

a) Ramus pubicus. This rims medianward on the posterior surface of the ramus superior 

ossis pubis and anastomoses on the upper surface of the lig. lacunare [Gimbernati] 
with the ramus obturatorius of the a. epigastrica inferior. By this anastomosis the 
a. obturatoria arises in about one-third of the cases from the a. epigastrica; it lies in 
half of these cases upon the lig. lacunare or upon the septum femorale, in the other 
half, lateralward from the annulus feraoraUs. 

b) Ramus internus, medial from the membrana obturatoria, do^vnward to the ischium. 



428 



Arteries of the Trunk. 



Ramus iTiternus 

Ramus anterior 

M. obturator externus 



M. pectineus 
I 

M. adductor loiigus 



Acetabulura- 



A. acetabuli- 



Kamus posterior 



Brancli to the 
m. obturator 
interiius 

M. quadratus- 
femoris 




Symphysis ossium 
pubis 



M. gracilis 
M. adductor brevis 



M. adductor minimus 



Membraua obluraloria 



M. adductor- magnus 



469. Terminal branches of the a. obturatoria 

d extra, viewed from in front and from the rig-lit. 
(The muscles of the thigh have been cut off short at their origin.) 

3. A. obturatoria (continued). Terminal branches: 

c) Ramus posterior, goes downward in the membrana obturatoria at the posterior margin 

of the foramen obturatum to the anterior surface of the ramus superior ossis ischii, 
and gives off, as it goes, the a. acetabuli, M'hich passes through the incisura acetabuli 
to the hip joint; it also gives off branches which pass through the membrane to the 
m. obturator internus, and sends its terminal branches in part forward upon the 
origin of the in. obturator externus, in part backward especialh' to the ischium. 

d) Ramus aiiterior, forward upon the external surface of the membrane and then, partly 

through, parti}- in front of the m. obturator externus, toward the preceding artery. 

4. A. glutaea superior (gluteal artery) (see Figs. 467, 470 and 477) goes backward 
through the upper part of the foramen ischiadicum majus, above the m. piriformis, gives small 
branches to the surrounding muscles and bones and divides into a superficial branch, which goes 
downward between the mm. glutaeus maximus and medius, and into a deep branch, which runs 
forward between the nun. glutaeus minimus and medius. This latter branch divides into a ramus 
superior along the upper margin of the m. glutaeus minimus and into a ramus inferior in the 
substance of the ni. glutaeus medius. It gives off, also, branches to the skm covei'ing the region. 

5. A. glutaea inferior (see Figs. 467, 470 and 477) runs backward and downward 
between the lower margin of the m. piriformis and the lig. sacrospinosum through the lower 
part of the foramen ischiadicum majus to the anterior surface of the m. glutaeus maximus. 
It supplies especially this muscle, its neighbors and the skin covering that region and gives off 
a fine a. comilans n. ischiadici which goes downward to the n. ischiadicus. 

B. Rami vlseerales. t 

1. A. umbilicalis (0. T. hypogastric artery) (see Figs. 470, 471, 510 and 511) present 
in its full development only beft>rc birth, runs in a curve, on the inner wall of the small pelvis, 
forward and upward to the anti^'ior abdomiiiid wall, arrives on this behind the lateral margin 
of the tendon of the m. rectus abdominis and tln'u goes, beneath the peritonaeum in the plica 
umbilicalis lateralis, to the navel (see also Figs. 328 and 599). It gives off the aa. vesicates 
superiores to the upper part of the bladder. After birth cmly the beginning of the artery 
an<l the branches to the bladder remain open, the largest part of the vessel becomes obliterated 
to form the ligameninm umbilieale laterale (0. T. lateral false ligament'. 



Arteries of the Trunk. 



429 



A. sacralis media 

A. iliaca communis 



Aorta abdominali 



A. mesenterica inferior 



A. testicularis 
A. circumflexa ilium profunda i 



A. iliaca externa 



Ureter 
A. hypogastrica 

A. obturatoria 

A. vesicalis superior 
A. sacralis lateralis 
A. deferentialis 

^ A. vesicalis 

/ inferior 

A. baemorrhoi- 

/ dalis media 

A. haemorrh< 

^ dalis superi( 

Intestinum 

rectum 




Ductus _ - , 
deferens ' 

A. epigastrica _ 
inferior 

Ligamentum um- ^\ ^\J 

bilicale laterale ** 

Ligamentum 
umbilicale medium 
A. vesicalis 
superior 

Vesica urinaria 



Prostata 



A. dorsalis penis _ 



A. scrotalis posterior 
A 



penis 



A. pudenda interna 
'A. vesicalis inferior 
Vesicula seminalis 



^ A. baemorrhoidalis 
media 
A. baemorrhoidalis 
\ inferior 

M. levator ani 



470. Arteries of the male pelvis, viewed from the left. 

(The rectum has been drawn somewhat to the left, the peritonaeum has been removed.) 

^- 2. A. deferentialis (0. T. artery of the vas deferens) (present only in the male), fre- 
quently arising from the preceding arteiy or from the following, passes forward and downward 
to the ductus deferens, there divides, one part going downward as far as the vesicula seminalis, 
'the other upward to the inguinal canal and thence to the epididymis; it anastomoses there 
with the a. testicularis. 

^^ 3. A. vesicalis inferior (see also Figs. 471 and 472) goes downward to the fundus vesicae: 
it goes also in the male to the vesicula seminalis and the prostate, in the female to the vagina. 
^^ 4. A. baemorrhoidalis media (middle haemorrhoidal artery) (see also Fig. 467) comes 
ftequently from the a. pudenda mterna and runs over the m. coccygeus and m. levator ani, 
downward and medianward to the rectum and to the surrounding muscles ; it gives off branches 
to the vesiculae seminales and to the prostate in the male, to the vagina in the female. 
Spalteholz, Atlas. . ' 28 



430 



Arteries of the Trunk. 



Aorta abdominalis 



Ureter 



A. ovarica 



M.'iliacu 



A. lumbalis IV 
Ureter 




A. iliaca externa 

A. epigastrica inferio 

A. obturatoria 

Ligamentum teres uteri 

A. vesicalis superior 

Lig. unibilioale laterale 

A. vcsicalis inferior 



Ligamentum teres uteri ' 
A. uterina 

Ureter 
Vesica urinaria 



Uterus / 
Symphysis ossium pubis* 

A. dorsalis clitoridis 



A. mesenterica 
inferior 

A. iliaca 

communis 

A. lumbalis 

ima 

A. sacralis 

media 

^ Rectum 

._ A. iliaca 
externa 

-- A. hypo- 
gastrica 

Eamus 

tubarius 

Kamus 
ovarii 

- A. vesicalis 
inferior 

- Branch to 
the vagina 

" A. uterina 
A. haemor- 
rhoidalis 
superior 
A. vaginalis 

Lig. umbili- 
cale laterale 
Ureter 

- Aa. vesicales 
superiores 

A. vesicalis 
inferior 

Vagina 



A. pudenda interna 

A. haemorrhoidalis 
inferior 

M. levator ani 






A. clitoridis 
A. labialis posterior 



471. Arteries of the female pelvis, viewed somewhat from the left. 

(The organs have been partly drawn out of tlieir position; the peritonaeum has been removed.) 

5. A. uterina (uterine artery) (present only iu the female) (see also Fi^r. 472) goes for- 
ward- beneath the peritonaeum at first on the inner wall of the small pelvis, then turns median- 
ward, runs through the parametriimi obli(iuely forward in Iront of the ureter to the cei'vix uteri 
aud there gives off the a. vaginalis, whieh runs downward on the lateral wall of the vagina. The 
uterine artery then runs aloug the margo lateralis uteri, following a very tortuous course between 
the layers of the ligamentum latum uteri, as far as the fundus uteri and sends off numerous 
corkscrew-like, tortuous branches to the anterior and posterior surfaces of the uterus, anastomosing 
with one another and with those of the other side; it ends in a branch which runs in the 
ligamentum latum partly to the ligamentum teres uteri and to the tuba wtemvA (ramus tuha- 
rins), partly to the ovary (ramus ovarii) ; the latter branch runs along the margo mesovariciLS 
of the ovarv and forms a broad anastomosis with the a. ovarica. 



Ai'teries of the Trunk. 



431 



Ramus tubarius 

Tuba uterina ' 

[Falloppii 

I 
I 




A. uterina 

Ureter 

Vesica urinaria . 

A. vesicalis inferior 



Vagina / 

A. vesicalis inferior, yi^ 
brandies to tlie vagina'^ 

M. levator ani 



Intestinum rectum 



472. Arteries of the uterus and surrounding 

structures, viewed from behind and somewhat from the left. 

(On the left side the ovary, the Fallopian tube and the ligamentum teres uteri have been 

displaced from their normal position.) 

Jt:^ k. pudenda iuterua (see Figs. 468, 473 and '474) goes dowBward at the lower 
mai^gin of the m. piriformis behind the lig. sacrospinosum, lies on the medial surface of the 
tuber ischiadicum and passes forward, in the form of a curve, upon this and on the medial 
surface of the ramus inferior ossis ischii; in its course it runs somewhat above the processus falci- 
formis and is covered bj' the fascia obturatoria; close behind the m. transversus peruiei super- 
ficialis it divides into the a. jjerinei and the a. penis (or a. clitoridis). It always gives off small 
branches to the surrounding muscles and nerves, and often, also, the a. haemorrlioidalis media. 

1) A. haemorrlioidalis inferior (0. T. external or inferior haemorrhoidal artery) (see Figs. 473 

and 474) usually double or triple. It runs, transversely medianward through the fat of 
the fossa ischiorectalis, being fairly superficial, to the fat, piuscles and skin about the anus. 

2) A. pei-inei (0. T. superficial, perineal artery) (see Figs. 473 and 474) extends, over or 

under the m. transversus perinei superficialis, forward and medianward; it is superficial, 
being covered only by the fascia superficialis perinei; it goes in the male to the posterior 
surface and to tlie septum of the scrotum by means of the aa. scrotales posteriores, 
in the female into the labium majus and labium minus by means of the aa. lahiales 
posteriores. It also gives off small branches to the superficial muscles of the perineum. 
3a) A. penis (in the male only) (see Figs. 46S, 473, 658, 673 and 677) runs forward, in 
the direction of the main stem, close to the ramus inferior ossis pubis, within the 
trigonum (diaphragma) urogenitale until it lies below the lig. arcuatum pubis where 
it is continued directly into the a. dorsalis penis. Branches: 

aa) A. btdbi nrethrae '(0. T. artery of the bulb) (see Fig. 473) goes off at the posterior 
margin of the trigonum urogenitale and runs medianward and forward to the bulbus 
urethrae and to the neighboring muscles. 

ab) A. xirelhralis (see Fig. 473) forward and medianward to the corpus cavernosum urethrae. 

- 28* 



432 



Arteries of the Trunk. 



Testis 
(fascia cremasterica) 



Peuis 
(corpus cavernosiira 
urethrae) 



M. bulbocavernosus 



M. ischiocavernosus 



Trigonum 
urogenitale 



M. transversus 
perinei superficialis 



M. sphincter ani _ 
externus 

M. levator ani- 
N. pudendns - 



M. glutaeus 
inaximus 







Aa. scrotales 
posteriores 



- - A. perinei 

- A. profunda penis 

- - A. dorsalis penis 
A. urethralis 
_ :_ A. penis 

- A. bulbi urethrae 



,.^1, A. pudenda 

^^^ interna 



A. 

haemorrhoidalis 

inferior 



Ligamentum 
sacrotuberosum 



473. Arteries of the male perineum. 

(On the left side the dissection shows the ni. transversus perinei profundus ; the crus penis has 

been drawn aside.) 

ac) A. profunda 'penis arises close undtn- the ligamentum areuatum pubis, penetrates the 
corpus caveniosum })enis on its medial surlace and runs in it partly backward, partly 
forward close to the septum penis (see also Fig. 659) as far as its tip; its branches 
anastomose with one anntlier and with those of the opposite side. 



Arteries of the Trunk. 



433 



A. perinei 
M. ischiocavernosus 



M. bulbocavernosus t_ 



Trigonum 
urogenitale " 

M. transversus 
perinei superficialis 

A. perinei - 

M. sphineter ani , 
exteinus 
M. levator ani . 



N. pudendus 



M. glutaeus 
maximus 




Aa. labiales 
posteriores 

A. perinei 
A. profunda clitoridis 

A. dorsalis clitoridis 

A. urethralis 
._ A. clitoridis 

- A. bulbi vestibuli 
[vaginae] 

_ A. pudenda interna 



A. haemorrhoidalis 
inferior 



474. Arteries of the female perineum. 

(Dissection similar that of Fig. 473; the eras clitoridis has heen drawn aside.) 

ad) A. dorsalis penis (see Figs. 470, 473, 475 and 659) goes near the lig. suspensorium 
penis to the dorsum penis and in its medial groove, on each side near the un- 
paired V. dorsalis penis, as far as the glans; it gives branches to the skin, to 
the corpora cavernosa penis et urethrae and especially to the glans penis. 
3b) A. cUloridis (present only in the female) is comparable in its course to the a. penis ; 
it gives off the a. hulbi vestibuli [oar/inaej to the perineal muscles, the vagina and 
the bulhus vestibuli , the a. urethralis to the latter and to the vestibulum vaginae, 
and the a. frofunda clitoridis to the crus clitoridis ; the a. dorsalis clitoridis runs 
upon the clitoris to the glans cUtoridis, praeputium clitoridis and labia minora. 
A. iliaca externa (external iliac artery) (see Figs. 463, 467, 468, 470, 471, 476, 
499, 500 and 503) downward, lateralward and forward on tlie medial, anterior surface of the 
m. psoas major: it runs first forward, then lateralward from the v. iliaca externa, in front of 
the fascia iliaca and behind the peritonaeum ; on the right side the anterior and medial surftice 
of its initial portion is crossed by the ureter. It goes through the lacuna vasorum beneath the 
lig. inguinale (see Fig. 370) and from there on is called the a. femoralis. Branches: 



434 



Arteries of the Leg. 



M. obliquus externus 
abdominis 



A. circumflexa ilium > 
superfieialis 

A. epigastrica 
superfieialis 



M. 

sartorius 

V. 

femoralis 

A. 
femoralis 

Bamus 
ascendens 

A. circum- 
flexa femo- . 
ris lateralis 

Bamus 
[descendens 



/ A. profunda ' 



femoris 

A. perforans 
prima 



M. rectus 
femoris 

Ramus 
descendens 
a. circum- 
flexae femo- 
ris lateralis 

M. vastus 
lateralis 



M. rectus' 
femoris 




A. circumflexa 
femoris medialis 



Aa. pudendae 



externae 



i^ 



inguinalis 



M. 

adductor 

longus 



Bami 
musculares 



V. 

femoralis 



A. 
femoralis 



M. 
artorius 



M. gracilis 



M. vastus 
medialis 



/ 



Rete patellae '^ 



A. genu ' 
suprema 
Bamus 
artieularis 

Bamus 
"saphenus 



A. genu 
inferior 
medialis 



475. Arteries of 
the right thigh, 

viewed from in front, 
superficial layer. 

(The m. sartorius has been 
for the most part removed 
and a piece has been cut 
out of the m. rectus fe- 
moris.) 

