(navigation image)
Home American Libraries | Canadian Libraries | Universal Library | Community Texts | Project Gutenberg | Children's Library | Biodiversity Heritage Library | Additional Collections
Search: Advanced Search
Anonymous User (login or join us)
Upload
See other formats

Full text of "Human anatomy for art students;"

rTt 



;OFCA1IFO% ^v)FCALIFO% 






£= < 



■mDNVSOl^ ^AaJAINfUWV' 



lUNIVFRS/A 



-" o 



t= < 



i33Nvsoi^ ^/^aiAiNamv 



.t 



^ILIBRARYO^^ ^HlBRARYQr 




%OJnVDJO- 



%OJnVDJO^ 






OFCALIFO%- 



Aavaan# 



OFCAlIFOfti' 



^Aavaan-^iVv^ 



OiP.IIRPABV/l^ 



<\^^•ll^liv^w/^ 



villNANi 



.MMmts. 



%a3AINn-3\\V^ ^'^M 



mm- 



mum-i^' 



;:n) 



.^ o *tf 



^-•^vi (^ru-u \Jit/j//- 




^^AHvaan# 



.vlOSANGE 



i :< - i. 


U 

4"""" 


) ^ 


to. 



^/smhw 



kIOSANl 




■'t^AavaaiH^ 



I\ 



Frontal 
Temporal 



Cervical Vertebrae, 

First Dorsal Vertebra 

First Rib 

Clavicle 

Acromion 

Coracoid 

Scapula 

Sternum 



Twelfth Rib. _ 
Lumbar Vertebrae 



Ulna.- 
Radius 
Hiac fossa 



Head of Femur . 

Small Troclianter._ 
Carpus 
Metacarpus 

Phalanges 



Patella... 
Head of Fibula - 



Fibula 
Tibia 



Tarsus — 

Metatarsus 

Phalanges — 




Temporal ) 

Orbit 



Mandible 



Crest of Ilium 

Trochlea 

Capitellum 

Coronoid of Uln^i 

Ulna 

Radius 

Diac fossa 

Sacrum 

Great Trochantcfi 

Neck of Femur 

Carptis 

Metacarpus 



Pubes 

Ischium 

Femur 



Fibula 
Tibia 



Internal malleol 
External malleoj 
-^Tarsus 



TRONT VIEW OF MALE FIGURE 



THE NEW ART LIBRARY 

HUMAN ANATOMY FOR ART STUDENTS 

} 

!By Sir Alfred Fripp, k.c.v.o., c.b., Surgeon-in-Ordinary 
to the King, & Ralph Thompson, m.b., ch.m., f.r.c.s., 
^Senior Demonstrator of Anatomy, Guys Hospital, with 
Drawings by Innes Fripp, a.r.c.a., Life Master, South 
London Technical Art School, & an Appendix on 
Comparative Anatomy by Harry Dixon, m.s.b.s. ^^ ^^ 

With one hundred & fifty-one 
ILLUSTRATIONS 




London 
Seeley, Service & Co. Limited 

196 Shaftesbury Avenue 



PRINTED IN GREAT BRITAIN 



c 



V3\ 



INTRODUCTION 



The object of this book is to give the shortest de- 
scription of human anatomy compcttible with the 
interests of the artist and essential for his work, 
and to burden his mind as little as possible with 
names, with technicalities, and with those details 
which do not bear directly upon the surface forms. 

It is, unfortunately, impossible to save the art 
student from the difficulties of the nomenclature em- 
ployed in anatomy. Attempts made from time to 

' time to simplify it have been found to impair the 
accuracy and clearness of the necessary descrip- 
tions, and have by common consent of teachers been 
abandoned. 

/ Further, inasmuch as the subject-matter is to a 
large extent made up of hard facts, the task of 

, remembering a string of these confronts the student 

' as soon as he has mastered the nomenclature, with 

' the result that the beginner usually finds the study 
(of anatomy dull and prosaic as well as difficult. The 

/superficial knowledge required for use in the studio 
Iseldom leads the student into those higher realms 

^ (where the study of anatomy becomes fascinating and 
suggestive, as indicated in some of the later chapters 

iand in the Appendix upon Comparative Anatomy. 

The names allotted to many of the structures, 
especially to the muscles, are long and cumbrous ; 

ix 

s 

r 444703 



INTRODUCTION 

i 
and many of the expressions used, e.g. " above," 
"below," "internal," "external," are employed in a 
more precise or more technical sense than that 
attributed to them by the layman. For instance, 
nobody but an anatomist would take exception to the 
common description of an overcoat as being worn 
" outside " the other clothes, or of the husk as lying 
"outside" the nut. The anatomical purist, on the 
other hand, would in each case substitute the term 
" superficial to," and the student, if he would keep 
his mental view of anatomy clear, however limited, 
must be urged to become a purist in the applica- 
tion of such technical terms as he is called upon 
to use. 

In anatomical description the subject is always 
supposed to be standing in the position of " atten- 
tion," the face looking straight towards the student, 
the upper limbs hanging by the side, with the 
palms of the hands to the front. Whatever may 
be the actual position of the subject under study, 
the terms Above or superior to, Belovr or inferior 
to, Anterior or in front, Posterior or behind. In- 
ternal or medial. External or lateral. Proximal 
or nearer to the axis, in distinction from Distal oi:* 
further removed from the axis, are applied in such 
a way that they would be true if the " attention " 
position were resumed by the subject or model. 

The human body is divided, for purposes of anato- 
mical description, into various parts ; and each of 
these is made up of several tissues or systems. 

After giving an account of the skeleton, with itsi 
joints and ligaments, we shall proceed to a descrip- 
tion of the various soft structures which clothe thti 
skeleton. 

Then the four parts into which the body is divided 



INTRODUCTION 

V? 11 each claim a chapter, and these will be taken in 
the following order : — 

1. The upper extremity, including shoulder, axilla, 
aim, elbow, forearm, wrist, hand, and digits or 
fingers. 

2. The lower extremity, including buttock, groin, 
thigh, knee, leg, ankle, foot, and digits or toes. 

3. The trunk, including back, thorax, abdomen, and 
pelvis. 

4. The head and neck. 

The systems of which these parts are built up are 
tfc e osseous system or skeleton ; the ligamentous system 
of fibrous tissue, whose chief function is to bind the 
bones together; the muscular system; the nervous, 
tie blood-vascular, and the epithelial systems. Of 
the last two examples may be readily seen with- 
out dissection, namely, the skin which covers the body 
g( nerally, and the mucous membrane which lines the 
internal surface of all the hollow viscera, such as the 
luags, stomach, and intestines, but is modified in its 
appearance in different organs, and is notable only 
in the undissected subject as the covering of the 
red part of the lips and mouth and of the eyeball 
and nostrils. 

A full knowledge of anatomy embraces all these 
parts and all the systems which build them up, and 
much more besides, such as embryology or the study 
of development from the embryo, histology or micro- 
scopical anatomy, and comparative anatomy or the 
science which compares the anatomy of all the 
diJferent members of the animal kingdom, and of 
tliis branch a short sketch is given in the Appendix. 

Physiology, the science of the functions of each 
otgan in health, and pathology, the science of disease, 
W!*ll also occasionally call for notice in any such 

xi 



INTRODUCTION 

attempt as this book makes to rivet the attention 
of the artist upon those details in structure and 
function upon which depends the external appear- 
ance. The chief objects of his study will be the 
bones, muscles, skin, and hair, with the variations 
of form and colour which may take place in those 
systems under different conditions of age, sex, race, 
activity or repose, occupation, and emotion. 

The latter is a very important subject and claims 
a chapter to itself. To deal at all adequately with 
its intricacies would need a volume. Though the 
expression of the emotions is chiefly apparent in 
the face, yet all the other parts of the body, and 
especially the limbs, may contribute appropriate 
movements or gestures. We recognise, for instance, 
the tottering lower limbs of the fear-stricken, the 
swagger of the arrogant, and the crouching gait of 
the coward, as gestures which indicate the condition 
of the affected person almost as much as, and indc ed 
sometimes more than, does the facial expression. 

In other words, certain attitudes of the anato- 
mical parts are liable to be associated with, and 
so to convey to the observer, the various mental 
and physical states of the individual, whence the 
claim of the subject to be included in the science 
of anatomy. 

For the assumption of any attitude is consequent 
upon the passing into action or repose of seme 
definite muscles or groups of muscles. The contrac- 
tion of any muscle causes a difference in the contour 
of the skin covering it ; usually, but not always, the 
skin becomes prominent over those muscles wh'.ch 
are in action, and vice versa. For instance, wken 
the elbow is forcibly bent, the shape of the frontj of 
the upper arm is considerably altered in comparis on 

xii 



INTRODUCTION 

wth its appearance in the passive position. The 
alteration is due to the fact that the large Biceps 
mascle has contracted and has produced a rounded 
prominence. 

At the joints, again, there is great variation in 
shape in the different positions assumed by the 
limbs. This is well seen in the case of the knee. 
When the model forcibly straightens the leg the 
patella or knee-cap is seen very distinctly, and so 
are the component parts of the quadriceps extensor 
muscle in its neighbourhood. When the knee is bent, 
the patella, having sunk between the condyles of the 
femur, is scarcely visible, though it may still be easily 
felt ; and while the flexor tendons or hamstrings now 
stand out prominently, the component parts of the 
quadriceps can no longer be clearly identified. 

But however noteworthy the effects of muscular 
action upon the surface-form of the body, there are, 
as already indicated, other factors to be studied. 

The alterations that take place with advancing 
years are due to several causes, and to these a 
separate chapter has been devoted. Such conditions 
as are associated with premature old age are akin 
to those of disease, and are of greater interest to the 
student of medicine than to the artist. The artist, 
however, at times depicts his subjects in age or 
infirmity, and therefore an attempt will be made 
to indicate the more obvious of these conditions. 

At the end of the book we have included a short 
series of photographic reproductions. These are 
designed to demonstrate points mentioned in the 
text, and it is hoped that they will be particularly 
useful to those students who find themselves pre- 
vented from attending at a life school while studying 
anatomy. 

xiii 



INTRODUCTION 

Constant reference from the text to the illustra- 
tion and to the actual model is most desirable. Su(3h 
knowledge and appreciation of the details of this 
laborious science as is evinced by the Tv^ork of 
Leonardo da Yinci and Michael Angelo, to mention 
only two of the greatest among the many great 
depictors of the beauty of the human form, can 
only be acquired by many years of close and devoted 
study. Yet even these great ones must have ex- 
perienced, during their novitiate, as we do nowadays, 
that sense of dejection in the presence of unexpected 
difficulties which bars the threshold of the study of 
each of the sciences. 

Let the student be cheered by the realisation that 
such dejection is unreasonable, in that the same diffi- 
culties have appeared just as great to, and yet have 
been overcome successfully by, countless numbers of 
students before us. And it is worth while to ove.?- 
come them; for the more knowledge we have of 
anatomy, the greater will be our appreciation of the 
beauties of the human form, and the greater our 
possibilities of portraying those beauties ; to ap- 
preciate all that is conveyed in a work of art, one 
must know what to look for. 



XIV 



CONTENTS 



Introduction , sx 



I. The Skeleton •*.... 

II. The Coverings of the Body , , , 

ni. The Regions of the Body . ^ . » 
IV. The Upper Extremity . , . . , 

Vo The Lower Extremity . . . ^ , 

VI. Movements of the Joints of the Upper Ex 

TREMITY . , , . . . 

VII. Movements of the Joints of the Lower Ex 

TREMITY , . . . 9 . . , 

VUl. The Trunk . c . . . . . 

IX. The Head and Neck . * , « = 

X. Expression and Gesture . , . . 

XL Differences of Size and Proportion in the 

Sexes ..... e . 
X II. Growth^ Development, and Measurements . 
Appendix on Comparative Anatomy 



INDEX 

XV 



33 
65 
70 
73 
103 

146 

153 

157 
179 
234 

252 
259 

267 

287 



I 



LIST OF ILLUSTRATIONS 



PLATES 

Front View of Male Figure 
I. Front View of Male Skeleton . , 

II. Front View of Female Skeleton , 

III. Back View of Male Skeleton . 

IV. Lateral View of Male Skeleton 

V. Muscles of the Body (Front View) . 
VI. Muscles of the Body (Back View) . 
VII. Muscles of the Body (Lateral View) 
VIII. Muscles of the Face, Head, and Neck 



Frontispiece 
24 
25 
26 
27 
28 
29 
30 
31 



REPRODUCTIONS FROM PHOTOGRAPHS TAKEN 
FROM LIFE 

These will he found at the end of the hook after the Index 

IX. Front View of Male Figure, standing alert 

and ready o = . o 3 . . 3 

X. Front View of Female Figure .... 7 

XI. Back View of Male Figure at "Attention" <, 11 

XII. Back View of Female Figure . . , » 15 

XIII. Figure of a Man straining his Muscles » , 19 

xvii B 



LIST OF ILLUSTRATIONS 

XIV. Figure of a Woman in Slightly Flexed 

Position . . o . . . . 23 

XV. Children . ,27 

XVI. Front View of Male Figure Stretching . 31 

XVII. Back View of Man Looking Upwards . . 35 

XVIII. Figure of a Woman Stooping . ... 39 

XIX. Figure of a Man Crouching .... 43 

XX. Figure of Man Resting on Outstretched Arm 43 

XXI. Figure of a Man in the '' Ready " Position 47 

XXII. Figure of a Man with Bowed Head . . 51 

XXIII. Bust of Woman with Chin Depressed . . 55 

XXIV. Front View of Man Straining his Neck 

Backwards ,,»■>., 59 
XXV. Side View of Man Straining his Neck Back- 
wards . ...... 59 

XXVI. Figure of the Legs of Man , , . , 63 
XXVII. Three Studies of the Male Lower Ex- 
tremities ....... (]I7 

XXVIII. Three Studies of the Male Lower Ex- 
tremities from Behind . , . .71 
XXIX. Outstretched Arm, Back View in State of 

Strain o ...... 75 

XXX. Outstretched Arm, Front View in State of 

Relaxation of Muscles . , . ,75 

XXXI. Figure of a Woman Sitting , , <> a 79 

xviii 



LIST OF ILLUSTRATIONS 



FIGURES AND DIAGRAMS 



5. 

6. 

7„ 

8 
10. 
11. 
12. 
13. 
14. 
15. 
16. 
17. 
18. 
19. 

'20. 
21. 
22. 



The Clavicle and Scapula of the Right Side, 

WITH THE Sternum. From the Front . . 25 
The Scapula and Clavicle of the Right Side. 

From the Back ...,,. 36 
The Right Humerus. Front View ... SB 
The Front of the Upper Extremity^ showing the 
" Carrying Angle " between Arm and Fore- 
arm ......... 39 

The Bones forming the Elbow Joint. Back View 40 

The Right Ulna and Radius. Front View . . 40 

The Bones of the Wrist and Hand. Front View 43 
and 9' Male and Female Pelvis . . . .45 

Right Femur. Front View o .... 48 

Right Femur. Back View ..... 48 

The Lower End of the Femur . . o . 51 

Bones of Right Foot. Inner Side ^ . . 53 

Bones of Right Foot. Outer Side . » . 53 

Antero-lateral View of Skull (Adult) . . , 55 
Skull of Young Child . o . ;. . ,56 

Front View of Skull (Adult) . , , . 56 

Side View of Skull (Adult) . ^ . , . 58 
Jhe Back of the Neck, Upper Part of the Trunk 

and Arm ........ 74 

The Muscular Prominences on the Back of the 

Trunk, Buttock, and Neck .... 75 

The Muscles on the Back of the Trunk, Buttock, 

and Neck . . . . . . . - 76 

The Outer Side of the Upper Extremity . , 77 
xix 



LIST OF ILLUSTRATIONS 

23. The Muscles of the Shoulder . . . .78 

24. The Muscles of the Inner Surface of the Arm 

AND of the Armpit ...... 79 

25. The Muscles on the Front of the Trunk and 

Neck 80 

26. The Muscles and Superficial Veins on Front of 

Arm and Elbow . . . . . .81 

27. The Muscular Prominences on the Front of the 

Trunk and Neck 83 

28. The Front and Inner Side of the Upper Ex- 

tremity ........ 84 

29. The Outer Side of the Right Upper Extremity . 85 

30. Muscles on the Back and Outer Side of the 

Elbow Joint ....... 86 

31. The Outer Side of the Upper Extremity, with 

Indication of the Varying Shape of Trans- 
verse Sections at Different I.evels . . 88 

32. The Back of the Forearm and Hand = . . 89 

33. Muscles and Superficial \'eins on Front of Fore- 

arm 89 

34. Muscles on Back of Forearm . . . . 90 

35. Right Upper Extremity. Surface Markings of 

Muscles, Tendons, and Superficial Veins . 91 

36. The Creases upon the Front of the Hand and 

Digits QS 

31. The Deep Palmar Fascia ... - . 94 

38. The Short Muscles of the Hand .... 94 

39. Showing Formation of Creases or ''Lines of 

Flexion " in the Skin of the Hand and 
Digits ........ 96 

XX 



LIST OF ILLUSTRATIONS 



40. 

41. 

42. 

43. 
44. 
4.5. 

46. 

47. 
48. 
49. 

50. 
51. 
52. 
53. 

54. 

55. 
56. 

57. 
58. 

59. 
60. 
61. 



The Hand in the Best Position for Demonstrat- 
ing THE Extensor Tendons . . . , 

Gluteal Muscles and Ilio-tibial Band. Outer 
Side of Upper Part of Thigh 

Muscles of the Back of the Thigh and Popliteal 
Space ....... 

The Muscles in the Region of the Groin 

Muscles on the Front of the Thigh 

Inner Side of Thigh^ showing Ridge formed by 

THE SaRTORIUS MuSCLE .... 

Vasti Muscles and Adductor Muscles. Front of 
Thigh ....... 

Ilio-psoas and Adductor Muscles of Thigh . 
The Flexed Knee ...... 

Muscles of the Popliteal Space and Calf of the 



The Outer Side of the Knee 

Muscles on Inner Side of Lower H\lf of Thigh 

Muscles on the Front of the Knee-joint 

The Inner Side of the Leg .... 

Extensor and Peroneal Muscles and Tendons of 

Foot. Outer Surface and Dorsum 
The Dorsum of the Foot .... 
Bones of Right Foot. Inner Side 
Bones of Right Foot. Outer Side 
To Show the Attitude and Proportions of an 

Infant who is Learning to Walk . 
Tendons on Inner Side of Ankle and Foot . 
The Dorsum of the Foot .... 



XXI 



98 
104 

106 

108 
109 

110 

110 
111 
113 

115 
116 
117 

119 
123 

131 

132 
132 
133 

134 
135 
136 
142 



LIST OF ILLUSTRATIONS 

62. The Muscles on the Back of the Trunk, But- 

tock, AND Neck .... . . 158 

63. The Muscular Prominences on the Front of the 

Trunk and Neck . . . . . .159 

64. The Muscles on the Front of the Trunk and 

Neck l65 

65. Muscular and Bony Surface Markings of Neck, 

Trunk, and Arm . . . . . .166 

66. The Muscles of the Inner Surface of the Arm 

and of the Armpit . . . . . . J67 

67. Lateral View of Neck. Massive Trapezius . . 180 

68. The Surface Markings of the Side and Front of 

THE Neck ........ 181 

69. Furrows around Mouth. Thin Lips. Double Chin 182 

70. The Surface Markings on the Neck of an Old 

Man. Front View .... = . 183 

71. The Surface Markings on the Neck of an Old 

Man. Side View 183 

72. The Large Thyroid Gland in a Girl's Neck . 185 

73. The Muscles of the Side and Front of the Neck 187 

74. Necklace-like Creases in Front of Neck of 

Youth 188 

75. Head and Face of an Old Man .... I90 

76. Back of Boy's Neck, showing Median Furrow . }g6 

77. Creases seen on Back of Extended Neck . . iO"^ 

78. Muscles of Side of Head, Face, and Neck . . 205 

79. Temporal Muscle. Zygoma cut away . . . 206 

80. Surface Markings upon a Thin Face and Neck . 207 

81. Figure to show Proportions of Face and Neck . 207 

82. The Palpebral Aperture, Eyelids, and Eyebrows. 210 

xxii 



LIST OF ILLUSTRATIONS 



83. 

84, 
87. 
88. 
S9, 
91. 
92. 
9o. 
94. 

95. 

96-. 

97. 

98. 

99. 
100. 
101. 
102. 
103. 
104. 
105. 



106. 

107. 

lOS. 
lOi)- 



The Angle formed by the Columna. Nasi with 
THE Upper Lip , . . . . 

85, 86. Various Types of Nose 

Nostrils and Mouth . , . , 

Dimpled Face of Smiling Child 

,90. Mouth and Chin . , . » 

Furrows around Mouth,, Chin^ and Neck 

Head and Neck of Baby 

Child sucking Thumb . - ♦ « 

Different Types of Ear 

Muscles of Side of Head, Face, and Neck 

Sorrow ....«,, 

Dejection . . » , » , 

Terror ...=.,. 
Anger . . = . » . . 

Self-appreciation . , . , c 

Suspicion o . , . . » 

Anticipation . ..... 

Figure of a Female Skeleton 

To SHOW THE Proportions of the Male Body 

To show the Characteristic Position of the 

Head, Body, and Limbs of a Child who is 

lying down ....... 

Child. Side View. . . » c . . 

To show the Attitude and Proportions of an 
Infant who is learning to walk . 
The Gait of an Old Man ...«,. 
•131. Comparison of the Structure of Man 

and the Lower Animals . , , 267 



220 
221 

224 
224 
226 
227 
228 
228 
229 
233 
243 
244 
245 
247 
248 
249 
2.50 
253 
255 



256 

257 

263 
265 

-284 



XXlll 



Frontal 
Temporevl 



Cervical Vertebra 

First Dorsal Vertebra 

First Rib 

Clavicle 

Acromion . — 
Coracoid 

Scapula —- 

Sternum 

Humerus 



Twelfth Rib 

Lumbar Vertebra 

Ulna 

Radius 

Iliac fossa 

Head of Femur 

Small Trochanter 

Carpus 

Metacarpus 



Phalanges 



Femur 



Patella 
Head of Fibula 



Fibula 
Tibia 




Tempor&J 
Orbit 



■^Thorax 



Crest of Iliuai 

Trochlea 

Capitellum 

Coronoid ol Ulna 

Ulna 

Radius 

Iliac fossa 

Sacrum 

Great Trochanter 

Neck of Femur 

Carpus 

Metacarpus 



Pubes 

Ischium 

Femur 



Fibula 
Tibia 



Internal malleolui 
External malleolu 
Tarsus 



Tarsus — 

Metatarsus .„ 

Phaianges ^ 



PLATE I.— FRONT VIEW OF MALE SKELETON 

Rigrht Forearm Pronated ; Left Forearm Supinated 




PLATE II.— FRONT VIEW OF FEMALE SKELETON 

Figure of a Female Skeleton, showing the characteristic narrow thorax, broad pelvis, and Increased 
degree of " knock knee," as compared with the Male. 

The general glenderness of the bones should also be noted. 



L*fc Part eta -=. 
OcclpltaJ 

Mastoid^ 
TranBverse process of Atlas 
Mandiblft^ 

Vertebra prominens^ 

First rib^ 

Clavicle 

Acromiou 

Head of Humerus 

Neck of Humerus 

Scapula 



Twelfth Rib 

Lumbar vertebra 

Olecranon 

Crest of Ilium 

Dorsum Ilii 

Ulna 

Sacrum 

Great Trochanter 

Radius 

Carpus 

Metacarpus) _, i/pi xt i 
Phalanges \ ''MS^g 

Email Trochanter. 
Femor 



External condyi* 
Olecranon 



aead of FlbnlA 



Flbma 



External malleolos 
External cuneifona- 
Phalanges— 
Metatarsus- 
Os Caicis 




1 Bones of \ Carpus 
i band "k Metacarpsj 



PLATE III.— BACK VIEW OF MALE SKELETON 
Right Forearm Pronated; Left Forearm Supinated 



Squamosal' 

Occipital' 

Mastoid 

Ertemal occipital 

protuberance 

Spinous process of 7th. 
Cervical Vertebra 

Acromion process 

Coracold process 

Scapula 



Frontfvl 

Orbit 
Nas&i 
Malar 
Superior MaxUJ; 



Olecranon process 
First Lumbar Vertebra 



Sacrum 
Great trochanter 



External condyle of Femm „. 




External malleolus 

Astragalus 

Os calcis 



Cuneilorm bones^ 
Metatarsus 



Small trochanter 



Internal condyle 
Patella 



Internal malleolui 

Astragalus 

Scaphoid 



Internal Cuneitoria 

Os Calcis 



PLATE IV.— LATERAL VIEW OF MALE SKELETON 



Frontalis 

Temporalis 

Orbicularis palpebrarum 

Muscles of face j 

Masseter 

Depressor angTili oris 

Mylo-hyoid 

Sternohyoid. 

Sterno-mastoid 

Trapezius 

Omohyoid- 



Deltoid 
Pectoralis major 

] Berratns magnus- 

Brachialis anticus- 

Biceps. 

Brachialis anticus 

Serratus magnus 

External oblique 

Rectus abdominis 

Supinator longus 

Extensor carpi radialis 

longior 

Muscles of forearm ' 



Tendons of wrist 

Posterior annular ligament 

Tendons of hand 

Sartorius 

Adductor longus 

Muscles of web of thumb 

Rectus femoris 



Adductor gracilis - 



Vastus intemns'- 
Vastus extemus— 



Sastrocnemias 

Soleus 

Tibialis anticus 

Extensor longus digitorum 

Peroneus longus 



Extensor longus hallucls 
Peroneus brevis 



Anterior annular ligament 



J 




Muscles of face 



Hyoid bone 



Platysma 



Deltoid 
Pectoralis majcr 



Latissimus dorsl 
Brachialis anticiu 



Brachialis anticus 



Semilunar fascia 

) 

V Muscles of foreann 

Pyramidalis 

niacus 

Psoas 

J^Tendons of forearm 

Pectineus 

I Muscles of hand 

Web of thumb 

Palmar fascia 

Adductor longus 

Rectus femoris 
Adductor gracilll 
V astus externus 

Vastus intemiu 



Patella 



Sartorius 
Gracilis 



Gastrocnemius 

Tibialis anticus 

Extensor longus digitonua 

Soleus 

Extensor longus digitomn 



Extensor longus hallucls 
Extensor longus digitorum 



PLATE v.— MUSCLES OF BODY (Front View) 



Compleraa 

gterno-mastoid 

- Splenius capitis 

bbvator anguli scapulae 



Trapezius 



Deltoid 

In'ra«pinatu3 

Teres minor 

Teres major 

Rhomboideus major ■ 

Triceps 

Latissimus dorsi 

Triceps 

Supinator longua 

Bxtensor carpi radialis 

longioi 



Muscles of back of 
forearm 



Tendons of forearm 



CendoQS of back of band 



Gluteus maximus. 

Adductor magnus. 

Semimembranosus.. 

Bemi-tendinosus 

Bicepsi 

Tendon of 

Ssiai membranosus 

Plantaris- 



Gastrocnemius 



I. 



7 

Geep muscles of calf j . 

Tendo Achillia 

Peroneus tertius 

-Muscles of sole of foot 




Vertebra promlnens 



Deltoid 
Infraspinatus 

Rhomboideus major 
Teres major 

Triceps 

Latissimus dorsi 
Biceps 

Supinator longus 
Gluteus medlus 



Muscles of forearm 



Gluteus maxlmos 



Tendons of hand 



Adductor magnus 
Semi membranosos 
Biceps 

Semi'tendinosus 
Vastus extemus 



Gracilis 

Popliteal spac* 
Plantaris 



Outer head) of gastroo. 

. . /nemiua 
Inner head j 



Deep muscles of calf 
Tendo Achillis 

\ Tendons of outer side ( 
ankle and foot 



PLATE VI.— MUSCLES OF BODY (Back View) 



temporalis 

Occipitalis 
Masseter 
Digastric 



Splenius capitis 

Sterno-mastoid 

Scalenus medius 

Trapezius 



Deltoid 
Infraspinatus 



Triceps 

Crachlalls anticus 

Biceps 

Latissimus dorsi 

Bupinator longus 

Extensor carpi f 
radialis longior | 
Extensor Muscles 



Gluteus medius 
Muscles of forearm •' 



Gluteus maximus 
Tensor fasciae femoris 



Tendons of hand 



Rectus femoris 



Biceps cruralis 
Vastus esternus 



FateUa 
Head of fibula 



Gastrocnemius 

Tibialis anticus 

Extensor longus digitorum 

Peroneal group 

Soleus 

Peroneal group 



Tendo Aclullis 
Anterior annular ligament 
Extensor brevis digitorum^ 

First metatarsal 




rrontallB 

Pyramldalls 

Orbicularis palpobranun 
}Zygomatici 
— Buccinator 
Depressors of lower lip 
Anterior belly of digastrl* 
Mylohyoid 
Omo-hyoid 

1 Depressor muscles Of 
( larynx 

.PectoraUs major 



Serratus magniiB 

External oblique 
Rectus abdominis 

Anterior superior spla* 

Sartorius 
Pyramidalis 

Sartorius 
Psoas 

Rectus, part of 



"Quadiiceps 
-■Ad ■ • 



dductor magniu 
Sartorius 
...Gracilis 

Semi-tendinosus 
.S emi-membrano8U3 
_. Vastus internus 

' Patella 



Gastrocnemius 
Tibialis antlcoi 



Flexor longus digitomm 
Anterior annular ligamesi 



Tibialis anticus 



PLATE VII.— MUSCLES OF BODY (Lateral View) 



- * Occlpitalii 




Stern o- 
mastoid 



Posterior 
triangle 



-MUSCLES OF THE FACE, HEAD, AND NECK 




..r"{ 



' \7 




PLATE Vin.— MUSCLES OF THE FACE, HEAD, AND NECK 



HUMAN ANATOMY FOR 
ART STUDENTS 

CHAPTER I 

THE SKELETON 

^O bone is either quite rigid or quite straight. The 
elasticity (which is greater in the young) and the 
jurves found in every bone are obviously adapted 
}o increase its strength. 

The skeleton of the adult is built up of almost 
igid bones, and the length of each bone is slightly 
ncreased by a layer of less rigid cartilage, forming 
\, kind of buffer at each end. In addition, within 
ertain of the joints, actual cushions of fibro-cartilage 
ntervene between the ends of the bones. 

There are various forms of bone. The femur, or 
:high-bone, may be taken as an example of the 
ong hone, while the spine, wrist, and ankle are com- 
posed of short hones. The scapula, or shoulder-blade, 
md the frontal, or forehead bone, are good examples 
of the flat hone. 

The stature of any individual depends chiefly upon 
the length of the long bones of the lower limb and 
of the short bones of the spinal column. 

1. The long- bones should be regarded as mecha- 
uical " level's "; every muscular action may be inter- 
preted as a power or force applied to such a part of 
the bar or bone as to overcome a definite weight or 
resistance, and so to produce movement about a fixed 
point or fulcrum. 

33 C 



THE SKELETON 

2. The short bones will plainly be less liable 
to fracture, and the multiplication of the cartila- 
ginous and articulating surfaces will, of course, 
result in the better breaking of jars and increased 
mobility. Thus, if the spine were a single rigid long 
bone, its relation to the cranium would be that of 
the broom-handle to the broom-head, and the eifect 
of a blow upon the other end, as when one sits down 
with a jerk, would be to drive the neck into the 
base of the skull, just as the handle of the broom 
is driven into the broom-head. 

3. The flat bones are generally protective ; thus 
the flat bones of the vault of the skull protect the 
delicate brain which lies in the cranium, and the 
flat bones on each side of the pelvis, known as the 
hip-bones or ossa innominata, afford protection to 
important viscera. In addition, flat bones provide an 
extensive attachment for strong muscles. Chewing 
or mastication, which is one of the most powerful 
and one of the most fundamentally important move- 
ments in the body, is brought about by the very 
strong muscles inserted into the jaw, which have 
an extensive origin from the flat bones of the 
cranium. In like manner the movements of the 
humerus are partly caused by muscles which arise 
from broad areas of the scapula. 

A muscle is said to *' arise or take origin " from that 
end which usually is flxed when the muscle acts, and 
its " insertion " is that end which usually moves most. 

The femur is the longest bone in the body ; the 
next longest are the bones of the leg and arm and 
forearm, some of the ribs, and then the clavicle. 

The bones of the upper limb comprise : — 

1. The clavicle, or collar-bone. 

2. The scapula, or shoulder-blade. 

34 



THE SKELETON 






3. The humerus, or bone of the arm. 

4. The ulna, the inner bone of the forearm. 

5. The radius, the outer bone of the forearm. 

6. The carpals or bones of the wrist. 

7. The metacarpals or bones of the palm of the 

hand. 

8. The phalanges or bones of the digits. 

1. The clavicle (Fig. 1) is situated in the front 
part of the thorax or chest, where the trunk 
merges into the neck. 
At its inner extremity 
it is joined to the 
sternum (breast-bone) 
by the sterno-clavi- 
cular joint. The inner 
ends of the right and 
left clavicles are about 
an inch apart. The 
outer extremity of the 
clavicle touches the 
acromion process of 
the scapula in the 
acromio-clavicular 
joint, and is situated 

at a somewhat higher level than the inner end (Fig. 1). 
This is the case even with people whose shoulders 
slope in a very marked degree. 

The clavicle has its curves so arranged that there 
is a convexity forward in the inner part, for rather 
more than half the length of the bone, and a con- 
cavity forward in the outer part, for rather less than 
half. It is thicker and more prominent internally 
than externally : a cross section made through the 
internal half is triangular ; through the external hall 
it is flattened from above downwards. 

35 




Fig". 1.— Tlie Clavicle and Scapula of the 
Right Side, with the Sternum. From 
the front. 



THE SKELETON 

In the clavicle, as in all other long bones, the 
degree of its roughness gives a fair indication of 
the muscularity of the individual. 

The clavicle is a bone of high importance to the 
student of anatomy. It forms a very prominent 
landmark, easily seen in thin people. In well-covered 
and muscular subjects, however, it lies at the bottom 
of a furrow, a situation common in many other parts 
of the body, e.g. the external condyle of the humerus 
and the great trochanter of the femur, a dimple 
indicating the position of a bone 
which in the skeleton appears 
to be prominent. 

The clavicle, unlike the other 

long bones, continues to increase 

much in length between the ages 

of twenty and twenty-five years, 

and thus produces, during this 

period, a great increase in the 

breadth of the shoulders, an 

Fig. 2.— The Scapula and increase w^hich constitutes one 

"Irl tt%aT' °f tte Chief characteristics dis- 

tinguishing the adolescent boy 

from the adult man. 

2. The scapula (Fig. 2) is chiefly visible upon 
the upper part of the back of the trunk, but two 
of its "processes" are apparent from the front of 
the skeleton, namely, the acromion, which makes 
the point of the shoulder, and the coracoid, which 
is covered by thick muscles, but in the wasted subject 
can be seen under the skin belo"w the outer part of 
the clavicle. 

It is a triangular flat bone having two sur* 
faces : — 

a. The front or ventral surface, applied to the ribs 

36 




THE SKELETON 

over the back of the thorax, from the second to the 
seventh. 

h. The hinder or dorsal surface, overlaid by the 
muscles and skin of the back. 

Three borders : — 

a. The upper. 

h. The mesial, vertical, or vertebral. 

c. The external, oblique, or axillary (lying in re- 
lation to the axilla or armpit). 

And three angles : — 

a. The superior. 

h. The inferior, which is prominent in persons who 
are " round-shouldered." 

c. The external, sometimes called the head of the 
scapula, which, with the head of the humerus and the 
connecting ligaments, forms the shoulder- joint. 

The three processes of the scapula are : — 

a. The spine or spinous process (Fig. 2, p. 36). 
This is a well-marked bony ridge which projects 
backwards from the dorsal surface. It begins in- 
ternally at the junction of the upper and second 
quarter of the vertebral border, and becomes more 
prominent externally, where it terminates in the 
second process. 

h. The acromion process. This is flattened and 
directed forwards, upwards, and outwards, to form 
the point of the shoulder. The acromion process has 
two borders, of which the inner one enters, with the 
external end of the clavicle, into the formation of 
the acromio-clavicular joint. 

c. The coracoid process is curved upon itself, and 
tapers rapidly to its apex, which is directed forwards 
and outwards just below the forward concavity of 
the outer third of the clavicle (Fig. 1). 

3. The humerus (Fig. 3), or bone of the arm 

37 



444703 



THE SKELETON 



proper, is described, like all the long bones, as con- 
sisting of a shaft and two extremities, upper and 
lower. (The extremities of the clavicle only are 
known as outer and inner, and the extremities of 
the ribs are called anterior and posterior.) 

The humerus articulates above with the head of the 
scapula, to form the shoulder- joint, and below ^vith 
the ulna and radius, where it forms the elbow- joint. 
The upper extremity, or head of the 
humerus, forms a small segment of a 
large globe. It is directed upwards, 
inwards, and backwards, and the size 
of it greatly influences the promi- 
nently convex shape and outline of 
the shoulder. When the arm is out- 
stretched, the head of the humerus 
may be felt, or even seen, in the axilla, 
especially in thin people. 

The tuberosities of the humerus are 
flattened projections which are sepa- 
rated from the head by the anatomical 
neck, to which the capsule of the 
shoulder- joint is attached. The vertical 
bicipital groove divides the greater and 
lesser tuberosities from each other, 
the groove running downwards, in- 
wards, and slightly forward, and lodging the tendon 
of the long head of the biceps muscle. The greater 
tuberosity lies outside and behind the lesser. 

The shaft of the humerus begins below the tubero- 
sities and head at a decidedly narrower part, which 
is know^n as the surgical neck on account of the 
frequency with which the bone is broken in this 
region. Below the neck the shaft becomes a little 
thicker, and is twisted, not bent, outwards through 

38 



Fig. 3.— The Right 
Humerus. Front 
view. 



THE SKELETON 



an angle of fifteen or twenty degrees. In its lower 
third it is slightly flattened from before backwards, 
and is concave for- 
wards. 

The lower extre- 
mity of the humerus 
is very wide from 
side to side. 

The condyles of 
the humerus lie on 
each side of the 
lower extremity. 
The internal, which 
is larger and lies at 
a lower level than 
the external, is 
directed chiefly in- 
wards but also 
slightly backwards, 
while the external is 
directed outwards. 

The condyles 
serve the usual 
purpose of bony pro- 
minences, namely, 
the attachment of 
muscles in this case, 
and of some of the 
ligaments of the 
neighbouring joint, 
the elbow. They 
form the lower 
hmits of correspond- 
ing ridges, called the supra-condylar ridges, which 
descend on each side of the shaft of the humerus, 

39 




Fig. 4.— The Front of the Upper Extremity, 
showing the "Carrying Angle" between 
Arm and Forearm. 



THE SKELETON 




Fig 5. —The Bones forming the 
Elbow Joint. Back view. 



The trochlea is a broad, smooth articular surface 
at the lower end of the humerus, grooved obliquely, 

so that behind the groove it 
is directed downwards and 
inwards, and in front it runs 
upwards and outwards. The 
inner lip of the trochlea is 
more prominent than the 
outer, especially towards its 
lower part. This lip, by its 
large size, is responsible for 
the maintenance of the carry- 
ing angle (Fig. 4). The arti- 
culation of the trochlea and the ulna forms the main 
part of the elbow- joint (Fig. 5). 

The capitellum lies between the trochlea 
and the external condyle and articulates 
with the radius in the elbow- joint. It is 
a rounded surface, and is not so well seen 
from behind as from in front. 

The bones of the forearm (Fig. 6) 
are the radius and the ulna. The two 
bones lie nearly parallel to each other in 
the position of " attention," which is that 
of " supination " of the forearm ; but the 
ulna begins higher up the limb and does 
not reach so far down as the radius. In 
pronation the radius crosses obliquely 
downwards and inwards over the ulna. 

They taper in different directions, the 
ulna being larger at the elbow end and 
the radius at the wrist. The elbow- joint 
is in great part formed by the ulna, while 
the radius is the more important constituent of the 

wrist. 

40 



Fig. 6. —The 
Right Ulna 
and Radius, 
Front view. 



THE SKELETON 

4. The ulna, the longer bone, lies to the inner side 
of the radius. The greater sigmoid cavity of the 
ulna is a deep hollow at its upper end, the concavity 
of which is directed forwards and articulates Tvith 
the trochlea of the humerus. This cavity is over- 
hung above and behind by the prominent olecranon 
process. The strong portion of bone known as the 
coronoid process projects forwards below the greater 
sigmoid cavity. 

The lesser sigmoid cavity lies on the outer side of 
the upper part of the coronoid process, and receives 
the head of the radius. 

The posterior surface of the olecranon process is 
triangular in shape and very easily felt, because sub- 
cutaneous. Its upper part forms the point of the 
elbow. The triangular area, with its apex below, is 
continuous with the sinuous posterior border of the 
shaft, which is also subcutaneous in the whole length 
of the bone. 

The shaft tapers towards the wrist where the 
lower end of the ulna presents two prominences 
separated by a deep groove. The larger, the head 
of the ulna, is very obvious on the back of the 
wrist in the pronated position. The slenderer styloid 
process is detected with more difficulty by the 
examining finger. 

Notice that the ulna tapers from elbow to wrist 
in about the same delicate graduation as does the 
undissected forearm, and that its shaft is not only 
concave forwards throughout its whole length, but 
also, when viewed from before back, it is concave 
outwards towards the radius. 

5. The radius has a head with a saucer-like de- 
pression at its upper end. The constriction below the 
head is the neck, from which the shaft gradually 



THE SKELETON 

swells out till it reaches the very large lower ex- 
tremity at the wrist. 

The bicipital tuberosity lies just inside and below 
the neck, and its posterior part gives attachment to 
the biceps tendon. 

The shaft is convex outwards, and concave towards 
the ulna. At the most prominent part of the curve 
is a noticeable rough area, into which an impor- 
tant muscle known as the " pronator radii teres " is 
inserted. 

The styloid process of the radius can be felt in 
the "anatomist's snuff-box" {vide p. 101); it is more 
massive, and situated at a lower level than the cor- 
responding process of the ulna. The back of the 
lower end of the radius is marked by four grooves, 
the deepest of which lies on the inner side of a 
prominent tubercle, and lodges the tendon of the 
extensor longus pollicis muscle. 

The sigmoid cavity, lying on the inner side of the 
lower end of the radius, receives the head of the 
ulna. 

The radius is joined by ligaments to the ulna. The 
chief of these are the collar-like orbicular ligament 
which surrounds the head of the radius, the triangular 
fibro-cartilage which unites the lower ends of the two 
bones, and the interosseous membrane, the fibres of 
which pass downwards and inwards from the shaft 
of the radius to that of the ulna. 

This membranous ligament is a very important 
factor in the mechanics of the forearm. When a 
thrust with the hand is made, pressure is transmitted, 
from the object pushed to the lower end of the 
radius, and this bone tends to be displaced upwards. 
But the direction of the fibres of the interosseous 
membrane is such that they are at once made tight, 

42 



THE SKELETON 



and so they pull upon the ulna. The thrusting force 
is thus transferred to the ulna, distributed through- 
out its whole length, but changed into a pulling one, 
and so shock is diminished. 

6. There are eight bones of the wrist or carpus 
(Fig. 7). They are so articulated with each other 
that there is a distinct general concavity of the 
anterior aspect of the carpus. This concavity is 
bounded on the inner side by the 
pisiform bone, the smallest of 
the series, and by the well- 
marked hook of the unciform 
bone, which lies more deeply 
and is just below the pisiform. 

The corresponding eminences 
which bound the concavity to 
the outer side are the tubercle 
of the scaphoid and the ridge 
on the trapezium. The latter 
bone is on the outer side of a 
deep groove that receives the 
flexor carpi radialis tendon. It 
possesses a very special import- 
ance in that it has a small 
process of bone which is directed 

downwards and inwards and throws the thumb away 
from the finger. The great range of movement in 
the thumb is characteristic of the human hand, and 
is of vital importance to man in the performance of 
many of the finer movements which in the process of 
civilisation he has acquired, such as are for instance 
essential to the proper use of pen and pencil. This 
range is so free that the palmar surface of the 
thumb's terminal phalanx can be opposed to the 
palmar surface of any part of the other digits. 

43 




Fig. 7,— The Bones of the 
Wrist and Hand. Front 
view. 



THE SKELETON 

7. The metacarpal bones (Fig. 7, p. 43) are 

five, one to each digit. Their posterior surfaces form 
longitudinal ridges on the back of the hand, more 
obvious in the aged or emaciated, and their heads 
form the first or proximal set of knuckles. 

8. The phalanges (Fig. 7) are fourteen in number 
— three to each finger, but only two to the thumb. 
They diminish in size from above downwards, and 
are described as long bones, in that each has a shaft 
and two extremities. The heads of the proximal^ 
and middle phalanges form the middle and distal 
rows of knuckles. 

The bones of the lower limb comprise : — 

1. The OS innominatum, or hip-bone. The bony 
basin of the pelvis is formed of the two ossa innomi- 
nata together with the sacrum and coccyx, which 
are the two lowest bones of the spinal column. 

2. The femur, or thigh-bone. 

3. The patella, or knee-cap. 

4. The tibia, or large bone of the leg. 

5. The fibula, or small bone of the leg. 

6. The tarsals. 

7. The metatarsals. 

8. The phalanges. 

1. The hip-bone belongs to the class of flat bones. 
Its functions are : — 

To give attachment to the strong muscles which 
maintain the erect position (Figs. 8 and 9, p. 45). 

To support the weight of the head, trunk, and upper 
limbs, and to transmit this weight to the lower limb. 

To protect the important viscera which lie in the 
lower part of the abdominal cavity and in the pelvis. 

^ The term " proximal " refers to that part which is nearer to the 
centre of the body ; the term distal, to that part which is farthej 
removed. 

44 



THE SKELETON 

The relation of the os innominatum to the sacrum 




Female Pelvis. 

Figs. 8 and 9.— These two fignres should be compared with one another. They show the characteristic 
features of the male and female pelvis. The bones forming the male pelvis are more massive, and 
the muscular prominences are better marked, than those of the female. In the female, on the other 
hand, the pelvic cavity is broader ; the subpubic angle wider ; and the thyroid foramen more 
triangular and set more horizontally than in the male. The increased breadth of the pubic bones, in 
the female, should also be noted. 

in the constitution of the pelvic cavity will be de- 
scribed later. 

