S'
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 ^^ 0
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)roc«ssus 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. 298—301). 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. 0 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 0 n : direct branches of
the cervical and brachial plexuses.
M. scalenus medius (see
also Figs. 299—301 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 0 n : direct branches of the
cervical and brachial plexuses.
M. scalenus posterior (0. T.
scalenus posticus) (see also Figs.
299—301 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 2—3 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 2»c' 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 9—10 tieshy digitations from the 8—9 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. 326—328) 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 2—3 processes to the tubercula
posteriora of the procc. transversi of the 2—3 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. 0 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 346—351). 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,dl«lis
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. 352—355, 357—359 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 to«the 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:h€f''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. 0 r i g i n : ulnar margin . ' ," >neurosis palmaris.
I n s e r t i 0 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. 363—365)
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 0 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 0 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 385—387). 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. 0 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. 376—379, 387 and
389). F 0 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. 376—379, 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. 0 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
(dra«n 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.
258,384,388—391). 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,
393—395, 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 -405—407). 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 0 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 2»c^— 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 0 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 2»d_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 §i€ernum 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, 416—419) 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, 417—420 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. 626—631) 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 c«llulae 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. 439—441) 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 (2°d 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, 446—448) 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. 454—456), 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, 455—460), 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, 629—631) 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), 2—3, 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. 462—465), 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, 469—471 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), 2—3, 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 0 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. 441—444.
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. jugularis 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. 486—488) 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. juirularis 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 s„bscapularis
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 2—3 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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