UK ■Ism? THE SKELETON. There are 200 Bones in the Human Skeleton, Arranged as Follows: Skull. Cranium. Frontal... 1 Occipital . . 1 rParietal . . 2 Teuiporal. . 2 Sphenoid . . 1 Ethmoid . . 1 - 8 Trunk. Vertebra. Cervical . . 7 Dorsal.. . .12 Lumbar. . . 5 • Sacral/1 .(5) Coccygeal (4) lv * -26 Ribs 24 Os Hyoid. . 1 Sternum . . 1 -26 Total in trunk. . . 52 Face. Nasal ... 2 Malar ... 2 Inf. turb. . 2 Maxilla . . 2 Lachrymal . 2 Palate ... 2 Vomer.. . . 1 Mandible. . 1 -14 Total in skull 22 Lower Extremities. Os Innomi- natum . . 2 Femur ... 2 Patella.. . . 2 Tibia. ... 2 Fibula ... 2 -10 Upper Extremities. Clavicle. . . 2 Scapula . . 2 Humerus.. . 2 Radius.. . . 2 Ulna 2 -10 Carpal. Scaphoid . . 2 Semilunar. . 2 Cuneiform . 2 Pisiform.. . 2 Trapezium . 2 Trapezoid. . 2 Os Magnum. 2 Unciform. . 2 -16 Metacarpal . 10 Phalanges . 28 Total in up- per extrem. 64 Tarsal. Os Calcis. . 2 Astragalus . 2 Cuboid ... 2 Navicular. . 2 Int. cunei- form.. . . 2 Mid. cunei- form.. . . 2 Ext. cunei- form ... 2 -14 Metatarsal . 10 Phalanges. . 28 Total in lower extr. 62 Summary of Bones. The Skull 22 The Trunk 52 The Upper Extremities 64 The Lower Extremities 62 200 3 4 ANA1OMY IN ABSTRACT. Bones are divided into four classes; Long', Short, Flat, Irregular. Long bones are typified by having a shaft and two enlarged extremities. The shaft or diaphysis is cylindrical. The external portion is dense and com- pact. The internal structure is can- cellous and contains small canals (Haversian) wfith a large center or me- dullary canal. The end or epiphysis is enlarged. Its external layer is dense and compact. The internal structure is cancellous throughout. The diaphysoepiphyseal line shows union of. the two portions as they are developed from different centers of ossi- fication. The long bones are humerus, clavicle, tibia, fibula, femur, radius, ulna, meta- carpal, metatarsal and phalanges. Short bones are generally cuboidal in shape, and are for strength. External surface is compact, and internal struc- ture is spongjr throughout. The short bones are tarsal, carpal and patella. Flat bones are for extensive protection or extensive muscular attachment. They are composed of an external or outer table, an internal or vitreous table, and a cancellous tissue oetween, known as diploe. The flat bones are occipital, parietal, frontal, nasal, lachrymal, vomer, scapu- la, os innominatum, sternum and ribs. Irregular or mixed bones are those not already named, hence cannot be in- cluded in any of the other classes. They are the vetebras, sacrum, coccyx, temporal, sphenoid, ethmoid, malar, maxilla, mandible, palate, inferior tur- binated and hyoid. Surface of bones contain eminences and depressions which increase their surface extent and have been given special names, as articular and non-ar- ticular. The articular depressions and emi- nences are the enlarged articular cavi- ties and ends of bones, as glenoid cavity, condyles, etc. The non-articular eminences are tuber- osity, tubercle, spine and line or ridge. The depressions are fossa, furrow, fissure, groove and notch. BONES IN GENERAL BONES. 5 STERNUM (the chest), breast bone. Di- vided into three parts. 1. Manubrium (handle). Presternum. Has for study superior margin, supra- sternal notch in center, with lateral notches for clavicles. Sides have two notches for first and second ribs. Ant. and post, surfaces are smooth. Inferior border continuous with second portion. 2. Gladiolus (mesosternum). Composed of four segments, ant. and post, surfaces are free. Lateral borders are notche*' for sec- ond, third, fourth, fifth and sixth ribs, occasionally sevenui. 3. Ensiform: or xiphoid (metaster- num). Cartilaginous lower end of sternum, projected into abdominal wall. Development: by six centers. One for manubrium. One for each segment of gladiolus. One for ensiform. 1. Manubrium (handle). Presternum. Articulation with clavicle and seven costal cartilages on each side. Ossification: Begins sixth fetal month. Completed in ensiform at fortieth year. (Last in body.) Muscles. Nine pairs and one single. Pectoralis major; entire length, ant. surface. Triangularis sterni; lower half, post, surface. Transversalis; ant. surface of ensi- form. External and Internal oblique; ant. surface of ensiform. Rectus abdominus, post, surface of 'ensiform. Sternocleidomastoid; above, ant. sur- face. Sternohyoid; above, post, surface. Sternothyroid; post, surface. Diaphragm; post, surface of ensiform. BONES OF THE TRUNK, HYOID (upsilon), the lingual bone at the base of tongue, shape horse- shoe. Five points for study: body two great- er, and two lesser cornua. Body: Central portion has ant. post., sup. inf. and lateral surfaces. The Greater Cornua project outward 6 ANATOMY IN ABSTRACT. and backward around the lateral walls of the larynx. The Besser Cornua are within the greater. Development. Five centers, one for body and one for each cornua. Ossification begins eighth month. In lesser cornua after birth. Muscles (twelve). In. Sternohyoid; superior surface. In. Thyrohyoid; greater horn and body. In. Omohyoid; inferior surface. Digastric aponeurosis. In. Stylohyoid; superior surface of body. In. Mylohyoid; median raphe of body. In. Geniohyoid; superior surface of body. In. Geniohyoglossus; superior sur- face of body. ©r. Chrondroglossus; lesser cornua. Or. Hyoglossus; body and cornua. Or. Middle constrictor; cornua. Lingualis occasionally. THE RIBS are twenty-four elastic arches forming the chief part of the thoracic wall; twelve on each side. Seven, true; five, false; two of latter are floating. Typical rib has following points for study: head, neck, tubercle, articular facet, angle, shaft and anterior end. Head; articulates with body of ver- tebra. Neck; is constriction back of head. Tubercle; roughened eminence, the lower half of which articulates with transverse process of vertebra. Angle; is sharp bend in shaft under internal margin of scapula. Shaft; forms greater portion of rib, is flat bone, convex on all surfaces ex- cept inferior, which has groove for intercostal vessels and nerves. Anterior; or sternal end, articulates with costal cartilage. The Peculiar Ribs are: first short', flat and horizontal. Head has one articu- lar facet, superior surface has two grooves for subclavian artery and vein. Tubercle between these ves- sels for scalenus anticus muscle. Second resembles first except it is larger and longer. Tenth has but one articular facet on end. Eleventh has an angle. Eleventh and twelfth have but one articular facet, nd neck; tuberosity or angle and ante- rior end free. development: upper ten by three centers, one each for head, shaft and tubercle. Eleventh and twelfth by two cen- ters, head and shaft. Ossification begins in early fetal life; completed about twenty-fifth year. Muscles: nineteen. Intercostal, eleven sets, between all ribs. Internal run downward and backward; external run downward and forward. Or. Iliocostalis attached to angle. Or. Scalenus medius; to superior sur- face of first rib back of artery. Or. Scalenus anticus; between artery and vein on first rib. Or. Serratus magnus; upper eight ribs. Or. Scalenus posticus; second, uppei surface. Or. Pectoralis major; cartilages of up- per six or seven ribs. Or. Obliquus externus; eight lower ribs. Or. Quadratus lumborum; twelfth rib. Or. Diaphragm; free margin of ribs. Or. Latissimus dorsi; three or four- ribs. In. Serratus posticus superior; second, third, fourth and fifth ribs. In. Serratus posticus inferior; four lower ribs. In. Iliocostales accessorius. In. Longissimus dorsi; from seventh to eleventh ribs. Or. Cervicalis ascendens; angle five upper ribs. In. Levatores costarum; all ribs. Infracostales; from one rib to an- other. SPINE. Vertebral column (vertere, to turn). Thirty-three distinct bones in early life, finally become twenty- six, as follows: Cervical, seven; dorsal, twelve; lum- bar, five; sacrum, five; finally one; coccyx, four; finally one. All vertebras present the following points for study. Body; large mass in front. Two pedicles; backward from body to lateral masses. Two laminas; flattened plates, which THE VERTEBRAL COLUMN. 8 ANATOMY IN ABSTRACT. meet behind to complete the arch. Spinous process; projection from union of laminas. Articulating facets (four); extend up- ward and downward from union of pedicle and laminas. Trans, process (two), outward from side of articular process. Spinal foramen; formed by body, two pedicles and two laminas. Intervertebral notches; become fora- mina when joined to fellow. Cervical Vertebras have in addition to the above, two vertebral foramina through base of transverse process. The bodies are smallest, all pro- cesses shorter, spinal foramen larg- est in spine. Bodies increase in size from above downward. Peculiar cervical are first, second and seventh. Atlas; next to skull, first bone. Ilas no body; but two lateral masses instead. Arch in front one-fifth and behind two-fifth from masses. Tubercle instead of spine and a small tubercle in front. Axis, second bone. Odontoid process; projection upward through atlas, taking place of body of atlas. Body triangular with broad articulat- ing surfaces above for atlas, and two small ones below for third bone. Vertebra prominens, peculiar because of its long, spinous process. Dorsal Vertebras have all points de- scribed as typical, except they have articulating facets on side of body for ribs. Peculiar dorsal bones are first, ninth, tenth, eleventh and twelfth. First has entire and half facet for ribs. Ninth has half facet for rib. Tenth, eleventh and twelfth have whole facets for ribs. Spines of dorsal droop down. Articulating facet on transverse pro- cess of upper ten for ribs. Dumbar Vertebras same as dorsal, ex- cept they have no facets for ribs, bodies are larger. Fifth has wedge-shaped body. Development: From four primary and numerous secondary centers. BONES. 9 From primary: Two for body, one for each lamina and process. Ossification: Begins sixth fetal week. Completed twenty-fifth year. Variations in development. Atlas, from two to five centers and three for odontoid process. Sacrum (sacer, sacred) triangular, con- tinuous from lumbar spine, forming post, part of pelvis. Wings (Ala) or lateral masses cor- responding to transverse process above, diminishes in size downward. Or. Pyriformis, lower half. Or. Coccygeus, side fifth segment. Anterior surface; smooth, concave. Eight sacral foramina, four on each side of bodies. Crossed by four ridges from foramina. Posterior surface, rough convex. Four posterior sacral foramina on each side. Lamina (broad) between foramina and' spine. Tubercles are remains of transverse process, external to foramina. Base directed upward and forward, articulates with fifth lumbar. Notch on sides for sacrolumbar cord. Apex downward and forward, articu- lates with coccyx. Sacral or spinal canal, triangular, ends posterior surface of fourth segment. Lateral borders; upper two-thirds, ar- ticulate with ilium, lower one-third free. Development: thirty-five centers. Three for each body, total fifteen. Six for lateral masses. Two for each arch, ten. Two for each lateral margins, four. Muscles: Eight pairs. To base of bone: Coccygeus, Iliacus and Pyriformis. Behind; Gluteus maximus; Latissimus dorsi; Multifidus spinae; Erector spinae and sometimes Extensor coc- cygis. Coccyx (cuckoo's beak), four segments. Continuous from sacrum. Inferior end of spinal column curved forward. Anterior surface, concave. Or. Coccygeus, margins. Posterior surface, convex. Or. Gluteus maximus, margin. 10 ANATOMY IN ABSTRACT. First segment; cornu project inward. Rudimentary transverse; process la- terally. Tubercles, side of second, third and fourth segments. Apex, rounded. Or. Levator ani and Sphincter ani. Development: four centers, one for each segment. Begins at birth. Completed twentieth year. BONES OF THE UPPER EXTREMITY. CLAVICLE (Clavis, Kev) collar bone. The only bone continuous from the thorax to the upper extremity. Shaped like the italic letter f. In- ternal two-thirds of shaft is cylin- drical. External one-third flattened horizontally. Articulations. Internal end with sternum. External end with acromion process. Development: from two centers. One for sternal head. One for shaft. Ossification: membranous. Begins thirtieth day (first in body). Completed in twenty-fifth year Muscles: seven. Or. Pectoralis major; sternal one- third, ant. surface. Or. Deltoid; acromial end of ant. sur- face. Or. Sternocleidomastoid; sternal end of sup. surface. Or. Platysma myoides; entire length of sup. surface. In. Trapezius; acromial end of post, surface. In. Subclavius; middle of inf. surface. Or. Sternohyoid; sternal end SCAPULA (spade). The shoulder blade. Triangular in shape. Points for study: Three borders, two angles, two surfaces, two processes, one spine and a glenoid cavity. Borders are internal, external and su- perior. Angles are superior and inferior. Surfaces are anterior and posterior. Processes are acromion and coracoid. Spine crosses horizontally the poster- ior surface. BONES. 11 Glenoid cavity: is cavity of shoulder joint. Articulation: two bones. Humerus in glenoid cavity. Clavicle with acromion process. Development: seven centers. Two, for coracoid process, one for body, two for acromion process, cne for vetebral border, one for inferior angle. Ossification: membranous. Begins second fetal month. Completed fifteenth to seventeenth year. Muscles: seventeen. In. Rhomboideus minor, int, border at base of spine. In. Rhomboideus major, int. border, lower half. Or. Biceps; long head above glenoid cavity, short head coracoid process. Or. Triceps: long head below glenoid. Or. Teres minor, central two-thirds, ext. border. Or. Omohyoid, sun. border near notch. In. "Latissimus dorsi, inf. angle. In. Levator anguli scapulae, sup. angle. In. Trapezius, internal border, acrom- ion process and sup. lip of spine. Or. Deltoid, ext. border, acromion pro- cess, and inf. lip of spine. Or. Coracobrachialis, coracoid pro- cess by common tendon. In. Pectoralis minor, coracoid process by common tendon. Or. Subscapularis, entire ant. surface. In. Serratus magnus, int. lip ant. sur- face. Or. Supraspinatus, above spine, post, surface. Or. Infraspinatus, below spine, post, surface. Or. Teres major, inferior angle, post, surface. HUMERUS (Arm). Shoulder to elbow. Largest, longest and strongest in up- per extremity. Points for study: A-Upper end. Head, articular surface with glenoid of scapula. Anatomical neck for capsule. Greater tuberosity, outer surface. Lesser cuberosity, anterior surface. Bicipital groove, between tuberosities. Surgical neck below tuberosities. 12 ANATOMY TN ABSTRACT. B-Shaft. Three surfaces; posterior, external and internal. Three borders; anterior, external and internal. Musculospiral groove, posterior sur- face. C-Lower end. Articular surface; radial with head of radius. Trochlear with greater sigmoid of ulna. Internal condyle and ridge. External condyle and ridge. Depressions; olecranon, posterior sur- face; coronoid, anterior surface. Articulation: with three bones. Upper end, glenoid cavity of scapula. Lower end, greater sigmoid notch of ulna and head of radius. Development: eight centers. One for shaft; one for head; one for each tuberosity; one for radial artic- ular surface; one for each condyle; One for trochlear surface (some- times absent). Ossification: membranous. Begins eighth fetal week. Completed twentieth year. Muscles. Twenty-four. In. Supraspinatus, greater tuberosity, upper facet. In. Infraspinatus, greater tuberosity, middle facet. In. Teres minor, greater tuberosity, lower facet. In. Subscapularis, lesser tuberosity. In. Teres major, post, lip bicip, groove. In. Pectoralis major, anterior lip bicip. groove. In. Latissimus dorsi, in bottom of bicip. groove. In. Deltoid, outer surface, two-fifth down. In. C'oracobrach. inner surface, one- half down. Or. Triceps. Posterior surface. Or. Brach, antic, ant. ridge, int. ext. surface, lower half. Or. Anconeus, post, surface external condyle. Or. Ext. carpi, rad. long. ext. condy- loid ridge. Or. Supinator longus, ext. condyloid ridge. Or. Ext. carpi, rad. brev. external condyle. BONES. 13 Or. Ext. com. digitorum, external con- dyle. Or. Ext. minimi digiti by common ten- don. Or. Ext. carpi ulnaris, by common tendon. Or. Supinator brevis by common ten- don. » • f' Or. Flex, carpi, radialis, internal con- dyle. Or. Palmaris longus, internal condyle. Or. Flex, sublim. digit, by common tendon. Or. Flex, carpi, ulnaris by common tendon. Or. Pronator radii teres, internal con- dyle. BADIUS (Ray, or spoke of a wheel). Outer bone of forearm; companion of ulna, and slightly smaller; upper end small, gradually increasing in size toward wrist; long bone. Points for study: Upper - Extremity. Head; cylindrical, cupped end for humerus, rotating in orbicular liga- ment. Neck; constriction below head. Bicipital tuberosity; lower half for Biceps, upper half covered by bursa. Shaft: triangular. Three borders; anterior, posterior and internal (interosseous). Three surfaces; anterior, posterior and external. Oblique line from tuberosity outward over anterior surface. Lower Extremity. Large quadrilateral. Two articular surfaces. Sigmoid cavity on internal surface for ulna; end for semilunar and scap- hoid. Styloid process projects from external portion. Grooves on dorsal surface for five ten- dons. Articulation. Four bones. Humerus, ulna, scaphoid and semi- lunar. Development. By three centers. One shaft, eighth week, twentieth year. One head, fifth year, fourteenth year. One lower end, second year, twentieth year. Muscles. Nine. 14 ANATOMY IN ABSTRACT. In. Biceps, to lower half of tuberosity. In. Supinator brevis to oblique ridge. Or. Flexor sublimus digltorum to ob- lique ridge. Or. Flexor longus pollicis, ant. surface of shaft. Or. Ext. ossis metacarpi pollicis, to posterior surface. Or. Extensor brevis pollicis, to pos- terior surface. In. Pronator radii teres to outer sur- face. In. Supinator 1c gus to styloid pro- cess. In. Pronator quaJratus to ant. sur- face. VINA (Elbow). Inside of forearm. Points for study: Upper Extremity. Olecranon process (head of elbow), post, surface subcutaneous, triangular; upper surface quadrangular for tri- ceps. Greater sigmoid cavity on upper sur- face for humerus. Lesser sigmoid cavity, external sur- face for head of radius. Coronoid process on superior surface. Tubercle of ulna, on upper surface of coronoid process. Shaft: triangular. Three surfaces; anterior, posterior and internal. Three borders; external (interosseous), anterior and posterior. Oblique line; upper part of external surface. Lower extremity: Head; end free, side articular with radius. Styloid process projects downward. Articulation: two bones, humerus and '•adius. Development: by three centers. One shaft; one olecranon, and one sty- loid process. Ossification: Begins about eighth week. Completed from sixteenth to twentieth year. Muscles. Fourteen. In. Triceps, tip of olecranon process. Or. Flex, carpi ulnaris, inner border olecranon process. In. Brachialis anticus to coronoid pro- cess. BONES. 15 Or. Pronator radii teres to coronoid process. Or. Flex, sublimus dig. to coronoid process. Or. Flex, longus pollicis to coronoid process. Or. Flex. prof, digitorum, ant. surface shaft. Or. Pronator quadratus, ant. surface shaft. Or. Extensor carpi ulnaris, external surface. Or. Anconeus, ext. surf, above oblique line. Or. Supinator brevis, upper anterior surface. Or. Extensor ossis metacarpi pollicis, posterior surface of shaft. Or. Extensor longus policis, post, sur- face. Or. Extensor indicis, external surface. HAND. Divided into three segments. Carpus or wrist; metacprpus or palm; phalanges or digits. CARPUS; eight bones, arranged in two rows. Scaphoid Semilunar Cuneiform Pisiform Trapezium Trapezoid Os magnum Unciform As above represents palmar surface of left hand. Classification, short bones. All are cuboid with six surfaces except oisi- form. Scaphoid (a boat). Articulates with (five) radius, trapezium, trapezoid, os magnum and semilunar. Semilunar (half moon). Crescent shap- ed; articulates with (five) radius, os magnum, unciform, scaphoid and cuneiform. Cuneiform (a wedge). Articulates with (three) semilunar, pisiform and un- ciform. Pisiform (a pea). Smallest of carpal bones; has four surfaces; articu- lates with (one) cuneiform. Trapezium (a table). Very irregular; ar- ticulates with (four) scaphoid, tra- pezoid, first and second metacarpal. 16 ANATOMY IN ABSTRACT. Trapezoid. Smallest in second row; wedge shaped; articulates with (four) scaphoid, second metacarpal, trapezium and os magnum. Ds magnum. Largest carpus; center of wrist; articulates with (seven) scaphoid, semilunar, second, third and fourth metacarpal, trapezoid and unciform. Unciform (a hook). So-called because of its hook process on palmar sur- face. Articulates with (five) semi- lunar, fourth and fifth metacarpal, cuneiform and os magnum. Developed: by one center for each bone. Os magnum and unciform first year. Trapezium and semilunar fifth year. Scaphoid sixth year. Trapezoid eighth year. Pisiform twelfth year. METACARPAL BONES: five, long, cylindrical, have shaft and two ex- tremities. Shaft: prismoid, curved upward in cen- A ter; three surfaces; two lateral, one dorsal. Carpal extremity or base; cuboidal, ar- ticulates with second row of carpal bones and their fellows. Digital extremity or head; rounded, ar- ticulates with corresponding first phalanx. Developed: by two centers each. One for the shaft and one for the digital extremity of the four inner, and one for shaft, and one for base of bone of thumb. Ossification: Begins eighth or ninth week in shaft. Ends about third year. They unite about twentieth year. PHALANGES (or digits). Long bones, with shaft, base and head. Articulation with other bones of same fingers. Developed: by two centers. One for shaft beginning eighth week. One for base beginning third year. Ossification: completed about twentieth year. OS INNOMINATUM (in nomen, without a name) nameless, because it re- sembles no known object. Compos- ed of three bones: Ilium, Ischium and Pubis. BONES OF THE LOWER EXTREMITY. BONES. 17 Ilium (ilia or flank); forms upper por- tion of prominence of hip. Points for study: Internal, external surfaces, anterior and posterior borders and a crest. External surface. Smooth, convex in front, concave behind. Curved lines: Superior, middle and in- ferior, cross downward and back- ward from crest to the sciatic notch, forming boundaries of the Glutei muscles. Internal surface: Iliac fossa, or ven- terilio, extends from crest down to iliopectineal line. Crest or Superior border: Anterior end is anterior superior spine. Pos- terior end is posterior superior spine. Anterior border: Anterior superior and anterior inferior spines. Notch be- tween spines and notch below. Posterior border: Posterior superior and posterior inferior spines. Great saprosciatic notch below post. inf. spine. Ischium (the hip). Points for study: Body, tuberosity and ramus. Body; upper triangular portion. Surfaces; external, internal and pos- terior. Spine projects from posterior surface. Lesser sacrosciatic notch below spine. Tuberosity; external, internal and pos- terior surface. Posterior surface roughened for at- tachment of muscles. Ramus or branch; thin, flattened, ex- tends upward and forward from tuberosity, joins descending ramus from pubis, forming anterior boun- dary of obturator foramen. Os Pubis; forms anterior part of os in- nominatum, quadrilateral in shape. Points for study: Two surfaces and three borders. Surfaces; anterior and posterior. Borders inner, outer and upper. Iliopectineal line, along internal margin of upper border. Spine; forward from upper part of an- terior surface. Crest; internal to spine. Angle; junction of crest with internal border. Symphysis; internal angle, articulation with fellow in median line. 18 ANATOMY IN ABSTRACT. Descending ramus; descends down- ward and outward to join ascending ramus of ischium. Surfaces; internal and external and same borders. Os Innominatum in general. Cotyloid cavity, or acetabulum, is deep, cup shaped, hemispherical depres- sion, constituting the cavity of hip- joint. Formed by three bones in following proportion: Pubis, one- fifth; Ischium, two-fifths; Ilium, two-fifths. Fossa acetabuli; depression in bottom for attachment of ligamentum teres. Cotyloid notch; at lower portion of cavity to admit blood vessels. Obturator or thyroid foramen; bound- ed in front by rami of ischium and pubis, behind by ischium, and above by pubis. It transmits the obturator vessels and nerves, and is covered by obturator membrane. Development. By eight centers; three primary and five secondary. Three primary centers: One Ilium; begins eighth week. One Ischium; begins twelfth week. One Pubis; begins sixteenth week. Five secondary centers. One anterior inferior spine. One tuberosity of ischium. One symphysis pubis. One crest of ilium. One bottom of acetabulum, eighth wreek. Ossification. Union between ramus about eighth year. Union between separate bones com- pleted about fifteenth year. Ossification completed about twenty- fifth year. Articulations: Three bones. Fellow opposite side, sacrum, femur. Muscles of ilium (sixteen). Or. Tensor vaginae femoris; outer lip of crest anterior portion. Or. Obliquus externus; outer lip of crest, ant. half. Or. Latissimus dorsi; outer lip of crest, post. half. Or. Iliacus; inner lip of crest through- out. Or. Transversalis; inner lip of crest throughout. • Or. Quadratus lumborum; inner lip of crest, post, portion. BONES. 19 Or. Erector spinae lumborum; inner lip of post, portion. Or. Obliquus internus; between lips of crest. Or. Gluteus maximus; above superior curved line. Or. Gluteus medius; below superior curved line. Or. Rectus femoris; anterior inferior spine. Or. Pyriformis; great sciatic notch. Or. Obturator int.; obturator fora- men. Or. Sartorius; anterior superior spine. Or. Multifldus spinae; post, ilia spine. Or. Gluteus minimus; between middle and inferior lines. Muscles of ischium (thirteen). Or. Obturator externus; ramus and body. Or. Adductor magnus; ant. surface of ramus. Or. Obturator internus; ramus and body. Or. Erector penis; int. surface of body. / Or. Gemellus superior; spine. Or. Levator ani; internal surface of tuberosity. Or. Coccygeus; internal surface of body. Or. Biceps; tuberosity, inferior sur- face. Or. Semitendinosus; tuberosity, inf. surface. Or. Semimembranosus; tuberosity, inf. surface. Or. Quadratus femoris; tuberosity. Or. Gemellus inferior; tuberosity. Or. Transversus perinaei; internal sur- face of body. Muscles of os pubis (sixteen). In. Obliquus externus; body and Pou- part's ligament. Or. Obliquus internus; body and rami. In. Transversalis; pectineal line. Or. Rectus abdominis; pubic crest. Or. Pyramidalis; body superior sur- face. Or. Psoas parvus; iliopectineal line. Or. Pectineus; iliopectineal line. Or. Adductor magnus; ant. surface of ramus. Or. Adductor longus; ant. surface of body. Or. Adductor brevis; ant. surface of ramus. 20 ANATOMY IN ABSTRACT. Or. Gracilis; ant. surface of ramus. Or. Levator ani; post, surface body and ramus. Or. Compressor urethrae; posterior surface of ramus. Or. Accelerator urinae; (occasionally). Or. Obturator externus; ant. surface of ramus. Or. Obturator internus; post, surface of ramus. FEMUR (thigh). Longest and strongest in body. Points for study. Shaft, upper and lower extremity. Upper Extremity. Head; cylindrical, artic, with acetabu- lum. Anatomical neck; insertion of capsule. Greater trochanter, lesser trochanter, ant. and post, intertrochanteric lines. Tubercle; anterior surface of neck. Digital fossa above neck. Shaft (triangular). Surfaces. Anterior, external, internal. Borders. Post, (linea aspera) external and internal. Gluteal ridge, post, surface upper end. Lower Extremity. Internal and external condyles. Intercondyloid notch. Outer and inner tuberosities on con- dyles. Articulation: Three bones. (1) Innominate; head. (2) Tibia; condyles. (3) Patella; anterior surface of con- dyles. Development: By five centers. One each for shaft, head, condyles, greater and lesser trochanters. Ossification. Begins seventh fetal week. Completed twentieth year. Muscles. Twenty-three. In. Gluteus medius; posterior surface of greater trochanter. In. Gluteus minimus; anterior surface of greater trochanter. In. Pyriformis; tip of greater tro- chanter. In. Obturator int.; tip of greater tro- chanter. In. Gemellus; sup.; tip of greate'- tro- chanter. In. Gemellus inf.; tip of greater tro- chanter. BONES. 21 In. Obturator externus; digital fossa. In. Quadratus femoris; linea quadrati. In. Psoas magnus; lesser trochanter. In. Iliacus; lesser trochanter and line below. In. Gluteus maximus; upper linea aspera. Or. Vastus externus; external surface of shaft. Or. Biceps; short head. Lower linea aspera. Or. Vastus internus. Internal surface of shaft. In. Adductor magnus; linea aspera. In. Adductor brevis; linea aspera. In. Adductor longus; linea aspera. • In. Pectineous; upper linea aspera.' Or. Crureus; anterior surface of shaft. Or. Subcrureus; lower anterior surface of shaft. Or. Gastrocnemius; both condyles; post, surface. Or. Plantaris; external condyle, post, surface. Or.'Popliteus; external condyle, post, surface. PATELLA (a small pan). Knee cap. Flat and triangular. Anterior part of knee joint. Usually regarded as a sesamoid bone. Articulates with anterior surface of condyles of femur. Developed in quadriceps tendon from one center. Ossification. Begins third year. Completed fourteenth year. Muscles. Four. Rectus; superior border. Crureus; superior border. Vastus externus; external border. Vastus internus; internal border. Patellar tendon from tip or inferior angle. TIBIA (flute or pipe). Large bone of leg. Points for study. Upper Extremity. (Head.) Internal and external tuberosities. Articular surfaces; concave. Spine between articular surface. Tubercle; anterior surface of head. Popliteal notch; between tuberosities ' posteriorly. 22 ANATOMY IN ABSTRACT. Articular surface; for fibula on outer tuberosity. Shaft (Triangular). Three borders; anterior (crest); ex- ternal (interosseous); internal. Three surfaces; internal (subcutane- ous), external and posterior. Lower Extremity. Internal malleolus. (Ankle bone.) Summit of malleolus for Deltoid liga- ment. Posterior surface grooved for Flexor longus digitorum and Tibialis pos- ticus. Anterior surface concave for extensor tendons. External surface articulates with fibula. Inferior surface articulates with as- tragalus. Articulation: Three bones. Femur (condyles) superior end. Fibula, outer side of external tuber- osity and outer side of lower end. Astragalus, lower extremity. Development: By three centers. One for shaft, one for each extremity. Occasionally one each for spine and internal malleolus. Ossification membranous. Begins seventh week. Completed twentieth year. Muscles. Twelve. In. Semimembranosus, internal tuber- • osity, post, surface. In. Biceps, external tuberosity, ant. surface. In. Sartorius, common tendon, below internal tuberosity. In. Gracilis, common tendon, below in- ternal tuberosity. In. Semitendinosus, below internal tuberosity. Or. Tibialis anticus, external surface, upper two-thirds. In. Popliteus, posterior surface above oblique line. Or. Soleus, posterior surface from oblique line. Or. Tibialis posticus, posterior sur- face below line to center. Or. Flexor longus digitorum, posterior surface central half. Or. Extensor longus digitorum to outer tuberosity. In. Ligamentum patella, to tubercle. Tensor fasciae femoris to external tuberosity. BONES. 