45 



THE SKELETON 

Although the hip-bone is responsible to a great 
extent for the configuration of the lower part of 
the trunk and the region of the buttock, and 
although many of its prominences can easily be felt, 
and indeed form important anatomical landmarks, 
yet few of them form projections visible in the 
undissected model, as do the clavicle, the tibia, 
and other thinly covered bones. The bone is 
developed in three separate parts which unite at 
puberty, viz. : — 

a. The ilium, the flat upper portion. 

h. The ischium, the tuberous lower portion. 

c. The pubes, the anterior part. 

The ilium presents two surfaces, an inner and 
an outer. The inner surface is smooth and hollow 
in front for the attachment of the iliacus muscle. 
Behind there is a smooth ear-shaped surface for 
articulation with the sacrum, and above a rough 
area to which are fixed the very strong posterior 
sacro-iliac ligaments, to be described later. 

The outer surface is generally convex, and affords 
origin to the three gluteal muscles, which are of 
great importance in attaining the erect position. 
Each of these surfaces is bounded above by the sinuous 
crest of the ilium. The crest forms the brim of the 
false pelvis ; it terminates in front in the oval anterior 
superior spine of the ilium, and behind in the pos- 
terior superior spine. The latter spine lies, in the 
living subject, at the bottom of a shallow dimple, and 
corresponds to the middle of the sacro-iliac joint. 

The tubercle of the ilium is a thickened portion 
of bone situated upon the outer lip of the crest 
some 2\ inches behind the anterior superior spine. 
It is the highest part of the iliac crest, and forms 
the extreme lateral portion of the bone. 

46 



THE SKELETON 

The ischium and puhes surround a large oval 
orifice, the thyroid foramen. The most important 
part of the ischium is its massive tuberosity, which 
forms to a large extent the prominence of the 
buttock, and is the resting point of the body in 
a sitting position. 

The pubes, lying in front of and above the ischium, 
is a flatter and less massive bone. It articulates 
with its fellow in the middle line at the symjphysis 
pubis. The crest of the pubes extends outwards 
from the symphysis for about an inch, and has 
the rectus abdominis attached to it. It ends in a 
palpable eminence called the spine of the pubes. 

The acetabulum. The three parts of the os inno- 
minatum converge at the deep cup-shaped hollow, 
the acetabulum, situated upon the outer surface of 
the bone, for the reception of the head of the femur. 
The margin of the hollow is deficient, at a point 
below and in front, which is known as the cotyloid 
notch. 

The ilium forms less than two-fifths of the aceta- 
bulum. 

The ischium forms more than two-fifths. 

The OS pubis forms about one-fifth. 

The Pelvis (Figs. 8 and 9, p. 45), which is formed of 
four bones — viz. the two hip-bones, the sacrum, and 
the coccyx — is of very great importance in determin- 
ing the shape of the skeleton, and difi^ers in the two 
sexes, most markedly, of course, in the adult, but also 
to some extent in the young. 

The pelvis forms an expanded, basin-like cavity for 
the reception, support, and protection of the viscera 
contained in the lower part of the abdomen, and for 
the attachment of large and powerful muscles. As 
it is open both above and below, it would be more 

47 



THE SKELETON 



correct to liken it to a funnel, which is broad above 
and narrow below. The expanded wings, which are 
formed on either side by the iliac portions of the 
hip-bones, constitute the false pelvis ; whilst the true 
pelvis, which Kes below this, is formed by the 
sacrum and coccyx, and the ischial and pubic portions 

of the hip-bones. In the 
female pelvis the bones, 
as elsewhere, are much 
lighter in texture than 
in the male, and the 
muscular prominences 
are not so Tvell marked. 
The iliac wings are more 
widely expanded, so that 
much more of their inner 
surfaces can be seen from 
the front. The diameters 
of the true pelvis are 
greater, as is also the 
subpubic angle. 

2. The femur, or thigh- 
bone (Figs. 10 and 11), 
is the longest bone in 
the body. As a general 
rule its length may be 
considered as equal to 
a quarter of the total length of the body from the 
vertex of the skull to the heel. It articulates above 
with the acetabulum to form the hip- joint, and 
below with the patella and tibia in the knee-joint. 

The femur presents for examination a shaft and 
an upper extremity consisting of head, neck, and 
two trochanters, and a lower extremity. 

The head is smooth, in shape rather more than 

48 




Fig. 10. — Right 
Femur. Front 



Tig. 11. — Right 
Femur. Back 
view. 



THE SKELETON 

half a sphere, and is received into the cup-shaped 
acetabulum. 

Just below is the long neck, broader and flatter 
externally, where it is continuous with the shaft of 
the bone at an angle of about 120 degrees. Some 
authorities consider that the angle diminishes with 
advancing age, but Sir George Humphry, to whom 
every student of anatomy owes so much, came 
eventually to the conclusion that no such diminu- 
tion takes place. 

The great trochanter is above and external to 
the neck, and into it several strong and important 
muscles are inserted — e.g. the glutei. The external 
surface of the great trochanter is painfully well 
known to skaters, among whom it has acquired the 
name of the " two-turn bone." It may be easily 
felt three or four inches below the crest of the ilium. 
In the thin subject it forms a visible prominence at 
uhat point ; in the well covered it lies at the bottom 
of a slight depression, best marked in the female. 

The lesser trochanter is a smaller tubercle lying 
deeply embedded in the muscles on the inner and 
posterior aspect of the upper part of the shaft. To it 
is attached the powerful ilio-psoas. 

The shaft of the femur is generally cylindrical, and 
swells out as it is traced downwards. It is marked 
usually by a slight forward convexity ; the concavity 
of the x^osterior aspect is greatly strengthened by a 
thick ridge of bone known as the linea aspera. 

The inferior extremity presents large internal and 
external swellings known as condyles, the former 
larger than the latter. They are separated by a 
hollow which is more pronounced below and behind, 
the intercondyloid notch. 

On the upper part of the postero-internal aspect 

49 D 



THE SKELETON 

of the internal condyle is the adductor tubercle for 
the insertion of the adductor magnus muscle. Both 
condyles are smooth behind, below, and in front. 
The smooth surfaces behind and below articulate 
with the tibia, and in complete flexion of the joint 
the latter articulates with the patella also, but the 
smooth surface on the front of each condyle, and the 
smooth surface between the condyles, articulate only 
with the patella. 

Inclination and torsion of the femur. In the 
erect position of the subject there is a distinct 
inclination of the shaft of the femur inwards as it 
approaches the knee. The angle of inclination from 
the vertical is about nine degrees, and is greater in 
the female, in consequence of the larger pelvis, 
than in the male. The shaft of the femur is also 
rotated inwards through an angle of about ten 
degrees, so that the inner end of the axis of the 
head and neck lies in front of the inner end of the 
transverse axis of the loTver extremity. In other 
words, the neck of the femur is directed not onl}? 
upwards and inwards, but also a little forwards, 

3. The patella, or knee-cap (Fig. 12), is a small, 
somewhat triangular bone having the apex pointed 
downwards. To its upper and lateral borders is 
attached the quadriceps extensor cruris, which is 
chiefly muscular at the superior border of the bone, 
and ligamentous at the sides. From the pointed 
lower end of the patella the thick ligamentum 
patellae passes to the tubercle of the tibia, and so 
transmits to the leg bones the force of the quadri- 
ceps extensor muscle. The posterior surface of the 
patella is smooth ; it articulates with the femur, and 
not at all with the tibia. 

4. The tibia, or large bone of the leg (Fig. 12), has 

50 



THE SKELETON 



a thick upper extremity for articulation with the 
femur by a wide upper surface forming a generally 
horizontal plane, on which there are two slight con- 
cavities for the femoral condyles. The upper end 
of the bone is slightly recurved, and made up of 
two tuberosities, and the internal one 
forms a marked prominence on the 
inner side of the knee. 

On the anterior surface, about two 
inches below the upper end, is the 
prominent " tubercle of the tibia," into 
which the ligamentum patellae is in- 
serted. This tubercle transmits the 
weight of the body in the kneeling 
posture. It is continuous below with 
the sinuous anterior border of the 
shaft. This border bounds, in front 
and externally, the subcutaneous an- 
terior surface of the tibia, which looks 
not only forwards but inwards. As 
no muscles intervene between them 
and the skin, both border and surface 
are easily felt and seen, and are com- 
monly known as " the shin." The ^^s- 12 



-The Lower 
r? • 1 J J • J- n J End of the Femur, 

surface is bounded mternally and with the Patella. 

behind by the internal border of the 
bone, and both here and at the an- 



Tibia, and Fibula 
of the Right Side. 
Front view. 



terior border a prominent mass of 

muscle is seen when the well-developed leg is thrown 

into muscular activity (Plate XXI.). 

The lower extremity of the tibia is considerably 
larger than the shaft, but is only prominent at its 
internal aspect, where it projects do^vnwards on the 
inner side of the ankle-joint as the internal malleolus. 
Through the groove at the back of the internal 

51 



THE SKELETON 

malleolus the tibialis posticus tendon may be always 
felt and, in positions of strain, seen as it passes down 
into the sole of the foot. 

5. The fibula, or small bone of the leg (Fig. 12, p. 51), 
lies on the outer side of the tibia, and is directed 
downwards and forwards from above in a slightly 
oblique position. It is almost completely covered 
by muscles. The posterior part of its head, how- 
evei', projects up\^^ards, and can be seen and felt 
just below the level of the knee (into which it does not 
enter) as the styloid process, for the attachment of 
the external lateral ligament of the knee-joint, and 
also of the biceps flexor cruris. The neck is a slightly 
constricted part just below the head. 

Similarly, the inferior extremity of the fibula, ex- 
panded and a little flattened from side to side, can 
be felt and seen as it forms the external malleolus. 
This is the prominence on the outer part of the 
ankle, and it reaches a lower level than does the 
internal malleolus of the tibia. It articulates with 
the tibia and with the astragalus, one of the bones of 
the foot. 

The Bones of the Foot (Figs. 13 and 14).— These 
form a composite arch, concave downwards, not 
only in a sagittal direction {i.e. from behind for- 
wards), but also in a transverse direction, so that the 
term "dome" would be more accurate than "arch." 
The arch has one pier behind, formed by the os calcis, 
but two in front formed by the heads of the first and 
fifth metatarsal heads. 

6. The tarsus is made up of seven bones ; the 
OS calcis is much the largest, and the middle cunei- 
form much the smallest. 

The OS calcis, or heel, forms the single posterior 
pillar of the arch, it articulates with the astragalus 

52 



THE SKELETON 

above and with the cuboid in front. Placed in the 
position it occupies in the body when the subject is 
standing upright, its long axis is directed backwards 




Fig. 18.— Bones of Right Foot. Inner side. 




Fig. 14.— Bones of Right Foot. Outer side. 

and downwards. Its posterior surface is convex 
and rough, unlike its anterior surface, which is 
smooth and slightly concave. 

53 



THE SKELETON 

The convex posterior surface of the os calcis may 
be divided into three parts. The middle part gives 
attachment to the Tendo AchilKs, the large tendon 
running to the heel ; the lowest part first receives 
the impact of the body when the foot is placed 
upon the ground in the action of walking. 

The sustentaculum tali is a prominent tubercle on 
the inner side of the bone, smooth above for articu- 
lation with the astragalus or talus, and grooved below 
for the transmission of the tendon of the flexor longus 
hallucis muscle. 

On the outer aspect is a small prominence called 
the peroneal tuhei'cle, separating the tendons of the 
two peroneal muscles. 

The astragalus is the keystone of the arch, and trans- 
mits pressure from the tibia to the foot. It pos- 
sesses a convex, smooth articular facet for the tibia, 
broader in front than behind, with the result that 
when the foot is flexed, i.e. brought as far as possible 
into a straight line Tvith the leg, a certain amount 
of lateral movement is allowed at the ankle-joint. 

A strong interosseous ligament fixes the astragalus 
very firmly to the os calcis. 

In front the astragalus articulates with the 
scaphoid, a bone situated on the inner side of the 
foot and prolonged internally and below into a pro- 
minent tuberosity which can be seen and felt. 

The scaphoid, or navicular, is flattened from before 
backwards, and articulates in front with the three 
cuneiform bones. Only the internal cuneiform re- 
quires mention here, as its lower border forms a 
well-marked ridge directed downwards. 

The cuboid, on the outer side of the foot, articu- 
lates behind with the os calcis, and in front with 
the fourth and fifth metatarsal bones. Its under 

54 



THE SKELETON 



surface is marked by a deep groove directed inwards 
and forwards for the transmission of the peroneus 
longus tendon. 

7. The metatarsal bones are five in number. 
The first is much the largest. It presents a notice- 
able tuberosity at its base, or extremity nearest the 
heel. The head forms the "ball of the toe," and 
constitutes the base of the anterior pier of "the 
arch of the foot" (Fig. 13, p. 53). 

8. The phalanges of the foot, fourteen in number, 
are much smaller than the 

corresponding bones of the 
hand. 

As has been stated, the 
astragalus is the keystone of 
the arch of the foot, and 
the OS calcis is the posterior 
single pillar. There are two 
pillars supporting the arch 
in front, an internal and an 
external. The scaphoid, the 
three cuneiform bones, and 
the three innermost meta- 
tarsals form the internal pillar, and the external is 
built up of the cuboid, and the two outer meta- 
tarsal bones. 

The Bones of the Skull. 

The skull (Fig. 15), with the exception of the inferior 
maxillary bone, appears in the adult to be made up 
of a continuous bony structure, whose various parts 
are inseparably and immovably united. 

However, if a young child's skull is examined 
(Fig. 16, p. 56), it will at once be obvious that there 
are in reality many bones, easily distinguishable from 
one another, and, at any rate in a newly born infant, 

55 




Fig. 15.— Anterolateral View 
of Skull (adult). 



THE SKELETON 

each bone is capable of being moved to some extent 
relatively to its neighbours. This mobility of the 
bones enables the head to be moulded in the process 
of birth to the shape of the maternal passages. 

In the adult, each bone is intimately articulated to 
its neighbours by means of tortuous and often deeply 
serrated " sutures." 

" The skull " means the entire skeleton of the head. 




Fig. 16.— Skull of Young CMld. 



Tig. 17.— Front View of 
Skull (adult). 



*' The cranium " is the term reserved for the skull 
without the mandible. 

" The calvarium " is that part of the skull which re- 
mains after the bones of the face have been removed. 

The " cranial bones " are eight in number : — 

1. One frontal. 

2. One sphenoid. 

3. One ethmoid. 

4. One occipital, 

5. Two parietal. 

6. Two temporal. 
1. The frontal bone 



(Fig. 
56 



17) is situated on the 



THE SKELETON 

anterior aspect of the cranium. It is responsible 
for the form of the forehead ; it provides the roof 
of the orbits, or cavities which contain the eyes, and 
of the nasal fossae. 

The " supra-orbital margin " is curved strongly with 
its concavity downwards ; it carries the eyebrows, 
and in common with all the cranial prominences it 
varies much in different individuals, both in its curve 
and in its degree of prominence. The broad but lov^r 
" superciliary ridge " lies above rather more than the 
inner half of each supra-orbital margin. Above this 
again is the " frontal eminence," lying on a vertical 
line drawn through the middle of the supra-orbital 
margin. 

On each side of the orbit the frontal bone is pro- 
longed downwards both externally and internally, 
but the external of these two angular processes does 
not reach so far down as the internal. 

The anterior aspect of the frontal bone is convex, 
while its posterior surface is concave, and lodges 
that portion of the brain which is known as the 
frontal lobe, and which is associated with intellect. 

Above the bridge of the nose the frontal bone may 
be very prominent. There is here an air-chamber, 
the frontal sinus, of very variable dimensions, between 
the two dense plates which constitute the chief struc- 
ture of all the cranial bones. This air cavity con- 
stitutes one of the many resonating chambers which 
largely determine the quality of the voice. 

The median nasal spine supports the two small 
nasal bones, and upon them the shape of the bridge 
of the nose chiefly depends. It is a slender process 
prolonged downwards and forwards from the inferior 
and anterior part of the frontal bone. 

2 and 3. The ethmoid and sphenoid bones 

67 



THE SKELETON 



scarcely come to the surface of the articulated skull, 
and therefore a full understaDding of them is not 
necessary for the art student. They play» however, 
an important part in the determination of the size and 
shape of the nasal cavity and of the face, and even 
of the skull, and like the frontal bone they contain 
large resonating air-chambers. 

4. The occipital bone (Fig. 18) forms the posterior 
and lower part of the cranium. It is 



roughly 



m 




diamond-shaped, and 
it is the large foramen 
magnum for transmission 
of the spinal cord to the 
cranial cavity. The fora- 
men is directed down- 
wards and forwards, the 
forward inclination being 
peculiar to the human. 

In the middle line, 
about the centre of the 
bone, on its posterior 
convex aspect, is the ex- 
ternal occipital protuber- 
ance, from which the ex- 
ternal occipital crest may be traced down^vards to 
the foramen magnum, while outwards on each side 
from the protuberance there runs a curved ridge 
for the posterior portion o:? the occipito-frontalis 
muscle to be attached above, and the trapezius and 
part of the sterno-mastoid below. Below this again 
some of the strong muscles of the back of the neck 
are inserted. 

5. The parietal bone (Fig. 18) Hes on each side 
of the middle line between the frontal and occipital 
bones. It is quadrilateral in shape, with a convex 

58 



Fig. 18 —Side View of SkuU (adult). 



THE SKELETON 

outer surface giving attachment in its lower half to 
the temporal muscle. A little above and behind the 
centre of each is the increased convexity or pro- 
minence known as the parietal eminence. Under 
this bone lies the part of the brain chiefly concerned 
with the motor and sensory functions. 

6. The temporal bone (Fig. 18) lies on each 
side below the parietal bone. It contains the organ 
of hearing, and supports the cartilaginous auricle 
or external ear. It shows on its external aspect 
a deep hole or canal called the external auditory 
meatus. Behind this is a nipple-like projection 
directed downwards, called the mastoid process, and 
giving origin to the very important sterno-mastoid 
muscle. 

The mastoid process is not fully developed till the 
age of seven years, by which time an air sinus is 
formed in its interior. It is relatively much smaller 
in the infant and young child, in whom the air cavity 
is yet to be developed, than in the adult. The 
flattening of the auricular region so obvious in 
young children is thus explained by a reference to 
the deep anatomy of the region. The part of the 
temporal bone above the meatus articulates with 
the parietal bone, and is called squamous, because of 
its likeness to a fish scale. 

The zygomatic process is a prolongation forwards 
from the outer surface of the temporal bone, just 
above the external auditory meatus. It forms, to- 
gether with a similarly named process of the malar 
bone, the zygomatic arch, under which the temporal 
muscle passes to its insertion, and from which the 
masseter muscle arises. 

The Bones of the Face (Figs. 15, 17, 18, pp. 55, 
56, 58), — Besides the ethmoid and sphenoid, which 

59 



THE SKELETON 

determine the ^dth between the eyes, the bones 
chiefly responsible for the shape of the face are the 
superior and inferior maxillary bones, the malar and 
the nasal. With the exception of the single inferior 
maxillary bone, these are all in pairs and are sym- 
metrical. 

1. The nasal bones lie close to, and articulate with, 
each other in the middle line. They are very small, 
forming the bridge of the nose only, and being assisted 
in this by the nasal spine of the frontal bone, which 
lies behind in the middle line, and by the nasal 
processes of the superior maxillae, which are on each 
side behind them. 

2. The superior maxillary bone, or upper jaw, 
underlies that part of the lips and cheek which is 
above the mouth, and it forms a great part of the 
inferior margin of the orbit. It also enters into the 
formation of the nasal chambers and of the buccal 
cavity, contributing the greater portion of the hard 
palate. It is a hollow bone, and besides containing 
the large air sinus known as the antrum of Highmore 
and the sockets for eight teeth, it gives attachment 
to numerous small facial muscles. 

The upper jaw articulates with its fellow below 
the nasal orifice. 

3. The malar or cheek-bone forms one-half of the 
lower margin of the orbit, and three-quarters of its 
outer margin. It causes a flat prominence below 
and external to the orbit, the so-called cheek-bone, 
of which the degree of development varies so enor- 
mously in different types of face. The malar has 
a zygomatic process prolonged backwards to form 
part of the zygomatic arch. 

4. The mandible (Figs. 17, 18, pp. 56, 58), inferior 
maxillary hone, or lower jaiv, supports the teeth of the 

6Q 



THE SKELETON 

lower jaw, sixteen in number, eight on each side in 
the adult; but nearly twice that number before the 
deciduous or temporary set have been shed. It is the 
most massive bone of the face, and articulates only 
with the temporal bone, by a transversely placed 
" condyle " playing, when the mandible is raised or 
lowered, in a hollow on the under surface of that 
bone known as the glenoid cavity. Its shape is 
that of an arcJi, with the convexity directed for- 
wards and its pillars turned upwards. Its lower 
margin is very prominent, especially in front, where 
it forms the mental protuberance, which supports, 
and is in great part responsible for the shape of, 
the chin. 

The angle of the jaw is situated behind, where 
the pillar of the arch turns upwards to change the 
name of **body" (horizontal part) for that of the 
" ramus " (or vertical part). 

The masseter muscle is attached to the outer 
surface of the angle, and is prominent in muscular 
individuals when the teeth are clenched. 

The ramus is set on to the body at an angle which 
approaches a right angle in the prime of adult life, 
but which is much more open or obtuse at both 
extremes of life. 

The hyoid bone will be described in connection 
with the neck. 

The Bones of the Vertebral Column or 
Vertebrae. 

The spinal column consists of t'wenty-six sepa- 
rate bones: seven "cervical" vertebrae in the neck; 
twelve, called " dorsal," in the back ; and five " lumbar," 
in the loin. Two conglomerate masses of vertebrae, 
the sacrum and the coccyx, help to form the pelvis. 

Each vertebra surrounds a ceotral spina I canal for 

61 



THE SKELETON 

the transmission of the spinal cord and its coverings. 
The anterior part of the bone is called its "body," 
and is absent in the case of the first cervical or atlas. 
The superincumbent w^eight is transmitted through 
the column of the bodies. A spinal nerve passes out 
on each side beneath each vertebra. The lateral part 
of the vertebra has a transverse process on each side, 
and the posterior part projects backwards as the 
spinous process, which in most regions can be fell 
and even seen on the model (Plate II.), especially 
when the spine is flexed. 

The spinous processes are especially prominent in 
the low^er cervical and upper dorsal region, the 
seventh cervical having the name of the vertebra 
froininens ; but the first dorsal is almost, if not 
quite, as prominent. 

The lumbar vertebrae are the most massive, and 
the buffer-like discs of cartilage separating them are 
much thicker than those between the other vertebrae, 
so that although there are less than half the number 
of lumbar vertebrae when compared with the dorsal 
vertebrae, the total length of the lumbar portion of 
the spinal column is considerably more than half the 
length of the dorsal portion. 

The sacrum (Figs. 8 and 9) is concave do^vn- 
wards and forwards, and convex above and behind. 
It is triangular in shape, base upwards, and continues 
the lumbar spine, and articulates on each side with 
the hip-bone. It is wider in the female. 

The coccyx is the involuted tail. 

The Curves of the Spine. — The spinous processes 
of all the vertebrae lie very nearly in the middle line 
of the back, but their line is, in right-handed persons, 
deflected by the stronger muscles to form a slight 
convexity to the right. Nowhere in anatomy is 

62 



THE SKELETON 

strict symmetry, or absolute similarity of the two 
sides, to be found. 

There are other curves to be noticed in a profile 
view, viz. the cervical and lumbar curves having 
their convexity forwards, and the dorsal curve with 
a backward convexity. The object of these curves 
is to increase greatly the elasticity of the spinal 
column. 

The thorax consists of the twelve dorsal vertebrae, 
the twelve ribs on each side, and the sternum in 
front. 

The seven upper ribs articulate in front by the 
intervention of costal cartilages with the sternum. 
The eighth, ninth, and tenth ribs articulate in a 
similar way with those immediately above them, and 
the eleventh and twelfth, lipped with cartilage, do 
not articulate in front with any bone, and are called 
"floating ribs." 

The first rib (Fig. 1, p. 35) is flattened from above 
downwards, lies very obliquely, so that its posterior 
end is two inches or more above its anterior end, and 
unites with the first dorsal vertebra behind to form, 
with the sternum in front, the inlet of the thorax. 
This rib is partially concealed and protected by the 
clavicle. 

The succeeding ribs gradually increase in length 
as far as the eighth, and then they begin to decrease. 
Thus the cavity of the thorax, which they enclose, is 
considerably more roomy below than above. 

The sternum, or breast-bone (Fig. 1, p. 35), is 
flattened from before backwards, and lies in the 
middle line between the clavicles above and the seven 
upper ribs on each side. It is divided into three parts, 
of which the middle, or gladiolus, is the longest. The 
upper part, or manubrium, is the broadest, and makes 

63 



THE SKELETON 

a very distinct angle, the sternal angle, on the front 
of the chest, with the middle part. 

The ensiforin or loicer 'part is frequently retracted, 
and lies in the pit of the stomach. 

The thorax difPers in the two sexes. In the 
female it is relatively shorter, and less flattened from 
before back, than in the male. Its capacity also ig 
not so great. 



64 



CHAPTER II 

THE COVERINGS OF THE BODY 

The Skin covers the whole body. On the face it is 
continuous with the mucous membrane hning the 
ahmentary canal at the red margin of the lips, and 
also with the mucous membrane of the nasal cavities, 
and with the conjunctiva or membrane covering the 
front of the eyeballs. 

It is elastic, and varies greatly in thickness, both 
in different individuals and in different parts of the 
same individual. Thus it is thick over the scalp, 
the back of the trunk, the palms of the hands, the 
soles of the feet, and the extensor surfaces of the 
limbs ; and thin over the face, the neck, the abdomen, 
and the flexor surfaces of the limbs, but perhaps 
thinnest of all in the eyelids. 

Its surface presents numerous fine but permanent 
ridges and furrows, best marked on the palmar 
surface of the hand, the fingers, and the thumbs; 
a fact which has been turned to account by the 
palmist, and to a more useful purpose by the crimi- 
Dologist, since the discovery that it is possible to 
register the finger-prints, and so to identify sus- 
pected individuals. 

Additional, but usually temporary, furrows are 
often caused by the action of underlying muscles. 
Sometimes even these tend to become permanent, as 
in the furrows on some foreheads and most necks. 

Numerous minute pits on the surface of the skin 

65 B 



t 



THE COVERINGS OF THE BODY 

indicate the orifices of the sweat and sebaceous (or 
grease) glands and the hair folKcles, but, as a lens 
is necessary for their accurate study, they hardly call 
for the notice of the artist. 

Moles are pigmented patches, usually small and 
flat, but sometimes large and hairy, and are liable 
to occur on any part of the skin. 

The colour of the skin varies enormously in diffe- 
rent individuals and in different circumstances. The 
ruddy colour of health is chiefly due to a good circu- 
lation ; the pallor of cold, of collapse, and of death ; 
the deep blush ; and the whiteness associated in 
certain persons with anger, are examples of the 
variation in colour resulting from altered blood 
supply. 

Pigment may be developed in the deep layers of 
the skin, not only in the negro races, but in 
white skins when afflicted with certain diseases, 
or when lately sunburnt. Certain parts become 
pigmented more readily than others, e.g. the flexure 
of the limbs, the eyelids, and the areola immediately 
around the nij)ple of a woman who has, or is about 
to, become a mother. 

The skin is marvellously well adapted to the 
multitudinous purposes it has to serve. It is tough, 
yet pliable and elastic ; smooth and moist, yet not 
messy ; sensitive, yet very resisting, and quick in 
repairing when damaged. 

The Nails are appendages specially developed from 
the skin. Each one is embedded by its root in the 
skin, and near the root is the crescentic lunula, 
which is responsible for its growth, opaque white, 
and offering a contrast to the pinkish hue of the rest 
of the nail. 

The nails are grooved longitudinally. In old 

66 



THE COVERINGS OF THE BODY 

persons they are apt to become very brittle. If 
allowed to grow long they become bent over the digit. 

Hair is demonstrable all over the skin, except 
upon the palms of the hands, the soles of the feet, 
and the dorsal surface of the distal phalanges of the 
fingers and toes. 

There is, of course, great variety in quantity, 
quality, and colour in different individuals. White 
hair is due to the presence of air spaces, and dark 
hair to the presence of pigment, within the cells of 
which each hair is composed. 

In many parts it is hardly visible without the aid 
of a magnifying glass. On the scalp and on the 
face of the male it is apt to grow long, while on 
the armpits, the pubes, the front of the chest, and in 
the eyebrows and eyelashes it seldom attains much 
length. Like the straws on a thatched roof, all hairs, 
whether in the human or the lower species, have that 
direction which is best calculated to carry off any 
rain that may fall on the part. 

The hairs, especially those of the trunk, are capable 
of being erected to some extent upon the surface 
of the skin by minute muscles. Such a condition, 
commonly called " goose-skin," is associated with 
fear or cold. 

The hair of the head may feel as if it were being 
erected, and without doubt actual bristling does 
occur in the lower animals, e.g. the cat and the dog, 
but it is doubtful whether this ever actually happens 
in man. The upturned moustache, so commonly 
affected by men, including those of the most equable 
temperament, is an artificial, even if unintentional, 
mimicry of the involuntary raising of the hair of the 
head and face in an animal aroused to anger. 

When puberty approaches the skin is particularly 

r>7 



THE COVERINGS OF THE BODY 

active. Pustules on the face, in association with 
increased formation of hair, are a common condition 
in youths who have just reached this time of life. 

Blushing and Pallor. — Blushing consists in a 
diffuse reddening of the skin of the face, and may 
extend to the forehead, neck, shoulders, or even the 
whole body. It is due to the determination to the 
surface of a larger quantity of blood than usual, and 
is not under the control of the will. Certain involun- 
tary nervous impulses act upon the superficial blood- 
vessels and dilate them. 

Pallor is the opposite condition to that of blushing, 
and it is less evanescent. Temporary pallor may be 
associated with fear or anger, but is more frequently 
due to a feeling of fatigue or faintness. 

The waxy appearance of anaemic subjects and the 
yellow tinge of jaundice are phenomena of disease. 

In albinos the usual deposits of pigment are want- 
ing. The skin is wax-like, the hair flaxen, and the 
irides of the eyes are pink, while the pupils appear 
red. 

Beneath the skin is a layer of Subcutaneous or 
Superficial Fascia or Tissue, the loose meshes of 
which are more or less loaded with fat (except under 
the skin of the eyelids, the scrotum, and the penis, 
which parts never in any circumstances have any 
fat). This layer of fat is known as the panniculus 
adiposus ; it rounds off angles and hollows, and fills 
up spaces ; it represents a storehouse of nourishment, 
and it protects against exposure to cold. The deposit 
of fat is apt to be especially marked over the buttocks 
and the breasts and the thighs, and over as well as 
within the abdominal cavity. 

The sub-mental pad of fat provides the familiar 
double chin of the corpulent, while the sucking pad 

68 



THE COVERINGS OF THE BODY 

makes the cheek of the infant prominent. There are 
other pads around the eyeballs and in the temporal 
fossae, which are very early absorbed in wasting ill- 
nesses, and so allow the prominences of the bones to 
give the appearance of emaciation. Old age is per- 
haps most difficult to conceal where the skin becomes 
baggy from absorption of fat, and especially in those 
regions of the neck which lie over and below the 
mastoid process and the hyoid bone. 

In certain regions — viz. the front of the neck, 
the face, the scrotum, and the inner side of the 
palm of the hand — muscular fibres are developed into 
definite sheets known by the name of the panniculus 
carnosus. Such sheets are remnants of a much more 
complete system in some of the lower animals, en- 
abling them to move the skin of the body, but in 
man the facial part of the panniculus carnosus 
attains special importance as the Platysma, a thin 
but strong and extensive sheet of muscle which 
contributes largely to the various movements of 
the face involved in different expressions (Plates 
XXIY., XXV.). 

Everywhere under the superficial fascia is the 
deep fascia, a much firmer fibrous sheet. It acts 
as a closely investing membrane bracing the muscles 
more or less tightly to the bones. In many regions 
it is connected deeply with the joints, and it is also 
frequently continuous with the periosteum or mem- 
brane covering the bones. In a few places it is 
thickened to form either very definite tendon-like 
bands — e.g. the ilio-tibial band in the thigh — or trans- 
versely disposed tunnels for the transmission of 
tendons past joints — e.g. the annular ligaments at 
the wrist and the ankle. 

69 



CHAPTER III 

THE regio:n^s of the body 

The form of the subject or model depends upon : — 

1. The shape of the skeleton, which varies with 
age, race, sex, condition of health, &c. 

2. The relative position of the various parts of the 
skeleton. 

3. The condition of the muscles, whether active or 
passive, and whether well or ill developed. 

4. The quantity and quality of subcutaneous fat. 

5. The condition of the other coverings — the skin 
and the hair. 

It is necessary for the student to understand various 
terms used in connection with muscles. 

When a muscle contracts it becomes broader, thicker, 
and shorter : individual bundles of fibres may become 
prominent, and its tendon, or leader, may stand out as 
a prominent ridge. 

Most muscles are attached to at least t"wo bones. 
The place of attachment to the more movable bone is 
called the muscle's insertion, and to the more fixed 
bone, its origin. 

In the limbs the more movable bone is usually, 
but not always, distal, i.e. more removed from the 
centre of the body. A very good example of the 
application of these terms is to be found in the 
latissimus dorsi. This muscle's chief action is to pull 
the arm down to the side, and therefore it is said 
to be insei'ted into the humerus ; but it may be put 

70 



THE REGIONS OF THE BODY 

to quite another use, viz. to pull the side up to the 
arm, as in climbing. 

The skeleton having been dealt with already, let 
us proceed to examine such of the muscles as are 
responsible for surface form, and are found in the 
various regions of the body as soon as the skin 
and superficial and deep fasciae have been dissected 
away. In this examination we will note some of 
the modifications observable in the normal surface 
form under varying conditions of activity and rest 
of these same muscles. 

For the purposes of anatomical description the 
regions of the body are classified as follows : — 

The upper extremity. 

The lower extremity. 

The trunk. 

The neck. 

The head. 

Each of these parts presents certain generally re- 
cognised subdivision. 

The upper extremity includes : — 

The shoulder, the axilla, the arm, the elbow, fore- 
arm, wrist, hand, and fingers. 

The loiver extre7nity includes : — 

The thigh, the buttock, the groin, knee, leg, ankle, 
foot, and toes. 

The trunk includes : — 

The spine, the thorax, abdomen, pelvis, and 
perineum. 

The head includes : — 

The cranium and the face. 

The neck includes all the parts which intervene 
between the head and the thorax. 

Some difficulty arises in fixing the boundaries be- 
tween the various regions of the body, and between 

71 



i 



THE REGIONS OF THE BODY 

the subdivisions of those regions. Unfortunately 
for precision of anatomical classification, several im- 
portant features lie on these boundaries, or cross a 
boundary and so occur in two or more adjacent 
regions, but the difficulty thereby created need not 
trouble the artist. 



72 



CHAPTER IV 

THE UPPER EXTREMITY 

This, as has just been indicated, is made up of the 
arm joined to the trunk and neck by the region of 
the shoulder and armpit ; of the forearm joined to 
the arm by the elbow ; and of the hand joined to 
the forearm by the wrist. 

When any limb is considered as a whole, it is 
at once seen to be more massive in the neighbour- 
hood of the joints than in the parts between them, 
and in the upper parts than the lower. The reasons 
for this are (1) that in the regions of the joints 
the ends of the bones are larger than the shafts ; 
(2) that muscles often take their origins in fleshy 
groups, while their insertions are usually tendinous 
and widely divergent ; (3) that in the upper regions 
of the limbs the muscles have harder work to do, and 
are therefore larger, than the muscles lower down, 
which have less powerful but more delicate tasks to 
perform. 

The Shoulder. 

A description of this region must trespass upon 
and overlap that of the trunk and neck. 

In the upper part of the back, and lying on each side 
of the vertebral column, is a flat eminence, roughly 
triangular in shape. It is formed by the scapula 
or shoulder-blade and the muscles which cover it 
(Figs. 19, 20 ; Plates XI., XII., XIII., XVII., XXIV.). 

The eminence is divided into two parts by a traus- 

73 



THE UPPER EXTREMITY 

verse furrow if the subject be well covered, or ridge 
if he be wasted, indicating the position of the spine 
of the scapula^ which is continuous externally with 
the acromion process. The acromion is directed 
upwards and forwards from the spine to articulate 




Fig. 19.— The Back of the Neck, Upper Part of Trunk, and Arm. 



with the clavicle, and so to form the point of the 
shoulder. 

The part above the ridge or furrow is the smaller, 
lodges the supra-spinatus muscle, and is obscured by 
the flat Trapezius (Figs. 20 and 21) muscle as the latter 
passes to its insertion into the spine, acromion pro- 

74 



THE UPPER EXTREMITY 

cess, and posterior border of the outer third of the 
clavicle. 





Fig. 20.— The Muscular Prominences on the Back of 
the Trunk, Buttock, and Neck. 



The lower part of the trapezius also conceals, over 
somewhat less than its inner quarter, the infra- 

75 



THE UPPER EXTREMITY 

spinatus muscle, which, as its name impHes, occupies 
the hollow in the scapula below its spine (Fig. 21), 




Fig. 21.— The Muscles on the Back of the Trunk, 
Buttock, and Neck. 



The inner limit of this flat triangular eminence i» 
of course, the vertebral border of the scapula, which 

76 



THE UPPER EXTREMITY 

lies parallel with the vertebral column and is made 
more obvious by the subject placing the hand upon 
the opposite shoulder. 

The rounded inferior angle of the eminence is con- 
cealed by the upper edge of the Latissimus dorsi 
(Fig. 21) on its way from the vertebral column to 
t-he upper part of the humerus. This inferior angle 




Fig. 22.— The Outer Side of the Upper Extremity. 

stands out when the subject places his hand behind 
his back. 

The upper part of the infra^spinatus is obscured by 
the thick posterior border of the Deltoid muscle. 

The posterior edge of the deltoid passes from the 
spine of the scapula near its root or inner part down- 
wards and outwards, and, in the dependent position 
of the arm, also slightly forwards, to its humeral 
attachment. 

77 



THE UPPER EXTREMITY 

It is owing to the great developraent of the 
trapezius and deltoid muscles that the position of 
the spine of the scapula is often actually indicated 
by a furrow in the living subject. 

The lower angle of the scapula is directed down- 
wards when the arm is hanging by the side or is 
raised to form a right angle, or less, with the side. 

If the angle formed by 
arm and side exceeds 
90°, the inferior angle of 
the scapula moves out- 
wards, owing to the rota- 
tion of the scapula upon 
the thorax around an 
antero - posterior axis, 
and it then becomes ob- 
vious in the back part 
of the armpit. 

The Deltoid (Figs. 22 
and 23) is the large fan- 
shaped muscle which 
covers the back, front, 
and outer side of the 

shoulder-joint. Together 
Fig. 23.— The Muscles of the Shoulder. .,, .i , j p .i 

With the head oi the 

humerus it determines the rounded form of the 

shoulder. 

The curved and conspicuous clavicle is a useful 

landmark on the front of the upper part of the trunk, 

as it is subcutaneous and easily traced by eye or 

hand. It is joined to the sternum near the middle 

line of the root of the neck, and curves first forwards 

and outwards, then backwards and outwards, and 

finally a little forwards again to join the acromion 

process just above the shoulder-joint (Fig. 25). 

78 




THE UPPER EXTREMITY 

Viewed from the front, the outer end of the clavicle 
is narrower, and is always situated on a higher 
plane than its inner end. 

The remaining part of the deltoid— viz. its anterior 
part— arises from this thin anterior border of the 



Eeailnnar Faacla 



"~Coraco Brachialis 
Pectoralis Major 




Scalenus Medius 
Bterno-Mastoid 



» XatlBsimiu Sorsi 



Rg. 24.-Tlie Muscles of the Inner Surface of the Arm and of the Armpit. 



outer third of the clavicle, also from its upper surface, 
and from the outer border of the acromion. 

The anterior border of the deltoid is directed down- 
wards, outwards, and slightly backwards as it con- 
verges upon the posterior border, the muscle being 
inserted by the apex of its delta into the middle of 
the outer surface of the shaft of the humerus. 

79 



THE UPPER EXTREMITY 

The deltoid raises the arm at the shoulder, and it 
also has an important function in keeping the parts 
of the shoulder-joint in apposition. 

Notice the tendinous intersections— four of origin 




Fig. 25.— The Muscles on the Front of tlie 
Trunk and Neck. 



and three of insertion — which groove the surface of 
the muscle longitudinally when in forcible action 
(Fig. 23, p. 78 ; Plate XX.). 

The Pectoralis Major (Figs. 24 and 25). — Arising 
from the anterior surface of the inner half of the 
clavicle, the clavicular portion of this fan-shaped 

80 



THE UPPER EXTREMITY 



muscle passes outwards and slightly downwards to 
the upper part of the humerus. 

The inclination of its upper border is less than that 
of the anterior border of the deltoid, so that the 
contiguous edges of these two muscles bound a 
narrow groove, which opens out above under the 
middle of the clavicle to form 
the infra-clavicular fossa. 

In very thin persons the apex 
of the coracoid process may be 
seen projecting forwards in this 
fossa. It is situated below the 
anterior border of the clavicle 
in the outer part of the infra- 
clavicular fossa, and is in close 
contiguity, if not in actual con- 
tact, with the under surface of 
the clavicle at the junction of 
its outer and middle thirds. 

The large median cephalic vein 
(Fig. 26) runs in the groove be- 
tween the deltoid and pectoral is 
major muscles, and disappears in 
the infra-clavicular fossa. It is 
especially noticeable when hard 
manual labour is being performed. 

So far we have only spoken of 
the thick clavicular head of the pectoralis major. 
There is, ho^wever, another and more extensive but 
thinner fan-like origin from the sternum and rib 
cartilages, the fibres of which passing outwards, and 
with increasing degrees upwards, converge to add to 
the thick mass of muscle whose tendon is inserted 
into" the humerus, under cover of the deltoid muscle. 

The thick rounded lower border is directed from 

81 F 




Fig-. 26.— Muscles and 
. Superficial Veins 
on Front of Arm 
and Elbow. 



THE UPPER EXTREMITY 

the bone of the seventh rib in its anterior part 
upwards and outwards to the humerus. About the 
middle of this border the inner part of the pectoi^alis 
minor may sometimes be seen as a slight ridge when 
the arm is raised above the head (Fig. 24). 

Emerging from the under surface of the outer 
part of the pectoralis major is a ridge formed by the 
bicej^s and coraco-hrachialis muscles (Fig. 24, p. 79). 
The pectoralis major in its extreme outer part passes 
under the anterior part of the deltoid. 

The Axilla or armpit (Fig. 24). 

This is a pyramidal space with its base directed 
downwards and outwards, and its apex directed up- 
wards and inwards behind the clavicle. In the adult 
the skin covering its base bears long, coarse hairs. 

The armpit is bounded in front by the pectorales 
major and minor ; behind, by the front of the scapula — 
or rather the sub-scapularis muscle, which arises there- 
from, but is unimportant to the art student — and by 
the latissimus dorsi, which winds from behind for- 
wards and outwards in a spiral manner round the 
lower portion of another muscle in this region named 
the teres major. Both of these muscles are attached 
to the humerus near the pectoralis major. 

The pectoralis major from the front, and the 
latissimus dorsi from behind, thus converge upon 
the humerus, a small width only of which forms the 
narrow outer ivall, while the wider inner wall of the 
unequally four- sided pyramidal armpit is formed by 
the thoracic wall covered by the Serratus magnus. 

This important muscle arises by " digitations," 
which are very obvious on the side of the chest when 
the muscle is in action (Figs. 24, 25, pp. 79, 80), from 
the nine upper ribs, half-way between the verte- 
bral column and the sternum. Passing horizontally 

82 



THE UPPER EXTREMITY 

backwards in front of the scapula, the sheet which 
is constituted of these digitations is attached to 
the front of its inner or vertebral border. 






\^ 



r 



''^//// 



Pig. 27.— The Muscular Prominences on the 
Front of the Trunk and Neck. 



The muscle is brought into use when the upper 
limb is outstretched, because it fixes the scapula, 
and so gives the muscles which arise from the 
latter a fixed origin from which to act. 

83 



THE UPPER EXTREMITY 



The Coraco-hrachialis muscle lies on the inner side 
of the short head of the Biceps. It passes from above 
downwards on the outer wall of the armpit (Fig. 24). 
The Arm denotes anatomically only that part 
of the subject which extends from the shoulder to 
the elbow (Figs. 4, p. 39 ; 19, p. 74 ; 22, p. 77). 

The two last-mentioned muscles form a distinct 
ridge on the front of the limb, which is more 

prominent when the arm 
is lifted up from the side, 
and which is seen emerg- 
ing from under cover of 
the outer part of the pec- 
toralis major. 

The coraco-brachialis 
(Fig. 24, p. 79) terminates 
half-way do^vn the arm, 
where it is inserted into 
the humerus. 

The short head of the 
Biceps joins with the long 
head, which also emerges 
from underneath the pec- 
toralis major, to form a 
fusiform mass of muscle, 
thicker in the middle than at its extremities, and 
very prominent upon the front of the arm when 
thro^\Ti into action. 

Even when it is not in a contracted condition, as 
it is in Fig. 28, an obvious ridge, extending the whole 
distance of the lower two-thirds of the arm, may be 
observed (Fig. 29). 

As the biceps passes to its insertion in the tubero- 
sity on the radius, it becomes narro^v and tendinous. 
The tendon may be traced as a sharp ridge veitically 

84 




Fig. 28.— The Front and Inner Side of 
the Upper Extremity. 



THE UPPER EXTREMITY 

across the hollow in front of the elbow nearly to it& 
insertion. 

The Semilunar fascia (Figs. 24, 26, 28) is a thin 
but strong fibrous expansion from the biceps in the 
upper part of the front of the forearm, extending from 
the inner border of the tendon of the biceps down- 
wards and inwaids to join the deep fascia of the 




Fig. 29.— The Outer Side of the Right Upper Extremity. 

forearm, and indenting transversely the mass of 
muscles which arises from the internal condyle of the 
humerus. 

On each side of the biceps is a groove (Fig. 26) ; in 
the outer lies the cephalic vein, in the inner the 
basilic vein and brachial artery, the latter more 
deej)ly situated, but visible sometimes in thin old 
l^ersons, and especially if it is tortuous. 