1 . A. epig"astrica in- 
ferior ((J. T. deep epi- 
gastric artery) (see Figs. 
450, 467, 468 and 470) 
arises just above the lig. 
inguinale and runs in a 
A. sperma- curve, first obhquelv me- 
tica externa (lij^nward, then vertically 
A. dorsahs i,pv\-ar(l. In its course it 

' Bamus '''^''* ^^ ^^'*^ b(>hind the lig. 
superfieialis inguinale and lig. inter- 
Bamus foveolare, medial- from the 
annulus inguinalis abdo- 
minalis and, then, passing 
behind the tendon of the 
m. transversus abdominis ar- 
rives at the posterior surface of 
the m. rectus abdominis. It 
causes the peritonaeum to bulge 
forward to form the plica epi- 
gastrica (see also Figs. 328 and 
599) and thus separates the 
fovea inguinalis medialis and 
the fovea inguinalis lateralis 
from each other. Finally, it 
sinks into the substance of the 
m. rectus abdominis, supplies 
this muscle and a part of the 
skin coveringit, and anastomoses 
freely with the a. epigastrica supe- 
rior. Branches : 

a) Ramus pubicus (see Fig. 467) 

goes niedianward behind the 
pelvic attachment of the 
m. transversus abdominis just 
above the ramus superior 
ossis pubis and gives off the 
ramus obturatorius , which 
runs downward behind the 
lig. lacunare [Gimbernati] to 
the ramus pubicus of the 
a. obturatoria (see p. 427). 

b) A. spermatica extei-na (0. T. 

cremasteric branch) (in the 
male) (see Fig. 468), a. li- 
gamenii terciis xiteri (in the 
female), perforates the poste- 
rior wall of the inguinal 
canal, enters the spermatic 
cord or the lig. teres uteri 
and spreads out in the tunics 
of the testicle, or in the 
lig. teres and in the labia 
majora. 



Arteries of the Leg. 



435 



476. Arteries of the right 

th igh, vie wed from in front, deep layer. 

(The mm. sartorius, tensor fasciae 
latae, rectus femoris, pectineus, ad- 
ductor longus and gracilis have heen 
removed.) 

2. A. circiimflexa ilium pro- 
funda (deep circumflex ihac artery) 
(see also Figs. 463. 467 and 4(38) 
arises behind or below the lig. in- 
guinale, passes hxteralwai-d and up- 
ward in the groove between the mm. 
transversus abdominis and iliacus, 
gives oft' small branches to the neigh- 
boring muscles, as well as one larger 
branch upward between the mm. 
transversus and obliquus internus 
abdomiais (see Fig. 450) and extends 
backward along the crista iliaca ; it 
anastomoses with the r. iUacus a. 
iliohunbalis. 

A. femoral is (femoral artery) 
(see also Fig. 47.5) follows a fairly 
straight course, in the groove between 
the mm. pectineus and adductores 
on the one hand, the m. iliopsoas 
and m. vastus medialis on the other, 
downward and medianward and fin- 
ally through the canalis adductorius 
(0. T. Hunters canal). It lies upon 
the deep layer of the fascia lata and 
is covered, from the inferior angle of 
the trigonum femorale on, by the 
m. sartorius. Above, it lies lateral- 
ward fi'om the V. femoralis, further 
down, it lies in front of the same 
(see also Fig. 505). Branches : 

1) A. epigastrica superflcialis 
(superficial epigastric artery) (see 
Fig. 475) arises just below the lig. 
inguinale, perforates the margo falciformis 
and runs upward as far as the region of 
the navel; it gives off branches to tbe skin 
and to the m. obliquus externus abdominis. 

2) A.'circumflexa ilium superflcialis 
(superficial circumflex iliac artery) (see Fig. 
475), fretpiently a branch of the preceding, 
goes lateralward, usually superficially upon 
the fascia lata, to the spina iliaca anterior 
superior and supplies the skin and muscles. 

3) Aa. pudeudae exteriiae (0. T. super- 
ficial and deep external pudic arteries) (see 
Fig. 475), usually two in number, run me- 
dianward, in front of and behind the v. femo- 
ralis, to the anterior surface of the scrotum 
and penis (aa. scrotales anteriores) or of 
the labia majora (aa. labiales anteriores). 

4) Rami iuguinales (see Fig. 475) to 
the lymph glands and muscles of the fossa 
iliopectinea. 

5) Rami musculares (see Fig. 475) to 
the neighboring muscles and skin. 



A. circiim- 
flexa ilium 

profunda 

M. tensor 
fasciae latae 

M. glutaeus 

miuimus 

JI. glutaeus 

medius 

A. 

epigastrica-- 
superiicialis 

Ramus 

ascendens 



A. cireumflexa 
femoris lateralis 

A. profunda 

femoris 

M. pectineus 



A. perforans 

prima 

Ramus 

descendens 



A. perforans. 
secunda 



A. perforans 

tertia 

M. adductor 
longus 

A. femoralis - 



iliaca externa 



A. cireumflexa 

' femoris medialis 

A. obturatoria, 
ramus anterior 



Ramus super- 
flcialis 




A. genu _ 
suprema 



Ramus 

-liviisculo 

articuTaris 

Rete 
articulare genu 

Ramus 

. articularis 



Ramus _ 
saphenus 



A. genu in- _ 
ferior lateralis 

A. genu in- 
ferior medialis 



436 



Arteries of the Leg. 



Ramus superior 
M. piriformis 
A. glutaea superior i 

Superficial branch j 

M. glutaeus I 

maximus 



Ramus inferior 
I M. glutaeus 
1 , niiniiiHis 

; W. glutaeus 




A. comitans n. 
ischiacliei 

M. quadratus 
femoris 
A. circumflexa 
femoris medialis 
r. profundus 

A. perforans 
prima 

A. nutricia 
femoris superior 

A. perforans 
secunda 



A. perforans 

tertia 

A. nutricia 
femoris inferior 

M. biceps femoris 
(caput breve) 



A. poplitea 



A. genu superior 
medialis 



A. genu 

- - superior 

lateralis 



Aa. suralos - -.1 



All, 
Arteries of the right 

thigh, viewed from behind. 

(The m. glutaeus maximus has been re- 
flected inward, the mm. glutaeus medius, 
(juadratus femoris and caput longum m. 
bicipitis have been partially removed.) 

6) A. genu suprema (0. T. anasto- 
motiea magna) (see Fig. 47G) goes off in 
the canalis adductorius, perforates its an- 
terior medial wall, runs downward between 
it and the m. sartorius behind the epi- 
condylus medialis and finally accompanies 
the n. sai)henus for a variable distance 
(ramus sapheiius). It gives off rami 
ijiuscularis, as well as a ramus musculo- 
uriicuLares (0. T. deep branch) in the 
m. vastus medialis and rami articulares 
(0. T. superficial branch) below the same 
to the rete articulare genu. 

7) A. profiiuda femoris (0. T. pro- 
funda or deep femoral arteiy) (see also 
Figs. 475 and 476) arises in the fossa 
iliopectinea and descends behind the a. 
femoralis. It lies in front of the mm. 
iliopsoas, pectineus and adductor brevis, 
covered by the m. adductor longus, and 
ends as the a. perforans tertia. Branches: 

a) A. circumflexa femoris medialis (0. T. 
internal circumflex artery) goes off near 
the origin and runs medianward behind 
the a. and v. femoralis. Branches: 

aa) Ramus superficialis , in front of the 
m. pectineus, medianward between the 
mm. adductores longus and brevis. 

ab) Ramus profundus, a larger branch, 
bends upward , passes backward be- 
tween the mm. iliopsoas and pectineus 
and, below the m. obturator externus, 
to the anterior surface of the m. qua- 
dratus femoris. It sends branches to 
the hip joint and divides into a branch 
ascending to the fossa troclianterica, 
and a branch descendinj^^^hind the 
adductor muscles; it^/Siipplies the 
neighboring muscles imd skin. 

b) A. circumflexa femoris lateralis [O.T. 
external circumflex artery) lateralward 
in front of the m. iliacus. Branches : 

ba) Ramus ascendens , goes upward and 
lateralward beneath the m. rectus 
femoris to the mm. glutaei and tensor 
fasciae latae and to the fossa tro- 
chanterica. 

bb) Ramus descendens , a larger branch, 
downward and lateralward beneath the 
m. rectus femoris between the mm. vasti 
intermedius and lateralis almost to the 

knee; it also gives off' branches to the skin. 
c) A. perforans prima (0. T. superior or first 
perforating artery) perforates the adductors 
at tiie lower margin of the m. pectineus: 



Arteries of the Lea". 



437 



478. Arteries of the right leg, 

viewed from bcliiud. 

(The muscles of the thigh with the exception of the 

m. adductor magnus have been eonijiletely reraoved ; 

the mm. gastrocnemius, plantaris, soleus and flexor 

haUucis longus have been partially removed.) 

d) A. pcrforaiis secnnda (see Figs. 476 and 477) 

perforates the adductors at the lower margin 
of the m. adductor brevis; 

e) A. perforaas tertia (see Figs. 476 and 477) 

perforates them somewhat above the hiatus 

tendineus. AU three aa. perforantes supply 

the adductors and the muscles and skin 

of the posterior surface. 

The a. nutricia femoris is usually single and 

given off by the a. perforans II; more rarely it 

is double (superior and inferior) and then comes 

from the aa. perforantes I and III. 

A. poplitea (popliteal artery) (see also 
Fig. 477) runs downward, from the end of the canalis 
adductorius on, upon the planum popliteum femoris. 
upon the capsula articularis of the knee joint, upon 
the posterior surface of the m. popliteus and in front 
of the tendinous arch between the origins of the 
ra. soleus and divides just below the latter into tlie 
a. tibialis posterior and the a. tibialis anterior. In 
its course it is covered above by the m. semimembra- 
nosus; in the popliteal space, behind and somewhat 
lateralward, by the v. poplitea and (behind this) is over- 
lapped by the n. tibialis ; below, it is liidden beneath 
the mm. gastrocnemius and plantaris. Branches: 

1) A. genu superior lateralis (0. T. superior 
external articular artery) (see also Fig. 479) goes, 
above the condylus lateralis femoris, dii'ectly upon 
the bone to the rete articrilarc fiemi. 

2) A. genu superior medialis (0. T. superior 
internal articular artery), like the preceding, above 
the condylus medialis femoris. 

3) A. genu media (0. T. azygos articular artery), 
perforates the capsule above the lig. popliteum obliquum 
and goes to the ligg. cruciata and to the synovial folds. 

4) A. genu inferior lateralis (0. t. inferior ex- 
ternal articular artery) (see also Fig. 479) goes, /irectly 
upon the meniscus lateralis, to the rete articulare r/eim. 

5) A. genu inferior medialiK (0. T. inferior 
internal articular artery) (see also \Fig. 476) goes, 
below the condylus medialis tibiae, covered by the 
lig. collaterale tibiale, to the i^ete articulare (jenu. 

6) Aa. surales, several, sometimes from one 
trunk, to the m. triceps surae and to the skin. 

A. tibialis posterior (posterior tibial artery) 
extends downward and medianward upon the posterior 
surface of the m. tibialis posteriin-, covered above by the 
m. triceps surae only, below by the m. flexor hallucis 
longus also. Below, it runs between the tendons of 
the mm. flexor digitorum longus and flexor hallucis 
longus upon the deep layer of the fascia cruris and 
of the lig. laciniatum, curved forward, and divides 
between the malleolus medialis and the tuber calcanei 
into the aa. plantares medialis and lateralis. It 
gives off branches to the muscles and to the skin 
and, in addition, the following : 



a 



A. poplitea 



A. genu superior 
lateralis 
A. gent I superior 
medialis 

Aa. surales 



A. genu media - - i. 

A. genu inferior \ 
lateralis ^ 

A. genu inferior 
medialis 

M. popliteus 

A. recurrens 
tibialis posterior 

A. tibialis 
anterior 

Ramus iibularis 

A. tibialis 
posterior 

A. nutricia tibiae 



M. soleus 



^fi 



A. peronaea 

A. nutricia 
fibulae 



A. tibialis 
posterior 

il. flexor 
hallucis longus 

M. tibialis . . 
posterior 

M. flexor 
digitorum longus 



Ramus perforans 



V 



A. malleolaris 
posterior lateralis 

A. malleolaris 
posterior medialis 

Ramus 
communicans 
Ramus calcaneus 
medialis 
R. calcaneus 
lateralis 



:_i. 



f" 



Rete calcaneum 



-^^- 



438 



Arteries of the Leg. 



479. Arteries of the right leg, viewed from in front. 

extensor hallucis longus have been partially removed.) 



(The mm. tibiahs anterior and 
A. genu superior medialis 



A. genu supe- 
rior lateralis 

Eete articulare 
genu 

Rete patellae 

A. genu inferior 
lateralis 



A. genu inferior 
medialis 



A. recurrens 
tibialis 
anterior 



A. tibialis 
anterior 

M. tibialis 
anterior 



M. extensor 
hallucis 
longus 

M. extensor 

digitorum 

longus 



M. extensor 
hallucis longus 

Eanius perforans 
a. peronaeae 



A. dorsalis pedis 







1) Ramus fibularis (see Fig. 478) extends lateral- 
ward toward the colhmi fibulae to the mm. soleus 
and peronaeus longus. 

2) A. peronaea (peroneal artery) (see Fig. 478) 
arises just below the coUum fibulae and runs down- 
ward on the posterior surface of the ra. tibialis poste- 
rior, between it and the m. flexor hallucis longus, 
near the fibula ; below, it lies upon the posterior sur- 
face of the tibia or the membrana interossea cruris and 
breaks up behind the ankle joint into the ?-ami cal- 
canti laterales (0. T. external calcaneal arteries) 
which go to the rete calcaneum and its neighborhood. 
Numerous branches to the muscles, and further: 

a) A. nutricia fibulae (see Fig. 478) into the canalis 

nutricius fibulae. 

b) Ramus perforans (0. T. anterior peroneal artery) 

(see also Figs. 478 and 480) perforates the mem- 
brana interossea just above the syndesmosis 
tibiofibularis , unites with the a. malleolaris 
anterior lateralis and helps to form the rete 
maUeolure laterale and the rete calcaneum. 

c) A. malleolaris "posterior lateralis (see Fig. 478), 

directly ^ upon the fibula, to the rete malleo- 
lar e laterale. 

d) Ramus commtmicans (see Fig. 478), upon the 

posterior surface of the tibia, just above the 
ankle joint, to the a. tibialis posterior. 

3) A. nutricia tibiae (see Fig. 478) into the 
canalis nutricius tibiae. 

4) A. malleolaris posterior medialis (0. T. 
internal malleolar branch) (see Fig. 478), directly upon 
the tibia to the rete malleolare mediate. 

5) Rami caleauei mediales (0. T. internal 
calcaneal branches) (see Figs. 478 and 481) form, 
with the rami calcanei laterales, the I'ete calcaneum, 
which is situated superficially upon the tuber calcanei, 
as well as upon the surrounding muscles and tendons. 

A. tibialis anterior (anterior tibial artery) 
goes forward above the membrana interossea cruris and 
directly downward upon its anterior surface. Above, 
it lies between the m. tibialis anterior and the m. ex- 
tensor digitorum longus; below, between the former 
muscle and the m. extensor hallucis longus. Farther 
down, it is situated upon the anterior surface of the 
tibia and of the capsule of the upper joint of the ankle, as 
well as behind the m. extensor hallucis longus and be- 
hind the deep layer of the lig. cruciatum and there be- 
comes continuous with the a. dorsalis pedis. It gives ofF 
numerous branches to the muscles and skin, and further: 

1) A. recurrens tibialis posterior (posterior 
tibial recurrent artery) (see Fig. 478) which comes oif at 
the beginning of the artery, extends, behind the fibula, 
to the articulatio tibiofibularis. It is often absent. 