23 FIBULA (a clasp). Outer bone of leg. Most slender of all long bones. Points for study. Upper Extremity. Head, irregular quad- rate. Styloid process, or summit. Internal surface; articulation for tibia. Prominence; external surface. Shaft Quadrate. Four surfaces; anterior, posterior, in- ternal and external. Four borders; anteroexternal, antero- internal, posteroexternal and pos- terointernal. Lower Extremity. Forms external malleolus. Internal surface; articular, with tibia. Posterior surface; grooved for peron= eus longus and brevis. External surface; subcutaneous. Summit; prominence of malleolus. Articulation: two bones. Tibia at both ends. Astragalus at lower end. Developed from three centers. One shaft. One for each extremity. Ossification. Begins eighth fetal week. Completed twenty-fifth year. Muscles: nine. In. Biceps, end and anterior surface of head. Or. Extensor longus digitorum, upper three-fourths. Or. Peroneus tertius, lower portion of shaft. Or. Extensor proprius hallucis, central half. Or. Peroneus longus, upper three- fourths; external surface. Or. Peroneus brevis, lower two-thirds. Or. Tibialis posticus, central half; in- ternal surface. Or. Soleus, upper portion; posterior surface. ~ Or. Flexor longus hallucis; central two-thirds. FOOT. Twenty-six bones. Tarsal bones, seven; namely: Os calcis, astragalus, cuboid, navicu- lar, internal, middle and external cuneiform. Five Metatarsal, 1-2-3-4-5. Fourteen Phalanges, three for each toe except great toe, which has two. 24 ANATOMY TN ABSTRACT. CALCANEUS (Os calcis). Heel. Largest and strongest, irregular cuboid, long axis forward and Outward. Re- ceives weight of body. Six surfaces. 1. Superior, two articular facets in middle third, articulates with as- tragalus. Posterior and anterior thirds free. Sustentaculum tali is lesser process, projects inward. 2. Inferior, convex and roughened. 3. External subcutaneous. Peroneal tubercle, anterior third. Superior groove for peroneus brevis tendon. Inferior groove for peroneus longus tendon. 4. Internal, concave from sustentacu- lum tali for tendons of Tibialis pos- ticus and Flexor proprius hallucis. 5. Anterior, articulates with cuboid. 6. Posterior tubercle, a roughened surface for attachment of tendo Achillls. Articulation: with astragalus and cuboid. Muscles: nine. In. Tibialis posticus, inferior surface. In. Gastrocnemius, posterior surface. In. Soleus, posterior surface. In. Plantaris, posterior surface. Or. Abductor hallucis, inferior surf. Or. Abductor minimi digiti, inferior surface. Or. Flexor brevis digitorum, inferior surface. Or. Extensor brevis digitorum, su- perior surface. Or. Flexor accessorius, inferior. ASTBAGALUS. (A die.) Next in size to os calcis. Six surfaces. Position, middle upper part of tarsus. Between malleoli under tibia. 1. Superior, posterior two-thirds, ar- ticulates with tibia, anterior third free. 2. Inferior, two articular facets for os calcis, groove between. 3. Internal, articulates with internal malleolus. 4. External, articulates with external malleolus. 5. Anterior (Head), articulates with navicular. 6. Posterior, narrow groove for Flexor longus hallucis. BONES. 25 Neck, constriction in front of superior articular surface. Tubercle, external portion of posterior surface. Separate bone when it is know as os trigonum. Articulates with four bones, namely: Tibia, fibula, os calcis and navicu- lar. No muscles. CUBOID (Cube). Outside of foot form- ing lower chain. Six surfaces, three articular. 1. Posterior, articulates with os cal- cis. 2. Anterior, articulates with fourth and fifth metatarsal. 3. Internal, articulates with cunei- form. 4. Inferior. 5. Superior. 6. External are free. Articulates with four bones, namely: os calcis, external cuneiform, fourth and fifth metatarsal. Muscles. Two, namely: parts of Flexor brevis hallucis and part of Tibialis posticus. NAVICULAB: (Scaphoid.) Forms inner prominence of instep. Six surfaces. Posterior, articulates with head of as- tragalus. Anterior, three facets, articulates with all cuneiform bones. All other surfaces free. Articulates with four bones, namely: Astragalus, three cuneiform and oc- casiona"y cuboid. Muscles, namely' part of Tibialis pos- ticus. CUNEIFORM (wedge like): Internal, middle and external with cuboid form anterior row of tarsal bones. All have six surfaces. Internal: largest, apex downward. Posterior is navicular. External is middle cuneiform and sec- ond metatarsal. Anterior is first metatarsal. Internal surfaces and superior sur- faces are free. Articulates with first and secon 1 me- tatarsal and navicular and ..middle cuneiform. 26 ANATOMY IN ABSTRACT. Muscles: three, namely: Tibialis anticus and posticus and Peroneus longus. All inferior surface. Middle: smallest of tarsal. Anterior, second metatarsal. Posterior, scaphoid. External, cuneiform. Internal, cuneiform. Articulates with four bones as above. Muscle: one, namely: part of Tibialis posticus. External: (Wedge shaped.) External, is cuboid. Internally, is middle cuneiform, and base of second metatarsarl. Anteriorally is third metatarsal. Posteriorally, is navicular. Articulation with six bones: namely: navicular, middle cuneiform, cuboid and second, third and fourth meta- tarsal. Muscles: two namely: Tibialis posticus and Flexor brevis hallucis. METATABSAIi: Five. (Long bones.) Have for study, shaft, post, end or base, anterior end or head. Prismoid, tapering toward phalanges, slightly curved upward in the center. Base is quadrangular wedge. Articu- lates with second row of tarsal bones and their fellows. Head rounded, articulating with first phalanges. Articulation: tarsophalangeal. With the tarsal bones at the bases. With first phalanges at the heads. Muscles: First bone, three muscles, namely: Tibialis anticus; Peroneus longus; First Dorsal interosseous. Second bone, four muscles, namely: Adductor obliquus hallucis; firstand second dorsal interosseous and part of Tibialis posticus. Third bone, five muscles: Adductor ob- liquus hallucis; second and third dorsal; first plantar Interosseous and part of Tibialis posticus. Fourth bone, five muscles; Adductor obliquus; third and fourth dorsal; second plantar interosseous; part of Tibialis posticus. • Fifth bone, six muscles; Peroneus brevis; Peroneus tertius; Flexor brevis minimi digiti; Adductor transversus hallucis; fourth dorsal and third plantar interosseous. BONES. 27 PHALANGES. (See hand.) Tarsal Bones. Development: from one center except os calcis, which has a second for posterior extremity. Ossification. Os calcis, sixth fetal month. Astragalus, seventh fetal month. Cuboid, ninth fetal month. External cuneiform, during first year. Internal cuneiform, in third year. Middle cuneiform, in fourth year. Navicular, in fourth year. Metatarsal Bones. Development: from two centers. First bone, one for shaft and one for base. Other bones, one for shaft and one for head. Ossification. Begins in center of shaft ninth w'eek. End of first bone third year. End of other bones fifth year. Union about eighteenth year. Phalanges. Developed from two centers. One for shaft. One for metatarsal extremity. Ossification. Shaft at tenth week. Epiphysis fourth to tenth year. Union about eighteenth year. The bones of the thorax and extremi- ties appear before the skull to prepare the student for the more difficult study of the cranium. Under bones, where Or. and In. are used before a muscle, it means that that muscle has its origin from or insertion into that bone. Abbreviations used to describe muscles: Or. Origin of the muscle. In. Insertion of the muscle. Nv. Nerve supply to the muscle. Ac. Action of the muscle. 28 ANATOMY IN ABSTRACT. FRONTAL (frons, the forehead), is formed like a cockle shell. It is divided into two portions, name- ly: Vertical and Horizontal. Vertical portion; external surface forms the forehead, and has for study, two eminences, two ridges, three processes, two notches, one spine and one arch. Eminences: frontal, prominence of fore- head, one on either side. Nasal, or glabella, in median line above nose. Ridges: Superciliary; arching outward from nasal eminence over orbits. Temporal; continuous from same ridge on temporal bone, gives attachment to temporal muscle. Processes: Internal angular; inner corner of eye articulating with nasal bone. External angular; forming external side of orbit, articulating with malar. Nasal, projects downward in median line back of nasal bones, supports bridge of nose. Notches: nasal, betwreen internal angular processes and before nasal process. Supraorbital; sometimes a foramen, through superior margin of orbit. Spine; nasal projects from nasal pro- cess. Arch; supraorbital, prominent margin of orbit below superciliary ridge. Internal surface of vertical portion con- cave, depressions for convolution of cerebrum and for pacchionian bodies and longitudinal sinus. Ridge on either side of longitudinal groove for attachment of falx cerebri. Foramen cecum at end of frontal crest completed by ethmoid Done for vein from nose to longitudinal sinus. Frontal sinuses; cavities between two plates of perpendicular portion ex- tending up to superciliary ridges. Infundibulum is opening from this sinus to nasal cavity. Horizontal portion: external or inferior surface consists of two thin plates forming roof of orbital cavities, separated by ethmoidal notch. De- pressions in external portion of or- bit for lachrymal gland. Internal BONES OF THE CRANIUM. BONES. 29 portion for pulley of superior oblique and along margin is notch. Internal or superior surface has emi- nences and depressions for convolu- tions of frontal lobe of the cerebrum. Notch in median line for ethmoid bone. Borders; superior articulates with parietal bones. Posterior with lesser wings of sphenoid. Articulates: with twelve bones. Two parietal; superior border. One sphenoid; to greater wing. One ethmoid; ethmoidal notch. Two nasal; nasal notch and spine. Two maxillary, internal angular pro- cess. Two lachrymal; internal angular pro- cess. Two malar; external angular process. Development: membranous. Two centers, one each lateral half. Muscles: three pairs. Or, Corrugator supercilii; below gla- beHa. Or, Orbicularis palpebrarum, internal angular process. Or, Temporal, temporal fossa and ridge. OCCIPITAL BONE (Ob caput, against the head). Shape trapezoid. Base of cranium, pos- terior half. Two surfaces, four borders, four angles and three processes. External surface, inferior convex. Occipital protuberance in center mid- way between superior margin and foramen magnum. Superior curved line curved outward and downward from tuberosity. Inferior curved line below, and paral- lel with superior. Crest, ridge from occipital protuber- ance to foramen magnum in median line. Condyles are two kidney shape emi- nences along sides of anterior half of foramen magnum, articulating with atlas. Two jugular processes, projecting la- terally from sides of condyles. Basilar process, anterior to foramen magnum. Condyloidal foramina, anterior for hypoglossal nerves. 30 ANATOMY IN ABSTRACT. Posterior for veins to lateral sinus. Foramen magnum for spinal cord. Internal surface, concave, constituting greater part of posterior fossa of cavity of skull. Crucial ridge divides posterior portion into four fossas. Superior fossa, for occipital lobes of cerebrum. Inferior fossa for cerebellum. Torcular Herophili corresponds to ex- ternal occipital protuberance. Grooves to sides of crucial ridges for sinuses. Lateral sinuses outward. Superior longitudinal sinus upward. Occipital sinus forward and down- ward. Tentorium cerebelli is attached to the lateral ridges throughout. Basilar process is anterior to foramen magnum, and is grooved for medulla oblongata. Superior border articulates with the two parietal bones. Inferior border, upper half articulates with mastoid portion of temporal. ' Inferior half articulates with the petrous portion of temporal bone. Notch back of jugular process is jugu- lar fossa, going to form jugular foramen. Angles are between the borders. Development, from seven centers. Four for tabular part posterior to foramen magnum. One for each condyle. One for basilar portion. Ossification begins eighth fetal week. Completes, twentieth year. Articulation with six bones, namely: two parietal, two temporal, sphe- noid, and atlas. Ligamentum nuchae to external oc- cipital protuberance. Muscles, 12 pairs. Or. Trapezius, superior curved line, in- ternal half. Or. Occipitofrontalis; center of supe- rior curved line. In. Sternocleidomastoid; outer third superior curved line. In. Splenius capitis; below external » half of sup. curved line. Tn. Complexus; entire extent, two- thirds surface between lines. BONES. 31 In. Obliquus capitis inferior; exter- nal to and below complexus. In. Rectus capitis posticus major; in- ternal to latter. In Rectus capitis posticus minor; be- tween crest, inferior curved line and foramen magnum. In. Rectus capitis lateralis; jugular process. In. Rectus capitis anticus minor; an- terior to condyle. In. Rectus capitis anticus major; basi- lar process. In. Superior constrictor; basilar pro- cess. PARIETAL (Paries, a wall). Form, ir- regular quadrilateral, concavocon- vex. Points for study: two surfaces, four borders, four angles. External surface; convex, smooth. Parietal eminence from center of primary ossification. Temporal ridges; 1, Inferior for tem- poral muscle; 2, Superior for tem- poral fascia. i-arietal foramen (not always pres- ent) ; near superior border for vein to superior longitudinal sinus. Internal surface. Depressions; two varieties. 1. Throughout surface for convolu- tions of the cerebrum. 2. Near superior margin for Pac- chionian bodies; more numerous with age. Grooves on internal surface. 1. From anterior inferior angle for middle meningeal artery. 2. From center of inferior border for same artery. 8. Along superior border for superior longitudinal sinus. 4. Across posterior inferior angle for lateral sinus. Borders: four. 1. Superior; articulating with its fel- low in median line, forming the sagittal suture. 2. Inferior; three parts; Anterior is thin, beveled, overlapped by greater wing of sphenoid. Middle third; arched and beveled, overlapped by squamous portion of temporal bone. Posterior third; thick serrated, for articulation with mastoid portion of temporal bone. 32 ANATOMY IN ABSTRACT. 3. .Anterior; deeply serrated, beveled at expense of outer border above, and inner below. Articulates with frontal bone, forming the coronal suture. 4. Posterior border; deeply denticu- lated. Articulating with occipital bone forming lambdoid suture. Angles: four. 1. Anterior superior; with its fellow and frontal bone, forming anterior fontanelle in early life. 2. Anterior inferior; received be- tween greater wing of sphenoid and frontal bones. 3. Posterior superior; corresponds with union of sagittal and lamb- doid sutures, also posterior fontan- elle of fetal life. 4. Posterior inferior; articulates with temporal. Development: Membranous, one center beginning at parietal eminence at eighth fetal w7eek. Articulation, with five bones; frontal, oc- cipital, opposite parietal, sphenoid and temporal. Muscle: one; Or. Temporal, below tem- poral ridge. TEMPORAL (tempus, time) on sides of base of skull. Divided into three portions. 1. Squamous (squama, a scale), an- terior superior part of bone. Is thin and scale like. External surface smooth, convex, groov- ed for deep temporal artery, and forms part of temporal fossa. Ridge continues from temporal bone.. Zygomatic arch projects from lower portion, and anteriorally articulates with malar. Eminentia articularis continues from tubercle around under base of pro- cess, forms anterior boundary of glenoid fossa, back part of which is formed by arch from base of zygo- matic arch. Glaserian Assure divides glenoid fossa into two portions. Anterior or man- dibular articulates with condyle of this bone. Posterior part lodges part of parotid gland. The floor is tym- panic plate and margin is auditory process. It lodges pro'cessus gracilis of malleus, transmits tympanic branch of internal maxillary artery. BONES 33 Canal of Huguier, parallel to the glaserian fissure, transmits chorda tympani nerve. (Branch of seventh.) Internal surface, concave; eminences and depressions for convolutions of temporal lobe of cerebrum. Grooves for middle meningeal artery. 2. Mastoid portion, (Nipple). Posterior part of bone. Mastoid process, downward back of ear. Mastoid foramen transmits a vein to lateral sinus, a small artery from occipital to dura. Digastric fossa; inner side of mastoid process. Occipital groove; internal to fossa, lodges occipital artery. Internal surface. Sigmoid groove for lateral sinus, termination of mas- toid foramen. Internal structure of mastoid process is cellular, called mastoid cells, lined with mucous membrane, and communicating with each other, terminate in cavity of tympanum by one or two openings. Cells not developed until after puberty. 3. Petrous portion. (A stone). Very dense, pyramidal. Has for examination base, apex, three surfaces, three borders, and con- tains within, the essential organs of hearing. Base is continuous with the squamous and mastoid portions at its mar- gins. Its central portion is free. The meatus auditorius externus is through its centre. The auditory process is the projecting margin of this opening. Apex projects between greater wing of sphenoid and basilar process of occipital bone. Has carotid canal for carotid artery, and forms part of foramen lacerum medium. Anterior surface forms posterior part of middle fossa of skull. Points for study: six:- 1. Eminence, Indicating superior semicircular canal. 2. Depression: external to eminence, locating tympanum, known as the tegmen tympani. 3. Hiatus Fallopli; for passage of petrosal branch of vidian nerve, and 34 ANATOMY IN ABSTRACT. petrosal branch of middle menin- geal artery. 4. Small opening; external to latter for small petrosal nerve. 5. Termination of carotid canal near apex of bone. 6. Shallow depression for Gasserian ganglion. Posterior surface forms front of pos- terior fossa of skull. Points for study: three:- 1. Meatus auditorius internus in center, four lines in length closed by verti- cal plate, cribrosa lamina, which is crossed by horizontal crest, crista falciformis, below crests are sets of foramen. (A), transmits nerves to saccule; (B), nerve to posterior semicircular ca-nal; (C), transmits nerves to cochlea, vestibule, supe- rior and external semicircular canals; (D), large opening for seventh nerve. 2. Aqueductus vestibuli behind meatus, transmits small vein and artery; lodges process of dura. 3. Depression above 1 and 2 lodges process of dura and transmits vein from cancellous tissue of bone. Inferior surface (Basilar), rough and irregular. Points for study: eleven, from apex to base. 1. Quadrilateral surface for attach- ment of two muscles: Levator palati; Tensor tympani. 2. Carotid canal, transmitting in- ternal carotid artery and carotid plexus. 3. Aqueductus cochlea, triangular opening, transmitting vein from cochlea to internal jugular. 4. Jugular fossa, with occipital bone, forms jugular foramen. 5. Foramen for Jacobson's nerve, (branch of glossopharyngeal). 6. Foramen for entrance*of Arnold's nerve (auricular branch of the tenth). 7. Jugular surface, articulating with jugular process of the occipital bone. 3. Vaginal process, plate of bone from carotid canal to styloid process, a partition between glenoid and jugu- lar fossa, origin of Tensor palati. BONES. 35 9. Styloid process from one-half to one Inch long, giving origin to the muscles, namely: Stylohyoideus; Stylopharyngeus; Styloglossus and two ligaments, namely: Stylohyoid, and Stylomaxillary. 10. Stylomastoid foramen, termina- tion of aqueductus Fallopii and transmits seventh nerve and stylo- mastoid artery. 11. Auricular Assure, between audi- tory and mastoid processes, exit auricular branch of tenth nerve. Borders: superior, posterior and anterior. Superior; tentorium attached, grooved for superior petrosal sinus, notched for Afth nerve. Posterior; inner half channel for in- ferior petrosal sinus, outer half forms half of jugular foramen. Anterior; outer half joins squamous portion, inner half articulates with spinous process of sphenoid. Between two halves are two foramina leading into tympanum, namely:-• 1st for Tensor tympani muscle. 2nd for Eustachian tube. Development: by ten centers. 1. Squamous portion and zygomatic arch. 1. Tympanic plate. 6. For petrous and mastoid portions. 2. For styloid process. OssiAcation: Begins second fetal month. Completed Afteenth year. Articulation: Ave bones, namely: Occipital, parietal, sphenoid, mandible and malar. Muscles: Afteen. To mastoid portion. In Sternomastoid. In. Splenius capitis. Tn. Trachelomastoid. Or. Digastric. To styloid process. Or. Styloglossus. Or. Stylohyoideus. Or. Stylopharyngeus. To zygomatic arch. Or. Masseter. To petrous portion. Or. Levator palatl and Tensor palati. Intrinsic muscles. Stapedius. Tensor tympani. To Squamous portion, Temporal. 36 ANATOMY IN ABSTRACT. SPHENOID BONE (a wedge). Keystone of the skull. Reaches entirely across base. Shape of bat. Has for examination: body; two greater, two lesser wings, two pterygoid processes. Body: cuboid, hollow, in median line. Superior surface extends from ethmoid to basilar process of occipital. Points for study: eleven. 1. Ethmoidal spine in front articu- lates with cribriform plate of eth- moid. 2. Optic groove for optic commissure, leads into optic foramen on either side. 3. Olivary process. 4. Pituitary fossa or sella iurcica for pituitary body. 5. Middle clinoid process. 6. Posterior clinoid process. 7. Dorsum ephippii, square plate be- tween these processes. 8. Petrosal process articulates with petrous portion of temporal. 9. Clivus, groove in median line con- tinuous with basilar groove, for pons Varolii. 10. Carotid groove, on sides for car- otid art. 11. Lingula, ridges on outside of lat- ter groove. Posterior surface of body articulates with basilar process of occipital bone. Points for study: anterior surface of body has three points. 1. Ethmoidal crest, articulating with perpendicular plate of this bone go- ing to form septum of nose. 2. Openings on either side of crest leading into cavity of body, or sphenoidal cells. 3. Lateral margins of this surface articulates with os planum of eth- moid. Points for study: inferior surface of body. 1. Rostrum articulating with vomer. 2. Vaginal processes receiving wings of vomer. 3. Pterygopalatine canal completed by palate bone, transmitting pha- ryngeal nerve and pterygopalatine vessels. Greater wings projected laterally from body to sides of cranium. BONES. 37 Each wing has three surfaces and a circumference. Superior or cerebral surface concave, forms part of middle fossa of skull. It is irregular to conform to sur- face of brain. Points for study: 1. Foramen rotundum for Second di- vision of fifth nerve. 2. Foramen ovale for thir^ division of fifth nerve. 3. Foramen vesalii for small vein. 4. Foramen spinosum near spine of this bone and transmits middle meningeal artery. External surface (convex). Forming part of surface of skull. Points for study: 1. Pterygoid ridge; passing trans- versely across, dividing surface into two portions, viz: A. Superior, forming internal wall of temporal fossa. B. Inferior, forming internal wall of zygomatic fossa. 2. Spine or inferior extremity. Anterior or orbital surface, quadrila- teral, assists in forming outer wall or orbit. Points for study: 1. Tubercle near apex of orbit for one head of external rectus. 2. Notch above for recurrent branch of lachrymal artery. 3. External orbital foramen for trans- mission of branches of deep tem- poral artery. Circumference of wing: from body to spine; outer half, articulates with petrous portion temporal bone; inner half forms jugular foramen. Vidian notch for vidian nerve. From spine forward it articulates with squamous portion of temporal bone. Tip articulates with parietal bone. In front of tip it articulates with frontal bone. Articulates with malar at anterior margin. Assists in forming sphenoidal fissure, Iiesser wing. (Processes of Ingrassias.) Triangular; projecting from sides . of body. Superior surface is smooth; supports part of frontal lobe of the brain. Inferior surface forms part of roof of orbit, and upper boundary of sphenoidal fissure. 38 ANATOMY IN ABSTRACT. Anterior clinoid processes are con- tinuous from inner portion of pos- terior border. Optic foramen is formed by the two roots of the wings as they extend to the body of the bone. Posterior border is received into the Assure of Sylvius. Pterygoid process (like a wing). One on each side descends perpendicu- larly from junction of greater wing and body. Points for study. 1. Internal plates forming lateral wall of posterior nasal cavity. 2. External plate extending outward and backward from internal. 3. Pterygoid fossa between these plates. 4. Scaphoid fossa between these plates near body. 5. Zygomatic fossa at root of ex- ternal plate. 6. Hamular process extreme inferior tip of internal plate. 7. Pterygoid tubercle on posterior surface of base of internal plate. 8. Pterygoid notch between plates. Development: in two parts, by 14 centers. Posterior sphenoid comprising body, . pituitary fossa, greater wings, and ' pterygoid process developing from eight centers. One for each wing and external plate. One for each internal plate. Two for posterior part of the body. One for each lingula. Presphenoidal, anterior half of body and lesser wings developing from six centers as follows:- One each lesser wing. Two anterior part of body. Two for sphenoidal turbinated bone. Ossification: begins eighth fetal week; completed twenty-fifth year. Articulation with all bones of cranium and five of the face, namely: two malar, two palate and vomer. Muscles: eleven pairs. Or. Temporal; to external surface greater wing. Or. External pterygoid; external sur- face same plate. Or. Internal pterygoid; between ptery- goid plates. Or. Superior constrictor; posterior edge of internal plate. BONES. 39 Or. Tensor Galati; scaphoid fossa. Or. Levator palpebrae; ^lesser wing. Or. Obliquus superior; lesser wing. Or. Superior rectus; internal rectus, inferior rectus, external rectus, all from lesser wing about optic fora- men. ETHMOID (a sieve). Exceeding light and spongy, cubical; forms central part of anterior fossa of cranium. Rests between orbital cavities. Points for study: three. 1. Horizontal or cribriform plate has for study:- 1. Crista galli projecting upward in median line in front. 2. Grooves on either side for ol- factory bulbs. 3. Perforations in plate for nerves to nasal cavity. 2. Perpendicular plate, thin, lamella of bone projecting downward from horizontal plate in median line, forming upper part of septum of nose, joins vomer posteriorally, and nasal bones in front and triangular cartilage below to complete septum. 3. Lateral masses, constituting the ethmoidal cells. Outer surfaces are called os planum, constituting part of inner wall of orbit. Unciform process projects downward from either lateral mass serving to close in the orifice of the antrum. Superior and middle turbinated bones, project inward from lateral masses. Superior meatus is between these two processes. Infundibulum, the orifice leading from frontal sinuses of frontal bone ter- minates in middle meatus, below the anterior end of middle turbinated bone. Development: three centers. One for perpendicular lamella, and one for each lateral mass Articulates: with fifteen bones: sphenoid, two sphenoidal turbinated, frontal, two nasal, two maxilla, two lach- rymal, two palatal, two inferior turbinated and vomer. No muscles. 40 ANATOMY IN ABSTRACT. NASA! (nasus, the nose). Two small oblong bones uniting in median line to form bridge of nose. Each has for study, two surfaces and four borders. Superior surface; smooth, concave from above downward; convex from side to side. Inferior surface; concave grooved from above downward for nasal nerve. Superior border; or end, narrow, artic- ulates with nasal notch of frontal bone. Inferior border; broad, has attached to it lateral nasal cartilage. Nasal .angle; spine in median line, formed by union of both bones. External border; beveled; articulates with nasal process of maxilla. Internal border; thicker above than below, articulates with fellow. Crest, projects backward from this border forming part of the septum. Development: one center for each bone. Articulation: with four bones. Frontal; ethmoid; maxilla and fel- • low. Muscle: few fibres of occipitofrontalis. BONES OF THE FACE. MALAE (mala, the cheek). Forming \.he prominence of the cheek. Points for study: two surfaces, four pro- cesses, and four borders. Surfaces (two): A. External; smooth and convex, and a foramen (malar), for nerve and vessels, forming prominence of cheek. B. Internal; irregular: outer half smooth, forming part of temporal fossa above zygomatic fossa, below, inner half articulates with maxilla. Processes (four): A. Frontal; articulates with external angle of frontal bone, forming outer border of orbit. B. Maxillary process; downward and forward, articulates with maxilla. C. Orbital process; projects back- Ward, forming part of floor and outer wall of orbit. D. Zygomatic process; projects out- ward, articulates with zygomatic process of temporal BONES. 41 Borders (four): A. Orbital; smooth, forming margin of orbit. B. Maxillary; articulates with max- illa. C. Temporal; beginning of temporal ridge above, and zygomatic below; temporal fascia attached. D. Zygomatic; continuous with lower border of zygomatic arch. Development: three centers. One zygomatic portion; two orbital portion. Ossification: begins eighth fetal week, completed fifth fetal month. Articulation: with four bones, namely: maxillary, frontal, sphenoid and temporal. Muscles (four): Or. Levator labii superioris proprius; inferior border. Or. Zygomatic major and minor; ex- ternal surface. Or. Masseter; zygomatic arch. INFERIOR TURBINATED (turbo, a whirl). Situated on either side of outer wall of nasal cavities, extending from before backwards horizontally, be- low orifice of antrum, projects down- ward like a scroll. Has for examination: two surfaces, two borders and two extremities. Internasal surface; convex, traversed by numerous grooves and perforated by many foramina for vessels. External surface; concave; forms part of inferior meatus. Upper border thin, irregular. Divided into three portions; (a) ant., for maxilla; (b) middle, lachrymal with this bone; (c) posterior with palate bone. Inferior border; free, thick, projects downward and inward into nasal cavity. Anterior extremity; continuous with maxilla. Posterior extremity; thin, tapers to a point, articulates with palatine bone. Development: by one center of ossifica- tion. Begins middle of fetal life. Articulations: with four bones, namely: ethmoid, maxilla, palate and lach- rymal. Muscles: none. 42 ANATOMY IN ABSTRACT. MAXILLA (2) (Superior Maxillary) (the jaw bone). Largest bone of face except mandible, constituting sides of face. Assists in forming three cavities; roof of mouth, floor of orbit, and outer wall of nasal; also helps to form two fossas; sphenomaxillary and zygomatic, and two Assures, sphenomaxillary and pterygomaxil- lary. Has for study: body, four processes, viz.: malar, nasal, palatal and alveo- lar. Body cuboid, hollow; cavity called antrum of Highmore or maxillary sinus. A. External or facial surface of the body is directed outward and for- ward. Eminences correspond with teeth. Canine eminence corresponds to this tooth. Canine fossa back of eminence. Incisive fossa above incisor teeth. Infraorbital foramen for exit of same vessels and nerve. B. Posterior or zygomatic surface is convex, directed backward and out- ward to form zygomatic fossa. Has for study; posterior dental canals, penetrate bone and transmit same vessels and nerve. Maxillary tuberosity from lower part of the surface. Posterior palatine groove along the surface. C. Superior or orbital surface is thin, smooth, triangular, forming part of floor of orbit. Lachrymal notch is on internal mar- gin and receives lachrymal bone. Os planum articulates in middle. Palate bone behind. Infraorbital groove runs forward across floor and dips down into bone and bifurcates to form infraorbital and anterior dental canals for ves- sels and nerves of same name to front teeth. D. Internal surface is divided by palatal process into superior forming outer wall of nose, and inferior forming cavity of mouth. Antral opening is from middle meatus. Posterior palatine groove, across pos- terior surface. Lachrymal groove is in front of antral orifice is for nasal duct. BONES. 