Lying behind the biceps on the inner side of the 
arm is the inner head of the Triceps, which arises 
from the humerus all the way from the lower border 

85 



THE UPPER EXTREMITY 






of the pectoralis major to the internal condyle of the 
humerus (Figs. 24, 28, 30). 

To the outer side of the biceps in the upper half of 
the arm is the great mass of the deltoid muscle (Figs. 
22, 23, 26), and in the lower half, arising from the ex- 
ternal supra-condylar ridge, are the Supinator longus, 
a muscle which is chiefly important as a flexor of the 
elbow joint, and forming when in the contracted con- 
dition a very obvious swelling ; and 
the Extensor carpi radialis longior, a 
smaller and very similarly arranged 
muscle lying below and behind the 
supinator longus (Figs. 19, 22, 30). 

The furrows which lie on each side 
of the biceps converge below where 
the mass of the muscle narrows, and 
terminate in a hollow on the front 
of the elbow called the Ante-cubital 
fossa. This fossa is triangular, with 
its base, directed upwards, opposite 
the elbow- joint (Figs. 26, 31, 34, 35). 

An important vein lies in the 
lower half of the groove upon the 
inner side of the biceps. It is known 
as the basilic vein. At the centre of the arm it 
passes through the deep fascia, and disappears from 
view to join the deep veins of the arm accompanying 
the brachial artery (Figs. 26, 33, 35). 

The back of the arm presents for examination two 
large muscles, the deltoid and the triceps. 

The posterior border of the deltoid runs from the 
inner part of the spine of the scapula downwards and 
outwards to the insertion of the muscle a little above 
the centre of the outer surface of the humerus. This 
ridge of muscle bounds a deep and obliquely placed 

86 




ii-^- 



Fig. 30,— Muscles on 
the Back and Outer 
Side of the Right 
Elbow-Joint, 



THE UPPER EXTREMITY 

groove which hes parallel to and immediately below 
it, and is succeeded again by the mass of the Triceps 
(Figs. 22, 23, 29), which passes downwards with a 
slight inclination inwards, to terminate below by 
being inserted into the upper part of the Olecranon 
process, or point of the elbow (Fig. 30). 

A second groove, passing similarly downwards and 
inwards, across the inner part of the back of the arm 
but nearer to the elbow, separates the upper and outer 
humeral head from the inner and lower humeral 
head of the triceps (Figs. 19, 22, 29). 

When the arm is abducted from the side against 
resistance, three other features are to be noted upon 
the posterior aspect of the arm. 

First, below {i.e. in the present abducted position 
of the arm) the posterior deltoid border, the scapular, 
or long, head of the triceps forms a slightly elevated 
ridge, passing from the back of the shoulder-blade to 
the arm (Fig. 24 ; Plates XIII., XVI.). 

Secondly, above the triceps, the biceps muscle may 
be seen, producing a marked prominence (Plate XVI.). 

Thirdly, the skin over the deltoid presents some 
longitudinal grooves, which indicate the position of 
some tendons within that muscle (Plate XX.). 

Thus it is to be noticed that, although the biceps 
is situated on the front of the arm, so prominent 
is it that a portion of it may be seen from the 
back on the outer side of the arm ; and similarly 
we have already pointed out (p. 85) that the triceps, 
although situated upon the back of the arm, can 
be seen also, in part, from the front. 

The Elbow. — The bony landmarks are very 
obvious. The " point of the elbow " is formed by the 
posterior part of the upper surface of the olecranon 
process (Fig. 5, p. 40). It bounds above a triangular 

87 



THE UPPER EXTREMITY 

subcutaneous area of bone, the sides of which con- 
verge below to form the posterior border, which is 
also subcutaneous, of the ulna. 

The internal and external condyles of the humerus 
lie a little above the bend of the elbow. The internal 
condyle is the more prominent, partly because of its 
actual size, and partly because the muscles arising 
from the external supra-condylar ridge of the humerus 
obscure the external condyle (Fig. 30). The two con- 
dyles lie on the same level, and the olecranon just 




Fig. 31.— The Outer Side of the Upper Extremity, with indication of the 
varying shape of transverse sections at different levels. 

comes up to this level in the extended position of the 
elbow- joint, but in the acutely flexed position these 
three bony eminences form the apices of an equi- 
lateral triangle. 

A transverse section of the arm above the elbow 
is nearly circular. The forearm just below the elbow 
is flattened from before backwards and bulges later- 
ally. It tapers towards the wrist, but remains more 
flat in males, while in females it has a more circular 
outline (Fig. 31). 

The Carrying Angle. — The extended forearm makes 
with the arm an angle of 160° or thereabouts, open out- 
wards (Fig. 35). This " carrying angle," as it is called, 

88 



THE UPPER EXTREMITY 



diminishes progressively as the arm is flexed until it 
completely disappears in full flexion 
(Fig. 32). Indeed, by the time the 
elbow is fully flexed, the hand will 
be seen to have been carried over 
actually on to the inner side of the 
arm. The presence of the carrying 
angle is independent of supination 
or pronation of the hand, and is of 
great importance mechanically; in- 
deed, it looks very much as if it was 
designed to allow weights which are 
being carried, e.g. a bucket, to swing- 
clear of the pelvis and lower limbs, 
thus saving much muscular effort. 
The carrying angle is due to the 
large size of the inner lip of the 
trochlea of the humerus (Figs. 3 
and 4, pp. 38, 39). 

The Forearm. — The triangular 
ante-cubital fossa is bounded on each 
side by prominent ridges of muscles (Figs. 26, 33, 34). 

On the inner side is the ridge formed by the super- 




-The Back of the 
Hand, 



Forearm and 



showing surface mark- 
ings of muscles and 
tendons. Notice the dis- 
appearance of "carry- 
ing angle," when arm 
is flexed at elbow. 




Fig. 33. —Muscles and Superficial Veins on Front of Rig-ht Forearm. 



ficial flexor muscles of the hand and the pronator 
radii teres. The latter is inserted into the middle of 

89 



THE UPPER EXTREMITY 

the outer surface of the radius. Notice the wisp 
of semi-lunar fascia springing off the inner side of 
the tendon of the biceps and passing inwards over, 
and indenting, the mass of muscle just below the in- 
ternal condyle (Figs. 24, 26). The indentation is most 
obvious when a muscular subject strongly flexes and 
supinates the forearm. The ridge which bounds the 
triangle externally is formed by the supinator longus 
muscle (Fig. 26). Under this the pronator radii teres 
passes to its insertion, and it is by the convergence of 
these muscles that the apex of the fossa is formed at 




Fig". 34.— Muscles on Back of Right Forearm. 



a point which lies under cover of the largest of the 
superficial veins depicted in Fig. 33, p. 89. 

Lower down the limb tapers gradually, because the 
muscles give place to tendons, only two of which are 
prominent on the surface, viz. the palmaHs longus and 
the flexor carpi radialis. These two tendons lie one 
on each side of the mid point at the wrist (Fig. 33). 

[A slight prominence which affords no evidence of 
extensive muscular development may occasionally be 
seen on the front of the forearm two or three inches 
above the wrist in the middle line. It is due to 
an extra muscular belly formed in connection with 
the palmaris longus.] 

90 



THE UPPER EXTREMITY 



The ''pulse'' in the radial artery may sometimes 
be seen, and nearly always felt, just external to the 
flexor carpi radialis tendon. 

On the inner side of the tendons previously 
mentioned is the flexor carpi ulnaris. This does not 
produce any external form, 
but internal to it is a small 
shallow depression (Fig. 28), 

The Veins of the Forearm 
(Figs. 26, 29, 33, 34, 35).— 
The main superficial veins 
of the forearm are found 
chieflyupon the front. They 
may be made to stand out 
much more clearly than 
usual if the fist be re- 
peatedly clenched, especi- 
ally if some constricting 
band is lightly applied 
meanwhile just above the 
elbow. Under these cir- 
cumstances the veins will 
be dilated at intervals in 
bead-like eminences, due 
to the presence of valves 
within them. 

These veins drain the 
hand. The median vein 
passes from the radial border of the lower part of the 
forearm to the ante-cubital fossa, where it divides into 
two branches, viz. : — 

1. The median cephalic, which joins with some veins 
passing from the radial side of the upper two-thirds 
of the forearm, to form the cephalic vein, and to pass 
upwards in the groove on the outer side of the biceps 

91 




Fig. 35.— Right Upper Extremity 
Surface markings of Muscles, 
Tendons, and Superficial Veins. 



THE UPPER EXTREMITY 

muscle, afterwards entering the groove between the 
pectorah's major and the deltoid, where it has already 
been alluded to. 

2. The median basilic, which passes over, or super- 
ficial to, the semi-lunar fascia and joins with some 
veins draining the ulnar side of the forearm to form 
the basilic, and then up the arm on the inner side of 
the biceps. This vein is not seen when it reaches the 
middle of the arm, as it then ceases to be superficial. 

The median basilic is the vein which is most con- 
veniently opened for the purpose of blood-letting, 
a practice quite fashionable a few decades ago, and 
still resorted to occasionally. 

If we now study the back of the forearm (Figs. 29, 
30, 32, 34), the first thing to be noticed is the triangu- 
lar subcutaneous area of the ulna below the olecranon 
process, continuing downwards into the posterior 
border of the shaft of the ulna, and easily traceable 
by the examining finger right down to the prominent 
little head of the same bone near the wrist. This 
border of bone lies close to the inner aspect of the 
forearm, being as a rule at the bottom of a small 
but distinct furrow, because it is subcutaneous all the 
way and therefore easily felt. The furrow is bounded 
by two ridges ; that on the inner side is due to the 
flexor carpi ulnaris, and that on the outer side, less 
well marked, to the extensor carpi ulnaris muscle. 

External to the olecranon is a slight fossa (Figs. 30, 
31), in which the head of the radius lies, and can be 
felt and sometimes seen. A distinct furrow runs 
downwards and inwards from this fossa, and to its 
outer side is a ridge due to the muscular mass of the 
extensor communis digitorum, which when it contracts 
draws the fingers backwards (Figs. 31, 32, pp. 88, 89, 
and Fig. 34, p. 90). 

Another slight groove to the Quter side of the 

9J 



THE UPPER EXTREMITY 



extensor communis separates this muscle from the 
extensor carpi radialis hrevior above and from the 
extensor ossis vietacarpi pollicis below. 

The anconeus (Fig. 34, p. 90) is a very short muscle 
which forms a triangular mass extending from the 
external condyle towards the posterior border of the 
ulna. 

The tendons of the extensor muscles (Fig. 34) passing 
to the fingers are placed in 
deep grooves on the back of 
the radius ar^d ulna, and can- 
not be seen through the skin 
till they get below the wrist, 
being hidden above by dense 
deep fascia. 

It is probably a very com- 
mon rule that when any muscle 
in the limbs is thrown into 
voluntary action its opponent 
undergoes a simultaneous but 
slighter contraction, so as to 
steady the moved part. A 
pretty illustration of this rule 
is found in the fact that if you 
watch the back of the forearm 
while you flex your fingers, 

however slightly, you w^ill see the extensor communis 
digitorum become more prominent. 

The Wrist (Figs. 36 e^seg.). — This is the region which 
connects the hand with the forearm. On the inner side 
of the Dorsum or back of the wrist is a bony promi- 
nence formed by the head of the ulna (Plate XXXI.). 
The stjdoid processes of the ulna and radius, that of 
the latter being placed a little lower, can be easily felt, 
but, except in very thin persons, they cannot be seen. 

93 




Fig-. 36.— The Creases upon the 
Front of the Hand and Digits. 



THE UPPER EXTREMITY 

Although a large number of tendons pass from the 
extensor muscle bellies in the forearm to become 
obvious on the dorsum of the hand, none of them is 
visible at or above the wrist, because they are bound 
down and obscured by a transverse, or rather a 




-The Deep Palmar 
Fascia. 




Fig". 38.— The Short Muscles of the 
Hand, and the Tendons passing 
under the Anterior AnniQar 
Ligament. 
The Palmaris longus is cut as it 
passes over the annular liga- 
ment. 



slightly oblique, band of the deep fascia, known as the 
posterior annular ligament (Fig. 34). It may be traced 
by dissection from the region of the lower end of the 
ulna to the outer surface of the radius on a rather 
higher level. This special thickening of the deep fascia 
bridges the grooves on the lower end of the radius 
and ulna, which transmit the extensor tendons from 
the back of the forearm to the dorsum of the hand. 

94 



THE UPPER EXTREMITY 

The Hand (Figs. 31, 32, 35, et seq.) presents for 
examination the palm and the dorsum, and the 
fingers and thumb collectively known as digits. 

The hand is broader and flatter than the wrist, 
the increased breadth being due in great part to 
the thumb. When this is bent into the palm — or, as 
the technical expression goes, when the thumb is 
*' opposed " — the hand becomes much narrower, and 
its breadth approximates to that of the wrist. 

The palrn of the hand (Fig. 36 et seq.) is continuous 
with the front of the forearm, but its general surface 
is raised from that of the forearm by the thenar and 
hypo-thenar eminences, composed of small muscles. 
Between these two eminences is a hollow lined by 
a thick fibrous structure, the palmar fascia, which 
succeeds to a fibrous transverse arch, the anterior 
annular ligament, whose function is to form the roof 
of a tunnel through which the flexor tendons pass 
on their way from the front of the forearm to the 
front of the fingers. The walls and floor of the 
tunnel are formed by the carpal bones (Fig. 38). 

The skin over the palm is very thick, and in persons 
accustomed to hard manual work it is horny. It is 
plentifully supplied with sweat-glands, but devoid 
of hairs and sebaceous glands. Certain lines or skin 
folds found on the palm will be described later. 

The palm of the hand forms a shallow, saucer-like 
hollow, bounded above and at the sides by the thenar 
and hypo-thenar eminences, and below by the promi- 
nences at the bases of the fingers. When the fingers 
are forcibly extended, these prominences can be seen, 
and in every position of the fingers they can be felt, 
to be due to the heads of the metacarpal bones. 

Between the four metacarpal heads there are easily 
seen, when the fingers are semi-flexed, three little 

95 



THE UPPER EXTREMITY 



soft eminences — caused really by pads of fat. The 
slight depressions between these three eminences are 
due to the prolongations from the base of a triangular 
sheet of fibrous structure (Fig. 37), which is attached 
by its apex above to the anterior annular ligament. 
Below, at the root of the fingers, the base of the tri- 
angle is split into four processes, each of which is 
attached to the tendon sheath on 
the front of a finger. The structure 
is dense and fibrous, and is known 
as the pa/7?2a7' fascia. It is con- 
tinuous above with the paZ??2a?^s 
longus (cut short in Fig. 38, p. 94). 
The anterior annular ligament is 
a strong fibrous bridge springing 
across from the base of the thenar 
eminence to the base of the hypo- 
thenar eminence. Its superficial 
surface is about the size of a 
postage stamp placed transversely, 
and under it the flexor tendons 
pass from the front of the fore- 
arm into the j)alm of the hand. 

The lines on the pahns, upon 
Tvhich " palmistry " is founded, 
are due to the varied and fre- 
quent movements of the fingers and thumb and the 
presence of underlying muscles. Their actual posi- 
tion and length undoubtedly vary in different in- 
dividuals. 

A very brief description of these lines must suffice 
(Fig. 36, p. 93, and Fig. 39). 

There are three main lines. The first passes from 
the inner side of the upper end of the thenar 
eminence and curves downwards and outwards to 

m 




Fig. 39.— Showing Forma- 
tion of Creases or 
"Lines of Flexion" in 
the Skin of the Hand 
and Digits. 



THE UPPER EXTREMITY 

a point on the outer border of the palm, situated 
half an inch below its centre, and on a level with 
the distal part of the outstretched thumb. This 
line is due to the movement of the thumb in 
" opposition " (p. 95), an action brought about by 
the short muscles of the thumb which form the 
thenar eminence. 

The second line passes from the inner border of 
the palm, three-quarters of an inch above the little 
finger, to the cleft between the index and middle 
fingers, but to the outer part of the cleft. It is 
made obvious by flexing the inner three metacarpo- 
phalangeal joints while the index and thumb are 
extended. 

The third main line passes outwards from the lower 
part of the hypo-thenar eminence between the other 
two main lines, and reaches the outer border of 
the hand one inch above the index finger, on about 
the same transverse level as the point at which the 
second line begins. It is made obvious by flexing 
the four inner metacarpo-phalangeal joints. 

The thenar eminence at the base of the thumb is 
especially scored by numerous smaller lines. 

The fingers are not attached to the palm on an 
exactly transverse plane. Their line of attachment 
is slightly curved, so that the cleft between the 
middle and ring fingers is one-third of an inch 
further from the wrist than the clefts between the 
other fingers. 

the Back of the Hand. — The skin on the back of 
the hand is rougher, looser, and thinner than that 
of the palm. It is covered with fine hair, and im- 
mediately beneath the skin lies an irregular venous 
plexus which receives the veins from the digits. 
There is usually discernible a more or less well 

97 G 



THE UPPER EXTREMITY 



marked venous arch, with convexity towards the 
digits, which receives these digital veins. 

In delicately nurtured hands the veins appear as 
thin blue lines ; in the horny hand of the labourer 
they are tortuous, dilated, and bulging ; in old age 
they become more obvious, and so do the spaces 
between the metacarpal bones, owing to the wasting 
of the soft tissues. 

Upon the back of the hand, and situated under- 
neath the veins, are various 
ridges corresponding to the 
tendons of the extensor muscles 
of the fingers. (The thumb is 
not now being described.) 
These ridges are seen to great 
advantage when the wrist is 
extended, i.e. bent backwards, 
and the metacarpo-phalangeal 
joints extended and the inter- 
phalangeal joints flexed, and 
the hand kept tight in this 
position (Fig. 40). 

Certain tendons make more 
obvious and constant ridges 
than others. Thus, in most 
subjects, the tendons passing to the middle and ring 
fingers stand out distinctly as compared with those 
passing to the index and little fingers. The tendons 
passing to the index and little fingers are duplicated, 
a fact which doubtless is associated with their freer 
movements. 

The innermost tendon of the index finger sends a 
slip to join the tendon passing to the middle finger, 
and the tendon of the ring finger sends a slip on each 
side to the adjacent tendons of the middle and little 

98 




Kg-. 40.— The Hand in the 
best position for demon- 
strating the Extensor 
Tendons. 



THE UPPER EXTREMITY 

fingers. These slips lie subcutaneously, and may 
occasionally be seen close to the base of the fingers. 
They are probably responsible for the difficulty the 
pianist experiences in raising the ring finger inde- 
pendently of the others. 

The Thumb. — It is chiefly the extraordinary 
mobility of the thumb that distinguishes the hand 
of man from the paw of the lower animals, including 
the anthropoid apes. 

When it is in its natural position of rest its surfaces 
look inwards and outwards — an important fact, for 
the surfaces of the other digits look directly forwards 
and backwards. It follows from this that when the 
limb is extended with the palm looking to the front, 
the nail of the thumb can be seen, whereas the nails of 
the fingers are not visible — except, of course, in those 
Eastern races, and their rare Western mimics, who 
cultivate extraordinary length of nails. 

The thumb rises from the surface of the palm in 
a distinct rounded prominence called the thenar emi- 
nence, oval, with its long axis directed downwards and 
outwards, and its skin scored by numerous trans- 
verse lines. Through this skin one or two veins 
may show, and occasionally in old persons the super- 
ficialis voice artery may be observed pulsating as it 
pursues a vertical course across the thenar emi- 
nence, but it disappears suddenly before it reaches 
the palm. 

The upper and outer free border of the thenar 
eminence is formed by the metacarpal bone of the 
thumb, and is straight, and inclined from the outer 
border of the forearm, with which it is continuous, 
at an angle of 45°, when the hand is in a position of 
rest with the palm forwards. This angle may, how- 
ever, be increased to 60° or 70° by powerful abduction, 

99 



THE UPPER EXTREMITY 

or by adduction of the thumb it may be wiped out 
altogether. 

This outer border of the thenar eminence, if traced 
on to the two phalanges, becomes the outer surface 
of the thumb. The metacarpo-phalangeal joint is 
rather less than half-way from the base of the thenar 
eminence to the tip of the thumb, and is nearly 
always kept slightly flexed. It is not a joint which 
permits of much mobility, but such as it has is 
extremely important to the function of this most 
important digit. Near the termination of this outer 
surface, the thumb-nail breaks into its continuity ; 
but short of this, in the part which corresponds to 
the first phalanx, the surface is concave. 

The internal surface of the thumb (Fig. 40) is also 
concave opposite the first phalanx, convex opposite 
the second. It is united by a web to the outer 
border of the palm, a little above the centre of a 
line drawn from the upper limit of the thenar 
eminence to the base of the index finger. 

The thumb is the shortest digit with the exception 
of the little finger. It is, however, much more massive 
than the other digits. Its shape is roughly cylindrical ; 
at its root it is thicker from before back, and distally 
wdiere the nail comes it is thicker from side to side. 
On its palmar aspect the skin presents the same 
characteristics as that of the palm. Its surface is 
broken at the joints by one or two lines of flexion; 
and shows multitudes of very fine lines, especially on 
the terminal phalanx, which, if studied ^th a hand 
lens, are seen to be arranged concentrically, but never 
exactly alike in any two individuals — a fact which 
has in recent years been used for the registration of 
criminals and others by taking and preserving their 
*' finger-prints." 

100 



THE UPPER EXTREMITY 

These finer lines are seen over the whole palmar 
aspect of the hand and digits, and are associated 
with the high development in these regions of the 
sense of touch. On the outer, inner, and posterior 
aspects of the thumb the skin is similar to that on 
the back of the hand. On the distal knuckle of the 
thumb are numerous transverse lines. 

The anatomical snuff-box is the name given to a 
depression on the back of quite the upper part of 
the thumb. Its boundaries are two ridges that are 
particularly obvious if the thumb is actively ex- 
tended. The outer ridge is formed by the extensor 
ossis metacarpi poUicis and extensor primi internodii 
poinds tendons ; on the inner side the snuff-box is 
bounded by the ridge of the tendon of the extensor 
secnndi intej-nodii pollicis (Plate XXX.). 

By waggling the thumb slightly while keeping it 
extended, each of these three tendons can be traced 
to the base of the bone indicated in its name. 

The Fing-ers. — The middle finger is the longest, 
and the ring and index fingers are commonly of 
equal length. The bases of the three inner fingers 
are of about equal breadth, but the base of the index 
is broader than the others in the proportion of 11 
to 10. With these figures as a guide, the base of 
the first phalanx of the thumb would be represented 
by the figure 12. 

The fingers, as a rule, taper to their extremities, 
and the more they taper the more beautiful they are 
supposed to be ; but the ends of the ring and middle 
fingers are frequently a little expanded. The fingers 
widen across the plane of the middle knuckles, 
but contract slightly across the plane of the distal 
knuckles. 

Transverse lines are seen on the palmar surface 

101 



THE UPPER EXTREMITY 

of the joints. The upper set lies three-quarters of 
an inch below the knuckle, the middle set exactly 
opposite, and the lowest set one-quarter of an inch 
above the corresponding knuckle (Fig. 39, p. 96). 

The individual variations of the hand are con- 
siderable, and indeed second only in importance and 
interest to the variations in type and character of 
the head and face. Sir Charles Bell and Sir George 
Humphry have written most able accounts of this 
fascinating subject, and the student should turn to 
their books if he would fathom its interest. But even 
the most casual observer sees at the first glance the 
essential difPerence between the tapering fingers and 
small supple hand of the lady of ease, the large 
horny and rigid fist of the manual worker, the 
clubbed and bluish fingers of the chronic i^ulmonary 
invalid, the chubby " braceletted " hand of the infant, 
the podgy, smooth, insensitive hand of the well-fed 
successful man of sedentary habit, and the bony, dry 
hand of old age with its fingers all tending to lean 
their tips towards the ulnar side. 



102 



CHAPTER V 

THE LOWER EXTREMITY 

The lower extremity comprises :— 

1. The buttock. 

2. The groin. 

3. The thigh. 

4. The knee. 

6. The popliteal space 

6. The leg. 

7. The ankle. 

8. The foot. 

9. The toes. 

The buttocks are the massive parts of the body 
which lie at the bottom of the back on each side of 
the middle line. With the exception of the breast 
in females, there is no part of the healthy body in 
either sex which owes less of its shape to bone, and 
more to fat and muscle, than the buttock (Figs. 20, 
21, 41, 42, 106, 107, 108, and Plates). 

The great size of the region is peculiar to the 
human species. The maintenance of the erect posi- 
tion in bipeds is rendered possible by the development 
of the great gluteal muscles, but the thick layer of 
subcutaneous fat prevents their contours from being 
seen as well as they would be otherwise. 

Without the powerful development of these muscles 
the erect position could never have been attained by 
man, yet once actually adopted, the maintenance of 
the attitude is facilitated by the ligaments on the 

103 



THE LOWER EXTREMITY 






front of the hip- joint, and economy of strength is 
observed by this relegation of constant duty to in- 
extensible ligaments. 

If these muscles were dissected away from the 
underlying bones, a deep and broad groove would be 
found between the great trochanter of the femur and 
the prominent portion of bone 
known as the tuberosity of the 
ischium, upon which we sit and 
from which the hamstring muscles 
arise. Now, this groove in the 
living body is not only completely 
filled up by muscles and fat, but 
it is overfilled, so that its position 
is marked by a massive promi- 
nence which prevents the bones 
from forming obvious landmarks 
in this region. 

The skin is thick and coarse, 
and the fat, even in ordinary in- 
dividuals, is nearly an inch thick. 
The boundaries of the buttocks 
are as follows : — 

The upper limit is formed by 
the crest of the ilium, from which 
several large muscles arise — some 
passing upwards to the abdominal 
wall, some downwards to the thigh. The promi- 
nences formed by these muscles when Tvell developed 
are separated by a groove, which does not accurately 
correspond, though it does roughly, to the iliac crest 
{vide Chap. VII.). 

Internally the two buttocks are separated from 
each other above by the flattened termination of the 
spinal furrow, which is here supported by the upper 

104 




Fig. 41.— Gluteal Muscles 
and Ilio-tibial Band. 
Outer side of upper 
part of tMgh. 



THE LOWER EXTREMITY 

part of the sacrum, or, more precisely, by the upper 
three sacral vertebrae, the individual spines of each 
of which are easily felt, and sometimes seen. Below 
the sacral vertebrae the two buttocks are separated 
by a deep narrow cleft, continuous between the 
thighs with the perineum. 

The lower limit of the buttock is formed by a well- 
marked furrow, the natal fold, sloping outwards and 
downwards from the median cleft, and running just 
below the level of the tuberosity of the ischium. The 
natal fold does not pass much beyond the middle line 
of the back of the thigh, for it then tapers rapidly 
away and turns slightly upwards, and leaves the 
outer half of the lower limit of the buttock quite 
ill defined. The natal fold does not correspond to, 
but crosses more horizontally, the very oblique lower 
border of the gluteus niaximus (Fig. 42). Further, 
it becomes less and less well marked as the thigh 
is flexed (Plates XL, XIY., XXXVIII.). It is very 
important to grasp and bear in mind these two facts. 

The outer boundary of the buttock is ill defined, 
but corresponds to a vertical line through the great 
trochanter of the femur. 

On each side of the sacrum the buttocks are sup- 
ported by the os innominatum, especially by the 
iliac part of that bone and by the tuberosity of 
the ischial part, which is easily palpable beneath the 
lower margin of the gluteus maximus. 

The two tuberosities of the ischia form oval pro- 
minences upon which the body is directly supported 
in the act of sitting, no muscle actually intervening 
between the bones and the superficial fascia and 
skin. It follows that when the subject bends the 
hip beyond the right angle which is employed in 
sitting, the tuberosity emerges from under cover of 

105 



THE LOWER EXTREMITY 



the gluteus maximus and becomes visible, and from 
it the hamstring muscles can then be seen to arise 
(Fig. 42). 

The position of the tuberosity of the ischium, 
although it cannot in all positions be seen, can 
always be felt. Not far away are 
two other bony landmarks of great 
importance, with which the student 
is already familiar — the anterior 
superior spine of the ilium, and 
the tip of the great trochanter of 
the femur. If a rule be laid upon 
the anterior superior spine and also 
upon the tip of the great tro- 
chanter, its continuation will pass 
through the most prominent part 
of the tuberosity. This line is 
absolutely constant in the normal 
individual ; it is called " Nelatons 
line" and is obliquely placed, being 
directed from the front round the 
side of the buttock, backwards, 
downwards, and finally a little 
inwards. 

It is only in fat persons that 
the buttocks are pendulous, and 
in such case their most prominent 
part is a little below and internal 
to the tuberosity of the ischium. 
It has already been pointed out 
that the fat in this neighbourhood is usually thick, 
and the outlines of the muscles consequently ob- 
scured; but if the body is bent forwards and then 
slowly raised, the gluteus maximus coming into 
vigorous action may generally be demonstrated. 

106 




Fig. 42. — Muscles of 
the Back of the 
Right Thigh and 
Popliteal Space. 



THE LOWER EXTREMITY 

The buttock is relatively larger in the female, 
because the pelvic skeleton is larger, and it is more 
rounded, because in this part, as in the thigh and 
chest, the female is apt to have a thicker covering 
of fat. 

The gluteus maximus (Figs. 41 and 42, pp. 104, 106, 
and 20 and 21, pp. 75, 76) is one of the largest muscles 
in the body. It is made up of exceptionally coarse 
and thick muscle fibres, between the bundles of which 
lie quantities of fat and fibrous tissue. It forms a 
regular quadrate mass, which is directed obliquely 
from near the middle line at the base of the spine 
to the upper part of the femur, and that well-marked 
portion of the deep fascia of the thigh known as the 
ilio-tihial band. 

The muscle has its origin from the back part of 
the crest of the ilium, from the sides of the sacrum 
and coccyx, and from the adjacent ligaments. Its 
upper and lower borders are parallel with each other. 
The upper border passes forwards and outwards, 
and somewhat rapidly downwards from the crest 
of the ilium ; the lower border does not correspond 
accurately to, but rather cuts across, the outer part 
of the natal fold, and is continued onwards to the 
back of the upper extremity of the shaft of the 
femur. 

The upper part of the insertion is into fascia 
forming the ilio-tibial band (Fig. 41, p. 104), and is 
not quite so prominent as the lower part, which is 
inserted into the femur. 

In that part of the buttock which lies above the 
upper sloping border of the gluteus maximus and 
beloTv the crest of the ilium, there is an extensive but 
shallow depression. This is occupied by the fibres 
of the gluteus medius, a fan-shaped muscle passing 

107 



THE LOWER EXTREMITY 



from the outer surface of the iliac bone to the outer 
part of the great trochanter of the femur. 

The chief action of the gluteus niedius is to draw the 
lower limb away from the middle line of the body; 
of the gluteus maximus, to extend the hip-joint, as 
in raising the body from the position of the quadruped 
to that of the biped. By its 
attachment to the ilio-tibial band 
it also steadies the knee-joint. 
When it is in action, the ilio- 
tibial band is rendered taut, and 
produces a flattening, or even a 
furrow, upon the outer side of 
the thigh (Fig. 44). 

The Groin (Figs. 25, 27, 43, 44, 
45, 46, 47) is a shallo^v oblique fur- 
row ^vhich separates the abdomen 
above from the thigh below. It 
may, in fat persons, be obscured, 
or indeed overhung, by the fat of 
the abdominal wall {vide infra). 
This shallow furrow is continu- 
ous with the iliac furrow, which 
nearly corresponds to the crest 
of the ilium, on the side of the 
body. Its extent is from the 
anterior superior spine of the 
ilium to the pubic region, and its general direction is 
do^vnwards and inwards. The furrow has a very 
slight convexity downwards and outwards, corre- 
sponding to the underlying and very important 
thickening of the tendon of the external oblique 
muscle named " Pouparfs ligaments 

The anterior superior spine of the ilium (Figs. 8, 9, 43 
to 47), from which the ligament passes, is a small oval 

108 




Fig-. 43.— The Muscles in 
the Region of the Groin. 



THE LOWER EXTREMITY 



prominence of bone on the side of the front of the 
body. The long axis of the oval is directed down- 
wards and inwards. 

The Thigh extends from the groin and buttock 
to the knee and popliteal space. 
It tapers considerably from above 
downwards, especially in the female 
{vide Plates), and becomes more 
circular as it approaches the knee. 
It is slightly constricted just above 
the knee, so that at the joint the 
limb slightly expands again (Fig. 44). 

The outer side of the thigh is 
flattened ; the inner side slopes from 
the inner end of the fold of the 
groin downwards and slightly out- 
wards. Immediately below the fur- 
row of the groin several important 
muscles are grouped in a region 
known as Scarpa's triangle, and some 
of them form very obvious surface 
markings. 

The chief ridge is due to the long 
tailoj^'s muscle, or sartorius (Figs. 43, 
44, 45). Its course is very long and 
some^vhat sinuous, reaching from an 
origin at the anterior superior spine 
of the ilium to an insertion at the 
upper end of the inner surface of 
the tibia, just below the knee, so 
that it passes over and acts upon two joints 
hip and the knee. 

At its beginning the sartorius is directed down- 
wards and inwards across the front part of the thigh, 
here forming the outer boundary of a slight hollow 

109 




Fig-. 44.— Muscles on 
tlie Front of the 
Right Thigh. 



-the 



THE LOWER EXTREMITY 

called Scai^pas triangle. At the junction of the upper 
and middle thirds of the thigh it reaches the inner 
side, and is directed downwards with a slight inclina- 
tion backwards. It then passes down on the inner 





Fig. 45.— Inner Side of Thigh, show- 
ing Ridge formed by the Sax- 
torius Muscle. 



Fig". 46.— Vasti Muscles (shaded), 
Adductor Muscles (outline). 
Front of Right Thigh. 



side of the knee, and finally turns forwards to reach 
its insertion into the tibia. 

The outline of this muscle will usually be seen, 
even in fat persons, if the subject holds his limb so 
that the knee is flexed, and the hip flexed and strongly 
abducted, and rotated outwards (Fig. 45). This is 

110 



THE LOWER EXTREMITY 



the old-fashioned tailor's customary position while 
sitting on his bench ; hence the name of the muscle. 
It should, however, be understood that several other 
muscles are concerned in producing this movement. 

Of the adductor muscles on the 
inner side of the thigh only the 
adductor longus needs mention 
here (Figs. 46 and 47). It passes 
from the front part of the pubic 
bone to the back of the middle of 
the femur. It starts above as a 
tendon and becomes much broader 
as it passes down. It lies in a 
doubly oblique plane — i.e. not only 
does it slope from above down- 
wards and outwards, but also from 
before backwards, so that its inner 
and lower margin is much more 
prominent than its outer and 
upper margin. The adductor 
longus passes behind the sartorius 
and bounds Scarpa's triangle inter- 
nally. 

Poupart's ligament bounds this 
triangular hollow above. The apex 
of the triangle is formed below by 
the meeting of the adductor longus 
and the sartorius. The inner part 
of the hollow is deeper than the 
outer, w^here the head of the femur pushes 
muscular floor of the triangle forwards. 

The upper end of the large superficial internal or 
long saphenous vein passes upwards in the inner half 
of the triangle to within an inch and a half below 
the inner end of Poupart's ligament, where it dips 

111 




Fig. 47.— Ilio-psoas and 
Adductor Muscles of 
Thigh. 



the 



THE LOWER EXTREMITY 

down among the deep structures to join the main 
vein of the limb, the common femoral vein. It is 
rarely visible unless abnormally large, or the subject 
very thin. 

The quadriceps muscle (Figs. 43 to 46, and Plates) 
is a great mass lying deep to the sartorius on the front 
and sides of the thigh. It consists of four parts : the 
first three, the vastus internus, vastus externus, and 
rectus femoris, all produce obvious surface markings ; 
but the crureus, v^hich forms the fourth head of the 
muscle, although responsible in great part for its 
bulk, producing the general anterior convexity of the 
thigh, which is well seen in Fig. 45, is completely 
covered up by the other three heads. 

The quadriceps mass emerges from under cover 
of the sartorius and passes to the knee. Its three 
visible constituents are : — 

1. The rectus femoris (Fig. 44), forming the super- 
ficial anterior part of the mass. It pursues, as its 
name implies, a nearly vertical course, starting from 
tho anterior superior spine of the ilium with a slight 
inclination inwards, and reaching to the upper border 
of the knee-cap. 

2. The vastus internus (Figs. 44, 46), giving rise to a 
large prominent mass on the inner side of the lower 
half of the thigh. Good development of this muscle 
is one of the characteristics of great strength. In 
some i)ositions of the limb its surface presents an 
oblique groove, some two or three inches above 
and internal to the knee-cap, best demonstrated 
perhaps when the subject stands on both legs but 
leans most of his w^eight on one. The groove will 
be noticed in the limb upon which the greater 
pressure is made, and it is directed downwards, 
inwards, and backwards (Plates XXVI., XXVII.). 

112 



THE LOWER EXTREMITY 



3. The vastus externus (Figs. 44 and 46, pp. 109, 110), 
on the outer side of the thigh, extending from the 
great trochanter above to the patella below. On the 
general prominence formed by this muscle there is a 
shallow longitudinal groove or flattening produced by 
the ilio-tihial hand (Plates XXII., XXVI., XXVIII. C), 
a longitudinal thickening in the deep fascial envelope 
of the thigh (the fascia lata), into which two muscles 
areinserted 
above, viz. the 
gluteus maximus 
and the tensor 
fasciae femoris 
(Figs. 41, 44). 

As a rule this 
groove is not ob- 
vious at a higher 
level than the 
middle third. Near 
the knee the band 
becomes more 
obvious as a ridge 
which terminates 
below in the ex- 
ternal tuberosity of the upper end of the tibia, and 
lies a short way behind the tendon of the biceps 
muscle. The tensor fascice femoris muscle, so called 
because it is inserted into (the front of) the ilio- 
tibial band, which is only a very strongly developed 
part of the deep fascia of the thigh, forms a pro- 
minent ridge running downwards from the anterior 
superior spine, with a decided inclination backwards 
(Figs. 43, 44). 

Into the top end of the ilio-tibial band is also in- 
serted the gluteus maximus muscle, but from behind. 
The band is very frequently taut and obvious, because 

118 H 




Fig. 48.— The Flexed Knee. 



THE LOWER EXTREMITY 

in most positions of the limb the muscles inserted 
into it have to be thrown into action in order to 
maintain the erect posture. 

In the middle third of the thigh, and on its inner 
side, where the saitorius is passing nearly vertically 
do^svnwards, this part of ihe muscle may not (as indi- 
cated in Fig. 46, p. 110) form a definite ridge, but may 
he at the bottom of a groove Tvhich separates the ad- 
ductor group of muscles behind from the quadriceps 
mass in front (Plates IX. and XXI.). 

The adductor inagnus 7nuscle is chiefly responsible 
for the mass of the adductor group, although very 
little of it can be seen to produce a distinctive 
ridge. In its loTver part the tendon of the muscle 
is capable of demonstration, forming a small ridge 
v/hich ends just above the internal condyle of the 
femur in the adductor tubercle. This can always be 
felt, and can in some spare limbs be seen (Fig. 47, p. 111). 

The great trochanter of the femur is easily felt in 
the upper part of the outer side of the thigh, covered 
to a certain extent, and therefore obscured, by the 
insertion of the great gluteal muscle. The actual 
position of the bone is marked by a slight hollow, yet 
the surrounding muscles form a pronounced general 
convexity in this region {vide Plates). 

The back of the thigh is, as we have already seen, 
marked off from the buttock by the deep fold of the 
nates, which is the lateral and inferior continuation 
on each side of the deep median groove passing 
downwards from the coccyx and lying between the 
two buttocks. 

Starting from the middle line, the two natal folds 
diverge, and each one curves at first downwards and 
outwards, then directly outwards, and finally even a 
little upwards and outwards, to terminate by gradu- 

114 



THE LOWER EXTREMITY 



ally fading away at a point usually a little externa] 
to the middle line of the thigh (Plates XI. and XII.). 

The bulk of the prominent muscularity of the 
back of the thigh is due to the harnstring muscles, 
along its whole length. They are three 
in number, and lie close together in 
the upper part of the thigh, where 
their superior attachments to the 
tuber ischii are concealed beneath the 
gluteus maximus, and they form when 
in action a single wide ridge (Fig. 42, 
p. 106). 

The biceps, the largest, so called 
from its having a second head of 
origin from the femur. 

The seini-memhi'anosus, so called 
because it forms in its upper and 
lower parts a flat membranous band. 

The seTYii-tendinosus, so called from 
its long thin tendon below, which is 
almost, if not quite, as long as the 
muscular portion. 

These three muscles pass down the 
back of the thigh and, forming the 
strings" of the "ham" or popliteal 
region (Figs. 42, 49, and 50), reach 
the bones of the leg below the back 
of the knee. It is of great import- 
ance to observe the manner in which 
they descend from their upper to their lower attach- 
ments. 

Just before reaching the middle of the back of the 
thigh, the single ridge formed by their combined 
origin from the tuber ischii splits into two ; the outer 
and larger and more prominent is the biceps, while 

115 



i 



n 



Fig-. 49, — Muscles 
of the Popliteal 
Space and Calf 
of tlie Leg. 



THE LOWER EXTREMITY 



the inner is the semi-tendinosus, lying upon the semi- 
membranosus. 

The two heads of which the biceps is composed 
cannot be distinguished from each other without 
dissection ; the ridge it forms is single. 

Not so, however, the inner ridge. Although it is 
true that in the upper part of the 
thigh the semi - tendinosus cannot 
be distinguished from the under- 
lying semi-membranosus, this is by 
no means the case in the lower 
part; for here a secondary ridge 
or crest, sharp and prominent and 
formed by the tendon of the semi- 
tendinosus, lies upon the main 
eminence, which is broader and is 
formed by the semi-membranosus 
(Fig. 42, p. 106). 

These two main ridges, one on 
each side of the middle line of the 
back of the thigh, diverge as they 
travel down the thigh, till the biceps, 
passing to the outer side of the 
popliteal space, gains its lower 
attachment in the head of the 
fibula ; while the other two muscles, 
passing the popliteal space well to the 
inner side, gain their insertions on the inner surface 
of the upper end of the tibia with the sartorius. 

These ridges diifer, then, in constitution and direc- 
tion, but there is yet another difference to be 
carefully studied. The biceps muscle is inserted into 
the fibula by a moderately long, rope-like tendon 
(Fig. 50). The ridge produced by the biceps muscle 
itself therefore narrows rapidly into this tendon as it 

116 




Fig. 50. — The Outer 
Side of the Knee. 




THE LOWER EXTREMITY 

travels down past the middle of the back of the 
thigh, and it is not obscured by any other structure. 
This point is one of great importance. 

Similarly, the semi - tendinosus muscular belly 
rapidly gives place to its much smaller tendon as 
it is traced downwards. 

But the main inner ridge, formed by the semi- 
membranosus, narrows comparatively little. The 
semi-tendinosus stands out much less consp)icuously 
than the biceps. 

Upon the outer side and in front of the bicipital 
ridge is a well-marked 
groove, succeeded by the 
ilio-tibial band, stretching 
from the gluteus maximus / 
to the knee. In front of i 
this band, again, lies the If^^ V 
flattened outer side of the ^ ^-\ 

thigh, the muscular bulk of ng. 51. -Muscles on inner Side 
which is chiefly contributed o^ Lower Half of Thigh. 

by the vastus externus. 

The Region of the Knee (Figs. 45, 48, 49, 50, 
51, and 52). 

It will have been observed that in the thigh 
the general shape of the limb is chiefly due to the 
large and important muscles. But very different 
causes influence the shape of the knee, for the chief 
prominences are formed not by muscles, but by the 
underlying bones. These are the patella, the lower 
end of the feniu?^ and the upper portions of the tibia 
and fibula. 

When the knee is viewed from the front it will 
be observed that the inner side is much more pro- 
minent than the outer, and shows, especially in 
women, a nnarked convexity, while the outer side 

117 



THE LOWER EXTREMITY 

is generally flat, but may even present a slight 
concavity (Fig. 52). 

The upper and lower limits of this concavity, 
or flattening, lie wider apart than the limits of 
the internal convexity. In other words, the ex- 
ternal concavity occupies a considerable length of 
the limb, while the internal convexity is short and 
sharp. It is produced by the internal condyle of the 
femur and the internal tuberosity of the tibia. The 
eye will not tell you where the femur ends and 
the tibia begins unless the knee is flexed. In a sitting 
position when one knee is crossed over the other, the 
internal tuberosity of the tibia is seen to be slightly 
more prominent than the internal condyle of the 
femur. In muscular subjects the prominence of the 
vastus internus very much obscures the bold outline of 
the internal condyle (Fig. 51), but the internal tube- 
rosity of the tibia is not similarly obscured by super- 
jacent muscles. In thin persons, of course, the bony 
prominences are much more obvious, and in them the 
internal condyle may be observed to begin abruptly, 
about the point at which the adductor tubercle, for 
the insertion of the tendon of the adductor magnus, 
is found on the inner side of the knee, half-way 
between the anterior and posterior surfaces. 

In fact, it is the absence of great muscle-masses 
which allows the bony prominences about the knee 
to be so clearly recognised. 

Although the external condyle of the femur may 
easily be felt upon the outer side of the limb, it is 
not usually seen as a marked prominence ; nor is the 
external tuberosity of the tibia, and chiefly because 
of the biceps tendon and the ilio-tibial band (Fig. 50). 

The most prominent bony point upon the outer 
side of the knee is that produced by the head cf the 

118 



THE LOWER EXTREMITY 



fibula. Like many other prominences this one lies, 
in well-covered persons, at the bottom of a slight 
depression. But if the knee is bent it forms almost 
always a definite prominence beloTv the external 
tuberosity of the tibia and indeed well below it, so that 
the fibula is excluded from the knee-joint (Fig. 50). 

The tendon of the biceps accounts for the well- 
marked ridge when the forcibly flexed knee is ex- 
amined from the outer side, and will 
guide the finger down to the head of 
the fibula. In front of the bicipital 
ridge, notice the longitudinal groove, 
and in front of that again, the longi- 
tudinal prominence formed by the 
ilio-tibial band. 

On the front of the knee, the patella 
or knee-cap is most obvious when the 
knee is extended or semi-flexed. It 
is the oval eminence which lies oppo- 
site the upper two-fourths of the con- 
vexity of the inner surface of the knee 
and the middle two-sixths of the con- 
cavity of the outer surface (Fig. 52). 