2) A. recurrens tibialis anterior (anterior 
tibial recurrent artery) upward, upon the anterior sur- 
face of the condylus" lateralis tibiae, to the rete arti- 
culare genu, which is spread out partly upon the 
bones and ligaments of the knee joint, partly upon the 
tendon of the m. quadriceps femoris, upon the lig. 
patellae and upon the patella itself (rete patellae). 



Arteries of the Foot. 



439 



480. Arteries of the back of the right foot. 



il. tibialis 
anterior 



A. tibialis 
anterior 

Kara us 

perforans a. 

peronaeae 

A. malleolaris 
anterior 
lateralis 



3. A. malleolaris anterior lateralis 

(0. T. external malleolar artery) to the 
malleolis lateralis, unites with the ramus 
perforans of the a. peronaea and helps to 
form the rete malleolare laterale upon 
the lateral malleuliis and its neighhorhood. 

4. A. malleolaris anterior medialis 
(0. T. internal malleolar artery) goes to 
the malleolus medialis and helps to form 
the 7'ete malleolare mediale, situated there. 

A. dorsalis pedis (see also Fig. 
469) extends forward, upon the ligaments 
and bones of the back of the foot, between 
the mm. extensor hallueis longus and ex- 
tensor hallucis brevis and breaks up between 
the proximal ends of the ossa metatarsalia 
I and II into the ramus plantaris profundus 
and the a. metatarsea dorsalis I. Branches : 

1. Aa. tarseae mediales (0. T. in- 
ternal tarsal artery), 23, rim upon the 
bones and ligaments to the medial 
border of the foot and help to form 
the rete malleolare mediale. 

2. A. tarsea lateralis (0. T. 
external tarsal artery) lateral- 
ward and forward upon the 
bones and ligaments, covered by 
the m. extensor digitorum brevis, 
toward the basis ossis metatar- 
salis V, unites there with the 
lateral end of the a. arcuata. 
Branches which anastomose with 
one another and, with branches 
of the a. dorsalis pedis and a. ar- 
cuata, form the rete dorsale pedis. 

3. A. arcuata (0. T. meta- 
tarsal arter}") lateralward directly 
upon the proximal ends of the 
ossa metatarsalia unites with the 
a. tarsea lateralis. Branches: 

a) Aa. metatarseae dorsales 11 
to IV [0. T. tarsal interosseous 
arteries) nm forward upon the 
2nd 4th m interosseus dor- 
salis and each divides into two 
aa. digitales dorsales (dorsal 
digital arteries) behaving just 
as do the arteries to the fingers. 
Larger rami perforantes pos- 
terior es and smaller, incon- 
stant anteriores between the 
bases (or between the heads) 
of the ossa metatarsalia, to go 
to the aa. metatarseae plantares. 

4. Ramus plautaris pro- 
fiiudus (0. T. communicating, first inter- 
osseus perforating or plantar artery) between 
the proximal ends of the ossa metatarsalia I 
and II, into the sole of the foot, to the arcus plantaris. 

5. A. metatarsea dorsalis I goes forward like 
the other aa. metatarseae dorsales and supplies the great 
toe and the medial surface of the 2nd toe. 



Eete 

malleolare 

laterale 



M. peronaeus 
brevis 



A. tarsea lateralis 

M. extensor 
digitorum ~" 
brevis 
(cut through) 

Eete dorsale 
pedis 



Rami 
perforautes 
posteriores 

Aa. 

metatarseae 

dorsales 

II IV 



Rami 
perforantes ^~ ^- 
anteriores 



Aa. digitales^. 
dorsales 




Rete 
malleolare 
mediale 
A. malleolaris 
- anterior 
medialis 



A. dorsalis 
pedis 



Aa. tarseae 
mediales 



A. arcuata 

Ramus 
plantaris 
profundus 



A. metatarse 
dorsalis I 



Ramus 

perforans 

anterior 



440 



Arteries of the Foot. 



481. Arteries of the sole of the right foot. 



(The muscles have, fu 



Rete calcaneuin 



Rami calcanei 
luediales 



A. tibialis 
posterior 

A . plantaris _ _ __,_ 
medialis 

M. quadratus _ 
plantae 



Ramus 
superflcialis 



A. plantaris 
lateralis 



Ramus 
profundus 



M. adductor 
hallucis 



Arcus _ 
plantaris 

Ramus plantaris 

profundus a. dor- - 

salis pedis 

Aa. 
metatarseae 
plantares ^r^^ 
I IV 



Rami 
perforantes 
antcriores 



- \ 



Aa. digitales,^^ 
plantares 




r the most part, been removed.) 

A. pliiutaris medialis (0. T. interaal 

phantar artery) goes forward , between the two 
Uiyers of the hg. hiciniatura (through its upper 
compartment, see p. 361), and there gives ofl' the 
/(Wins superftcialif! , which passes through the 
m. abductor halhicis, giving off branches to 
it, arrives at the medial margin of the foot 
and runs as far as the great toe. It then 
enters the groove between the mm. abductor 
hallucis and flexor digitorum brevis (ramus 
J IT fundus), supplies these muscles and the 
skin and goes, between the two bellies of the 
m. flexor hallucis brevis, into the a. meta- 
tarsea plantaris 1 or into the medial a. di- 
gitalis plantaris of the great toe. 

A. plantaris lateralis (0. T. 

external jilautar artery) runs, between the 
two layers of the lig. laciniatum (through 
its lower compartment see p. 361), then 
between the mm. flexor digitorum brevis 
anil ((uadratus plantae, forward and la- 
teralward towards the basis ossis 
metatarsalis V; there it lies more 
superficially, between the mm. qua- 
dratus plantae and flexor digiti V 
and bends around medianward into 
the arcus plantaris. It gives off 
branches to the neighboring bones, 
ligaments, muscles and skin. 

The arcus plantaris lies di- 
rectly beneath the proximal ends 
of the 2"<i to the 4<li metacarpal 
bone and beneath the mm. inter- 
ossei, between them and the caput 
obliquum of the m. adductor hal- 
lucis, being more superficial lateral- 
ward than medianward. It dimi- 
nishes in calibre from the lateral 
toward the medial margin of the 
foot, arises, lateralward, directly 
from the a. plantaris lateralis and 
unites medianward, between the 
ossa metatarsalia I and II, with 
the ramus plantaris profundus of 
the a. dorsahs pedis. It gives off 
riH'urrent branches ti> the bones 
and muscles; running forward from 
it are the 4 aa. metatarseae plan- 
tares (0. T. digital or plantar di- 
gital arteries). Each of these passes 
forward between two metacarpal 
bones, receives the rami perforantes 
of the aa. metatarseae dorsales and divides 
at the bases of the first phalanges into the 
aa. diffitales plantares (0. T. collateral 
digital arteries), which behave just as do 
thnse to the fingers. The artery for the 
uieilial margin of the grt>at toe is usually given off 
by the a. metatarsea plantaris I ; that for the lateral 
margin of the little toe arises usually as a separate 
arterv from the end of the a. plantaris lateralis. 



Veins of the Head. 



441 



Sinus cavernosus 



A. carotis interna 



Hypo- 
physis 

Sinus 

inter- 

cavernosus 

posterior 



Corpus ossis 
splienoidalis 

Sinus 
splienoidalis 
(cut through) 




N. oculo- 
motorius 

N. 
trochlearis 

N. 
abducens 

N. oph- 
~ thalmicus 

N. maxil- 
laris 



482. Frontal section through the right sinus 

cavernosus, viewed from behind. Magnification 5:2. 

The sillUS dlirae lliatris (sinuses of the dura mater) are venous canals which run, 
chiefly, between the separated hiyers of the dura mater and lie at the same time in corresponding 
hony grooves. They stand open on section and are devoid of valves ; the sinus sagittalis superior 
and cavernosus are crossed in a network-like manner by bands of connective tissue. They receive 
the vv. cerebri, meningeae, diploicae (partially), mulitivae internae and the vv. ophihalmicae . 

1. Sinus trausrersus (0. T. lateral sinus) (see Figs. 483 and 484), paired, collects 
most of the blood from the skull cavity. It begins on each side at the protuberantia occipitalis 
interna, communicating with that of the other side by an opening of variable size ; it is usually 
larger on the right than on the left side and runs curved lateralward in the sulcus transversus 
of the occipital bone and of the parietal bone, in the attached margin of the tentorium cere- 
belU. Thence, it goes tortuous medianward and downward, in the sulcus sigmoideus of the 
temporal bone and in the sulcus transversus of the pars lateralis oss. occiptalis, to the foramen 
jugulare to become continuous there with the upper end of the v. jngularis interna. In the 
region of the tentorium cerebelli it is triangular-prismatic in shape, elsewhere semi-cylmdrical. 

2. Sinus sagittalis superior (0. T. superior longitudinal sinus) (see Figs. 483 and 484), 
unpaired, extends from before backward, in a curve, in tht> attached margin of the falx cerebri 
near the crista frontahs and in the sulcus sagittalis of the frontal bone, of the parietal bones 
and of the occipital bone and opens into the sinus transversus (usually into the xight). It is 
triangular in transverse section. The sinus anastomoses with the following. 

3. Sinus sag'ittalis inferior (0. T. inferior longitudinal sinus) (see Figs. 483 and 484), 
unpaired, from before backward in the free margin of the falx cerebri into the sinus rectus. 

4. Sinus rectus (straight sinus) (see Figs. 483 and 484), unpaired, goes as a triangular 
canal, at the point of attachment of the falx cerebri to the tentorium cerebelli, ffom in front 
and above, backward and downward and opens into the sinus transversus (usually into the left). 

'5. Sinus occipitalis (see Figs. 483 and 484), unpaired or paired, begins at the pro- 
tuberantia occipitalis interna and goes downward, close to the median plane, in the attached 
margin of the feLx cerebelli. Above, it begms at the spot where the sinus transversi, the sinus 
sagittalis superior and the sinus rectus meet (confluens simmrn). Below, it bifurcates, turns 
lateralward and forward on both sides above the foramen occipitale magmmi and enters the 
sinus transversus, close to the foramen jugulare. It anastomoses with the plexus venosi verte- 
brales interni and varies much in the degree of its development. 

6. Sinus cavernosus (see also Figs. 442, 483 and 484), paired, is an irregular space, 
which is situated, on each side, near the sella turcica and the corpus oss. sphenoidalis. It is 
bounded above and lateralward by that part of the dura mater which is stretched out between 
the proc. clinoidens anterior and the dorsum sellae and the apex of the pyramis oss. ternporalis 
and goes over into the tentorium cerebelli; it surrounds, in addition, the a. carotis interna, 
the n. abducens and the plexus caroticus internus. Tributaries: 



442 



Veins of the Head. 



V. ethmoidalis posterior 
N. opticus. 



,V. ethmoidalis anterior 



Sinus 

intercavernosus 

anterior 



V. nasofrontalis 



vorticosa 



Sinus 
cavernosus 



Sinus 
inter- 
cavernosus 
posterior 



V. lacriinalis 

V. ophthalmica superior 
A. carotis interna 



Sinus 
plienoparietalis 

N. 
octilomotorius 

N. 
trochlearis 

N. 
' raaxillaris 




Vv. 

meningeae 

mediae 



Plexus 
basilaris 



v. cerebri 



Tentorium cerebelli 

Sinus trausversus 

Sinus rectus' 



Sinus 
^ petrosus 
superior 

Sinus 
transversus 



Sinus petrosus inferior 
Sinus transversus 
Sinus occipitalis 



483. Sinus durae matris, viewed from above. 

(The right orbit and sums cavernosus have been opened; the tentorium has been cut away.) 

a) V. ophthalmica superior (superior ophthahnic vein) (see also Fig. 4S8), devoid of valves, 
corresponds only ajipruxiniately to the a. ophthalmica, wbit-h possesses, in addition; two 
delicate accoinjtanying veins. It anastomoses lively above the lig. palpebrale mediale by 
its anterior extremity (v. nasofrontalis) (see Figs. 487 and 488) with the v. angularis 
(of the V. facialis anterior), runs l)aclvward near the m. obliquus superior, then lateral- 
ward l)etween the n. opticus and the m. rectus sujierior, finally backward through the 
fissura orbitalis superior into the sinus cavernosus. Medianward, it sends an anastomosis 
to the V. ophthalmica inferior. It receives the vv. ethnioidales anterior et posterior, 
V. lacrimalis, vv. musciilares and the veins of the bulbus oculi and of the eyelids (see 
Sense Organs; the v. centralis retinae op^ns into the sinus cavernosus). 






Veins of the Head. 



443 



Vv. meningeae f 
Siuus sagittalis superior ^ 



,'Vv. menirgeae mediae 



Sinus sagittalis inferior^ 



Falx cerebri 



V. etbmoidalis 
posterior 



V. cerebri magna 
[GaleniJ 

I Sinus rectus 



V. 

etbmoidalis 
anterior 



'/V 



h 







bmus 
trans versus 



Brauclies 

of tbe V. spheno 

palatina 



Plexus 
basilaris Sinus' 

petrosus inferior 



Sinus 
occipitalis 



Plexus venosi 
vcrtebrales interni 



484. Sinus durae mat r is of the right half of the skull, 

viewed from the left. 

b) V. ophthahnica inferior (see Fig. 488), devoid of valves, arises from the veins of the 

tear-sac, of the eyehds, &c., in the anterior part of the orbit, between the medial and 
inferior wall : it runs in the inferior part of the orbit and divides into two branches. 
One branch goes backward through the fissura orbitahs superior into the sinus caver- 
nosus ; the other passes lateralward through the fissura orbitalis inferior and opens into 
the ramus profimdus of the v. facialis anterior. It receives vv. musculares and veins 
of the bulbus oculi and anastomoses medianward with the v. ophthahnica superior. 

c) Sinus sphmoparictalis (see Fig. 483), paired, begins on each side a little behind the 

sutura coronalis on the parietal bone in a bonv groove or in a bony canal, turns 

medianward beneath the ala parva ossis sphenoidalis and enters the anterior end of the 

sinus cavemosus. It receives usually one v. meningea media, vv. cerebri inferiores 

(from the fissura cerebri lateralis [Sylvii]), as weU as the v. ophthalmomeniufjea, and 

often, also, the v. dijdoica temporalis anterior. 

7. and 8. Siuus iutercavernosus anterior and siuus intereaveruosus posterior 

(see Fig. 483), unpaired, run in front of, behind and partly also beneath thi| hypophysis and 

unite the two sinus transversi Avith each other. They form, with these, the siuus circularis. 

9. Siuus petrosus superior (superior petrosal sinus) (see Fig. 483), paired ,^ goes 

lateralward and backward on each side, from the posterior part of the sinus cavernosus in the 

sulcus petrosus superior of the temporal bone and in the attached margin of the tentorium 

cerebeUi, to the sulcus sigmoideus and into the sinus transversus. 



444 



Veins of the Head. 



Emissariuni 
parietale 



v. diploica temporalis anterior 



V. diploica 
frontalis 



V. diploica 
occipitalis 

I 




Emissarium 
occipitale 

V. diploica temporalis i Emissarium 
posterior mastoideum 



485. Venae diploicae, viewed from the right. 
(The lamina externa of the roof of the skull has been filed off.) 

10. Sinus petrosHS inferior (inferior petrosal sinus) (see Figs. 483 and -484), paired, 
extends lateralward and downward on each side from the posterior, inferior portion of the sinus 
caveniosus in the sulcus petrosus inferior of the occipital and temporal bones to the foramen 
jugulare and runs downward through its most anterior subdivision; it opens, either in the 
foramen jugulare ov l)elow it, into the bulbus v. jugularis superior. 

li. Plexus basilaris (see Figs. 483 and 484), unpaired, lies as a plexus upon the 
clivus and is connected above, on both sides, with the sinus cavernosus and the sinus petrosus 
inferior, below, at the foramen occipitale magnuui, witli the plexus venosi vertebrales interni. 