43 Inferior turbinated crest is in front of lachrymal groove, and articulates with same bone. Outer wall of inferior cavity is alveo- lar process. Maxillary sinus (Antrum of Highmore), is a large pyramidal cavity, capacity from one to four drachms. Apex outward toward malar process. Base toward nasal cavity; walls thin, and formed by orbital, facial and zygo- matic surfaces. Antrium or orifice is through base into middle meatus of nasal cavity; sometimes two. Lamina occasion- ally cross the cavity. Posterior dental canals cross posterior wall, and transmit same vessels and nerves to teeth. Conical processes corresponding to roots of teeth are ' sometimes seen in floor. Malar process is triangular, projects outward, and articulates with this bone. Nasal process projects upward, exter- nal to nasal bone and forms inner margin and part of wall of orbit. On Internal surface is found inferior and middle meatuses, separated by inferior turbinated crest; also lachrymal, groove and tubercle. Alveolar process projects downward and has eight cavities to receive upper teeth. Palatine process, projects inward to median line, forming part of roof of mouth, and floor of nasal cavity. Inferior surface is concave, roughened, perforated by numerous foramina, the important ones being the follow- ing: anterior palatine canal or fossa, formed by union of the two bones from bottom of which lead the fol- lowing: Scarpa's foramina; (2) In median line, transmitting left an- terior, and right the posterior naso- palatine nerves. Stenson's (2) in front of former to sides of median line, for transmission of posterior palatine arteries. Incisive or inter- maxillary bone is that part of the maxillas in front of canine teeth. Development: from four centers in mem- brane. One body of bone, internal to infra- orbital canal and nasal wall. One body external to infraorbital canal, including malar process. 44 ANATOMY TN ABSTRACT. One palatine process, posterior to Stenson's canal and adjacent nasal wall. One incisive or premaxillary portion carrying the incisive teeth. Ossification: begins about eighth fetal week. Completed: middle life. Articulation : with nine bones, namely: frontal, ethmoid, nasal, malar, lach- rymal, inferior turbinated, palate, vomer and fellow. Muscles: twelve. Or. Orbicularis palpebrarum; nasal process. Or. Obliquus oculi inferior; orbital plate. Or. Levator labii sup. aleque nasi; nasal process. Or. Levator labii sup. proprius; low- er margin of orbit. Or. Levator anguli oris; canine fossa. Or. Compressor nasi; canine eminence. Or. Dilator naris posterior; nasal notch. Or. Masseter; malar process. Or. Buccinator; alveolar process. Or. Internal pterygoid; pterygoid fossa. Or. Orbicularis oris; nasal septum. Or. Depressor alae nasi; incisive fossa. LACHRYMAL (2) (lachryma, a tear). Smallest and most fragile bones of the face. Resemble finger nail, and hence called (ossa unguis). Situation; inner wall of orbit. Points for study: two surfaces and four borders. External surface (orbital); lachrymal crest running vertically, -terminates below in hamular process, sometimes a separate bone. Has in front two depressions: (1) Upper, for lachrymal sac; (2) lower, lachrymal groove for nasal duct. Back of ridge is smooth, forming part of orbit. Internal or nasal surface; furrow ver- tically in front of which is middle meatus. Behind it helps to form ethmoidal cells. Superior border articulates with frontal. Posterior articulates with os planum. Anterior articulates with nasal process of maxilla. BONES. 45 Inferior two portions; posterior with orbital plate of maxilla. Anterior with turbinated bone, assists in forming lachrymal groove. Development by single center. Articulates with four bones: frontal, maxillary, ethmoid and turbinated. Muscles: Or. Tensor tarsi (Horner) from ridge and surface behind it. PAIiATE 2 (palatum, the palate). Situated back part of outer wall of nasal cavity, extending from orbit to mouth. Assists in forming three cavities, namely: nose, mouth and orbit. Bone resembles letter L. Points for study: horizontal and vertical plates, orbital and sphenoidal pro- cess. Horizontal plate is quadrangular and has two surfaces and four borders. Superior surface; concave from side to side, forms back part of floor of nose. Inferior surface; forms hard palate for aponeurosis of Tensor palati muscle. Outerside is groove with maxillary, forms posterior palatine canal; two accessory palatine canals are near. Posterior border; serves for attach- ment of soft palate. Posterior nasal spine in median line formed with fellow; Azygos uvulae attached. Anterior border serrated, articulates with palatine process of maxilla. External border; unites with perpen- dicular plate at right angle. Internal border; thick serrated, artic- ulates with fellow in median line. Vertical plate is directed upward and in- ward, has two surfaces and four borders. Internal surface fiousns lateral wall of posterior nares. Inferior turbinated crest crosses from before backward, separates middle and inferior meatuses, articulating with inferior turbinated bone. Su- perior turbinated crest above former for articulation with middle turbin- ated bone. Superior meatus above latter. 46 ANATOMY IN ABSTRACT. External surface rough for articulat- ing with maxilla. Upper and back part is smooth and helps to form sphenomaxillary fossa. Smooth in front and covers orifice of antrum. Posterior palatine canal is long, back part of which articulates with the maxilla. Transmits posterior palatine vessels and nerve from Meckel's ganglion. Anterior border is thin, irregular, has maxillary process in middle. Posterior border is grooved, and articu- lates with pterygoid process of sphenoid and below forms bottom of pterygoid fossa. Pterygoid process of palate received between ptery- goid plates at lower ends. Outer surface articulates with maxilla. Superior border has two processes; or- bital and sphenoidal. Orbital process forms back part of orbit at sphenoidal fissure. Articulates with ethmoid and both wings of sphenoid and maxilla. Sphenoidal process is thin and directed upward and inward. Superior surface; articulates with sphenoidal turbinated bone. Internal surface forms outer wall of nose. External surface articulates with in- ternal pterygoid plate of sphenoid, and also forms part of sphenomax- illary fossa. Anterior border forms posterior boun- dary of sphenopalatine foramen. Posterior articulates with internal pterygoid plate. Development: from one center, begins second fetal month. Articulation: six bones: sphenoid, eth- moid, maxilla, inferior turbinated, vomer and fellow. Muscles: four. In. Tensor palati; transverse ridge of horizontal portion. Or. Azygos uvulae; posterior nasal spine. Or. Internal pterygoid; pterygoid notch. Or. Superior constrictor of pharynx, posterior surface. VOMER (Vomer; a ploughshare) (single). Forms back and lower part of nasal septum. Has two surfaces and four borders. BONES. 47 Surfaces, lateral, are smooth and free. Have nasopalatine groove some- times a canal. Superior border or base of bone ex- panded portion; has groove, articu- lating with sphenoid, alae project laterally from base and fit under the vaginal processes of sphenoid. Inferior border projects downward and fits in between the two maxillary and two palatine bones as they form floor of nasal cavities. Anterior border; articulating with triangular cartilage below and eth- moid above. Posterior border is free, forming pos- terior margin of nasal septum. Development: by two centers, one on each side of median line and sepa- rated by vomerine cartilage. Ossification: of two halves completed after puberty. Articulation: with six bones: sphenoid, ethmoid, two maxillas, two palatine. Muscles: none. MANDIBLE (inferior maxillary), (lower jaw). Largest and strongest bone of the face, serves for reception of lower teeth. Points for study: Horizontal and per- pendicular portions. Horizontal portion has body, symphy- sis and angle. Perpendicular portion (called ramus) has condyle, coronoid process, and sigmoid notch. Body; shape of horseshoe, has two sur- faces and two borders. External surface convex from side to side, concave from above downward. Symphysis is median line. Its lower end is mental process, on either side of which are mental tubercles. Incisive fossas are on either side of symphysis. Next is mental foramen between bicuspid teeth for mental vessels and nerve. External oblique line runs from mental process to an- terior surface of ramus. Internal surface concave from side to side, convex from above downward. Linear depression is in median line, and to each side are found two genial tubercles. Sublingual fossa is just back of upper tubercle. 48 ANATOMY IN ABSTRACT. Internal oblique line (mylohyoidean), extends from lower tubercle upward and backward towards inferior den- tal foramen. Submaxillary fossa is below oblique line. Superior border, wide, thicker behind, has 16 cavities (in adult) for teeth. Inferior border, rounded, thicker in front, groove behind for facial artery. Perpendicular portion, rami are quadri- lateral in shape. Points for study: two surfaces, four borders and two processes. External surface, flat, roughened for insertion of Masseter, almost entire extent. Internal surface; inferior dental fora- men in center for same vessels and nerve, runs through body to sym- physis. Lingula is spine over latter foramen. Processes are from upper border. Condyle covered with cartilage, articu- lating with temporal bone. Neck is constriction below. Coronoid process in front. Sigmoid notch between processes. Development: principally membranous from one center. Ossification: begins fifth week, on out- side of Meckel's cartilage (dentary), second center (splenial), in mem- brane, forms inside of sockets of teeth, terminates in lingula. An- terior extremity of Meckel's carti- lage ossifies at symphysis forming body of bone. Six other secondary centers complete bone as follows: one for each angle, condyles, and coronoid processes. Completed first year. Articulation with two temporal bones. Muscles: fourteen pairs and one single. To its external surface from before backwards. Or. Levator menti. Or. Depressor labii inferioris. Or. Depressor anguli oris. In. Platysma myoides. Or. Buccinator. In. Masseter. Or. Portion of orbicularis oris (single). (To its internal surface; from before backwards. BONES. 49 Or. Geniohyoglossus. Or. Geniohyoid. Or. Mylohyoideus. Or. Digastric. Or. Superior constrictor. In. Temporal. In. Internal pterygoid. In. External pterygoid. SKULL AS A WHOLE. Land-marks on external surface. Bregma; union of parietal and frontal. Lambda; union of two parietal and oc- cipital. Obelion; between parietal foramina. Pterion; union of parietal, frontal and sphenoid. Inion; external occipital protuberance. Asterion; union of temporal, occipital and parietal. Stephanion; where coronal suture and temporal ridge cross. Auricula; external auditory meatus. Nasion; union of frontal and nasal bones in median line. Glabella; between the superciliary ridges. Dacryon; in orbit, union of lachrymal and frontal. Principal sutures. Sagittal; between parietal bones. Coronal; between parietal and frontal. Lambdoid; between parietal and oc- cipital. Squamous; between parietal and tem- poral. Basilar; between occipital and sphe- noid. Other sutures. Frontomalar. Frontosphenoid. Mastoparietal. Sphenoparietal. Squamoparietal. Petrooccipital. Mastooccipital. Petrosphenoidal. Squamosphenoidal. Points for study found thereon. Superciliary ridge; on frontal bone above orbits. Nasal spine; median ends of nasal bones. ' Incisive fossa; maxilla near incisor teeth. ANTERIOR REGION OF SIUL1. 50 ANAIOMY IN ABSTRACT. Supraorbital ridge; frontal, over or- bits. Supraorbital notch or foramen, frontal, above orbit. Infraorbital foramen; maxilla, below orbit. Canine fossa; maxilla, near alveolus. Symphysis; is tip of chin, mandible. Mental foramen; mandible, in body. External oblique line; mandible across body. FOSSAS OF SKULL (external surface;. Temporal fossa. Formed by five bones; namely, frontal, sphenoid, parietal, temporal and malar. Boundaries: Superior and posterior; is the tem- poral ridge. Anterior; is frontal, malar and greater wing of sphenoid. External; is the zygomatic arch. Inferior; is pterygoid ridge. Contents: deep temporal artery and temporal muscles. Zygomatic fossa. Boundaries: Superior, pterygoid ridge, outer sur- face of sphenoid and squamous por- , tion of temporal. Anterior; is the maxilla. Posterior; is the external pterygoid plate and eminentia articularis. Internally; is external pterygoid plate. Inferior; is alveolar border of maxilla. External; is zygomatic arch and ramus of mandible. Contents: Temporal artery and internal ptery- goid muscle, internal maxillary artery and vein. Inferior maxillary nerve and branches. Sphenomaxillary fossa. Boundaries: Situated at the junction of the spheno- maxillary and pterygomaxillary fissures. Sphenoidal fissure termi- nates here. Superior; body of sphenoid and orbital process of palate. Anterior; maxilla. Posterior; pterygoid profess and greater wing of sphenoid. Internal; palate. Communicates with: Cranial cavity. Orbit by sphenomaxillary fissure, BONES. 51 Nasal fossas; by sphenopalatine fora- men. Zygomatic fossas; by pterygomaxil- lary fissure. Termination of foramina: Foramen rotundum. Vidian canal. Pterygopalatine canal. Sphenopalatine foramen. Posterior palatine canal. Contents: Superior maxillary nerve. Meckel's ganglion. Internal maxillary artery. INTERNAL OR CEREBRAL SURFACE of the BASE OF SKULL is divided into three fossas as follows: Anterior fossa has for study from be- fore backwards: Groove for superior longitudinal sinus. Groove for anterior meningeal artery. Foramen cecum; transmits an emis- sary vein. Crista galli. Slit for nasal nerve; transmits the nasal branch of the ophthalmic nerve. Groove for nasal nerve. Anterior ethmoidal foramen. Orifices for olfactory nerves. Posterior ethmoidal foramen. Ethmoidal spine. Olfactory grooves. Body and lesser wing of sphenoid. Cribriform plate of ethmoid. Middle fossa has for study from before backwards: Sphenoidal fissure, transmits third, fourth, sixth and first division of the fifth nerve, the ophthalmic vein, and sympathetic nerves. Optic foramen; transmit the optic nerves and the ophthalmic artery. Optic grooves. Olivary process. Anterior clinoid process. Foramen rotundum, transmits the second or superior maxillary divi- sion of the fifth nerve. Foramen ovale, transmits the third division of the fifth nerve and small meningeal artery. Foramen spinosum, transmits the great or middle meningeal artery. 52 ANATOMY IN ABSTRACT. Foramen sphenotic, transmits facial and carotid petrosals for vidian nerve. Cavernous groove. Sella turcica. Eminence of semicircular canal. Hiatus Fallopii, transmits petrosal branch of the vidian nerve. Petrosal foramen, transmits the small- er petrosal nerve. Posterior clinoid process. Groove for sixth nerve. Foramen lacerum medium. Carotid canal, transmits Internal caro- tid artery and sympathetic nerves. Depression for Gasserian ganglion. Posterior fossa: presents for study from before backwards: Internal auditory meatus, transmits seventh and eighth nerves and au- ditory artery. Slit for dura mater. Superior petrosal groove. Foramen lacerum posterius, transmits jugular vein, ninth, tenth and eleventh nerves. Anterior condyloldal foramen, trans- mits the hypoglossal. Aqueductus vestibuli. Posterior condyloidal foramen. Stylomastoid foramen, for facial nerve. Posterior meningeal grooves. Foramen magnum, transmits (1) me- dulla and its meninges; (2) the ver- tebral arteries and their sympathet- ic nerves; (3) the spinal accessory nerve (the eleventh nerve). Note the eleventh nerve coming up through the foramen, passing forward, and leaving the cranium with the ninth and tenth nerves by the jugular foramen. Basilar process of occipital. Groove for inferior petrosal sinus. Groove for occipital sinus. Torcular Herophili. Groove for superior longitudinal sinus. INFERIOR SURFACE OF BASE OF SKULL presents from before back- wards the following points for study: The teeth. Anterior palatine fossa. Foramen for left nasopalatine nerve. Foramen for anterior palatine vessels. Foramen for right nasopalatine nerve. BONES. 53 Roof of mouth. Posterior palatine groove and fossa. Accessory palatine foramen. Zygomatic fossa. Posterior nasal spine. Hamular process. Posterior nares. Pterygopalatine canal. Foramen ovale. Vidian canal. Eminentia articularis. Glenoid fossa. Glaserian fissure. Carotid foramen. Vaginal process. Petrous portion of temporal. Pharyngeal spine. Styloid process. Jugular fossa. Anterior condyloidal foramen. Condyles, articulating with atlas. Basilar process. Canal for Jacobson's nerve. Aqueductus cochlea. Foramen lacerum posterius. Canal for Arnold's nerve. Stylomastoid foramen. Mastoid process. Auricular fissure. Tubercle for check ligament. Occipital groove. Posterior condyloidal foramen. Foramen magnum. External occipital crest. External occipital protuberance. NASAL FOSSAS: Two large irregular cavities situated on either side of median line of face, extending from roof of mouth to base of skull. Separated by a thin vertical septum. Openings: each nasal fossa. Anterior naris to exterior. Posterior naris to pharynx. Infundibulum, to frontal sinus through roof. Orifice of antrum, to maxillary sinus through outer wall. Orifice of sphenoid, to cavity of bone through roof. To ethmoid cells above which form the roof. Boundaries of nasal fossas: Roof, or sup. wall; nasal, frontal, ethmoid, sphenoid and vomer. Floor, or inf. wall; maxilla and palate. 54 ANATOMY IN ABSTRACT. Septum or int. wall; nasal, frontal, ethmoid, vomer and sphenoid, max- illa, palate and triangular cartilage. Outer or ext. wall, maxilla, lachrymal, ethmoid, inferior turbinated, palate and internal pterygoid plate of sphe- noid. ORBITS. Two quadrilateral pyramidal cavities, situated at anterior superior part of face. Seven bones form each orbit, namely: frontal, sphenoid, ethmoid, maxilla, malar, lachrymal and palate. Frontal, ethmoid and sphenoid help to form both orbits, therefore eleven bones form the two orbits. Boundaries: Superior; formed by frontal, lesser wing of sphenoid. inferior; or floor, formed by maxilla, malar and palate. Internal; formed by nasal process of maxilla, lachrymal, ethmoid and sphenoid. External; formed by malar, greater wing of sphenoid. Angles are: Superior; internal and external. Inferior; internal and external. Circumference is the margin of the base. Apex; posterioi" end of orbit, terminates in optic foramen and sphenoidal fissure, Nine openings into orbit: Optic foramen. Sphenoidal fissure. Sphenomaxillary fissure. Supraorbital foramen. Infraorbital canal. Ant. and post, ethmoidal foramina. Malar foramina. Canal for nasal duct. Contents of orbital cavity: Eye ball. Optic nerve. Lenticular ganglion. Lachrymal gland. Seven muscles within the orbit, name- ly: four Recti, two Oblique and Lev- ator palpebrae superioris. JOINTS. 55 Dentata, having tooth-like processes. As in interparietal suture. Serrata, having serrated edges like the teeth of a saw. As in interfrontal suture. Iiimbosa, having beveled margins and dentated processes. As in frontoparietal suture. Squamosa, formed by thin beveled margins overlapping each other. As in squamoparietal su- ture. Harmonia, formed by the ap- position of contiguous rough surfaces. As in intermaxillary suture. Schindylesis. - Articulation formed by the reception of a thin plate of one bone into a Assure of another. As in articulation of rostrum of sphenoid with vomer. Gomphosis.-Articulation formed by the insertion of a conical process into a socket: the teeth. Synchondrosis.-Epiphyseal lines. CLASSIFICATION OF JOINTS. (After Gray.) Sutura Vera (true), artic-. ulate by in- dented borders. Sutura notha (false), artic- ulate by rough surfaces. Sutura. Ar- ticulation by processes and. indentations in- terlocked to- gether. Synarthrosis, or im- movable joint. Surfaces separated by fibrous membrane or by line of cartilage, with- out any intervening synovial cavity, and im- movably connected with each other. As in joints of cran- ium and face (except lower jaw). 56 Symphysis.-Surfaces connected by flbrocartilage, not separated by synovial membrane, and having limited motion, as in joints between bodies of vertebras. Syndesmosis.-Surfaces united by an interosseous ligament, as in the inferior tibiofibular articulation. Ginglymus.-Hinge-joint; motion limited to two directions, forward and backward. Articular surfaces fitted together so as to permit of movement in one plane, as in the interphalangeal joints and the point between the humerus and the ulna. Trochoides, or Pivot-Joint.-Articulation by a pivot process turning with a ring or ring around a pivot, as in superior radioulnar articulation and atlantoaxial joint. Reciprocal Reception.-Saddle-joint. Articular surfaces inversely con- vex in one direction and concave in the other. Movement in every di- rection except axial rotation, as in the carpometacarpal joint of the thumb. Condyloid.-Ovoid head received into elliptical cavity. Movements in every direction except axial rotation, as the wrist joint. Enarthrosis.-Ball-and-socket joint; capable of motion in all directions. Articulation by a globular head received into a cup-like cavity, as in hip and shoulder joints. Arthrodia.-Gliding-joint; articulations by plane surfaces which glide upon each other, as in carpal and tarsal articulations. ANATOMY IN ABSTRACT. Amphiarthrosis, Mixed articulation. Diarthrosis, Movable Joint. JOINTS. 57 Structures entering* into formation of a movable and some fixed joints, are: bone, cartilage and ligaments, syno- vial sac, fluid and capsule. Structures surrounding joints of ex- tremities and some other joints are: tendons, muscles, arteries, veins, lymphatics, nerves, fascia and skin. Movements in joints are gliding, angu- lar, circumduction and rotation. ABTICULATIONS OF TRUNK. 1. Vertebras to each other (amphiar- throdiosymphysis). Bodies; anterior, posterior and inter- vertebral. Laminas; ligamenta subflava. Articular processes; capsule containing synovia. Spinous processes; interspinous. Transverse processes; intertransverse. 2. Atlas and axis; anterior and pos- terior. Atlantoaxial; transverse, two cap- sules. Atlas with occipital; (double condy- loidal). Anterior, posterior; two lateral, two capsule. Axis with occipital. Occipitoa*ial; three odontoid. 3. Vertebras with ribs (arthrodial). Vertebras to head of ribs; capsule, stellate, interarticular. Transverse process and ribs; anterior, middle, posterior, costotransverse and capsule. 4. Cartilage of ribs with sternum (arthrodial), are six ligaments, anterior and posterior chondroster- nal, capsule, interarticular chon- drosternal, anterior and posterior chondroxiphoid. 5. Bibs with cartilages; periosteum. 6. Sternum; anterior and posterior intersternal. 7. Vertebras with pelvis (arthrodial) Anterior and posterior, from vertebra. Intervertebral substance, or disc. Subflava continued. Capsule for articular processes. Interspinous and supraspinous. Lumbosacral. Iliolumbar. 8. Ligaments of pelvis (amphiarthro- dioarthrosis). ARTICULATIONS. 58 ANATOMY IN ABSTRACT. Anterior and posterior sacroiliac. Great and lesser sacrosciatic. 9. Sacrum and coccyx. Anterior, posterior and lateral sacro- coccygeal. Interposed fibrocartilage and interar- ticular. 10. At symphysis pubis (amphiarthro- sis). Anterior, posterior, superior, subpubic and interpubic disc. TEMPOROMANDIBULAR (Ginglymo- arthrodial). Ligaments are: 1. External lateral; from zygoma to outer surface of neck of mandible. 2. Internal lateral (sphenomandibu- lar); from spine of sphenoid to lingula and margin of dental fora- men. 3. Stylomandibular; from styloid pro- cess of temporal to angle of mandi- ble. 4. Capsule; surrounds joint proper from temporal bone to mandible. 5. Interarticular fibrocartilage in glenoid cavity, separates two syno- vial membranes. 1. STERNOCLAVICULAR (arthrodial or reciprocal reception). Capsule (synovial membrafte) anterior and posterior sternoclavicular and interclavicular. Costoclavicular (rhomboid), and interarticular fibro- cartilage. 2. Acromioclavicular; superior and in- ferior acromioclavicular. Interarticular flbrocartilage. Two coracoclavicular, trapezoid, conoid, and synovial membrane. 3. Ligaments of scapula. Coracoacromial and transverse. 4. SHOULDER JOINT; ball-and-socket. (Diarthrodioenarthrosis.) Bones; scapula and humerus. (1) Capsule; from scapula to humerus. (2) Coracohumeral; from coracoid process to greater tuberosity. (3) Transverse-humeral; from one tuberosity to other across bicipital groove. (4) Glenoid cartilage; attached to rim of glenoid cavity of scapula. Flood's ligament; part of capsule from edge of glenoid cavity to lesser tuberosity. JOINTS. 59 Schlemm's ligament; under lip of glenoid cavity to neck of humerus. 5. ELBOW JOINT (ginglymus). (Diar- throdioginglymus.) Bones; humerus, radius and ulna. (1) Anterior; from humerus to radius and ulna, forming capsule. (2) Posterior; from humerus to ole- cranon process. (3) Internal lateral; from external condyle to orbicular ligament, syno- vial membrane and capsule. 6. Radioulnar articulation. (Diarthro- diotrochoides.) (1) Superior, or orbicular, surrounds the head of radius attached to the ulna and external condyle of hu- merus. (2) Middle; oblique and interosseous; extends from radius to ulna. (3) Inferior; anterior and posterior; from head of ulna to base of radius. Interarticular fibrocartilage. 7. Radiocarpal, or wrist joint. (Diar- throdiocondylarthrosis.) (1) External lateral; from radius to Scaphoid. (2) Internal lateral; from ulna to cuneiform and pisiform. (3) Anterior; from radius and ulna to first carpal row. (4) Posterior; from radius and ulna to scaphoid, semilunar and cunei- form. 8. Carpal bones to each other. (Diar- throdioarthrosis.) Dorsal and pal- mar throughout. One on internal and external sides. There are five distinct joint cavities in wrist. (1) Between ulna and triangular fibro- cartilage. (2) Between triangular fibrocartilage and base of radius, and the first carpal row. (3) Between first and second row, and between these bones and bases of metacarpal bones. (4) Between trapezium and thumb. (5) Between cuneiform and pisiform. 9. Carpometacarpal joints. (Diarthro- dioarthrosis.) Dorsal, palmar. Between metacarpal, interosseous. 10. Metacarpophalangeal (condyloidal); anterior, two lateral and capsule. 60 ANATOMY IN ABSTRACT. 11. Phalanges. (Ginglymus.) Capsule; anterior and two lateral ligaments thru ghout. ARTICULATIONS OF LOWER EXTREMITY. 1. HIP JOINT.. (Diarthrodioenarth- rosis.) (Ball-and-socket.) Bones; innominate and femur. (1) Capsule; from margin of acetabu- lum to neck of femur, entirely sur- rounding the joint. (2) Iliofemoral (Y ligament of Bige- low). From low'er part of anterior inferior spine of ilium to the ante- rior intertrochanteric line. (3) Iiigamentum teres; within joint cavity. Origin. Depression in cen- ter of acetabulum; insertion in de- pression in head of femur. (4) Cotyloid; fibrocartilaginous rim . attached to margin of acetabulum increasing its depth. (5) Transverse; fills in notch in lower part of acetabulum; also 'supports cotyloid ligament. 2. KNEE JOINT (Ginglymus). Fif- teen ligaments. Bones; femur, tibia and patella. External ligaments; six. (1) Anterior (patellar). From patella to tibial tubercle. (2) Posterior (ligamentum posticum Winslowii). From intercondyloidal notch of femur to posterior surface of tibia. (3) Internal lateral; from inner tuber- osity of femur to inner tuberosity of tibia. (4) Long ext. lateral; from posterior surface of outer tuberosity of femur to head of fibula. (5) Short ext. lateral; from anterior surface of tuberosity of femur to styloid process of fibula. (6) Capsule; extends entirely around the joint, filling in the spaces be- tween and under the above named ligaments with synovial membrane. Internal ligaments; nine. (7&8) Crucial. Anterior or external; posterior or internal, extend from intercondyloidal notch of femur to spines and interarticular space of tibia. JOINTS. 61 (9 & 10) Semilunar fibrocaitilages; external and internal, attached to the margin of the head of tibia and interposed between it and condyles of femur. (11) Transverse ligament extends from one semilunar cartilage to the other. (12 & 13) Coronary ligaments are portions of the capsule connecting semilunar cartilages to margin of head of tibia. (14) Ligamentum mucosum; a prolong- ation of synovial membrane below patella, and its free end extends backward toward intercondyloidal notch. (15) Ligamentum alaria; fringed edges of mucosum, extending up along sides of patella. 3. Articulation Between Tibia and Fibula. Upper end (arthrodial). Capsule; sometimes continuous with knee joint. Anterior and posterior superior tibio- fibular. Interosseous membrane along shafts. Lower end; anterior and posterior in- ferior tibiofibular. Transverse or inferior. Inferior interosseous. 4. ANKLE JOINT (Ginglymus.) Bones; tibia, fibula and astragalus. (1) Anterior; from tibia to astragalus. (2) Posterior; from tibia to astraga- lus. (3) Internal or deltoid; from internal malleolus down to navicular, os calcis and astragalus. (4) External; three fasciculi to exter- nal malleolus. Anterior; to astragalus. Middle; down to os calcis. Posterior; back to astragalus. 5. ARTICULATIONS OF THE TARSUS, (1) Between os calcis and astragalus. (1) External calcaneoastragaloid, be- low external malleolus from os cal- cis to astragalus. (2) Internal; from tubercle on astra- galus to sustentaculum tali. (3) Posterior; from external tubercle of astragalus to upper part of os calcis. (4) Interosseous; from one bone to the other, between the two articular facets. 62 ANATOMY TN ABSTRACT. Two synovial membranes; one for each facet. (2) Between os calcis and cuboid. Dorsal; superior and interosseous. Plantar; long and short. (Plantar fascia.) (3) Between os calcis and navicular. Superior or external. Inferior or internal. (4) Between astragalus and navicular; superior astragalonavicular and synovial membrane. (5) Between navicular and cuneiform; dorsal and plantar and synovial membrane. (6) Between navicular and cuboid; dorsal, plantar, interosseous and synovial membrane. (7) Cuneiform bones with each other; dorsal, plantar, Interosseous and synovial membrane. (8) Ext. Cuneiform with cuboid; dor- sal, plantar, interosseous and syno- vial membrane. 6. Tarsometatarsal articulations. All have same ligaments, namely: dor- sal, plantar, interosseous and syno- vial membrane throughout. 7. Metatarsal bones with each other. Ligaments; dorsal, plantar and inter- osseous. There are six synovial membranes be- tween the tarsal and metatarsal bones. (1) Posterior calcaneoastragaloid. (2) Anterior calcaneoastragaloid. (3) Calcaneocuboid. (4) Between navicular and three cunei- form bones. Three cuneiform bones with each other. External cuneiform with cuboid and the middle and external cuneiform with the base of the sec- ond and third metatarsal bones. <5) Between internal cuneiform and base of metatarsal of great toe. (6) Between cuboid and fourth and fifth metatarsal bones. 8. Metatarsophalangeal articulations all have same ligaments. Plantar (glenoid ligament of Cou- velhier). Two lateral and synovial membrane. 9. Phalangeal articulations have plantar and two lateral with synovial mem- brane. MUSCLES. 