The patella is much less noticeable 
when the joint is completely flexed. This is due to 
the fact that as the knee is bent the patella shifts 
from its position on the front of the femur to the 
inferior surface of that bone, here to lie in a groove 
and so to bury itself not only between the condyles 
of the femur, but also in the triangular space be- 
tween the lower end of the femur and the upper end 
of the tibia (Fig. 48, p. 113). * 

The upper and lower edges of the patella are not 
so obvious as its lateral margins. The quadriceps 
muscle of the thigh is attached to the upper border 

119 




Fig. 52. — Muscles 
on the Front ol 
the Right Knee, 



THE LOWER EXTREMITY 

and the ligamentum patellcB is fixed to the lower 
border, which is iriore pointed than the upper. The 
patella thus forms a connecting link between the 
quadriceps muscle and the ligamentum patellae. The 
latter produces a Tvell-marked ridge, and narrows as 
it descends to terminate in the tubercle of the tibia, 
upon which bone it acts as the tendon of inser- 
tion of the quadriceps muscle. The patella is the 
largest of the sesamoids, or little bones specially 
formed in tendons at the places where they glide 
over bony prominences. The ligamentum patellae 
stands out conspicuously as the knee is extended, i.e. 
straightened out (Fig. 52). 

The tubercle of the tibia, the ligamentum patellae, 
and the pointed lower part of the patella receive the 
body weight when the kneeling posture is assumed, 
and the skin over them is very coarse. The front 
of the knee is marked by numerous transverse 
furrows, analogous to the wrinkles of the face, and 
to the lines of flexion upon the fingers and upon 
the palm of the hand. 

When the leg is forcibly straightened, the loose fat 
which lies between the ligamentum patellae and the 
tibia is squeezed and forms a slight bulging on each 
side of the ligament. 

The vastus internus forms a much more obvious 
muscle-mass, just above the patella level, than does 
the vastus externus, and presents in the muscular 
a curious groove directed downwards, inwards, and 
backwards (vide p. 122). The maintenance of the 
erect posture depends both at hip and knee rather 
upon ligaments than on muscles, so that the Quad- 
riceps is often off duty, and then the patella falls 
somewhat forward. 

The ham, or popliteal space (Figs. 42 and 49, pp. 

120 



THE LOWER EXTREMITY 

106, 115), is the hollow behind the knee. But it must 
be remembered that it is a hollow only when the 
knee is bent, for when the limb is straightened out 
a prominence takes the place of the hollov This is 
chiefly caused by the shape of the Iowl ; end of 
the femur and of the upper end of the tibia, both 
of which, but especially the former, are prominent, 
and press backwards the soft fat and other contents 
of the popliteal space, such as the main artery and 
vein and nerves of the lower limb. 

The hollow of the hajn proves on dissection to be 
diamond-shaped, with its vertical axis at least three 
times the length of the horizontal. The apices of the 
diamond may as a rule be easily seen without dis- 
section, but the more obvious one is the upper. 

The upper sides of the diamond are longer than 
the lower ; thus there is more length in the part lying 
above the horizontal line joining the lateral angles 
of the diamond than there is in the part lying below. 

It will be remembered that the hamstring muscles, 
as they pass down the thigh, form two ridges which 
diverge from each other. At the angle of divergence 
is the upper apex of the popliteal space. This is 
situated at the junction of the middle with the lower 
third of the back of the thigh. It will be quite plain 
that the biceps forms the upper and outer boundary, 
and the semi-membranosus and semi-tendinosus the 
upper and inner boundary of the diamond. 

The lower sides of the diamond are formed by 
the two heads of the gastrocnemius rniiscle, and are 
much less prominent than the upper sides ; in fact, 
they lack definition until dissected. The upper parts 
of the gastrocnemii are overlapped by the muscles 
which term the upper boundaries of the popliteal 
space. 

121 



THE LOWER EXTREMITY 

There is yet another muscular ridge to be noticed 
in connection with the inner side of the knee. This 
is obliquely placed and directed from behind the 
prominence which is formed by the internal condyle 
of the femur, downwards and forwards, to terminate 
on the inner surface of the tibia, at or about the 
level of its tubercle (Fig. 42 ; Plate XXVI.). 

The ridge is due to the tendons of the gracilis, 
sartorius, and semi-tendinosus muscles, all three of 
which have a common insertion, though they arise 
from the os innominatum at very different points 
nearly equidistant from each other. The gracilis 
arises from near the symphysis pubis, the sartorius 
from the anterior superior spine, and the semi- 
tendinosus, from the tuber ischii. 

The external concavity and the internal convexity 
mentioned above in connection Tvith the sides of the 
knee will repay close and careful examination, as 
they differ considerably in young children and adults 
of both sexes {vide Plates). The difference between 
the male and female is nowhere more pronounced 
in the limbs than in the region of the knee. The 
inward convexity is much more marked in the 
female than in the male, and in the child than in 
the adult, and is due in both sexes, first, to the 
inclination inwards of the femur as it extends down- 
wards from the hip to the knee, and secondly, to the 
large size of the internal condyle. 

Owing to the larger relative, and, frequently, 
absolute, distance between the ace tabula of the 
pelvis, which is an exact indication of its breadth, 
the femoral inward slant is more pronounced in the 
female than in the male. 

The line of the knee-joint itself is transverse ; the 
legs lie parallel to each other, but the thighs incline 

122 



THE LOWER EXTREMITY 



towards one another, and so some slight degree of 
that condition which, when exaggerated, is called 
" knock-knee " is apparent even in the normal subject. 

By the Leg" (Figs. 48, 49, 50, 53, and Plates) is meant 
anatomically only that part of tlie subject which 
extends from the knee to the ankle. 
It is thicker and more circular in 
the upper part or calf, owing to 
the relatively large size of those 
muscles, which are usually well 
developed because in constant use. 
Legs vary more in extent of mus- 
cular development than appears 
to correspond with their varia- 
tion in strength. Very extensive 
muscular development, such as 
appears to be aimed at by some 
exponents of so-called "physical 
culture," is no more necessary 
or desirable from the point of 
view of health, strength, or effi- 
ciency than from the point of 
view of beauty. 

The leg is smaller in its lower 
half, and oval in cross section. 
The decreased calibre is due to 
the replacement of the muscles by 
their tendons, and the level at 
which this takes place varies in ^'^- f;-"?" irr'"^'"' 

^ . , . . of the Right Leg. 

different types or nationalities ; 

the negro has a high calf, just as the Scandinavian 

has a high cheek-bone. 

Immediately below the knee the leg is not so thick 

as it is a little lower down, and again after rapidly 

and gracefully tapering below the calf it increases 

123 




THE LOWER EXTREMITY 

a little in thickness when the actual ankle-joint is 
reached (Fig. 53). 

The Bony Landmarks of the Leg. — The shin is 
formed by the inner surface of the tibia (Fig. 53), 
which is directed forwards as well as inwards, and 
by the sharp anterior border of the same bone. The 
anterior border of the tibia is named the crest ; it 
pursues a sinuous course down the front of the 
leg, and is easily felt all the way from the tubercle 
of the tibia to the ankle-joint. 

The crest is, in its upper two-thirds, slightly concave 
forwards, and in its lower third slightly convex. 

The inner surface of the tibia, which extends sub- 
cutaneously along the whole length of the bone, tapers 
somewhat as it is traced downwards, but becomes 
expanded again in the region of the ankle-joint. 

The crest and inner surface, which together form the 
shin, are for the most part immediately subcutaneous. 
In the upper part of the leg, however, the thin spread- 
ing tendons of the sartorius, gracilis, and semi- 
tendinosus muscles cover the inner surface as they 
come forwards below and inside the knee (Figs. 
44, 51) ; and in the lower part of the leg, the crest 
of the tibia is obscured by the passage of the dorsal 
extensor tendons from the leg to the foot. 

As an analysis of these tendons can readily be 
made \vithout dissection, their relative positions will 
be described in more detail later (p. 127). 

The bony prominences of the tibia and fibula in 
the region of the knee have already been noticed 
(p. 117) ; and with the exception of the shin, nothing 
more can be felt or seen of the bones till the region 
of the ankle is approached. Here the expanded 
lower portions of the tibia and fibula become again 
subcutaneous, an4 form two well-marked promi- 

124 



THE LOWER EXTREMITY 

nences, the malleoli, situated one on each side of the 
ankle. 

The internal malleolus of the tibia (Fig. 56), is more 
massive, but shorter and less prominent, than the 
external malleolus of the fibula (Fig. 57). The relative 
positions of these pointed lower extremities of the 
leg bones are as follows : — 

The tip of the external malleolus is situated a full 
half-inch below and half an inch behind the corre- 
sponding point of the tibia. The external surface 
of the fibula is immediately subcutaneous for nearly 
three inches above the tip of its malleolus, but 
above this it is buried by the adjacent tendons and 
muscles. 

The internal malleolus can be traced up into the 
subcutaneous shin. 

Although the inner border. of the tibia may be 
identified by the sense of touch, it is obscured from 
view by the bulging of the subjacent calf muscles 
on the back of the leg (Fig. 53). 

In addition to the bony, muscular, and tendinous 
prominences, a careful inspection of the leg, which 
has habitually less fat than the thigh, will reveal three 
superficial structures, viz. the internal saphenous vein, 
the external or posterior saphenous vein, and the 
musculo-cutaneous nerve. They are all difficult to 
see except in thin subjects — and especially difficult 
is the nerve. 

The internal, or long saphenous, vein has already been 
described in the thigh (p. 111). In the leg it forms a 
blue line or ridge, just in front of the internal mal- 
leolus, and passes up the limb, just behind the shin, to 
the inner side of the knee, near the posterior aspect 
of which it lies. This vein receives several tributaries 
from the front and sides of the leg, and is liable to 

125 



THE LOWER EXTREMITY 

be dilated at intervals, or to pursue a very tortuous 
course in those who are the subject of varicose veins. 

The short, or posterior saphenous, vein passes behind 
the external malleolus and reaches the back of the 
leg, where it occupies the middle line. Its course is 
straight to the back of the knee, and as it passes in 
this upward direction it lies between the two bellies 
of the gastrocnemius muscle. 

If the foot is strongly bent downwards and in- 
wards, the inuscido-cutaneous nerve may occasionally 
be demonstrable as a faint, obliquely longitudinal 
ridge in the lower half of the front and outer side 
of the leg. 

The prominences made by muscles in the leg are 
numerous, and fall into three groups. The first group 
comprises four muscles, three of which can usually be 
identified, and lies between the tibia and fibula on 
the front of the leg. The tendons of these muscles 
may be traced in favourable circumstances for their 
entire course as they pass to the upper surface of 
the foot. 

The second group, which is made up of two muscles, 
lies on the outer side of the fibula, and its tendons 
also pass to the foot, but behind and below the ex- 
ternal malleolus. This group is the smallest of the 
three. 

The third group, which lies on the posterior aspect 
of the leg, may be further subdivided into the super- 
ficial massive muscles, which are inserted by the 
tendo Achillis into the heel, and the deep muscles and 
tendons which pass onward behind the inner malleo- 
lus to reach the sole of the foot, where for the most 
part they cannot be detected without dissection. 

The first or anterior group of leg muscles are the 
extensors of the foot and toes. They comprise, from 

126 



THE LOWER EXTREMITY 

within outwards, the tibialis anticus, the largest ; 
the extensor longus hallucis ; the extensor longus 
digitorum, the longest; and the peroneus tertius, 
the smallest, which may be regarded as part of 
the extensor longus. 

The tibialis anticus (Figs. 50, 53) forms a promi- 
nent muscular mass on the outer side of the crest of 
the tibia, in the upper two-thirds of the leg, best seen 
when the toes are forcibly raised. The inner border 
of the muscle is separated, except in fat persons, by a 
groove from the crest of the tibia, and its outer 
border by another groove from the adjacent extensor 
longus digitorum. The tibialis anticus is often suffi- 
ciently bulky to endow the front of the leg with a 
longitudinal convexity, so that its contour viewed 
from the side is curved distinctly forwards when the 
muscle is in action (Fig. 48 and Plate XXI.). 

This curve, due to a muscular prominence, must 
be carefully distinguished from any forward bowing 
of the tibia, which may be present, but only as a 
deformity. It has already been pointed out that 
the upper half of the normal tibial crest is slightly 
concave forwards. 

In the lower third of the front of the leg, the 
muscular belly of the tibialis anticus gives place to 
a strong tendon, which may be rendered so prominent 
by forcible action of the muscle (as in raising and 
inverting the foot) that the ridge which it produces 
may be seen through the boot (Fig. 59). 

As the tendon passes downwards to the foot, this 
ridge is found to be directed slightly inwards, and to 
pass over the lower end of the shin and part of the 
ankle-joint, slightly internal to the mid-point between 
the two malleoli. When the body is raised on tiptoe, 
both muscle and tendon stand out well. 

127 



THE LOWER EXTREMITY 

Tke extensor longus digitorum (Figs. 50, 53) lies 
upon the outer side of the tibialis anticus in the 
upper third of the leg, in close relation to the fibula. 
The two muscles are separated by a groove which 
ends above in the head of the tibia, and not in the 
interval between the fibula and tibia. As this groove 
is traced downwards, it is interrupted or filled by the 
tendon of the extensor longus hallucis, coming to the 
surface and appearing to the outer side of the tibiahs 
anticus (Fig. 53). 

The ridge formed by the extensor longus digitorum 
muscle broadens out just above the ankle-joint j)re- 
vious to dividing into four tendons. This ridge is 
external to the mid-point between the two malleoli. 

Theperoneus tertius (Fig. 53, p. 123) is a small muscle 
which forms a slight elevation on the front of the leg 
in its lower third ; but as its muscle is continuous 
with the ridge formed by the extensor longus digi- 
torum, it has no defined limit above. 

The muscle, in passing towards the foot, diverges 
a little from the extensor longus digitorum, and its 
tendon passes to the outer part of the dorsum of the 
foot (Fig. 54). 

The second or external group of leg muscles com- 
prises the two peronei — longus and brevis — as they 
run down the outer surface of the fibula. 

The peroneus longus (Figs. 49, 50) lies behind the 
brevis and obscures its outline. Both peronei become 
tendinous in the lower third of the leg, and pass 
behind and beloTV the external malleolus to the sole 
of the foot. The two tendons may usually be demon- 
strated, and they preserve the same relative position 
as the muscular bellies (Fig. 54). 

The third or posterior group of leg muscles is the 
largest and the most characteristic of the three 

128 



THE LOWER EXTREMITY 

groups. Its great size is due chiefly to the two 
superficial members of the group, though there are 
four other deeper and much smaller members. The 
gastrocnemius and soleus are very large, and lie 
upon the other muscles, the gastrocnemius being 
most superficial of all. This is the group that forms 
the calf of the leg. 

The gastrocnemius (Figs. 48, 49, 53) has two promi- 
nent heads, an inner and an outer, both extending 
about half-way down the leg and separated by a deep 
vertical groove ; the inner head is longer and broadei 
than the outer. 

The most prominent part of the calf of the leg lies 
at about the junction of the upper and middle thirds. 
The explanation of this is, that while the gastroc- 
nemius arises from the lower end of the femur 
between the upper and diverging boundaries of the 
ham, the soleus (Figs. 49, 50, 53), at least in its main 
part, arises from the tibia and fibula considerably 
below the knee-joint. And although the gastroc- 
nemius is responsible, so to speak, for the superficial 
expression of the calf of the leg, it is the soleus 
which chiefly influences its size and its general shape. 

The gastrocnemius, in the lower half of the leg, 
tapers rapidly as it is traced downwards, and a very 
prominent longitudinal ridge is formed, which passes 
to the back of the os calcis or heel. The ridge is due 
to the presence of the thickest and strongest tendon 
in the body, the Tendo A chillis (Fig. 49, p. 115), which is 
the name applied to the conjoined tendons of insertion 
of the soleus and the gastrocnemii. It is about one 
inch broad at its lowest part, convex from side 
to side, and slightly concave from above down- 
wards. The skin covering it is scored by transverse 
furrows, caused by the movement of the ankle- 

129 I 



THE LOWER EXTREMITY 

joint ; few and deep and striking in the infant (Fig. 58), 
more numerous and more superficial in the adult. 

The edges of the soleus become prominent on each 
side of the gastrocnemius, and are seen to melt 
away completely into the tendo Achillis about three 
or four inches above the heel (Fig. 49). 

The lateral parts of the calf, which, as has been 
pointed out, are formed by the soleus muscle, may 
easily be distinguished (even in the front view of a 
muscular leg), as they bulge outwards beyond the 
inner border of the tibia on the inner side of the 
leg, and the peroneus longus muscle on the outer 
side (Plate XXVI.). The four deep muscles of the 
calf are completely covered by the gastrocnemius, 
the soleus, and their tendo Achillis, and cannot be 
seen w^ithout dissection. 

On each side of the tendo Achillis there is a marked 
hollow. These hollows are continuous with depres- 
sions lying behind and below each malleolus, and 
gradually disappear as they are traced upwards. 

The functions of these two large muscles, viz. the 
gastrocnemius and the soleus, are of great interest. 
By raising the back part of the os calcis, which lies 
behind the axis of the ankle-joint, they forcibly 
depress the foot, and are thus, as will be seen 
later, of great use in the act of walking (Fig. 60). 
Further than this, the gastrocnemius assists in main- 
taining the erect attitude by means of its action upon 
the knee-joint, and so is in constant use. This explains 
why the muscle is so membranous compared with the 
soleus, as, for constant use, membrane, which is a 
lowly organised but elastic tissue, is much more eco- 
nomical than muscle, which is very highly organised. 

It is important to notice that the tendo Achillis 
does not extend as far as the lowest level of the back 

130 



THE LOWER EXTREMITY 

part of the os calcis, but only to its middle (Fig. 49). 
The lowest level of the backwardly projecting os 
calcis forms the actual heel, and is obscured by a 
very thick pad of fat, upon which the weight of the 
body is received when the heel is brought to the 
ground in the act of walking or jumping. 

When the leg is viewed from the side, the calf of 
course presents a marked convexity occupying the 
upper two-thirds of the leg in white races — decidedly 
less in negroes. 




Tig. B4.— Extensor and Peroneal Muscles and Tendons 
of Foot. Outer surface and Dorsum. 



The Ankle is the joint at which the foot is set on 
to the leg at about a right angle. The malleolar 
prominence on each side, the several tendons on the 
front of it, and the one large tendo Achillis at the 
back, with hollows on each side of it, have already 
been described with the lower part of the leg. 

There is a marked, and not easily explicable, dif- 
ference in individuals in the girth of the limb at, and 
just above, the ankle. 

The Foot (Fig. 55), although constructed in much 

131 



THE LOWER EXTREMITY 

the same way as the hand from the scientific anato- 
mist's point of view, differs from it in many respects, all 
of v/hich are of great importance to the student of art. 




Wig. 55— The Dorsum of the Foot. 

Thus the angle which the main axis of the foot 
makes with the leg is rather more than a right 




Tig. 56.— Bones of Right Foot. Inner side. 

angle. Further the foot is usually turned outwards 
at an angle of about ten degrees from the strictly 
anteroposterior line. This angle of torsion of the 

132 



THE LOWER EXTREMITY 

foot upon the axis of the leg varies, however, very 
much. It may amount to nothing at all, or it may 
be very much greater than usual. 

Formerly drill instructors commonly taught that 
the outward pointing of the toes was essential to 
powerful walking and running ; further observa- 
tion has, however, demonstrated that the athlete in 
making a big efPort is prone to invert rather than 
evert his toes (Plate XXVII. C, XXVIII. B). 




Tig. 67.— Bones of Right Foot. Outer side. 

The foot is broader and flatter in front than behind, 
where it is thicker and more cylindrical. The com- 
paratively great breadth in the neighbourhood of the 
toes is the characteristic feature of a natural and 
beautiful foot, and it is a thousand pities that' this 
fact is not recognised by the genius which directs 
the fashions emanating from the boot factories. 

The great breadth of the foot is especially well 
seen in infants, partly because there is less arching 
of the foot than in an older subject (Fig. 58). 

133 



THE LOWER EXTREMITY 



In the natural state the foot is broadest at the root 
of the toes, or perhaps a little behind this level. The 
breadth is a little less at the points of the toes, unless 
the body is raised on tiptoe, when the broadest part 

is at the level of the 
toes (Plate XXVII.C). 
As indicated before, 
the foot becomes nar- 
rower as it is traced 
backwards. 

Various bony pro- 
minences mark the 
surfaces and borders 
of the foot. A de- 
scription of these 
must presuppose a 
knowledge of the re- 
lative positions of the 
internal and external 
malleoli, which have 
already been de- 
scribed. 

On the inner sur- 
face (Figs. 56, 58, 59) 
of the foot the follow- 
ing bony points may 
be recognised : — 

The tubercle of the 
scaphoid or navicular 
bone produces a pro- 
minence one inch 
below the tip of the internal malleolus and one 
inch and a half in front of it. Though actually 
situated chiefly upon the under surface of the bone, 
this tubercle cannot be felt so well upon the sole of 

134 




rig. 58 —To show the attitude and pro- 
portions of an infant who is learning 
to walk. 



THE LOWER EXTREMITY 

the foot, owing to the thickness of the structures 
there lying superficial to it. 

If the upper and lower levels of the inner surface 
of the foot be observed, the tubercle of the scaphoid 




Flexor Longns Hallticli 
Flexor Longua Digltomm 
Tibialis Posticas 
Tibialis Anticus 

Extensor Longua Hallucls 



Fig. 59.— Tendons on Inner Side of Ankle and Foot. 



will be found to lie half-way between them. One 
inch and a half in front of the tubercle of the 
scaphoid, and about a finger's breadth below it, is 
the projection formed by the base of the first meta- 
tarsal hone, much more easily felt than seen (Fig. 56). 

135 



THE LOWER EXTREMITY 



Three fingers' breadth in front of this is a better 
marked prominence, made by the head of the same 
bone. IncKned almost directly forwards from it, but 
also slightly outward, i.e. towards the middle line of 
the foot, the inner border of the great toe shows a 
projection a little beyond its centre, due to the base 
of the terminal phalanx. 

Upon the outer border (Figs. 54, 55, 57, 58, 60) of the 
foot the chief prominence is made by the tuberosity of 

the fifth TYietatarsal 
hone, some two 
inches below and 
two inches in front 
of the external mal- 
leolus. 

From the tuber- 
osity of the fifth 
metatarsal bone the 
outer border is con- 
tinued forwards, 
with a very slight 
inclination out- 
wards. It is inter- 
rupted at the level 
of the root of the little toe by a small prominence, 
caused by the presence of the head of the same 
metatarsal bone. 

On the upper surface of the foot, when in an easy 
position, no prominences are noticeable, except the 
knuckles of the toes, and occasionally that portion 
of the astragalus which lies immediately below and 
a little in front of the ankle-joint. 

The heads of all the metatarsal bones, but espe- 
cially that of the first, may be observed forming 
a ridge near the roots of the toes. This ridge is 

136 




Fig-. 60.— The Dorsum of the Foot. 



THE LOWER EXTREMITY 

directed obliquely from within outwards and slightly 
backwards. Near the toes it may occasionally be 
found broken up into five separate prominences, 
formed by the individual heads of the metatarsal 
bones, with slight intervening grooves. 

Many important points may be demonstrated by 
the study of an imprint of the sole of the foot. This 
may be done in sand, as Crusoe discovered, or by 
taking two pieces of brown paper, one wet and the 
other dry, and stepping from one to the other so 
that as much of the wetted sole as possible shall 
press upon the dry paper. 

The imprint is broadest at the line of the metatarsal 
heads, and quite narrow at the heel ; but between 
these two it is even narrower and confined to the 
outer side of the foot, because the middle part of the 
inner side of the sole does not touch the ground at 
all. This is of great importance, for it indicates that 
the foot is arched from before backwards. 

The arch of the foot is by no means a simple one. 
We have just demonstrated that it is much more 
pronounced on the inner than the outer side of the 
foot. Moreover, dissection reveals the fact that in 
addition to the longitudinal arch there is a transverse 
one. Strictly speaking, therefore, it would be more 
correct to call the " arch " of the foot its " dome." 

A complete examination and understanding of 
these arches can only be gained by dissection ; but 
it, is obvious that their integrity is of great value 
in the artistic " set " of the foot. If they give way, 
the result is a very unsightly deformity, with flatness 
and spreading out and eversion of the whole foot. 

The posterior pier of the arch is formed by the os 
calcis, and the anterior piers by all the bones of the 
tarsus and metatarsus, except the astragalus. The 

137 



THE LOWER EXTREMITY 

astragalus forms the keystone. This antero-posterior 
arch projects the dorsum upwards as the convex 
" instejo," while to the corresponding concavity in the 
sole the name of " tvaist " is given (Fig. 56). 

The pier or pillar in front of the keystone is much 
longer than the pier at the back, and, moreover, it is 
made up of several constituents, whereas the posterior 
pillar has only one, viz. the os calcis. This anatomical 
fact explains why a person prefers when jumping 
from a height to land upon the fore or mobile part 
of the foot, rather than upon the heel or single 
and rigid part, as the resulting jar to the body is 
much less. 

Again, though the anterior pillar is made up of 
many bones, it may be resolved into two halves, 
outer and inner. The inner half Tvas shown by the 
wet and dry brown-paper test to be the more pro- 
nouncedly arched. There is more spring and elasticity 
about this inner half of the antero-posterior arch. 

The surface form of the foot must be studied in 
greater detail. The student must all the time be 
careful to bear in mind the various bony land- 
marks already described ; otherwise he will get into 
difficulties. 

The surfaces of the foot may be taken as four in 
number, viz. the upper, lower, inner, and outer, though 
the last is so narrow as to be little more than a 
border. The surfaces are not distinctly demarcated 
from each other except at this outer border. 

The upper surface of the foot will be described first, 
as it is in many ways the most characteristic portion 
(Figs. 54, 55, and 60). It is set somewhat obliquely, 
so that it runs from the ankle downwards, for- 
wards, and outwards. This surface presents the 
convexity already alluded to as the " instep," which, 

138 



THE LOWER EXTREMITY 

be it remarked, is more pronounced in women than 
in men. 

There are slight depressions below and above the 
actual instep, very shallow, and continuous Tvith each 
other on the outer side of the dorsum of the foot, 
where the instep is not present. 

Then there are blue lines, or faint ridges, due 
to subcutaneous veins, to be noticed. A very easy 
and excellent way to make these veins more apparent 
than usual is to put the foot in hot water, rubbing 
meanwhile the leg with the palm of the hand in a 
downward direction. 

It will be found in many cases that there is little 
regularity in the arrangement of these veins at or 
near the toes, yet as they are traced backwards 
towards the ankle they form an irregular arch, con- 
vex forwards, whose two extremities give origin to 
the two saphenous veins. One of these, usually the 
larger of the two, passes upwards on the leg in 
front of the internal malleolus, and will be readily 
recognised as the beginning of the long or internal 
saphenous, which has already been described, in the 
regions of the leg, knee, and thigh. The external 
saphenous vein is usually smaller, and passes upwards 
on to the leg behind the external malleolus. 

Beneath these veins other structures may be seen, 
but before any further consideration is given to the 
foot, the toes must be briefly described. 

The toes, or digits of the foot, are shorter and less 
slender than those of the hand. They are numbered 
one to ^ve from within out^vards, Tvhereas the digits 
of the hand are numbered from without inwards. 
In the process of evolution the foot has undergone 
rotation inwards and the hand rotation outwards. 

The great toe corresponds closely to the thumb. It 

139 



THE LOWER EXTREMITY 

has much less range of movement, however, partly 
because its evolution has been impeded by the wear- 
ing of boots, but chiefly because in man the foot is 
associated with standing and progression rather than 
with prehension. 

This toe is usually the longest of all from base to 
tip, although, like the thumb, it has only two phal- 
anges ; but the second toe tip may project further. 
It is always much more slender than the first. 

The second toe is frequently bent and crowded on 
to or under the great toe, in those who have been 
accustomed to wear tight and pointed boots. 

The third, fourth, and fifth toes are progressively 
smaller in every dimension. 

The toes, numbering from one to five, spring from 
the front of the foot at progressively diminishing 
distances from the ankle. In other words, the foot is 
shorter on the outer than the inner side, and the line 
of the base of the clefts between the toes is curved 
backwards as it proceeds outwards. 

Each of the four outer toes possesses three bones or 
phalanges, except that it is not rare to find the ter- 
minal and middle phalanges of the little toe conjoined 
— an indication probably of its commencing involu- 
tion. The knuckles are very similar in number and 
constitution to those of the hand, though they are 
not nearly so prominent. 

The first row lies at the root of the toes, and 
can only be well made out by forcibly flexing the 
toes. 

The line made by joining the second row is curved 
from within outwards and backwards, and runs 
parallel with the line of the clefts ; and if this line 
be continued inwards, it will pass through the second 
knuckle of the great toe. 

140 



THE LOWER EXTREMITY 

The line of the third row of knuckles, confined, of 
course, to the four outer toes, passes similarly from 
within outwards, and decidedly more backwards than 
the line of the second row. A continuation of this 
line iuAvards would pass across the base of the nail 
of the great toe. 

There are transverse lines on the under surfaces 
of the toes that correspond with the knuckles. 

The club-like ends of the four inner toes are larger 
than the bases ; the fifth toe usually tapers to a 
pointed extremity. 

The nail of the great toe is four times as large 
as the next, and the succeeding nails progressively 
diminish in size. 

Returning now to the foot, the tendons of the 
muscles which have already been described as form- 
ing the anterior group in the leg are as a rule very 
plainly seen, as they run forward in the dorsum of 
the foot, and are easily demonstrated and studied by 
making the toes strain to assume different positions. 
The degree of voluntary control over the movements 
of the individual toes varies considerably in different 
people. 

There is a small but conspicuous soft mass on the 
outer part of the dorsum, just in front of the external 
malleolus and outside the tendons of the extensor 
longus digitorum (Figs. 54, 60). It is bluish, and has 
been likened in size and shape to an oyster. It is due 
to a small muscle known as the extensor brevis digi- 
torum, but it has often been mistaken, even by those 
who should know better, for a bruise. Four tendons 
proceed from the front of this small muscle and 
pass to the four inner toes. The innermost tendon 
may be seen passing to the great toe. When a 
person is standing upon tiptoe the other tendons 

141 



THE LOWER EXTREMITY 



may with some difficulty be seen lying a little to the 
inner side of the ridges formed by the large tendons 
and passing to the upper surface of the toes. 

The extensor brevis is the only muscle on the 
dorsum of the foot ; all the other and larger tendons 
come down from the muscles of the leg. 

It will be remembered that the muscles of the leg 
are divided into three main groups. The anterior 
group passes in front of the ankle-joint, and its 

tendons are found 
on the upper sur- 
face or dorsum of 
the foot; the ex- 
ternal group passes 
behind the external 
malleolus ; the pos- 
terior group passes 
chiefly into the os 
calcis as the tendo 
Achillis, but also the 
deeper tendons be- 
hind the internal 
malleolus, to be lost 
to view in the sole 
of the foot, where their precise arrangement is unim- 
portant to the art student. 

The various groups are enclosed on their way 
to the foot in sheaths or tubes of soft tissue, con- 
taining an oily fluid, and are kept in place by bands 
of fascia, specially developed to tie the tendons down 
tightly at the ankle and to form tunnels for them to 
run through. The most important of these so-called 
annular ligaments (Figs. 53, 54, 59) is situated on the 
front of the ankle-joint. This pulley arrangement 
ties the tendons tight to the bones, and so at once 

142 




Fig. 61. —The Dorsum of the Foot. 



THE LOWER EXTREMITY 

obscures them from view and enables them to alter 
their direction, while the oiled sheaths reduce to a 
minimum the friction of their play in the tunnels. 

Of the anterior group, the thickest tendon, and 
one which produces a very prominent ridge, is the 
tibialis anticus. This can easily be traced by eye and 
finger as it passes inwards to the base of the meta- 
tarsal bone of the great toe, and terminates at a point 
midway between the tip of the internal malleolus 
and the head of the first metatarsal bone (Fig. 54). 

On its outer side the tendon of the extensor longus 
hallucis passes slightly inwards to the terminal small 
bone of the great toe, producing a distinct ridge in 
the concavity already described betw^een the summit 
of the instep and the great toe. On the outer side of 
this tendon a faint ridge, widening out and even- 
tually dividing into four, may be detected passing 
to the four outer toes. This is the extensor longus 
digitorum. The tendon of the 'peroneus tertius may 
be detected, in favourable cases only, passing to the 
region of the tuberosity of the fifth metatarsal bone. 

The outer surface of the foot shows the tendons of 
the muscles of the outer group which lie behind and 
'below the tip of the external malleolus. If the foot 
be depressed and turned inwards, they will be found 
to be two in number and to diverge gradually from 
each other, that of the peroneus brevis passing for-, 
wards to the tuberosity of the fifth metatarsal, and 
lying above the tendon of the peroneus longus, which 
inclines more downwards to disappear in the sole of 
the foot. 

The oyster-like extensor brevis digitorum muscle is 
visible on this aspect of the foot. Below its promi- 
nence and that of the external malleolus there is a 
longitudinal valley, and below this again the outer 

143 



THE LOWER EXTREMITY 

edge of the sole touches the ground throughout its 
entire length, and presents the prominence of the 
styloid process of the fifth metatarsal about half-way. 

The inner surjace of the foot is wide at the back 
part, but gradually tapers to a border in front. It 
contains in its concavity the tendons of the posterior 
deep group of muscles which come from the leg. 
They are too deeply placed to be identified by the 
eye, though they may be felt just below the tip of the 
internal malleolus (Fig. 59). 

Below and behind the internal malleolus is a deep 
fossa ; another fossa below and in front is limited 
in front again by the tendon of the tibialis anticus. 
The inner edge of the sole, "which bounds this surface 
of the foot below, is arched all the way from the heel 
to the head of the first metatarsal bone, and at the 
highest point of this arch the tubercle of the navi- 
cular can be distinctly felt and even seen. In front 
of the large rounded head of the metatarsal bone 
the first phalanx of the great toe presents somewhat 
of a waist, which hardly touches the ground, until 
the terminal phalanx buried in a massive pulp or 
" ball," and covered again by denser skin, is reached. 

The sole is provided, for the purpose of resisting 
pressure, with a skin so thick, and a superficial and 
deep fascia so dense that few landmarks can be seen 
or felt ; it will be observed that the skin of those 
parts which have had to adapt themselves to the 
habitual reception of the weight of the body — or, in 
other words, of those parts which our imprint experi- 
ment showed to touch the ground — is the thickest of 
all. Thus, the balls of the toes, the bases of the toes, 
and the heel, with the outer part of the sole, are 
covered with very thick skin, whereas comparatively 
thin skin covers the waist of the foot on the inner side. 

144 



THE LOWER EXTREMITY 

The heel and the bases of the toes receive the chief 
impact in walking, and form marked prominences. 

One longitudinal furrow may be observed in the 
skin of the sole. This is a broad one lying in the 
middle line. 

The lines of flexion in the toes are arranged as in 
the fingers, but are less obvious, owing to the fact 
that the toes are not used for grasping as are the 
fingers. 



145 K 



CHAPTER VI 

MOVEMENTS OF THE JOINTS OF THE 
UPPER EXTREMITY 

The mechanism of the joints in the upper ex- 
tremity is adapted more particularly to the easy 
performance of tAvo actions which are of equal and 
fundamental importance to the preservation of the 
life of the individual, viz. the assumption of the 
positions necessary for his own defence, and for the 
prehension and conveyance in the direction of his 
mouth of articles of food. In the lower limb, on 
the other hand, the shape of the bony surfaces at 
the joints, and the strength and tightness of the 
ligaments which connect them, are modified in such 
a manner as to confer great strength and rigidity 
upon this member as the 'weight-bearer in the erect 
attitude. Thus, though there are many points of 
similarity between the shoulder and the hip joint, 
the elbow and the knee joint, the wrist and the 
ankle joint, important differences exist in each of 
these comparisons. The hip- joint is a more secure 
ball-and-socket joint than the shoulder, because 
of the comparative smallness of the head of the 
femur, and its more complete envelopment by the 
cup-shaped acetabulum ; while the shoulder presents 
a large ball applied to, but hardly at all received 
into, the slight cup of the glenoid cavity, so that 
the range of movement is much more free. Further, 
the innominate bone, which forms the acetabulum, 

14(5 



JOINTS OF THE UPPER EXTREMITY 

is fixed almost immovably to the spine, whilst the 
scapula, which provides the glenoid cavity, is only 
secured to the trunk by elastic muscles and the 
movable collar-bone. Again, the great length of the 
collar-bone throws the centre of the shoulder-joint 
farther away from the spine than is the centre of 
the hip- joint, and the freedom and mobility in the 
small joints at each end of the clavicle permit of the 
shoulder being raised or lowered, brought forwards 
or backwards, so that the glenoid cavity is capable 
of being pointed in almost any direction, in the same 
way as the muzzle of a gun with modern mountings. 

The shoulder-joint is thus endowed with almost 
universal movement. If the arm is carried forwards 
we speak of flexion; backwards, of extension; lifted 
away from the body, of abduction ; carried towards 
the body, of adduction. Rotation is a twisting of 
the arm upon its own axis at the shoulder-joint. 
Circumduction is a describing, by means of the arnij 
of a cone, the apex of which is at the shoulder-joint' 
while the hand sweeps round the circular base. The 
result of this greater range of movement in the 
shoulder-joint is seen at once in the fact that the 
individual can touch practically any part of his body, 
including the back, with his fingers, whereas there 
are few parts which the toes can be made to explore, 
even when the lower limb reaches its maximum of 
mobility, as in the case of the acrobat. 

Similarly, if one compares the movements at the 
elbow with those at the knee, it is at once obvious 
that, while both of them are checked in extension 
when the limb reaches a straight line, in the case 
of the knee flexion is a purely antero-posterior 
hinge movement, but in the case of the elbow it is 
accompanied, owing to the bevelling of the trochlear 

147 



MOVEMENTS OF THE JOINTS 

surface of the humerus, by a sweeping inwards of 
the hand, towards the middle Hne of the body, in 
order to facilitate its approximation to the mouth. 
And again, in the case of the wrist there is a con- 
siderable amount of lateral movement, and of rota- 
tion between the radius and ulna, in addition to 
flexion and extension, Tvhereas at the ankle there is 
hardly any movement permitted except flexion and 
extension, and even these movements are much more 
limited than they are at the wrist. 

The muscles chiefly concerned in the production 
of these several movements at the shoulder- joint 
are seen to make prominences under the skin of 
the model when the particular movement they 
cause is performed with considerable force, i.e. when 
any resistance has to be overcome. These are in 
Flexion — the pectoralis major and the anterior part 
of the deltoid ; in Extension — the latissimus dorsi, the 
supra and infra spinnatus, and the posterior part 
of the deltoid; in Abduction — the entii^e deltoid, the 
prominent belly of which may then be seen, esi3ecially 
in the thin, to be grooved longitudinally by the 
three or more intra-muscular tendons of origin, and 
the two or more intra-muscular tendons of insertion ; 
in Adduction when performed with force th.e pectoralis 
major and the latissimus dorsi muscles together with 
the long head of the triceps. Rotation inwards — calls 
into action the pectoralis major and the latissimus 
dorsi. 

At the elbo'W-joint flexion is, of course, the move- 
ment which brings out the familiar prominence 
of the biceps and also the supinator longus, which, 
it is to be noticed, has not been happily named, 
for it is very little of a supinator and very much 
of a flexor. Extension makes prominent the triceps 

148 



OF THE UPPER EXTREMITY 

muscle. Pronation and supination are the terms 
applied to that rotation of the forearm upon its 
own axis which results in the back of the hand 
or the front of the hand respectively being made 
to look forwards (in the subject standing in the 
position of attention). By means of this rotation 
of the forearm alone, the hand is capable of being 
rotated through a half -circle. But if the shoulder- 
joint is also brought into play so that the elbow is 
first abducted and then adducted, another half -circle 
is added to the play of the palm, enabling it to be 
made to face any point of a complete circle. These 
movements of pronation and supination take place 
at the radio-ulnar articulations, two small joints 
situated one at the upper and one at the lower 
end of the ulna and radius. The ulna in the 
motion now being described moves scarcely at all. 
The radius describes a cone around it. The apex 
of this cone is at the upper end, and the base of 
the cone at the transverse measurement between 
the styloid processes of the radius and ulna. Notice 
that when the hand is supinated the radius lies 
parallel with the ulna, whereas when the hand is 
pronated the radius crosses obliquely over the ulna. 
It has already been pointed out that the supi- 
nator longus is ill-named, because it is much more 
of a flexor than a supinator. Observe now that 
neither of the pairs of muscles whose names in- 
dicate that they help to produce the movements 
under consideration makes any obvious prominence 
when in action. The pronator quadratus and the 
supinator brevis are quite undemonstrable without 
dissection, and the pronator radii teres and supinator 
longus can only be demonstrable with difficulty, 
unless their flexing effect upon the forearm is also 

149 



MOV^EMENTS OF THE JOINTS 

brought into play. The biceps muscle, powerful 
flexor that it is, has also a very great use as the 
chief supinator. It is, in fact, much stronger than 
either of the pairs of supinators and pronators which 
have just been mentioned, and its great strength 
is responsible for the fact that supination is a 
more powerful movement than is pronation, a fact 
which is acknowledged and turned to account by 
the direction in which hand-driven screws are 
planned to work, viz. by a supinating movement. 
Notice, before leaving this subject, that if you want 
to demonstrate on your own arm the semi-lunar 
fascia coming off the inner edge of the tendon of 
insertion of the biceps (and so giving to this muscle 
an attachment into the deep fascia in the region of 
the ulna), you must not only flex your elbow^ but 
also supinate powerfully ; by so doing you evoke each 
of the actions of the biceps, and then a gutter or 
depression will be seen running obliquely downwards 
and inwards across the prominent belly formed by 
the flexor group of the forearm, and the tip of your 
thumb can be thrust under the semi-lunar fascia. 

At the wrist-joint flexion, or the bending of the 
palm towards the forearm, is produced by that 
powerful group of muscles just alluded to which arise 
from the internal condyle; Extension — by a con- 
siderably less powerful group of muscles at the 
back of the forearm which arise from the external 
condyle, and in neither case can the individual 
members of the group be at all clearly differentiated 
without dissection. Adduction — or movement of the 
hand towards the ulna in the extended position of 
the wrist — is more free than abduction, because the 
styloid process of the ulna is less prominent than 
the similar process of the radius. Powerful radial 

150 



OF THE UPPER EXTREMITY 

abduction is largely brought about by those tendons 
which bound the " anatomist's snuff-box " (p. 101), 
which therefore is best demonstrated in this action. 

Coming now to the movements in the joints of 
the hand, it is to be noted that flexion, together 
with opposition into the palm, of the thumb makes 
prominent the muscular form of the thenar eminence 
or ball of the thumb. Extension or straightening, 
together with radial abduction of the thumb, brings 
into play, and so makes obvious, three tendons chiefly 
concerned in the production of the " snuff-box," and 
on a spare wrist each of these is easily identified. 
The extensor ossi metacarpi pollicis, as its name 
implies, runs to the base of the metacarpal bone, 
and can be traced by the finger. The extensor primi 
internodii pollicis is seen to extend over the whole 
length of the metacarpal bone to its insertion into 
the base of the first phalanx. The extensor secundi 
internodii pollicis, which forms the inner limit of 
" the snuff-box," can similarly be seen and felt as it 
extends along the dorsum of the metacarpal bone 
and the first phalanx to its insertion into the base 
of the second phalanx. 

Before leaving the thumb we must notice that 
circumduction, or making its extended bones describe 
a cone w^ith the apex at the wrist, is very free, and 
that the freedom of this movement at the carpo- 
metacarpal joint results in the capacity to approxi- 
mate the flexor surface of the tip to the flexor 
surface of any part of the four flngers. This ap- 
proximation of flexor to flexor surface is called 
opposition. Its great development is a characteristic 
of the human thumb, and is obviously of the greatest 
possible use in all prehensile movements of accuracy. 
There is no corresponding movement in the great 

151 



JOINTS OF THE UPPER EXTREMITY 

toe, or in any of the other digits in the hand 
or foot. 

In the fingers flexion and extension are practi- 
cally the only movements permitted, though at the 
metacarpo-phalangeal joints, which are at the junc- 
tion of the fingers and the palm, a certain amount 
of adduction and abduction movement is possible, 
which facilitates greatly the widening of the span 
in such actions as piano-playing. This adduction and 
abduction of the fingers is chiefly brought about 
by the short muscles called the interossei, a curious 
group of muscles, too deep to be visible without 
dissection, which account to a large extent for 
the filling up of the gaps between the bones, 
making the hand roundly moulded when they are 
well developed, and skeleton-like when they and 
the superficial tissues are wasted in disease or old 
age. If the tip of the thumb is forcibly ap- 
proximated to the tip of the forefinger, the first 
of this series of interossei forms a hard muscular 
prominence between the first and second metacarpal 
bones. It is known as the " abductor indicis," and, 
like the thenar and hypothenar muscular eminences, 
it is especially well marked in such people as masseurs, 
who have to cultivate strong development of the 
muscles which move the digits. 

Enough has now been said to exemplify the 
truth of the remark with which this chapter 
opened, to the effect that in the upper limb the 
bones and joints have become modified upon a 
plan calculated to attain wide range of move- 
ment, with great delicacy and precision, rather 
than extreme strength. For the latter character- 
istic we shall have to look to the bones and joints 
of the lower extremity. 

152 



CHAPTER VII 

MOVEMENTS OF THE JOINTS OF THE LOWER 
EXTREMITY 

The mechanism of the three large joints of the lowei 
limb is chiefly subservient to the maintenance of the 
erect posture and to the act of progression. 

The Hip, which is the articulation between the 
pelvis and the femur, is the only joint of the lower 
limb which permits free movement in any and every 
direction; and it is a very perfect example of that 
type of joint which is known as a " hall and socket" 
the globe-shaped head of the thigh fitting into the 
cup-shaped hollow of the acetabulum, and being 
kept in position by the accurate fitting of the two 
articular surfaces, aided by powerful ligaments and 
muscles. 