Yv. cerebri collect the blood partly from the surface, partly irom the ijiterior of the 
brain and open into sinus durae matris (see Neurology); they possess no valves. 

Vv. nieningeae (see Figs. 483 and 484), stand open, are devoid of valves, are numerous 
in the dura mater encephali, are connecttxl above with the sinus sagittalis superior and anasto- 
mose manifoldly with one another. They accompany the stems of the corresponding arteries, 
there being usually two veins to one artery, and open into a neighboring sinus. The vv. 
mcningeae mediae, usually two in number, run near t\w a. meningea media, are connected with 
the sinus splienoparietalis and the reto foramiuis ovalis, extend downward through the foramen 
spinosum and open into the plexus pterygoideus. 

Vv. auditivae intcrnae (not illustrated) come fi-om the internal ear through the meatus 
acusticus internus and open into the sinus transversus or the sinus petrosus inferior. 



Veins of the Head and Neck. 445 

Yeiiae diploioae (see Fig. 485) are thin-walled tubes, which lie in the fiat canales 
diploid [Brescheti] in the substance of the bones of the roof of the skuU. They have no 
valves ; they are arranged in the form of a network and are very variable. The main stems run 
from above downward and are connected at their extremities by openings (emissaria) with the 
external veins of the skull or with the sinus durae matris or (usually) with both at tlie same time. 

1) V. diploica frontalis opens into the v. supraorbitalis and the sinus sagittalis superior. 

2) V . diploica temjioralis anterior mio a v. temporalis profunda and the sinus sphonoparietahs. 

3) V. dijiloica temporalis posterior (0. T. external parietal or posterior temporal diploic 

vein) extends from the emissarium parietale to the emissarium mastoideimi. 

4) V. diploica occipitalis opens into the emissarium occipitale. 

Emissarium jmrietale, in the foramen parietale, unites the sinus sagittalis superior with 
the superficial veins of the skull; its valves permit a flow in an outward direction only. 

Emissarium. masioidevm, in the foramen raastoideum, unites the sinus transversus with 
the V. auricularis posterior or with the v. occipitalis or with the beginning of the v. jugularis externa. 

Emissarium occipitale, at the level of the protuberantiae occipitales, opens usually either 
internally into a sinus transversus or into the confluens sinuimi or externally into the v. oc- 
cipitalis, often into both. 

Emissarium condyloideum (not illustrated), in the canalis condyloideus, unites the sinus 
transversus and the plexus venosi vertebrales externi. 

Plexus Yeuosus caroticiis internus (see Fig. 442) surrounds the a. carotis interna 
in the canalis caroticus in the form of a network, is connected above with the sinus caveniosus, 
receives veins from the cavum tympani and opens below into the v. jugularis interna. 

Rete foramiuis ovalis (not illustrated) in the foramen ovale from the sinus cavemosus 
to the plexus pterygoideus : it is often connected above with the vv. raeningeae mediae. 

"Rete canalis hypoglossi (not illustrated) in the canalis hypogiossi from the sinus 
occipitalis and from the plexus venosi vertebrales intemi to the sinus petrosus inferior. 

Yena cava superior (see Figs. 411, 427, 486 and 495), impaired, free from valves, 
arises behind the first right costal cartilage by the union of the YV. auonymae dextra et 
sinistra and extends downward, and curved moderately convex toward the right, in fi-ont 
of the root of the right lung and of the right side of the aorta ascendens, to the right atrium. 
It is bounded in front by the thymus and on the right by the right lung; it is covered above 
on its right side by the pleura mediastinalis, below by the visceral layer of the pericardium. In 
the upper part of its course the v. azygos (see p. 456) opens into it from behind. 

y. ailOliyma (0. T. innominate vein) (see also Figs. 427, 486 and 495) is formed 
behind the articulatio sternoclavicularis and in front of the a. subclavia by the union of the 
V. jugularis interna, v. subclavia and y. jugularis externa 5 the latter opens usually 
into the v. subclavia. The right vein is bounded on the right by the right lung and runs 
vertically downward ; the left, distinctly longer, extends to the right and downward, behind the 
manubrium sterni and the thymus, directly over the arcus aortae, in front of the aa. subclavia 
sinistra, carotis communis sinistra and anonyma. Both veins are devoid of valves. Branches : 

\. Vy. thyreoideae inferiores (inferior thyreoid veins) (see Fig. 486) from the plexus 
thyreoideus impar. This lies partly in front of the lower margin of the isthmus glandulae 
thyreoideae, in part it surrounds the beginning of the trachea like a ring ; it anastomoses with 
the vv. thyreoideae superiores of both sides and receives, behind, the vv. tracheales, the 
vv. oesophageae and the v. laryngea inferior (corresponding to the arteries of the same names). 
Three veins usually go off from the plexus: a right vein opens at the angle of junction of the 
w. anonymae or into the v. anonyma dextra or into the v. jugularis interna dextra, a left vein 
into the V. anonj-ma sinistra and a v. thyreoidea ima, running downward in front of the 
trachea, into tlie v. anonyma sinistra. 

2. V. mammaria interna (internal mammary vein) (see Figs. 313 and 486) con-esponds 
almost exactly to the artery of the same name. Arismg from the union of the 2 vv. epi- 
gastricae stiperiores (rich in valves) and the vv. mtisculophrenicae it is double in the region 
of the m. transversus thoracis; above the latter it is single and situated medial from the artery. 
It receives (with the vv. musculophrenicae) the anterior extremities of the 9 ( 10) superior 
vv. intei-costalcs (see p. 455), which have valves at their mouths, further the rami perforantes, 
which have valves (especially marked in the l^t or 2nd intercostal space), as well as rami 
sternales from the networks which are situated upon both surfaces of the sternum, and in 
which there are several large transverse connections between the trunks of the two sides, 
sometimes especially one such on the anterior surface of the processus xiphoideus. 

3. Yv. phrenicae superiores (not illustrated), possess valves, are double, and con-e- 
spond to the a. pericardiacophrenica. 

4. Yy. thymicae, pericardiaeae, niediastinales anteriores, bronchiales anteriores 
(not illustrated) from the viscera of the thorax, open separately or partially in cummon. 

Spalteholz, Atlas. 29 



446 Veins of the Head and Neck. 

5. V. Tertebralis (see Fig. 488) coiTesponds to the cervical part of the a. vertebralis, 
on the latei-al side of which it extends downward from the foramen magnum tbrough the foramina 
transversaria of the.l^t Q^^ (often 7'^) cervical vertebra. It begins in the plexus venosi 
vertebrales, anastomoses with the v. occipitalis and receives branches from the spinal canal, 
from the deep muscles of the neck and from the plexus vertebrales externi. It stands open 
and has valves at its mouth. Branch: 

a) V. cervicalis profunda (see Fig. 486) coiTesponds approximately to the a. ceryicalis pro- 
funda, begins near the back of the head in the plexus vertebralis posterior and runs down- 
ward behind or in front of the m. semi spinalis cervicis ; it goes forward beneath the proc. 
transversus of the T^b cervical vertebra into the v. vertebralis. There are valves at its mouth. 
Y. jugularis interna (internal jugular vein) (see also Fig. 489) corresponds together 
with the V. jugidaris externa to 'the a. carotis communis. It arises as the direct continuation 
of the sinus transversus in the lateral compartment of the foramen jugulare with a swelling, 
the bulbus v. jugulai'is superior, above runs doT^-nward behind the a. carotis interna on the 
lateral wall of the pharynx, becomes displaced gradually to the lateral side first of the a. carotis 
interna, then of the a. carotis communis and extends downward, close to the latter, to the 
V. anonyma. A little above its termination it presents a spindle-shaped dilatation, the bulbus 
IK jugularis inferior, which is closed above by a single or double valve. Otherwise it is 
devoid of valves. Branches: 

1. Sinus durae matris see pp. 441444. 

2. V. canaliculi cochleae (not illustrated) comes from the cochlea (see Organ of 
Hearing) through the canaliculus cochleae and opens into the bulbus v. jugidaris superior. 

3. Yv. pharyngeae vary in number and come at different levels from the plextis ])ha- 
ryngeus which covers the outer surface of the pharynx and receives branches from the deep 
muscles of the pharvTix, fi-om the tuba auditiva, the palate and the dura mater (o. meningea, 
corresponding to the a. meningea posterior), as well as the v. canalis pterygoidei [ Vidii] (from 
the canalis pterv'goideus) ; it is connected with the neighboring veins. The inferior vv. pharyngeae 
may open also into other branches of the v. jugularis interna. They are all devoid of valves. 

4. V. liugiialis (lingual vein) (see also Fig. 489) runs backward at first exactly as does 
the a. lingualis, later, however, on the lateral surface of the m. hyoglossus; it receives a 
large v. sublingualis and the vv. dorsales linguae. The a. Ungualis is accompanied medial 
from the m. hyoglossus by small veins, which together with the v. comitans n. hypoglossi 
open into the v. lingualis. All branches of the lingual vein possess valves ; the vein communi- 
cates with the vv. pharyngeae and the v. thyi-eoidea superior; it opens sometunes into a v. facialis. 

5. y V. thyreoideae superiores (superior thvTeoid veins) (see also Fig. 489), usually two, ac- 
companying the artery only in part; one opens far below, the other above, in the neighborhood of the 
a. thyreoidea superior. The latter 'receives a v. siernocleidomastoidea and the v. laryngea superior 
(corresponding to the a. laryngea superior), which may also open into the v. facialis comnumis, 
and frequently the whole vein opens into the v. facialis communis. These veins possess valves. 

6. V. facialis communis (see also Figs. 488 and 489) arises beneath the angle of the 
lower jaw, from the vo. faciales anterior and posterior, which may also open separately into 
the V. jugularis interna. It nms.- downward and backward, covered only by the platysma, crosses 
the a. carotis externa and terminates at the level of the hyoid bone. It has no valves. Branches: 

a) V. facialis antei-ior (see also Figs. 487 489) corresponds in its course to that of the 
a. raaxillaris externa, which itself possesses in addition two small accompanying veins ; 
it is a little tortuous and runs usually behind the artery and in part more superficially, 
covered only by the m. zygomaticus and platysma, from the root of the nose to the 
angle of the lower jaw. It arises superficially at the medial angle of the eye as the 
V. angularis, formed by the vv. frontalis (usually unpaired, and then very frequently 
opening into the left v. angularis), supraoi'bitalis (runs transversely median ward partly 
beneath the m. orbicularis oculi over the margo supraorbitalis, anastomoses with the 
vv. temporales superticialis and media) and nasofrontalis (see p. 442) ; in front of the 
root of the. nose it forms a broad union with the vein of the other side. Above, 
it receives further: the vv. palpebrales superiores, nasales externae, palpebrales in- 
feriores and labialis superior, besides the ravnis profundus ; this is formed in the 
fossa infratemporalis by the vv. alveolares superiores (corresponding to the arteries 
of the same name) and by branches of tho plexus pterygoideus, and receives one branch 
of the V. ophthalmica inferior; it runs forward upon the facies infratemporalis maxillae 
and terminates below the arcus zygomaticus. Farther down enter the v. labialis in- 
ferior, vv. massetericac and vv. parotideae anteriores. Beneath the lower jaw it 
receives further the large v. submentalis, which is connected with the v. sublingualis 
and V. jugularis anterior as well as one v. palatina, which corresponds to the a. 
palatina ascendens. All the branches of the vein possess efficient valves at their mouths ; 
the main trunk also contains such valves at the level of the ductus parotideus. 



Veins of the Head and Neck. 



447 




V. transversa colli 

V. iugu- 
laris anterior 



Y. trans- 
versa 
scapulae 



V. 

subclavia 



A. axillaris 

V. axillaris 



V, ca.'fa, superior 
V. anonyma dextra 



Y. anonyma sinistra 
mammaria interna dextra 



486. Deep veins of the neck, viewed from the right. 



(The muscles of the neck and face have been in hirge part 

have been partially removed.) 



removed: the bones of the face 
29* 



448 



Veins of the Head. 



V. temporalis 
^luperficialis 



Anastomosis with 

,the V. temporalis 

media 



- v. frontalis 

-..V. supra- 
orbitalis 

V. nasofroiitalis 
V. angularis 

Vv. nasales 
externae 




V. 

auricularis - 

posterior 

Emissarium 

mastoideum 



Vv. aurieulares - 
anteriores 
V. parotidea 



V. transversa faciei 

V. occipitalis 

M. sternocleido- 
mastoideus 

M. trapezius. 
Glandula paroti 



V. jiigularis..,_-ij 
externa ^ 



B. profundus 

Ductus 
parotideus 

V. labialis 

superior 
V. facialis 

anterior 

v. labialis 
inferior 

A. maxillaris 
externa 



I 



V. parotidea anterior \ 
V. facialis communis! 



V. submentalis 
V. masseterica 



487. Superficial veins of the face, viewed from the right. 

(With partial use ol' a preparation by W. Braune.) 
(Below the zygoma, tlie subcutaneous fat and a part of the muscles have been removed.) 
b) V. facialis posterioi- (see also Figs. 486 and 488) arises superficially in front of tlie ear 
through the union of the vv. temporales, runs downward in the substance of the glandula * 
parotis behind the ramus mandibulae and lateral from the carotis externa and bends 
obliquely forward below the angulus mandibulae, over or under the m. digastricus, to 
the V. facialis conumuiis. It gives off a large branch at a variable level to the v. jugu- 
laris externa. It receives : 

ba) V. temporalis super ficialis, from the superficial plexus of the roof of the skull, runs 
downward beliiud the trunk of the artery. It possesses a valve in front of the ear. 

bb) V. temporalis media runs transversely backward, deviating from the artery, in the 
m. temporalis, anastomoses at the lateral angle of the eye with the superficial veins, 
in the muscle with the vv. temporales profundae and perforates the fascia temporalis 
over the root of the zygoma. It possesses valves. 

be) Vv. aurieulares anteriores, from the lateral surface of the external ear. 
bd) Vv. parotideae posteriores, from the glandula parotis. 



Veins of the Head. 



449 



Plexus pterygoideus Vv. temporales profundae 
Vv. articulares mandibulaei i '. 