63 MUSCLES. musci.es in general. Muscles are connected directly or in- directly to bone, cartilage, ligaments and skin. Muscles are named as follows: Because of shape, as quadrate, deltoid, rhomboid, etc. Because of size, as magnus, maximus, minimus, etc. Because of function, as flexors, exten- sors, abductors, etc. Because of direction of fibres, as ob- liquus, transversalis, etc. Because of number of heads, as biceps, triceps, quadriceps, etc. Because of position, as anticus, exter- nus and internus. Because of attachment, as ulnaris, fe- moris, hyoid, etc. Tendon is the white fibrinous end, or at- tachment of a muscle. Aponeurosis is a flat ribbon-shaped ten- don. Fasciae (a bandage), are fibroareolar or aponeurotic lamina, investing and binding together soft parts, and are divided,, because of their position, into two groups, superficial and deep. Superficial fascia are found immediately beneath the skin. Deep fascia between the muscles and deeper structures. (No muscle is duplicated when it is in- cluded in two groups.) MUSCLES OF THE CRANIUM AND FACE. I. CRANIAL REGION. Occipitofronta'lis. Or. Superior curved line of occiput and angular process of frontal. In. Aponeurosis. Nv. Posterior auricular, small occipi- > tai, facial. Ac. Moves scalp. Facial expression. 64 ANATOMY IN ABSTRACT. 2. AURICULAR REGION. Attol'lens au'rem. Or. Occipitofrontalis aponeurosis. In. Pinna. Nv. Branch cervical plexus. Ac. Elevates pinna. At'trahens au'rem. Or. Lateral cranial aponeurosis. In. Helix. Nv. Facial. Ac. Advances pinna. Ret'rahens au'rem. Or. Mastoid process. In. Concha. Nv. Posterior auricular. Ac. Retracts pinna. 3. MUSCLES OF MIDDLE EAR. Stape'dius. Or. Interior of pyramid. In. Neck of stapes. Nv. Facial. Ac. Depresses base of stapes. Laxa'tor tym'pani. Or. Spinous process of sphenoid and tube. In. Neck of malleus. Nv. Facial. Ac. Relaxes membrana tympani. Ten'sor tym'pani. Or. Temporal bone, Eustachian tube and canal. In. Handle of malleus. Nv. Otic ganglia. Ac. Renders tense membrana tympani. 4. PALPEBRAL REGION. Orbicula'ris nalpebra'rum. Or. Internal margin of orbit. In. Outer margin or orbit. Nv. Facial. Ac. Closes eyelids. Corruga'tor supercil'ii. Or. Superciliary ridge. In. Orbicularis palpebrarum, Nv. Facial. Ac. Draws eyebrow down and in. Ten'sor tar'si. , Or. Lachrymal bone. In. Tarsal cartilages. Nv. Facial. Ac. Compresses puncta and lachrymal sac. MUSCLES. 65 6. ORBITAL REGION. Leva'tor pal'pebrae superior'is. Or. Lesser wing of sphenoid. Im Upper tarsal cartilage. Nv. Third. Ac. Lifts upper lid. Rec'tus supe'rior. Or. Upper margin of optic foramen. In. Sclerotic coat of eyeball. Nv. Third. Ac. Rotates eyeball upward. Rec'tus infe'rior. Or. Lower margin of optic foramen. In. Sclerotic coat of eyeball. Nv. Third. Ac. Rotates eyeball downward. Rec'tus inter'nus. Or. Inner margin of optic foramen. In. Sclerotic coat of eyeball. Nv. Third. Ac. Rotates eyeball inward. Rec'tus exter'nus. Or. Two heads, outer margin of optic foramen. In. Sclerotic coat of eyeball. Nv. Sixth. - Ac. Rotates eyeball outward. Obli'quus infe'rior. Or. Orbital plate of superior maxillary. In. Sclerotic. Nv. Third. Ac. Rotates eyeball up and out. Obliquus supe'rior. Or. Above optic foramen, through pulley. In. Sclerotic. Nv. Fourth. Ac. Rotates eyeball down and out. 6. NASAL REGION. Pyramida'lis na'si. Or. Occipitofrontalis. In. Compressor naris. Nv. Facial. Ac. Depresses eyebrow. Leva'tor la'bii superio'ris alae'que na si. Or. Nasal process of superior maxil- lary. In. Alar cartilage and upper lip. Nv. Facial. Ac. Elevates lip, dilates nostril. Dila'tor na'ris ante'rior. Or. Alar cartilage. In. Border of ala. Nv. Facial. Ac. Dilates nostril. 66 ANATOMY IN ABSTRACT. Dilator na'ris posterior. Or. Nasal notch of superior maxillary. In. Skin at margin of nostril. Nv. Facial. Ac. Dilates nostril. Compres'sor na'si. Or. Superior maxillary. In. Fellow muscle. Nv. Facial. Ac. Dilates nostril. Compres'sor na'rium mi'nor. Or. Alar cartilage. In. Skin at end of nose. Nv. Facial. Ac. Dilates nostril. Depres'sor a'lae na'si. Or. Incisive fossa of superior max- illary. In. Septum and ala of nose. Nv. Facial. Ac. Contracts nostril. 7. MAXILLARY REGION. Leva'tor la'bii superio'ris. Or. Lower margin of orbit. In. Upper lip. Nv. Facial. Ac. Elevates lip. Leva'tor an'guli o'ris. Or. Canine fossa of superior maxillary In. Angle of mouth. Nv. Facial. Ac. Elevates angle of mouth. Zygomat'icus ma'jor et minor. Or. Malar bone. In. Angle of mouth. Nv. Facial. Ac. Elevates lip outward. 8. MANDIBULAR REGION. Levator la'bii inferio'ris, or Levator Menti. Or. Incisive fossa of inferior maxillary. In. Skin of lower lip. Nv. Facial. Ac. Elevates lower lin. Depres sor an'guli o'ris. Or. External oblique line of inferior maxillary. In. Angle of mouth. Nv. Facial. Ac. Depresses angle of mouth. Depres'sor la'bii inferio'ris. Or. External oblique line of inferior maxillary. In. Lower lip. Nv. Facial. Ac. Depresses lip. MUSCLES. 67 9. INTERMAXILLARY REGION. Buccinator. Or. Alveolar process of maxillary bones and pterygomaxillary liga- ment. In. Orbicularis oris. Nv. Facial. Ac. Compresses cheeks. Riso'rius. Or. Fascia over masseter. In. Angle of mouth. Nv. Facial. Ac. Draws out angle. Orbicula'ris o'ris. Or. Nasal septum and' canine fossa of inferior maxillary, by accessory fibres. In. Forms lips and sphincter of mouth. Nv. Facial. Ac. Closes mouth. 10. TEMPOROMANDIBULAR REGION Masseter. Or. Zygomatic arch. In. Angle and ramus of jaw. Nv. Inferior maxillary. Ac. Muscle of mastication, molar teeth Temporal. Or. Temporal fossa and fascia. In. Coronoid process of inferior max- illary. Nv. Inferior maxillary. Ac. Brings incisor teetli together. 11. PTERYGOMANDIBULAR REGION Pter ygoid (external). Or. 1. Ext. pterygoid plate of sphenoid. 2. Great wing. In. Neck of condyle. Nv. Inferior maxillary. Ac. Draws inferior maxillary forward. Pter'ygoid (internal). Or. Pterygoid fossa of sphenoid. In. Inner surface of angle of Jaw. Nv. Inferior maxillary. Ac. Raises and draws inferior maxil- lary forward. 1. SUPERFICIAL REGION. Platys'ma myoi'des. Or. Clavicle, acromion, and fascia In. Inferior maxillary, angle of mouth, etc. Nv. Facial and superficial cervical. Ac. Wrinkles skin and depresses mouth. MUSCLES OF THE NECK. (9 Group.) 68 ANATOMY IN ABSTRACT. Sternocleidomas'toid. Or. Two heads, sternum and clavicle. In. Mastoid process. Nv. Spinal accessory and cervical plexus. ' Ac. Depresses and rotates head. 2. DEPRESSORS OF OS HYOID AND LARYNX. Sternohyoid. Or. Sternum and clavicle. In. Hyoid bone. Nv. Descending and communicating branches of hypoglossal. Ac. Depresses hyoid. Sternothy'roid. Or. Sternum and cartilage of first rib. In. Side of thyroid cartilage. Nv. Hypoglossal. Ac. Depresses larynx. Thyrohy'oid. Or. Side of thyroid cartilage. In. Body and greater cornu of hyoid. Nv. Hypoglossal. Ac. Elevates larynx. Omohyoid. Or. Upper border of scapula. In. Body of hyoid. Nv. Descendens and communicans noni. Ac. Depresses and retracts hyoid. 3. ELEVATORS OF OS HYOID AND LARYNX. Digas tric (anterior belly). Or. Inner surface inf. maxillary, near symphysis. Tn. Hyoid bone. Nv. Inferior dental. Ac. Elevates hyoid and tongue. Digas tric (posterior belly). Or. Digastric groove of mastoid pro- cess. In. Hyoid bone. Nv. Facial. Ac. Elevates hyoid and tongue. Stylohy'oid. Or. Styloid process. In. Body of hyoid. Nv. Facial. Ac. Draws hyoid up and back. Mylohyoid. Or. Mylohyoid ridge of inferior max- illary. In. Body of hyoid and raphe. Nv. Inferior dental. Ac. Elevates and advances hyoid. Forms floor of mouth. MUSCLES. 69 Geniohy'oid. Or. Inferior genial tubercle of infe- rior maxillary. In. Body of hyoid. Nv. Hypoglossal. - Ac. Elevates and advances hyoid. 4. MUSCLES OF TH.I TONGUE. (Extrinsic). Genioliyoglos'sus. Or. Superior genial tubercle of infe- rior maxillary. In. Hyoid and bottom of tongue. Nv. Hypoglossal. Ac. Retracts and protudes tongue Hyoglos'sus. Or. Cornua of hyoid. In. Side of tongue. Nv. Hypoglossal. Ac. Depresses side of tongue. Chrondroglos'sus. Or. Inner side and base of lesser cornu of hyoid bone. In. Substance of tongue. Nv. Hypoglossal. Ac. Depresses and retracts tongue. Palatoglossus. Or. Soft palate. In. Side and dorsum of tongue. Nv. Sphenopalatine ganglion. Ac. Constricts fauces. Styloglossus. Or. Styloid process. In. Side of tongue. Nv. Hypoglossal. Ac. Elevates and retracts tongue (Intrinsic). Lingua'lis. Or. Under surface of tongue. Nv. Chorda tympani. Ac. Elevates center of tongue. 5. MUSCLES OF THE PHARYNX. Superior Con'stricter. Or. Palate bone, internal pterygoid plate, pterygomaxillary ligament, alveolar process of jaw, and side of tongue. In. Posterior median raphe. Nv. Pharyngeal plexus, glossophar- yngeal. Ac. Contracts pharynx, as in swallow- ing. Middle Constric'tor. Or. Cornua of hyoid and stylohyoid ligament. In. Posterior median raphe. 70 ANATOMY IN ABSTRACT. Nv. Pharyngeal plexus and glosso pharyngeal. Ac. Contracts pharynx, as in swallow- ing. Inferior Constric'tor. Or. Cricoid and thyroid cartilages. In. Posterior median raphe. Nv. Glossopharyngeal, pharyngeal plexus, and external and recurrent laryngeal. Ac. Contracts pharynx, as in swallow- ing. Stylopharyn'geus. Or. Styloid process. In. Thyroid cartilage. Nv. Glossopharyngeal and pharyngeal plexus. Ac. Elevates pharynx. Palatopharyn'geus. Or. Soft palate. In. Thyroid cartilage and pharynx. Nv. Sphenopalatine ganglion. Ac. Closes posterior nares. 6. MUSCI.ES of the soft palate. Leva tor pala'ti. Or. Petrous portion of temporal. In. Soft palate. Nv. Sphenopalatine ganglia (facial). Ac. Elevates soft palate. Ten'sor pala'ti. Or. Scaphoid fossa of sphenoid. In. About hamular process into soft palate. Nv. Otic ganglia. Ac. Renders palate tense. Az ygos u'vulae. Or. Posterior nasal spine of palate bone. In. Uvula. Nv. Facial through sphenopalatine ganglion. Ac. Raises uvula. Palatoglos'sus. Or. Anterior surface of soft palate. In. Dorsum and side of tongue. • Nv. Palatine branches of sphenopala- tine ganglion. Ac. Closes posterior nares and faucial orifice. Lalpingopharyn'geus. Or. Eustachian tube near nasophar- ynx. In. Posterior part of palatopharyn- geus. Nv. Internal branch of spinal acces- sory. Ac. Raises nasopharynx. MUSCLES. 71 I. MUSCLES OF ANT. VEBTEBBAB KELION Rec'tus cap'itis anti'cus ma'jor. Or. Transverse processes of third to sixth cervical. In. Basilar process. Nv. Cervical plexus. Ac. Flexes head. Bec'tus cap'itis anti'cus mi'nor. Or. Transverse process and lateral mass of atlas. In. Basilar process. Nv. Cervical plexus. Ac. Flexes nead. Bec'tus cap'itis later'alis Or. Transverse process of atlas In. Jugular process. Nv. Cervical plexus. Ac. Draws head laterally. Lon'gus col'li: 1. Superior oblique portion. Or. Transv. processes third to fifth cervical vertebra. In. Anterior tubercle of atlas. 2. Inferior oblique portion. Or. Bodies of first to third dorsal vertebra. In. Transverse processes of fifth and sixth cervical. Nv. Lower cervical. Ac. Flexes cervical vertebras. 3. Vertical portion. Or. Bodies of three dorsal and two cervical. In. Bodies of second to fourth cervi- cal. 3c MUSCLES OF THE LATERAL VBB TEBRAL REGION. Scale'nus anti'cus. Or. Tubercle on first rib. In. Transverse processes of third to sixth cervical. Nv. Lower cervical. Ac. Flexes neck laterally. Scale'nus me'dius. Or. First rib. In. Transverse processes of six lowei cervical. Nv. Lower cervical. Ac. Flexes neck laterally. Scale'nus posti'cus. Or. Second rib. In. Transverse processes of thrdO lower cervical. Nv. Lower cervical. Ac. Bends neck laterally. 72 ANATOMY IN ABSTRACT. 9. MITSCLES OF THE LARYNX. Muscles of Vocal Cords and Sim Glottidis. CricoarytenoiLdeus latera'lis. Or. Side of cricoid. In. Angle and external surface oi arytenoid. Nv. Recurrent laryngeal. Ac. Closes glottis. Cricoarytenoi'deus posti'cus. Or. Back of cricoid. In. Base of arytenoid. Nv. Recurrent laryngeal. Ac. Opens glottis. Cricothyroid. Or. Cricoid cartilage. In. Thyroid cartilage (lower inner border). Nv. Superior laryngeal. Ac. Tightens vocal cords. Arytenoi'deus. Or. Posterior and outer border of one ) arytenoid. In. Back of other arytenoid. Nv. Superior and recurrent laryngeal. Ac. Closes back part of glottis. Thyroarytenoid'eus. Or. Thyroid and cricothyroid mem- brane. (n Arytenoid, inferior and anterior surface. Nv. Recurrent laryngeal. Ac. Rotates vocal cords. MUSCLES OF EPIGLOTTIS. Aryte'noepigTottid'eus inferior. Or. Arytenoid (anteriorly). In. Epiglottis. Nv. Recurrent laryngeal. Ac. Compresses saccule of larynx. Aryte'noepigTottid'eus supe'rior. Or. Apex of arytenoid. In. Arytenoepiglottidean folds. Nv. Recurrent laryngeal. Ac. Constricts aperture of larynx Thyroepiglottid'eus. Or. Inner surface of thyroid. In. Epiglottis. Nv. Recurrent laryngeal. Ac. Depresses epiglottis. MUSCLES. 73 MUSCLES OF THE BACK. (5 Layers.) FIBST XAYEB. Trape'zius. Or Superior curved line of occipital, spinous processes of last cervical and all dorsal vertebras. In. Clavicle and spine of scapula, and acromion. Nv. Spinal accessory and cervical plexus. Ac. Draws head and shoulders back- ward. Latiss'imus dor'si. Or. Spines of six lower dorsal and lumbar and sacral vertebras, crest of ilium, and three or four lower ribs. In. Bicipital groove of humerus. Nv. Subscapular. Ac. Draws arm backward and down- ward. SECOND LAYER. Leva'tor an'guli scap'ulae. Or. Transverse processes of four upper cervical vertebras. In. Posterior border of scapula. Nv. Fifth cervical and cervical plexus. Ac. Elevates upper angle of scapula. Bhomboi'deus ma'jor. Or. Spines of five upper dorsal. In. Root of spine of scapula. Nv. Fifth cervical. Ac. Elevates and retracts scapula. Bhomboi'deus mi nor. Or. Spines of seventh cervical and first dorsal. In. Root of spine of scapula. Nv. Fifth cervical. Ac. Retracts and , levates scapula THIRD LAYER. Serra'tus posti'cus infe'rior. Or. Spines of last two dorsal and first three lumbar. In. Four lower ribs. Nv. Posterior branches of dorsal. Ac. Depresses ribs In expiration. Serra'tus posti'cus supe'rior. Or Spines of seventh cervical and two upper dorsal. Tn. Second, third, fourth and fifth ribs Nv, Posterior branches of cervical Ac Raises ribs in inspiration. 74 ANATOMY IN ABSTRACT. Sple'nius cap'itis et col'li. Or. Half of ligamentum nuchae and spines of six upper dorsal. In. Into occiput and mastoid, also trans, processes of four upper cer- vical. Nv. Posterior branches of cervical. Ac. Retracts head and keeps neck erect. FOURTH LAYER (Elevan). Sacrolumba'lis. Or. Erector spinae. In. Angles of six lower ribs. Nv. Branches < f dorsal. Ac. Erects spine and bends trunk backward. Erec tor spi'nae. Or. Iliac crest, back of sacrum, lum- bar and three lower dorsal spines. Nv. Divides into sacrolumbalis and longissimus dorsi. Longis simus dor si. Or. Erector spinae. In. Transverse processes of lumbar and dorsal vertebras, seventh to eleventh rib. Nv. Branches of lumbar and dorsal Ac. Erects spine and bends trunk backward. Spina lis dor'si. Or. Last two dorsal and first two lumbar spines. In. Remaining dorsal spines. Nv. Dorsal branches. Ac. Erects spinal column. Cervica'lis ascen'dens. Or. Angles of five upper ribs. In. Transverse processes of fourth, fifth and sixth cervical. Nv. Branches of cervical. Ac. Keeps neck erect. Trachelomas'toid. Or. Transverse process of third to sixth dorsal, and articular process of three or four lower cervical. In. Mastoid process. Nv. Branches of cervical. Ac. Steadies head. Complex'us. Or Transverse process seventh cervi- cal and three upper dorsal, and ar- ticular processes of fourth to sixth cervical. In. Occipital bone. Nv. Suboccipital, great occipital, and branches of cervical. Ae. Retracts ana -otates head. MUSCLES. 75 Biven ter cervi'cis. Or. Transverse processes, two to four upper dorsal. In. Superior curved line of occipital. Nv. Portion of complexus. Ac. Retracts and rotates head. Spina lis col li. Or. Spines of fifth and sixth cervical. In. Into spine of axis, or third and fourth cervical spines. Nv. Cervical branches. Ac. Steadies neck. Mus'culus accesso'rius ad sacrolumba'- lem. Or.. Angles of six lower ribs. In. Angles of six upper ribs. Nv. Branches of dorsal. Ac. Erects spine and bends trunk backward. Transversa'lis col'll. Or. Transverse processes of third to sixth dorsal. In. Transverse processes of five lower cervical. Nv. Cervical branches. Ac. Keeps neck erect. FIFTH LAYER (Twelve). Semispina'lis dor'si. Or. Transverse process„of lower dorsal. In. Spines of last two cervical and four upper dorsal. Nv. Branches of dorsal. Ac. Erects spinal column. Semispina'lis col'll. Or. Transverse processes of four up- per dorsal and articular processes of four lower cervical. In. Spines of second to fifth cervical. Nv. Cervical branches. Ac. Erects spinal column. Multif'idus spi'nae. Or. Sacrum, iliac spine, artic, proc, lumbar and cervical vertebras, and transverse proc, of dorsal. In. Laminas and spines of next four vertebras above. Nv. Posterior spinal branches. Ac. Erects and rotates spinal column. Rotato'res spi'nae. Or. Transverse processes of second to twelfth dorsal. In. Lamina of next dorsal above. Nv. Dorsal branches. Ac. Rotate spinal column. Supraspina'les. Or. Lie on spinous processes in cervi- cal region. 76 ANATOMY IN ABSTRACT. tnterspina'les. Between spines of contiguous verte- bras. Intertransversa'les. Between transverse processes of con- tiguous vertebras. Exten'sor coccy'gis. Or. Last bone of sacrum or first of coccyx. In. Lower part of coccyx. Nv. Sacral branches. Ac. Extends coccyx. Rec tus cap'itis posti'cus major. Or. Spine of axis. In. Inferior curved line of occipital bone. Nv. Suboccipital and great occipital. Ac. Rotates head. Rec tus cap'itis posti'cus mi'nor. Or. Posterior arch of atlas. In. Below inferior curved line of oc- cipital bone. Nv. Suboccipital and great occipital Ac. Draws head backward. Obli'quus cap'itis infe'rior. Or. Spinous process of atlas. In. Transverse process of atlas. Nv. Suboccipital and great occipital. Ac. Rotates atlas and cranium. Obli'quus cap'itis supe'rior. Or. Transverse process of atlas. In. Occipital bone. Nv. Suboccipital and great occipital. Ac. Draws head backward. MUSCLES OF THE THORAX. Intercos'tals, external, 11. Or. Outer lip of inferior costal border. In. Superior border of ribs above. Nv. Intercostal. Ac. Raise ribs in inspiration. Intercos tals, internal, 11. Or. Inner lip of inferior costal border. In. Superior border of ribs below. Nv. Intercostal. Ac. Depress ribs in expiration. Infracos'tals, 10. Or. Inner surface of ribs. In. Inner surface of two or three ribs below. Nv. Intercostal. Ac. Inspiration. Triangula ris ster'ni. Or. Ensiform cartilage, costal cartil- age of three or four lower ribs and sternum. MUSCLES. 77 'n. Edge of inner surfaces of second, third, fourth and fifth costal carti- lages. Nv. Intercostal. Ac. Expiration. Gevato'res costa'rum, 12. Or. Transverse urocesses of dorsal vertebras. In. Each to the rib below. Nv. Intercostal. Ac. Raise ribs. Diaphragm. Or. Ensiform cartilage, six or seven lower ribs, ligamenta arcuata, bodies of lumbar vertebras. In. Central tendon. Nv. Phrenic. Ac. Respiration and expulsion. MUSCLES OF THE ABDOMEN. SUPERFICIAL GROUP. Obli'quus exter'nus. Or. Eight lower ribs. In. Middle line, iliac crest, Poupart's ligament. Nv. Intercostal, iliohypogastric, ilio- inguinal. Ac. Compresses viscera and flexes thorax. Obli'ciuus inter'nus. Or. Lumbar fascia, iliac crest, Pou- part's ligament. In. Four lower ribs, linea alba, pubic crest, pectineal line. Nv. Intercostal, iliohypogastric, ilio- inguinal. Ac. Compresses viscera and flexes thorax. Transversa'lis. Or. Poupart's ligament, iliac crest, six lower ribs, lumbar vertebras. In. Linea alba, pubic crest, pectineal line. Nv. Intercostal, iliohypogastric, ilio- inguinal. Ac. Compresses viscera and flexes thorax. Rec tus abdom'inis. Or. Pubic crest. In. Cartilages of fifth to seventh rib Nv. Intercostal, iliohypogastric, ilio- inguinal. Ac. Compresses viscera and flexes thorax. 78 ANATOMS' IN ABSTRACT Pyramida'lis. Or. Pubes. In. Linea alba. Nt. Iliohypogastric. Ac. Tightens linea alba, DEEP GROUP. Pso as mag'nus. Or. Bodies and trans, processes of last dorsal and all lumbar vertebras. In. Lesser trochanter. Nv. Lumbar. Ac. Flexes and rotate® thigh outward, and flexes trunk on pelvis. Pso as par'vus. Or. Bodies of last dorsal and first lumbar vertebras. In. Iliopectineal eminence and iliac fascia. Nv. Lumbar. Ac. Tensor of iliac fascia. Ili'acus. Or. Iliac fossa, crest, base of sacrum. In. Lesser trochanter. Nv. Anterior crural. Ac. Flexes and rotates femur outward. Quadra'tus lumbo'rum. Or. Crest of ilium, ilio-lumbar liga- ment. In. Last rib. transverse processes of four upper lumbar vertebrae. Nv. Lumbar. Ac. Flexes thorax laterally. X. MUSCLES OF ISCHIORECTAL REGION. Cor'rugator cu'tis a'ni. Or. Submucous tissue interior of anus. In. Subcutaneous tissue on opposite side of rectum. Nv. Sympathetic. Ac. Corrugates skin of anus. Sphinc ter a'ni. Or. Tip of coccyx. In. Tendinous center of perineum Nv. Hemorrhoidal. Ac. Closes anus. Leva'tor a'ni. Or. Posterior body and ramus of pu- bes, pelvic fascia, Ischial spine. In. Rectum, coccyx, and fibrous raphe. Nv. Sacral and perineal. Ac. Supports rectum, vagina, etc. Coccy'geus. Or. Ischial spine. In. Coccyx. Nv. Sacral MUSCLES. 79 Ac. Supports coccyx, and closes pelvic outlet. 2. musci.es of male perineum. Transver'sus perinae'i. Or. Ramus of ischium. In. Central tendon. Nv. Perineal. Ac. Tensor of central tendon Acclera'tor uri'nae. Or. Central tendon of perineum and median raphe. In. Bulb, spongy and cavernous part of penis. Nv. Perineal. Ac. Ejects urine. Erec tor pe'nis. Or. Ischial tuberosity, crus penis and pubic ramus. In. Crus penis. Nv. Perineal. Ac. Maintains erection. Compres'sor ure thrae. Or. Ramus of pubes. In. Fellow muscle. Nv. Perineal. Ac. Compresses urethra. 3. MUSCLES OF EEMALE PERINEUM. Sphinc'ter vagi nae. Or. Central tendon of perineum In. Corpora cavernosa and clitoris. Nv. Homologue of accelator urinae in male. Erector clitoridis. Or. Tuberosity of ischium. In. Each side of crura clitoris. Nv. Perineal. Ac. Maintains erection. MUSCLES OF THE UPPER EXTREMITY. 1. ANTERIOR THORACIC REGION. Pectora'lis ma'jor. Or. Clavicle, sternum, and costal car- tilages. In. External bicipital ridge of hu- merus. Nv. Anterior thoracic. Ac. Draws arm down and forward. Pectora'lis mi nor. Or. Third, fourth, and fifth ribs. ■ In. Coracoid process. Nv. Anterior thoracic. Ac. Depresses paint of shoulder. Arranged in Thirteen Groups. 80 ANATOMY in abstract Subcla'vius. Or. Cartilage of first rib. In. Under surface of clavicle. Nv. Fifth and sixth cervical. Ac. Draws clavicle downward. 2. LATERAL THORACIC REGION. Serra'tus mag'nus. Or. Eight upper ribs. In. Inner margin of posterior border of scapula. Nv. Posterior thoracic. Ac. Elevates ribs in inspiration. Muscles of the Shoulder and Arm. 3. ACROMIAL REGION. Del'toid. Or. Clavicle, acromion, and spine of scapula. In. Shaft of humerus. Nv. Circumflex. Ac. Raises humerus outward. 4. ANTERIOR SCAPULAR REGION. Subscap'ular. Or. Subscapular fossa. In. Lesser tuberosity of humerus. Nv. Subscapular. Ac. Rotates head of humerus inward. 5. POSTERIOR SCAPULAR REGION. Supraspina'tus. Or. Supraspinous fossa. In. Great tuberosity of humerus. Nv. Suprascapular. Ac. Supports shoulder-joint, raises arm. Infraspina'tus. Or. Infraspinous fossa. In. Great tuberosity of humerus. Nv. Suprascapular. Ac. Rotates humerus outward. Te res ma'jor. Or. Inferior angle of scapula. In. Internal bicipital ridge of humerus. Nv. Subscapular. Ac. Draws arm down and back. Te res mi'nor. Or. Axillary border of scapula. > In. Great tuberosity of humerus Nv. Circumflex. Ac. Rotates humsuus outward. MUSCLES, 81 i ANTERIOR HUMERAL REGION. Cor'acobrachia'lis. Or. Coracoid process of scapula. In. I.iside shaft of humerus. Nv. Musculocutaneous. Ac. Draws arm forward and inward. Biceps (2 heads) (humeri). Or. 1. Dong-Glenoid cavity. 2. Short -Coracoid process. In. Tuberosity of radius. Nv. Musculocutaneous. Ac. Flexes and supinates forearm. Brachia'lis anti'cus. Or. Lower half shaft of humerus. In. Coronoid process of ulna. Nv. Musculocutaneous, musculospiral. Ac. Flexes forearm. 7. POSTERIOR HUMERAL REGION Triceps (3 heads). Or. External and internal heads nea> musculospiral groove, shaft of hu- merus. Middle or long head, lower edge of glenoid cavity. In. Olecranon process of ulna. Nv. Musculospiral. Ac. Extends forearm. Subancone'us. Or. Humerus above olecranon fossa. In. Posterior ligament of elbow. Nv. Musculospiral. Ac. Tensor of ligament. Muscles of the Forearm 8. ANTERIOR RADIOULNAR REGION SUPERFICIAL LAYER. Prona tor ra'di te res. Or. Internal condyle and coronoid pro- cess. Tn. Outer side of shaft of radius. Nv. Median. Ac. Pronates hand. Flex'or car pi radia'lls. Or. Internal condyle. In. Metacarpal bone of index. Nv. Median. Ac. Flexes wrist. Palma'ris lon'gus. Or. Internal condyle. In. Annular ligament and palmar fascia. Nv. Median. Ac. Tightens fascia. Plex'or car'pi ulna'ris (2 heads). Or. 1. Internal condyle. 2. Olecranon and ulna. 82 ANATOMY IN ABSTRACT. In. Fifth metacarpal, annular lig., and pisiform bone. Nv. Ulnar. Ac. Flexes wrist. Flex or subli'mis digito'rum (3 heads). Or. 1. Inner condyle. 2. Coronoid pro - cess. 3. Oblique line of radius. In. Second phalanges by four tendons. Nv. Median. Ac. Flexes second phalanges. DEEP LAYER. Flex or profun'dus digito'rum. Or. Shaft of ulna. In. Last phalanges by four tendons. Nv. Ulnar and anterior interosseous. Ac. Flexes phalanges. Flex or lon'gus pol'licis. Or. Shaft of radius. In. Last phalanx of thumb. Nv. Anterior interosseous. Ac. Flexes phalanx. Prona'tor quadra'tus. Or. Lower fourth of ulna. In. Lower fourth of shaft of radius. Nv. Anterior interosseous. Ac. Pronates hand. 9. RADIAL REGION Su'pinator lon'gus. Or. External condyloid ridge of hu- merus. In. Styloid process of radius. Nv. Musculcspiral. Ac. Supinates hand. Exten'sor car pi radia'lis bre'vior. Or. External condyle of humerus. In. Base of third metacarpal. Nv. Posterior interosseous. Ac. Extends wrist. Exten sor car'pi radia'lis lon'gior. Or. Lower third of ext. condyloid ridge of humerus. In. Base of second metacarpal. Nv. Musculospiral. Ac. Extends wrist. 10. POSTERIOR RADIOULNAR REGION. SUPERFICIAL LAYER. Exten'sor communis digito'rum. Or. External condyle of humerus. In. All second and third phalanges. Nv. Posterior interosseous. Ac. Extends fingers. MUSCLES. 83 Exten'sor min'imi di'giti. Or. External condyle of humerus. In. Second and third phalanges of lit- tle finger. Nv. Posterior interosseous. Ac. Extends little finger. Exten'sor car'pi ulna'ris. Or. Ext. condyle of humerus. In. Base of fifth metacarpal. Nv. Posterior interosseous. Ac. Extends wrist. Ancone'us. Or. Back of external condyle o± hu- merus. In. Olecranon and shaft of plna. Nv. Musculospiral. Ac. Extends forearm. DEEP LAYER. Su'pinator bre'vis. Or. Ext. condyle of humerus, oblique line of ulna. In. Neck of radius and its bicipital tuberosity. Nv. Posterior interosseous. Ac. Supinates hand. Exten'sor os'sis metacar'pi pol'licis. Or. Back of radius and ulna. In. Base of metacarpal of thumb. Nv. Posterior interosseous. Ac. Extends thumb. Exten'sor bre'vis pol'licis. Or. Back of radius. In. Base of first phalanx of thumb. Nv. Posterior interosseous. Ac. Extends thumb. Exten'sor lon'gus pol'licis. Or. Back of ulna. In. Base of last phalanx of thumb. Nv. Posterior interosseous. Ac. Extends thumb. Exten'sor in'dicis. Or. Back of ulna. In. Second and third phalanges of in- dex. Nv. Posterior interosseous. Ac. Extends index. Ulna'ris. Or. Lower fourth of anterior surface of ulna. In. Unciform bone. Nv. Ulnar. Ac. Flexes wrist. 84 ANATOMS' IN ABSTRACT. Muscles of the Hand. 11. RADIAL REGION. Adduc'tor pol'licis. Or. Third metacarpal, os magnum. In. First phalanx of thumb. Nv. Ulnar. Ac. Draws thumb to median line. Oppo'nens pol'licis. Or. Trapezium. In. Metacarpal of thumb. Nv. Median. Ac. Flexes thumb. Elex'or bre'vis pol'licis. Or. Trapezium, trapezoid, os magnum base of third metacarpal. In. Base of first phalanx of thumb. Nv. Median and ulnar. Ac. Flexes thumb. Abduc'tor pol'licis. Or. Trapezium. In. First phalanx of thumb. Nv. Median. Ac. Abducts thumb. 12. ULNAR REGION. Palma'ris bre'vis. Or. Annular ligament and palmar fas cia. In. Skin of palm of hand. Nv. Ulnar. Ac. Corrugates skin of palm. Abduc'tor min'imi di'giti. Or. Pisiform bone. In. First phalanx of little finger. Nv. Ulnar. Ac. Abducts little finger. Elex'or bre'vis min'imi di'giti. Or. Unciform bone. In. First phalanx of little finger. Nv. Ulnar. Ac. Flexes little finger. Oppo'nens min'imi di'giti. Or. Unciform bone. In. Fifth metacarpal. Nv. Ulnar. Ac. Flexes little finger. 13. MIDDLE PALMAR REGION. Lumbrica'les, 4. Or. Tendons of deep flexor. In. Tendons of common extensor Nv. Median and ulnar. Ac. Flex first phalanges. MUSCLES. 85 Falma'ris interos'sei. Or. Palmar surfaces, second, fourth, and fifths metacarpals. In. Bases of first phalanges, of corre- sponding. fingers. Nv. Ulnar. Ac. Adductors of fingers. Dorsal interos'sei, four. Or Sides of metacarpal. In. Bases of phalanges. Nv. Ulnar. Ac. Abduct fingers from median line. MUSCLES OF THE LOWER EXTREMITY. Arranged in Nine Groups. Muscles of the Thigh. 1. ANTERIOR lEMORAL REGION Ten sor vagi nae fem'oris. Or. Iliac crest and anterior superior spinous process. In. Fascia lata. Nv. Superior gluteal. Ac. Tensor of fascia. Sarto'rius. Or. Ant. sup. spine of ilium. In. Upper int. shaft of tibia. Nv. Anterior crural. Ac. Flexes and crosses legs. Rec'tus fem'oris. Or. Anterior inferior iliac spine, brim acetabulum. In. Tuberosity of tibia. Nv. Anterior cruraL Ac. Extends leg. Vas tus exter'nus. Or. Anterior edge of great trochanter and linea aspera. In. Tuberosity of tibia. Nv. Anterior crural. Ac. Extends leg. Vas'tus inter'nus and crurLVs. Or. Inner lip of linea aspe'a. In. Tuberosity of -tibia. Nv. Anterior crural. Ac. Extends leg. Subcrure'us. Or. Anterior inferior part of femur. In. Synovial sac beh'nd patella. Nv. Anterior crural. Ac. Draws sac up. Quad'riceps exten's/r. Or. Includes th . Rectus, Vastus int. and ext., and Jrureus muscles. Com- mon tendon contains the natella. 86 ANATOMY IN ABSTRACT. Crure'us. Or. See Vastus internus. 2. INTERNAL FEMORAL REGION Gra'cilis. Or. Rami of pubes and ischium. In. Tibia, upper and inner part. Nv. Obturator. Ac. Flexes and abducts leg. Pectine'us. Or. Iliopectineal line and pubes. In. Femur below lesser trochanter. Nv. Anterior crural, obturator. Ac. Flexes thigh and rotates it out- ward. Adduc'tor bre vis. Or. Ramus of pubes. In. Upper part of linea aspera of femur. Nv. Obturator. Ac. Adducts and flexes thigh. Adduc tor lon'gus. Or. Front of pubes. In. Middle of linea aspera of femur. Nv. Obturator. Ac. Adducts and flexes thigh. Adduc tor mag'nus. Or. Rami of pubes and ischium. In. Linea aspera of femur. Nv. Obturator and great sciatic. Ac. Adducts thigh and rotates it out- ward. 3. GLUTEAL REGION. Glute'us max'imus. Or. Superior curved iliac line and crest, sacrum and coccyx. In. Fascia, and femur below great tro- chanter. Nv. Inferior gluteal and sacral plexus. Ac. Extends, abducts, and rotates thigh outward. Glute'us me'dius. Or. Ilium between sup. and middle curved lines. In. Oblique line of great trochanter. Nv. Superior gluteal. Ac. Rotates, abducts, and advances thigh. Glute'us min'imus. Or. Ilium between middle and int. curved lines. In. Great trochanter. Nv. Superior gluteal. Ac. Rotates, abducts, and draws thigh forward. MUSCLE. 87 Pyrifor'mis. Or. Front of sacrum, through great sciatic foramen. In. Great trochanter. Nv. Sacral. Ac. External rotator of thigh. Quadra'tus fem'oris. Or. Tuberosity of ischium. In. Quadrate line of femur- Nv. Sacral. Ac. External rotator of thigh. Ob'tnrator exter'nus. Or. Obturator foramen and membrane. In. Digital fossa, ba^e of great tro- chanter. Nv. Obturator. Ac. External rotator of thigh. Ob turator inter'nus. Or. Obturator foramen and membrane. In. Great trochanter. Nv. Sacral. Ac. External rotator of t^igh. GemelTus supe'rior. Or. Ischial spine. In. Great trochanter. Nv. Sacral. Ac. Ext. rotator of thigh. GemelTus inferior. Or. Tuberosity of ischium. In. Greater trochanter. Nv. Sacral. Ac. Ext. rotator of thigh. 4. POSTERIOR FEMORAL REGION. Bi'ceps (2 heads) (.'em'oris). Or. 1. Ischial tuberosity. 