The movements 'permitted by the hip-joint, the 
subject starting from the position of "attention," 
are: — 

1. Flexion, when the thigh is raised and knee 
brought forward. 

2. Extension, when foot is placed again on the 
ground. 

3. Abduction, when the thigh is raised outwards 
from the middle line. 

4. Adduction, when it is drawn inwards towards 
the middle line. 

5. External rotation, which occurs round a ver- 
tical axis when the toe is turned out. 

153 



MOVEMENTS OF THE JOINTS 

6. Internal rotation, when the toe is turned 
inwards. 

7. Circumduction, by a combination of all these 
movements, inwards or outwards, may be performed ; 
i.e. the parts of the lower limb which are further 
away from the hip -joint move round a larger circle 
than do the parts nearer the hip- joint. 

1. The important ^ea?or of the joint is the ilio-psoas, 
a large muscle which does not form a definite ridge, 
and which is invisible except on dissection. Other 
flexors are the sartorius and the rectus femoris, 
which can be seen when in strong action. 

2. The important extensor of the hip is the gluteus 
maximus, ^lich, when it is in action, forms a very 
well-marked prominence upon the buttock. The 
general direction of its fibres is from the middle line 
downwards and outwards. The hamstring muscles 
also extend the joint, and may stand out when in 
action. 

3. The abductors, with the exception of the gluteus 
medius and minimus, cannot be observed, for they 
lie under cover of the gluteus maximus. The gluteus 
tnedius is a fan-shaped muscle, part of which is sub- 
cutaneous on the buttock between the front half of 
the crest of the ilium and the antero-superior border 
of the gluteus maximus, which overlies and hides the 
rest of the medius. 

4. The adductors of the joint are the three adductor 
muscles on the inner side of the thigh. 

5. The external rotators are the same as the 
adductors of the joint for the most part. 

6. The only muscles which rotate the hip inwardly 
are the front part of the gluteus Tnedius and the 
tensor fascice femoHs. The student must remember 
that in the recumbent position the lower limb rotates 

154 



OF THE LOWER EXTREMITY 

itself outwards, as it were, owing to its own weight, 
unless the internal rotators are keiDt in action. The 
lower limb of a corpse, therefore, assumes the posi- 
tion of external rotation, unless prevented by some 
force greater than its own weight. 

The Knee. — Although the movements of this 
joint are really very complicated, only two — flexion 
and extension — are of importance to the artist. 
Extension is brought about by the large mass of 
the quadriceps muscle, flexion by the hamstring 
muscles. It has already been pointed out that the 
hamstrings act as extensors of the hips ; similarly, 
the rectus femoris, which flexes the hip, assists in 
extending the knee. 

The movements at the ankle-joint are flexion, when 
the toes are depressed, and extension when they are 
raised. These definitions are gathered from mor- 
phological anatomy, and the nomenclature presents 
difficulty to some students, which may be obviated 
by speaking of plantar-flexion and dorsal-extension. 

Flexion, or dropping of the foot, is brought about 
by the muscles attached to the tendo Achillis, and 
so to the OS calcis ; extension, by the muscles on the 
front of the leg. It is frequently said that there is 
some lateral movement permitted in the ankle when 
flexed. This is very doubtful. 

The movements of the toes are flexion and 
extension, and each muscle which eifects one of these 
movements proclaims the fact in its name. 

Internal and external rotation of the foot are 
also allowed at a transverse joint between the os 
calcis and astragalus behind, and the cuboid and 
scaphoid in front. The rotation takes place around 
a nearly horizontal axis, directed mainly forwards but 
fiUghtly downwards. 

155 



JOINTS OF THE LOWER EXTREMITY 

Outward rotation at this joint, when the sole looks 
a little outwards, is brought about by the peroneal 
muscles. Rotation inwards, which is a rather freer 
movement, is due to the action of the tibiales, anticus 
and posticus, muscles. 

The joints between the other small bones of the 
foot possess a limited degree of movement, but are 
more important in that they largely diminish shocks 
to the feet ; thus a " jar " loses much of its force 
before being transmitted to the leg, thigh, and trunk. 



156 



CHAPTER VIII 

THE TRUNK 

The trunk, as understood by the artist, differs some- 
what in its extent from that described by the 
scientific anatomist. 

It will be considered here to include the back, 
chest, abdomen, and their immediately adjacent parts. 
The shoulders have been described to some extent 
(p. 73), but they will be mentioned again now with 
the trunk. A description of the neck will be found 
on p. 180. 

The back of the trunk (Figs. 19, 20, 62) consists 
really of two parts — the back of the thorax, and the 
loins, or back of the abdomen. The distinction be- 
tween these two regions is not so obvious behind 
as it is in front, where the chest is marked off from 
the abdomen by the margin of the ribs ; and as these 
are covered behind by exceedingly thick and strong 
muscular and ligamentous structures, the last rib is 
usually completely hidden from sight, and in most 
subjects is only palpable with difficulty. 

The dorsal vertebrce are those which carry the 
thorax, while the lujnbar vertebrce support the loins. 

The spine, when seen in profile, hrvs been explained 
in a previous section to be convex backwards in 
the dorsal region, concave in the lumbar ; and these 
curves contribute much to the elasticity, and there- 
fore to the strength, of the back. There is no 
visible line of demarcation between these two curves 
or regions. 

157 



THE TRUNK 

A prominent feature of the back is the deep furrow 
which extends in the middle ime for nearly its 




Fis:. 62. —The Muscles on the Back of the Trunk, 
Buttock, and Neck. 



whole length (see Plates). The depth of this furrow is 
caused by the large mass of the erector spinse muscle 

158 



THE TRUNK 

which projects on each side of it, and gradually in- 
creases in width but diminishes in prominence as it is 
traced upwards. At the upper part of the buttocks 




Fig. 63.— The Muscular Prominences on the 
Front of the Trunk and Neck. 



the furrow gives place to a slightly depressed flat area, 
to which again there succeeds the deep and narrow 
furrow which separates the two buttocks and passes 
forwards into the perineum. 

159 



THE TRUNK 

The furrow is deepest below the middle of the 
back. If the distance from the lowest part of the 
back of the neck — i.e. at the level of the seventh 
cervical vertebra, or vertebra 'prominens — be measured 
to the termination of the furrow between the but- 
tocks and divided into fifths, it will be found that 
the deepest part of the furrow lies in the third and 
fourth fifths, counting from above. 

This increased depth of the furro^v is due to two 
causes : first, to the concavity of the vertebral column, 
which in this region is directed backwards ; secondly, 
to the great height of the sides of the furrow. The 
sides are formed by the powerful and prominent 
mass of muscle lying on each side of the middle line, 
known as the erector spince, a name which sufficiently 
explains its action. In the dorsal region the back- 
ward projection of the ribs makes the erector spinae 
prominent, and so accentuates the furrow. 

At the bottom of this median furrow all the pro- 
jecting spines of the dorsal and lumbar vertebrae 
can either be felt or seen. 

The first dorsal vertebra lies immediately below 
the vertebra prominens (the seventh cervical), and 
its spine is the most prominent of any. All the 
spines can be seen more clearly when the back is 
bent and the distance between each one is thus 
slightly increased. It can then be noticed that the 
dorsal spines are single processes, unlike those of 
the cervical region, which are double. Frequently, 
especially in wasted subjects, circles of superficial 
veins may be seen around the spines. 

When the back is straightened it is not unusual 
or abnormal for a slight side-to-side curve to be 
demonstrable in the dorsal region, the convexity of 
which is, except in left-handed subjects, directed to 

160 



THE TRUNK 

the right. This curve is the result of the greater 
development of the muscles of the right side, in 
association with the freer and stronger movements 
of the right upper extremity in connection with 
right-handedness. 

In left-handed persons the curve is found in the 
opposite direction. Since the normal slight curve is 
produced by muscular over-development, it naturally 
is the rule for it to be more pronounced in men than 
women, but its exaggeration owing to weakness or 
disease is more common in women. 

The art student will do well to remember that 
such a lateral curve may develop as a result of tilting 
of the pelvis, e.g. when the subject is standing on one 
leg. It may also be pointed out that any lateral 
curve in the dorsal spine must present also some 
prominence of the shoulder-blade on the convex side. 

It is important to notice that although the pos- 
terior convexity of the dorsal region of the back 
is much increased when the body is bent forwards, 
it never entirely disappears, even in the most erect 
Guardsman. Any apparent diminution of the curve 
as the erect position is assumed is due to an increase 
in the lumbar concavity backwards and to hyper- 
extension of the hip-joint. 

Note also that although the lumbar vertebrae 
number only five to the dorsal vertebrae twelve, 
the former are so much larger individually that the 
lumbar portion measures nearly two-fifths of the 
total length of the back, and the dorsal portion only 
the remaining three-fifths. 

The erector spinas muscle, which forms a thick 
mass below, where it is attached to the iliac crest, 
breaks up above into numerous smaller portions 
which go to the vertebrae and ribs. Marked pro- 

161 L 



THE TRUNK 

jections on each side of the middle line are formed 
by two comparatively thin sheets of muscle which 
lie superficial to the erector spinse, passing from the 
trunk to the upper limb. The lower of the two is 
the latissimus dor si ; the one lying above is the 
trapezius (Fig. 62). The trapezius forms also a con- 
spicuous landmark in the neck, which will be de- 
scribed in a later section. The lower two-thirds of 
the trapezius belong to the thorax, and this portion 
passes from the dorsal region of the spinal column, 
where it is attached to the spines of all the dorsal 
vertebrae. The cervical and dorsal parts of this 
triangular sheet of muscle converge upon, and are 
attached to, the concavity of the horseshoe of bone 
which is formed by the clavicle and the spine of the 
scapula (Figs. 21, 23). 

The lower fibres of the trapezius are more vertical 
than those in the middle of the triangular sheet 
of muscle. They form a straight edge, passing; 
from the spine of the lowest dorsal vertebra to the ' 
root of the spine of the scapula, which is on a level! 
with the third dorsal vertebra. 

In the middle line of the back the origins of the- 
two trapezius muscles are separated only by the lines 
of spinous processes, so that the two triangles form^ 
together a diamond-shaped sheet under the skin, 
which from its position, size, and shape has beene 
likened to a collapsed monk's hood ; hence the alter- 
native name of the " musculus cucullaris." 

The latissimus dor si (Fig. 62, p. 159) is a muscle oi 
great importance, and has a large share in pulling 
the body after the arm as in the act of climbing^ 
It has three visible edges when in action — inner^ 
upper, and outer. By the inner border it arises 
from the spine opposite the lumbar and the lower*! 

162 



THE TRUNK 

SIX dorsal vertebrae. The upper border emerges 
from under cover of the trapezius in such a direc- 
tion that it is curved with its concavity upwards. 
The lower border passes upwards and outwards from 
the back part of the crest of the ilium, and the two 
latter borders converge upon one another so that the 
muscle eventually forms a comparatively narrow 
thick band, the upper part of which overlaps the 
lower angle of the shoulder-blade. It then winds 
in a spiral manner round a thick muscle, only to 
be identified in muscular subjects, the teres major, 
and with it forms the thick and rounded posterior 
fold of the axilla or armpit (Fig. 24). 

Between the outer or lowest borders of the trape- 
zius, the upper border of the latissimi dorsi, and the 
inner border of the scapula, a triangular interval 
is formed which lies over a portion of the space 
between the sixth and seventh ribs. The floor of 
this triangle is formed by a flat muscle called the 
rhomhoideus major (Fig. 62). 

External to the inner border of the scapula, and 
below its spine, two thick muscles with a dividing 
groove may be seen in muscular subjects, passing 
under the posterior border of the deltoid muscle. 
The upper one is the infraspinatus, and the lower the 
teres major. The teres major conceals the scapular 
head of the triceps from view. 

Just as in connection with the upper border of the 
latissimus dorsi a triangular interval is displayed 
between it and the muscle which lies above and 
internal to it, viz. the trapezius, so frequently there 
is to be observed another but much smaller triangular 
space between it and the muscle lying below and 
external to it on the abdominal side, which is 
the external oblique. The edges of this triangle, 

163 



THE TRUNK 

only demonstrable on dissection, are bordered by 
tbe latissimus dorsi internally, the external oblique 
externally, and by the crest of the ilium below. The 
triangle is floored by the internal oblique. 

The external oblique muscle forms a distinct promi- 
nence upon the lateral part of the small of the back, 
which is concealed, however, by the latissimus dorsi 
in its upper part. In a very muscular subject the 
origin of the external oblique from the lowest ribs 
may appear in digitations, one arising from each rib. 

All these muscles of the back produce hardly any 
prominence in persons who are well covered ^th fat, 
as, being flat sheets, their outlines may be completely 
obscured by the more superficial coverings. 

Only in a very emaciated subject can the ribs be 
seen on the back, and there is difficulty even in 
feeling them clearly enough to count them. Their 
convexity makes the erector spinse prominent on 
each side of the furrow in the middle line. 

Frequently, in persons who are well covered with 
fat, the only obvious landmark in the general con- 
vexity of the back is the median furrow. In such 
cases the back forms a gentle uninterrupted curve 
on each side of the furrow. 

In muscular subjects a further groove may be 
noticed, which is directed round the side of the body 
from the lower part of the lumbar spinal furrow. 
The groove separates the loins and abdomen above 
from the buttocks below, and is replaced in thin 
persons by a slightly sinuous ridge. In fat persons 
neither groove nor ridge can be detected. The ridge 
is due to the presence of the crest of the ilium, which 
is the expanded wing of the pelvis ; the groove, when 
present, arises from the massing of muscles above 
and below it. 

164 



THE TRUNK 

Anteriorly the groove is traceable into the deep 
cruro-scrotal fold, and as it runs forwards it lies 
a little below Poupart's ligament. Note that the 
groove is somewhat curved, and more horizontal 
than Poupart's ligament. 




Fig. 64.— The Muscles on the Front of the 
Trunk and Neck. 



In either case, whether ridge or groove, it may 
be traced posteriorly by the fingers into a slight 
elevation on the innominate bone, known as the 
poste7^ior superior spine of the ilium (Fig. 62, p. 158), 
which in nearly all cases lies at the bottom of a 
dimple or depression in the skin. The situation of 

165 



THE TRUNK 



the dimple is an inch and a half from the middle 
line, and a little above the prominence formed by 
the spine of the fourth sacral vertebra, which is the 

last spine of the verte- 
bral column to be seen 
or felt. 

When the crest of 
the ilium is traced for- 
wards from this dimple 
round the side of the 
body, it is found to be- 
come thickened into a 
tubercle which marks 
the highest part of the 
crest. Some two or 
three inches farther 
forward the crest ter- 
minates a little below 
its highest level in the 
large and conspicuous 
bony prominence of the 
anterior sujperiors'pine of 
the ilium (Figs. 8, 9, 44). 
Laterally, between 
the last rib and the 
crest of the ilium, the 
ilio-costal space is un- 
supported by bone. The 
height of this space 
varies much, according 
to the stature of the subject, but perhaps two or 
three inches is the average measurement from the 
tip of the rib to that portion of the crest of the ilium 
which lies immediately below it. Here lies the 
narrowest part of the body, the t^^ue waist (Fig. 103). 

166 




Fig-. 65.— Muscular and Bony Surface 
Markings of Side of Neck. Trunk, 
and Arm. 



THE TRUNK 



The chief superficial landmarks of the hack have 
nc been mentioned, and attention must next be 
dix^c ted to the side of the body (Fig. 65). 

Pk order that as many points as possible may be 
studied, it is better for the student to raise the arm 
of uhe subject from the 
side. It will be ob- 
served that the armpit 
lies at the highest level 
of the side of the trunk. 
The skin is here covered 
with numerous coarse 
hairs, and is often 
moist, owing to the 
secretion of perspira- 
tion (Fig. 66). 

But the armpit is not 
only the highest part 
of the side of the trunk, 
it is also the narrowest. 
This is because it is en- 
croached upon by two 
large muscular masses, 
viz. the pectorales form- 
ing the anterior "fold 
of the axilla," the latis- 
simus dorsi and teres 
major forming the 
"posterior fold." The 

side gradually increases in breadth below the armpit 
as the ribs which support it become longer, and as 
these musculat**? folds of the axilla diverge forwards 
and backwards. 

Most of the ribs can easily be felt on the side of 
the chest even in the fattest, and they lie at the 

167 




Fig. 66.— The Muscles of the Inner Sur- 
face of the Arm and of the Armpit. 



THE TRUNK 

bottom of furrows between well-marked digitationa 
of certain muscles. Although there are twelve vlbs, 
only those between the fourth and the tenth (; md 
exceptionally the eleventh) can be seen on the . de. 
The upper three lie so deeply covered by muscles and 
bones that they cannot be seen ; the t^velf th is not 
long enough to reach the side. The muscles which 
produce the inter-digitating prominences on the side 
are the serratus viagnus above, and the external 
oblique of the abdomen beloTV. 

There is a distinct decrease in the breadth of the 
side below the level of the tenth rib, except in 
prominent abdomens. 

The groove or ridge which separates the side 
of the body from the region of the hip has 
been described on p. 164. In front of this ridge 
the lower part of the abdomen is rather more 
prominent than the portion which lies above it ; 
below and behind the prominence of the buttocks 
is obvious. 

The Front of the Trunk (Figs. 63 and 64).— 
The lateral parts of the front view of the body pass 
insensibly into the side view which has just been de- 
scribed. Above, however, the bony ridge produced 
by the horizontally lying clavicle clearly marks off the 
trunk from the neck, and below, the front of the body 
is very obviously demarcated from the thighs and the 
pubic region by three surface markings from without 
inwards, viz. : — 

1. The crest of the ilium, which terminates in front 
in the anteHor superior spine. 

2. Poujoarfs ligament, underlying the slight groove 
of the fold of the groin, which is more horizontal 
in the female than in the male, and relatively more 
pronounced when the abdomen is protuberant, 

168 



THE TRUNK 

passing downwards and inwards from the anterior 
superior spine. 

3. The spine of the puhes. This bony prominence 
can be felt, but cannot be seen, one and a quarter 
inches from the middle line which here is formed by 
the symphysis of the pubic bones. Poupart's liga- 
ment is a very important structure, for to it many 
muscles are attached. 

Between the clavicles above and Poupart's ligament 
below, the front of the body (even in fat persons) 
is obviously divided into two parts by the margin of 
the thorax. The chest or thorax is the part of the 
body which is surrounded on all sides by a bony frame- 
work ; the abdomen or belly lies below it, and is sur- 
rounded for the most part by soft structures only. 

The clavicles form well-defined ridges which ap- 
proach closely to each other in the middle line, but 
without meeting. Between the prominent inner 
ends of the clavicles there is a deep depression, 
which, as it lies above the breast-bone, is called the 
supra-sternal fossa. It is very deep and conspicuous, 
the two tendinous heads of the sterno-mastoid 
muscles converging as they bound it laterally. In 
its depth the main vessels of the neck and limb 
diverge from each other, occasionally allowing pulsa- 
tion to be observed in the fossa. The windpipe also 
lies very deeply at the bottom of the hollow, and 
here, or a little higher, it is opened in the frequent 
operation of tracheotomy (Fig. 68). 

Below the supra-sternal fossa is the sternum. Its 
borders, which are separated by a space of, roughly, 
two inches, are overlaid by the long margin of origin, 
in muscular subjects somewhat knotted, of a large 
fan-shaped muscle passing to the arm, and called 
the pectoralis major (Fig. 64, p. 165). This origin 

169 



THE TRUNK 

extends from the clavicle to the seventh rib, and is 
a little arched, presenting a convexity towards the 
middle line, and leaving rather more of the anterior 
surface of the sternum exposed in its upper and 
lower than in the intermediate parts. 

Indeed, in muscular subjects the area left between 
the prominent muscles of the two sides may amount 
to little more than a deep median groove at the level 
of the second and third ribs, though more expanded 
above and below. 

When a skeleton is examined in profile it is seen 
that the sternum does not lie in a purely vertical 
plane. It not only slopes decidedly forwards, as it is 
traced downwards, but it is also bent so as to present 
a curved surface, or rather two surfaces, inclined at 
an angle to each other. This " sternal angle " is the 
most prominent part of the bone ; it is situated at 
the level of the second rib, two inches below the 
supra-sternal fossa, and is continued on each side 
into the ridge produced by the second rib, the most . 
easily identified of all the ribs, and therefore the one 
from which any enumeration of the ribs should be 
made. The first rib lies deeply beneath the clavicle in 
such a way that it can neither be seen nor easily felt. 

Above this projecting sternal angle lies the ex- 
panded part of the median groove, already described 
as separating the two pectoral muscles, and sup- 
ported by the upper portion of the sternum or 
manubrium. 

The second part of the sternum which lies below 
the angle is called the gladiolus; it is more than 
twice as long as the part above it. It extends doAvn- 
wards, with a distinct inclination forwards, until it 
reaches the level of the seventh costal cartilage. At 
this level the bone is somewhat expanded. 

170 



THE TRUNK 

Belcw this second part of the sternum, in what is 
popularly known as the " pit of the stomach," called 
by anatomists the infra-sternal fossa, is the some- 
what recurved ensiform cartilage, which forms the 
lower end of the sternum. Its point may occasion- 
ally be distinctly projected forwards ; it is always 
much narrower than the rest of the sternum. 

Below the infra-sternal fossa a groove occupies the 
centre of the body, fading away as it approaches 
the pubic bone. It lies between the two wide strap- 
like muscles, the recti abdominis. The linea alba, a 
strong fibrous band, supports the groove, which is 
broken in its line by the umbilicus, or navel, the 
pitted scar of the vascular cord which connected 
the mother and the foetus in utero. 

This scar lies a little below the centre of a line 
drawn from the infra-sternal fossa to the symphysis 
pubis, or junction of the two pubic bones. It is a 
circular, and usually depressed, area, with the sur- 
rounding skin raised and wrinkled, and it lies oppo- 
site the disc between the third and fourth lumbar 
vertebrae. Some hair may be found in the course 
of the middle line, even quite high up ; this fact 
will be referred to later. 

Three muscles should next be studied on each 
side of the middle line, viz. the pectoralis major, 
serratus magnus, and rectus abdominis (Figs. 63 
and 64, pp. 159, 165, and Plates). 

The pectoralis major is large and fan - shaped, 
converging from a w^ide origin from the inner 
half of each clavicle and from the margin of the 
sternum (Fig. 64), which it frequently obscures, to 
its narrow insertion into the upper part of the arm. 
The clavicular and sternal parts are separated by a 
groove which is nearly as distinct as that which 

171 



THE TRUNK 

separates the adjacent borders of the deltoid and 
pectoralis major (Fig. 64). Sometimes the groove is 
not easy to identify, but even then the clavicular 
part of the muscle may be distinguished from the 
sternal. If the subject be instructed to lift the out- 
stretched arm against some resistance, the clavicular 
portion will be noticed to stand out. If, on the con- 
trary, he be instructed to depress the outstretched 
arm against resistance, the lower or sternal part will 
be put into action, and will become prominent. 

There is a groove between the upper margin of the 
pectoralis major and the deltoid. The inner end of 
this groove opens out just below the clavicle into 
a depression known as the infra-clavicular fossa 
(Fig. 64, p. 165). Immediately below and external to 
the lower margin of the pectoralis major may be ob- 
served the lower digitations of the serratus tnagnus 
and the upper digitations of the external oblique 
muscle. The serratus magnus pulls the scapula 
forwards, and is thus used in stretching out the 
arm, as in shaking hands. 

The rectus abdominis is the flat muscle lying upon 
each side of the middle line of the abdomen, and its 
effect upon the surface form of the abdomen is great. 
Even in fat persons it forms a definite ridge when 
in action. Its upper limit stretches as high as the 
fifth rib, close to the sternum, and here the muscle 
is somewhat narrower. Tracing it down, as it 
reaches the sixth and seventh ribs it widens, and 
continues of the same breadth until a point is 
reached a little below the umbilicus, whence it 
rapidly tapers to its lower end, which is quite 
narrow, on the front of the pubic bone. The 
narrowing of the lower part of the muscle is brought 
about by the incurving of its outer edge. 

172 



THE TRUNK 

There are three or four horizontal lines, or rather 
grooves, dividing it into several parts or segments. 
The grooves lie in very constant positions — one at 
the level of the umbilicus, one at the level of the 
ensiform cartilage, and another midway between 
these points. Sometimes also a groove may be seen 
dividing the portion of muscle which lies below the 
navel into two nearly equal parts. 

In the muscular subject, therefore, the rectus abdo- 
minis forms a very striking object. The inner edge 
is not so prominent as the outer border, which is 
known as the linea semi-hmaris, OT^ng to the marked 
curving towards the middle line, below the umbilicus, 
already noted. There is an inclination on the part 
of some artists to make the rectus a little too 
broad, and to accentuate rather much the promi- 
nence of its individual segments, and it is not very 
rare to see too many segments of this muscle and of 
the serratus magnus depicted, especially in sculpture. 

The rectus acts by drawing the chest and pelvis 
together, and in forcible bending forwards of the 
body its shape and actions may be demonstrated. 
It has other important functions ; it helps to keep the 
viscera in position, and, like the pectoralis major and 
the serratus magnus, it is an accessory muscle of 
respiration. The linea alba is sometimes stretched 
to such a degree, especially in fat women, that the 
two recti become widely separated. 

The vertical height of the chest wall is greater 
behind than in front ; the abdominal wall, on the con- 
trary, is more extensive in front than at the sides and 
back. The chest contains the heart and lungs, and 
other important structures, protected by the dorsal 
vertebrae, ribs, and sternum. The abdomen contains 
the alimentary canal and its great glands the liver and 

173 



THE TRUNK 

pancreas, the urinary and the genital viscera (with 
the exception of the testicle and a part of its duct, 
which are contained in the scrotum), but they have 
no bony protection in front and at the sides. Both 
cavities also contain many large blood-vessels and 
nerves. 

These two great cavities of the body are well 
adapted for their several purposes. 

Respiration chiefly depends upon the action of the 
diaphragm, the thin dome-shaped muscular sheet 
intervening, inside the body, between the chest and 
abdomen. This muscle cannot be seen without deep 
dissection, but it produces such an effect upon the 
general shape of the chest and abdomen that it 
must be mentioned here. A series of little muscles 
essential to the full action of respiration must 
also be described, viz. the intercostals, which line and 
pass betTv^een the adjacent ribs. 

When the diaphragm contracts, its dome becomes 
flatter and less rounded, with the result that the 
capacity of the chest, whose floor it forms, is increased 
and air rushes in through the windpipe to fill the 
cavity. The abdominal viscera are at the same time 
pushed downwards, thus producing a bulging of 
the abdomen. This type of respiration, •' the abdo- 
minal type," occurs in both sexes, but is especially 
deep in men. 

The little intercostal muscles raise and evert the 
ribs, and again the chest capacity is increased and air 
inspired. This "costal type" of breathing is more 
marked in women. 

We have seen that the costal margin indicates 
the boundary line between chest and abdomen, and 
forms an obvious landmark on the front surface of 
the body, and that only the seven upper ribs arti- 

174 



THE TRUNK 

culate with the sternum by means of their car- 
tilaginous ends. The eighth, ninth, and tenth ribs 
articulate with the cartilage which lies immediately 
above each of them. 

The costal margin may be traced, either by sight 
or by palpation, from the sternum to the vertebral 
column. Near the middle line of the sternum the 
seventh costal cartilage passes downwards and out- 
wards from the expanded part of that bone which lies 
just above the infra-sternal fossa. This part of the 
costal margin is a little curved, so as to present a con- 
vexity pointing inwards and downwards. Below this 
the margin is directed outwards and downwards 
along a line which has a slight concavity open in- 
ward and downward ; this part of the costal margin 
corresponds to the eighth, ninth, and tenth costal 
cartilages. If a vertical line be dropped from the 
middle point of the clavicle, it passes through the 
junction of the eighth and ninth costal cartilages. 

The tenth cartilage is the lowest part of the costal 
margin, and lies at the side of the body. From it 
the costal edge passes upwards and backwards along 
the eleventh and twelfth ribs to the last dorsal 
vertebra. 

The last two ribs can only be felt with difficulty, 
and are very rarely visible through the skin. They 
are called "floating ribs," because they do not join 
up by their tips with the cartilage of the rib above. 

The greatest transverse diameter of the thorax lies 
between the seventh, eighth, and ninth ribs. 

The tenth, eleventh, and twelfth ribs are sepa- 
rated by rather narrower intercostal spaces than 
the others. 

Owing to the obliquity of the first rib, the upper 
aperture of the barrel-like thorax, or chest cavity, 

175 



THE TRUNK 

slopes from the sternum upwards and backwards, 
the supra-sternal fossa lying opposite the cartila- 
ginous disc between the second and third dorsal 
vertebrae, some two inches lower than the first dorsal, 
which bounds the aperture behind. 

Although the ribs are the support of the thoracic 
or chest wall, it is clear that the greater breadth of 
the upper part of the trunk cannot be due to them; 
for the first rib is quite short, and the length of the 
ribs increases from above downwards till the seventh 
is reached. The greater width at the top of the 
trunk is, in fact, entirely the result of the length of 
the clavicle. 

The function and formation of the chest having 
now been briefly explained, the student's attention 
should be turned to the position of the nipples. They 
lie one on each side of the middle line. In the male 
they are little pigmented nodules, surrounded by a 
pinkish area, and raised upon a somewhat elevated 
base from the general surface of the chest. They lie 
in the fourth intercostal space, four inches from the 
middle line. 

Very different is the appearance of this part in 
the female. In the adults of this sex the nipple is 
much larger, and surmounts a large prominent mass 
known as the breast, which contains the milk-secret- 
ing "mammary" gland, embedded in a layer of fat 
which varies enormously in different individuals. 

The female nipple has a less uniform position on 
the front of the chest, as the breast is very often 
pendulous, and so the nipple may hang considerably 
below the fourth intercostal space. 

The fat which is present around the breast is 
responsible for the gentle curves of this part. 
Each breast lies upon the pectoralis major and the 

176 



THE TRUNK 

serratus magnus, two-thirds upon the former and 
one-third upon the latter muscle. 

The nipple is light brown in colour in the virgin, 
in whom it is surrounded by a pink areola. The 
nipple becomes browner and the areola more pig- 
mented in the pregnant woman, and these tints 
remain in the matron. 

The saucer-shaped mammary gland extends from 
the level of the second as far as the sixth rib, and 
from the margin of the sternum to the anterior 
fold of the axilla. These limits are the boundaries 
of the actual mammary gland when fully developed, 
l)ut in the young it is less extensive, and in the old 
it is usual for it to become much smaller, though in 
both the young and the old there may be such a de- 
velopment of fat as to make the breast appear large. 

Blue lines, which mark the presence of veins, may 
be seen on the surface of the fully developed breast, 
and these become much larger during pregnancy and 
lactation. 

Notice that the shape of the breast varies not only 
with its consistence, but with the position of the 
trunk, and even with the position of the arm. 

Notice also that while the nipple is in the middle 
of the breast, the contour of the upper half of the 
organ is less convex than the lower half, which makes 
with the chest wall a well-marked thoraco-mammai^y 
fold (Plates X., XVIII, XXIII., XXXI.). 

The abdomen is usually, even in muscular men, 
rather more prominent in its lower than in its upper 
part. In w^omen who have borne children a change 
is demonstrable in the skin throughout the lower part 
of the abdomen. Numerous pink, silvery lines are 
seen. In the old the lines become distinctly brown 
and pigmented, and are known as ''linece atrophicce,'' 

ill M 



THE TRUNK 

The abdomen is apt to increase in size with ad- 
vancing age, especially in elderly and sedentary men. 
This is the consequence of a great increase of fat, 
which causes the protuberant abdomen to hang 
downwards over the upper part of the thighs. 

Three layers of muscle-sheets support the abdomen, 
viz. the external and internal oblique, and the trans- 
versalis. They are so arranged that their fibres 
cross each other, thereby adding very greatly to 
the strength of the abdominal wall. 

The external oblique muscle is a flat sheet on 
the side of the abdomen. The anterior limit of its 
muscular portion is prominent along a curved line, 
slightly convex towards the middle of the body, and 
nearer to the middle at the level of the costal margin, 
than below, where again it is very obvious just above 
and in front of the anterior superior spine of the 
ilium. Therefore its aponeurosis or spread-out tendon 
is broader below than above (Plate XVI.). 

Just above the two pubic bones, the lower limit 
of the abdominal wall contains a pad of fat, which is 
covered with hair and marked off from the abdominal 
wall just above by a well-marked furrow in the skin, 
not quite transverse, but concave upwards. In the 
fat subject a similarly disposed furrow crosses at the 
umbilicus (Plate X.). 

The hair upon the front of the trunk varies much 
in amount. The pubic hair extends up the middle 
line towards the umbilicus. 



178 



CHAPTER IX 

THE HEAD AND NECK 

In the previous sections the trunk and extremities 
have been considered. The student must now devote 
his attention to the most difficult, and yet in many 
ways the most interesting, part of anatomy, viz. the 
head and neck. It will be convenient to take the 
neck first. 

Close attention, assisted by repeated observation, 
is absolutely necessary, as it is by the narrowest 
scrutiny only that certain details can be understood. 

For example, one frequently hears some such ex- 
pression as "a beautiful light in the eye." But the 
explanation of such an expression is beset with great 
difficulties. In the first place, the light is not in the 
eye at all, but is reflected from it. Secondly, the 
manner of the reflection of the light depends to a large 
extent upon the curvature of the reflecting surface 
of the eyeball itself and of the surrounding lids and 
prominences. Thirdly, not only the surface of the 
eyeball, made up of the transparent cornea and the 
opaque white sclerotic, but also its internal parts, 
and in particular the iris, reflect and modify the light 
which falls upon it. And again, the expression, de- 
pendent upon the movements of the facial muscles 
surrounding the organ, is a very important factor in 
modifying " the light of the eye." 

In expression one part of the face seldom acts 
alone ; almost always there is a correlated action 

179 



THE HEAD AND NECK 

of other sets of facial muscles. The student has to 
study and to learn how to indicate the associated 
actions involved in such expressions, e.g. of the eye 
and mouth ; and further, he must also learn to 
correlate the expression of the face generally with 
the movements of the limbs and trunk ; to leam, 
in other words, to combine expression with appro- 
priate gestureo 




¥ig. 67. —Lateral View of Neck. Massive trapezius. 



The Neck is the narrow part of the body between 
the head and the trunk. It supports the head upon 
the trunk, and it is based upon the two shoulders, 
and so connected with the upper limbs. The shape 
of the neck varies much in different individuals : it 
may be long or short ; it may show well-marked 
muscular prominences, especially in males ; it may 
be gently rounded, especially in the female, owing to 
the i-resence of a normal quantity of healthy fat 

180 



THE HEAD AND NECK 

and the absence of any great muscular development ; 
or it may present pendulous rolls of unhealthy fat. 

The neck displays perhaps its most striking features 
in front. 

If the student looks at the subject in profile 
(Figs. 67 and 68), he will observe that the upper 
part of the neck in front lies considerably behind the 
point of the chin. 

As the profile is traced downwards towards the 
front of the chest, it 
is seen to incline a 
little forwards. In 
the natural easy posi- 
tion of the head the 
angle made by the 
lower jaw with the 
front of the neck is 
about ninety degrees, 
but of course it varies 
with changing posi- 
tions. 

When the head is «^- ^'-r/rro^r^for'''^'''^ 
bent backwards so 

that the face looks up, the angle is opened out 
(Fig. 77) ; when, on the contrary, the head is bent 
forwards, the angle is much diminished (Fig. 75). 
A greater range of movement is allowed in a down- 
ward than in an upward direction. 

The angle also depends upon the extent of fulness 
in the submaxillary and submental regions. The 
surface here is gently rounded in youth (Fig. 72), while 
later in life it may be divided into two or even more 
rolls by transverse furrows, giving rise to the popular 
expression " double-chin " (Fig. 69). 

These extra chins are the result of the presence of 

181 




THE HEAD AND NECK 

fat in large quantities, and of the subdivision of the 
fat by fold^ in the skin, which are primarily caused 
by some fibres of the platysma muscle (Fig. 25) cross- 
ing to the other side, and by the movement of the 
head upon the neck ; but they are secondarily per- 
petuated by the formation of fascial, or fibrous, bands 
under the skin. 

Note that in the case of a well-marked double chin 




Fig. 69.— Furrows aronnd Moutli. TMn lips. Double cliln. 

the intervening furrow is prolonged on to the lower 
part of the side of the face. 

Immediately under cover of the lower jaw, never 
visible, and but very rarely even palpable until the 
head is bent backwards, is the slight median body of 
the hyoid hone. So small is this that it would hardly 
be Tvorth noticing in a study of surface form were it 
not for the fact that from the hyoid many muscles 
pass to the lower jaw and tongue, and to the thyroid 

182 



THE HEAD AND NECK 

cartilage, muscles which assist in the acts of talking, 
mastication, swallowing, etc. (Fig. 73), and become 
prominent during some of these actions. Moreover, 
since the hyoid bone is arched just like the body of 
the lower jaw, and is smaller, and placed just below 
it in the neck, it follows that the muscles which pass 
between these two bones must converge upon the 
smaller bone from the mandible. The general sloping 





/ 



I 



' /M^- 



Fig. 70.— The Surface Markings Fig. 71.— The Surface Markings 

upon the Neck of an Old Man. upon the Neck of an Old Man. 

Front view. Side view. 

inwards and backwards of the skin from the lower 
jaw to the upper part of the neck is thus explained ; 
its direction is backwards in the submental region, 
best seen in profile, and downwards and inwards in 
the submaxillary regions, best seen from in front 
(Figs. 70, 71, 72). 

The first prominent landmark which makes itself 
apparent in the profile below the lower jaw is due to 
the largest cartilage of the larynx, as the voice-box 
or upper part of the air-tube is called (Fig. 68). 

183 



THE HEAD AND NECK 

This thyroid cartilage consists of two wings or aJoSi 
which lie in a vertical plane, one on each side of the 
middle line. The alse converge and are united to 
form a sharp though not straight edge, which is 
palpable in the middle line in front in both sexes, 
though more easily visible, because larger, in the 
male; it is called the pomurn Adanii, or "Adam's 
apple." 

The adult male, then, has a prominent thyroid 
cartilage, and a much deeper voice than the female ; 
the student will rightly anticipate that the two facts 
may be associated with each other. 

It is in the upper part of the larynx that the vocal 
cords lie. The vibration of these by air during ex- 
piration produces phonation. Owing to the large 
size of the thyroid cartilage, to which in part they 
are attached, the vocal cords are much longer in 
the male than the female — indeed the proportion is 
3 to 2 — and thus a deeper sound is produced when 
they vibrate. 

There is little or no difference in size between the 
young girl and the boy. In the latter, however, a 
great increase takes place at puberty, and accounts 
for the " breaking " of the voice. 

The alse are flat, and can be easily felt as they 
diverge backwards from the pomum Adami. 

The thyroid cartilage is separated from the hyoid 
bone by a shallow and broad groove which is obli- 
terated by the superficial coverings. The groove is 
supported by the thyro-hyoid membrane and thyro- 
hyoid muscle. 

The Cricoid cartilage, in shape like a signet-ring, 
lies below the pomum Adami, and can be felt in tha 
middle line of the neck. It is broad behind and 
narrow in front. It is partly by the movements of 

184 



THE HEAD AND NECK 

the thyroid upon the cricoid cartilage that altera- 
tions in the pitch of the voice are brought about 
by causing different states of tension in the vocal 
cords. 

The thyroid and cricoid cartilages are separated 
by a transverse furrow, and are connected with each 
other in two ways : first, by a membrane which is 
continuous with the vocal cords, and which is known 
as the crico-thyroid membrane ; and secondly, by a 
small joint on each side. 

The cricoid cartilage is ! \ 
directly continuous below \^, 'ysf>s^^ 

with the trachea or wind- ^^ t:y^t^.- 

pipe, which passes down 
behind the supra-sternal , 

fossa into the upper part ( 1 

of the chest and so to the ^*^ 

The windpipe may ^^ 

generally be felt, but is ^"^^^^ -^€^'^ 

only seen in very thin '"" 

subjects. It would be "^- ''-,r';l,^:?:f^''"<"^* 

•^ , , in a Girls Neck, 

legitimate to indicate it, 

or at least its first ring, as visible through the skin 

in a man suffering from starvation. It consists of 

alternate rings of fibrous tissue and cartilage. The 

more prominent rings are the cartilaginous, which 

are not quite complete, being deficient behind, where 

they are replaced by fibrous tissue. 

The second, third, and fourth rings are obscured 

by the isthmus of the thyroid body (Fig. 72) ; the 

lower rings are not seen, because as the trachea is 

traced downwards towards the chest, it lies much 

more deeply, i.e. further away from the surface, until, 

in a fat adult male, it may be an inch and a half 

185 



THE HEAD AND NECK 

from the floor of the supra-sternal fossa. This 
increased depth of the trachea from the surface is 
partly due to the fact that the neck, as seen in profile, 
slopes slightly forwards again just above the sternum 
(Fig. 77). 

The larynx and trachea can be seen to move 
upwards during the act of swallowing, and down- 
vrards when the action is completed. 

Just above the sternum lies the supra-sternal fossa, 
which has already been alluded to in the description 
of the trunk. Occasionally a small blue vein may be 
seen passing across this fossa in a transverse direc- 
tion ; it connects the lower parts of two veins which 
lie close to the middle line. They are the anterior 
jugular veins, and pass from the region beneath the 
chin to the lower part of the neck. There they diverge 
outwards on each side, under cover of the sterno- 
mastoid muscle. These veins are only obvious when 
enlarged in cases of asphyxia. 

If the neck of a young female is thrown forcibly 
backwards a distinct bulging will be noticed in its 
lower part — in a very thin subject the bulging may 
reveal the shape of an H. The swelling, which is 
quite distinct in this position, and often obvious in 
any position, is due to the presence of an important 
structure known as the thyroid gland. This gland 
is very frequently enlarged, giving rise to a " goitre," 
a comparatively common condition amongst the in- 
habitants of some of the Swiss and Tyrolese valleys. 
In England the condition sometimes bears the name 
of " Derbyshire neck." 

There are fashions in appreciation and portrayal 
of beauty, and the neck has in two very different 
periods been the part selected for exaggeration. 
Rossetti and Burne-Jones often endow^ed the lower 

186 



THE HEAD AND NECK 

part of the side and back of the neck with extra- 
ordinary muscular development (Fig. 67), while in the 
Renaissance women the thyroid was often depicted 
as verging on a goitre (Fig. 72, p. 185). 

Some of the landmarks hitherto referred to in the 




"^W^ 



Digastric (Posterior Beliy* 

Mylo-Hyold 
Sterno-Mastoid 
Omo-Hyoid (Anterior Belly) 

Omo-Hyoid (Posterior Belly) 
Clavicle 



Pectoralis Major 



Fig, 73. - Tlie Muscles of the Side and Front of the Neck. 



neck can only be demonstrated with difficulty, and all 
are of little importance when compared with that to 
which the student's attention will now be called. This 
is the most marked muscular feature of the neck, in 
either sex, an oblique ridge formed by the sterno- 
mastoid on each side (Figs. 68, 70, 71, 73, 74). 

This muscle is very thick and strong, and passes 
downwards from the mastoid process of the skull, 

187 



THE HEAD AND NECK 

which is situated behind the external ear or auricle, 
as well as from a part of the occipital bone continued 
backwards from it (Fig. 73). 

From this origin, where the ridge it forms is 
hardly so pronounced as elsewhere, the muscle passes 
downwards, forwards, and inwards, becoming pro- 
gressively more prominent. It is attached below to 



^^■-^^^'■-^ 




f 



Fig. 74.— Necklace-like Creases in Front of 
Neck of Youth. 

the inner two inches of the upper surface of the 
collar-bone, and, by an independent tendon, to the 
front of the upper part or manubrium of the 
sternum. The clavicular portion is broad, flat, and 
fleshy ; the sternal portion round, cord-like, and 
tendinous. The two parts of the muscle become 
separated from each other at only a short distance 
above the clavicle ; in this way a small and variable 
triangular interval is left between them. 

188 



THE HEAD AND NECK 

Although the sterno-mastoid muscle runs obliquely 
when the head is directed forwards, its position is 
very different when the head is turned on one side. 
Then the sterno-mastoid of the side opposite to 
that towards which the face is turned assumes a 
vertical position, and stands out well, because it is 
in action, while the sterno-mastoid of tho other side 
becomes more oblique and less prominent, because it 
is not in action. 

Whatever position the head may occupy the 
prominence formed by the sterno-mastoid is always 
obvious, although naturally it is more pronounced 
when the muscle is in forcible action. 

This large and important muscle has a complicated 
action. When the muscles of the two sides act 
together and the thorax is fixed, they bend the head 
forward. But when the head is fixed, they raise 
the chest, and can thus be used as accessory muscles 
of respiration. This happens when there is difficulty 
in breathing, as in a case of asphyxiation, or in 
a man suffering from asthma. 

When one muscle acts alone the face is rotated to 
the opposite side, and the head is depressed on the 
shoulder of the side of the acting muscle. This 
composite movement results in a slight elevation of 
the chin, and a corresponding upward inclination 
of the face. The exercise of rowing displays it in 
vigorous action. 

The sterno-mastoid muscle forms the boundary of 
certain regions of the neck, viz. the slightly hollow 
areas known as the triang-les of the neck (Figs. 
68, 73). 

There are two chief triangles, anterior and pos- 
terior, so called from their position relative to 
the sterno-mastoid. They are of course bi-lateral, 

189 



THE HEAD AND NECK 

and in the " attention " position of the head are 
symmetrical. 

The anterior tmangles are immediately adjacent to 
each other, the boundary being the anterior middle 



^^ 








Fig. 75.— Head and Face of an Old Man, 

line of the neck, the various points of which have 
just been described. 

The apex of each anterior triangle points down- 
wards, and is formed by the convergence upon the 
middle line at the lower part of the neck of the 
sterno-mastoid muscle as it passes to its sternal 
attachment. 

The base of the anterior triangle is directed up- 

190 



THE HEAD AND NECK 

wards, and is formed on each side by the lower 
margin of the jaw, and by a Hne drawn backwards 
from this to the tip of the mastoid process. 

The sides of the triangle are formed by the middle 
line of the neck and the anterior border of the 
sterno-mastoid muscle. 

. During the act of coughing, in a well-developed 
muscular subject who has very little fat, three ridges, 
or perhaps furrows, may occasionally be observed 
converging upon the hyoid bone. These indicate the 
presence of small subjacent muscles. 