V. temporalis media 
V. temporalis siiperficialis 
Vv. auriculares anteriores 



M. temporalis 




/V. ophthalmica superior 



V. nasofrontalis 



- V. angularis 



v. ophthal- 
mica inferior 



V. 

alveolaris 
inferior 

Plexus 
vertebralis - 
posterior 

y. vertebralis 



M. 

semispinalis 
capitis 



V. alveolaris 
superior 

R.inius 
profundus 



V. jugularis externa 

V. jugularis interna 



W. facialis anterior 
V. facialis communis 
V. facialis posterior 



488. Deep veins of the face, viewed from the right. 
(The bones and muscles have been removed as in Fig. 438.) 

be) Vv. articulares mandibulae , from a plexus surrounding the joint of the jaw, which 

also receives the vv. Ujmpanicae (not illustrated) (through the fissura petrotympanica 
[Glaseri] from the middle ear) and veins from the external auditory passage and 
drum membrane and is connected with the plexus pterygoideus. 

bf) V. stijlomastoidea (not illustrated), corresponding to the artery of the same name, 

anastomoses at the hiatus canalis facialis with the vv. meningeae mediae. 

bg) V. transversa faciei (transverse facial vein), frequently double, corresponds to the 

artery of the same name, 
bh) Plexus jfi^i'yQoideus extends from the fossa pterygopalatina as far as the coUura 
mandibulae and lies, with wider vessels, on both sides of the m. pteiygoideus externus, 
with narrower vessels, also on the medial surface of the m. pterygoideus internus and 
on the membranous waU of the tuba auditiva ; it forms a sheath for the a. maxiUaris 
interna. It receives: the v. sphenopalatina (from the nasal cavity through the 
foramen sphenopalatinum), the vv. meniufjeae mediae (see p. 444), the vv. temporales 
profundae (from the m. temporaUs, in which it forms a plexus with branches of the 
v. temporahs media), the vv. massetericae , v. alveolaris inferior (the latter two 
corresponding to the arteries of the same names) and the rete foramiais ovalis (see 
p. 445). It anastomoses with the vv. articulares mandibulae and with the plexus 
phar}Tigeus and empties in part through the ramus profundus v. facialis anterioris, 
especially however through two valve-bearing vessels, which accompany the a. maxil- 
laris interna, into the v. facialis posterior. 



450 



Veins of the Nect. 



Anastomosis with the v. sublingualis 
V. submentalis 
v. comitans n. \ 

hypoglossi 

V. lingualis 
V. palatina 
V. facialis 
anterior 

M. steruocleido- 
masto ideas 

V. j ugularis i 

externa 



Vv. thyreoideae 
superiores 

Ramus deseenden.' 
n. liypoglossi 



M. digastricus (venter anterior) 
M. mvlohvoideus 



- -V. facialis 
anterior 

V. facialis 
posterior 



V. facialis 
communis 




_M. omohyoideus 
M. sternohyoideus 



V. jugularis 
externa 



V. jugularis anterior 
V. jugularis externa 

V. subclavia 



M. slernocleido- 
mastoideus 
.Arcus venosus 
juguli 
V. transversa 
I colli 



V. axillaris 

V. cephalica 



489. Veins of the neck, viewed from in front. 
(On the right the m. sternocleidomastoideus, on the left the m. pectoraUs major, has been removed.) 
V. jUjETUlaris externa (external jug-ular vein) (see also Figs. 486488) arises below 
the ear by two roots: the antiiU2' ft'cqnently the larger, comes from the v. facialis posterior 
(see p. 448), the posterior arises behind the ear. It crosses the m. sternocleidomastoideus 
obliquely, covered by the platysma, goes into the depth and opens usually into the v. subclavia, 
generally with the v. juiru laris ant^ 'rior. Valves at its mouth and in its middle. Branches: 

1. V. occipitalis corresponds to the artery. It opens partly into the preceding vein, 
partly doubled, accompanies the arteiy to the v. jugularis interna; it anastomoses with the 
})le.\us vertebralis posterior. 

2. V. aiiriciilaris posterior from the superficial jilexus behind the ear. 

3. V. jugularis anterior, downward from the chin upon the mm. mylohyoideus and 
sternohyoideus, extends lateralward below the origins of the m. sternocleidomastoideus to the 
V. jugularis externa or the v. sulj^Javia. It anastomoses with the adjacent veins, and, by the 
large arcus venoxus juguli, below the glandula tliyreoidea with the vein of the opposite side. 
More rarely instead of this vein only an unj)airt'd median trunk (v. mediana colli) is present. 



Veins of the Arm. 



451 



490. Superficial veins of the back of the right 

hand. (Partly after W. Braune.) 



V. basilica 



Processus 

styloideus 

ulnae 



The Tcins of the upper extremity 

run partly in the depth hetween the nuiscles, 
partly in plexuses, superficially, upon the fascia 
supei-ficialis , in the subcutaneous tissue. Both 
possess numerous valves, the deep veins more 
than the superficial, and are manifoldly connected 
with one another by anastomoses, which are 
devoid of valves. 

The deep Teins (not illustrated) follow al- 
most exclusively the corresponding- arteries and 
are double, with the exception of 
those in the fingers and in the axilla. 
In the palm they begin as single 
vv. digitales vnlares propriae (see 
Fig. 491), which unite to form the 
vv. digitales volares communes and 
go into the double arcus volaris 
venosus super ficialis. In the de]jth 
run the vv. metacai-peae volares, 
which open into the double aims 
volaris venosus profundus; they 
send in addition several rami perfo- 
rantes into the spatia iuterossea metacarpi 
to the deep veins of the back of the hand, 
several smaller and regularly two larger 
veins into the 1 st metacarpal space and 
through the muscles of the little finger 
to the rete venosum di)rsale manus. From 
the palmar arch arise th? vv. ulnares 
and vv. radiales and fi-om these again 
the vv. hrachiales with their tributaries, 
corresponding exactly to the arteries. On 
the hack of the hand the deep veins 
accompany, as small vessels, the deep layer 
of the rete carpi dorsale (see p. 414) and 
emty partly into the vv. radiales, partly 
into the rete venosum dorsale manus. 

The superficial veius of the 
hack of the hand represent the 
chief canals of outflow for 
the skin. They begin upon 
the phalanges of the fingers 
in a plexus, which permits 
of the recognition of longi- 
tudinal trunks, vv. digi- 
tales dorsales propriae, and 
each terminates on the first 
phalanx in the arcus veno- 
sus digitalis which is con- 
cave proximalward. From the 
union of every pair of these 
arches, arise four larger vv. 
metacarpeae dorsales ; these 
form the rete venosum dor- 
sale manvs , the meshes of 
which are elongated in the 
direction of the long axis of 
the Umb. 



V. cephalica 



Processus 

styloideus 

radii 



Kete venosum 
dorsale manus 



Vv. iuter- __ 
capitulares 



Vv. digitales ^ 
dorsales 
propriae 




Ramus 
perforans 

Vv. meta- 
carpeae 
dorsales 



452 



Veins of the Arm. 



V. cephalica 



V. mediana 
cubiti 



N. cutaneus ,- / I \ / I 
antibrachii "^c, / - ^-^ I / / 
lateralis | i i A" / 



V. cephalic 
accessoria 




N, cutaneus 

antibraohii 

medialis 



V. basilica 



V. basilica 



491. Superficial veins 
of the right forearm, 

viewed from in front. 
(Palm after W. Bramie.) 

The superflciaj yeiiis of the palm 

are much finer than those of the back 
of the hand. They begin upon the pha- 
hinges in a plexus in which one can 
make out more or less distinctly the 
vv. digitales volares propi-iae and out 
of which most of the blood is conducted 
to the posterior surface through several 
vessels at the lateral margins of the 
fingers. Similarly the vv. mte?-capitu- 
lares (see also Fig. 490) conduct blood 
into the spaces between the fingers from 
the volar to the dorsal vessels. The 
superficial network of the palm hes upon 
the aponeurosis palmaris and upon the 
fascia of the tlienar and hypothenar 
eminences; in the latter two places the 
network is somewhat closer. Proximal- 
ward it goes over into the plexus in the 
forearm. 

The superlicial veins of the forearm are 

also arranged in the form of a plexus. Among 
them two are usually very distinct: 



V. cephalica 



metacarpea dor- 
the ulnar side of 



Vv. inter- 
capitulares 

Vv. digitales 

volares 

propriae 



1. V. basilica (see also Fig. 490) begins upon 

the back of the hand, frequently as the 
continuation of the v 
salis IV, loops around 
the forearm to its volar surface and rims 
on this as far as the elbow, then in the 
sulcus bicipitalis medialis along the upper 
arm as far as its middle third. There 
it perforates the fascia, goes still- some 
distance upward and unites sooner or 
later with one of the (more delicate) 
vv. brachiales. 

2. V. cephalica (see also Fig. 490) arises on 

the back of the hand, often especially 
from the v. metacarpea doi'salis I, winds 
around the radial side of the forearm to 
its volar surface and extends on this as 
far as the elbow; thence it goes u]>ward 
in the sulcus bicipitalis lateralis and (in 
a duplicature of the fascia brachii) in the 
groove between the mm. pectoralis major 
and deltoideus, sinks into the depth just 
below the clavicle and after union with 
a V. thoracoacromialis empties into the 
V. axillaris (see also Fig. 492). Some- 
times a second longitudinal vessel is sit- 
. uated lateral ward on the forearm , the 
V. cephalica accessoria, which opens into 
the main vein. 



Veins of the Arm. 



453 



V. thoracoacromialiSN 

A. axillaris , 

N. musculocutaneus | 

N. medianus ' 



V. axillaris 






V. circumflexa humeri anterior i ' 



I I 



M. deltoideus 



v. cephalica 




Vv. biaehiales 
:M. coracobrachial is 
;N. medianus y sbscapularis 



V. thoracalis lateralis , 
M. latissimus dorsi 



yr- 



^ 






Costa in 
-V. costoaxillaris 



A , 



M. pectoralis minor 



\i-M 



M. subscapularis 



Vv. costoaxillares 



492. Veins of the right axilla, viewed from in front. 

(Arrangement as in Tig. 451.) 

3) V. mediana cubiti (see Fig. 491) is a connecting branch, which usually leads obliquely 

upward in the flexure of the elbow from the v. cephalica to the v. basUica and, 

lateralward fi*om the lacertus fibrosus, anastomoses freely with the deep veins. 

In other cases (not illustrated) a vein (v. mediana antibrachii) goes upward upon the 

middle of the volar surface of the forearm, bifurcates in the flexiu'e of the elbow and goes 

partly to the v. basUica (as a v. mediana basilica), partly to the v. cephalica (as v. mediana 

cephalica). There is always, however, even then, free anastomosis with the deep veins of 

the elbow. 

y. axillaris (axillary vein) (see also Fig. 486) arises usually at the lower margin 
of the m. pectorahs major by the union of the two w. brachiales and extends as far as the 
clavicle on the medial and anterior surface of the artery, which is also accompanied directly 
by small veins. Its branches correspond to those of the artery. The T. thoracalis lateralis 
receives the Y. thoracoepigastrica (see Fig. 504), which extends subcutaneously upward 
fi'om the V. femoraUs or fi'om the v. epigastrica superficialis on the anterior and lateral surface 
of the trunk. Into this or into the neighboring veins empty the TV. costoaxillares, which, 
in the upper 6 7 intercostal spaces , cany the blood from the middle portions of the 
vv. intercostales (see p. 455) to the axilla. The v. axillaris and its branches are richly 
pro\dded with valves. 



454 



Veins of the Trunk. 



Plexus venosi vertebralis interni/i 



Corpus 
vertebrae 



-Processus articularis superior 

Anastomosis with the plexus 
,-vcnosus vertebralis posterior 



Fibrocartilago 
intervertebralis" 




"-^Plexus venosus verte- 
bralis posterior 
Foraiueu intervertebrale 



Sinus vertebralis 
longitudinalis 



' Processus spinosus 



493. Spinal VGinS, seen in a median section, viewed from the left. 

y. SUl)Cljlvia (subclavian vein) (see Fig. 486) is the name of the continuation of the 
V. axillaris from the lower margin of the m. subclavius on. It accompanies the a. subclavia on 
its anterior and inferior surface and crosses the first rib in front of them, scalenus anterior. 
Behind the articulatio sternoclavicularis it helps to form the v. anonyma. It has valves at its 
beginning and at its termination. In addition to it some small veins directly accompany the 
a. subclavia. Tributaries (besides the v. jugularis externa): 

1. and 2. V. transversa scapulae and y. transversa colli (see Figs. 486 and 489) 
near the corresponding arteries, unite usually to form one stem, which fi-equently opens into 
the V. jugularis externa. They carry valves at their mouths. 

Veins of the spinal column, in the canalis vertebralis, between the two layers 
of the dura mater spinalis, lie close venous plexuses, plexus venosi vertebrates interni, the 
tributaries of which come partly from th(> verteljrae, partly from the spinal cord. These j)lexuses 
(see also i'ig. 494) extend chiehy in the longitudinal direction from tJie foramen occipitale magnum 
to almost as far as the tip of the sacrum and permit the recognition of four trunks, two anterior 
and two posterior. The anterioi- lie upon the posterior surface of the bodies of the vertebrae 
and of the intervertebral disks on each side lateral from tbe lig. longitudinale posterius; they 
consist of several large veins, running very close together, which anastomose manifoldly with 
one another, possess a lumen which stands open especially in the cervical and thoracic part 
and are accordingly also called the sinus vertebrates tongitudinales. Tbe posterior plexuses 
are situated on both sides on the anterior surface of the arcus vertebrarum and of the ligamenta 
flava and anastomose through spaces in the latter with the plexus externi posteriores ; they are 
more delicate and less numerous and form more irregular, wider networks. The anterior plexuses 
are imited with one another on the posterior surface of each vertebral bodj' by transverse trunks, 
whicb run between the periosteum and the lig. longitudinale posterius and there receive the 
vv. basivertebrales. The latter (see also Fig. 494) extend radially in the vertebral body toward 
the middle of the postei'ior surface and open there in common or separately, being provided at the 
mouth with valves; in front they anastomose through tbe bones with the plexus externi anteriores. 
The posterior plexuses are connected with one another by branches arranged in the form of a 
network; with the anterior they are connected by numerous shorter vessels which are present 
especially on the medial side of each radix arcus vertebrae and leave free only the upper part 
of the I'oramen intervertebrale. Through the connecting branches of the different plexuses with 
one another arise the more or less distinct vascular rings, retia venosa vertebrarum, one at 
the level of each vertebra. The upper end of the plexus surrounds the foramen occipitale magnum 
like a wreath (see Fig. 484), is connected with the sinus occipitalis, plexus basilaris and rete 
canalis hypoglossi and empties into the v. vertebralis. In the canalis sacralis the vessels become 
smaller, the plexuses become looser and empty through the foramina saci'alia into the vv. sacrales. 



Veins of the Trunk. 



455 



Processus spinosus 

, Plexus venosus vertebralis 
/ posterior 

Rete venosum vertebrae 

I 



Processus 
articularis superior 




V. intervertebralis -S-i 



Processus 
transversus 



Plexus venosi vertebrales 
interni 



V. basivertebralis 



Corpus 
vertebrae 



Plexus venosus 
vertebralis anterior 



494. Spinal veins in a inorizontal section, 

viewed from above. 
(Only the body of the vertebra has been cut through.) 

Plexus A'enosi xertebrales externi (see also Fig. 493) lie on the external surface 
of the spinal column and are divisible into anterior, smaller plexuses and posterior, larger 
plexuses. The plexns reiiosi vertebrales anterior es are best developed in the cervical spine and 
there lie upon the bodies of the vertebrae and upon the mm. longi capitis et colli; they receive 
tributaries from the muscles and fi"om the bodies of the vertebrae and are connected lateralward 
-n-ith the vv. intervertebrales and with the following plexuses. The plexus venosi vertebrales 
posteriores lie in part directly upon the posterior surface of the vertebral arches, processes and 
ligaments, in part between the short muscles of the back. They are best developed in the 
cenical portion (see also Figs. 486 and 4S8) and are connected there especially with the v. 
occipitalis , v. vertebralis and v. cervicalis profunda ; besides, they anastomose through spaces 
in the ligamenta flava with the plexus interni and unite in front with the plexus anteriores 
and with the vv. inteiwertebrales. 