2. Linea aspera. In. Head of fibula, Nv. Great sciatic. Ac. Flexes and rotates leg out'vard. Semimembranosus. Or. Tuberosity of ischium. In. Inner tuberosity of tibia, Nv. Great sciatic. Ac. Flexes leg and rotates it inward. Semitendino'sus. Or. Tuberosity of Ischium. In. Upper and inner surface of tibia. Nv. Great sciatic. Ac. Flexes leg on thigh. Muscles of the Leg. 5. ANTERIOR TIBIOFIBULAR REGION. Tibia lis anti'cus. Or. Outer tuberosity and upper part of «haft of tibia. 88 ANATOMY IN ABSTRACT In. Internal cuneiform and first meta- tarsal. Nv. Anterior tibial. Ac. Flexes tarsus and elevates inner border of foot. Gxten'sor pro'prius hallucis. Or. Middle of fibula. In. Base of last phalanx of great toe. Nv. Anterior tibial. Ac. Extends toe. Exten sor lon'gus digito'rum. Or. Outer tuberosity of tibia and shaft of fibula. In. Second and third phalanges of toes. Nv. Anterior tibial. Ac. Extends toes. Perone'us ter'tius. Or. Lower fourth of fibula. In. Fifth metatarsal bone. Nv. Anterior tibial. Ac. Flexes tarsus. 6. POSTERIOR TIBIOFIBULAR REGION. SUPERFICIAL LAYER. Gastrocne mius (2 heads). Or. Condyle of femur. In. Os calcis by tendo Achillis. Nv. Internal popliteal. Ac. Extends foot. Soleus. Or. Shaft of fibula, obV.^ue line of tibia. In. Os calcis by tendo Achillis. Nv. Internal popliteal. Ac. Extends foot. Planta'ris. Or. Outer bifurcation of linea aspera and posterior ligament of knee. In. Os calcis tendo Achillis. Nv. Internal popliteal. Ac. Extends foot. DEEP LAYEB. Poplite'us. Or. External condyle of femur. In. Shaft of tibia above oblique line. Nv. Internal popliteal. Ac. Flexes leg. Flex'or Icn'gus hallu'cis. Or. Lower two-thirds of shaft of fibula. In. Last phalanx of great toe. Nv. Posterior tibial. Ac. Flexes great toe. MUSCLES. 89 Flex'or lon'gus digito'rum. Or. Shaft of tibia. In. Last phalanges of toes. Nv. Posterior tibial. Ac. Flexes ^phalanges and extends toes. Tibia'lis posti'cus. Or. Shaft of fibula and tibia. In. Tuberosity navicular and internal cuneiform. Nv. Posterior tibial. Ac. Extends tarsus and inverts foot. 7. FIBULAR GROUP. Perone'us bre'vis. Or. Middle third of shaft of fibula, ex- ternally. In. Base of fifth metatarsal. Nv. Musculocutaneous. Ac. Extends foot. Perone'us lon'gus. Or. Head and shaft of fibula. In. First metatarsal of great toe. Nv. Musculocutaneous. Ac. Extends and everts foot. Muscles of the Foot. 8. DORSAL REGION. Exten'sor bre vis digito'rum. Or. Os calcis, externally. In. First phalanx of great toe and tendons of extensor longus. Nv. Anterior tibial. Ac. Extends toes. 9. PLANTAR REGION. FIRST LAYER. Abduc'tor hallu'cls. Or. Inner tubercle of os calcis. In. Base of first phalanx of great toe Nv. Internal plantar. Ac. Abducts great toe. Flex or bre'vis digito'rum. Or. Inner tuberosity of os calcis and plantar fascia. In. Second phalanges of lesser toes. Nv. Internal plantar. Ac. Flexes lesser toes. Abduc'tor min imi di giti. Or. Outer tuberosity os calcis, and plantar fascia. In. First phalanx of little toe. Nv. External plantar. Ac. Abducts little toe. 90 ANATOMY AIM ABSTRACT. SECOND LAYER. Flex or accesso rius (2 heads). Or. 1. Inner, and, 2, outer surface cf os calcis. In. Tendon of flexor longus digitorum. Nv. External plantar. Ac. Accessory flexor of toes. Humbrica'les, 4. Or. Tendons of flexor longus dig. In. Second phalanges of lesser toes. Nv. Internal and external plantar. Ac. Accessory flexors. THIRD LAYER. Flex or bre'vis hallucis. Or. Cuboid and external cuneiform bones. in. First phalanx of great toe. Nv. Internal plantar. Ac,. Flexes gfeat toe. Transver'sus pe dis. Or. Head of fifth metatarsal. In. First phalanx of great toe )Nv. External plantar. Ac. Adducts great toe. Adduc'tor obllquus hallu cis. Or. Tarsal end of three middle meta- tarsal bones. In. First phalanx of great toe. Nv. External plantar. Ac. Adducts great toe. Flex or bre vis min imi di'giti. Or. Base of fifth metatarsal. In. Base of first phalanx of little toe. Nv. External plantar. Ac. Flexes little toe. FOURTH LAYER. Dorsal interos'sei. Or. Sides of metatarsals. In. Base of first phalanx of corre- sponding toe. Nv. External plantar. Ac. Adduct toes. Planta'ris interos'sei. Or. Shafts of third, fourth and fifth metatarsals. In. Base of first phalanges of same. Nv. External plantar. Ac. Adducts toes. MUSCLES OF RESPIRATION. Ordinary Muscles. Diaphragm. Or. Ensiform cartilage, six or seven lower ribs, ligamenta arcuata, bodies of lumbar vertebra. MUSCLES. 91 In. Central tendon. Nv. Phrenic. Ac. Respiration and expulsion. Intercostals, external, 11. Or. Outer lip of inferior costal border. In. Superior border of ribs above. Nv. Intercostal. Ac. Raise ribs in inspiration. Intercostals, internal, 11. Or. Inner lip of inferior costal border. In. Superior border of ribs below. Nv. Intercostal. Ac. Depresses ribs in expiration. Scalenus anticus. Or. Tubercle on first rib. In. Transverse processes of third to sixth cervical. Nv. Lower cervical. Ac. Flexes neck laterally. Scalenus medius. Or. First rib. In. Transverse processes of three lower cervical. Nv. Lower cervical. Ac. Flexes neck laterally. Scalenus posticus. Or. Second rib. In. Transverse processes of three lower cervical. Nv. Lower cervical. Ac. Bends neck laterally. Serratus Posticus Superior. Or. Spines of seventh cervical and two upper dorsal. Tn. Second, third, fourth and fifth ribs. Nv. Posterior branches of cervical. Ac. Raises ribs in inspiration. Serratus Posticus Inferior. Or. Spines of last two dorsal and first three lumbar. In. Four lower ribs. Nv. Posterior branches of dorsal. Ac. Depresses ribs in expiration. Extraordinary and Accessory Muscles of Respiration. Quadratus lumborum. Or. Crest of ilium, transverse pro- cesses of lower three lumbar verte- ■ bras. In. Last rib, transverse processes of last three lumbar vertebras. Nv. Lumbar. Ac. Flexes thorax laterally. Pectoralis major. Or. Clavicle, sternum and costal car- tilages. In. External bicipital ridge of humerus. 92 ANATOMY IN ABSTRACT. Nv. Anterior thoracic. Ac. Draws arm down and forward. Fectoralis minor. Or. Third, fourth and fifth ribs. In. Coracoid process. Nv. Anterior thoracic. Ac. Depresses point of shoulder. Serratus magnus. Or. Eight upper ribs. In. Inner margin of posterior border of scapula. Nv. Posterior thoracic. Ac. Elevates ribs in inspiration. Latissimus Dorsi. Or. Spines of six lower dorsal and lumbar and sacral vertebras, crest of ilium, and three or four lower ribs. In. Bicipital groove of humerus. Nv. Subscapular. Ac. Draws arm backwards and down- wards. Infrahyoid muscles. Extensors of spine. MUSCLES OF MASTICATION. Mass'eter. Or. Malar process of superior maxil- lary; anterior two-thirds lower bor- der zygomatic arch. Inner surface zygomatic arch; post, one-third of lower border. In. Angle lower one-half outer sur- face of ramus. Outer surface of upper half of ramus and coronoid process. Ac. To draw jaw forward and up- ward. To draw jaw up and back. Par. Lessened ability to protrude chin. Lessened ability to retract and ele- vate jaw. Tem'poral. Or. Temporal ridge and fossa. In. Coronoid process. Ac. Ant. half elevates the jaw; post, half retracts and elevates jaw. Par. Partial loss of power to elevate and retract jaw. External pter'ygoid. Or. Ala of sphenoid. Outer surface of external pterygoid plate. Jn. Interarticular cartilage. Neck of condyle. MUSCLES. 93 Ac. To draw cartilage inward and forward on to the eminentia articu- laris. To draw jaw forward and inward. Par. A peculiar creaking noise pro- duced by the condyle riding over the stationary fibrocartilage; noise both subjective and objective symp- tom. Inability to move jaw toward the affected side, when chin is depres- sed deviation of jaw to paralyzed side. (Gowers.) Internal pter ygoid. Or. Inner surface of external pter- ygoid plate; tuberosities of palate and superior maxilla. In. Inner surface of lower half of ramus. Ac. To draw jaw forward, upward, and to the opposite side. Par. Inability to draw closed jaw for- ward. Buccina'tor. Or. Outer surfaces of both upper and lower alveolar processes; pter» ygomaxillary ligaments. In. Orbicularis oris. Ac. To abduct corners of mouth; to force food into vestibule. Par. Inability to widen the mouth; pendulous cheeVs during mastica- tion. TRIANGI.ES OF NECK with boundaries. 1. Submaxillary or digastric. Above; mandible and line to mastoid. Below; anterior belly of Digastric. Behind; posterior belly or Digastric and Stylohyoid muscles. 2. Superior carotid. Behind; Sternocleidomastoid. In front; Omohyoid, Stylohyoid, and posterior belly of Digastric. 3. Inferior Carotid or Tracheal. In front; median line. Behind; Sternocleidomastoid, and anterior belly Omohyoid. 4. Occipital. Behind; trapezius. In front; Sternocleidomastoid. Below; posterior belly of Omohyoid. 5. Subclavian. Below; clavicle. Above; posterior belly of Omohyoid. In front; Sternocleidomastoid. 94 ANATOMY LN ABSTRACT. OTHER TRIANGLES. Scarpa's triangles; boundaries. Roof; skin and superficial fascia. Floor; Iliacus, Psoas, Pectineus and Adductor longus muscles. Superior or base; Poupart's ligament. Internal; adductor longus muscle. Externally; sartorius muscle. Pettit's triangle; boundaries. Roof; skin and fascia. Floor; Internal oblique. Below; crest of ilium. Behind; Latissimus dorsi. In front; external oblique. Hesselbach's triangle; boundaries. Internal; Rectus abdominus. Externally; deep epigastric artery. Below; Poupart's ligament. HUNTER'S CANAL extends from the apex of Scarpa's triangle to the aperture in the Adductor magnus muscle, linking together the popli- teal space and Scarpa's triangle. It is bounded externally by the inner part of the Vastus internus muscle; internally by the front surfaces of the Adductor longus and Adductor magnus muscles. Its roof is the deep fascia passing across from the adductors to the vastus internus. It contains the superficial femoral artery and vein. The vein lies be- hind the artery, according to the rule governing the relations of veins and arteries below the Diaphragm, the long saphenous nerve (on the outer side of artery) and the com- municating branch to the obturator nerve via the subsartorial plexus. The INGUINAL CANAL has the follow- ing points: 1. External ring in the aponeurosis of the External oblique. 2. Internal ring in the transversalis fascia. 3. Floor, the upper inner surface of Poupart's ligament. 4. Roof, the arched fibres of the In- ternal oblique and Transversalis. 5. Outer wall, the aponeurosis of the external oblique. 6. Inner wall, conjoined tendon, tri- angular ligament, Transversalis. 7. Contents; spermatic cord, sper- . matic artery and veins in the male; and round ligament in the female. MUSCLES. 95 8. Extent, from external to internal abdominal ring. 9. Location of internal ring, one-half of an inch above Poupart's ligament and midway between symphysis pubis and anterior superior iliac spine. 10. Length of canal, one and one-hal? inches. The COVERINGS of FEMORAL HER- NIA from without inward are: 1. The skin. 2. The superficial fascia. 3. The cribriform fascia-the deep layer of superficial fascia that cov- ers the saphenous opening in the fascia lata. 4. The femoral sheath. 5. The septum femorale. 6. The subperitoneal connective tissue, 7. The peritoneum. AXILLARY SPACE. The region under the arm. Base. Skin, superficial and deep fascia. Apex. Clavicle, first rib and scapula. Anterior border. Pectoralis major and minor and fascia. Inner border. Ribs, intercostal spaces and serratus inagnus. Posterior boundary. Latissimus dorsi, teres major and scapula. Contents. Axillary artery, vein and branches, glands, connective tissue and brachial plexus. POPLITEAL SPACE. The region back of the knee, diamond shaped. Floor. Condyles of femur and head of the tibia. Ligament of Winslow. Roof. Skin, superficical fascia and deep popliteal fascia. Boundaries. Above externally-biceps muscle. Above internally - semimembranosus, semitendinosus, Sartorius and gra- cilis. Below externally-outer head of gas- trocnemius and plantaris. Below internally-inner head of the gastrocnemius. Contents. Popliteal artery, bifurcation and branches. Veins, popliteal, long and short saph- enous. Sciatic nerve and branches Popliteus muscle. 96 ANATOMY IN ABSTRACT. THE BLOOD VASCULAR SYSTEM composed of (1) heart; (2) arteries; (3) capillaries; (4) veins, which make the complete circuit of blood from the heart back to this organ. There are two circuits, or systems; (1) the general circulation from the heart to all parts of the body and back again, and (2) the pul- monic, from the heart to the lungs and back to the heart again. The general circulation takes a short cut from the abdominal aorta to the in- ferior vena cava through the stomach, intestines, spleen, and liver, known as the portal circula- tion. THE PERICARDIUM is a conical mem- branous sac containing the heart and commencement of greater ves- sels. It is back of sternum and third to seventh ribs, and between the lungs in the middle inferior medias- tinum. Apex is directed upward, surrounds the great vessels two inches above the heart. Base is downward, attached to cen- tral tendon of Diaphragm. Anteriorally it is attached to the sternum by remains of thymus gland, and loose areolar tissue, with anterior margin of lungs laterally. Fosteriorally; are found bronchi, eso- phagus, and aorta. Laterally; it is covered by pleura and rests against the inner surface of the lungs, with the phrenic nerve intervening. Structure; composed of external fi- brous layer and internal serous layer. The external is reflected about the heart, being attached to the boundaries above named by a loose areolar tissue. The serous or internal layer is continuous with the external. Its internal surface is free, smooth and lined with endo- thelial cells. At the base of the heart it is continuous over the ves- sels and heart, where it is known as the visceral pericardium. Arteries; from internal mammary and pericardial branch of aorta. Nerves; Vagus, phrenic, and sym- pathetic. THE VASCULAR SYSTEM. THE HEART. 97 ENDOCARDIUM is serous internal lin- ing of heart assisting to form valves, and continuous through all openings. Structure. Muscular fibres composing the heart present an exceedingly in tricate interlacement, arranged in superficial and deep-looped and an- nular fibres. Arteries are right and left coronary from aorta. Veins accompany arteries and termin- ate in right auricle. Lymphatics terminate in right lym- phatic and thoracic ducts. Nerves from cardiac plexus, partly from cardiac nerves, and partly from sympathetic and pneumogastric. THE HEART. THE HEART is a hollow muscular organ, cone shaped, enclosed in the pericardium, and placed between the lungs. Is back of sternum. One- third is to right and two-thirds to left of median line. Position. Base is upward, backward, and to right, opposite fifth to eighth dorsal bodies. Apex is downward to left at fifth in- terspace, three-fourth inches in- ward, and one inch below the nipple, or 3% inches to le"*. of median line. Size: 5 inches long: 3^2 inches broad, and 2^ inches thick. Weight: male 10 to 12 ounces. Female 8 to 9 ounces. Divisions: Auricular (upper) and ven- tricular (lower) portions. These are again divided into right and left auricle and ventricle by a median septum. Upon the surface these divisions are marked by the auriculo ventricular grooves. The interventricular groove marks the interventricular septum. 98 ANATOMY IN ABSTRACT. RIGHT AURICLE; capacity two ounces. Divided into two cavities. The sinus venosus; posterior, princi- pal cavity, quadrangular, placed between the two venae cavae, con- nected below with right ventricle. Appendix auriculae; resembles dog's ear. Is a conical muscular pouch with dentated margins, projecting forward, overlapping root of aorta. The following are found in Right Auricle. (Superior cava. I Inferior cava. Openings. Coronary sinus. Foramina Thebesii. lAuriculoventricular. Valves J Eustachian, valves. | Coronary. Fossa Ovalis. Annulus Ovalis. Tuberculum Loweri. Musculi Pectinati. The superior and inferior venae- cavae enter the lateral wall separately. The inferior is larger. They return the blood from the general vascular system to the heart. The coronary sinus terminates be- tween inferior vena cava and auricu- loventricular opening and returns blood from heart muscle. It has a valve of Thebesius or coronary valve. Foramina Thebesii are numerous small openings of veins from heart muscle. Auriculoventricular opening is com- munication from right auricle and ventricle. Eustachian Valve is anterior to infe- rior vena cava, is a semilunar dupli- cation of the internal wall. In fetus it is large and serves to direct the blood from inferior vena cava through the foramen ovale to the left auricle. * Fossa Ovalis is remains of foramen ovale, and annulus ovalis is prom- inent oval margin of same. Tuberculum Loweri is small projec- tion between the cavae. THE HEART. 99 RIGHT VENTRICLE. Triangular in form, extends from right auricle to apex of the heart. Anterior surface rounded, under surface flattened and rests on Diaphragm. Posterior wall is formed by septum ventri- culorum. Conus Arteriosus, or infundibulum is upper and inner angle, giving origin to pulmonary artery. Wall Is thinner than left. Capacity 3 ounces. Points in the right ventricle. Auriculoventricular. Openings. Opening of pulmonary artery. Valves Semilunar, varves. Tricuspid. Muscular C'olumnae carneae. Columns. Chordae tendineae. Auriculoventricular opening from auricle to-ventricle is 1% inches in diameter, lined with endocardium and guarded by the tricuspid valve. Pulmonary opening is beginning of pulmonary artery leading from right ventricle to lungs. Is guarded by semilunar pulmonary valve. Tricuspid valve consists of three seg- ments or cusps; viz., marginal, in- fundibular, and septal cusps, which project from auriculoventricular opening into the right ventricle, and are held or supported by muscular bands the chordae tendineae. Columnae Carnae are rounded muscu- lar columns throughout inner sur- face of ventricle. Semilunar valves, three, guard the opening of pulmonary artery, form- ed by duplication of lining mem- brane and project upward into the artery when open. Free margin is thickened with nodule at centre, the corpus Arantii. Sinuses of Valsalva are three pouches back of these valves. LEFT AURICLE, smaller than right; wall thicker, consists of sinus, and appendix. Sinus is cuboid back of aorta and pul- monary artery. Internal wall Is septum. Openings are for four pulmonary veins receiving arterial blood from the lungs. 100 ANATOMY IN ABSTRACT. Auriculoventricular opening is connec- tion between this cavity and left ventricle. Musculi pectinati are same as on right and confined to appendix. IiEFT VENTRICLE generally same as right, but longer, more conical; forms apex and posterior part of heart, wall three times thicker than right. Points for study. Openings. {Auriculoventricular. Valves i Mitral, vaives. (Semilunar. Chordae tendineae. Columnae carneae. Auriculoventricular opening is through base of heart, to left of aorta, small- er than on right side, admitting two fingers, broadest transversely, and surrounded by dense fibrinous ring, and guarded by mitral valve. Aortic opening is circular, in front and to right of auriculoventricular opening. Orifice is guarded by the semilunar valves. Slbson's aortic vestibule is below. It does not col- lapse during diastole. Mitral Valve is attached to circum- ference of auriculoventricular open- ing. Projects toward apex. Consists of two unequal segments, stronger than tricuspid, formed by duplica- tion of lining membrane. Largest segment is in front. They are sup- ported by chordae tendineae, same as on right side. Semilunar valves surround orifice of aorta, project upward, same as pul- monic. Sinus Valsalva are dilatations back of valves. Columnae carneae are practically same as on right side. ARTERIES. 101 External Carotid. Internal Carotid. External Carotid. Internal Carotid. Right Common Carotid. Right Subclavian. Pericardiac. Bronchial. Esophageal, Post. Mediastinal. Intercostal, usually nine on each sida THE ARTERIAL SYSTEM, Left Common Carotid. Left Subclavian. Right Coronary. Left Coronary. Innominate. Arch of Aorta. Thoracic Aorta. AORTA. 102 ANATOMY IN ABSTRACT. Anterior tympanic, Deep Auricular, Middle meningeal, Small meningeal, Inferior dental. (Mandible.) Superior or alveolar (maxilla). Infraorbital, Posterior Palatine, Vidian Pterygopalatine, Naso or Sphenopalatine. Deep temporal, Pterygoid, Masseter, Buccal. Hyoid, Sternomastoid, Sup. laryngeal, Cricothyroid. Ascending palatine, Tonsillar, Submaxillary, Submental. Muscular, Inf. labial, Sup. and Inf. Coronary. Lateralis nasi, Angular. Muscular, Glandular, Stylomastoid, Auricular. Hyoid, Dorsalis linguae, Sublingual, Ranine. interior, Posterior, Middle Temporal. Interior Auricular, Transverse Facial. Muscular, Auricular. Inf. meningeal, Arteria Princeps. External branches. Pharyngeal branches. Meningeal branches. First Part. Third Part. Second Part. Ascending Pharyngeal. Internal IMr.xillary. Superior Thyroid. Lingual. Occipital, Posterior Auricular. Temporal. Facial. EXTEBNAL CAROTID. ARTERIES. 103 Lachrymal. Supraorbital. Post. Ethmoidal. Ant. ethmoidal. Palpebral Sup. Inf. Frontal. Nasal. Muscular. Ant. Ciliary. Short Ciliary. Long Ciliary. Arteria centralis retinae. Orbital Group. Ocular Group. Ant. Cerebral. Middle Cerebral. Post. Communicating. Ant. Choroid. No branches. Art. receptaculi. Ant. Meningeal. Tympanic. Ophthalmic. Cervical Portion. Petrous Portion. Cavernous Portion. Cerebral Portion. INTERNAL CAROTID. 104 ANATOMY IN ABSTRACT. Transverse. Ant. Cerebral. Sup. Cerebral. Post. Cerebral. Laryngeal. Tracheal. Esophageal. Ascending cervical. Superficial cervical. Post. Scapular. Superior Phrenic. Mediastinal, Pericardiac, Sternal. Ant. Intercostals, Perforating. Musculophrenic, Sup. epigastric. Basilar. Profunda Cervicis. Lateral Spinal. Muscular. Post. Meningeal. Ant. Spinal. Post. Spinal. Inf. Cerebral. Inferior Thyroid. Transversalis colli. Suprascapular. Superior Intercostals. Thyroid Axis. Internal Mammary. Vertebral. SUBCLAVIAN. ARTERIES. 105 Radial recurrent. Muscular. Superflcialis volae. Anterior carpal. Post, carpal. Metacarpal. Dorsales pollicis. Dorsales indicis.' Princeps pollicis. Radialis indicis. Perforating. Interosseous. Palmar recurent. Deep or Commun. branch. Digital, from sup. palm. ar. Ant. ulnar recurrent. Post, ulnar recurrent. Ant. and Post. Inteross, Muscular. Ant. carpal. Post, carpal. yorearra^ Wrist. Hand. roreann. RADIAL. (Forms Deep Palmar Arch.) Wrist. Hand. VINAB.* (Forms Superficial Palmar Arch.) Sup. thoracic. Acromial thoracic. Thoracica longa. Thoracica alaris. Subscapular. Ant. circumflex. Post, circumflex. Anastomotica magna Sup. profunda. Nutrient artery. Inf. profunda. Muscular. 1st Part. 2d Part. 3d Part. AXILLARY. (From Subclavian.) BRACHIAL. (From Axillary.) 106 ANATOMY IN ABSTRACT Left Ant. Cerebral Ant. Com. Right Ant. Cerebral CIRCLE OF WILLIS Left Int. Carotid Right Int. Carotid Left Com- municating Right Com- municating Pancreatica parvae. Pancreatica magna. Gastric (vasa brevia). Gastroepiploica sinistra. Pyloric. Gastroduodenalis. Cystic. Reft Post Cerebral Right Post Cerebral Inf. pancreaticoduodenal. Vasa intestini tenuis. Ileocolic. Colica dextra. ■Colica media. BASILAR Suprarenal, right and left. I Renal, right and left. Spermatic in male (ovarian in female). Lumbar, usually four on each side. Sacra media. Sup. hemorrhoidal. Colica sinistra. Gastric. Hepatic. Splenic. Sigmoid. Celiac Axis. Superior Mesenteric. Inferior Mesenteric. Phrenic. ABDOMINAL AORTA. ARTERIES. 107 Superior, Inferior, Middle Vesical, Middle hemorrhoidal. Iliac, Pudic Br. Inf. Superficial perineal. Transverse perineal. Artery of the bulb. Artery of the carpus cavernosum. Dorsal artery of penis. Cremasteric, Pudic and Muscular branches, iliac. Muscular branches. Int. Ext. Br. Coccygeal, Rectal, Auricular. Gluteal, Iliolumbar, Lateral sacral. Within the pelvis. External to the pelvis hemorrhoidal. Muscular. Uterine. Vaginal. Obturator. In Female. Internal Pudic. Sciatic. Anterior Trunk. Posterior Trunk. Epigastric, Circumflex Internal Iliac. External Iliac. COMMON ILIAC. 108 ANATOMY IN ABSTRACT. Superior. Inferior. Cutaneous. Sup. Ext. articular. Sup. Int. articular. Azygos. Inf. Ext. articular. Inf. Int. articulai Posterior perforating. Digital, Ant. perforating. Tarsal, Metatarsal, Interosseous. Dorsalis hallucis. Communicating. Muscular. POPLITEAL. PLANTAR ARCH. Bifurcation of Post. Tibial. DORSALIS PEDIS. External Circumflex. Int. Circumflex. Three perforating. Superficial epigastric. Superficial Circumflex Iliac. Superficial external pubic. Deep external pubic. Perineal Ant. peroneal. Muscular. Nutrient. Communicating'. Metat. calcanean. Internal plantar. External plantar. Anastomotica magna. Recurrent tibial. Muscular. Internal malleolar. External malleolar. Profunda. Muscular. POSTERIOR TIBIAE. FEMORAE. ANTERIOR TIBIAE. VEINS. 109 THE VEINS. THEM ARE TWO SYSTEMS. 1. Pulmonary. From lungs to left auricle. 2. Systemic or general. From entire body to right auricle. Pulmonary. Formed by four veins, two from the right and two from the left lung. All terminate in the left auricle. They carry arterial blood. They have no valves. Systemic or general veins conduct the blood from the capillaries in every part of the body back to the right auricle of the heart. Divided into three sets. 1. Superficial; under skin. 2. Deep; with artery of same name. 3. Sinuses; found within the skull. SINUSES OF BRAIN. Torcular Herophili, main reservoir or terminal, resting' on internal occipi- tal protuberance. Superior Longitudinal, along median line of skull from crista galli to terminate in torcular Herophili. Inferior Longitudinal, in free edge of falx cerebri. Terminates in straight sinus. Straight; formed by union of inferior longitudinal, vena Galena and su- perior cerebellar. Terminates in torcular Herophili. Occipital; rests on occipital bone. Origin about foramen magnum. Terminates in Torcular Herophili. Ophthalmic; from orbit and anterior region of the skull. Terminates in the cavernous. Cavernous; from ophthalnjic alongside of body of the sphenoid. Terminates in petrosal. Circular; two veins crossing from right to left cavernous around pitui- tary body. Transverse; crossing from right to left inferior petrosal sinuses. Rest- ing on basilar process. Superior Petrosal; from cavernous to lateral, passing along petrous bone. Inferior Petrosal; from cavernous to ' lateral at jugular foramen. 110 ANATOMY TN ABSTRACT. Lateral Sinuses; passing to right and left from torcular Herophili around under petrous to jugular foramen, where they pass from the cavity of the cranium to became the internal jugular veins. SUPERIOR VENA CAVA; returns blood to the right auricle from head, neck and upper extremities. Tribu- taries and subtributaries are; Right Innominate; receives internal jugular; subclavian; inferior thy- roid; mediastinal and pericardial. Left Innominate; receives internal jugular, subclavian, inferior thyroid, internal mammary and superior in- tercostal. Vena Azygos Major; receives ten in- tercostal, azygos minor, esopha- geal, pericardial and mediastinal. Vertebral; right and left through pos- terior condyloidal foramen from the cranial cavity. They unite and terminate in innominate vein. INTEBNAL JUGULAR; Is formed by the lateral and inferior petrosal sinuses as they pass from the cra- nial cavity through the jugular for- amen. It unites with the subclavian to form innominate in the same way on the two sides. The tributaries are as follows: Facial Tributaries; Angular, anterior internal maxillary; inferior palpe- bral; superior and inferior labial; buccal; masseter; submental; sub- maxillary; inferior palatine and ranine. Lingual; from the tongue. Pharyngeal; tributaries, vidian and sphenopalatine. Superior Thyroid; tributaries (from thyroid gland) superior laryngeal and cricothyroid. Middle Thyroid; from larynx and trachea. EXTERNAL JUGULAB; terminates in the subclavian. Its tributaries are from superficial facial region as follows: Temporal is formed by parotoid; ar- ticular from jaw; anterior auricu- lar; transverse facial; middle tem- poral and orbital. VEINS. 111 Posterior External Jugular; from oc- cipital region. Posterior Auricular; from back of ear. Subscapular; from under scapula. Anterior External Jugular; occasion- ally two veins from anterior region of neck. Anastomose across me- dian line. Terminates usually in the subclav- ian, occasionally in the external jugular. SUBCL AVIAN; terminates in the in- nominate. Tributaries are external jugular; an- terior external jugular; branch from cephalic. Thoracic duct on left side. Lympha- tic duct on right side. AXILLARY; terminates in subclavian, and is continuous from bacilic. Cephalic is the only considerable branch. Bacilic; is companion of brachial artery; with tributaries practically the same. INFEBIOB VENA CAVA: formed by right and left common iliac veins. Receives blood from all parts below diaphragm. Branches are as follows: Lumbar; four on each side. From lumbar vertebra and region con- nected by ascending lumbar. Frequent origin of vena azygos. Spermatic Veins; spermatic plexus or plexus pampiniformis. From testi- cles. Left spermatic enters renal. Ovarian; in female same as spermatic in male. Benal; (two) from right and left kid- neys. Suprarenal; right and left. From suprarenal glands. Phrenic; two, right joins vena cava, left joins suprarenal or left renal. Hepatic; main vessels from liver. Three in number. COMMON ILIAC VEINS ABE FOBMED BY EXTEBNAL AND INTEBNAL ILIAC. External Iliac; formed by femoral. Deep epigastric (2) along same artery. Deep circumflex iliac (2) with same artery. 112 ANATOMY IN ABSTRACT. Internal iliac; vena comites of same artery from pelvis. Internal pudic; from same artery. Hemorrhoidal plexus; Surrounds lower end of rectum. Middle sacral to left common iliac. PEMOBA1 VEIN. TRIBUTARIES. Internal or Eons' Saphenous. From dorsum of foot along inner side of leg and thigh. Joins femoral vein just below Pou- part's ligament at Saphenous open- ing. External or Short Saphenous. Ascends from behind external malle- olus over calf muscles. Perforates deep fascia and joins pop- liteal vein in this space. Popliteal formed by posterior tibial, which is formed by external and in- ternal plantar. Anterior tibial formed by dorsalis pedis and tributaris. Superficial epigastric. Superficial circumflex iliac. Superficial external pudic. Profunda femoris unites with femoral one and one-half inches below Pou- part's ligament. POBTAL SYSTEM OF VEINS. (Vena Porta.) Formed by veins which collect ven- ous blood from viscera of digestion (stomach, pancreas, and Intestines), and from the spleen. Branches always single as follows: Superior Mesenteric. From small intestines, cecum, as- cending and transverse colon. Splenic; five or six branches return blood from spleen. Single vessel enters vena porta, vena brevia from left end of stomach. Left gastroepliploic pancreatic. Pancreaticoduodenal. Inferior Messenteric; joins splenic. Anastomoses with internal iliac, unit- ing general with portal circulation. Gastric; two, pyloric along lesser curve of stomach. Receives branches from pyloric and duodenum. Corollary; along lesser curve front ' esophageal opening. Cystic; from gall bladder. VEINS. 113 The following veins have no valves: the facial, angular, Vesalian and ophthalmic; the intracranial veins and dural sinuses; the hepatic, renal, spermatic, ovarian, and uter- ine; the superior and inferior venae cavae, and veins of bone; the veins of the whole portal system. 