One of the ridges or furrows is more obscure than 
the others, and passes from the hyoid bone down- 
wards, outwards, and backwards, beneath the sterno- 
mastoid. This is the anterior portion of a slender, 
long, tape-like muscle, the omo-hyoid, w^hich passes 
downwards across the anterior triangle in its lower 
part, and subsequently across the base of the posterior 
triangle, to find attachment on the scapula (Fig. 73). 

The other two ridges are due to the two portions 
of one muscle, the digastric, the anterior part of 
which passes to the hyoid bone from the chin, while 
the posterior part passes to the same bone from the 
mastoid process, in company with a small muscle, 
the stylo-hyoid, which cannot be separately distin- 
guished without dissection (Fig. 73). 

These three ridges divide the anterior triangle into 
three smaller ones, of which the upper, or digastric 
triangle, is the most obvious. It lies beneath the 
lower margin of the jaw, and contains the sub- 
maxillary salivary gland, which produces a fulness 
in this region, and a part of the parotid gland, which, 
except in the glutton, forms no prominence, but 
merely tills up what would otherwise be a hollow 
between the ramus of the lower jaw and the ear. 

191 



THE HEAD AND NECK 

The 'posterior triangle lies behind the posterior 
border of the sterno-mastoid. 

This is a much smaller area than the anterior 
triangle, and differs from it in having its base directed 
downwards and its apex upwards. 

The base of the posterior triangle is formed by 
the middle third of the upper border of the clavicle. 
The sides are formed in front by the posterior border 
of the sterno-mastoid, and behind by the anterior 
border of the upper or cervical portion of the tra- 
pezius. The apex of the triangle is at the point 
where these muscles meet, or nearly meet, at the 
middle third of the superior curved line of the 
occipital bone. That is, the apex is about the mid- 
point of a line drawn between the tip of the mastoid 
process and the external occipital protuberance. 

Occasionally the base of this triangle may be 
narrowed by the attachments of the sterno-mastoid 
and trapezius muscles to the clavicle approaching 
each other more nearly than usual. 

Such decreased breadth is not necessarily due to 
excessive muscular development. Such development 
would merely cause the boundaries to be more pro- 
minent and the triangle to be deeper, and therefore 
more pronounced. 

The apex of the triangle may, on the other hand, 
be replaced by a short line in those subjects in whom 
the attachments of the same two muscles to the 
occipital bone fail to meet. 

The basal part of the area behind the sterno- 
mastoid may show pulsation, owing to the presence 
of the subclavian artery which lies deeply in this 
region just above the clavicle. 

The neck, as it reaches the trunk, becomes rather 
thicker. The increased thickness is due to certain 

192 



THE HEAD AND NECK 

deep muscles which pass from the neck to the upper 
ribs, but they will not repay the artist for an attempt 
at differentiation. 

In persons who have not much superficial fat the 
external jugular vein is easily discerned, but it is seldom 
as striking an object in nature as in art (Fig. 68, p. 
181). It is one of the largest of the superficial veins 
in the whole body. Its course is indicated by a line 
drawn from the mid-point between the angle of the 
lower jaw and the tip of the mastoid process to the 
middle of the upper border of the clavicle. Just 
above the clavicle it disappears from view by passing 
deeply under the outer margin of the sterno-mastoid, 
to join the subclavian vein. There is no such thing 
as a "jugular artery." The main artery in the neck 
is the carotid, and the vein which runs with it, too 
deep to be seen, is the internal jugular. 

Expiratory eif ort, as in singing, makes the external 
jugular vein full and prominent, and then it may 
show one or two dilatations in its course,, the result 
of valves within its lumen. 

There is a very interesting thin, but wide, muscle 
on each side of the neck, called the platys7na inyoides 
(Fig. 25), the best example in the human being of the 
superficial sheets of muscular fibres similar to those 
which cover a great part of the body of some of the 
lower animals, e.g. the horse. A very good representa- 
tion of this is to be found in the hall of the Royal 
College of Surgeons. The platysma lies in the super- 
ficial fascia of the neck and upper part of the chest. 
Sweeping downwards from the face, it covers both 
anterior and posterior triangles, and obtains a weak 
attachment to the margin of the lower jaw and of the 
clavicle as it passes with a slight inclination back 
wards over the latter bone, to terminate in the skin 

193 N 



THE HEAD AND NECK 

of the upper part of tlie chest and shoulder. When 
the platysma acts, it pulls the skin of the chest up- 
wards and the angle of the mouth downwards and 
outwards. Some of the muscles of the face are 
derived from the same subcutaneous muscular sheet, 
but have become specially developed in connection 
with the expression of the emotions. The platysma 
is sometimes very strongly marked, and the individual 
bundles of muscle fibres which form the sheet may 
even be seen through the skin. Being concerned in 
expression, it is innervated to a large extent by the 
facial nerve (Plates XXIY., XXY.). 

Notice the double destiny of this subcutaneous 
muscle sheet, so useful to certain animals for start- 
ling away, by the sudden movements it can give to 
the skin, any irritating insects which are out of reach 
of the tail. Over the greater part of the human body 
the muscle has degenerated ; it has, in other words, 
undergone involution. The facial part of it, however, 
has become evoluted and differentiated, and is of 
great importance in the expression of the emotions. 

Notice also that it is the anterior borders of the 
two platysma muscles which account for those two 
vertical cord-like folds of baggy skin in the pre-hyoid 
and pre-thyroid region of the aged and withered neck. 
Here, and about the apex of the posterior triangle of 
the neck, are the two places where are earliest shown 
the eifect of age in withering the subcutaneous 
structures and rendering the skin baggy (Fig. 70). 

The superficial fat of the neck, as of the rest 
of the subject, is relatively more abundant in the 
female than the male, and fills up i]m hollows and 
rounds oif the prominences, so that in the female 
the muscles, and especially the sterno-mastoids, are 
not nearly so conspicuous as in the male. 

194 



THE HEAD AND NECK 

We must now concentrate our attention upon the 
trapezius muscle, which forms a flat sheet situated 
on each side of the cervical and dorsal vertebrae. 

The trapezius (Fig. 62, p. 158) has the most ex- 
tensive attachment of any muscle in the body. 
Its origin lies in and near the middle line, and 
embraces attachments above to the external occipital 
protuberance, and to an inch or more of the superior 
curved line of the occipital bone ; below this to the 
ligamentum nuchse, a strong, deep, elastic ligament 
which bridges the backward concavity formed by 
the cervical spine as seen in the profile view of the 
skeleton; and below this again to all the dorsal 
spinous processes. 

The ligamentum nuchce, from Tvhich this muscle 
arises in the neck, is a broad band of fibrous material 
containing some elastic tissue, and extending from 
the external occipital protuberance to the spine of 
the seventh cervical vertebra. It is attached to all 
the cervical spines, and gives origin to several layers 
of muscles situated on the back of the neck. It helps 
to keep the head erect, and so diminishes, but does 
not abolish, the need for continued muscular activity 
in order to maintain the poise of the head ; in quad- 
rupeds it is enormously hypertrophied, because, their 
spine being disposed horizontally, its task is increased. 
But for the ligamentum nuchse, any quadruped with 
a heavy head would have to hang it vertically from 
the shoulder as in the position of grazing, or to 
develop some stronger muscles in the back of the neck ; 
muscular tissue becomes tired, while ligaments do not. 

If the student will now examine that border of the 
trapezius which bounds the posterior triangle (Fig. 62, 
p. 158), he will observe that it is not nearly so vertical 
as the lower border which lies upon the back. The 

195 



THE HEAD AND NECK 



cervical outer border is curved somewhat forwards, 
so that the back part of the side of the neck is gently 
rounded. The shape and bulk of the trapezius will 
be better realised if the model shrugs his shoulders, 
while the student examines the part just above 
the scapula (Figs. 67, 77). 

In a muscular subject it can be appreciated that 
in the greater part of the dorsal region, and in the 

upper part of the cervical 
region, the muscular fibres 
of the trapezius extend right 
up to the middle line ; but 
in the lower cervical and 
upper dorsal regions a short 
flat tendon of origin, or 
aponeurosis, is developed on 
each side, which produces a 
slight flattening or depres- 
sion on either side of the 
vertebra prominens (Fig. 62, 
p. 158). 

In the middle line of the 
neck between the two tra- 
pezii there is a deep furrow, 
frequently obscured by fat, 
and best seen perhaps in the boy's neck (Fig. 76), con- 
tinuous with that already described in the account 
of the trunk. At the bottom of this nuchal furrow 
lie the ligamentum nuchse and the spines of the 
vertebrae. Although the trapezius makes the longi- 
tudinal elevation on each side of this furrow, it is 
by no means entirely responsible for its prominence, 
the thick complexus rnuscle contributing largely 
though its outline is obscured by the trapezius. 
The complexus lies under the trapezius and pushes 

196 




Tig. 76.— Back of Boy's Neck, 
showing Median Furrow. 



THE HEAD AND NECK 



it up. The ridge it forms is narrower and more 
prominent above than below (Fig. 76). 

If the student now adds to what he can see that 
which he can feel by pressing his finger down this 
furrow, he will make acquaintance with the spine of 
the axis, or second vertebra. 

The axis forms a massive, though not prom.inent, 
eminence below the 
occipital protuber- 
ance. The spines 
of the first, third, 
fourth, and fifth 
vertebrae cannot be 
felt, but the sixtli 
and seventh arc 
quite distinct. Tlu' 
spine of the vertebra 
proviinens is, how- 
ever, hardly more 
conspicuous than 
that of the first 
dorsal vertebra, 
which lies below it 
and is almost if not 
quite as obvious. 

These spinous pro- 
cesses of the verte- 
brae are best ob- 
served when the skeleton spine is bent forwards. In 
this position they are also separated by wider intervals 
than when the head is erect (Plate XXII.). 

When the head is bent backwards (Fig. 77), trans- 
verse superficial folds may be seen running across 
the back of the neck. Hair is found in the upper 
part of the neck, and especially in the median nuchal 

197 




Fig. 77. 



-Creases seen on Back of 
Extended Neck. 



THE HEAD AND NECK 

furrow (Fig. 76, p. 196). In the muscular subject the 
back of the head is often nearly, but seldom quite, 
flush with the back of the neck (Figs. 65, 67), a very 
different condition from that seen and described in 
the front part of the same region. 

The Head and Face. 

The skull, or skeleton of the head, is divided by 
anatomists into (a) the Cranial Bones, concerned 
chiefly with the protection of the brain, and there- 
fore dense and strong ; and (b) the Facial Bones, 
designed for the accommodation of the organs of 
special sense and of mastication and expression, and 
therefore comparatively light. 

The Scalp, as the soft parts covering the cranium 
are collectively called, is, with the exception of the 
forehead, covered with hair. The scalp is very dense 
and tough and mobile, but quite thin, so that the 
shape of the cranium is dependent upon the bones, 
which vary much in different skulls, and are rarely 
exactly similar even on the two sides of any in- 
dividual — in fact, no human being is in any part 
strictly symmetrical. Two main types of skull may 
be mentioned— the " doHchocephalic " or long head, 
and the " brachycephahc " or broad head. Between 
these two main types is an intermediate one, to which 
belong the higher races of mankind. 

The various relations of length and breadth of the 
skull in its different parts are dealt with in the 
science of anthropology. 

We will study first the skull with its coverings, 
and later the face. 

The Hairy Scalp.- The hair throughout the body 
varies in many qualities — e.g. colour, texture, thick- 
ness, and moisture — but it never varies in the direction 
of its slope, which as a general rule is such that if 

198 



THE HEAD AND NECK 

one goes down on all-fours, rain falling on one's back 
would be directed to the ground by the hairs. The 
hair of the scalp slopes downwards from a point 
situated rather behind the vertex of the skull. 
Possibly the direction of the slope of the hair may be 
to some limited extent determined, or even altered, 
by habitual brushing in a definite direction. The 
frequent early disappearance of hair at the upper 
part and sides of the forehead is in all probability 
due partly at least to the wearing of some form 
of hard head-gear. Readers of Scott will recall his 
description of Marmion. 

Hair also often disappears and produces baldness 
in the mid-line of the head, behind and around the 
vertex. From this "tonsure" the area of disap- 
pearing hair spreads forward, laterally, and back- 
wards, until finally only the sides of the head are 
left covered. In the majority of persons becoming 
bald the area immediately surrounding the patch 
of baldness is poor not only in quantity, but also 
in the size of the individual hairs. 

The scalp has no definite boundaries except in front, 
where it is separated from the face by the curved 
upper margin of the bony orbit, a line corresponding 
with the eyebrotvs. Laterally the boundary is that 
arch of bone, the zygomatic arch, which forms a 
flying buttress on each side of the head, and is 
composed of a slender process of the temporal bone, 
called the zygomatic process, at the back of the 
arch, and of the malar bone at the front. 

Behind this arch the mastoid process, the superior 
curved line, and the external occipital protuberance 
mark the boundary between head and neck. 

The auricle, or ear, ought properly to be considered 
as a part of the cranium. For various reasons, and 

199 



THE HEAD AND NECK 

especially for the art student, it will be more con- 
veniently considered ^th tlie anatomy of tlie face. 

The part of the Cranium ^vhich is not covered 
with hair, and which is known as the forehead, is 
as liable to sho\^ variety of shape as any part of the 
skeleton. Any eminences which may be present 
upon it are due chiefly to the surface form of the 
underlying frontal hone. On each side of the middle 
line the student will notice the frontal eminence. This 
is situated some t^vo inches above the orbit, and as 
a rule is smooth and rounded, and only slightly 
elevated. 

The frontal eminences are said to be well marked 
in high types of intellect, as the intellectual nerve 
centres are specially developed in the frontal lobes 
of the brain. But it is only right to state that these 
eminences are also particularly well developed in 
feeble children suffering from rickets. 

It is necessary to distinguish the frontal eminences 
from those others which are situated mvich nearer 
to the middle line, just above the root of the 
nose. These siiperciliary ridges, which, owing to the 
absence of any intervening furrow, occasionally run 
into one another, are due to the development of air 
spaces within the frontal bone connected with the 
nasal cavity, and are probably useful as resonating 
chambers for the modulation of certain qualities of 
voice. They are hardly developed at all until after 
the age of seven years, and afford little, if any, indi- 
cation of the intellectual power of the individual. 

They lie above and parallel to the supra-orhital 
margins, being separated from them by a distance 
of one-third of an inch. These ridges can always be 
felt, but not always seen. 

The root of the nose, where the forehead becomes 

200 



THE HEAD AND NECK 

continuous with the face, will be described with the 
latter. 

The skin of the forehead is usually smooth and 
frequently shiny ; it is liable, as in the act of raising 
the forehead to express surprise, to be thrown into 
a series of slightly curved folds, or furrows, some of 
which, to a varying extent in different individuals, 
are permanent. 

Three or four such frontal furroxos are demon- 
strable. The upper ones run across the middle line, 
but the lower are interrupted there. They are 
concavo-convex, the convexity lying on each side of 
the middle line and the concavity lying across it, and 
both ends being directed downwards (Fig. 75). 

The upper furrows, as well as being larger and 
more complete, are deeper. All the furrows are 
prolonged outwards on each side to the margin of 
the hairy portion of the scalp. They occupy usually 
only the lower half of the forehead. 

The furrows are due to the contractions of the 
underlying frontalis muscle^ which is the anterior 
muscular portion of a musculo-membranous sheet 
called the occipito-fr on talis. The muscle is con- 
nected above with the aponeurosis, while below it is 
inserted into the skin of the forehead, and passes 
down into the nose. It also blends with the muscle 
chiefly concerned in the opening and shutting of the 
eye, viz. the orbicularis palpebrarum. 

In the act of frowning, additional grooves are to 
be noticed placed vertically or obliquely near the 
middle line just above the nose. These important 
grooves are formed by the contraction of a tiny 
muscle known as the corrugator supercilii. 

The upper border of the frontalis muscle corre- 
sponds to the limit of the transverse furrows on the 
forehead . 

201 



THE HEAD AND NECK 

The two frontales muscles lie immediately adjacent 
to one another in the middle line, and their upper 
edges, where they blend with the aponeurosis, are 
sharply convex. The outline of these muscles is 
particularly well seen in young subjects. 

On the side of the forehead a tortuous, pulsat- 
ing ridge may be seen in the old, or even in those 
who are prematurely old ; and, be it remembered, 
a man's age is rarely so correctly ascertained 
at Somerset House as by an examination of his 
blood-vessels. The condition of this heaving and 
pulsating ridge, due to the presence of the sub- 
jacent superficial temporal artery, is a far better 
indication of senility than the records of a registrar 
(Fig. 75). 

Its conspicuousness in old persons is a consequence 
partly of that wasting of the superficial tissues which 
occurs with age, but chiefly of the deposit of a lime 
salt within the walls of the artery. The deposit 
renders the artery more rigid, so that it stands 
out much more distinctly than it would do other- 
wise. The artery is at the same time lengthened, 
which causes it to become tortuous. 

The forehead varies very much in expanse and 
shape. The low forehead, which is considered by 
some to be a point of beauty in the female, to others 
suggests chiefly the criminal taint with which it is 
often associated in the male. 

The high forehead is thought to be a characteristic 
feature of intellect; notice, for instance, the busts 
of Shakespeare, or the portraits of Walter Scott. 
Certainly the height of forehead may be due to 
actual expanse of cranium, but beware of the false 
impression conveyed by baldness or the brushing 
back of the hair. 

202 



THE HEAD AND NECK 

The forehead may bulge forwards, or it may be 
decidedly " retreating." 

The prominences noticeable upon that part of the 
head which is covered with hair are symmetrically 
placed, like those of the forehead. 

The 'parietal eminences are seen at the broadest 
part of the head on each side, above and behind the 
ear. They indicate the spots at which the ossifica- 
tion of those bones originally started. 

Immediately behind the ear is the nipple-shaped 
mastoid process (Figs. 15, 16, and 18, pp. 55, 56, 58), 
a bony eminence which is better developed, actually 
as well as relatively, in the adult than in the child. 
The reason for this diiference is, that after the age 
of seven years air spaces are developed in the sub- 
stance of the temporal bone in connection with the 
middle ear, a part of the organ of hearing buried 
deep in that bone. The air spaces are in direct 
continuity with the middle ear, as the box which 
has the drum of the ear in its outer wall is 
called. All vibrations entering through the passage 
of the external ear disturb the drum which lies at 
the bottom of it. The drum transmits the disturb- 
ance or vibration by means of three small bones, 
advantageously placed for this special purpose, to 
the internal ear, which is the actual organ of hearing. 

The external occipital protuberance can be more 
easily felt than seen, but its position should be ob- 
served, as it forms an important landmark. It lies 
just above the nuchal furrow in the middle line of 
the back. The superior curved line, and therefore 
the boundary between the head and the back of the 
neck, is continued outwards on each side from this 
protuberance. 

In young children who have not yet obtained a 

203 



THE HEAD AND NECK 

covering of hair, and to a less extent in older persons 
who may have lost it, the posterior muscular part 
of the epicranial musculo-aponeurotic sheet will be 
noticed, forming a flat, slightly raised eminence of 
thin muscle called the occipitalis. This corresponds 
behind to the frontalis already described as a land- 
mark of the forehead. 

The whole sheet is called the occipito-frontalis 
muscle. The posterior part is known as the occipi- 
talis muscle, and arises from the superior curved line 
of the occipital bone. The origins of the two occipi- 
tal muscles are separated, unlike the frontales, by a 
distinct interval, measuring at least an inch. 

The occipito-frontalis muscle (Fig. 78) is not capable 
of throwing the skin of the scalp into folds except in 
the forehead, where it accounts for the transverse 
grooves so obvious in the expression of surprise. 
The extent to which these folds can be voluntarily 
produced varies much in different individuals, and 
in a few, especially after youth is past, the grooves 
are permanently impressed upon the skin. Similar 
differences are found in the degree of voluntary 
control possessed by individuals over the movement 
of the scalp and of the external ear. 

On the side of the skull, but chiefly in front of the 
ear, a fan-shaped, slightly elevated region, broad with 
convex border above, and narrow below, is due to the 
subjacent temporal muscle (Figs. 79, 80). This is one 
of the immensely powerful closers, or elevators, of the 
lower jaw. It arises from the temporal fossa of the 
skull, and is inserted into the coronoid process of the 
mandible. When vigorously contracted, as in grind- 
ing the teeth, the belly of the muscle can be felt as 
a rounded eminence above the zygomatic arch. The 
muscle descends deep to this arch (which has been 

204 



THE HEAD AND NECK 

cut away in Fig, 79 to show the tendon) as it passes 
to its destination. The facility with which this 
muscle may be felt, or even seen, to contract when 
the jaw is clenched has been utilised by fraudulent 
thought-readers as a means of communicating with 
the confederate by a sort of Morse code. 




Fig. 78.— Muscles of side of Head, 
Face, and Neck. 

M=Masseter. Inset of Jaws showing:— 
B. Origin of Buccinator. 
Ill Insertion of Masseter. 



The Superficial Anatomy of the Face.— Even 

in the more vacant countenance, which has been said 
to bespeak the empty mind, there are variations in 
expression from moment to moment. When the 
subject of our study is an active-minded and in- 
telligent person, the difficulties which confront us 
are complex and varying in the extreme. 

The Face, for the purposes of convenient descrip- 

205 



THE HEAD AND NECK 

tion, includes the chin, cheek, mouth, nose, eyes, and 
ears. 

The ordinary anatomist is content to consider all 
faces to be as much alike as a row of pins, yet in 
reality there is as much difference between any two 
faces as there is between any two finger-prints; no 
two faces are exactly alike, and no face is strictly 
symmetrical. Even as a doctor must be a student 
all his life, so a portrait-painter finds that the longest 




Fig. 79.— Temporal Muscle. 
Zygoma cut away. 



life is too short to fathom all the depths and diffi- 
culties presented by facial expression. 

Let us attempt a brief account of the anatomy 
of the face and its component parts, in order that 
the student may begin to understand something of 
its various movements and resultant expressions. 

When the face is viewed from the front (Fig. 81), 
the outline of the forehead (as high as the vertex) 
and face may be seen to resemble that of an egg, 
the broad part of the head being situated above 
and the narrow part below. 

206 



THE HEAD AND NECK 

Let the ovoid be quartered or divided by a vertical 
median line and by a horizontal line through the 
middle of the vertical one (Fig. 81). 

The eyeballs lie on a level with the line drawn 




:^-;,., 




5. '/A 




Fig. 80.— Surface Markings upon 
a Thin Face and Neck. 



Fig. 81.— Figure to show Propor- 
tions of Face and Neck. 



horizontally through the middle of the ovoid, or even 
slightly beloTV this level. This is a most important 
point to realise, for if the eyes are placed too high, 
it becomes at once manifest that the head belongs 
to that microcephalic type which is usually associated 
with the criminal class. 

207 



THE HEAD AND NECK 

Most of the face therefore lies in the lower half 
of the ovoid ; only a small part, indeed, passes into 
its upper half, which is chiefly occupied by the 
forehead. 

If the lower half of the vertical median line be 
bisected by another horizontal line so as to subdivide 
the lower half of the ovoid, the mouth and chin will 
be found to lie in the lowest quarter of the face, 
and the nose in the quarter above this. 

If the horizontal line through the eyeballs be con- 
tinued outwards it will pass a little below the highest 
points of the ears. 

If a horizontal line be drawn between the tips of 
the ears, and the face be still viewed from the front 
and considered as if it were flat, and this line be 
divided into fifths, the middle fifth corresponds to 
the root of the nose, and the fifths on each side 
of the middle, to the eyes ; and the fifths to the 
side of this again correspond to the foreshortened 
temples. 

The eyeballs are the organs of vision by which 
light waves are received and transmitted to the brain. 
They are well protected from injury by surrounding 
bony ridges, orbital margins, ^svhich bound the anterior 
part of the bony cavities in the skull, known as the 
orbits. 

Above the eyeball is the particularly well-marked 
ridge formed by the supra-orbital margin (Fig. 82, 
p. 210) of the frontal bone. This is sharp and con- 
cave downwards, and terminates externally in the 
well-marked external angular process to which the 
temporal muscle nearly reaches, and internally in the 
less noticeable internal angular process on the side 
of the root of the nose. 
Externally to the eyeball, the antero-internal part 

208 



THE HEAD AND NECK 

of the malar bone forms a protecting ridge. Below 
the eye the infra-orbital margin of the malar and 
superior maxilla forms a ridge which, though less 
prominent than the supra-orbital, yet projects enough 
to bring this margin also in front of the eyeball. 

Internally, the boundary of the orbit is formed by 
the nasal process of the superior maxilla and part of 
the frontal bone. 

It is the prominence of the nose, however, that is 
responsible in the main for the protection of the 
eyeball from blows directed on its inner side. Owing 
also to this same prominence, vision is more obscured 
on the inner or nasal side of the eye than on the 
outer or temporal side ; so that ^len the eyes are 
directed to an object situated on the left side, the 
left eye sees much more of the object than does the 
right eye. 

The supra-orbital margin is covered by closely set 
and rather coarse hairs, forming the eyebrows. The 
line of the eyebrows, in the inner half of its length, 
lies on a nearly horizontal plane, but in the outer 
half it is prolonged somewhat downwards. 

The inner ends of the two eyebrows sometimes 
meet in the middle line of the root of the nose, 
running somewhat downwards to do so, and pro- 
ducing a " beetling brow." 

The individual hairs of the eyebrows are directed 
for the most part upwards and outwards, but ex- 
ternally the outward or even a downward direction 
may be more apparent (Fig. 82, p. 210). 

In some people the eyebrows project directly for- 
wards, and are very long; in some the outer part 
may be almost wanting, or may be directed upwards 
and outwards. 

The upper and lower soft fleshy curtains or eyelids 

209 o 



THE HEAD AND NECK 

form an additional protection to the delicate organ 
of vision, upon which they move almost without 
friction because of the sac of the conjunctiva, which 
is lubricated by tears. 

The conjunctiva covers the apposed surfaces of the 



^^■ 




"^^^ 




'4 




A 



<i 





■^^'i^^m-j 



Fig. 82.— The Palpebral Aperture, Eyelids, and Eyebrows. 



lids and eyes. It is a transparent sheet of mucous 
membrane, and allows the colour of the tissues 
lying beneath it to show through ; so that the inner 
surface of each lid is ruddy, while the fibrous coat 
of the eyeball, or sclerotic, shines white through the 

210 



THE HEAD AND NECK 

ocular conjunctiva. The transparency of this mem- 
brane is further proved by the fact that, although 
it covers the cornea, or clear part of the eyeball, it 
does not obstruct vision. 

The chink between the two lids is known as the 
palpebral fissure (Fig. 82). When the eyelids are 
separated from each other and the eye open, this 
fissure is oval or almond-shaped, with the outer corner 
sharp and angular, and the inner corner rounded or 
punched out. At this inner corner the edges of the 
lids run for a space parallel with each other, and 
thus a little bay is formed, in which is to be seen the 
caruncle, a small pink fleshy structure. 

In certain races, e.g. in the Chinese, the inner end 
of the upper eyelid is prolonged on the face, over 
the inner end of the lower eyelid (Fig. 82 b). 

Naturally the shape and appearance of the palpe- 
bral fissure vary according as the eye is open or 
shut ; and the fissure, when the eyelids are approxi- 
mated, is generally transverse, with a slight con- 
vexity downwards and forwards. When the eye is 
open, the edge of the upper lid is convex forwards 
and concave downwards. The edge of the lower 
eyelid is convex forwards and slightly concave up- 
wards. Both these edges become straighter when the 
eye is closed. 

Near the entrance of the punched-out bay at the 
inner angle of the fissure, a black spot will be 
noticed on each eyelid at the summit of a very small 
eminence. This is the punctum, and is the entrance 
to the lachrymal canaliculus. It is by the apposition 
of the lids to the globe of the eyeball that the tears 
are enabled to enter these puncta, and to be thence 
transmitted along the canaliculi to the lachrymal 
duct, and so to the nose. 

211 



THE HEAD AND NECK 

The lids act not orly as curtains, but also as 
brushes ; they move ^ • tears along, and they also 
sweep away the part les of dust which constantly 
enter th. > conjunctiva c. 

Incre: ed formation of tears, in certain emotional 
states, It ids to their accumulation in the conjunctival 
sac till they overflow the lower eyelids and run down 
the face, the canaliculi being too small to deal with 
such an increased flow. 

As age advances, the lids, which are normally kept 
in close apposition with the eyeball, fall away a little 
(Fig. 82 D, p. 210), owing to loss of tone in the muscle 
controlling the movements of the lids. As a con- 
sequence the tears are very apt to flow over the face, 
and the eyes to become " blear " — i.e. the ruddy inner 
surface, especially of the lower lid, becomes visible as 
in most hounds and some other dogs. 

The free edge of each eyelid is thicker than the 
rest of the lid, and is very slightly everted. Each 
free edge also carries a roA of short, coarse, curved 
hairs, the eyelashes, which are not very numerous, 
vary greatly in thickness, in length, and in curve, 
and are directed f orwar ' *. They afford protection 
against small foreign bod <^s, which otherwise would 
enter the eye more frequently. 

J'he Movements of the Eyelids. — Both lids are capable 
of an upwarc* nd downward movement, but the 
upper lid mo- auch more freely and extensively 

than the lowe For this reason the palpebral fis- 
sure, when clo 1, lies below the level of the pupil 
of the eye. 

Within each lid there is a crescentic plate of 
cartilage, which gives ' rigidity to the curtain without 
impairing its mobility. 

212 



THE HEAD AND NECK 

Two muscles bring about the movements of the 
lids, viz. the orbicularis palpt rum and the levator 
palpebrse superioris. The fc ner is a flat sheet of 
muscular fibres, arranged ir Ixrallel and c icentric 
circles around the margin Ol t the palpebr. fissure. 
This muscle is not visible through the skin, at when 
the skin has beer dissected away it may be seen to 
spread outwards in the temporal and malar regions ; 
inwards, upon the nose ; and downwards, upon the 
face. 

A part of the orbicularis palpebrarum lying actually 
upon the eyelids may be distinguished from the main 
part, which lies wide of these curtains. The nerve 
supply, as is the case with all the muscles of ex- 
pression, comes from the seventh cranial, i.e. the 
facial, nerve. 

The upper eyelid is distinguished from the lower 
by having an additional muscle which assists in per- 
forming and controlling its movements. This is the 
levator palpehralis sup ioris. It runs forwards in 
the cavity of the orbit, as do most of the muscles 
which move the eyeball. By the contraction of this 
muscle the upper eyelid * raised, and owing to it 
the upper eyelid has moi . active movements than 
the lower. 

Forcible closure of the lids is brought about by 
the contraction of the orbicularis t '^lebrarum, and 
the eye is opened by the relaxati' ' this muscle, 

together with the contraction of the viator. 

Blinking is a quick forcible actic of the orbicu- 
laris, resulting in momentary closing of the eye. It 
occurs at periodic intervals, and assists in the moisten- 
ing of the surface of the eyeball itself, as well as in 
the circulation of the tears and the removal of small 

213 



THE HEAD AND NECK 

foreign bodies from the conjunctiva. Blinking also 
occurs with any sudden shock, especially one of a 
visual nature. 

Winking is a slower movement, is purely voluntary, 
and is dependent upon the action of the orbicularis, 
especially in connection with the lower lid, which is 
raised in the process. Winking does not take place 
without the will and knowledge of the subject, and 
it is not given to everybody to have the necessary 
amount of voluntary control over each orbicularis 
independently of the other ; blinking, on the contrary, 
is usually as much an involuntary act as breathing, 
and the agent is not conscious of either unless it 
is performed under the influence of some unusual 
stimulus. Another essential distinction between 
these tw^o actions is that in winking only one eye 
is involved at a time, while it is usual for both eyes 
to blink together — in the human being, at least, 
though the closing of a single eye in cats and other 
animals is probably of the nature of an unconscious 
blink rather than a conscious wink. 

Ptosis, or drooping, is a condition of the upper 
eyelid which the art student should notice. It is 
sometimes due to paralysis of the facial nerve, 
which of course supplies the orbicularis ; and some- 
times to paralysis of the third cranial nerve, which 
supplies the levator. In either of these cases it is 
generally unilateral. It may, however, be congenital, 
and is then more frequently bilateral. Ptosis is 
an exaggerated degree of the condition known as 
drooping of the eyelids,, "which is of considerable 
interest as indicative of certain emotional states {vide 
infra). 

Some of the various means by which very efficient 
protection is afforded to the eyeball have now been 

214 



THE HEAD AND NECK 

considered, and the student should direct his atten- 
tion next to the organ itself. 

The eyeball is the organ of vision, and is connected 
with the brain by means of the optic or second 
cranial nerve. It is contained in the orbit, which is 
a cavity developed in the skull in special adaptation 
to the important structures which it contains. 

The expression " globe of the eye " almost exactly 
describes its shape. It is a little over one inch in 
diameter, almost as large in the infant as in the 
adult, and about the same size in all adults. When 
we say that " the eye is large," we really mean " the 
palpebral fissure is large." 

Only that part of the eyeball which lies in front 
can be seen without the aid of dissection, or the 
use of the ophthalmoscope, an instrument devised 
by Helmholtz, by means of which the interior of the 
eyeball can be illuminated and examined. 

The wall of the eyeball consists of three coats. 
The inner coat, or retina^ contains the terminals 
of the optic nerve, or rods and cones, which are 
the only structures in the body capable of receiving 
and transmitting to the brain for interpretation the 
vibrations of light ; the middle, or choroid, is remark- 
ably rich in blood-vessels for the supply of the com- 
ponent parts of the eyeball ; and the outer coat, or 
sclerotic, is protective. 

The sclerotic is fibrous and firm, and to it are 
attached the various small muscles which bring about 
the movements of the eyeball. It is white in colour, 
with a faint tinge of blue, and forms the " white 
of the eye." 

The front part of the sclerotic presents a nearly 
circular window, filled in by a thick membrane, as 
transparent as glass and bulging slightly more than 

215 



THE HEAD AND NECK 

the sclerotic. This is the cornea, and through it rays 
of Hght pass to the interior of the eye. In addition 
to its transparency, the cornea differs in certain other 
respects from the sclerotic. It is, in the first place, 
thinner ; in the second place, it bulges from the 
surface of the sclerotic because it is a segment of a 
smaller globe. It would not be quite correct to say 
that the cornea is circular, for it is slightly longer 
horizontally than it is vertically. 

The colour of the eye, which varies in different 
individuals, depends upon the presence of a pig- 
mented circular membrane behind the cornea, known 
as the iris. 

The iris might properly be described as a circular 
disc perforated in its centre. The perforation, how- 
ever, presents a most remarkable peculiarity ; it is 
capable of alterations in size. If the student brings 
a light suddenly in front of the eye he will notice 
that the aperture becomes smaller. If, on the con- 
trary, he places his hand partially over the eye 
BO as to cut off some light, he will observe that the 
perforation becomes larger. 

The perforation or aperture is known as the pupil 
of the eye. The iris, in addition to being responsible 
for the colour of the eye, produces also alterations 
in the size of the pupil, which are of supreme im- 
portance to the subject. 

The iris contains muscular fibres which are so 
disposed, in both a radiating and a circular manner, 
as to cause increase or decrease of the size of the 
pupil by their action. There are certain definite 
conditions which cause dilatation — e.g. when the sur- 
rounding light is obscured, when a distant object is 
being observed, and when the subject is under the 
influence of certain drugs. Belladonna is one of 

216 



THE HEAD AND NECK 

these, and no doubt it received its name from the dark 
large pupils it produces, which are commonly con- 
sidered beautiful, and which result from the contrac- 
tion of the radiating fibres in the iris or the paralysis 
of the circular fibres. 

The pupil is contracted and small during sleep ; 
also, when an object close at hand is being observed, 
and when the subject is under the influence of certain 
other drugs, of which opium is one. 

The iris contains pigment, which is variable in 
quantity and not in quality. If there is little pig- 
ment the eyes are lighter and bluer; if there is 
much pigment the eyes are dark. Occasionally there 
is no pigment at all, in which case the red colouring 
matter of the blood alone colours the iris. This con- 
dition of pink eyes, occurring in albinos, is asso- 
ciated with an absence of pigment elsewhere. The 
hair of such individuals is white, and the skin has 
a pinkish tinge. Owing to the absence of pigment 
their irides are too transparent, so that they do 
not like a bright light, and hide from it as far as 
they can. 

A large pupil will make the whole eye appear 
larger than usual. 

There is another cause, though a less important 
one, for the varying colour of eyes, namely, that 
the iris being thrown into folds radiating from the 
pupil the rays of light which strike it are reflected 
and refracted from it. Refraction implies the split- 
ting up of white light into the various primary 
colours, and it will be clear that this must be re- 
sponsible for much of the variation in the colour of 
irides and for some factors in that interesting and 
obscure subject " light in the eye." 

The student, if he make a close observation, will 

217 



THE HEAD AND NECK 

observe that the iris is not a flat surface, but is 
slightly curved forwards. 

Behind the iris, and filling up the pupil, is the 
lens of the eye, a transparent structure shaped like 
an ordinary magnifying glass. It is capable of 
alteration in its convexity, by means of the action 
of the small ciliary muscle situated within the eye. 

By alteration in the shape of the lens distant as 
well as near objects can be focussed upon the retina 
without the necessity for any change in the other 
parts of the eyeball. The power of thus altering 
the shape of the lens lessens Tvith advancing years? 
so that old persons find they can read print more 
readily when it is held well away from the eyes. 
The explanation of this phenomenon is as follows: 
In the old, the lens tends to become set for dis- 
tant vision only, i.e. for parallel rays of light. Only 
parallel rays fall upon the lens in such a manner 
as to be accurately focussed on the retina ; and it 
is in the effort to produce as much parallelism as 
possible that the old man holds his paper as far off 
as the length of his arm will allow, and sometimes 
increases the distance yet more by the backward 
bending of his head and spine. 

Between the lens and the cornea is the anterior 
chamber, filled with transparent aqueous humour. 

Behind the lens lies a second and larger chamber, 
which contains the transparent vitreous hum^our. 

All these parts, which go to make up the internal 
structure of the eye, would be useless if the eyeballs 
could not be moved. Their movement is brought 
about by six tiny muscles in each orbit. They 
all, with the exception of the smallest, arise from 
the back part of the orbit, and pass forwards to 
their destinations in the white sclerotic coat. 

218 



THE HEAD AND NECK 

The four recti muscles, superior, inferior, external, 
and internal, are attached to these aspects of the 
eyeball a little beyond its centre of rotation. The 
smallest, or inferior oblique muscle, passes from the 
inner side of the front of the floor of the orbit, and 
is attached behind the centre of rotation. The fifth, 
or superior oblique muscle, passes from the back of 
the orbit to a little sling or pulley situated at the 
junction of the inner wall and roof of the orbit in 
front. The tendon of this muscle passes round the 
pulley, and is attached to the upper surface of the 
eye behind its centre of rotation. 

The individual actions of the internal and external 
rectus are simple. The internal rectus rotates the 
eyeball inwards, while the external rectus turns it 
outwards. When the eyeballs move together to one 
side, the external rectus of the same side and the in- 
ternal rectus of the opposite eye are acting together. 
Such a system of interaction between two muscles of 
different sides is called "co-ordination." This parti- 
cular co-ordinated movement is controlled by a special 
collection of nerve cells in the brain. 

The other muscles have a more complicated action, 
but it will be sufficient to state here that the eyeball 
is rotated upwards by the simultaneous action of the 
superior rectus and the inferior oblique, and is rotated 
downwards by the inferior rectus and the superior 
oblique acting together. 

The co-ordination of these groups of muscles acting 
on each eyeball must be a very complicated matter. 
How much more complicated, then, the familiar and 
well-known action of making limbs and eyes act 
together in games or other actions of precision, 
e.g. shooting, cricket, and golf. The popular phrase, 
" a good eye," implies almost perfect co-ordination 

219 



THE HEAD AND NECK 

between, and cerebral control of, the movements of 
very many muscles in the limbs, trunk, and eyes. 

Squinting is a consequence of independent action 
of the muscles of the eye, their proper co-ordination 
being temporarily or permanently suspended. Many 
persons are incapable of turning both eyeballs simul- 
taneously outwards, though most persons can turn 
them both inwards, and indeed do so frequently. 



<^x^^'c> 







m 



A B 

Fig. 83— Compare these two drawing's. The ang-le formed by the 
Columna nasi with the upper lip is very different. 

When the eyes are accommodated for very near 
vision, they look decidedly inwards, as in reading 
small print held close to the eyes. 

It may be added that in sleep the eyeball is rotated 
on a transverse axis upwards ; the eyelids are slightly 
separated from each other, and only a small lower 
part of the cornea can be seen through the palpebral 
fissure. 

In death the eyelids are widely separated, the 
cornea becomes dull, and the pupil semi-dilated. 

220 



THE HEAD AND NECK 

The Nose is the most prominent part of the 
face. Its root is situated between the two eyes and 
is continuous with the forehead. Its varying shape 
in different individuals is due to several factors, which 
will be described later (Figs. 83 to 88). 

The nose is narrower and depressed at its 7^oot, and 
more prominent at its lower end, the front part of 



'¥\ 




S 





Fig. 84. Rg. 85. Fig. 86. 

Various Types of Nose. 

which is named the tip^ while the lateral parts are 
called the alee. 

The broadening at the lo^wer end is due to the 
opening of the nostrils, or anterior naj-es, bilateral 
orifices through which air passes into the nasal cavity 
and thence to the windpipe. 

The nose is supported by both bone and cartilage — 
or rather by either bone or cartilage, for where the 
bone supports the nose there is no cartilage, and vice 
versa. The bony framework lies chiefly at the root 
of the nose, the cartilaginous nearer the tip. 

Thus the support of the bridge is formed by the 

221 



THE HEAD AND NECK 

nasal bones and the nasal process of the superior 
maxilla, assisted by the spine of the frontal bone. 
This part of the nose, being fixed to the skull, is 
immovable. 

The lower part of the nose is supported by car- 
tilages, and is movable, and in the skeleton it is 
absent. The cartilages, just under the skin, are four 
in number, two on each side. They lie in apposi- 
tion with each other in the mid-line, and the median 
groove between them can often be seen on the front 
of the tip. 

In addition to these cartilages, the nasal septum^ 
which divides the cavity of the nose into two parts, is 
also partly cartilaginous. It is cartilaginous where it 
forms the substance of the columna nasi, separating 
the two nostrils, and is covered by superficial fat 
and skin. By the presence of these stiffenings of 
cartilages the nostrils are kept open. The lateral 
cartilages are attached only by fibrous tissue to the 
adjacent superior maxillary bone, and are responsible 
for the slight bulge at the lower part of the lateral 
aspects of the nose. 

The orifices of the nasal chamber, known as the 
nostrils or anterior nares, look almost directly down- 
wards. 

Sometimes the nostrils are much narrower than is 
usual or natural; in such cases the subject will be 
found to breathe almost entirely through his mouth, 
which he keeps constantly open. 

The nostrils produce a bulging on each side of the 
lower part of the nose, and owing to the action of 
some tiny muscles these bulgings become more pro- 
minent during the action of respiration, especially 
if at all forced, as in distress of beathing. 

There is always a slight depression, or fossa, to 

222 



THE HEAD AND NECK 

be felt at the junction of the root of the nose with 
the forehead. Below this fossa the nasal bones may 
descend almost vertically from the frontal bone ; or 
they may be inclined more obliquely forwards, when 
the result is a prominent bridge (Figs. 84, 85, p. 221) ; 
or the nasal bone may be sunk in, either as a con- 
genital defect or following upon accident or disease, 
in which case the bridge is very much depressed and 
the nose is said to be " snub." 

The nostrils are separated by a median partition 
or columna, which is the anterior end of the septum 
dividing the right and left nasal chambers from each 
other. It is also continuous with the central part 
of the upper lip, which may by its means communi- 
cate slight movement to the tip of the nose. 

Hairs project from each nostril, especially, it is 
said, in the very strong. Those in front are directed 
backwards as well as downwards ; those behind have 
a forward as well as downward direction. This 
arrangement produces a very efficient filter, which 
guards against the entrance of some gross impurities 
from the air. 

The tip of the nose is sometimes red, rough, and 
blotchy, owing to cold, indigestion, or other causes. 
It varies much in shape — pointed, flattened, bulbous, 
and almost bifid varieties frequently running in 
families (Figs. 83 to 88). Age often has much to do 
with the shape of the nose ; a prominent bridge is rare 
in childhood, but a cunning tip-tilt is common. Note 
also another characteristic which runs in families, 
and that is the extent to which the columna nasi is 
visible in profile (Fig. 83 A and B, p. 220). 

The Mouth is as important an object in the 
study of expression as the eye. Just as the an- 
terior nares form the entrance to the large nasal 

223 



THE HEAD AND NECK 

cavities, so the mouth, surrounded by the lips, is the 
entrance to the large buccal cavity which contains 
the tongue and teeth (Figs. 87 to 92). 

There is a great distinction between the shapes of 
the upper and lower lips. 

The lips of a well-formed mouth that is unspoiled 
by bad usage exhibit curves which are certainly 
among the most beautiful features of the face, and 
as certainly they are among the most difficult to 
describe adequately. It is not too much to say that 



■■'-^ 






Fig. 87. —Nostrils and Mouth. 



Fig. 88.— Dimpled face of Smiling Child. 



a child's mouth, which has not been pulled out of 
shape, is that part of the face which best repays close 
inspection (Fig. 88). 

The t^vo lips occupy rather different planes, the 
upper one, as a rule, projecting farther forwards 
than the lower (Figs. 89, 90). 

The lips consist of muscle and a little fat, with a 
covering of skin and red mucous membrane. 

The cutaneous surface of the upper lip shows a 
centi^al vertical depression, beginning above at the 
septum of the nose, and terminating, after expand- 
ing a little, below, immediately above the middle 

224 



THE HEAD AND NECK 

of the red margin of the lip, which here is rather 
prominent (Fig. 87). 

On each side of the depression is a ridge passing 
vertically downwards from the inner side of each 
nostril towards the upper lip. 

The curved line of demarcation between the skin 
and the mucous membrane of the upper lip may be 
traced on each side from the middle line, where it is 
slightly depressed. It then turns upwards, and with 
a magnificent sweep downwards, nearly reaches the 
corner of the mouth, before it again passes somewhat 
upwards for a brief space. This lateral part is well 
seen in profile to lie below and behind the central 
part (Figs. 89 to 91). 