Yv. intervertebrales accompany the nn. spinales in the foramina intervertebralia and 
lie chiefly in plexuses on their anterior surfaces. They receive the vv. spinales (from the spinal 
cord), which bear valves at their openings and are connected with the plexus vertebrales interni 
and exteiTii representing their channels of outflow ; they have valves where they terminate in the 
neck in the v. vertebralis, or in the trunk in the vv. intercostales, lumbales or sacrales laterales. 

The TV. intercostales (see lig. 495), situated usually singly at the lower margin of 
a rib in the sulcus costae, close to and above the artery, increase evenly in diameter from 
above downward. The upper 9 ( 10) form venous circles which empty their contents partly 
sternalward into the w. mammaria interna and musculuphrenicae (see p. 445), partly vertebral- 
ward into the system of the v. azygos; at their mouths they carry valves coiTespondingly 
dii-ected ; from their middle portiuns they send off branches in the 1 st 6th (or 7*^) intercostal 
spaces to tlie axilla (vv. costouxillaresj (see p. 453). The lower 23 vv. intercostales have 
no outflow forward and receive tributaries, supplied with valves, from the diaphragm and ft'om 
the abdominal muscles. Veins of smaller diameter and inconstant in length are to be found 
also at the upper margin of each rib; they are manifoldly connected with the others. Each 
V. intercostahs receives a ramus posterior near the bodies of the vertebrae, which is larger 
than it is itself and which runs near the ramus posterior of the a. intercostalis ; into this 
flow tributary vessels from the skin and from the muscles of the back, as well as the ramus 
spinalis, which , as a continuation of the vv. intervertebrales (vide supra), collects the blood 
from the spinal colimm and its contents. 



456 



Veins of the Trunk. 



V. vertebralis 




V. iliaoa 
communis 

. iliolumbalis 

\'. sacralis 
media 



495. Vena azygos, 

viewed from in front. 

(The diaphrafj^m and the lumbar 
nuiseles have been removed.) 

y. azyg'OS, unpaired, begins 
as a continuation of the v. kim- 
balis ascendens dextra (seep. 4 GO), 
between the right erus niediale and 
cms intermedium of the diaphragm, 
ascends in the spatium mediastinale 
posterius on the right side of the 
vel-tebral bodies, and in its course 
V. hemiazygos lies in front of the aa. intercostales, 
to the right of the aorta thora- 
calis and of the ductus thoracicus 
and behind the oesophagus. At 
the level of the 5tb or 4* tho- 
racic vertebra it bends forward 
over the root of the right lung 
and opens into the v. cava supe- 
rior (see also Figs. 427 and 628). 
In this latter portion of its course 
it usually possesses valves, which, 
however, are not efficient. It re- 
ceives the nine lowermost vv. inter- 
costales of the right side, as 
well as tlie vv. oesophageae, 
vv. broncJiiale.<: posterioi-es and 
vv. mediastinales posteriores (from 
the corresponding organs) (not 
illustrated), besides the V. hemi- 
azygos. The latter (see also Fig. 
629) begins, unpaired, between 
the left crus mediale and cms 
intermedium of the diaphragm as the 
continuation of the v. lumbalis ascen- 
dens sinistra , but is also connected 
with the v. renalis sinistra. Devoid 
of valves, it extends upward, behind 
the aorta thoracalis, on the left side 
of the bodies of the vertebrae, re- 
ceives several vv. intercostales sinistrae, 
vv. oesophageae and vv. mediastinales 
posteriores, and bends to the right in 
front of one of the inferior or middle 
thoracic vertebrae behind the ductus 
thoracicus to go to the v. azygos. The 
intercostal veins, next higher up on 
the left side, empty into a V. liemi- 
azygos accessoria, which goes down- 
ward on the left side of the thoracic 
spine and empties either into the 
V. hemiazygos or directly into the 
V. azj'gos. The 3 4 upper intercostal 
veins open on each side into a v. inter- 
costalis snprema, which on the right 
side usually opens into the v. azygos 
(supplied with valves), on the left side 
into the v. hemiazygos, but in addition 
also conmiunicates above on each side 
with the V. anonvma. 