6 THE FETAL CIRCULATION. The circulation in the fetus and the umbilical cord and placenta. The blood enters the body through the umbilical vein, by which and its branches and connections the larger portion passes through the liver, a relatively small quantity entering the inferior vena cava through the ductus venosus. The portion which passes through the liver enters the ascending vena cava, which then contains the blood from the lower portion of the body, that which comes directly from the umbilical vein, and that from the hepatic veins. It then enters the right au- ricle of the heart, where it is de- flected by the Eustachian valve through the foramen ovale into the left auricle. The blood from the head and the upper portion of the body enters the right auricle and passes through the auriculoventric- ular opening Into the right ventri- cle. That in the left auricle passes into the left ventricle, and thence into the aorta, while that in the right ventricle passes through the ductus arteriosus also into the aorta. The blood in the aorta, with the ex- ception of that which goes to the head and upper portion of the body, passes down into the internal iliac arteries, and thence, with the excep- tion of that supplying the lower portion of the body passes through the hypogastric arteries to the um- bilicus, where they form the umbil- ical arteries. Through the umbil- ical arteries it passes to the placen- ta, and thence to the umbilical vein. The left auricle and ventricle re- ceive a small amount of blood by the pulmonary veins, and a small quantity goes to the lungs from the right ventricle. 114 ANATOMY IN ABSTRACT. THE LYMPHATIC SYSTEM. This system includes all the vessels, glands, and lacteal or chyliferous vessels. Is absorbent system. Be- gins by minute ramifications in all parts of the body (except nails, hair and cuticle), and empties into the veins. The Vessels are delicate and trans- parent. Arranged into superficial and deep. Superficial are im- mediately under skin. They per- forate deep fascia, and join deep. Deep are along other deep vessels and from viscera. They freely anas- tomose everywhere. The Glands (lymphatic, absorbent or conglobate) are bodies in the course of the vessels. Size, from hemp seed to almond. Color, grayish pink. Afferent vessels (several); enter gland. Efferent vessel (one); emerges from gland. Thoracic Duct; conveys the principal portion of lymph and chyle into the blood, from all parts of body except right side of head, neck and tho- rax, right lung and right side of heart, right upper extremity, and the convex surface of liver. The thoracic duct passes through diaphragm with aorta, and accompanies it to fourth dorsal, where it turns to the left under aortic arch to left of eso- phagus back of left subclavian artery curving over it. It terminates in left subclavian vein, at its junc- tion with internal jugular vein. Valves are found throughout its course, more numerous above. Size of duct is goose quill. Length, eighteen inches. Coats, three. - Internal, endothelial layer. Middle, white connective tissue with elastic fibre. External; areolar, elastic and muscu- lar fibres. The Receptaculum Chyli, or the cis- tern of Pecquet, is in abdominal cavity, resting on body of second lumbar vertebra, to the right and behind the aorta. Tributaries: entire body except as shown (see lymphatic duct). VEINS. 115 Bight lymphatic duct; length, one and one-half inches. Diameter, one-twelfth inch. Termination; right subclavian vein at its junction with the right internal jugular vein. Orifice guarded by two semilunar valves. Tributaries come from the right side of head and neck, right upper ex- tremity, right lung, right side of heart, and convex surface of liver. 116 ANATOMY IN ABSTRACT. THERE ARE TWO NERVOUS SYS- TEMS, viz; 1. Sympathetic, composed of series of ganglia and cords. 2. Cerebrospinal, composed of brain, spinal cord, nerve trunks and ter- minals. ENCEPHALON, or brain, is the great- est division of the cerebrospinal axis, and is contained within the cranial cavity. The embryonic divisions are as fol- lows; 1. Forebrain, prosencephalon, 2 hem- ispheres. 2. Interbrain, thalamencephalon. 3. Midbrain, mesencephalon. 4. Hindbrain, epencephalon, cerebel- lum and pons Varolii. 5. Afterbrain, metencephalon, medul- la oblongata. These five divisions correspond to the live secondary cerebral vesi- cles found during early embryon- ic life. The gross divisions of the brain are as follows: 1. Cerebrum, including first, second and third embryonic divisions. 2. Cerebellum, part of fourth divis- ion. 3. Fons varolii, completing fourth di- vision. 4. Medulla oblongata, fifth embryonic division. MEMBRANES of the brain, from with- out, are dura mater, arachnoid, and pia mater. VJURA MATER, is a thick, dense, fibrous membrane, serving as a periosteum to interior of sk-ull. Outer surface is rough, and at- tached to skull. Inner surface is smooth, free and lined with endo- NERVOUS SYSTEMS. BRAIN. 117 ihelial cells. It sends prolonga- tions through all the foramina leading from the skull. Structure, is white fibrous and elastic tis- sue. It forms the sheath for struc- tures passing through foramina in base of skull. Layers; endosteal, external, inter- nal periosteum of skull; menin- geal, or internal. Internal layer sends four processes inward; 1. Falx cerebri; anteroposterior, in median line between hemispheres. It contains longitudinal sinus at base. 2. Tentorium cerebelli; extends hori- zontally across skull below occip- ital lobes, and above cerebellum. 3. Falx cerebelli, is in median line, extending from tentorium cere- belli toward foramen magnum. 4. Diaphragma sellae, forms roof of sella turcica, and covers pituitary body. Is perforated for infundi- bulum. Arteries of dura; meningeal branches from internal and external caro- tid, and branches from posterior cerebral, coming principally from bone. Veins, anastomose with diploic veins and terminate in sinuses through venous lacunae. Nerves; from Gasserian ganglion, fifth, tenth, twelfth, cranial, and sympathetic. ARACHNOID; (like a spider's web) del- icate web-like membrane com- posed of white fibrous and elas- tic tissue. Outer surface cover- ed with endothelium. Subdural space, external to arachnoid, contains small quantity of fluid. Arachnoid invests brain loosely, and its under surface is attached to pia by loose arachnoidean fila- ments. It has many spaces which contain subarachnoid fluid. 118 ANATOMY IN ABSTRACT. Four large spaces are found, viz., 1. Cisterna pontis (anterior); beneath anterior and between temporal lobes. 2. Cisterna magna ''posterior); be- tween hemispheres of cerebellum and medulla. 3. Above corpus callosum, below free margin of falx cerebri. 4. In fissure of Sylvius. Arachnoid does not dip down into sulci. Foramina from subarachnoid space are as follows: 1. Foramen of Majendie, into the fourth ventricle. 2. Foramina of Key and Retzius, into lateral recesses of fourth ventricle. 3. Foramen of Merkel, into apex of descending horns of lateral ven- tricles. Subarachnoid fluid, is in subarach- noid space, and communicates with ventricles through foramen of Majendie. Nerves of arachnoid; from fifth, sev- enth and eleventh cranial. Vessels; from meningeal. Glandulae Pacchioni, or arachnoid villi, are numerous whitish gran- ulations arranged in clusters, found most frequently, as fol- lows: 1. On superior surface of dura along superior longitudinal sinus. 2. On inner surface of dura, irreg- ularly arranged. 3. In superior longitudinal sinus. . 4. On pia, near margin of hemis- pheres. PIA MATES, is the capsule of the brain, and serves as the nutrient membrane, receiving blood from the internal carotid and vertebral arteries. It dips down into the fissures and sulci, and is pro- longed into the ventricles, being the liqing membrane of these cavities. Vessels, are given off at right angles and dip down into the brain sub- stance; size and length depend- ing upon the depth- of structure to be supplied. BRAIN. 119 Morves, are from sympathetic, third, Afth, sixth, seventh, ninth, tenth and eleventh cranial. It contains lymphatics. SURFACE OF THE HEMISPHERES. THE HEMISPHERES form the greater portion of the encephalon, or fore- brain. They are separated by the longitudinal fissure. They are ob- long, convex, occupying the greater portion of the cranial cavity. Upper surface and sides are irregu- lar, traversed by many grooves, known as fissures and sulci; be- tween which are ridges called convolutions, or gyri. Under surface, is irregular; anterior portion resting in anterior and middle fossas of skull, and be- hind on tentorium cerebelli. Each hemisphere is divided into four lobes, named from the bones on which they rest, viz.: frontal, parietal, occipital and temporal. Fissures separate these lobes, as fol- lows: On surface: 1. Rolando; between frontal and parietal. 2. Sylvius; between temporal and parietal. Between hemispheres, in the longi- tudinal fissure, the following fis- sures are found: 1. Callosomarginal; between fron- tal and limbic. 2. Calcarine; between occipital and temporal. 3. Dentate; between hippocampal gyrus and corpus callosum. EOBES are separated into convolutions by sulci, as follows: 1. Frontal lobe, is divided into four convolutions, viz., superior, mid- dle, inferior, and ascending. Under surface, is divided into poste- rior, anterior, and internal orbital convolution, isle of Reil and gy- rus rectus. 9. Parietal lobe, is divided into four convolutions, viz., ascending, su- perior, supramarginal, and angu- lar. 120 ANATOMY IN ABSTRACT. 3. Occipital, is divided into superior, middle, and inferior occipital. 4. Temporal, is divided into first, sec- ond and third convolutions, by superior and middle sulci. Special sulci on surface of these lobes are: 1. Precentral; between middle and ascending frontal. 2. Postcentral; between ascending and superior parietal. 3. Anterior, posterior, and external sulci of Reil surround isle of Reil. 4. Olfactory sulci pass through internal orbital convolution, on under surface of frontal lobe. In longitudinal fissure between hem- ispheres, are found: 1. Cuneate lobe; part of occipital. 2. Quadrate lobe; part of parietal. 3. Paracentral convolution; part of parietal. 4. Marginal convolution; part of frontal. 5. Uncinate convolution; part of temporal. 6. Gyrus fornicatus; around corpus callosum. Special convolutions: Limbic lobe includes callosal and hippocampal in longitudinal fis- sure. Convolution of Broca, the left in- ferior frontal, is center of lan- guage, and is around ascending Sylvian fissure. THE UNDER SURFACE of the brain presents the following points for study, in median line, from be- fore backward: 1. Longitudinal fissure, continuing from superior surface, dividing the anterior portion of the fron- tal lobes, 2. Rostrum and peduncles of corpus callosum, forming the union be- tween the hemispheres of the brain, and containing the con- necting fibers. 3. Lamina cinerea, the termination of the corpus callosum; composed of gray matter, extending to ante- rior perforated space and forming anterior boundary of third ven- tricle. BRAIN. 121 4. Optic commissure, situated in front of tuber cinereum below lamina cinerea. It forms junction be- tween optic nerves and optic- tracts. 5. Tuber cinereum, eminence of gray matter between optic tracts, and extends from the corpora albi- cantia to optic commissure. 6. Infundibulum is pedicle of the pituitary body, and is attached to the tuber cinereum. 7. Pituitary body (hypophysis cerebri) ; reddish gray vascular mass, weighing eight grains, resting in sella turcica. It is composed of an anterior and a posterior lobe. 8. Corpora albicantia (mamillaria) are two small white masses size of pea, behind tuber cinereum; are connected across median line; formed by anterior pillars of for- nix, which loop as the bundle of Vicq d' Azyr as they enter the body of the optic thalamus. 9. Posterior perforated space (pons Tarini); between corpora albican- tia in front and pons Varolii be- hind, with crus cerebri to sides. It forms part of floor of third ventricle. Is perforated for branches from posterior commun- icating artery. 10. Pons Varolii, situated behind the two crura of the cerebrum; grooved in median line for basi- lar artery, from which radiate broad bands of white fibers. 11. Medulla oblongata is continuous from pons, to become spinal cord; pyramidal in shape. On either side of the median line are found the following struc- tures: 12 Frontal lobes (orbital lobes); form anterior part of base of brain, resting in frontal fossa of skull. 13. Olfactory lobes, composed of a bulb and a tract. Bulb is ex- panded end, composed of gray matter, resting on cribriform plate of ethmoid, giving off olfac- tory nerves (smell) to nasal mu- cous membrane. Tract is band of white matter from bulb r to brain, terminating in two roots, viz., outer, to gyrus hyppocamp^ 122 ANATOMY IN ABSTRACT. or limbic lobe; and inner, to Broca's area and callosal convo- lution; trigonum olfactum, is a third root, between the preceding. 14. Optic tract, extend backward from optic commissure over the crus cerebri, and disappear under the temperosphenoidal lobes. (See cranial nerves.) 15. Crus cerebri (peduncles of the cere- bellum); are bundles of white fibers from hemispheres to pons; three-fourths of an inch long. 16. Temporal lobes, rest In middle fos- sa of skull, extending from either side of crura. Anteriorally is fis- sure of Sylvius. INTERNAL STRUCTURE OF BRAIN. CORPUS CALLOSUM-The great com- missure of the Cerebrum, com- posed of transversely directed nerve fibres passing across the median line, and radiating into all parts of the hemispheres. It forms the floor of the longitudin- al fissure, and roof of the lateral ventricles. Genu, is the anterior end, and as it curves downward and backward to form the anterior boundary of the lateral ventricles, it is known as the rostrum from which is con- tinued the lamina cinereum. The genu extends laterally into the frontal lobes within one and one- half inches of the anterior surface of brain. Splenium, is the posterior end, and it widens and is projected into the occipital lobes to within 2 inches of the posterior extremity of brain. The pad is the thickened post, ex- tremity. Baphae, is longitudinal depression above. Nerves of Lancisi are first striae to the sides and taeniae tectae are second lateral striae. The forceps anterior (minor), is that part of the genu laterally form- ing cover of the anterior cornu of lateral ventricle. BRAIN. 123 The forceps posterior (major); is lat- eral extension of splenium into occipital lobes. The tapetum, or mat; is lateral exten- sion into temporal lobes, and forms roof of body of lateral ven- tricles. SEPTUM LUCIDUM is a thin vertical median septum of white matter, suspended from under surface of the corpus callosum, forming the partition between the body and anterior horns of the lateral ven- tricles. Its cavity is the fifth ventricle. It extends forward within the anterior curve of cor- pus callosum. Sides are covered by ependyma. , FORNIX is a longitudinal triangle of white matter under the corpus callosum, but anteriorly it is sus- pended to the lower margin of the septum lucidum. Its body is triangular, forming principal portion, and forms pavt of floor of lateral ventricles. Its under surface rests on velum in- terpositum, which forms roof of third ventricle. Laterally It is free, but projects towards the op- tic thalami. It has four pillars, namely: two anterior and two posterior. Anterior pillars extend forward and loop down to form corpus albi- cans, then turn upward as bundle of Vicq, d' Azyr into substance of optic thalami. The olfactory fasciculus passes down- ward to the olfactory tract and corpus callosum. Posterior pillars project backward from body of fornix along under surface of corpus callosum, curv- ing around posterior end of optic thalamus, continues as the corpus fimbriatum along cavity of hip- pocampus major, into the uncus of the hippocampal convolution, forming roof of posterior cornu. The Xyra are obliqi'e lines passing between the pillars of fornix. LATERAIi VENTRICLES (right and left, or first and second), consti- tute the cavities of the hemis- pheres. 124 ANATOMY IN ABSTRACT. Each consists of body and three cornua. Body is bounded as follows: Hoof by under surface of corpus call- osum. Floor and outer wall from before backwards by caudate nucleus, taenia semicircularis, optic thala- mus, choroid plexus, and part of fornix. Inner wall by septum lucidum. Anterior cornu curves round anterior end of caudate nucleus into fron- tal lobe, becoming the foramen of Monro, leading into the third ven- tricle. Roof is corpus callosum. Floor is reflected portion of ros- trum. Internally is septum lucidum. Externally is head of caudate nu- cleus. Posterior cornu, boundaries are: Roof, by corpus fimbriatum of cor- pus callosum. Internally, by hippocampus minor, or calcar avis. Bulb of posterior horn is projected > from this horn into occipital lobe. Middle cornu, largest is projected transversely into temporal lobe, curving around the optic thala- mus. Roof is tapetum of corpus callosum, tail of caudate nucleus, taenia semicircularis, and amygdaloid nucleus of latter. Floor has following points: hippo- campus major, pes hippocampus, pes accessorious, corpus flmbria- tum, and choroid plexus. Internally is found lower part of transverse Assure with invagina- tion of pia mater. INTERBRAIN (thalamencephalon) is the region of the third ventricle, below and between the hemis- pheres, and is developed from the second cerebral vesicle and in- ternal portion of first. THIRD VENTRICLE is the cavity be- tween optic thalami, which form its outer walls. Roof is velum interpositum. Floor; from before backwards is DRAIN. 125 found tuber cinereum, infundibu- lum, and pituitary body, corpora albicantia, posterior perforated space, tegmenta of crura cerebri. In front by anterior pillars of for- nix and lamina cinerea. Behind by pineal gland, posterior commissure, and upper end of ac- queduct of Sylvius. The cavity is broader above, and deeper in front, whera it is con- cave to become the infundibulum of the pituitary body. In front on the sides, it becomes the foramen of Monro. It be- comes narrow posteriorly, and be- comes the iter a tentio ad quartum ventriculum (aqueduct of Syl- vius), forming communication with the fourth ventricle. The Commissures are bundles of fibres crossing the median line and connecting the two sides of the brain. They are anterior, middle, and posterior. Anterior commissure is in front of anterior pillars of fornix, and connect corpora striata. Its fibres through the globus pallidus into the temporal lobes and olfactory tracts, establishing crossed anos- mia. Middle commissure is composed of . gray matter crossing third ventri- cle and connects the optic thalami. Posterior commissure connects poster- ior portion of optic thalami, is above the aqueduct of Sylvius. Its fibres connect the corpora quadrigemina to the opposite fil- let, and from tegmentum through opposite crura cerebri, optic thala- mus to hemisphere. Other fibres originate in pineal gland and ganglion habenule cross median line to oculomotor nucleus. The Basil ganglia of gray matter are the optic thalamus and corpus striatum. OPTIC THALAMI are two oblong masses of gray matter situated on either side of the third ventricle, in the base of brain. It has six surfaces. Outer surface rests against the in- ternal capsule, separating it from the lenticular nucleus. 126 ANATOMY IN ABSTRACT. Inferior surface rests upon and is continuous with the tegmentum of the crus cerebri. Superior surface is free, forming part of floor of lateral ventricle. Its outer portion is separated from the caudate nucleus by the taenia semicircularis. Its inner part is covered by the velum in- terpositum. Internal surface forms lateral wall of third ventricle. Posterior surface or pulvinar pro- jects beyond the corpora quadri- gemina. Anterior surface is narrow, and forms posterior boundary of fora- men of Monro. Composition is principally gray mat- ter with an external white layer, the external medullary lamina. It is arranged in outer and inner nuclei, which are again partially separated by the internal medul- lary lamina. The outer nucleus is connected with the internal capsule. The internal nucleus is connected with its fel- low of opposite side by middle commissure. The gray matter contains multipolar, and fusiform cells, being traversed by numer- ous nerve fibres. Internally it is connected with: 1. TegmentunTof crus cerebri. 2. Optic tracts through pulvinar. 3. Cerebral cortex. 4. Corpus striatum. 5. Corpus albicans, through bundle of Vicq d' Azyr. Pineal gland (epiphysis cerebri), a small conical shaped reddish, gray body with following rela- tionships: Below, is posterior commissure. Laterally, are anterior corpora quad- rigemina. Above, is velum interpositum. Fedunculus conarii are white stalks projected laterally into the poste- * rior commissure. Peduncles are upper of stalks pro- jected forward and blend with the anterior pillars of fornix. BRAIN. 127 CORPUS STRIATUM Is gray matter (one of basil ganglia) external to ventricle, imbedded in white sub- stance of each hemisphere. It is separated from optic thalamus by Internal capsule. It is divided into the lenticular and caudate nuclei, and separated by the upper portion of the internal capsule. Nucleus Caudatus curves around optic thalamus, anterior end is large, and forms outer boundary of an- terior cornu of lateral ventricle. It tapers posteriorally and lies ex- ternally to posterior cornu. It continues downward in roof of middle cornu and becomes nucleus amygdalae. Nucleus lenticularis is large deposit of gray matter external to the in- ternal capsule. It is subdivided into four portions, from within outward, namely: globus pallidus, (two portions), putamen and claustrum. External capsule is a white area con- taining nerve fibres, and is be- tween the claustrum and puta- men. External to claustrum is area of white matter, and exter- nal to this is the external gray of the fissure of Sylvius. Internal capsule is formed by fibres of the crusta of the crus cerebri, and fibres from the corpus striat- um and optic thalamus, projected into the hemispheres as the ante- rior limb between the lenticular nucleus and optic thalamus. Fifth ventricle is cavity of the sep- tum lucidum. It was originally a portion of the longitudinal fis- sure, but has no connection with the other ventricles. Tim MIDBRAIN (mesencephalon) is constricted portion of brain (isth- mus) connecting pons Varolii with hemispheres. Has for study: crura cerebri, corpora quadrlgemlna, genticulate bodies, aqueduct of Sylvius, tegmentum, substantia nlger and subthalmic region. 1. Crura cerebri or cerebral peduncles are two cylindrical bundles of white matter on ventral surface extending from pons to hemis- pheres, separated in median line by interpeduncular space, com- posed of three bundles of fibres, (1) outer; from nucleus pontius of pons to occipital and 'temporal cortex; (2) middle; from Rolandic area of cortex to internal capsule genu, thence through pons to an- terior pyramid of medulla; (3) probably from crusta itself through internal capsule to fron- tal cortex. 2. Corpora quadrigemina are four rounded eminences on either side, separated by a crucial depression. They project upward from mid- brain back of the posterior com- missure, and beneath the splen- ium of the corpus callosum. The upper or anterior pair (nates) are larger and are oval. The lower or posterior pair (testes) are hemispherical. The Brashium (anterior and pos- terior), extend outward and for- ward from outer sides of all. 3. Corpora geniculata (externum and internum), are two oblong masses behind the pulvinar of optic thalmus. 4. Aqueduct of Sylvius (iter a tertio ad quartum ventriculum) or the way from the third to the fourth ventricle is a T shaped duct in the median line connecting these two cavities. It is lined with columnar ciliated epithelium, and surrounded by a layer of gray matter, (the central gray matter of the aqueduct), continuous with gray matter of ventricles. Below aqueduct are nuclei for third, fourth and fifth cranial nerves. 5. Tegmentum is central region of midbrain between aqueduct and substantia nigra, composed of bundles of nerve fibres and depos- its of gray matter. There are four bundles of fibres. (1) •Pos- terior longitudinal in median line below aqueduct. They come from anterior column of cord through pyramid of medulla, and in pass- BRATX. 129 ing give off fibres to nuclei of third and fourth nerves and con- tinue to subthalamic region. Some decussate to posterior commis- sure. (2) Coming from cerebellar peduncle decussate in the median line to pass to the opposite side of cerebrum. They surround the red nucleus. (3) The fillet divid- ed into upper mesial and lower (a) upper fibres passes to upper corpora quadrigemina and occipi- tal lobe. (b) Mesial fibres to subthalamic region. (c) Lower (lemniscus) in ventral past of tegmentum pass upward to the in- ferior corpora quadrigemina. (4) Fibres from the olivary nucleus of the medulla through formatio recticularis to the internal cap- sule. 6. Substantia nigra, a crescent shaped layer of deeply pigmented gray matter extending entirely across the midbrain from the two later- al sulci, separating the tegmen- tum above from the crustae be- low. It is composed of multipolar cells. 7. Subthalamic region, Is a forward prolongation of the tegmentum, becoming continuous with under surface of the optic thalamus. It contains a forward prolongation of the red nucleus. It is com- posed of three layers. a. Stratum dorsale; composed of long- itudinal fibres to optic thalamus. 'a. Zona incerta; continuation forward from formatio recticularis of teg- mentum. c. Corpus subthalamicum; a mass of gray matter. jXlNB BRAIN (Epencephalon) is com- posed of pons cerebellum and upper half of fourth ventricle. Fons Varolii (teber annulare) is bond of union of the various seg- ments of the encephalon; the cerebrum above, the medulla be- low, and the cerebellum behind. It has four surfaces: 1. Anterior or ventral rests on clivus of sphenoid, is concave from side to side, with median groove for basilar artery, from which white fibres arch outward 130 ANATOMY IN ABSTRACT. converging to form the middle peduncles of the cerebellum. 2. Posterior or dorsal; is free, above which is cerebellum. It forms up- per half of floor of four ventricle. 3 Superior; continuous with mid- brain. 4. Inferior; continuous with the me- dulla below. Cross section of the pons shows that it consists of two portions; (1) Ventral or anterior, and (2) tegmental. 1 Ventral is composed of (a) trans- verse fibres going from one side of cerebellum to other, (b) Long- itudinal fibres, continuous from the pyramid of medulla to the crusta of midbrain. (c) Deep transverse fibres, interlacing in the median line pass outward to the middle peduncle of the cere- bellum. 2. Tegmental or dorsal portion con- tains gray matter and fibres from formatio reticularis. It is di- vided into two halves by a me- dian ridge continuous from the medulla. Trapezium; is bundle of (a) trans- verse fibres connected with the accessory auditory nucleus. (b) Anterior longitudinal fibres con- tinuous from sensory tract of cord, known as fillet, and poster- ior near floor of fourth ventricle, containing ascending and de- scending fibres. Six deposits of gray matter or nu- clei are found as follows: 1. Superior olivary nucleus; Situated on outer side of trapezium. Fibres cross median line to ac- cessory auditory nucleus. 2. Fifth, nerve; two motor and one sensory. (a) Motor; (descend- ing) situated high near floor of fourth ventricle, (b) Sensory; ex- ternal to motor, beneath superior peduncle of cerebellum. 3. Sixth nerve; in floor of fourth ven- tricle near median line, and nu- cleus of seventh, corresponding to upper half of funiculus teres. Fibres pass through substance of pons and emerge between it and medulla. BRAIN. 131 4. racial (seventh); situated deep In reticular formation, below floor of fourth ventricle, and above su- perior olivary nucleus. 5. Auditory nerve (eighth), two; dor- sal and ventricle, (a) Dorsal; in medulla, extending into pons be- neath upper half of floor of fourth ventricle, (b) Ventral, (ac- cessory) external to dorsal in pons and medulla, in outer aspect of restiform body, (c) Third (nu- cleus of Deiters), situated below outer angle of fourth ventricle. Fibres emerge between olivary and restiform bodies. 6. Nucleus Pontis, small masses of gray matter in anterior or ven- tral portion of tegmentum. CHOROID PLEXUS is highly vascular fringe-like structure in body, and descending horn of lateral ventri- cle. It extends into the third ven- tricle under the fornix, as the velum interpositum forming the roof of this cavity. It extends forward through the anterior cor- nu and foramen of Monro into the third ventricle. Laterally ( it covers the inner part of the optic thalamus, forming a partition be- tween the floor of lateral and roof of third ventricle. Vena Galena are veins of the choroid plexus returning the blood from the ventricles to become the vena niagna Galena, which empties into the straight sinus. STRUCTURE OF THE CEREBRUM. It is composed of white and gray matter. White matter, in the center of hemis- pheres forming principal part, is medullated fibres separated by neuroglia. Fibres are arranged in three distinct systems. 1. Projecting, or peduncular, which connect hemispheres with medul- la, forming the internal capsule principally. 2. Tranverse or commissural con- necting the two hemispheres, forming as they cross the median line the corpus callosum, ante- rior and posterior commissures. 3 Associating which connect the various lobes and convolutions, in the same hemisphere. 132 ANATOMY IN ABSTRACT. Gray matter is divided into (1) ex- ternal or cortex, and (2) central or basil ganglia. (Corpus striat- um and optic thalamus.) 1. External gray, covering the entire surface of the hemispheres is ar- ranged in alternating white and gray layers from the surface in- ward as follows: 1. First layer of white. 2. First layer of gray. 3. Second white. 4. Second gray. 5. Third white. 6. Third gray layer. The nerve cells in the cortex are ar- ranged from surface inward as follows: 1. Molecular layer composed of cells, polygonal, triangular or fusiform in shape. 2. Layer of small pyramidal cells. 3. Layer of large pyramidal cells. 4. Polymorphous layer. 5. White medullary substance. THE CEREBELLUM, contained in in- ferior occipital fossas beneath oc- cipital lobes of cerebrum, from which it is separated by the ten- torium cerebelli. Is oblong, flat- tened from above downward, long- est from side to side. Dimensions: transverse, three and one-half inches; from before backwards two and one-half inches. Above downward two inches; composed of external (gray) and internal white matter. Eobes, Three: two lateral and median, (a) Median (worm or vermiform process), has transverse ridges and furrows on upper surface, (b) Hemispheres (lateral lobes). Lobes are separated on anterior and posterior surfaces by notches, (cerebellar). Anterior notch is close to pons, upper edge encircles corpora quadrigemina. Posterior receives upper part of falx cere- belli. Cerebellum is connected to other parts by three pairs of peduncles. (a) Superior with cerebrum. (b) Middle with pons. (c) Inferior with medulla. THE CEREBELLUM. BRAIN. 133 Lobes and fissures of the cerebellum are named as follows from before backwards. Lobes in worm: Lobes in hemispheres. Lingula. Frenulum. Precentral fissure. Lobulus centralis. Ala Lobuli centralis. Postcentral fissure. Culmen monticuli. Anterior crescentic. Preclival fissure. Clivus monticuli. Posterior crescentic. Postclival fissure. Folium cacuminis. Posterior superior. INFERIOR SURFACE. Nodule. Flocculus. Postnodular fissure. Uvula. Amygdala Prepyramidal fissure. Pyramid. Biventral lobe. Postpyramidal fissure. Slender lobe. Tuber Valvule. Postgracile fissure. Inferior semilunar lobe. SUPERIOR SURFACE. 134 ANATOMY IN ABSTRACT. Internal structure of cerebellum is composed of white and gray mat- ter. White matter arrange in center of hemisphere in form of tree, called Arbor vita. The arms project into the various lobes. Fibres are of two varieties, (a) peduncular, continuous with ped- uncles, (b) fibrae propriae within cerebellum, which are commis- sural from one-half to the other, and associating from one lobe to other in same hemisphere. Gray matter of cortex is composed of (a) external gray molecular lay- er, (b) Internal rust colored granular, between which are found the corpuscles of Purkinje. 