The edge of the red margin, which actually bounds 
the oral fissure or chink between the closed lips, 
begins in the mid-line at the papilla, and passes 
outwards and upwards, then slightly downwards, 
and then upwards again, to reach the angle ; but the 
curves here are not so pronounced as in the upper 
line of demarcation between skin and mucous mem- 
brane. The visible red area of the lightly closed 
lips is broadest in the middle, and dwindles away to 
nothing at the angle. 

The line of demarcation between the skin and red 
mucous membrane in the lower lip lies in a nearly 
horizontal plane, but as it projects forwards in pro- 
file it is directed slightly downwards (Fig. 90). The 
edge which bounds the chink between the closed 
lips is concave upwards, and consequently the oral 
fissure is convex downwards in the middle third, and 
concave downwards on each side of this (Fig. SS) 
Lips vary very greatly in different races, and even 
in different ages and sexes, and are valuable ex- 
ponents of character. We expect more fulness in 

225 P 



THE HEAD AND NECK 

youth, and are not surprised if in old age vertical 
wrinkles occur from wasting and withdrawal of 
support by loss of teeth (c/. Figs. 89, 90, and 75, 91). 

The Chin.— The face terminates below in the chin, 
which is peculiar to the human being, but varies 
much in shape. 

The chin is supported by the front part of the 
lower jaw, or mental protuberance, and like it may 
be pointed or square, prominent or retreating ; occa- 



^^5^ 



\^ 




Fig. 89. Fig. 90. 

Bloutb and Chin. 



sionally, especially in broad chins, it may be sur- 
mounted by a central small pit of varying depth. 

A deep transverse furrow separates the chin from 
the mouth (Fig. 90). 

Very often, although not by any means always, 
the chin is a good indication of character. 

Many men lack a good development of chin, and 
grow a beard to cover this deficiency. With their 
beard on they may have a strong face ; without it, a 
weak one. 

It may interest the student to consider the associa- 
tion of a small chin and weak character. If he will 

226 



THE HEAD AND NECK 



take the trouble to notice a man who has recently 
passed through a great physical struggle, he will find 
that the jaw is dropped, as if even the facial muscles, 
and the muscles of mastication, were tired. He is 
so tired and breathless that he cannot even keep his 
mouth shut. He is not in a position now to force 
home arguments, even to a child. His appearance 
of strength has gone. 
Depression of the jaw, 
then, is associated with 
great physical exertion 
and fatigue, so that the 
man is no longer quite 
himself. Depression of 
the jaw leads to an ap- 
parent retraction of the 
chin. The small chin is, 
therefore, associated in 
our minds with the man 
who is wanting in de- 
cision and in strength 
of character, because the 
depressed jaw is seen 
in the man who has not 
the physical force to 
make his will prevail. 

The hair of the face deserves more than the 
passing consideration which can be given in these 
pages. First, be it observed, the man who can grow 
a good beard cannot necessarily groAV a good mous- 
tache. The moustache varies very much. Some- 
times it curves downwards, sometimes forwards, 
sometimes upwards. Sometimes it may appear 
asymmetrical. Sometimes, even in a young person, 
it may be different in colour from the beard. 

227 




Fig. 91.— Furrows around Mouth, 
CMn, and Neck. 



THE HEAD AND NECK 

Below the eyes^ that part of the face known &3 
the Cheek bulges a little forward in the average 
well-nourished adult. In the infant the bulging is 
more pronounced, owing to the presence of a mass of 
fat called the " sucking pad " (Figs. 92 and 93). 

The emaciated may actually become "hollow- 
cheeked," and then the zygomatici and other facial 
muscles may be identified when in action. 




\ 



Fig. 92.— Head and Neck of Fig. 93.— Child Sucking Thumb. 

Baby. 

In edentulous or toothless persons the alveolar 
margins of the jawbones, which formerly contained 
the teeth, waste and the cheeks fall in (Fig. 75). The 
changes which the face undergoes with advancing 
age will be dealt with more fully in a succeeding 
chapter (p. 264). 

The ear, the organ of hearing, consists of special 
sense as well as transmitting parts. The former 
or inner ear, and half the transmitting part or 
middle ear, lie deeply buried in the bones at the base 
of the skull, and fortunately the study of these is not 

228 



THE HEAD AND NECK 



expected of the art student, for they are extremely 
complicated. 

The remaining half of the transmitting part, 
namely, the auricle and meatus, together constituting 
the external ear, forms a prominent object on the 
side of the head, and claims the attention of the art 
student (Fig. 94). 

It should be noticed how well adapted the auricle 
is for collecting the waves of vibration which, when 






M i 



Fig. 94.— Different Types of Ear. 



transmitted to, and interpreted by, the end organs 
of the auditory nerve in the inner ear, constitute 
sound. In respect of this function, however, the 
human auricle falls below that of certain of the 
lower animals, to whom hearing is of even greater 
importance than it is to man. They have not only 
larger but also more mobile auricles. 

There is a little eminence on the curled-over edge 
of the auricle which is known as Darwin's tubercle 
(Fig. 94 b), after the great naturalist who was the 
first to explain its significance. It is said to be more 

229 



THE HEAD AND NECK 

marked in members of the criminal classes. It is 
held to represent the extreme point of the auricle 
in the long-eared horse and ass, and thus to form 
one of the indications of the descent of man and 
beast from a common ancestor. 

If the student will further observe the auricle of 
such an animal — for example, the horse — he will 
notice that it is capable of extensive movement. 
Owing to this great range of mobility, the open orifice 
of the funnel can be directed towards the back, side, 
or front of the animal, and thereby sounds can be 
collected from all quarters much more efficiently 
than by the fixed human organ. These movements 
are brought about by muscles which, in man, having 
undergone involution, are very tiny, and indeed 
quite rudimentary. Upon only a few members of 
the human species is the power of moving the 
auricle bestowed. Yet small muscles can be found 
by dissection of any auricle in exactly the situations 
to be expected. 

One lies above the auricle, another behind it, and 
another in front of it. There are also some minute 
muscles lying on the auricle itself. All of them 
are, as one would expect, supplied by the seventh 
or facial nerve, because that is the nerve specially 
destined for the supply of all the muscles of expres- 
sion. The student will quickly call to mind the very 
obvious infiuence produced by the movements of its 
ears upon the expression of a horse or a donkey. 

The rigidity of the auricle, and the fact that when 
it is forcibly bent down it will recover its shape as 
soon as the pressure is released, indicate that it has 
some form of strong framework which is not bony. 
The support is afforded by a strip of cartilage folded 
upon itself and fixed within a bony orifice upon the 

230 



THE HEAD AND NECK 

outer surface of the temporal bone, known as the 
external auditory meatus. 

The cartilaginous support of the ear is immediately 
under the skin, which is very thin in this region, 
there being no fat except in the lower extremity or 
lobule. For this reason, and because it is apt to get 
compressed against the hard skull, bruising is pecu- 
liarly frequent upon the ear. An unsightly swell- 
ing results, and has been depicted in ancient statues 
of boxers. 

The external ear varies very much in size, in degree 
of prominence, in shape, in quality of skin, and even 
in colour. 

Maltreatment during development is prejudicial to 
the beauty of any feature, and the auricle suffers 
perhaps as often and as much as any. 

The bony parts in immediate relation to the external 
ear are as follows : — 

Behind it is the mastoid process ; in front of it is 
the ramus of the mandible, while below there is a 
deep hollow, which is to some extent filled up by 
the upper part of the sterno-mastoid muscle. 

The auricle has various named parts. Thus the 
part hanging downwards, which is thicker and softer 
than the rest of the ear, is known as the lobe or 
lobule. Its substance is fatty, and it contains no car- 
tilage. The lobule usually hangs free at its posterior 
and inferior edges, but is attached in front to the 
cheek and above to the auricle. It may be very large 
(Fig. 94 A and b), and may then have a free anterior 
edge as well ; or it may be very small (Fig. 94 c), and 
hardly separable from the rest of the auricle. 

This is the part of the ear which is perforated for 
ear-rings, and certain races specially cultivate it for 
supposed aesthetic reasons, hanging weights upon it 

231 



THE HEAD AND NECK 

for the purpose of increasing its length. Ear-rings 
have been considered a relic of this barbarous prac- 
tice. 

Above the lobule is the concha, a wide open depres- 
sion which leads to the external auditory meatus. 

The incurved margin of the ear, which begins below 
and behind at the lobule and curves round the ear 
to the middle of its anterior border, is the helix. 
"Darwin's tubercle" is situated in the upper and 
back part of this margin. 

The concha is bounded at its upper and back part 
by a ridge known as the antihelix. The ridge bifur- 
cates at its uj)per extremity, and is separated from 
the helix by a depression, somewhat in the shape 
of an elongated pear bent upon itself, called the 
scaj^hoid fossa. 

The concha is prolonged downwards into a little 
bay, whose boundaries are the tragus anteriorly, and 
the antitragus situated at the back. The little bay 
has the name of the incisura intertragica. 

Just above the tragus, and slightly in front of it, 
the crus helicis forms a prominence directed back- 
wards into the fossa of the concha. There is no 
cartilage between this part of the helix and the 
tragus. 

The auricle is apt to become red in cold weather, 
and it takes a part in the general reddening of the 
face known as blushing. 

Large ears are often prominent. Ears may be 
nearly triangular in shape, broad above and narrow 
below. There may be hardly any lobule developed 
at all, and it may be closely attached to the side of 
the head. 

Upon the back part of the side of the face a massive 
quadrate swelling is formed by the masseter muscle 

232 



THE HEAD AND NECK 



(Fig. 95), lying on the angle of the jaw. Its promin- 
ence is much more noticeable when the jaws are 
clenched, and it can then be seen passing between the 
mandible near its angle and the zygomatic arch. 

The outline of the contracted muscle may be some- 
times obscured in the glutton by the over-develop- 
ment of a tongue-like lobe 
of the parotid gland, which 
lies horizontally upon the 
surface of the masseter. 

In a face which has clearly 
cut and well-marked fea- 
tures, the following points 
should be noted by the 
student. There is a well- 
marked furrow, running 
from a point just below the 
inner angle of the eye, down- 
wards and outwards, well 
on to the cheek. There is 
a second furrow below, and 
nearly parallel, continuous 
above with the fossa above 
the ala of the nose, and 
curved downwards below to 
pass just outside the angle 

of the mouth. Between these two furrows is the 
naso-]abial fold. There is a third furrow passing 
in a curved direction downwards and outwards 
from the angle of the mouth. The furrows, or 
wrinkles, best seen in old people at the sides of 
the eyes, lie at right angles to the fibres of the 
orbicularis palpebrarum, and thus are disposed in 
a radiating manner. 








Fig. 9- 



-Muscles of side of Head, 
Face, and Neck. 



M=Masseter. Inset of Jaws showing :— 
B. Origin of Buccinator. 
M. Insertion of Masseter. 



233 



CHAPTER X 

EXPRESSION AND GESTURE 

The important subject of Expression and Ges- 
ture must now engage the student's attention. 

Those ^vho are intimate with the habits and in 
sympathy with the affections of the lower animals 
will be aware of the great part which is played, not 
only by the face but by the whole body, in the 
expression of various emotions. A very familiar ex- 
ample of this is the attitude and actions of the tail 
and the ears in the dog, and the different posi- 
tions they assume according to whether the animal 
is pleased or otherwise. In the human species few 
except actors make much use of the possibilities 
we still possess, in spite, of clothes, for the expression 
of our emotions by gestures of the head, trunk, and 
limbs, so that the body has come to play a much 
smaller part in emotional expression than it does 
in some animals. But the variations in the form 
of the face which betray different mental conditions 
are greatly in advance, both in variety and degree, of 
those of most of the lower animals, possibly for a 
similar reason — viz. that our face is not covered with 
hair as theirs is. 

Figure 96 and Figure 100 exemplify better perhaps 
than words can explain some of the minutiae which 
produce the obvious differences in expression. The 

234 



EXPRESSION AND GESTURE 

one shows depression and grief, perhaps long con- 
tinued ; the other, pride and good health. 

In the space at our disposal only a very short 
account can be given of this complicated subject. 
To begin with, we must surely recognise that while 
there is infinite variety, and no two faces are exactly 
alike, yet there are very definite and distinct tyjpes 
of face. Next, that, given any particular face, its 
expression will vary much from time to time. And 
lastly, that each variation of expression will depend 
upon alterations of the surface form, and that these 
alterations are caused by the contraction or relaxa- 
tion of the facial muscles. The facial muscles are 
small, because they have not got to move heavy 
bones, therefore they are rarely capable of being 
identified through the skin, and they are supplied 
by the facial, or seventh pair of cranial nerves. Of 
these muscles there is an exceedingly good dissection 
in the Hunterian Museum at the Royal College of 
Surgeons. These muscles are developed in connec- 
tion with, and are capable of pulling upon and so 
altering the shape of, one or other of the orifices 
of the face — the ear, the nose, the eye, but especi- 
ally the mouth — and so influencing the expression. 

The muscles which converge upon and surround 
the mouth may first be considered. 

The orbicularis oris (Fig. 95, p. 233) surrounds the 
oral fissure much in the same way that the orbicu- 
laris palpebrarum lies disposed around the palpebral 
fissure. This muscle forms in great part the mass 
of each lip, and has its fibres arranged in parallel 
and concentric circles. But it has an intimate con- 
nection with other smaller muscles whose fibres 
blend with its own. Not only do these muscles 
pass into the orbicularis, but they send a variable 

235 



EXPRESSION AND GESTURE 

number of their fibres into the overlying skin, and 
so contribute materially to the infinity of small 
differences which characterise each individual face. 
They are very numerous, twenty in all, ten on each 
side of the face. Their insertions, either to muscle 
or skin, are extremely movable, whilst their origins 
are fixed to bone. They are as follows : — 

1. Levator labii superioris. 

2. Levator anguli oris. 

3. Levator labii superioris alseque nasi. 

4. Zygomaticus major. 

5. Zygomaticus minor. 

6. Buccinator (the largest). 

7. Risorius. 

8. Depressor labii superioris. 

9. Depressor anguli oris. 
10. Levator menti. 

If the name is long there is this compensation, that 
in most cases it tells you the attachments or action 
of the muscle. 

The huccinatoi^ (Fig. 95, p. 233), the sixth muscle on 
the list, is a thin sheet which blends in front with the 
muscles at the angle of the mouth. It arises behind 
from a D -shaped area of the jawbones correspond- 
ing to the three molar teeth. 

The muscles numbered from 1 to 5 on the above 
list lie above and in front of the buccinator, the 
others below and in front. 

The levator labii superioris (Fig. 95, p. 233) passes 
from just below that part of the infra-orbital margin 
which is formed by the superior maxillary bone to 
the upper lip. 

The levator anguli oris lies chiefly under cover of 
the last-named muscle, and passes from the superior 

236 



EXPRESSION AND GESTURE 

maxilla to the angle of the mouth. The two latter 
muscles are those which raise the angle of the mouth 
and the upper lip. If the student makes this obser- 
vation himself, he will notice that this action is in- 
variably accompanied by the raising of the nostril 
on the same side. This is due to the fact that there 
is a small muscle with a long name (No. 3 on the 
list), which passes from the side of the nasal process 
of the superior maxilla, and which is inserted not 
only into the upper lip, but also into the ala of 
the nose. 

The zygomaticus minor passes from the anterior 
part of the outer surface of the malar bone to the 
upper lip. The zygomaticus major passes from the 
posterior part of the outer surface of the malar bone 
to the angle of the mouth. 

The buccinator, as has been mentioned, passes to 
the corner of the mouth. The student should notice 
that it lies on a deeper plane than the other muscles. 
It supj)orts the cheek and prevents food from collect- 
ing between the teeth and the inside of the cheek. 

The risorius (Fig. 95, p. 233) passes from the side of 
the cheek to the angle of the mouth, and lies in a 
slightly curved horizontal plane. By its contraction 
it draws the angle of the mouth backwards. 

The depressor anguli oris passes from the inferior 
margin of the mandible to the angle of the mouth. 
The depressor lahii inferioris passes from under cover 
of this muscle to the lower lip. 

The levator menti has only an indirect action upon 
the shape of the mouth, for it passes from that part 
of the mandible which lies below the incisor teeth to 
the skin on the chin. Its action is to raise the chin, 
and so it helps to protrude the lower lip. 

Two of the muscles which surround the eye have 

237 



EXPRESSION AND GESTURE 

already been described (p. 213), viz. the orbicularis 
palpebrarum and the levator palpebrse superioris. A 
third, the corrugator supercilii, lies under the inner 
portion of the upper part of the orbicularis palpe- 
brarum. By its contraction the skin of the lower 
and middle part of the forehead is thrown into 
vertical or oblique folds. 

The muscles of the nose are as follows : — 

The 'pyramidalis nasi lies on the upper part of the 
nose, and is really a part of the orbicularis palpe- 
brarum. 

The compressor naris passes from each side over 
the lower half of the nose. 

The depressor alee nasi passes from the superior 
maxilla above the incisor teeth to the septum and 
alse of the nose. 

There are also two feeble muscles known as 
dilatores naris, placed on the outer side of each 
nostril. 

The expression of the emotions is chiefly effected 
by varied combinations of these facial muscles. But 
there are other factors, such as the state of con- 
traction or relaxation of the blood-vessels in the 
skin, and the secretion of certain glands, such as 
tears or perspiration. 

Blushing. — This is due to the increased flow of 
blood through the superficial vessels, especially of the 
face, external ear, forehead, and neck. The shoulders 
and chest, and even the whole body, may participate 
in the general flush of the skin. 

Blushing must be distinguished from hectic, in 
which the face is usually dra^wn and pale, with a 
scarlet flush on each cheek ; it must also be dis- 
tinguished from the rubicund face associated with 
good health, sunburn, or chronic alcoholism, when 

238 



EXPRESSION AND GESTURE 

the nose especially is red and bloated, and small 
superficial veins appear on the skin, chiefly at the 
margin of the nose. 

Secretion of Tears. — The tears, the popular name 
for the lachrymal secretion, come in regular, never- 
ceasing supply from the lachrymal gland, situated 
under cover of the outer and upper angle of each 
orbit. This lachrymal secretion enters the upper 
and outer part of the conjunctival sac, and when 
the quantity is not excessive it is conducted by the 
movements of the lids to each punctum, and from 
thence into the nasal cavity via the canaliculi and the 
lachrymal canal. The secretion of the lachrymal 
gland, and probably of all glands in the body, never 
quite comes to a standstill, but any normal amount 
is carried away by the lachrymal canal, and evapo- 
rates in the nasal cavity, an important function of 
which is to moisten and warm the inspired air before 
it reaches the lungs. 

An abnormally brisk secretion, however, is apt to 
prove more than the lachrymal canals can carry 
away, and then, as in exposure to high winds or 
other irritation, or the presence of a foreign body 
m the eye, the tears roll out of the palpebral fissure 
and down over the face in drops of various size ; 
and similarly in grief. 

Secretion of Stceat. — Cold-blooded animals are not 
provided with the means of maintaining an even 
body temperature in the face of considerable altera- 
tions in the temperature of their surroundings. 
Warm-blooded mammals, on the other hand, are so 
provided, and the complex co-ordination of functions 
which is necessary to achieve this very desirable end 
is more efficient in the human than in any other 
species. Energy is defined as the power to do work, 

239 



EXPRESSION AND GESTURE 

and no organ in the body — indeed, no living cell, 
whether of nerve, gland, muscle, or bone — can do any 
work without setting free some heat. Every living 
body is therefore constantly generating heat, some- 
times less, as during rest and starvation, sometimes 
more, as during exercise and plethoric feeding. The 
surrounding medium is sometimes so much colder 
than the body that much heat is abstracted from the 
surface of the body — as in the case of prolonged 
immersion in a cold bath, or of exposure to cold air. 
This condition is promptly met by the withdrawal of 
blood from the surface, with resulting pallor and dry- 
ness of the skin. Sometimes, on the other hand, the 
air is so much hotter than the body that the latter 
would actually be raised to fever heat, or even to boil- 
ing {e.g. in a Turkish bath), if blood was not promptly 
supplied in excess to the skin, and the sweat-glands 
stimulated to pour forth moisture, the evaporation of 
which cools the surface. A dog cannot sweat, and 
therefore exposes as much moist surface as he can to 
evaporation on a hot day by hanging out his tongue 
and " panting " air to and fro over it. 

The average temperature of the body of a large 
Qumber of human beings in health is found by obser- 
vation to be 98.4° F. — rather lower in the morning and 
rather higher in the evening. And within a degree or 
two of this normal we are enabled, by a very deli- 
cate nervous adjustment between the heat-producing 
(especially the muscular) and the heat-losing (espe- 
cially the cutaneous) systems, to maintain an equi- 
librium in spite of very considerable extremes of 
tropical heat and arctic cold. Only when so much 
sweat is secreted that it cannot evaporate off the 
surface of the skin as quickly as it oozes from the 
millions of mouths of the sweat-glands, does it 

240 



EXPRESSION AND GESTURE 

accumulate into visible drops and the subject is 
commonly said to " perspire " or " sweat," though as 
a matter of fact we are unconsciously perspiring 
every minute from our birth to our death, and 
cannot live many days if this function of the skin 
is abolished. Visible sweating occurs also in certain 
mental states, e.g. the fainting condition, and great 
fear, and that is Tvhy some explanation of the 
phenomenon has been offered here. 

The phenomena of blushing and its opposite, pallor, 
the escape of tears, and the accumulation of sweat 
on the skin of the face, are associated Tvith many and 
various expressions, but the actual production of 
these expressions is chiefly brought about by the 
action, or want of action, of the small muscles of the 
face, of which the attachments have just been con- 
sidered, together with the action, or want of action, 
of those larger muscles, and especially the masseter 
and the platysma, which move the lower jaw. 

The student's attention has already been drawn to 
the fact that the form of the body and limbs in man 
differs from that of the lower animals in the follow- 
ing essentials : — 

(1) The relatively large size and arched shape of 
the foot, because of its increased importance in the 
erect attitude. 

(2) The large size of the buttocks, which has a 
similar explanation. 

(3) The breadth of the chest. 

(4) The extent of the movement permitted in the 
joints of the upper limb. 

(5) The power of opposition of the thumb, and 

(6) The large size of the head. 

But these characteristics of the human form are not 
more marked than the differences which exist in the 

241 Q 



EXPRESSION AND GESTURE 

capacity for variation of expression, by means of the 
facial muscles, between man and the lower animals. 
And for him who would master the finer gradations 
of those expressions a careful and detailed study of 
the origins of the small muscles of the face will 
well repay the labour involved. 

The facial muscles can be divided into groups sur- 
rounding the various orifices, viz. the palpebral, buccal, 
and nasal apertures. Each group may be subdivided 
into those muscles which by their action close the 
particular orifice and those which open it. Let us 
take as an instance the expression of mirth or 
laughter. We see at once that the lips and the 
angles of the mouth are widely separated, and thus 
the shape of the buccal orifice tends to assume a 
quadrilateral form as in the Mask of Comedy. The 
teeth are exposed unless, perchance, the individual 
happens to have very bad ones, when the natural 
expression will be vitiated by an unnatural and con- 
scious and constrained effort to attempt to conceal 
this blemish, revealing at once some element of self- 
consciousness in the expression of mirth, an expression 
which in its ideal form is entirely unconscious, or at 
least involuntary. Some wrinkling will occur round 
the eyes, and the eyelids be drawn upwards owing to 
the action of "orbicularis palpebrarum," and there 
will be some drawing upwards of the angles of the 
mouth and of the whole of the side of the face, caused 
by the action of the zygomatici ; and indeed, if the 
expression stops at a smile short of laughter, the 
characteristic upward pulling of the angles of the 
mouth is due chiefly to these muscles. 

In the expression of grief (Figs. 96 and 97) the 
opposite of each of the actions which produce laughter 
is seen ; the angles of the mouth, and indeed the whole 

242 



EXPRESSION AND GESTURE 

of the substance of the cheek, is drawn downwards. 
The corrugator supercilii draws the eyebrows inwards 
and produces a vertical wrinkling at the root of the 
nose ; the lower jaw droops, and so do the eyelids ; the 
lips are slightly separated from each other. To take 



m 





Fig. 96.— SorroT^. 



one more instance, viz. the expression of pain, the 
mouth is either slightly opened or firmly closed ; its 
angles are either drawn together or retracted ; the 
jaws and gums are firmly clenched ; and soma frown- 
ing is produced again by the corrugator supercilii. 
In the case of fear the chief play of the muscles is 
seen in the parts surrounding the eyes and the mouth. 
The eyes are widely opened, fully exposing the " white 

243 



EXPRESSION AND GESTURE 

of the eye " ; the eyelids are raised by the occipito- 
frontalis, and the forehead is wrinkled transversely 
The mouth is opened, but in a somewhat expression- 
less way ; and, be it noted, this opening of the mouth 
is not as great as the separation of the jaws, so 



> 




X 




Fig. 97.— Dejection. „ 

that the teeth are hardly, if at all, uncovered, 
whereas in the expression of grief or pain the upper 
teeth are apt to be shown. Terror (Fig. 98) is a \\l 
higher degree of fear, and is indicated by a knitting * 
of the forehead concurrently with an elevation of the 
inner or median part of the eyebrows, and the pupils 
are widely dilated. Despair expresses itself by re- 

244 



EXPRESSION AND GESTURE 

laxation not only of the muscles of the face, but also 
those of the whole body. Many other expressions 
will occur to the student as worthy of study and 
description, but our attempt has been rather to select 
typical ones and to remember that, as Darwin said, 
"In our estimate of any particular expression we 



Af 



i 



h 



*x^ 






'iSiiS^fr: 







Fig. 98.— Terror. 

are often guided to a much greater extent than 
we suppose by a previous knowledge of the person 
or the circumstances." Indeed, the subject is a very 
complex one, and its full consideration would involve 
an examination of the personality of the individual 
concerned in each instance. It has often been said, 
for instance, that guilt is rarely unassociated with 
some degree and expression of fear. There are, how- 

245 



EXPRESSION AND GESTURE 

ever, children who certainly have no sense of fear, 
yet present quite a guilty expression when reproved. 
Conversely, even the partial lowering of the eyelids, 
the shifty travelling of the eyes, and the blushing of 
the face must not convince us of their guilt, for it 
may well be that they are only afraid. Shyness is 
associated with a curious tendency to lateral move- 
ments either of the face alone or of the whole trunk. 
The question may be asked. Is this based upon an 
attempt on the part of the individual to avoid looking 
any facts or individuals in the face ? 

The shaking of the head from side to side which 
indicates the word " no," and the upward and 
downward movement of the head to express the 
word " yes," are familiar and interesting phenomena. 
These are the movements associated in infants with 
the refusal or acceptance of food, and it looks as if 
nature had stereotyped these movements to save 
herself from having to invent fresh expressions for 
dissent and assent in the adult. 

Professor Cleland gives an admirably concise de- 
scription of the expression of deceit. " The culprit 
sheltering himself by a lie hangs his head over his 
secret, while he steals upward glances to see the effect 
which he distrusts." Scorn, disdain, sneering", and 
defiance have, as Dar^n has pointed out, much in 
common. There is a slight raising of one side of the 
mouth so that the canine tooth is exposed ; the side of 
the nose is also slightly elevated, and this expression 
may easily pass into a smile. A young child's smile 
is always delightful to watch, and especially when 
talking with a " grown up," for then there is often 
just a trace of derision in it. In derision as in 
other expressions, many other parts of the mus- 
cular system besides the face are called into play, 

246 



EXPRESSION AND GESTURE 

to aid in the depiction of the mental state of the 
subject. 

The subject of " gesture," as these various secon- 
dary movements of the different parts of the skele- 
ton are called, is a very large one, and can but be 
hinted at here. Notice the aversion of the face by 







^ 
•<*/, 




r 



.iM"^" 



Fig. 99.— Anger. 

turning of the head in derision ; the shrugging of 
the shoulders in doubt, indecision, or depreciation ; 
the erect head of candour ; the bowed head of shame 
or great grief; the confident and decisive step and 
action of the whole body in conscious rectitude ; the 
shuffling gait of the Uriah Heap, and even the spitting 
of the affronted and slighted Shylock. Blushing, and 
the inability to keep the limbs quiet, particularly 

247 



EXPRESSION AND GESTURE 

the hands, are two characteristics of shyness or 
self-consciousness ; the eyes, too, are then turned 
downwards. Self-conceit is quite different from self- 
consciousness, and has totally different expressions 
and gestures, though both may be considered to be 







Fig. 100.— Self-appreciation. 



due to an over- estimation of the Ego. Sulkiness is 
generally indicated by pouting and frowning. Decision 
by firm closure of the mouth ; though, as we have seen, 
it is ati open question how far there is any ground for 
the popular impression that a massive chin goes with a 
strong nature. Sir Charles Bell drew attention to the 
role which the muscles of respiration play in the 

248 



EXPRESSION AND GESTURE 

production of certain expressions ; those which are 
dependent upon the firm closing of the mouth are 
usually associated with fixation of the chest in the 
position of full inspiration. The deep, long-drawn 
breath known as a sigh and associated with grief 
or despair, and the convulsive movement of the 




Fig". 101.— Suspicion. 



diaphragm, together with some degree of spasm of 
the laryngeal muscles, causing audible laughter, are 
notable instances ; and so, probably, is the slightly 
increased rapidity of breathing, together with dis- 
tinct raising of the alse nasi and compression of the 
mouth, so that the breathing takes place through 
the nose, in the expression of anger. 
The Teeth. — Voltaire has said that no woman can 

249 



EXPRESSION AND GESTURE 

be really good-looking who has bad teeth, and no 
woman who has good teeth can be considered ugly. 

The condition of the teeth is, indeed, an important 
factor in the appearance. The shape of the jaws and 




y^'.4^^^S?^. 







1. 



Fig. 102. —Anticipation. 



the play of the facial muscles is largely dependent 
upon their physiological perfection, and so in no less 
degree is the health, and the appearance of health, in 
the individual. It is therefore desirable that the art 
student should consider a few points in their develop- 
ment and anatomy. There are two sets of teeth 
which erupt from the gums at two distinct periods of 

250 



EXPRESSION AND GESTURE 

life The temporary or milk teeth begin to appear 
at about the sixth month, and are complete by the 
end of the second year. They are pearly white and 
translucent, but smaller of course than the perma- 
nent teeth, and as a general rule more narrow at 
the bases than at the cutting edge. There are 
five of them on each side in both jaws, and they 
are named from the middle line outwards : (1) 
central incisor, (2) lateral incisor, (3) canine or eye 
tooth, (4) first molar, and (5) second molar. There 
should be a, distinct gap between each of them. 
The temporary teeth are pushed out and loosened by 
the eruption of the permanent set, the first of which 
to appear is one of the molars, usually at about 
the sixth year. There are more permanent teeth 
than temporary, viz. thirty-two instead of twenty, 
or eight instead of five in each half of each jaw, 
and named from the middle line outwards : central 
incisor, lateral incisor, canine, first and second pre- 
molars, or bicuspids, and first, second, and third 
molars, of which the last is given the nickname of 
wisdom tooth because it does not erupt until about 
the eighteenth year. The most striking demonstra- 
tion of the effect of the teeth upon the appearance 
of the face is, of course, to be found when they are 
shed, and when, following upon their loss, the alveolar 
or tooth-bearing margin of the t^vo jaws is absorbed. 
The edentulous stage is then reached and the lower 
jaw has to modify its form considerably, so that 
its toothless gum may be approximated to the upper 
jaw, as seen in the elderly nutcracker type of face, 
a change in the skeleton which obviously must leave 
the soft parts covering the jaws in a baggy and 
wrinkled state. 

251 



CHAPTER XI 

DIFFERENCES OF SIZE AND PROPORTION 
IN THE SEXES 

The average female is smaller than the average 
male, and the only part of the skeleton which 
does not conform to this general rule is the pelvis. 
The muscles are usually not nearly so well marked, 
owing partly to their less vigorous use, but chiefly 
to the presence of a larger quantity of superficial 
fat, which is especially thick over the chest, the 
buttocks, the hips, and the thighs. 

The outline of the body of the female differs very 
much from that of the male. (Compare Fig. 103 and 
Frontispiece.) The narrow part of the body, or waist, 
of the female is situated at the level of the tenth or 
eleventh rib, and is therefore rather higher up than 
the narrow part of the male. Owing to the greater 
breadth of the female pelvis, the femora are more 
inclined towards each other at the knee than are 
those of the male. Hence the normal slight degree 
of "knock-knee," or genu valgum, is more obvious 
in females than in males. The limbs generally are 
more rounded and "shapely" in women than in 
men. The calves are more pronounced, the ankles and 
wrists more slender, and the instep more markedly 
convex in the female. 

The face is smaller in females than in males, and 
the comparatively small development of the occipital 

253 




Fig. 103.— Figure of a Female Skeleton, showing the characteristic narrow thorax hroad pelvis, aflo 
Increased liegree of " knock-knee," as compared with the Male 
The general glpndernesB of the bones should also be noted. 



DIFFERENCES OF SIZE AND 

and frontal regions of the skull in females is also to 
be noticed. 

But a comparison of the Plates at the end will 
demonstrate that the three most obvious differences 
between the male and female form are to be found at 
the waist, the pelvis, and the thigh. With regard to 
the waist, it will be remembered that between the 
costal margin and the pelvis the body has no bony 
support except that of the vertebral column at the 
back, the rest of the circumference at this level 
being composed of the soft tissues of the abdominal 
wall. In every normal subject, whether male or 
female, there is a distinct narrowing at this part of 
the trunk, which is named the Tvaist, or the "true 
waist." In the female, owing to the greater width 
of the pelvic bones, it happens that the narrowest 
girth is in the upper rather than the lower part of 
this unsupported interval, and therefore the waist 
is, or should be, at about the level of the costal 
margin ; the figure of the Venus of Milo is often 
named as an example of the correct proportion 
which the female figure should possess. 

The anatomical ivaist is found to be about equal 
to one and a half times the breadth of the head 
in either sex. It appears to be less than this in 
the female, because relatively and absolutely the 
breadth of the pelvis is greater in the female, and 
also because the concavity backwards of the lumbar 
spine is greater in the female profile. This increased 
tilting of the pelvis as seen in the female profile, 
besides making the waist more obvious, also makes 
the buttocks more prominent below. Further, the 
increased width of the pelvis separates the femoral 
trochanters more from one another and increases the 
width across the hips, and this increased massive- 

254 



PROPORTION IN THE SEXES 



ness is observable all down 
the upper two-thirds of the 
thigh ; it is contributed to, 
not by increased muscular 
development, but by a thick 
deposit of subcutaneous fat, 
so that while the greatest 
breadth of the male hips is 
at the level of the great tro- 
chanters, the greatest breadth 
of the female hips is at a 
slightly lower level. 

Relative Measurements in 
Children and in Male and 
Female Adults. — Although 
there may be a great fasci- 
nation for some minds in 
formulating elaborate rules 
for the accurate measure- 
ment and comparison of 
various parts of the body, 
the student of art anatomy 
will do well to remember 
that the more exact the 
measurements which are 
made upon one special in- 
dividual, the more liability 
to error is there if you 
attempt to lay down general 
rules therefrom. One can- 
not measure the parts of the 
human skeleton in milli- 
metres or quarters of an 
inch. The prominences and 
fossae which are taken for landmarks are not 

255 




Fig-. 104.— To show tlie Proper 
tions of the Male Body. 



DIFFERENCES OF SIZE AND 

" points," but surfaces too large to yield incontestably 
accurate observations. The position of a limb will 
alter its apparent length ; and the two limbs, more- 
over, may be, and frequently are, even in a normal 
individual, of unequal length, just as every face, 
every cranium, and every trunk is to some slight 
degree asymmetrical. 

It has already been pointed out that differences 
in the height of individuals are due chiefly to the 




Tig. 105.— To show the characteristic position of the head, body, and limbs 
of a child who is lying down. 



length of the trunk or to the length of the lower 
limbs. 

Professor Marshall took for his measurements 
a unit of nearly one inch, rather more than an 
inch in the male, rather less than an inch in the 
female. 

In the lower limb of a male subject the thigh 
measures 18, the leg 14, and the foot 9 units (Fig. 
104). 

In the female the thigh is still 18 and the leg 14 
but the foot is only 8 units. 

In the male upper limb the ai-m is 13, the forearm 
9, and the hand 7J units. In the female the corre- 
spondmg figures are 12^, 9, and 7^. 

The stature of the adult is equal to 7J heads. 

256 



PROPORTION IN THE SEXES 



The axial part of the body equals 4 heads, viz. : — 

1. From vertex to below chin. 

2. From below chin to lower end of the breastbone 

3. From lower end of breastbone to 
crest of ilium. 

4. From crest to below the tubero- MUik -^^^^y^i^ 
sity of the ischium (Fig. 104, p. 255). 

Other measurements which will be 
found useful are as follows : — 



/' 



1 



( 'A 



The head in both sexes is 6J units 
wide. 

The face in both sexes is 6 units 
wide. 

Breadth of the shoulders in the 
male is 18 units. 

Their breadth in the female is 17 
units. 

Breadth of the neck in the male is 
5 units. 

Breadth of the neck in the female 
is 4J units. 

The stature of the newly born 
child is equal to a little more than 
4 heads. 

The mid point of the stature is 
situated — 

1. At birth, a little above the navel 
(Fig. 105). 

2. At two years, at the navel. 

3. At ten years, on a level with the upper part of 
the femoral trochanters (Fig. 106). 

4. In the adult, on a level with the arch of the 
pubes. 

These levels emphasise the large relative size of 
the head of a child compared to that of an adult. 

267 B 



Fig. 106.— Child, 
Side view. 



DIFFERENCES IN THE SEXES 

The student will do well to remember this point, and 
should never make the mistake, as has frequently 
been made, in the portraiture of the mother and her 
child, of drawing the head of the child too small. 
Nor should he make the child's face intellectual ; full 
of expression, if he likes, may be the face he draws, 
but of intellect there is no indication at such an 
early age. 



258 



CHAPTER XII 

GROWTH, DEVELOPMENT, AND MEASUREMENTS 

Although special points about growth and develop- 
ment have already been alluded to in the chapters 
upon the anatomy of the adult, many others which 
will interest the art student yet remain. 

The somewhat lengthy dependence of the human 
infant upon his elders is noteworthy. Owing to the 
large size of the head, it is unusual for him to be 
able to sit up much before he is nine months old, to 
stand much before he is twelve months, or to toddle 
much before fifteen months. 

The new-born infant is frequently jaundiced, and 
his head bears the impress of the maternal passages 
through which he has passed. His head is often 
long and triangular, and markedly asymmetrical, and 
altogether not a very beautiful object. 

The infant, even when not being fed, purses up 
his lips and sucks as if his life depended on the 
sucking — as indeed it does — and to this end nature 
develops the cartilage of his lower jaw into bone 
earlier than anywhere else in the skeleton. 

At first he hardly notices anything, not even 
a bright light. The arms are long, compared 
with the legs ; the abdomen is large in comparison 
with the chest ; the buttocks are small, and the 
thighs somewhat flexed upon the trunk. The nails, 
which are fully developed before birth, are of a 
beautiful pink tinge. 

9AO 



GROWTH, DEVELOPMENT 

The measurements of the foot are very character- 
istic in an infant. Its greatest breadth is nearly, if 
not quite, half its length. The foot is a little flexed, 
and is turned in^vards at the ankle, and presents no 
obvious arch of the sole. 

The statement sometimes made that there is no 
bony arch is inaccurate. The bony arch of the 
young child is as well developed as that of the 
adult. But, owing to the large amount of sub- 
cutaneous fat, the external features of the arch are 
obscured. 

As the days pass the child pays a little more atten- 
tion to external objects, and is fascinated especially 
by a bright light. 

In the early days of infancy the child is, or should 
be, continually either sleeping or feeding. Later on 
he will begin to amuse himself by sucking his thumb 
or fingers. The child either sucks the thumb or two 
fingers. Nature has provided that the object sucked 
should be sufficiently large to fill up the orifice of the 
mouth. Thus the ball of the thumb is engaged in 
the mouth, and by this happy provision no air is 
sucked in by the side of the thumb. When the child 
sucks two fingers, the groove between them exactly 
corresponds to the portion of the central papilla of 
the lip, so that a minimum amount of deformity of 
the lip is produced. 

As yet no teeth are present. The cheeks are 
prominent with fat, forming the " sucking pad.' 
The lips are full, and deep red in colour. The back 
is straight; no secondary curves are yet developed 
in the spine ; only a generally convex one directed 
backwards is present in the first year of life. 

Constant motion, while awake, is the characteristic 
feature of the infant. Tears and laughter are rarely 

260 



AND MEASUREMENTS 

seen. He may wail, he may yell, but it is not 
till he is over two months old that he will begin to 
smile or actually to drop tears. He may very readily 
be made to smile after this age by placing the tip of 
the index finger upon both upper and lower lip at the 
same time. 

The muscles generally do not stand out well ; they 
have had little opportunity yet of developing, and 
there is an extraordinarily thick covering of fat under 
the skin. 

Later the child begins to take an interest in things 
generally, and his anatomy undergoes a development 
which is the necessary preliminary to the assumption 
of the erect attitude. 

It is a general belief that girls adopt the erect atti- 
tude earlier than do boys. This belief may be founded 
on correct statistics, but it is difficult to explain on 
anatomical grounds. The pelvis, differing consider- 
ably in the two sexes, differs not only in the adult but 
also in the infant and in the child. The pelvis even at 
birth shows well the sexual differences which have 
been described in the adult. Now the pelvis of the 
female is not nearly so well adapted for the assump- 
tion of the erect position as is that of the male, but 
the more forward mental development of the female 
child may possibly get over this difficulty. 

The infant cannot at first sit upright. By the 
time, however, that he reaches the age of eighteen 
months, he would be considered backward if he were 
not able to walk without assistance. 

Let us trace the development of the power to 
stand upright. To begin with, the upper limbs are 
relatively larger than in the adult, the lower limbs 
relatively smaller. But as the baby begins, very 
soon after birth, to kick his legs about, and to use 

261 



GROWTH, DEVELOPMENT 

them more than his arms, they grow faster (vide 
Plate XV.). The child next sits up with a little sup- 
port. Then he desires to get about from place 
to place. He may begin by crawling, or, as often 
happens, he may prefer to ^walk, clinging on to the 
furniture or other supports with his hands, always 
leaning a little forward. 

The baby's crawl is not quite the same as that 
which is often practised by adults to please the 
young. It is a far superior performance. A young, 
strong, and vigorous baby can make almost a trot 
of his crawl, and progresses upon hands and feet, 
only occasionally using the knees. The adult always 
puts his knees on the ground in this method of 
progression. 

Skill comes with age, and the child depends less and 
less upon his upper limbs for support, until finally 
he is able to stand, without their aid, by himself. 
It is to be noticed that the buttocks increase in 
size, partly, and perhaps chiefly, because in the 
effort to stand the gluteal muscles are developed 
(Fig. 107). 

But there is another reason. The student will 
remember that there are four curves in the spinal 
column, viz. cervical, dorsal, lumbar, and sacral. 

The sacral and dorsal concavities forwards are 
present and merged into one at birth, and the thighs 
are slightly flexed upon the abdomen. This means 
that when the child attempts to stand upright, the 
abdomen, or, to be more accurate, the pelvis, finds 
itself slightly flexed upon the thighs. In order that 
the child may not fall forwards, the spine above the 
pelvis has to be carried backwards, and thus the con- 
cavity backwards in the lumbar region is produced. 
And the production of this curvature, in addition 

262 



AND MEASUREMENTS 



to some forward rotation of the sacrum, very much 
increases the prominence of the gluteal region. 

When the infant has adopted the erect attitude, 
the legs continue to grow at a greater rate than the 
upper limbs, till in the 
adolescent \vho is not 
yet fully developed 
the lower limbs may 
appear almost ridicu- 
lously long. 

The rather promi- 
nent abdomen, due to 
the very great size of 
the liver, and the 
small chest of the 
quite young child give 
place to the promi- 
nent chest and some- 
what retracted abdo- 
men of the youth. 
It may interest the 
student to know that, 
although the young 
child is commonly said 
not to have a very 
big chest, yet we have 
seen, not once nor 
twice, but many times, 
young children with 
magnificent develop- 
ment of the upper 

part of the trunk. Though increase of stature ceases 
as a rule well before twenty, proportional increase of 
massiveness does not usually supervene till five, ten, 
or even fifteen years later, except that the shoulders 

263 




Fig. 107.— To show the attitude and pro- 
portions of an infant who is learning 
to walk. 



GROWTH, DEVELOPMENT 

become broader, owing to increase in the length of 
the clavicle by growth at its inner extremity. 

Between the ages of twenty and thirty the muscu- 
lar system is at its best, and the individual muscles 
are best seen and felt. After thirty they tend, espe- 
cially in dwellers in civilised countries, to become 
obscured by the presence of fat, unless special care 
is taken to keep them in condition. The fat which 
thus becomes obvious on the surface of the body 
is associated with a deposit of the same material in 
the deeper parts, notably in the abdominal cavity, 
and especially in that portion of it known as the 
great omentum. This is a structure which hangs 
down like an apron in front of the bowels and pro- 
tects them to a material degree from exposure to 
cold, and to a lesser degree from injury. Thus arises 
that "lower chest" which is so much dreaded by 
men who are particular about their figure. 

As old age advances the skin usually becomes paler, 
and the face, neck, limbs, especially the shoulders 
and buttocks, and trunk, with the possible exception 
of the abdomen, thinner. A general forward curve 
of the back, as seen in the infant, develops again, 
and in fact the old man returns to some of the 
anatomical, as well as other, characteristics of child- 
hood ; he is compelled to re-enlist his upper limbs 
as aids to his withering legs, and when he loses 
his teeth he must take once more to baby-food and 
almost to sucking. He loses that control which is 
the hall-mark of the prime of life, he totters and 
shakes once more, and is easily pleased, and as easily 
vexed, in his second childhood as he was in his first. 

The changes from birth to old age in the curvatures 
of the spine, as seen in profile, are thus remarkable. 
The infant, as already stated, presents only a single 

264 



AND MEASUREMENTS 



primary curve, convex backwards. As he grows older 
secondary curves appear ; the sacrum becomes more 
deeply concave downwards and forwards ; then the 
lumbar and cervical curves, concave backwards, de- 
velop, and the original 
primary convexity back- 
wards persists only in the 
dorsal region ; this per- 
sists until senility brings 
a diminution again in the 
lumbar and cervical con- 
cavities backwards, with 
that stooping shoulder 
and drooping head which 
are so characteristic of 
old age. 