_V. anonyiua 
sinistra 



_V. intereostalis 
suprema 
sinistra 

_V. cava 

superior 
.V. intereostalis 

suprema dextra 



accessoria 



^_J V. hemiazygos 



~~~V. bronchialis 
posterior 



_ _V. azygos 
V. intereostalis 

.V. hemiazygos 

-V. oesophagea 

V. 

mediastinalis 
posterior 



"V. renalis 
sinistra 



"V. cava 
inferior 

V. 

lumbalis 

III 



V. lumbalis 
ascendens 



Veins of the Trunk. 



457 



496. Arteries and veins of a piece of small 

intestine. 

The vena portae 

(portal vein) (see Figs. 497 
and 49S) collects the blood 
from the whole digestive tube 
from the cardia on as far as 
the m. levator ani, from the 
pancreas, the gall bla<lder 
and the spleen. Its trunk 
arises behind the caput pan- 
creatis, on the left and poste- 
rior surface of the pars supe- 
rior duodeni, from the union 
of the V. mesenterica supe- 
rior and the v. lienalis; it 
is 2 3 cm long and runs 
upward in the lig. hepato- 
duodenale, behind the a. he- 
patica and the hepatic and 
biliary ducts, to the porta 
hepatis ; there it divides into 
a right and left branch one 
for each half of the liver. 
Its roots follow, in general, 
the branches of the arteries 
of the same name and are 
supplied with valves only in 
their finer subdivisions im- 
mediately after their exit 
from the wall of the stomach 
and intestine. 

1 . V. mesenterica 
superior (see Figs. 497 and 
498) runs on the right side 
of the a. mesenterica supe- 
rior arises from nvmierous 
vv. iniestinales (from the 
small intestine), from the 
r. ileocolica, vv. colicac 
dexirae , v. pancreatico- 
duodenalis , vv. duodeiiales, 
vv. pancreuticae , v. cotica 
media and v. gastroepiploica 
dextra. The intestinal veins 
anastomose with one another 
veiy much as the arteries do 
but more frequently. 

2. T. mesenterica inferior (see Figs. 497 and 49S) collects its blood from the 
v. haemorrhoidalis superior, the vv. sigmoideae and the v. colica sinistra. Its peripheral 
course agrees with that of the a. mesenterica inferior; its trunk however separates from this 
and goes in a curved direction upward and to the right behind the peritonaeiun (frequently in 
the plica duodenojejunalis) and behind the pancreas; it usually opens into the v. lienalis, 
fi-equently into the v. mesenterica superior, sometimes at the point of junction of the two. 

3. y. lienalis (see Figs. 497 and 498) is formed by the union of the veins of the 
spleen with the v. gastroepiploica sinistra and with the vv. gastricue breves; it runs from 
the left to the right beneath the a. lienalis and behind the pancreas, and in its course receives 
several pancreatic veins. 




458 



Ductus choledochus 



Ligaraentum 
hepatoduodenale A 

V. cystica * 



Vesica fellea 
Hepar 



V. gastro- 

epiploica 

dextra 

V. 

'pancreatico 

duodenalis 



V. 

pancreatica 

Duodenum - 

Vv. colicae 
dextrae 



, Veins of the Trunk. 

A. hepatica propria 
/ V. portae 

V. pylorica 



v. coronaria ventriculi 
' Ventriculus 



V. gastroepiploica sinistra 
\. lienalis 
Lien 




V. 

mesenterica 
inferior 

A. 

mesenterica 

superior 

V. 

mesenterica 

superior 
V. colica 
sinistra 

Vv. 
intestinales 

A. 

mesenterica 
inferior 



Colon ascendens 



V. ileocolica 

Intestiniim ileum'' 



\ Colon 

\, . ., descendens 
^ V V. sigmoideae 

V. haemorrhoidalis superior 

Colon slgmoideum 



497. Tributaries of the portal vein. 

(The transverse colon and the small intestine have been partially removed; the Hver has heen drawn -u^vard.) 



Veins of the Trunk. 



459 



V. hepatica ^ V. cava 
\ inferioi' 
Y. portae 



Y. coronaria 
ventriculi A- coeliaca 



V. pylorica 



A. gastroduodenalis \ \ 



' A. lienalis 




/ ^ Y. lienalis 




1 / \ 


|Y. gastrica 
1 brevis 



' Lien 




Duodenum 
Y. panereaticoduodenalis 

V. gastroepiploica dextra 



/ Y. mesenterica 
superior 



^ Y. gastroepiploica 

u sinistra 

Pancreas 

Colon descendens 



Y. colica sinistra 



A. mesenterica superior 



498. Trunk of the portal vein. 

(The stomach, liver and pancreas have heen partially, the small intestine and the transverse 

colon completely, removed.) \ ' ' , 

4. V. coronaria veutrieuli (see also Fig. 497) 'runs- I'rora the right to the. left along 
the curvatura minor of the stomach, anastomoses at the pyloru's with the v. pylorica, at the 
cardia with the oesophageal veins and opens near the a. gastrica sinistra into the trunk of the 
V. portae or the v. Menalis. ; . . 

5. Y. pylorica (see also Fig. 497), more delicate than the preceding, exteiids from the 
left to the right near the a. gastrica dextra at the curvatura minor of the stomach, anastomoses" 
with the preceding vein and opens at the pylorus into the stem of the v. portae. 

6. V; cystica (see Fig. 497) from the gall bladder; opens into the stem or the right 
branch of the portal vein. 

The accessory portal reius (not illustrated) are small vessels which arise in the folds 
of the per'itonaeum connected with the liver or which come from the stomach and pass either 
into the stem of the portal vein or directly into the substance of the liver. 

The anastomoses of the portal with the vv. cavae are regularly present as follows: 

1) At the cardia of the stomach between the v. coronaria ventriculi (v. portae) and the 

oesophageal veins (v. azygos) ; 

2) at the rectum in the pL^xus haemorrhoidales between the v. haemorrhoidalis superior 

(v. mesenterica inferior) and the vv. haemorrhoidales mediae et inferiores (vv. hypo- 
gastricae) ; 

3) iw. fartimbilicales [Sappeyi] (not illustrated), 4 5 small vessels, which are connected 

in the neighborhood of the navel with the superficial veins and with the vv. epigastricae 
inferiores, extend near the lig. teres hepatis to the liver and (>mpty usually directly 
into its substance. The largest anastomoses also with the left v. epigastrica superior. 
One of these veins is said to be the remains of the v. umbilicalis. Tliey are suppUed 
with valves; the current is directed toward the liver. 



460 Veins of the Trunk. 

Y. cava inferior (see also Fig. 633) arises by the union of the vv. ihacae communes 
in front of the intervertebral disk between the i^^ and 5^^ limibar vertebra behind the first 
])ortion of the a. iliaca communis dextra somewhat to the right of the median plane. From 
there on, it ascends at first in front of the bodies of the lumbar vertebrae and in front of the 
origins of the right m. psoas major, then in front of the a. renalis dextra and in front of the 
right crura diaphragmatis and at the same time somewhat to the right and forward, goes through 
the foramen venae cavae of the diaphragm and, cuiwed somewhat forward, opens into the right 
atrium of the heart. In its course it lies on the right side of the aorta abdorainalis and is 
covered in front by the peritonaeum, by the pars inferior duodeni and by the caput pancreatis; 
above, it is embedded in the fossa venae. cavae of the liver and firaily fused with it, so that 
only its posterior wall lies partly fi-ee (see Fig. 581). It is devoid of valves. Its branches are 
divisible into radices parietales (from the walls of tM jieritoneal cavity) and radices 
viscerales (from the abdominal viscera)^ 

A. Radices parietales: ^ - . . - ,.' 

1. Y. phreiiica inferior, paired, corresponds to the a. phrenica inferior and opens at 
the foramen venae cavae. 

2. Yv. liimbales (see also Figs. 495 and 500), on eg,ch side 4 5, run close to and 
over the aa. lumbales, correspond to tlie' yv. intercostales (see p. 455) and receive tributaries 
from the muscles and from the skin of the back, from tlie plexuses of the spine and from the 
abdominal muscles. They possess (insufficient) valves, run medianward upon the lateral and 
anterior surface of the bodies of the yertebrae (those of the left side behind the aorta) and 
open into the posterior wall of the v. cava. The vv. lumbales are united on each side with 
one another by means of longitudinal anastomoses which are situated behind the ra. psoas 
major in front of the roots of the procc. transversi. The sum of these anastomoses forms on 
each side a vessel running vertically, the v. lumbalis ascendens, - which is connected below with 
the V. iliolumbalis and frequently with the v. iliaca communis, above however is continued on 
the right side directly into the v. azygos, on the left side into-. the v. hemiazygos (see p. 456); 
each anastomoses usually with the a: renalis of the same side. 

B. Radices viscerales: 

1. Yv. hepaticae (see also Fig. 580), 2 3 large trunks, collect the blood which is led to 
the capillary system of the liver through the a. hepatica propria and v. portae; they leave the 
liver in the uppermost part of the fossa venae cavae and open into the v. cava just below the dia- 
phragm. The right v. hepatica, largest, carries the blood from the right lobe of the liver, the 
middle, smallest vein fi-om the lobi caudatus [Spigeli] and quadratus, the left from the left lobe I 
of the liver. Several small vv. hepaticae open in the fossa venae cavae, below the large ones, 
directly into the v. cava inferior. Valves are only rarely present at the mouths of the large veins. 

2. Y. renalis. (renal vein) (see also Fig. 633),- paired, arises by the fusion of ft-om three 
to five branches near the hilus renalis , runs medianward and at the same time somewhat 
upward at the level of the 2"'! lumbar vertebra in front of the a. renalis and opens into the 
lateral wall of the v. cava. The left v.. renalis is -somewhat "the -larger and longer; it lies 
usually in front of the aorta just beneath the origin of the a. mesenterica superior. It re- 
ceives tributaries ft-om the capsula adiposa of the kidney and from the ureter; the left v. renalis 
receives also usually the v. spermatica sinistra. In addition the left vein anastomoses very 
frequently with the v. hemiazygos and the v. lumbtilis ascendens , the right with the latter 
only. The vv. renales rarely possess valves at their mouths.* 

3. Y. suprarenalis (suprarenal vein) (see also Fig. 639), paired, comes from the anterior 
surface of the adrenal and opens on the right side usually into the v. cava, on the left side 
into the v. renalis. It is devoid of valves. 

4. Y. spermatica (spermatic vein) (see also Figs. 500, 502 and 503), paired, accompanies 
the a. spermatica interna directly and is separated from it only at its termination. It consists 
of from 2 to 3 anastomosing vessels which surround the artery like a plexus, receive branches 
from the ureter, from the peritonaeum and from the capsula adiposa of the kidney and imite 
finally to form a single trunk. The right vein opens obliquely into the anterior wall of the 
V. cava and there possesses efficiinit valves, the left goes almost at a right angle into the in- 
ferior wall of tlie V. renalis sinistra. The beginning of the vein is different in the two sexes. 

In the male, v. testicularis, .it begins with numerous branches at the posterior margin 
of the testicle and epididymis (see also Fig. 650), forms a close plexus (plexus pmnpiniformis) 
around the artery inside the funiculus spermaticus and extends, with this, through the canalis 
inguinalis. Outside the inguinal canal it usually possesses (insufficient) valves. 

In the female, v. ovarica, it arises partly from numerous vessels, which leave the ovary 
at its hUus, jiartly from broad anastomoses with the upper ends of the vv. uterinae ; in addition 
it receives some branches from tlie lig. teres uteri and from the tuba uterina. All these 
branches, anastomosing, form a close plexus (plexus immpiniforinis) around the artery, mside 
the lig. suspensorium ovarii and are devoid of valves. 



Veins of the Trunk. 



461 



Vv. hepaticac 



V. cava inferior 
V. renalis j 

v. spermatica iuterna 
(v. testicularis) \ 
V. lumbalis III \ 

V. lumbalis 
ascendens \ 



V. phreuica inferior 

1 Oesophagus 

I 

I |V. suprarenalis 

1 I 

I V. renalis 



V. spermatica interna 
(v. testicularis) 



Aorta abdoniiualis 




V. ilio-/ 

lumbalis i 

V. eireumfiexa/ 
ilium profunda 

Ductus deferens 

V. epigastrica inferior 

Plexus pampiniformis 



Ureter 
'V. iliaca communis 



V. hypogastrica' 1 

V. saeralis media 



II / 



1 V. epigastrica inferior 

V. saeralis lateralis 
Plexus saeralis anterior 

499. Vena cava inferior in the male, viewed from in front. 

(On the right side the kidney has been removed, a piece of the ni. psoas and of the a. iliaca 
communis has been cut out ; on the left side the abdominal wall has been reflected downward.) 
Spalteliolz, Atlas. 30 



462 



Veins of the Tranli. 



V. cava inferior 

V. lumbalis III 
Aorta abdominal is 



V. lumbalis ascendens 
V. iliolumbalis 



hypogastrica 

V. 

haemorrhoi- 
dalis superior 




V. circura- 

flexa ilium 

profunda 

V. 

epigastriea 
inferior 



Ductus 

deferens 

V. 

obturatoria 



"Vesica 
urinaria 

V. dorsalis penis 



Penis 
Plexus pudendalis 



Prostata 
Vv. scrotales posteriorcs 

Plexus vesicalis 



M. levator ani | 

Vv. vesicales I 

V. haemorrhoidalis media 



Rectum 

' Plexus 

haemorrhoidalis 
externus 

V. 

haemorrhoidalis 
inferior 



V. ]iiidenda interna 



500. Veins of the male pelvis, 

I'iglit halt', viewed from the lett. 
(Tlie left in. psoas major bas been removed, the rectum bas been drawn somewliat to the side. 



}\ 



' ' 



1 



i 



Veins of the Trunlv. 



463 



V. labialis 
posterior 



M. transversus 

perinei 

superficialis 



v. pudenda' 
interna. 



Yv. 

haemorrhoidales- . 
inferiorc'S 



Anus with tlie 

veins of exit 

of the plexus 

liaemorrhoidal 1 s 

intern us 




Crus clitoridis 



V. dorsalis 
clitoridis 



V. pudenda 
interna 

Bulbus vestibul 



M. ischio- 
cavernosus 



' ' " - V. profunda 
^^^^ clitoridis 



' V. urethralis 



V. bulbi vestibul 
[vaginae] 



JI. glutaeus 
maximus 



501. Veins of the female perineum (see iig. 474). 

A", iliaca COmillUllis (common iliac vein) (see Fig. 491)), paired, devoid of valves, 
liebiud and to the right of the artery, arises from tlie V. hypogastrica and the Y. iliaca 
externa. It frequently anastomoses with the v? lumbalis ascendens. Branch of the left vein : 

1. y. sacralis' media (middle sacral vein), unpaired, often double below, near the a. sa- 
crahs media , forms with branches of the vv. sacrales laterales the flexus sacralis anteinoi' 
(see p. 466) ; it is connected with the plexus haemorrhoidalis externus and vesiealis. 

T. hypOgastrica (hypogastric vein) (see Fig. 500) lies directly behmd thi' a. hypo- 
gastrica. Its branches possess valves only outside the pelvis. Branches : 

V. pudenda interna (0. T. internal pudic vein) (see also F'igs. 500 and 503) begins 
below the symphysis ussium ])ubis with an anastomosis from the v. dorsalis penis (cHtoridis) and 
receives the vv. proftmdac penis (clitoi-idis), vv. urethrales, vv. bulbi urethrae (bulbi vestihdi 
[vaginae], vv. scrotales (labiales) postcriores and vv. haemorrhoidales inferiores ; the latter 
are connected with the plexus haemorrhoidales. AU the branches correspond to the arteries of 
the same name. The vein is for the most part double and accompanies the artery. 

30* 



464 



Veins of the Trunlv. 



i 



V. ovarica 



Ovarium 



Ligamentiim teres uteri 
Vesica urinaria 



Plexus utero- 
vagiualis 

Kectum 
/ V. liaenior- 

/ rhoidalis 
superior 




y. dorsalis 
clitoridis 



Plexus pudeiidalis 
Beginning of tlie v. pudenda interna 



Ureter 



Plexus 
-. haemorrlioidalis 

externus 



Plexus vesicalis 

Plexus uterovaginalis j 

Intestinum rectum 



M. levator ani 

\ Vv. uterinae 
A. uterina 

Vagina 

\ Vv. vesieales 



502. Veins of the female pelvic organs, 

viewed from the left. 
(The superficial layers of the venous plexuses [see Fig. 503] have heen removed; the peritonaeum 

has been for the most part removed.) 

2. Plexus haemorrlioidalis interiins (see Figs. 501 and 576) in thi' tela snhmucosa 
of the rectum, with ampulla-like dilatations in the region of the annulus haemorrhoidalis, empties 
partly into a dehcate superficial network at the anus, partly by means of numerous perforating 
branches into the plexus haemorrlioidalis externus (see also Fig. 500) situated upon the 
external surface of the tunica muscularis. From the latter arise the v. haemorrhoidalis superior 
(to the V. mesenterica inferior of the v. portae), the vv. haemorrhoidales mediae, paired, which 
receive branches from the bladder, prostate and seminal vesicles (uterus and vagina) (to the 
V. hypogastrica) and the vv. haemorrhoidales inferiores, paired, Irom the neighborhood of the 
anus (to the v. imdeuda interna) ; in addition branches go to the v. sacralis media. 

3. Plexus vesicalis (see also Figs. 500, 503 and 677) surrounds the lower part of 
the bladder and the basis prostatae lateralward and behind, is comiected with the following 
plexus and is emptied nu cacli side liy means of several vv. vesieales. 

4. Plexus pudeiidalis (see also Figs. 500 and 503) lies beliind and over the lig. ar- 
cuatum pubis, in Iront of the prostate and bladder (in the male, the bladder and urethra in 
the iemale), receives the main trunk of the unpaired v. dorsalis penis (ciitoridisj (see also 
Fig. 656), which runs between the lig. arcuatum pubis and the lig. transversum pelvis, is 
connected with the v. pudenda interna and with the plexus vesicalis and empties partly into 
the vv. vesieales, partly directly into the v. hypogastrica. 

5. Plexus uterovag'inalis (in the female) extends over the walls of the vagina and as 
an especially close plexus ahing the nuirgo lateralis of the uterus, where it partly fills up the 
parametrium and surrounds tiie un>ter. It is connected in front with the plexus pudendalis and 
haemorrhoidalis externus and empties on each side chiefly through the large vv. titerinae, which 
s!irruund the a. uterina and form ]mnu\ anastomoses with the plexus pampiniformis of the v. ovarica. 



Veins of the Trunk. 



465 



V. lumbalis III 



V. lumbalis ascciuleiis 

V. iliolunibalis 



V. cava inferior - 



Aorta alidominalis 
Intestinum rectum 



Ovarium' 



V. hypo- 
gastrica] 




V. circiim- 
flexa ilium 
profunda / 

V. iliaca externa ' 

V. 
epigastrica inferior' 

Liganientum /' 
teres uteri 



V. obturatoria ' 

V. vesicalis' 

Vesica urinaria ' / 




Uterus ' I 

V. dorsalis clitoridis/ 



Clitoris 



???V^^^^ 


w 






V. 










uterina 








> Vv. 


vesicales 








^ V. pudenda 








intorna 


I 








' Plexus 








i 


vesicalis 




'i ^ 


1 


'v. labialis posterior 






1 1 

1 ^^ 


levator ani 








'lUilbus 


vestibuli 






Plexus 


pudendalis 







503. Veins of the female pelvis, right half, 

viewed from the left and somewhat in front. 

(The ovaries and uterus have been dra-mi out of their position ; the peritonaeum has been 

largely removed; the ureters have been removed.) 



466 "^^eius of the Trunk. 

6. V. ilioliimbalis (see Figs. 495, 499 and 500), in })art double, accompanies the 
a. iliolumbalis and often opens into the v. iliaca communis. It receives the vt. intervertebrales 
(see p. 455), muscular veins and sometimes the v. luml)a]is Y, anastomoses with the ^T. lum- 
balis ascendens, circuraflexa ilium profunda and sacrales laterales and possesses many valves. 

7. Yy. sacrales laterales (see Fig. 499), usually' double, run near the a. sacralis lateT 
ralis and open into the v. hypogastrica or into a branch of the same. Their branches form, with 
those of the v. sacralis media, the plexus sacralis anterior upon the facies pelvina of the sacrum. 

8. y. obturatoria (see Figs. 500 and 503) near the a. obturatoria; its branches are 
usually doubled; it forms a broad anastomosis with the v. iliaca externa, and sometimes opens 
into this. Its branches anastomose freely with the v. cireumflexa femoris medialis. 

9. y. gliitaea superior (see Fig. 506) accompanies the a. glutaea superior; its branches 
are usually doubled. At its entrance into the pelvis its walls stand open and it possesses 
valves. Behind the m. piriformis it anastomoses with the v. glutaea inferior. 

10. y. glutaea inferior (see Fig. 506), near the a. glutaea inferior; its branches, 
usually doubled, accompany the branches of the latter. It receives a large branch from the 
n. ischiadicus and anastomoses on the m. quadratus femoris by means of very wide vessels with 
the V. cireumflexa femnris medialis and with the uppermost v. perforans of the vv.profundae femoris. 

y. iliaca externa (external iliac vein) (see Figs. 499, 500 and 505) begins as 
the continuation of the v. femoralis behind the lig. inguinale, on the medial side of the a. iliaca 
externa and, as it ascends, becomes displaced behind the artery. It receives a broad anastomosis 
irom the v. obturatoria and frequently possesses one (usually insufficient) valve. Branches : 