1. External layer contains the follow- ing: (a) Dendrites and axon col- laterals of Purkinje's cells, (b) Fibres from cells in granular lay- er. (c) Fibres from central white substance. (d) Fibres from mo- lecular layer itself. Basket cells are in inner portion of medullary layer of numerous small reddish brown cells and many nerve fibres. Golgi cells are in external por- tion. Internal gray deposits are (a) corpus dentatum (ganglion of cerebel- lum) in center of stem of a white matter. The hilum is notch above for exit of fibres to peduncles, (b) Nucleus emboliformis, inter- nal to former above its hilum, (cl Nucleus globosus internal to pre- ceding. (d) Nucleus fastigii (roof nucleus of Stilling), larger than two preceding, is internal to them near median line in anterior end of vermiform process. It is im- mediaately over roof of fourth ventricle. Weight of cerebellum, five oz. 4 drs. Proportion to cerebrum, one to eight. Valve of Vieussens is a transparent lamina of white matter stretched across from one peducle to the other, forming the roof of upper part of fourth ventricle. Corpora quadrigemina is above, and fourth nerves emerge from sides. . BRAIN. 135 THE MEDULLA OBLONGATA (meten- cephalon) the spinal bulb, the last division of the encephalon, ex- tends from the pons to the spinal cord. Developed from the 5 th cerebral vesicle. The cavity is the lower half of the fourth ventricle. It is on a plane with the foramen magnum. Directed obliquely downward and backward. Its an- terior surface rests upon the basilar process of the occipital bone. Dorsal or posterior surface is received between the hemis- pheres of the cerebellum, and forms the lower part of the floor of the fourth ventricle. Its shape is pyramidal with broad end upward. Dimensions. Length, one inch; width, three-quarter inch; thickness, half inch. It is divided into hemispheres by anterior and posterior median As- sures. Its surface presents for study: (a) Pyramid or anterior column, an elongated eminence of white mat- ter bounded internally by anterior median fissure and externally by slight depression, through which emerges root of hypoglossal nerve. Its fibres continue into pons. (b) Decussation of pyramid where fibres cross fissure from right to left half. (c) Lateral column continuous up- ward from cord as the anterolat- eral ground bundle and antero- lateral cerebellar tract, dips un- der the olivary body. (d) Olivary Body. A prominent oval mass external to pyramid and hypoglossal nerve, and separated from the restiform body by a groove through which emerge the 9th, 10th and 11th nerves. The superficial arciform fibres wind around its lower portion to enter the restiform body. (e) Funiculus of Boiando, a promi- nence on the outer side of the lateral tract, its upper end being the tubercle of Rolando, which blends with the funiculus cunea- tus half inch below the pons. THE MEDULLA OBLONGATA. 136 ANATOMY IN ABSTRACT. (f) Funiculus cuneatus, a continua- tion upward of column of Bur- dach of cord, external to funicu- lus Rolando, externally is found funiculus gracilis. It terminates in the cuneate tubercle. (g) Funiculus gracilis, a continua- tion upward from column of Goll of cord, extending to the postero- median Assure. They diverge to form the lower and lateral boun- daries of the 4th ventricle. The clava is an enlargement close to the median Assure. TIE RESTIFORM BODY, largely form- ed by direct cerebellar tract in- ternal and external arcuate Abres. They are the largest prominences of the medulla, and are between the lateral tracts in front with the funiculus cuneatus behind. They ascend along outer boundary of 4th ventricle to form the infe- rior peduncles of the cerebellum. THE FOURTH VENTRICLE, is a dia- mond shaped space upon the su- perior or dorsal surface of pons and medulla. Boundaries, Lower half of sides by funiculus gracilis and cuneatus and restiform bodies; upper half by superior peduncles of the cere- bellum. It has four angles. (1) Upper to superior boundary of pons, and is beginning of aqueduct of Syl- vius. (2) Lowqr continuous with central canal of spinal cord. X3) and (4> terminate in lateral re- cess formed by union of superior peduncles with funiculus gracilis and cuneatus. Roof is formed as follows from above downward. Superior peduncles of cerebellum. Superior and inferior medullary velunr, the tela chor- oidea inferior, obex and ligula. Superior peduncle! of the cerebel- lum are bundles of Abres passing from the medullary substance of the hemispheres to the corpora quadrigemina. Valve of Vieussens (Superior Velum), is a thin layer of white matter continuous with white center of the cerebellum. BRAIN. 137 Inferior Velum; white matter con- tinuous from above structure to the ligula. Tela Choroidea inferior, is a layer of pia mater below inferior velum. Composed by two choroid plex- uses arranged in shape of T in transverse and vertical portion, the vertical extending near middle line from foramen of Majendie, and the transverse extending laterally to the foramina of Key and Ret- zius. These three foramina per- forate the tela and make the cav- ity of the 4th ventricle continu- ous with the subarachnoid space. The Obex, is a. thin triangular lamina of gray matter continuous below with the anterior gray commis- sure of the cord. The Iiigula are narrow bands of white matter projected from inner bor- der of the funiculus gracilis. Floor of Fourth ventricle presents for study, (a) Sulcus longitudinalis media; (b) eminentia teres; (c) fovea superior; (d) striae acusti- ca; (e) trigonum acustici; (f) trigonum hypoglossi; (g) locus ceruleus; and (h) ala cinerea. A cross section of the medulla through middle of olivary body presents the following points for study: 1. Sulcus longitudinalis medianus. 2. Nucleus of funiculus teres. 3. Hypoglossal nucleus. 4. Two nuclei of vagus. 5. Ligula. 6. Funiculus solitarius. 7. Nucleus gracilis. 8. Nucleus cuneatus. 9. Corpus restiformis. 10. Nucleus of Rolando. 11. Ascending root of fifth nerve. 12. Vagus root exit. 13. Nucleus amygdalae. 14. Arciform fibres. 15. Nucleus lateralis. 16. Formatio reticularis. 17. Olivary body and nucleus. 18. Hypoglossal root exit. 19. External arciform fibres. 20. Nucleus of ext. arciform fibres. 21. Accessory olivary nucleus. 22. Pyramid. 23. Anterior mediam fissure. 138 ANATOMY IN ABSTRACT. WEIGHT OF THE ENCEPHALON: Average male, 49^ ozs.; max., 65; min., 34 ozs. Average female. 44 ozs.; max., 56; min., 31 ozs. THE SPINAL CORD. THZ MEMBRANES of the spinal cord have same name, arrangement, and are continuous from the mem- branes of the brain already de- scribed. The arachnoid and pia mater are practically the same as in the brain. The Dura Mater of the cord differs from that found in the cranial cavity. It is attached to the cir- cumference of the foramen mag- num to axis, and third cervical vertebra, and blends with the periosteum of the coccyx. Throughout its length it hangs loosely within the spinal canal, being attached to the bones by a loose areolar tissue. Its inner surface is smooth and lined with endothelium. Its sides are per- forated by the roots of the spinal nerves throughout, sending tubu- lar prolongations to the inter- vertebral foramina. The Ligamentum Denticulatum, is a narrow fibrous band situated on each side of the spinal cord throughout its entire length, be- tween the anterior and posterior spinal ner.ve roots. The internal margin is attached to the pia of the side of the cord. From its outer margin 21 serrations project laterally to be attached to the in- ternal surface of the dura, the first to the margin of the fora- men magnum. It supports the cord in the subarachnoid fluid. THE SPINAL CORD, (medulla spinalis) is a cylindrical elongation of the cerebrospinal axis. Length; usually about 18 inches. Weight; one and one-half ounces. It occupies two-thirds of spinal canal from upper border of atlas to lower border of first lumbar vertebra, where it becomes the Cauda Equina, the lower end of which is the filum terminale. Two SPINAL CORD. 139 enlargements are found, 'one the cervical where the brachial plex- us is given off, and a lumbar for the lumbosacral cord and plexus. The cord is cylindrical, flattened from side to side, divided into lat- eral halves by anterior median and posterior median fissures. Bach hemisphere is divided from be- fore backward as follows: (a) Anteromedian fissure, (b) Anterior column. (c) Anterolateral fissure. (d) Lateral column. (e) Posterior Intermediate furrow. (f) Posterolateral column. (g) Posterolateral fissure. (h) Posteromedian column. A cross section of the cord shows a central H shaped gray area, sur- rounded by a cortical white area. From the anterior (motor) horns of gray matter, the anterior spinal nerve roots emerge from the cord through the anterolateral fis- sures, and from the posterior (sensory) horns the posterior spinal nerve roots make their exit through the posterolateral fissure. The following points are found for study upon cross section of the cord: (a) Anteromedian fissure. (b) Column of Turek or direct pyr- amidal tract. (c) Anterior nerve root, and antero- lateral fissure. (d) Anterolateral tract. (e) Anterolateral ground bundle. (f) Crossed pyramidal tract. (g) Direct cerebellar tract. (h) Tract of Lissauer. (i ) Posterior nerve root. (j ) Column or tract of Burdach. (k) Column or tract of Goll. (1 ) Posterior vesicular column of Clark. (m) Posteromedian fissure. The gray matter of the cord consists of the following: (a) Nerve fibres smaller than those found In w'hite matter. (b) Nerve cells multipolar in ante- rior horn and bipolar in posterior horn. (c) Blood vessels and connective tissue. 140 ANATdMY IN ABSTRACT. THE SPINAL NERVES. The spinal nerves make their exit from the spinal canal through the Intervertebral foramina. There are thirty-one pairs as fol- lows: Cervical 8 Dorsal 12 Lumbar 5 Sacral 5 Coccygeal 1 31 They have their origin by two roots, viz.: 1. Anterior or ventral (motor) root comes from the anterior horn of the spinal cord, (anterior root zone). It is slightly shorter than the posterior and has smaller rootlets. It has no ganglion. 2. Posterior or dorsal (sensory) comes from the posterior horn of the spinal cord through the postero- lateral sulcus. A ganglion is found on this root just within the intervertebral foramen. The dorsal and ventral roots unite as they pass through the interverte- bral foramen, and again divide into the anterior and posterior nerve trunks after making their exit. They now contain fibres from both motor and sensory roots and hence are mixed nerves The posterior trunk is usually divided into an internal and external branch supplying the vertebral gutter. The anterior trunk has several branches varying in size in differ- ent regions as demands are made for greater nerve supply, notably for upper and lower extremities. They supply that part of the body anterior to the vertebral line, and both upper and lower extremities. They are larger than the poste- rior throughout, except the first three cervical. NERVES. 141 NERVES OF THE CERVICAL REGION. FIRST CERVICAL NERVE: Posterior Division; branch to poste- rior division of 2nd cervical. Branch to Complexus muscles. Branches to the posterior cranio- vertebral set of muscles. Branch to integument of occiput. Anterior Division; branch to Rectus cap. ant. major. Branch to Rec- tus cap. ant. minor. Branch to Rectus cap. lateralis. Communicating branches to 2nd Cer- vical, Pneumogastric, Hypoglos- sal, Superior cervical ganglion. SECOND CERVICAL NERVE: Posterior Division is very large. Ex- ternal branch supplies Splenius, Cervicalis ascendens, Transversa- lis colli, Trachelomastoid, Com- plexus. Internal branch (great occipital nerve). Joins with 1st cervical nerve. Supplies integument of occiput as far as vertex. Anterior Division; Filament to sterno- mastoid. Ascending branch to first cervical nerve. Descending branch to third cervical nerve. Filament to communicans non! nerve. Small occipital nerve (oc- cipitalis minor). THUD CERVICAL NERVE: Posterior Division; External branch supplies: Splenius, Cervicalis ascendens, Transversalis colli, _ Trachelomastoid. Internal branch supplies integument of occiput. Anterior Division; ascending branches, Auricularis magnus, Superficial cervical. Branch to second cer- vical nerve. Branch to the spinal accessory. Descending branches, Filament to fourth nerve. Filament to Leva- tor anguli scapulae. Supraclavi- cular. FOURTH CERVICAL NERVE: Posterior Division; (distributed to muscles of the back). Anterior Division; Filament to third cervical nerve. Filament to fifth cervical nerve. Filament to phrenic nerve. Filament to Scal- enus medius. Filaments to Su- praclavicular nerve. 142 ANATOMY IN ABSTRACT. CERVICAL PLEXUS OF NERVES. < Formed by the anterior branches of the first four cervical nerves. Superficial branches (integumentary). Ascending set: Occipitalis minor. Auricularis magnus, Superficialis colli. Descending set: Supraclav- icular branches. Deep branches. Internal set. Com- municating. Muscular. Rect. cap. ant. major. Rect. cap. ant- minor. Rect. cap. lateralis. Com- municans noni. Phrenic, from third, fourth and fifth, distrib- uted to Diaphragm, pericardium and pleura. External set, mus- cular, Sternomastoid, Levator anguli scap, Trapezius, Scalenus medius. Communicating. NERVES OF THE DORSAL REGION. POSTERIOR DIVISIONS: Internal branches in upper 6 nerves: Filaments to Transversalis colli, Longissimus dorsi, Trachelomas- toid, Levatores costarum, Sacro- lumbalis and Accessorius. In the lower six nerves: Same mus- cles as in preceding. And to in- tegument of the back. Internal branches in upper 6 nerves: Filaments to Semispinalis dorsi. Filaments to Multifidus spinae and to Integument of back. In lower six nerves: Same mus- cles as in preceding. No cutane- ous filaments. ANTERIOR DIVISIONS: Six upper or thoracic intercostals; Muscular branches: Intercostals, Triangularis sterni. Lateral cutaneous: Integument of chest and mammae, Upper part of External oblique muscle. Anterior cutaneous: Integument over upper part of Latissimus dorsi and the scapular region. Six lower or thoracicoabd.om.inal in- tercostals; Muscular branches: Intercostals and abdominal muscles. Lateral cutaneous: Integument of abdomen, as far as the edge of rectus, Integument over lower part of Latissimus dorsi. Anterior cutaneous: Upper part of > rectus and integument in front part of abdomen. NERVES. 143 NERVES OF THE UPPER EXTREMITY. BRACHIAL PLEXUS; Is formed by the union of thrae cords. The Anterior division of the fifth and sixth Cervical nerves form the Outer cord. The Anterior division of the eighth Cervical and first Dorsal nerves form the Inner cord. A branch direct from the seventh and one from the Outer and one from the Inner cords unite and form the Posterior cord. Above the Clavicle: Posterior thorac- ic (external respiratory nerve of Bell). Suprascapular: To Supraspinatus, Infraspinatus, and to shoulder joint. Muscular (8): Rhomboidei muscles, Subclavius, Scaleni muscles, Lon- gus colli, and Levator anguli scapulae. Communicating (to phrenic nerve). Below the Clavicle: Outer cord. (Branches.) Ext. Ant. Thoracic (Pectoralis Ext. Musculocutaneous. Anterior branch: Integument of the front of forearm, and ball of thumb. Joins with radial nerve. Post branch: Integument of radial side of back of forearm. Joins with the radial nerve. Joins with ext. cutaneous branch of muscu lospiral. Median: In the forearm. Muscular: Prona- tor radii teres. Flexor carpi radi- alis. Palmaris longus. Flexor sublimus digitorum. Ant. Interosseous: Flexor longus polllcis, Flexor profundus digi- torum, Pronator quadratus. Palmar Cutaneous: Integument of palm and of ball of thumb. in the hand. Ext. branch: Abduc- tor pollicis, Opponens polllcis, Flexor brevis pollicis (outer head), Digital to thumb, and to index finger. Int. branch: Digital to contiguous sides of index, middle, and ring fingers. Filaments to the two outer lumbricales muscles. 144 ANATOMY TN ABSTRACT. Inner cord. (Branches.) Inner head of median nerve. Int. Ant. Thoraci: Both pectoral muscles. Internal Cutaneous. Ant. branch: Integument of Ant. surface of the Inner side of the forearm as low as the wrist. Post branch: Integument of the posterior surface of the inner side of the forearm to near wrist. Xesser Int. Cutaneous: Integument of the posterior surface of the lower third of the arm. Ulnar. In the forearm: Articular (to el- bow joint). Muscular: Flexor carpi ulnaris. Inner half of Flexor profundus digitorum. Palmar cutaneous: Integument of front of wrist and palm of hand. Dorsal cutaneous: Integument of back of wrist and 1% fingers on inner side of dorsal surface of hand. Articular (to wrist joint). In the hand: Superficial branches: Palmaris brevis, Integument of inner 1% fingers on palm. Deep branches: Muscles of little finger. Interossei muscles. Ad- ductor pollicis. Flexor brevis pol- licis (inner head). Posterior cord. (Branches.) Subscapular nerves: The upper or first, Subscapular muscle. The long or second, Latissimus dorsi. The lower or third, Teres major. Circumflex. Superior branch: Del- toid. And to integument over shoulder. Inferior branch: Teres minor, Del- toid (posterior portion) Integu- ment over the shoulder. Musculospiral. Muscular branches: Triceps, Anconeus, Brachialis an- ticus, Supinator longus, Extensor carpi radialis longior. Cutaneous branches: Integument of inner posterior and outer an- terior portions of the arm, and outer aspect of forearm. Radial: Ext. branch: Integument of outer side and ball of thumb. NERVES. 145 Int. branch: Integument of 3% fingers on radial side of dorsum of hand. Post. Interosseus: All muscles on back of forearm except three. Anconeus, Supinator longus, Ex- tensor carpi radialis longior. Filaments to wrist joint. NERVES OF THE LUMBAR REGION. Posterior Divisions: External branches: Filaments to erector spinae muscle; Filaments to intertransversales; Filaments to integument of back part of gluteal region. Internal branches: Filaments to multifidus spinae muscle; Fila- ments to integument near spinal column. Anterior Divisions: First Lumbar nerve: Iliohypogas- tric nerve; Ilioinguinal nerve; Communicating to second lumbar. Second Lumbar nerve: Genitocru- ral nerve; External cutaneous nerve; Communicating to third lumbar. Third Lumbar nerve: Part of ante- rior crural nerve; Part of obtura- tor nerve; Part of accessory obtu- rator nerve; Communicating to fourth lumbar. Fourth Lumbar nerve: Part of an- terior crural nerve; Part of obtu- rator nerve; Part of accessory obturator nerve; Part of Lumbo- sacral cord. DISTRIBUTION OF THE BRANCHES OF THE LUMBAR PLEXUS. LUMBAR PLEXUS. (Seven branches.) Formed bv the anterior divisions of the first four lumbar nerves. 1. Iliohypogastric: Iliac branch, in- tegument of gluteal region. Hy- pogastric branch to integument of the hypogastric region. 2. Ilioinguinal: internal oblique mus- cle. Integument of upper and in- ner portion of thigh. Integument of scrotum. Integument of penis. Integument of labium. 146 ANATOMY TN ABSTRACT. 3. Genitocrural: Genital branch. Cremaster muscle. Scrotum. Round ligament of female. Cru- ral branch. Integument of the front and upper portion of the thigh. 4. External Cutaneous: Anterior branch. Integument on the ante- rior and outer aspect of thigh, as low as knee. Posterior branch. Integument of the posterior and outer aspect of thigh. 5. Anterior Crural: Anterior division. Middle Cutaneous nerve: The Sartorius muscle. Integument of anterior aspect of thigh, as low as the knee. Internal Cutaneous nerve: External branch, Integu- ment of inner and outer sides of knee; Posterior branch, Integu- ment of inner sides of the thigh and leg. Long or Internal Saph- enous nerve: Integument of knee joint and front and inner sides of the leg and foot. Posterior division: Muscular branches, All the muscles on front of thigh, except the Tensor vaginae femoris and the Sartori- us; Articular branches. Two in number. Distributed to capsule of knee-joint. 6. Obturator Nerve: Anterior branch: Articular branches, To hip-joint. Muscular branches, To Gracilis; To Adductor longus; To Pectine- us; To Adductor brevis. Anasto- matic branches, With internal cu- taneous nerve; With internal saphenous nerve. Posterior branch: Articular branch- es, To knee-joint. Muscular branches, Obturator externus; Adductor magnus. 7. Accessory Obturator Nerve: Mus- cular branches, To Pectlneus. Ar- cular branches, To Pectineus. Ar- Cutaneous branches, To the in- tegument of thigh and leg. SACRAL NERVES: Posterior Divisions: External branches: From anasto- motic loops on back part of sacrum and on the posterior as- NERVES OF THE SACRAL REGION. NERVES. 147 pect of the great sacrosciatic ligament. Terminate in cutaneous branches in the gluteal region. Internal branches: Are distributed to the Multifidus spinae muscle. The back part of the coccyx is supplied by the lower two nerves. DISTRIBUTION OFTHE ANTERIOR BRANCHES OF THE SACRAL PLEXUS. SACRAL PLEXUS. (Six branches.} Formed by Lumbosacral cord with ant. divisions of first three and part of the fourth Sacral nerve. (1) Superior Gluteal: Superior branch: Gluteus medius muscle; Gluteus minimus muscle. Inferior branch: Gluteus medius muscle; Gluteus minimus muscle; Tensor vaginae femoris. (2) Muscular branches: Pyriformis. Obturator internus; Gemellus superior; Gemellus in- ferior; Quadratus femoris. (3) Articular branches: To hip-joint. (4) Small Sciatic: Inferior gluteal branch: Gluteus maximus muscle. Inferior pudendal branch: Integu- ment of perineum; Integument of upper and inner part of the thigh; Integument of scrotum or labium. Cutaneous branch: Ascending In- tegument over Gluteus maximus muscle. Descending to integument of inner and outer sides of pos- terior aspect of the thigh. (5) Great Sciatic: Articular (to hip-joint). Muscular: Adductor magnus; Sem- imembranosus; Semitendinosus; Biceps and Crureus. Terminal: External popliteal; In- ternal popliteal. (6) Pudic Nerve: Perineal: Cutaneous or superficial perineal, Integument of anal re- gion, scrotum, penis and labia; Sphincter ani muscle. Muscular: Muscles of the perineum. Inferior hemorrhoidal: Dorsal nerve of penis, Integument of the dorsum and sides of penis; branch to corpora cavernosa. 148 ANATOMY IN ABSTRACT. NERVES OF THE LEG AND FOOT. (From Great Sciatic.) EXTERNAL POPLITEAL NERVE. (Peroneal.) 1. Articular branches: Three in num- ber. Distributed to knee-joint. 2. Cutaneous branches: Two or three in number. Supply integument of outer and back part of leg. 3. Anterior Tibial Nerve: Muscular (to muscles in front part of leg and to the Peroneus tertius). External branch: Extensor brevis digitorum. Articulations of the tarsus. Internal branch: Integument of the adjoining sides of the great and second toes. 4. Musculocutaneous Nerve: Muscular: Peroneus longus; Peron- eus brevis. External branch: Integument of outer side of foot and ankle; In- tegument of the adjoining sides of third, fourth and fifth toes. Internal branch: Integument of the inner side of the foot and ankle; Integument of the adjoining sides of second and third toes and inner side of great toe. INTERNAL POPLITEAL NERVE. 1. Articular: Three in number. Distributed to knee-joint. 2. Muscular: Grastrocnemius, Plantaris, Soleus, Popliteus. 3. External Saphenous Nerve: (Formed by two filaments, one from each of the popliteal nerves); In- tegument of the outer side of foot and the little toe. 4. Posterior Tibial Nerve: Muscular: Flexor longus pollicis; Flexor longus digitorum; Tibialis posticus. Plantar Cutaneous: Integument of heel and inner part of sole of foot. Internal Plantar: Digital branches, Integument of the 3% toes on in- ner side of foot. Muscular: Flexor brevis digitorum. Abductor pollicis. Flexor brevis pollicis. Two inner lumbricales muscles. NERVES. 149 Articular (to tarsus). Cutaneous (to sole of foot). External Plantar: Muscular: Flex- or accessorius. Abductor minimi digiti. Superficial branch, 1% outer toes. Flexor brevis minimi digiti. 4th interosseous muscle. Deep branch: Third and fourth lum- bricales. Rest of interossei. Ad- ductor pollicis. Transversus pedis. The nervous supply of the toes is as follows: External Saphenous Nerve: Outer side of dorsum of the foot and of the little toe. Musculocutaneous Nerve: Inner 4% toes on the dorsum of the foot. Anterior Tibial Nerve: Adjoining sides of first and second toes on the dorsum of the foot. Internal Plantar Nerve: Inner 3% toes on the sole of the foot. External Plantar Nerve: Outer 1^ toes on the sole of the foot. TABLE OF CRANIAL NERVES. There are twelve Cranial Nerves, as follows: 1. OLFACTORT. Sup. or. Olfactory bulbs. Deep or. Gyrus fornicatus, trigonum, olfactori, uncus hippocampi. Exit. Foramina in the cribriform plate of ethmoid. Distrib. Upper one-third nasal mu- cous membrane. Func. Special sense smell. 2. OPTIC. Sup. or. Optic chiasma. Deep or. External geniculate, pulvin- ar, optic thalamus, and ant. quad- rigeminal body. Exit. Foramen opticum. Distrib. Retina. Func. Special sense sight. 3. OCULOMOTOR. Sup. or. Inner side crus cerebri. Deep or. Floor of aqueductus Sylvii. Exit. Sphenoidal fissure. Distrib. To all the muscles of the > eyeball except External rectus and the Superior oblique. Func. Motor. 150 ANATOMY IN ABSTRACT. 4. TROCHLEARIS. Sup. or. Valve of Vieussens. Deep or. Floor of aqueductus Sylvli. i Exit. Sphenoidal fissure. Distrib. Superior oblique muscle. Func. Motor. 6. TRIFACIAL. Sup. or. Middle of the lateral surface of pons. Deep or. Motor root; floor of fourth vent, and beneath aqueductus Syl- vii. Sensory cells in Gasserian gan- . glion; a sensory nucleus in fourth vent, and in nucleus of Rolando. Exit. 1. Sphenoidal fissure. 2. For- amen rotundum. 3. Foramen ovale. Distrib. Sensory; to face, forepart of scalp, ear, eye, cheek, tongue, gum, and teeth. Func. Ordinary sensation. Motor. Ganglia on fifth nerve are Lenticular on first division. Meckels on sec- ond division and Otic and Man- dibular on third division. 6. ABDUCENT. Sup. or. Groove between pons and medulla. Deep or. Floor of fourth ventricle. Exit. Sphenoidal fissure. Distrib. External rectus and a few fibres to Internal rectus of the op- posite eye. Func. Motor. 7. FACIAL. Sup. or. Groove between pons and medulla. Deep or. Floor of fourth ventricle. Exit. Internal auditory meatus. Distrib. Facial muscles, Frontalis, Platysma, Stylohyoid, and posterior belly of Digastric. Func. Motor. 8. AUDITORY. Sup. or. Groove between pons and medulla. Deep or. Chief nucleus in floor of fourth ventricle. Dieter's nucleus to inne"* side of restlform body Ac- cessory nuclear post, quadrigeminal body and internal geniculate by lat- eral commissure. Floor of fourth ventricle. Exit. Internal auditory meatus. Distrib. Membranous labyrinth. Func. Special sense, hearing, equilib- rium. NERVES. 151 9. GLOSSOPHARYNGEAL. Sup. or. Groove between olivary and restiform bodies. Deep or. Floor of fourth ventricle. Exit. Jugular foramen. Distrib. Pharynx, post. part of tongue, fauces, soft palate and Sty- lopharyngeus muscle. Func. Ordinary sense, special sense (taste), motor. 10. PNEUMOGASTRIC. Sup. or. Groove between olivary and restiform bodies. Deep or. Floor of fourth ventricle. Exit. Jugular foramen. Distrib. Sensory to ear; motor and sensory to pharynx, trachea, larynx, lungs, heart, esophagus, stomach and liver. Func. Ordinary sense, motor. 11. SPINAL ACCESSORY. Sup. or. Groove between olivary and restiform bodies and from cord. Deep or. Floor of fourth ventricle and intermediary column of cells and spinal cord. Exit. Jugular foramen. Distrib. Motor to Trapezius and Sternomastoid and accessory to pneumogastric. Func. Motor and ordinary sense. (2. HYPOGLOSSAL. Sup. or. Between the pyramidal and olivary bodies. Deep or. Trigonum hypoglossi in floor of fourth ventricle. Exit. Anterior condyloid foramen. Distrib. Intrinsic and extrinsic mus- cles of tongue and by a common branch to (ansa hypoglossal loop) depressors of hyoid. Func. Motor. THE SYMPATHETIC SYSTEM. This system of nerves controls or- ganic life. It consists of four divisions: 1. Series of ganglia connected by in- tervening cords extending from base of skull to coccyx in two chains, one on each side of the bodies of the vertebra. 2. Three great ganglionated plexuses, one in thorax, one in abdomen, and third in pelvis. r 152 ANATOMY IN ABSTRACT. 3. Smaller ganglia presiding over function of individual viscera. 4. Nerve fibres, (a) connecting, which connects various ganglia and com- municates with the cerebrospinal system; (b) distributing, which supply the viscera and the coats of the blood vessels. Each ganglionated cord consists of the following individual ganglia; Cervical, 3; Dorsal, 12; Lumbar, 4; Sacral, 4 or 5. Above they probably communicate through fibres of the fifth cranial * nerve, and below they unite in the GANGLION IMPAR on the anterior surface of the coccyx. t. GANGLIONATED CORD. Cervical Ganglionated cord is com- posed of three ganglia: (a) Superior Cervical Ganglion gives off superior branches to base of skull, outer to form the carotid plexus to the carotid artery, com- municating with the Gasserian ganglion, the sphenopalatine ganglion, the sixth and other nerves. The third branch goes to form the cavernous plexus, which communicates with its fellow across the median line in the ganglion of Ribes. The Carotid Plexus rests external to the internal carotid, sends out filaments to the walls of the car- otid arteries, dura mater, Gasser- ian and sphenopalatine ganglia, and communicate with the sixth, Vidian, and Jacobson's nerves and other structures at base of skull. The Cavernous Plexus is situated in the cavernous sinus, at side of sella turcica, communicates with third, fourth, sixth and first di- vision of fifth nerves, ophthal- mic ganglion to the carotid arte- ries and their branches. (b) Middle Cervical Ganglion. (Thy- roid) is smallest, at sixth cervical vertebra. Its branches are supe- rior to first and inferior to third ganglion; external to fifth and sixth spinal nerves; internal to thyroid gland and middle cardiac nerve, forming connection with the cardiac plexus and thyroid to NERVES. 153 thyroid gland, where it joins the laryngeal nerves. (c) Inferior Cervical Ganglion, situ- ated above neck of first rib, lar- gest. Its four branches are as follows: (1) Superior from second cervi- cal; (2) Inferior to dorsal; (3) Internal to inferior cardiac nerve, going to subclavian artery, recur- rent laryngeal nerve; (4) Exter- nal, to seventh and eighth spinal nerves. The Thoracic or dorsal ganglionated cord is composed of twelve gang- lia corresponding to the vertebra, resting upon the head of the ribs, postplural. They have ex- ternal and internal branches to the chest walls. The greater splanchnic nerve is formed from the sixth to the ninth, and goes through the crura of Diaphragm to the solar, renal, and suprarenal plexuses. The lesser splanchnic nerve is form- ed from the tenth to twelfth, and passes into the abdomen to the solar plexus. The smaller or renal splanchnic is from the last ganglia and termin- ates in the renal plexus. The lumbar ganglionic cord com- posed usually of four ganglia, sends out superior, external and internal branches, the latter going to the aortic and solar plexuses. The Pelvic or Sacral portion of the ganglionated cord has superior branches to the lumbar, Internal, entering the sacral foramina and external to the sacral nerves. 