We have seen already 
that at birth and in the 
young child the skull 
differs from that of the 
adult in being much 
larger in proportion to 
the trunk and limbs. 
Notice also that the 
frontal and occipital re- 
gions are small, the 
frontal eminences are re- 
latively higher and wider 
apart in the child, the 
lower jaw is small, and 
the mastoid process is hardly developed at all. 

The differences which exist in the size, shape, and 
appearance of the jaw, at varying ages, may be con- 
sidered as entirely due to the presence or absence 

of teeth. 

265 




Fig. 108.— The Gait of an Old Man 



GROWTH, MEASUREMENTS 

The jaw of the adult has been described as having 
the shape of a horseshoe, whose two free ends are 
bent upwards at a right angle to form the rami. 
In infancy and old age these rami are less abruptly 
bent upwards, with the result that the angle of the 
jaw is less marked. In the infant the muscles of 
mastication have not been used to any great 
extent; in the old, when the teeth have gone, the 
muscles, which perhaps act too powerfully, tend to 
straighten out the jaw. The "nutcracker" appear- 
ance of the aged is familiar, and is thus explained. 
The small size of the jaw in a child is due to the 
small number and size of the teeth. The fangs 
of the teeth are surrounded on all sides by bone, 
and when the teeth are removed, the sides of the 
bone, which surround the empty sockets, drop to- 
gether, and that which was formerly a broad margin, 
supporting and filling out the face, now becomes a 
narrow edge. In fact, the hollow face, retracted 
mouth, and thin lips of the old man are chiefly caused 
by the loss of his teeth (Fig. 75). 

In Fig. 108 the student should notice the totter- 
ing attitude of the old man, the flattened foot, the 
bent knees, the prominent and "baggy" lower part 
of the abdomen, and the curved back — factors which 
all tend to shift the centre of gravity forwards, so 
that the man has to support himself with his arms 
by means of a stick. 



26« 



APPENDIX 



COMPARATIVE ANATOMY 

It is not proposed in this chapter to deal in any way 
minutely or scientifically with the subject, neces- 
sarily a large one, of comparative anatomy, but 
rather to put forward some at least of the more 
salient points of resemblance and difference bet^veen 
the structure of man and the animals. 

On looking at the subject, we quickly realise that 
there is, to a considerable extent, a relationship of 
construction running through all the mammalia, in- 
cluding man. They may, indeed, be almost regarded 
as modifications of a single form. The possession of 
a head, trunk, and four limbs is of course (except 
in the case of certain entirely aquatic mammals) a 
common link ; but the resemblance is deeper than 
that, and is to be traced not only through the 
mammalia, but also through the birds, and even to 
the quadrupedal reptiles. 

The head, trunk, and limbs are modified and 
adapted to meet the varied requirements of the 
different orders and species, whether for predatory 
purposes or for defence, for simple progression on 
land or for swimming, climbing, digging, seizing, and 
so forth. These modifications go, indeed, sometimes 
as far as practical eliminations, as in the case of the 
hind-limbs of the whales (mammals), which are merely 
rudimentary and invisible, in no way affecting the 

267 



COMPARATIVE ANATOMY 

external form of the aniraal, the largely developed 
and adapted tail supplying their place as a power of 
locomotion. Or, the modification may be in the 
direction of increased development, as in the case of 
the bat, where the metacarpus and phalanges are 
very greatly lengthened, forming a ^ng, by means of 
a membrane stretched between them, this membrane 
extending to the hind-leg, which, as the animal is 
non-terrestrial, is very small and useless for locomo- 
tion on the ground. But such extreme forms as 
these need hardly be considered in the present 
chapter. 

With regard to the quadrupeds, it will be found 
that, in common with man, they possess skull, spine, 
ribs, and sternum, scapula, pelvis, humerus, and 
femur. The clavicle, important in man, and in such 
animals as have free lateral movement of the fore- 
limbs, is absent in many cases —in the horse or the 
ox, for instance — or it may be rudimentary, as in 
the cats. 

It is below the humerus and femur that the varia- 
tion in the number of bones in the limbs of the 
different creatures commences, and towards the ex- 
tremities the differences are very great : for instance, 
between the foot of the bear — with five digits, and 
plantigrade like man — and of the horse, which con- 
sists of a single digit, enclosed within a rigid nail, 
the hoof— or the forefoot of one of the cats, with 
five digits, each with a retractile claw and a pad 
beneath, a foot silent and powerful, and, unlike the 
horse's, an instrument of more than mere progression. 

A common purpose of the limbs in all terrestrial or 
partly terrestrial animals is to sustain the weight of 
the body (except, of course, in the case of the arms in 
man, and to a considerable extent of the monkey) and, 

268 



COMPARATIVE ANATOMY 

more particularly in the case of the hind-limbs, to 
propel that weight forward. Without doubt, the 
main design to be traced through such a variety 
of forms is the one best suited for that purpose. 

The accompanying drawings will show at a glance 
the resemblances as well as the differences between 
a human leg and the hind-legs of several animals 




■\ 




Fig. 109. 



Fig. 110. 



of different types ; man, the gorilla, and the bear 
(plantigrades when standing at rest) being shown 
with the calcaneum raised from the ground as in 
movement, whereby the limb is pulled more into 
the position of those of the habitually digitigrade 
animals which follow. 

It is seen that all these limbs are divided by 
two joints into three principal lengths, corresponding 
to the thigh, leg, and foot in man (though this 

269 



COMPARATIVE ANATOMY 

division is certainly least apparent in the case of 
the elephant), and that there is also a similarity 
in the relative direction of the angles, one with 
another, formed by these lengths. 

Each foot of the gorilla and bear, Hke that of 
man, has five digits, and when standing the whole 
of it is placed upon the ground. The foot of the 






Fi^. 111. 



Fig. 112. 



bear has a strong resemblance to man's, much more 
than that of the ape, which more resembles a hand. 
In the bear the toes are short as compared with 
the metatarsus, as in the human foot. 

The dog and the lion (digitigrades), which may 
be taken as types of the canidce and felidce, have 
each four digits on the hind-foot, though the dog 
occasionally has five. Both have five on the fore-foot, 
the innermost being of little importance with the 

270 



COMPARATIVE ANATOMY 

dog, but in the cats the "thumb," with its well- 
developed claw, is a powerful instrument for seizing 
and holding, and is capable of being bent to a right 
angle with the other claws. When " sitting " — the 
familiar attitude of the cat or dog — these animals 
are for the time being plantigrade, the whole of 
the foot being upon the ground. The limb is then 



■■~-^x. 



~-; A 



\ 




^■J 




Fig. 113. Fig-. 114 

in much the same position as the leg of an Indian 
or African native when " squatting." 

The deer (digitigrade) has the calcaneum (the 
" point of the hock " in the horse and the heel in man) 
high above the ground ; the digits are two in number, 
enclosed one on each side of the divided hoof. The 
length of foot — that is, from the calcaneum to the 
hoof — gives the animal great springing power. It 
is a limb built for sustained speed ; the foot is very 

271 



COMPARATIVE ANATOMY 

light, and the sinew corresponding to the " Achillis " 
is as powerful as the haunch. 

The greyhound has, in proportion to the rest of 
the Kmb, a shorter foot than the deer, but the femur 
is longer and more free from the body, which is 
much lighter in build than the deer's. This, then, is 
a different type of limb to that of the last-named 
animal, but it is also designed for speed. 

The lion's is relatively a heavier type of limb than 
the deer's or the greyhound's, and is more adapted for 
strength and sudden spring than for sustained rapid 
motion. 

The elephant, even more pronouncedly digitigrade 
than the dog, has a hind-limb ^lich can hardly be 
likened to that of any other mammal. 'The femur 
and tibia make a slighter angle than in other quad- 
rupeds, the calcaneum ("hock") is very near the 
ground, and the bones of the metatarsus, five in 
number, are short. It is the shortness of these bones 
which gives the peculiar and distinctive character 
to the animal's hind-leg. The toes are not separated, 
and are supported behind by a large pad of fleshy 
substance ; and there are in the African species 
three stout short nails, the Indian having four. The 
general appearance of the limb suggests that there 
is but one joint, viz. the knee. The foot has, indeed, 
but little power of movement at the ankle, and when 
kneeling to receive its load, the elephant rests upon 
the knee, with the limb below that point stretched 
along the ground to the rear. A similar disposition 
of the hind-limb may be observed in a quadrupedal 
reptile, the tortoise, which also has the calcaneum 
low and the metatarsus short — indeed the two limbs 
are not dissimilar in character. As with the tortoise, 
the elephant's limb is designed for weight-bearing, 

272 



COMPARATIVE ANATOMY 

and not for rapid movement, for the animal pro- 
gresses mainly by the mere swing of the leg from the 
pelvis. The elephant must, in proportion to his size, 
be considered as a slow mover. This lack of speed is 
due to the straightness of the limbs. It is true that 
man, when standing erect, has the femur and tibia 
more in line, one with the other, than is the case with 




Fig. ur. 

any quadruped ; but the entire length of the femur is 
free from the trunk, the leg is capable of great flexion, 
and the elasticity and length of the foot, worked by 
the well-developed soleus and gastrocnemius, afford 
that spring which in the elephant is practically 
absent. He is therefore, in proportion to size, a 
much more speedy mover than the elephant, which, 
according to Sir Samuel Baker (when speaking of 
the longer limbed of the two varieties, the African), is 
only "capable of a speed of fifteen miles an hour, 

273 8 



COMPARATIVE ANATOMY 

which it could keep up for two or three hundred 
yards, after which it would travel at about ten miles 
an hour." This is a very moderate rate of speed for 
an animal of the elephant's size and length of hmb, 
when compared with that of many vastly smaller 
creatures. 

A great contrast to the elephant's leg may be seen 
in the frog's. The thigh, leg, and foot are still here, 
but differently proportioned. The thigh is free of 




Fig. 116. 

the body, the leg muscular, the joints extremely 
flexible, the foot and digits long. It is a limb for 
leaping and swimming. 

In the fore-limbs the same general resemblance in 
the three principal lengths, humerus, ulna, and meta- 
carpus, is again apparent. A man's arm is here 
compared with the fore-limbs of two widely differing 
animals — the lion and the deer. The inner side of 
the limb is shown in each case ; the " wrist " in man 
and the lion corresponds to the " knee " in the deer. 
The five metacarpal bones in man and the lion are 
reduced to two, closely united and greatly lengthened 

274 



COMPARATIVE ANATOMY 

in the deer. The two digits enclosed in the divided 
hoof are of very hmited use in comparison with the 
five digits of the lion. The deer's limb is designed for 
support and locomotion alone, the lion's, in addition, 
for striking, seizing, and pulling. In the lion, as in 
man, the flexors of the forearm and wrist are well 
developed, and it will be seen that on the outside of 




Fig. 117. 

the limb the olecranon is more developed than in 
man, and that the extensors of the forearm are very 
powerful. The lion is able to strike down by a blow 
from the paw, and to drag away his prey, which 
often consists of animals of great weight. The lion, 
like the felidce in general, possesses power of supina- 
tion in the forearm, though not to the same extent 
as man. The deer, in common with all hoofed 
animals, is devoid of that power. 

It will be noticed that the humerus in man is free 

275 



COMPARATIVE ANATOMY 

from the body. This is not so with the lion or deer, 
the former having a limited power of lateral move- 
ment of the limb, the latter none. This character- 
istic will also apply generally to the two classes which 
these animals represent. 

Compared with the arm in man, the fore-limb of 
the lion, deer, or indeed of any animal, splendidly 
adapted as it may be to that animal's special require- 




Tig. 118. 

ments, is restricted in its appointed movements and 
uses. It would be, for instance, impossible for one 
of the felidce, creatures with exceptionally supple 
limbs, to place the forearm across the back — an 
action perfectly easy in man. 

The monkeys and apes come nearest to man in 
freedom of arm movement, though even they are 
probably, not capable of such a variety of action, 
while in the hand they are very deficient, owing 
to the poor development of the thumb. In one 

276 



COMPARATIVE ANATOMY 

species, the Spider monkey, this raember is entirely 
absent. 

It is a curious fact, which has been provocative of 
much speculation, that the primary apes. Gorilla, 
Chimpanzee, and Orang-utan — the creatures most 
nearly approaching man in organisation and struc- 
ture (indeed, from a strictly natural history point 




fig. 119. 



of view, there is little to separate them from man) — 
should be amongst the least beautiful of animals; 
and though certain of the monkeys have considerable 
grace of form (apart from their colouration, which 
is often beautiful), yet they can hardly be compared 
for beauty of shape with many less highly classed 
animals, such, for instance, as the horse, greyhound, 
or almost any member of the felidce. 

The superiority of man's form, from an artistic 
standpoint, over that of the apes is due to the fact 

277 



COMPARATIVE ANATOMY 

that he habitually stands and moves supported only 
upon the legs, thus accounting for the fine develop- 
ment of those limbs, vt^hich are ungraceful and poor 
in the primary apes, and of the trunk, with its dis- 
tinctive curve of the spine. 

It is perhaps in the development of the trunk that 
man, in the higher human types, is pre-eminent in 
beauty of form over any of the animals, many of 
which, particularly amongst graminivorous classes, 
though they may possess finely shaped head, neck, 
and limbs, have no great beauty in the form of 
the trunk, the abdomen being often large and 
barrel-like. 

Man's arms are shorter, and his legs longer, in rela- 
tion to the trunk than is the case with the apes — a 
significant step in the direction of beauty. He also 
possesses an important feature in the neck, in which 
respect the apes are very deficient. The differences 
in the formation of the head and features are too 
obvious to need comment. The foot is another point 
in which the ape compares unfavourably with man. 
It has not the arch of the human foot, and the toes 
are much longer. The innermost of these toes pro- 
ject at an angle from the others, and are better 
developed as a serviceable thumb than the corre- 
sponding member on the hand of the animal. 

It may be claimed that man, in his structural de- 
velopment, is capable of a greater variety of position 
and action than any of the animals, and to this is 
doubtless due the fact that in him is found the 
highest type of beauty of form. Though planti- 
grade in standing or walking, he becomes digitigrade, 
or nearly so, in swift running ; indeed, it requires 
but little effort for him to remain for a considerable 
time with the heels raised from the ground. He 

278 



COMPARATIVE ANATOMY 

is capable of rapid movement in water (the apes 
and monkeys cannot swim), and he is able to climb 
and to leap ; his spine is supple. The contortionist 
and the gymnast show what the human figure is 
capable of under special training, and the "strong 
man " to what a degree of development the muscular 
system may be brought. In the hand man has, of 
course, an instrument such as no animal possesses. 

There is here reproduced a photograph from a 
group of the skeletons of man and the horse, in 
the Natural History Museum, London. 

If we begin a brief comparison of these skeletons 
at the heads, we recognise at first sight that the 
two skulls are very differently attached to the neck, 
though this difference is as much apparent as real, 
being partly caused by the great difference in the 
jhape of the skulls, and the fact that man's neck is 
upright while the horse's inclines to the horizontal. 
Man has a "back" to the skull, which is entirely 
wanting in the horse, and his head is poised upon 
the neck with a fair distribution of weight before 
and behind. 

The horse has a great elongation of the nasal and 
maxillary bones. Finding his food upon the ground, 
length is necessary. For the same reason, the neck 
is required to be long, and although there is the 
same number of cervical vertebrae as in man, seven, 
they are each much greater in relative length. The 
giraffe, with its elongated neck, has still only seven, 
which is the almost invariable number of cervical 
vertebrae throughout the mammalia. 

To sustain the Tv^eight of the head and neck, there 
must be much power above the cervical vertebrae, 
which, it will be seen, run downward from an imagi- 
nary straight line drawn from the occiput to the 

279 



COMPARATIVE A ^i ATOMY 

highest part of the shoulder (the " A^'thers"), thus 
affording a large triangular space. In addition to the 
muscles, there is in this space a special provision for 
sustaining the great weight of the head, which is 
hung on the more or less horizontal neck. This is 
a strong elastic ligament which proceeds from the 
occiput to the high processes of bone on the dorsal 
vertebrae. This ligament acts automatically, and the 
head is sustained without fatigue. The droop of the 
head in an old horse is due to its w^eakening. 
Although this ligament sustains the head without 
effort, it is apparent that it must also be capable of 
relaxation, as when tired, or sleeping whilst stand- 
ing, as a horse will often do, the head is hung 
down, while the action is not produced by muscular 
exertion. 

It is the great height of the processes from the 
spine at the "withers," just referred to, together 
with the fact of the actual vertebrae being somewhat 
higher at the pelvis than where they pass between 
the scapulae, which gives the hollow appearance to 
the horse's back. The spine is in reality somewhat 
arched, and is therefore the better capable of sus- 
taining the weight of the rider. 

The horse has eighteen ribs (while man has twelve), 
and seven or eight of these are attached to the 
sternum. The equine sternum is very unlike the 
corresponding bone in man, ^vhich has a flattish face, 
the ribs attached flush with the face ; in the horse 
it nearly resembles the keel of a boat, with the ribs 
attached to the sides of the keel. 

There is no clavicle ; the limbs are restricted 
practically to " fore and aft " movement, and the fore- 
limbs are relatively less widely separated than are 
the arms in man, where they have the whole width 

280 



COMPi^RATIVE ANATOMY 

of the trunk jetween them. The inner faces of the 
scapulae are opposed, whereas in man they face in 
the same direction. The horse possesses no power 
of pronation or supination, for the ulna and radius 
are closely united and, as the animal ages, become 
actually one bone. 

The scapula is a bone of great strength, and is 
longer than the humerus, contrasting strongly with 
man in this respect. The last-named bone is com- 
pletely hidden by muscle, and in a sense is joined on to 
the body — another marked difference. In the living 
animal the humerus is only visible at the point of 
the shoulder, w^here its head is conspicuous. The 
scapula is not attached to any other bone (there 
being no clavicle), and it is very strongly muscled, 
having to sustain the greater part of the shock 
when the horse alights on the ground after leaping, 
at which moment the limb is straightened out. The 
supple pastern (corresponding to the phalanges in 
man) take a certain part of the shock. 

Below the carpus (the "knee" in the horse), the 
metacarpus consists of one principal bone (as against 
five in man), with two much smaller bones, the heads 
of which are opposed to the carpus, but 'which taper 
downward to a point, and cease before the next joint 
is reached. These small bones also become one with 
the principal bone as the horse becomes aged. Fossil 
remains show that these bones, now evidently in the 
course of disappearance, were once fully developed, 
and that the ancestor of the horse was not supported 
upon a single digit as is the animal of the present 
time. 

It will be noticed that the olecranon is much more 
developed in the horse than in man, affording hold 
for two strong and very conspicuous muscles in the 

281 




'^^ 



M 




Fig. 121.— Leg of Man- 



Fig. 122.— Leg of Gorilla. 





Fig. 123 —Hind-leg of Bear. 




<i< 



Fig. 124 —Hind-leg of Dog. 



COMPARISON OF THE STRUCTURE OF MAN 
AND THE LOWER ANIMALS. 



\ ;^ 



^\ 



4/ 



'■'I 





Fig. 125.— Hind-leg of Lion. 



Fig. 126.— Hind-leg of Deer. 












) 



Ig. 127 Hind leg of Elephant. 



Fig. 128.— Hind-leg of Frog. 



COMPARISON or THE STRUCTURE OF MAN AND THE 
LOWER ANIMALS. 




fig. 129.— Arm of Uaa. 





Fig. 130.— Fore-leg of Lion. 



Fig. 131.— Fore-leg of Deer. 



COMPARISON OF THE STRUCTURE OF MAN AND THE 
LOWER ANIMALS. 



COMPARATIVE ANATOMY 

horse, the anconoeus muscles, which are used to 
straighten the Hmb, as does the human triceps. 

The pelvis is very unlike man's, and the femur is 
shorter in proportion. This bone is also much covered 
with muscle, and is very strongly made. The horse 
has a patella. The tibia is of great strength, while 
the fibula is reduced to insignificance. 

As with the metacarpus, the metatarsus is reduced 
to a single important bone, with two smaller ones 
dwindling downward to a point, and, as in the fore- 
limb, there is a single toe. 

Although the principal bones of the human frame 
are represented in the horse, the differences in the 
proportional sizes and shapes of the bones, and the 
uses to which the limbs are put, necessitate a great 
modification of the muscular system. Whereas, for 
instance, the deltoid is the most noticeable muscle 
on the man's shoulder, where it is the means of 
raising the arm from the side, an action impossible 
for the horse, any equivalent to this muscle is not 
prominent in the latter. But the anconoeus, already 
referred to, is very apparent. The pectoral muscle is 
present in the horse, but as it has a more restricted 
use and covers a narrower space it is smaller than 
in man, and differently shaped. 

The muscles of the trunk are, as compared with 
man, not very conspicuous. In man, the trunk is not 
only self-supporting, but carries, in addition to its 
own weight, that of the head and arms, the latter 
being in the horse a source of support instead of a 
burden. The horse's trunk is also capable of but 
Httle movement independent of the limbs. There is 
therefore no necessity for such development. 

In the case of animals (such as the larger felidce or 
the dog) which may be in the habit of pulling at 

285 



COMPARATIVE ANATOMY 

weight held by the jaws, the muscles of the loin are 
well developed. These, along with the decreased size 
of the abdomen, give to these creatures a more grace- 
fully shaped trunk than that of the horse, ox, deer, or 
animals of kindred classes. 

There is much muscle about the thigh and between 
the knee ("stifle") and the carpus ("hock"). The 
muscles on the outer side of the limb, with the com- 
paratively concave form of the limb on the inner side, 
help to endow the leg with a very beautiful shape. 

If the student, when drawing or modelling any 
animal, will, instead of regarding it as an altogether 
new form, rather consider it as one approximating in 
a greater or less degree to the human form with 
which he is familiar, he will find the difficulties of 
his task lessened, and will be able to avoid many of 
the errors which are often to be noticed in the depic- 
tion of animal forms by those who have not given the 
subject special attention. 



286 



INDEX 



Abdomen or bellv, 169, 173, 177 

„ of the 'infant, 263 
^* Abdominal type" of breathing, 

the, 174 
Abdominal wall, the, 173 
Abduction, of the arm, 147 
Abductor indicis, the, 152 
Acetabulum, the, 47 
Acromio-clavicular joint, 37 
Acromion, the, 74 

„ process, the, 35 

" Adam's apple," 184 
Adduction of the arm, 147 
Adductor magnus muscle, the, 
50, 114 
,, muscles, 111 
„ tubercle, the, 50 

Air-cavity or frontal sinus, 57 
Air sinus of the mastoid process, 

59 
Alae of the nose, 221 
,, or wings of the thyroid car- 
tilage, 184 
Albinos, 68, 217 
Anaemic subjects, 68 
Anatomical waist, the, 254 
" Anatomist's snuff-box," the, 42, 

101, 151 
Anconeus muscle, 93 
Angle of torsion of the foot, 132 
Angles of the scapula, 37 
Ankle, the, 33, LSI 
Ankle-joint, movements of the, 
166 



Annular ligament, the, 95 

„ ligaments of the foot, 

142 
Ante-cubital fossa, the, 86 
Anterior superior spine of the 

ilium, 166 
Antrum of Highmore, the, 60 
Aponeurosis, the, 178 
Aqueous humour of the eye, 218 
Arch or '^ dome " of the foot, the, 

52, 137 
Arm, the, 84 

„ the human, 278 

„ and leg compared, 147 
Armpit, the, 82, 167 
Astragalus, the, 52, 54 
Auricle or ear, 199, 229 
Axilla or armpit, 38, 82 



B 



Back of the hand, the, 97 

Baldness, 199 

" Ball and socket " joint, 153 

Ball of the toe, the, 55 

Basilic vein, 86 

Bat, limbs of the, 268 

Bear, the foot of the, 268, 270 

" Beetling brow," the, 209 

Biceps flexor cruris, 52 

„ muscle, the, 38, 82, 115, 
150 

,, the tendon of the, 119 
Bicipital groove, the, 38 



287 



INDEX 



Bicipital tuberosity, the, 42 

''Blear," 212 

Blinking, 213 

Blushing, 288 

Blushing and pallor, 68 

" Body" or horizontal part of the 
mandible, 61 

Bones of the foot, the, 52 
,, of the forearm, 40 
„ of the lower limb, the, 44 
,, of the skull, the, 6o 
,, of the vertebral column, 61 
,, of the wrist, 43 
,, various forms of, 33 

Borders of the scapula, 37 

Brachial artery, the, 85 

Brachycephalic or broad head, 
198 

^'Breaking" of the voice, 184 

Breast, the female, 176 

Breast-bone, the, 63 

Bridge of the nose, 221 

Buccal cavity, the, 60 

Buccinator muscle, 236 

Buttocksj the, 103 



Calcaneum, the, 271 
Calvaria, the, 56 
Capitellum, the, 40 
Carotid artery, the, 193 
Carpals, or bones of the wnat^ 

35, 95 
Carpus or wrist, 43 
Carrying anirle, the, 88 
Cartilage of the nose, 221 
Cartilaginous auricle, the, 59 
Caruncle, the, 211 
Cat, the foot of the, 268 
Cephalic vein, the, 85 
Cervical vertebrae, 61 
Cheek, the, 228 
Cheek-bone, the, 60 
Chest or thorax, the. 169 
Chin, the, 61 



Chin, the, as an indication of 

character, 226 
Choroid of the eye, the, 215 
Ciliary muscle, the, 218 
Circumduction of the arm, 147 
Clavicle, the, 34, 35, 78, 169 

fy in quadrupeds, the, 268 
Coccyx, the, 44, 62 
Colour of the skin, QQ 

of the eye, the, 216 
Columna nasi, the, 222 
Comparative Anatomy, 267 
Complexus muscle, the, 196 
Compressor naris, 238 
Concha of the ear, the, 232 
Condyles, 49 

„ internal and external, 

88 
„ of the humerus, the 
39 
Conjunctiva or membrane of the 

eyes, 65, 210 
Contraction of the muscles, 70 

„ of the pupil of the 

eye, 217 
'^ Co-ordination " of muscles, 219 
Coraco-brachialis muscles, 82, 84 
Coracoid process, the, 36, 41, 81 
Cornea, the, 211, 216 
Corrugator supercilii muscle, 202, 

238 
" Costal type" of breathing, 174 
Cotyloid notch, the, 47 
Cranial bones, the, 56, 198 
Cranium, the, 56 

„ in relation to the spine, 
34 
Crest of the ilium, the, 164, 168 

„ of the tibia, the, 124 
Cricoid cartilage, the, 184 
Crico-thyroid membrane, the, 185 
Criminology and the skin, 65 
Crureus, tiie, 112 
Crus helicis, the, 232 
Cuboid, the, 53 
Cuneiform bones of the foot, the, 

54 
Curve in the spine, 161 



288 



INDEX 



Dark hair^ 67 

Darwin's tubercle, 229 

Deceit, 246 

Decision, 248 

Deep fascia, the, 69 

Deer, the foot of the, 271 

Defiance, 246 

Deltoid muscle, the, 77, 86 

Depressor alaj nasi, 238 

„ anguli oris, 237 

Despair, 244 
Diaphragm, the, 174 
Digastric muscle, the, 191 
,, triangle, the, 191 
Digitations, 82 
Digitigrade animals, 269 
Digits, the bones of the, 85 
Dilatores naris, 238 
Disdain, 246 
Distal, 44 

Dog, the foot of, 270 
Dolichocephalic or long head, 

198 
Dorsal surface of the scapula, 37 

„ vertebrae, 61, 157 
Dorsum of the foot, 138 
" Double chin," the, 181 



E 



Ear, the, 199, 228 

Elbow, the, 87 

,, and knee compared, 147 

Elbow-joint, the, 40 

Elephant, the foot of the, 272 

Emaciation, the appearance of, 69 

Ensiform or lower part of the 
sternum, 64 

Ensiform cartilage, 171 

Erector spinas muscle, 158 

Ethmoid bone, the, 56 

Expression dependent on corre- 
lated action of facial muscles, 
180 



Expression and G^esture, 180 

Extension of the arm, 147 

Extensor brevis digitorum, 143 
„ carpi radialis brevior, 93 
„ carpi radialis long"io- 

muscle, 86 
„ communis digitorum, 92 
„ internodii pollicis, 161 
„ internodii pollicis ten- 
dons, 101 
„ longus digitorum, 128 
„ longus hallucis, 127 
„ longus pollicis muscle, 

the, 42 
,, ossis metacarpi pollicis, 
93, 151 

Extensors of the foot and toes, 
126 

External auditory meatus, 59 
„ malleolus, the, 52 
„ oblique muscle, the, 163 

Extremities, divisions of the, 71 

Eye, the light in the, 179 

Eyeballs, the, 208 

Eyebrows, the, 57, 209 

Eyelashes, the, 212 

Eyelids, the, 209 



Face, the, 206 

„ types of, 235 
Facial bones, the, 198 

,, nerve, the, 213 
False pelvis, the, 46 
Fascia lata, 113 
Fat, the deposit of, 68 
Fear, 243 

Female waist, the, 254 
Femur, the, 33, 34, 45, 48, 117 
Fibula, the, 44, 52, 117 
Fingers, the, 101 

„ flexion and extension of 
the, 152 
Flat bones, the, 33 
Flexion of the arm, 147 



289 



INDEX 



Flexor carpi radialis tendon, the, 
43,90 
,, longus hallucis muscle, 54 
^^ Floating ribs," 63, 175 
Fold of the axilla, 167 
Foot, the bones of the, 52, 131 
„ the human, 278 
„ of the infant, the. 260 
Foramen magnum, the, 58 
Forearm, the, 89 

„ the bones of the, 35, 40 
„ veins of the, 91 
Forehead, the, 57, 200 

„ types of, 203 
Form of the model, the, 70 
Frog, the leg of a, 274 
Frontal bone, the, 83, 56, 200 
J J eminence, the^ 57, 200 
„ furrows, 201 
,, sinus, the, 57 
Frontalis muscle, the, 202 



Gastrocnemius muscle, 121, 129 
Gesture and expression, 180 
Gladiolus, part of the sternum, 

63, 170 
Glands of the skin, 66 
Glenoid cavity, the, 61, 146 
Globe of the eve, the, 215 
Gluteal muscles, the, 46, 49, 103 
Gluteus maxim us, the, 105, 107, 
154 
„ medius, the, 107 
" Goitre " or " Derbyshire neck," 

186 
"Goose-skin," 67 
Gracilis muscle, the, 122 
Great omentum, the, 264 

„ toe, the, 139 

„ trochanter, the, 36 49, 
114 
Greyhound, the foot of the, 272 
Grief, 242 
Groin, the, 108 



Hair, the, 67, 178 

,, direction of the, 199 

„ follicles, 66 
Ham or popliteal space, 120 
Hamstring muscles, the, 106, 115, 

154 
Hand, the, 95 
Head, divisions of the, 71 
Hectic, 238 

Heel or os calcis, the, 52, 130 
Helix of the ear, 232 
Hill, Sir Charles, 102 
Hip-bones, the, 34, 44, 146, 153 
Hip-joint and shoulder compared, 

146 
Horse, the foot of the, 268 
Humerus, or bone of the arm, 35, 
37 
„ movements of the, 34 
,, in man and quadrupeds, 

276 
Humphrey, Sir George, 102 
Hyoid bone, the, 61, 182 



Iliac crest, the, 46 
„ wings, the, 48 

Ilio-costal space, the, 166 

Ilio-psoas flexor, the, 154 

Ilio-tibial band, the, 107 

Ilium, the, 46, 104 

Imprint of the foot, 137 

Inclination and torsion of the 
femur, 50 

Infancy and old age, 264 

Infant, the development and 
measurements of, 259 

Infants, male and female, com- 
parison of, 261 

Infant's skull, 55 

,, smiles and tears, 261 

Inferior angle of the scapula, 37 

Infra-clavicular fossa, the, 81, 172 



290 



INDEX 



Infra-spinatus mustile, the, 76^ 

163 
Infra-sternal fossa, or " pit of the 

stomach," 171 
'^Insertion " of a muscle, the, 34, 

70 
Instep, the, 138 
Intercondyloid notch, 49 
Intercostals, the, 174 
Internal malleolus, the, 61 
Interossei muscles, 152 
Interosseous membrane of the 

arm, 42 
Iris of the eye, the, 216 
Ischium, the, 46 



Jaundice, the yellow ' tinge of, 

68 
Jaw, the rnovements of the, 34 
Jugular veins, the, 186, 193 



K 



Keystone of the arch of the foot, 

the, 55 
Knee, the, 117, 155 
" Knee " of the deer, the, 274 
Knee-cap, the, 44, 119 
" Knock-knee," 123, 252 
Knuckles, the, 44, 102 
„ of the toes, 140 



Lachrymal cananiculus, the, 211 

„ gland, the, 239 

Larynx, the, 183 
Latissimus dorsi, the, 70, 162 
Laughter, 242 
Leg, the, 123 



Lens of the eye, the, 218 
Lesser trochanter, the, 94 
Levator anguli oris, 236 
„ labii superioris, 236 
„ menti, 237 
„ palpebralis superioris, 213 
Ligaments joining the radius to 

the ulna, 42 
Ligamentum nuchae, the, 195 

„ patellae, the, 60, 

120 
" Liglit in the eye," the, 179 
Linea alba, the, 171 

„ aspera, the, 49 

,, semi-lunaris, the, 173 
Lineae atrophicae, 177 
Lines on the palms, the, 96 

„ of the thumb, 100 
Lion, the foot of the, 270 
Lips, the, 224 

Lobe or lobule of the ear, 231 
Loins, the 167 
Long bones, the, 33 
" Lower chest," the, 264 
Lower jaw, the, 60 
Lumbar vertebrae, 61, 157 
Lunula of the nails, 66 



M 



Malar or cheek-bone, the, 60 
Male and female outlines, 252 

„ pelvis, 46 
Malleolus, the, 61, 125 
Man, the leg of, 273 
Man and horse compared, skeletons 

of, 279 
Man and lower animals, essential 

differences between, 241 
Mandible, the, 60 
Manubrium, part of the sternum, 

63, 170 
Masseter muscle, the, 69, 232 
Mastoid process, the, 69, 203 
Maxillary bones, the, 60 
Meatus, the, 229 



291 



INDEX 



Median basilic vein, 92 

„ cephalic vein, the, 81, 91 
„ nasal spine, the, 57 
,, vein, the, 91 

Membranous ligament of the fore- 
arm, 42 

Mental protuberance, 226 

Mesial border of the scapula, 
37 

Metacarpal bones, the, 44, 95 

Metacarpo-phalang-eal joint, the, 
100 

Metatarsal bones, the, 44, 55, 
136 

Moles, 6Q 

Monkey compared with man, the, 
277 ' 

Motor and sensory functions, the, 
59 

Moustache and beard, the, 227 

Mouth, the, 223 

Movements of the ankle-joint, 155 
,, of the bones, 34 

„ of the hip-joint, 153 

„ of the knee, 155 

„ of the toes, 155 

Mucous membrane, the, 65 

Muscle, anconeus, 93 

^ adductor mag-nus, 114 
„ biceps, 84 
„ the coraco-brachialis, 84 
„ the deltoid, 77, 86 
„ erector si)inae, 158 
„ extensor communis dig-i- 
torum, 92 



,, carpi radialis 

brevior, 93 
„ carpi radialis 

longior, 86 
„ ossis metacarpi 
pollicis, 93 
the gastrocnemius, 121 
the gracilis, 122 
the infra-spinatus, 76 
pectoralis major, 80 
pronator radii teres, 89 
quadriceps, 112, 119 
supinator longus, 86 



Muscle, the supra-spinatus, 74 
,, tailor's, 109 
„ the tensor fasciae femoris, 

113 
,, the trapezius, 7*» 
,, the triceps, 85 
Muscles, adductor, 111 

,, attached to flat bones, 

34 
,, contraction of the, 70 
,, of the back of the neck, 

58 
„ of the ear, 230 
,, oftheeye, 219 
„ of the fingers, 152 
„ the hamstring, 106, 115 
„ of the hip-joint, 154 
„ of the leg, 126 
„ of the mouth, 235 
„ of the nose, 238 
„ of the shoulder-joint, 148 
,, superficial flexor, 89 
„ tibialis anticus, extensor 
longus hallucis, exten- 
sor longus digitorum, 
peroneus tertius, 127 
Musculo-cutaneous nerve of the 

leg, 125 
" Musculus cucullaris," 162 



N 



Nails, the, 66 

„ of the toes, 141 
Nasal bones, the, 57, 60 

„ fossae, the, 57 

„ se|)tum, the, 222 
Naso-labial fold, the, 233 
Natal fold, the, 105, 114 
Navicular or scaphoid, the, 54, 

135 
Neck, the, 71, 180 
Nelaton's line, 106 
Nipples, position of the, 176 
Nose, the, 221 
Nostrils, the, 221 

292 



INDEX 



Occipital bone, the, 56 

,, protuberance, the, 204 
Occipitalis muscle, the, 204 
Occipito-fi'ontalis muscle, the, 58 
Old age, 69, 264 - 
Olecranon process, the, 41, 87 
Omo-hyoid muscle, the, 191 
Opposition, of the thumb, 151 
Orbicularis oris_, 235 

,, palpebrarum muscle, 

202 
Orbital margins_, 208 
Orbits of the eyes, the, 57 
Origin of the muscle, the, 70 
Os calcis or heel, 52, 129 
„ pubis, the, 47 
Ossa innominata, 84, 44, 46, 105 



Pain, 243 

Palate, the, 60 

Pallor, 68 

Palm of the hand, the, 95 

Palmar fascia, 95 

Palmaris longus tendon, 90, 96 

Palpebral fissure, the, 211 

Panniculus adiposus, 68 

,, carnosus, the, 69 

Parietal bones, the, 56 

,, eminence, the, 59, 203 
Parotid gland, the, 191 
Patella, the, 44, 50, 117, 119 
Pectoralis major muscle, 80, 169, 
171 

,, minor, the, 82 
Pelvis, the, 44, 47 
Peroneal tubercle, the, 54 
Peronei, the, 128 
Peroneus longus tendon, the, 55 
"' Perspiration " or ^' sweat," 241 
Phalanges or bones of the digits, 
the, 35, 44 

„ of the foot, the, 55, 140 
Pigment of the skin,. 66 



Pisiform bone, the, 43 
'' Pit of the stomach," the, 171 
Plantigrade animals, 208 
Platysma, the, 69, 182, 193 
Popliteal space, the, 120 
Posterior annular ligament, the, 

94 
„ superior spine of the 

ilium, 165 
Poupart's ligament, 108, 168 
Processes of the scapula, 87 
Pronation of the forearm, 40 

„ and supination, 149 
Pronator quadratus, the, 149 

„ radii teres, the, 42, 89 
Proportions, male and female, 252 
Protective bones, 84 
Proximal, 44 
Ptosis or drooping of the eyelids, 

214 
Puberty, 67 
Pubes, the, 46 
Pulse, the, 91 
Punctum, the, 211 
Pupil of the eye, the, 216 
Pyramidalis nasi, 238 



Quadriceps extensor cruris, the, 
50 
„ muscle, the, 112, 119 



293 



R 



Radio-ulnar articulations, 149 

Radius, the, 40, 41, 93 

'^ Ramus " or vertical part of the 

mandible, 61 
Rectus abdominis, the, 47, 171 

„ femoris, the, 112, 154 
Relative measurements, 255 
Resonating air-chambers, 58 
Retina of the eye, the, 215 



INDEX 



Rhomboideus major, the, 163 
Ribs, tlie, 63, 167, 175 

„ of man and horse compared, 
the, 280 
Ridges and furrows of the skin, 65 
Risorius, the, 237 
Root of the nose, the, 221 
Rotation of the arm, 147 
'' Round shoulders," 87 



S 



Sacral vertebra^, the, 105 

Sacro-iliac ligaments, 46 

Sacrum, 44, 62 

Saphenous vein, 111, 125 

Sartorius or tailor's muscle, 109, 
154 

Scalp, the, 198 

Scaphoid, the, 54 

,, fossa of the ear, 232 
„ tubercle of the, 43, 135 

Scapula, the, 33, 34, 36 
„ of a horse, the, 281 

Scarpa's triangle, 109 

Sclerotic, the, 210, 215 

Scorn, 246 

Sebaceous glands, 6Q 

Self-conceit, 248 

Semilunar fascia, the, 85, 90 

Semi-membranosus, the, 115 

Semi-tendinosus, the, 115 

Serratus magnus muscle, the, 82, 
171 

Sesamoids, the, 120 

Shaft of the humerus, 38 

Shape of the nose, 223 

Shin, the, 51, 124 

Short bones, the, 33 

Shoulder, the, 73 

Shoulder-blade or scapula, 34 

Shoulder-joint, the, 147 

Shyness, 246 

Sigmoid cavity, the, 41 

Skeleton, the shape of the, 70 

Skin, the, 65 



Skin of the forehead, the, 201 

„ of the palm, the, 95 
Skull of an adult, the, 55 

„ of an infant, tlie, 55 

,, divisions of the, 198 
Sneering, 246 
^^Snub" nose, 223 
Sole of the foot, the, 144 
Soleus, the, 129 
Sphenoid bone, the, 56 
Spinal column, the, 61 

„ cord, 62 

„ nerve, 62 
Spine, the, 33, 157 

„ in relation to the cranium, 
the, 34 

„ of the pubes, the, 47, 169 

,, of the scapula, the, 74 
Spinous process, the, 62 

„ „ of the scapula, 37 

,, processes of the vertebrae, 
197 
Squamous part of the temporal 

bone, 59 
Squinting, 220 
" Sternal angle," the, 170 
Sterno-mastoid muscle, the, 58, 

187 
Sternum or breast-bone, 63, 169 
Stylo-hyoid muscle, the, 191 
Styloid process, the, 41, 52, 93 
Subcutaneous tissue, 68 
Sub-mental pad, the, 08 
Sucking pad of the infant, 68, 228 
Sulkiness, 248 

Superciliary ridge, the, 57, 200 
Superficial fascia, 68 

„ flexor muscles, 89 

Superficialis volse artery, the, 99 
Superior angle of the scapula, 37 
Supination and pronation, 149 

,, of the forearm, 40 

Supinator longus muscle, 86, 149 
Supra-condylar ridges, the, 39 
Supra-orbital margin, the, 57, 200 
Supra-spinatus muscle, the, 74 
Supra-sternal fossa, the, 169 
Surface form of the foot, 138 



294 



INDEX 



"Surgical neck," the, 38 

Sutures of the bones of the skull, 
56 

Sweat glands, 66 

,, secretion of, 239 

Symmetry in anatomy, the ab- 
sence of strict, 68 

Symphysis pubis, the, 47, 171 



Tailor's muscle or sartorius, 109 

Talus, the, 54 

Tarsus, the, 44 

Tears, 211, 239 

Teeth, the, 249 

Temporal bones, the, 56 

„ muscle, the, 205 
Tendo Achillis, the, 54, 126, 

129 
Tendon, flexor carpi radialis, 90 

„ ,, „ ulnaris, 91 

Tendons of the foot, 141 

„ of the hand, 98 

,, of the thumb, 101 
Tensor fasciae femoris, 113 
Teres major, the, 163 
Terror, 244 
Thenar eminence, 96 
Thigh, the, 109 
Thigh-bone, the, 44 
Thoraco-mammary fold, the, 177 
Thorax or chest, the, 35, 63, 

157 
Thumb, the, 95, 99, 151 

,, movement of the, 43 
Tliyroid cartilage, the, 184 

„ foramen, the, 47 

„ gland, the, 186 
Tibia, the, 44, 50, 117 
Tibialis anticus, the, 127 
rip of the nose, the, 221 
Toes, the, 139, 155 
Tortoise, hind limbs of the, 272 
Trachea or windpipe, the, 185 
Tragus of the ear, 232 



Transversalis muscle, the, 178 

Trapezium, ridge of the, 43 

Trapezius muscle, the, 74, 162, 
195 

Triangles of the neck, 189 

Triceps, the, 85 

Trochanters, the, 48 

Trochlea, the, 40, 89 

Trunk, the, 157 

„ divisions of the, 71 
„ of man and horse com- 
pared, 285 

Tubercle of the ilium, 46 
„ of the scaphoid, 135 
„ of the tibia, the, 51, 
120 

Tuberosities of the humerus, 38 

Tuberosity of the ischium, the, 104 



U 



Ulna, or bone of the forearm, the, 

35, 40, 93 
Umbilicus or navel, 171 
Unciform bone, the, 43 
Upper extremity, the, 73 

,, jaw, the, 60 



Vastus intern us and exiernus, 112, 

120 
Ventral surface of the scapula. 

36 
Venus plexus, 97 
Vertebra prominens, the, 62, 160 
Vertebrae, the, 61, 160 

,, or quadrupeds, 279 
Vertebral border of the scapula, 

37 
Vertical border of the scapula. 

37 
Vitreous humour of the eye, 218 
Vocal cords, the, 104 



295 



INDEX 



w 



Waist, the true, 166 

„ of the foot, the, 138 

Wasting illnesses, effect of, 68 

Whale, rudimentary limbs of the, 
267 

White hair, 67 

„ of the eye, the, 215 

Wi^^pipe, the, 169, 185 

Winking, 214 

Withers of a horse, the, 280 



Wrist, the, 33, 43, 93 

,, the bones of the, 35 

,, and ankle compared, 148 

,, man's, 274 

Wrist- joint flexion, 150 



Zygo3iatic arch, the, 59, 199 

„ process, the, 59 

Zygomaticus, the, 237 



THE END 



Printed in Great Britain by R. (&= R. Clark, Limited, Edinburgh. 1941 



J' 



m 

URtI 



ID. 
\JRU 



rp) 



Form L9-' 



UNIVERSITY OF CALIFORNIA LIBRARY 

Los Angeles 

This book Is DUE on the last date stamped below. 



I?ECD LDURli; 

JUNO 3 ^988 

REC^D LO-URfc 

J^0V231988 



SFP 2 1 WW 



DRiQn 



iBnr 



MAY 2 a.)991 



JU!" 



nj-osr 



^2ij9J0 




KIVED 







ikivcAi"^ 'tyVciiiATwn.quv^ '^AHVHfflH^^ 



3 1158 00206 3658 



^* 




fJI> 



.HDNVSOP 






■\}m\m^/y 



rrt 



AINniWV 



(?i:i 



%CM7AiMn-:nt^ 




/njvvm- 



UBRARY6 



(^?;r\ T TTv/'i !r\V»^ 



I'mnkTU om>e