1. y. epigastrica inferior (see Figs. 499, 500 and 505), usually doubled, accompanies 
the a. epigastrica inferior. It anastomoses with the vv. epigastricae superiores and behind the 
ramus superior ossis pubis with the v. obturatoria ; in addition it receives the vv. parimibilicales, 
as well as the vv. speimaticae externae (not illustrated) from the funiculus spermaticus and 
branches from the vv. cutaneae alnlominis. Below the navel it possesses numerous valves. 

2. y. circumilexa ilium profunda (see Figs. 499, 500, 503 and 505), doable in most 
-of its course, surrounds the a. cireumflexa ilium profunda like a plexus and often opens into 
the V. epigastrica inferior ; in so doing it crosses the a. iliaca externa on its anterior or posterior 
surface. It anastomoses with the v. iliiilumbalis and is supplied with valves. 

Y, femoralis (femoral vein) (see Fig. 505) is the continuation of the vv. popliteae 
from the lower end (if the canalis adductorius [Hunteri] on. In this canal it lies behind the 
a. femoralis and somewhat lateralward from it: further up> it runs for the most part exactly 
behind the artery, and arrives finally on the medial side of the artery in the fossa iliopecttnea. 
In its lower portion two vv. comitantes also run close to the artery. It possesses usually 
4 5 pairs of valves. Branches: 

1. y. epigastrica superiicialis (see also Fig. 508) is situated in the subcutaneous 
tissue and carries the blood downward from the lower half of the anterior abdominal wall. 
It opens in the fossa ovalis separately or, united with neighboring veins, into the v. femoralis 
or into the v. saphena magna and possesses valves which conduct downward. 

2. y. cireumflexa ilium superiicialis (see Fig. 508), sometimes doubled for i)art 
of its course, close to the corresponding artery in the subcutaneous tissue, opening either 
independently or in common with the v, epigastrica superficialis. It is supplied with valves. 

3. y. thoracoepigastrica, single or doubled for long distances, extends, on the anterior 
or lateral wall of the trunk, in the subcutaneous tissue, from the axilla as far as the fossa 
ovalis. Its middle portion is devoid of valves, in its upper part valves direct the blood upward 
to the axilla, in its lower part downward to the fossa ovalis. Above, the vein opens into 
the T.^ thoracalis lateralis (see p. 453), below it goes either separately or united with the 
V. epi^dl^trica superficialis into the v. femoralis. 

4. yy. pudendae externae (see also Fig. 508), near the aa. pudendae externae, 
fi-equently flow into the v. saphena magna; they receive l)ranches from the skin of the ab- 
domen, from the scrotum (or the labia raajora), vv. scrotalcs (labiales) anteriores , and ft'om 
the penis (or the clitoris), v. dorsalis jjenis (clitoridis) cutanea; the latter runs unpaired or 
doubled upon the fascia penis ,as far as the symphysis pubis and there bends lateralward. " 

(Continuation see ]>. 46S.) 

yv. cutaneae abdominis et pectoris form, in the subcutaneous tissue of the abdominal 
and thoracic wall, a network of vessels, supplied with valves, from which the blood is led away 
on each side 1^* by superficial vessels to the neck, to the axilla (v. thoracoepigastrica) and to 
the fossa ovalis (vide siijrra), 2"^ by deep, perforating vessels to the thoracic cavity (to the 
w. mammaria interna and intercostales), to the peritoneal cavity (vv. parumbilicales) and to 
the veins of the anterior abdominal wall (\v. epigastricae superiL>res et inferior). 

In the neighborhood of the papilla mammae the vv. cutaneae form a wreath of vessels 
of imeven caliber, the plexus venosus mamillae. 



Veins of the Trunk. 



467 



Branch to the v. subclavia sinistra 



Eamus perforans 
V. mammariae internae 




Branch to the vv. epigastricae 
superiores 



Branch to the 
V. epigastrica inferior 



v. epigastrica 
superficialis 



V. femoralis 

V. saphena magna 

V. dorsalis penis 
cutanea 



504. Superficial veins of the trunk, 

viewed from in front (after W. Braunej. 
(The an-ows indicate the way in which the current is directed by the valves.) 



468 



Veins of tho Leg. 



Spina iliaca 
anterior superior 



jM. sartorius,- 



M. rectus feraoris. 



A. femoralis. - 

A. circumflexa 
femoris lateraJlis 

V. circumflexa _ 
femoris lateralis 

Y. profunda femoris - 



v. perforans j 



M. yastiis 
intermedius" 

M. vastus lateralis- 

M. rectus_ 
femoris 



V. circumflexa ilium profunda 
/A. iliaca externa 

\. iliaca externa 



V. epigastrica inferior 
V, femoralis 

v. obturatoria 
'' , M. pectineus 




> 


V. circumflexa 
femoris niedialis 




V. saphena magna 

(cut off) 




M. adductor longus 




M. pectineus 




V. femoralis 




-=-Vy. comitantes 




M. adductor magnus 


^^ 


M. adductor longus 


Ml' 


- - jM. gracilis 




A. femoralis 


- 


M. vastus medialis 


1 


M. sartorius 
(cut through) 



505. V. femoralis dextra, viewed from in front. 

(The li;^-. inguinale and the nnu. sarturiu.s, rectus femoris, pectineus and adductor longus have 
l^een entirely or partially removed; a piece has been cut out of the^a. femoralis.) J 

T. femoralis (continued): 

5. V. saphena magna (see p. 471). 

6. y. profunda femoris accompanies the a. prnfunda femoris and possesses several 
pairs of valves. Branches: 

a) ViK per'forantes (sec also Fig. 506), ])artly doubled, arise du tln^ posterior surface of 

the m. adductor magnus and comnmnicate freely there by longitudinal anastomoses with 
one another, with the vv. glutaea inferior, circumflexa femoris medialis and with 
the V. poplitea; they then perforate the mm. adductores near the aa. perforantes. 

b) Vv. circumflexue femoris mediales (see also Fig. 506) run near the corresponding 

arteries and anastomose freely lichind, on the m. quadratus femoris, with the vv. glutaea 
inierior and perforans I, in front with the v, ol)turatoria. They are supplied with valves. 

c) Vv. circwnflexae femoris later ales, supplied with valves, accompany the a. circumflexa 

ienioris lateralis and anastomose with the ])receding and with the v. glutaea inferior. 
y. poplitea (popliteal vein) (see Fig. 506) arises froui the union of the vv. tiliiales 
and runs just behind the a. poplitea, in its distal part at the same time somewhat medianward, 
in its proxiiual part somewhat lateralward from it. Besides, near the artery there is below a 
V. comtians lateralis, above a v. comituns medialis. It is su])plied with valves, receives the 
v. saphena parva (see p. 472) and the vv. articulares genu (double near the corresponding 
arteries, not illustrated) and anastomoses with the lower \v. perf irantes. 



Veins of the Leg. 



469 



506. Deep veins 
of the right thigh, 

viewed from behind. 



(The m. jjlutaeus raaximus has 
been reflected lateralward ; other- 



glutaea superior 
glutaea inferior 

N. ischiadicus 
M. glutaeus maxlmu; 



wise like Fig. 



477.) 



The deep yeins of the 

foot and leg (not iUustrated) 
accompany the arteries, usually 
two to each artery, and are 
plentifully supplied with val- 
ves. Numerous anastomoses 
with the supei-ficial veins in 
the foot lead the blood fi-om 
the depth to the surface, in 
the leg (also in the thigh) from 
the surface to the depth. 

In the sole of the foot 
they begin as the vv. digitales 
plantares and then form the 
vv. metatarseae plan- 
tares, which empty part- 
ly through several rami 
per for antes into the deep 
and the superficial veins 
of the back of the foot, 
partly into the arcns 
venosus plantaris pro- 
fundus. From the latter 
go off the vu. plan- 
tares later ales , which 
by union with the finer 
vv. plantares medialcs 
form the vv. tibiales 
posteriores; in the leg 
the latter receive the 
vv. peronaeae. The vv. 
plantares laterales also 
send an anastomosis to 
the V. saphena parva, 
the w. plantares me- 
diales to the v. saphena 



On the back of the 
foot they are relatively 
delicate; they begin as 
the vv. metatarseae dor- 
sales pedis and are con- 
tinued into the tt. ti- 
biales aiiteriores. 




"V. pudenda 

interna 

M. quadratus 

femoris 

Vv. circumflexae 

femoris mediales 



M. biceps femori> 
(caput longum) 

V. perforans I 

M. 
semitendinosus 

V. perforans II 



M. biceps femoris 
(caput longum) 

V. 
femoropoplitea ' 
Branch of tlie v. sa- 
pliena parva to the -- 
V. profunda femoris 

M. 

semimembranosus 

Branch of the v. saphena 

parva to the v. pophtea 

V. poplitea 

V. comitans lateralis 

V. saphena parva 



470 



Veins of the Leg. 




_ Patella 



V. saphena 
magna 



V. saphena 
magna 



Rete venosum 

dorsale pedis 

cutaneum 



Malleolus 
medialis 



V. marginalis 
medialis 

Arcus venosus 
dorsalis pedis 

cutaneus] 
Yv. digitales 
communes pedis 

v. intercapitularis 

Vv. digitales 
pedis dorsales 



507. Superficial veins 
of the right leg, 

viewed from in front (after 
W. Braune). 

(Tlie arrows indicate the way the stream 
is directed by the valves.) 

The superficial yeins of the 

leg form a continuous network in the 
subcutaneous tissue, varying in complexity, 
rich in valves, and permittmg the recogni- 
tion in it of single larger vessels which act 
as the principal canals of exit. They are 
connected with the deep veins by numerous 
anastomoses (for direction of current see 
p. 469). 

In the sole of the foot (not illu- 
strated) there is a very close network (rete 
venosum plantar e cutaneum), which pos- 
sesses different channels of outflow. In the 
first place branches go to the deep veins, 
secondly, however, and chiefly, the blood is 
led away through superficial trunks around 
the borders of the foot to the d( irsum of the 
foot. These pass at the medial and lateral 
margins of the foot into the vv. margrnales 
medialis and lateralis of the dorsum of the 
foot, dorsalward over the margin of the heel 
toward the leg, and forward intij a larger 
vessel (arcus venosus plantaris cutaneus)^ 
which runs in the toe-ball furrow at the 
distal margin of the fasciculi transversi 
aponeurosis plantaris and is continued over 
the medial and lateral margins of the foot 
into the beginnings of the vv. marginales 
(vide infra). This vascular arch receives 
superficial brandies from the toes and 
sends off' into the space between each 
two toes single or double vv. intercapitu- 
lares to the vv. digitales dorsales pedis. 
On the back of the foot the veins 
begin at the toes as the vv. digitales pedis 
dorsales, which unite after receiving the 
vv. mtercapitulares to form the short vv. di- 
gitales communes pedis and flow into the 
arcus venosus doi:mlis pedis [cutaneus] ; 
this is an irregular chain of anastomoses 
between the \y. digitales communes and 
the vv. marginales and lies upon the distal 
portion of the ossa metatarsalia. Proximal- 
ward from it lies the irregularly shaped 
rete venosum dorsale pedis cutaneum, 
which receives many tributaries from the 
depth and is contmued into the anterior 
network of the leg. In the network, near 
the lateral and median margins of the foot, 
can be made out on each side a larger 
vessel, the v. marginalis lateralis (see 
Fig. 509) and the v. marginalis medialis, 
which chiefly receive tributaries from the 
rete venosmn plantare cutaneum. 



Veins of the Leg. 



471 



508. Superficial 
veins of the 
right thigh, 

viewed from in front. 

(The arrows indicate the way 

the current is directed by the 

valves.) 

In the plexus of superficial 
veins of the leg two large 
venous trunks stand out above 
the foot, the v. saphena mag-na 
and the v. saphena parva, of 
which the latter belongs es- 
sentially to the leg aLme. 

T. sapheua magna (see 
also Figs. 505 and 507) begins 
in front of the medial mal- 
leolus as the continuation of 
the V. marginalis medialis 
and there receives superficial 
branches fi'om the rete veno- 
sum plantare cutaneum and 
deep branches fifom the vv. plan- 
tares mediales. It then runs 
almost vertically upward upon 
the facies medialis tibiae, makes 
a slight curve behind the con- 
dyli mediales of tlie tibia and 
femur and then goes fairly 
straight but obliquely upward 
on the medial and anterior 
surface of the thigh, and enters 
the anterior medial waU of the 
V. femoralis in the fossa ovalis. 
In its entire course it is sit- 
uated subcutaneously upon 
the fascia cruris and fascia 
lata. On its way it receives 
numerous In-anches frum the 
superficial networks of the 
heel, of the leg and of the 
thigh, as well as veins from 
the tibia, and anastomoses 
manifoldly with the v. saphena 
parva. The superficial veins 
coming from the back of the 
thigh often form a separate 
trunk, the v. saphena acces- 
soria (not illustrated), which 
accompanies the v. saphena 
magna medianward at a vari- 
able distance from it and 
empties intc it at an incon- 
stant level. 



V. ciicuniflexa ilium 
superficialis 

V. epigastrica 
/ superficialis 




Fossa ovalis 



Vv. pudendae 
extern ae 



A. pudenda 
externa 



Vv. dorsales 
penis cutaneae 

V. scrotalis 
anterior 

V. dorsalis 
penis 



V. saphena 
magna 



Patella 



472 



Veins of the Leg. 



\ 



F/^ 



/ 



; .} 



\^ 



'A 



V. femoro- 
poplitea 



Branch to the 
V. profunda 
femoris 



Branch to the 
' ' V. poplitea . 

V. saphena 
magna 



i\ 



Connections 

with the 
deep veins 



^ 



I V. saphena 

parva 



K \ 



.;!^ 



Malleolus lateralis 

Rete venosuni 
^ dorsale pedis 
, '' cutaneum 

^ V. niarginalis 
lateralis 






509. 

Superficial veins of 
the right leg, 

viewed from behind (after 
W. Braune). 

(The arrows indicate the way the cur- 
rent is directed by the valves.) 

y. saphena parra (see also 
Fig. 506) l)egins behind the lateral 
malleolus as the continuation of the 
V. niarginalis lateralis of the ioot; in 
its furination there take part, besides 
superficial branches of the rete venosuni 
plantare cutaneiim, also an anastomosis 
from the deep vv. plantares laterales. 
It runs at first on the lateral margin, 
then on the posterior surface - of the 
tendo calcaneus [Achillis] ; farther up 
ensheathed in a duplicature of the fascia 
cruris, it lies in the groove between 
the two heads of the m. gastrocnemius, 
perforates the fascia at a variable level, 
sinks into the depth in the 2)ophteal 
space and always bifurcates into two 
branches, of which one opens into the 
posterior wall of the v. poplitea and 
the other farther up into the beghuiing 
]iortiiin of the v. profunda femoris. 
The latter branch also receives a vessel 
of superficial course, running on the 
back of the thigh, the v. femoropoplitea, 
the contents of which flow for the most 
part from above downw^ard but can 
also find a channel of exit by passing 
upward beneath the m. glutaeus maxi- 
mus into the vv. glutaeae. The v. sa- 
phena parva receives in its course 
numerous branches from the superficial 
network of the heel and of the leg 
and anastomoses usually manifoldly 
with the V. saphena magna. It may 
open also into other deep veins of the 
thigh or into the v. saphena magna. 



Placental Cii'cnlation. 473 



The foetal eirenlatioii. 

Daring embryonic life the apparatus concerned in the circulation of the blood under- 
goes various transfoiinations. 

The arrangement which exists in the second half of pregnancy up to birth is designated thi; 
placental circulation. This presents the following peculiarities (see Figs. 510 and 511): 

The T. iimbiliealis (u7nbilical vein), devoid of valves, leads the blood, which has become 
arterial in the placenta, through the umbilical cord (funiculus umbilicalis) to the navel and 
thence in the free margin of the lig. falciforme hepatis to the fossa' venae umbilicalis of the 
liver. There a part of the blood goes through direct branches to the capillary system of the 
liver ; another part becomes mixed, in that the v. umbilicalis connects with the left branch of 
the V. portae, with the venous contents of the portal vein (from the stomach, intestine, pancreas 
and spleen) and also anives, along with this, in the capillary system of the liver; finally, 
the third, smaller part runs directly to the left v. hepatica and thus to the v. cava inferior 
through the ductus venosus [Arantii], which is situated in the fossa ductus venosi of the liver 
(see also Fig. 5S1) and connects the v. umbihcaUs with the left v. hepatica. The v. cava 
inferior carries mixed blood therefore on its passage through the foramen venae cavae of the 
diaphragm. This is composed of 1st the pure arterial contents of the ductus venosus (Arantii], 
2nd the contents of the v\. hepaticae, which cany the blood away from the capillary system 
of the liver, and 3rd the venous contents of the v. cava inferior (especially from the renal veins, 
pelvic veins and those of the lower extremities). Passing through the v. cava inferior, this 
blood reaches the right atrium , which, in the foetus, is freely connected with the left atriimi 
through the foramen ovale (see Fig. 423). Since the foramen ovale is situated in the direction 
of the cun-ent of bL lod arriving through the v. cava inferior, and since, in addition, the valvula 
venae cavae [inferioris, Eustachii] to a certain extent hinders an alteration of this direction 
of the cm-rent, the main mass of blood streams into the leit atrium and in so doing receives 
and mixes with only part of the venous blood which arrives in the heart through the v. cava 
superior. Into the left atrium open the vv. pulmonales and their l)lood, which in the foetus 
is venous, mixes with the other contents. The so-called mixed arterial blood thus arising 
goes especially to the upper half of the body through the loft ventricle, the aorta ascendens 
and the arcus aortae and its large branches, the aa. anonjTua , carotis sinistra and subclavia 
sinistra ; only a part comes into the aorta thoracalis. 

The V. cava superior carries the venous lilood from the upper half of the body and 
(through the v. azygos which is markedly developed in the foetus) fi-om the wall of the trunk, 
to the right atrium. Thence a small part passes through the foramen ovale into the left 
atrium, the larger part, however, mixed with a part of the blood from the v. cava infei-ior 
and hence called mixed venous blood, enters the right ventricle and passes into the a. pid- 
monaLis. The a. pulmonalis divides, in the foetus, into three branches: tlie rami dexter et 
sinister, which go to the lungs (as yet not functioning) and the ductus arteriosus [Botalli], 
which runs ia the direction of the main trunk and enters, at the end of the arcus aortae, 
into the concave anterior wall of the latter. The greater part of the mixed venous blood now 
rims through this ductus arteriosus as far as the beginning of the aorta thoracalis; there it 
mixes with the residue of the mixed arterial blood coming from the end of the arcus aortae 
and passes through the 1)ranches of the aorta thoracalis and aorta abdominahs to the intestmal 
canal, to the inferior portion of the wall of the trunk and to the lower extremities, chiefly, 
however, through the two aa. umbilicales (see p. 428) into the umbilical cord and to the 
placenta, where it again becomes arterialized. 



474 



A. pulmonalis 
V. cava'superior 



Placental Cii-culati(in. 

Arcus aortae Ductus^artcriosus [Bolalli] 



Raiiuis sinister 
a. pulmonalis 



Aorta thoracalis 



Hepar 



Ductus venosvis 
[Arantii] 



V. 

umbllicalis 




V. portae 



V. cava inferior 



Aorta abdomiualis 



V. umbilioalis 



Aa. unibilicales '' 



A. iliaca 
communis 



510. 
Blood- 
vessels of 
the foetus, 

viewed from in front and soiuewliat 

from the left. (The abdominal and thoracic cavities Lave been widely opened, the lungs, 
the whole alimentary tract, the pancreas, the spleen, the left lohe of the liver and the serous 
membranes have been removed and tln' ln'art has been drawn aside to the ri^'ht.) Text see p. 473. 



iliaca externa 
^A. hyjiogastrica 



I A. umbilicalis 



Placental Circulation. 



475 



V. cava superior 
Aorta asceiidens - 

Foramen ovale 

Valvula venae eavae 
[inferioris, Eustachii] 

Atrium dextrum - . 

Veiitriculus dexter - 



V. liepatica sinistra 

Ductus venosus 
[ArantiiJ ->^ 



Distributions 
in the liver 




cus aortae 

Ductus arteriosus 
[Botalli] 



Ramus sinister 

a. pidmonalis 

A. pulmonalis 



Ventriculus 
sinister 



V. portae 



V. umbilicalis 



..V. cava inferior 



- Aorta abdoiiiinalis 



Aa. umbilicales--: '. 



A. iliaea communis 



--V. iliaea communis 



..A. iliaea externa 



A. hypogastrica 



Vesica urinaria - 



511. Scheme of 

the circulation 

of the blood in 

the foetus, 

viewed from in front and somewhat from the left (see Fig. 510). 

(The heart is in its correct position and has been partly opened. The arrows indicate the 

direction of the blood cuiTent.) Text see p. 473. 



Printed l\y Fischer &: Wittig, Leipzig. 




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