2. THE THREE GREAT PLEXUSES are (1) Cardiac; (2) Solar, or epigastric, and (3) Pelvic or hypogastric. Cardiac Plexus; divided into (a) Deep or great part situated in front of the bifurcation of the trachea, and behind the arch of the aorta. It is formed by the cardiac nerves from the cervical sympathetic, the recurrent laryngeal and pneu- mogastric. (b) Its superficial or anterior branch is distributed to the pulmonary arteries, bronchi, 154 ANATOMY IN ABSTRACT. auricles and structures in region of base of heart. Its posterior or right coronary plexus is distrib- uted to the ventricles. Its ante- rior or left coronary plexus is dis- tributed to the anterior surface of the heart. The Epigastric, or solar plexus is composed of a great network of plexuses situated behind and above the stomach, and by its subplexuses is distributed to the entire abdominal viscera. The two semilunar principally form it. It goes to fdrm the following: phrenic, suprarenal, renal, sper- matic, gastric, splenic, hepatic, superior mesenteric and aortic plexuses, all of which give off branches to the organs and struc- tures named. The Hypogastric plexus is subdivided to form the two pelvic plexuses, and it has smaller plexuses from which fibres are distributed as follows: Inferior hemorrhoidal, vesicle, and in the male, prostatic, large and small cavernous, and in the female vaginal uterine, etc. 6 3. SMALLER GANGEIA subordinate to the three great ganglia with fibres distributed tc individual viscera, and structuies control- ling their function. 4. NERVE FIBRES connecting the vari- ous ganglia and plexuses to each other and to the cerebrospinal system. They are composed of white fibres from cerebrospinal to sympathetic and gray in opposite direction, with principally gray fibres within the sympathetic sys- tem. THE ORGANS OF SPECIAL SENSE. THE EYE. THE EYE is the organ of the special sense of sight. The eye ball is situated in the center of the orbital cavity, surrounded by the capsule of Tenon, permitting it to rotate. It is imbedded in a cush- ion of fat. Its movements are con- trolled by six muscles. THE EYE. 155 There are three coats of the eye ball: 1. Sclerotic and cornea. 2. Choroid, ciliary body, and iris. 3. Retina. (1) SCLEROTIC (hard) is external coat, forming five-sixths of the en- tire ball; the cornea forming the anterior one-sixth. It is firm and unyielding, maintaining the form of the globe. It is thicker behind; slightly thinner where muscles are attached. Cornea, transparent, anterior one- sixth of the eye ball. Composed of four layers from without: 1. Epithelial layer, continuous with conjunctiva. 2. Substantia propria, thick fibrous structure. 3. Homogeneous elastic lamina. 4. Lining membrane of anterior chamber. It sets in the anterior margin of the sclerotic like the crystal of a watch. (2) SECOND COAT (TUNICA VASCU- LOSA OCULI) consists of choroid, ciliary body and iris. It is the vascular and pigmentary layer. Choroid occupies posterior five-sixths of the globe. Outer surface is in- timately adherent to the sclerotic. Inner surface is attached to the retina. The layers from without are: 1. Lamina suprachoroidea, composed of endothelial cells, and vessels as they pass through; also, some pigment cells. 2. Choroid proper; composed of ar- teries, veins, and capillaries, ar- ranged in two layers. The external, or lamina vasculosa; composed principally of veins. It also contains pigment cells and capillaries. The internal layer (lamina chorio capillaries) consists of a fine capil- lary plexus. Ciliary body, composed of orbiculus ciliaris, ciliary processes, and cili- ary muscle. Orbiculus ciliaris is one-sixth of an inch wide, around anterior margin of the choroid 156 ANATOMY IN ABSTRACT. Ciliary process is irregular folding surface around circumference of lens and suspensory ligament of lense. Ciliary muscle (Bowman); unstriped fibers encircling the anterior portion of the globe. Composed of two sets of fibers: 1. Circular; contracts to relax sus- pensory ligament. Nerve, is mo- tor oculi. 2. Radiating; contracts to tighten the suspensory ligament. Nerve, sympathetic. Iris (a rainbow); containing the col- oring matter of the eye. Delicate curtain attached at its outer circum- ference to the ciliary body. Its free margin projects inward, dividing the aqueous chamber into an anterior and a posterior chamber. The pupil is the opening through its center. Its circular and radiating fibers give it power to increase (di- late), and diminish (contract) the size of the pupil. It is composed principally of involun- tary (non-striated) muscular fibers in two layers, viz.: 1. Circular, contracts to close pupil. 2. Radiating, to dilate pupil. Third nerve supplies circular fibers of both iris and ciliary muscle. Sympathetic, supplies the radiating of both muscles. (3) THE RETINA IS THIRD LAYER. It is a delicate membrane which re- ceives the images of external ob- jects as they are conducted to the brain. The choroid is external, and the vitreous is internal to it. Be- hind it is continuous with the optic nerve. Anterior margin (orra serrata), ter- minates near the ciliary body. Macula lutea (yellow spot), is in cen- ter of posterior surface, where rays are focussed. Fovea centralis is center of macula lutea. Iiayers of retina from within outward: 1. Membrana Limitans Interna. 2. Layer of nerve fibers (stratum opticum). 3. Ganglionic layer, consisting of nerve cells. 4 Inner molecular, or plexiform layer. 5. Inner nuclear layer, or layer of inner granules. 6. Outer molecular, or plexiform layer. 7. Outer nuclear layer, or layer of outer granules. 8. Membrana limitans externa. 9. Jacob's membrane (layer of rods and cones). 10. Pigmentary layer (tapetum ni- grum). Refracting media of the eye are: 1. Aqueous humor, between cornea and lens, and divided into two chambers by iris. 2. Vitreous body, forms posterior * four-fifths of the globe. It fills the cavity of the retina. Hol- low in front for reception of lens. Membrana hyaloidea is the delicate, transparent capsule of the vitreous. The vitreous humor is transparent jelly, like mass composed of water, albumin and salt. 3. Crystalline lens is situated be- hind the pupil and in front of the vitreous body. It is biconvex, transparent, slightly more firm than the vitreous humor. The capsule is transparent, highly elastic, brittle, closely surrounding lens. Its margin on circumference is the suspensory ligament, and is attached to the ciliary body, which, when the ciliary muscle contracts or dilates, increases or diminishes the convexity of the lens, and thus changes its focal distance. The appendages of the eye: Eye brows (supercilia); thickened in- tegument arched over the eye and covered with hair. Eyelids (palpebrae); two thin, mova- ble folds placed in front of the eye, with power to open and close at will. Upper lid larger. Outer surface, skin; inner surface, mucous mem- brane, Margins contain the tarsal cartilages, which preserve their form. They are covered by the Orbicularis pal- pebrae muscles. The upper lid is elevated by the Levator palpebrae muscle. The outer and inner angles are known as the outer and inner canthus. r THE EYE. 157 158 ANATOMY IN ABSTRACT. Eyelashes (cilia) are hairs attached to free margin of lids. Glands of Moll are small and are near the cilia. Meibomian glands are situated in eye lids, between tarsal plates and con- junctivae. There are about thirty in upper lid and twenty in lower. Their ducts terminate along mar- gins of the lids. Conjunctiva; mucous membrane lining under surface of the eyelids and deflected over anterior surface of eyeball. Lachrymal .apparatus; composed of lachrymal gland, lachrymal ducts, puncta lachrymalia, lachrymal ca- nals, lachrymal sac, and nasal duct. Iiachrymal gland; situated in outer superior portion of orbit. Resem- bles salivary glands. Shape and size of almond. Ducts; 6 to 12; terminate under eye lid. G Lachrymal canals; two in number; begin in minute orifices (puncta lachrymalia) at inner canthus, and pass inward and terminate in the lachrymal sac. Lachrymal sac is the upper dilated end of the nasal duct and it rests in deep groove in lachrymal bone. Nasal duct is a membranous canal, three-quarters of an inch long, ex- tending from lachrymal sac through bony foramen formed by maxilla, lachrymal, and inferior turbinated bones, and terminates in the infe- rior meatus of the nose. Its lower orifice is provided with a valve (Hasner's). The entire lachrymal canal is lined with mucous membrane containing columnar epithelium. THE EAR. THE EAR is the organ of special sense of hearing. Divisions: External, mi idle, and in- ternal. EXTERNAL EAR is divided into pinna and meatus. Pinna, or auricle, is expanded; ex- ternal to head; ovoid shape, with large end upward. THE EAR. 159 Outer surface; concave and irregular; cartilaginous throughout, pre- serving its form. Helix, is external prominent rim. Antihelix, is second curved promi- nence. Fossa of antihelix, is triangular de- pression in front, between these ridges. Fossa of helix, is groove between these ridges. Concha, is large depression in cen- tral part of ear, divided into cym- ba, above, and cavum, below. Tragus, is eminence, projecting backward over meatus. Antitragus, is prominence, opposite the tragus. Incisura intertragica, is depression between tragus and antitragus, below meatus. Lobule, is soft appendage forming lower portion of ear. Tubercle of Darwin, is prominent lower end of helix. Cranial surface of pinna presents elevations which correspond to depressions on outer surface. Structure of pinna; yellow flbrocar- tilage throughout, except lobule, all covered with skin. ligaments of pinna: Extrinsic: 1. Anterior, from spina helicis to zygoma; 2. Posterior, from posterior surface of concha to mastoid. Intrinsic: 1. Band from tragus to helix; 2. Band from antihelix to cauda helicis. Muscles of pinna: Extrinsic: Attollens, above; Attra- hens, in front; Retrahens, behind; extend from cartilage to bones of skull. Intrinsic: Helicis major, Helicis minor, Tragicus, Antitragicus, Transversus auriculae, and Ob- liquus auriculae. Auditory canal (meatus auditorius ex- ternus); extends from bottom of concha to membrana tympani, one inch long, S shaped, cartilaginous portion is one third of an inch external to bone. Osseous portion is two-thirds of an inch within the bone. 160 ANATOMY IN ABSTRACT. Sulcus tympanicus, is a groove at internal end for insertion of mem- brane tympani. Skin, is thin; continuous from exte- rior; contains ceruminous glands, secreting wax. Glands resemble sweat glands. Arteries; from posterior auricular, internal maxillary, and temporal. Nerves; principally from fifth and tenth. MIDDI.E EAB, OB TYMPANUM; situ- ated within the petrous bone. Boundaries; externally, the meatus auditorius; internally, the laby- rinth; behind, the mastoid cells; in front, the carotid canal; below, the jugular fossa. It contains air, and communicates with pharynx by Eustachian tube. The tympanic cavity is divided into two parts, viz., the antrum or lower principal portion, and the attic, or smaller recess above margin of the membrane. The roof (paries tegmentalis); form- ed by thin plate of bone (tegmen tympani), separating it from cra- nial cavity. It is continuous with roof of mastoid antrum, posteri- orally. The floor (paries jugularis); separat- ed from jugular fossa by thin plate of bone (fundus tympani). Jacobson's nerve near inner wall. Outer wall, is formed principally by membrana tympani. Near it are three small appertures, viz., iter chordae posterius and anterius, and glasserian fissure. Inner wall (paries labyrinthica); ver- tical. Has for study: 1. Fenestra ovalis, leading into the vestibule, and occupied by base of stapes; 2. Fenestra rotunda, opening into cochlea, and closed by the membrana tympani secun- daria; 3. Promontory, formed by first turn of cochlea; is between the fenestra; 4. Aqueductus Fal- lopii, a prominent long canal con- taining seventh nerve. Posterior wall (paries mastoidea), has for study: 1. Opening of antrum leading into the mastoid cells, lined with mucous membrane, and THE EAR. 161 containing air; 2. Pyramid, a conical eminence back of fenes- tra ovalis. It is hollow, and con- tains stapedius muscle. The anterior wall (paries carotica); near carotid canal. Has for study: 1. Canal for tensor tym- . pani; 2. Eustachian tube, or tube of communication with pharynx; inch and a half long; formed partly by bone and partly by car- tilage; 3. Processus cochleari- formis. Membrana tympani (ear drum), sep- arates middle from external ear. Thin, transparent membrane; at angle of 55 degrees; composed of three layers: external, cuticle; middle, fibrous; and internal, mucous. Has two sets of fibers, radial and circular. Ossicles (bones) are malleus, incus, and stapes, arranged as named from without inward. Malleus (hammer), has for study: head, neck, manubrium, processus gracilis, and processus brevis. Incus (anvil), resembles bicuspid tooth; has for study: body, short and long process. Stapes (stirrup), has for study: head, neck, two crura, and base. Ligaments of ossicles; anterior, supe- rior, and external ligaments of malleus; posterior and superior, of incus; and annular ligament of stapes. Muscles of tympanum are two: Tensor tympani: Or. Temporal bone, Eustachian tube, and osseous canal. In. Handle of malleus. Nv. Otic ganglion (fifth nerve). Ac. Renders tense membrana tym- pani. Stapedius: Or. Interior of pyramid. In. Neck of stapes. Nv. Facial. Ac. Rotates base of stapes. Mucous membrane of middle ear is continuous from pharynx through Eustachian tube. Arteries; from internal maxillary, posterior auricular, middle men- ingeal, ascending pharyngeal, and tympanic from internal carotid. 162 ANATOMY IN ABSTRACT. Veins: rminate in pterygoid plexus and superior petrosal sinus. Nerves: tympanic branch of glosso- pharyngeal, small deep petrosal, superior petrosal, and small su- perficial petrosal. Chorda tympani (branch of seventh) crosses this cavity. INTERNAL EAR, or labyrinth, divided into osseous and membranous. Osseous, subdivided into: 1. Vestibule; 2. Semicircular canals; 3. Coch- lea, which are cavities hollowed out in the bone and lined by peri- osteum. Contain clear fluid, peri- lymph, or liquor Cotunnii, in which membranous labyrinth is situated. Vestibule, is central cavity of com- munication between the parts of internal ear. 1. On outer wall is found fenestra ovalis, closed by base of stapes and annular liga- ment. 2. Inner wall has fovea hemispherica, perforated by mac- ula cribrosa media for auditory nerves. Behind this is a vertical ridge, or crista vestibuli. At back part of inner wall is aque- ductus vestibuli for transmission of vein. 3. Roof contains fovea semielliptica. 4. Behind are the five openings for the semicircu- lar canals. 5. In- front is opening into scala vestibuli of cochlea. Semicircular canals are three bony canals above and behind the ves- tibuli; irregular in length; one- twentieth inch in diameter. Ampulla, is dilitation at one end of each. Superior canal, is vertical; at right angle with petrous; is two-thirds of a circle. Ampulla on outer ex- tremity. Crus communis, is union of supe- rior and posterior canals. Posterior canal, is vertical, and par- allel with petrous bone. Is long- est of three. External, or horizontal canal, is shortest; arch directed outward and backward. Each canal is at right angle to the others. THE EAR. 163 Cochlea, forms anterior part of laby- rinth, in front of vestibule; form of snail's shell; conical; apex, or cupola, directed forward and out- ward; base corresponds with de- pression of internal auditory meatus, and is perforated for au- ditory nerve. One-fourth inch from ba; j » apex. Modiolus, ic conical shaped central axis. Canal ir. ikes two and three- quarter turns about modiolus. Lamina spiralis ossea, projects from modiolus, and, with membrane at- tached to free margin, divides spiral canal. Commencement of canal has three openings: 1. Fenestra rotunda, covered by membrana tympani secunda, and leads into middle ear; 2. Opening into vestibule; 3. Aqueductus cochlea; through petrous bone from subarachnoid space. Lamina spiralis ossea, is bony shelf; projects outward from modiolus, and, with the spiral lamina se- cundi, divides the spiral canal into two passages, leaving a fis- sure, the fissure vestibuli: 1. Up- per or scala vestibuli; 2. Lower, or scala tympani. Upper end of lamina terminates in hamuluq. Helicotrema, is small opening at hamulus, making communication between the two scalae. Membranous labyrinth, is contained in the cavities just described, sur- rounded by the perilymph, exter- nally, and, containing endolymph, or internal fluid. The vestibule, contains two sacs, viz.: The utricle and saccule, which contains macula acustica utricularis, where some filaments of auditory nerve terminate. Oto- liths are also found here. The ductus endolymphaticus, formed by union of canals from saccule and utricle; passes through aque- ductus vestibuli. ' Canalis reuniens of Hensen, is tube from saccule to ductus cochlearis. 164 ANATOMY IN ABSTRACT. Membranous semicircular canals, are one-third diameter of bony canals, but conform to them In other ways. They terminate by five orifices in the utricle. Septum transversum, is partition across ampulla where the nerves end. Membranous cochlea (ductus cochle- aris, or scala media), is in spiral tube of cochlea, on spiral lamina. Membrana basilaris, forms roof of scala tympani, its outer attach- ment being the ligamentum spirale. Membrane of Reissner, from lamina spirale to outer wall of cochlea, forming the scala media. Three canals, within the spiral canal, are thus found, viz.: Scala tym- pani, below the spiral lamina; scala vestibuli, above, with the scala media, a subchamber of the latter. Organ of Corti, situated on mem- brana basilaris; composed of cells, the rods of Corti. Tunnels of Corti, are spaces under the rods, extending the entire length of cochlea. Bods of Corti, rest on basilar mem- brane, and are arranged in inner and outer row. Inner are 6000; project above, and resemble up- per end of ulna. Are formed of nucleated protoplasm, surmount- ed with inner hair cells. Outer, are about 4000; resemble head of a swan, and are sur- mounted with outer hair cells. Cells of Deiters, are between outer row of hair cells and supporting cells. The clubbed ends are pha- langeal processes. Supporting cells of Hensen, are five or six rows of columnar cells out- side of preceding, with cells of Claudius external to these. Spaces of Nuel, are between outer rods of Corti and outer hair cells, liamina reticularis (membrane of Kol- liker), is formed by rows of fid- dle-shaped structure; extends from inner organs of Corti to outer hair cells, perforated by round holes. THE NOSE. 165 Membrane of Corti, (tectorla) is stretched across above organs of Corti, and overlies the auditory teeth of Huschke. Its outer half, is stripe of Hensen. Arteries of labyrinth are: Auditory, from basilar; stylomastoid, from posterior auricular. Veins; same. Nerve; auditory (8th) special nerve of hearing. THE NOSE. TH NOSE is the Peripheral organ of the sense of smell. Assists taste in appreciating food. Filters air before it enters lungs. Divisions: External or outer; and, in- ternal or nasal fossas. OUTER NOSE. Points for study: Integument or external covering. Mucous membrane, internally throughout. Bones; 2 nasal, and nasal processes of maxillas. Cartilages; (5) 2 upper, 2 lower, and the septum. Arteries; branches from facial, supe- rior coronary, ophthalmic, and in- fraorbital. Veins; terminate in facial and oph- thalmic. Nerves; facial, motor to muscles. To skin, supraorbital, infratroch- lear, and ophthalmic. Base, or Inferior part. Root, on summit, at forehead. Dorsum, prominence in center. Columns, septum between nares. Anterior nares, orifices through base. Alae nasi, wings or outer margin of nares. Muscles; Pyramidalis nasi, Devator labil superioris alaque nasi, Dila- tor nares (anterior and posterior). Compressor nasi, Compressor nar- ium minor, and Depressor alae nasi. NASAL FOSSAE are two irregular cavi- ties in middle of face. Each ex- tends from outer nose to pharynx. Posterior nares, is posterior opening leading into pharynx. Vestibule, is dilatation under alae nasi. 166 ANATOMY IN ABSTRACT. Ventricle, is pouch under tip of nose. Olfactory portion, is upper central part of septum. Respiratory portion, is lower remain- ing portion of cavity. OUTER WALL is found superior, mid- dle, and inferior turbinated bones. The meatuses, are depressions below these bones. Bulla ethmoidalis, is large eminence in middle meatus. Hiatus semilunaris, is groove in front of former. - Infundibulum, opening into frontal sinus, terminates in middle meatus. Antrium, opening into antral cav- ity. Nasal duct, from eye, terminates in inferior meatus. Septum, is partition between the two nasal fossas, extending from outer nose to pharynx, and from roof of mouth to the ethmoid. Nasopalatine recess, is depression in lower part of septum, over in- cisive foramen. Organ of Jacobson, (rudimentary) has a minute orifice near this re- cess. Cartilage of Jacobson, small plate supporting latter orifice. Schneiderian, or pituitary membrane, is mucous membrane lining nasal fossas throughout, leading into all accessory cavities. Openings into nasal fossas are an- trium into maxillary sinus; in- fundibulum into frontal sinus; nasal duct into eye; sphenoidal into body of this bone; ethmoidal cells throughout roof. Vibrissae, are hairs guarding anterior nares. Mucous membrane; respiratory por- tion has columnar ciliated epithe- lium. There are also found lymph corpuscles, adenoid tissue, mucous and serous glands. Olfactory cells and glands of Bowman are found in upper portion. Arteries, are anterior and posterior ethmoidal from ophthalmic, sphenopalatine from internal max- illary; inferior coronary from THE TONGUE. 167 facial; infraorbital and alveolar from internal maxillary. All form a plexiform network. Veins, tributaries, to facial and oph- thalmic. Nerves, olfactory for sense of smell; ophthalmic, superior, maxillary, vidian, and from Meckel's gan- glion. THE TONGUE. TIE TONGUE is the organ of special sense of taste, situated in floor of mouth, within the mandible. Base, directed backward, has four points of attachment: 1. Os hyoid, by Hyoglossus and Genio- hyoglossus muscles, and hyo- glossal membrane. 2. To epiglot- tis, by three folds of mucous membrane. 3. To soft palate, by anterior pillars of fauces. 4. To pharynx, by Superior constrictor and mucous membrane. Apex, or tip, is thin and narrow, and directed forward toward mouth. Under surface smooth, attached to lower jaw by Geniohyoglossi muscles; its sides connected to body of mandible by folds of mucous membrane, and in median line is vertical fold, frenum, linguae, to floor of mouth. Dorsum is convex, covered by mu- cous membrane. Rapha, is groove along median line of dorsum, from tip to foramen cecum. Sulcus terminalis of His, are grooves from latter foramen across base to sides. Muoous membrane of dorsum is rough. It contains tubular glands, lymph follicles, and papil- lae. Epithelium is stratified. Glands, racemose to posterior one- third of dorsum. Lymphoid tissue and follicles, same as crypts of tonsils. Glands of Nuhn, along sides of frenum. Papillae, are four varieties: Simple; over entire mucous mem- brane. Filiform; anterior two-thirds of tongue. 168 ANATOMY IN ABSTRACT. Fungiform; dorsum, sides, and apex. Circumvallate; arranged in V shape across dorsum, near base. Glands; are mucous and serous. Lymphatic vessels, from tongue, ter- minate in glands under same. Taste buds, are throughout mucous membrane. They are composed of gustatory and sustentacular cells. Muscles: Intrinsic muscle (lingualis); one for each half; fibers run in vari- ous directions. Other muscles are extrinsic; Genio- hyoglossus, Hyoglossus, Stylo- glossus, Palatoglossus, and Chon- droglossus. Nerves; lingual branch of fifth for or- dinary sensation to anterior two- thirds; chorda tympani of seventh gives taste to anterior two-thirds; lingualis < f ninth gives taste and sensation to posterior third, and to circumvallate papillae; hypo- glossal gives motion to all mus- cles. Recapitulation of nerves: Taste; anterior two-thirds, chorda tympani; posterior third, lingu- alis of ninth. Sensation; anterior two-thirds, lingu- al of fifth; posterior third, lingual of ninth. Motion; twelfth, or hypoglossal. Motion to base and epiglottis; su- perior laryngeal of tenth. Sympathetic; usual function through- out. THE ALIMENTARY CANAL. ALIMENTARY CANAL is a Musculo- membranous tube thirty feet long from mouth to anus. It has four coats below the Diaphragm, as follows: 1. External, peritoneum. 2. Muscular: Circular, internal. Longitudinal, external. 3. Areolar, submucous or muscularis mucosae. • 4. Mucous membrane throughout. ALIMENTARY CANAL. 169 Divisions, lengths, glands, and coats of alimentary canal: 1. Oral cavity, from lips to pharynx, 4 to 6 inches long. Contains Tongue, Teeth, 20 tem- porary and 32 permanent. Salivary glands; parotid, mandibu- lar, lingual. Lined with mucous membrane throughout. Mucous glands; buccal, labial, and molar. 2. Pharynx, from body of sphenoid to disk between fifth and sixth cervical vertebra. Length, four and one-half inches. Openings, mouth, posterior nares, larynx, esophagus, and eustachian tubes. Mucous lining throughout, containing racemose mucous glands and crypts. 3. Esophagus, nine inches long. From pharynx or fifth cervical to tenth dorsal vertebra. Coats, three above Diaphragm, viz.: (1) Muscular, (2) areolar, (3) mucous. Gland are racemose. 4. Stomach. Located in abdomen. Length, ten inches. Capacity, five to eight pints. x Coats, four: (1) Peritoneal or external. (2) Muscular ( V (three layers). 1 ^ul. or 215?. J? ' I Int. cr oblre. (3) Areolar. Muscularis mucosae. (4) Mucous. Glands: (1) Peptic or oxyntic through- out. (2) Pyloric, at pyloric end. (3) Lenticular. Orifices: cardiac from the esoph- agus, and pyloric Io duodenum. 5. Small intestines; twenty-one feet long; four coats, same as above. Subdivisions: (A) Duodenum, ten inches long. (B) Jejunum, nine feet long. (C) Ileum, eleven feet long. 6. Large intestines; five feet long; four coats; same as above. Subdivisions: (A) Cecum, two and one-half inches long. (B) Colon, four feet long. (C) Rectum, seven inches long. 170 ANATOMY IN ABSTRACT. GLANDS OF ALIMENTARY CANAL. Pharynx. Racemose mucous. Phar- yngeal tonsil. Esophagus: Minute papillae. Com- pound racemose. Stomach: Pyloric, near pylorus. Car- diac, throughout. Lenticular, lymphoid. Duodenum: Villi. Crypts of Lieber- kuhn. Solitary glands. Glands of Brunner. Jejunum and Ileum: Valvnlae conni- ventes. Villi. Crypts of Lieber- kuhn. Solitary glands.- Pyers', or agminated glands. Brunner's glands, upper part of jejunum. Cecum and Colon: Simple follicles of Lieberkuhn. Solitary glands. Valvulae coniventes throughout. THE MOUTH. THE MOUTH (oral, or buccal cavity) the beginning of the alimentary canal, oval shaped, in which food is masticated. Divided into (a) vestibulum oris, or outer part, between cheek exter- nally, and the teeth and gums in- ternally, and (b) cavium oris proprium. Principle portion bounded above by hard and soft palate, below by tongue, laterally and in front by alveolar arches and their contained teeth. And behind it is continuous with the pharynx. . It receives the secre- tion from mandibular and lingual glands. Mucous membrane is continuous from skin of lips throughout both cav- ities, thick over hard parts and covered with stratified epithe- lium. The Lips are two fleshy folds form- ing the mouth. Externally is skin, internally is mucous mem- brane with Orbicularis oris and other muscle, vessels, nerves and adipose interposed. The frenum labii superioris and inferioris are the folds of mucous membrane as it joins the gums. Labial glands are the size of a pea, internal to muscle, with ducts terminating in margin of lips. THE TEETH. 171 The cheeks constitute the lateral walls, and are formed by skin, muscle and mucous membrane similar to lips. Buccal glands are internal to Buc- cinator muscle, same as labial, but smaller. The gums are composed of dense fibrous tissue adherent to peri- osteum of alveolus, and about neck of teeth, covered by smooth, vascular membrane, with little sensibility. It is continuous with periosteum lining cavities of alveolus. The human subject has two sets of teeth, viz.: Temporary, deciduous or milk and permanent. THE TEMPORARY TEETH. The temporary, deciduous or milk teeth resemble permanent teeth but are smaller. Neck more marked. Labial and lingual con- vexities greater. Second upper molar is largest, is succeeded by second bicuspid. First upper molar has three cusps, while sec- ond has four. First lower molar has four cusps, while the second has five. Roots are smaller and more diverg- ent. The temporary teeth are twenty in number, and are named as fol- lows in each jaw, beginning at the middle line: Central incisor, lat- eral incisor, canine, first molar and second molar, or more briefly, two incisors, one canine, two molars. This is conveniently ex- pressed by the "dental formula" for the deciduous teeth in man, which shows the number of each class of teeth above and below on one side of the mouth, viz.: i. 2 c. 1 m. 2 2 12 THE TEETH. THE PERMANENT TEETH. The permanent teeth, thirty-two in number, are named in each jaw, beginning at the middle line: 172 ANATOMY IN ABSTRACT. central incisor, lateral incisor, canine, 1st premolar (or bicus- pid), 2d premolar (or bicuspid), 1st molar, 2d molar, and 3d molar or wisdom tooth (dens serotinus). The dental formula for the per- manent set in man is thus: i. 2 c. 1 pm. 2 m. 3 2 1 2 3 Each tooth has the following points for study: Crown; or top forming the cutting portion. Body; the part above the gum. Neck; the constriction above the mar- gin of the gum. Boot; that part within the alveolus. Buccal; the surface toward the cheek, (outer). Labial; that toward the lip. Lingual; that toward the tongue, (internal). Proximal (anterior); that toward the mesial line. Distal (posterior); that away from the mesial line. PERMANENT TEETH. Incisors or cutting teeth, eight in number, four upper and four lower. Crown is vertical, forming truncated cone, with horizontal cutting edge. Mesial and distal surfaces are trian- gular. Iiabial surface, convex. Lingual surface, concave. Neck, constricted. Boot, is single, forming transverse flattened cone, apex occasionally curved. Upper incisors larger than lower. Canine (Cuspidati) four in number, two upper and two lower, placed lateral to incisors, larger and stronger than latter. Crown is large, spear-head. Labial surface convex, lingual is con- cave; both marked by three ridges, which meet at baslal ridge. Boot is oval or elliptical in trans- verse section, longer than incis- ors. THE TEETH. 173 Upper canine (cuspid; eyetooth) larger than lower, (stomach). Bicuspid (premolar) eight in number, four upper and four lower, distal to cuspids. Crown is surrounded by two buccal and two lingual cusps, separated by a groove. Necks are oval, roots laterally com- pressed, the first upper root fre- quently bifid. Molar (multicuspidati), grinders twelve in number, largest, broad crowns for crushing food. Crown is cuboidal, convex on buccal and lingual sides, flattened on mesial and distal sides. Formed by three primitive cusps in upper and four in lower, with a disto- lingual tubercle in second upper and a distobuccal tubercle to first and third lower molars. Necks are large and rhomboidal. Boots of upper are three in number, one large lingual and two small buccal. Lower have two roots each, one mesial and one distal. First are largest of all teeth. Have four cusps on upper and five on lower. Second are smaller, distolingual cusps reduced and cusps at angles. Third (wisdom) three cusps on upper and five on lower teeth. Roots of upper are frequently fused, form- ing a cone, and of lower are com- pressed and curved backward. 174 ANATOMY IN ABSTRACT. Upper (have two cusps separated by a ' groove) 1st premolar ■2d premolar bifid or nearly so Lingual smaller than labial. single Lingual nearly as large as labial. Lower (have two cusps united by a ridge.. 1st premolar 2d premolar single Lingual much smaller than labial. single Lingual nearly as large as labial. 1st Upper 2d Upper 3d Upper Cusps 4 3 or 4 3 or 4 Roots 3 3 3 (or 1) A 1st Lower 2d Lower 3d Lower Cusps 5 4 or 5 4 or 5 Roots 2 2 2 (or 1) Difference in Arrangement of Roots of Premolars: Difference in Arrangement of Roots of Molars: THE TEETH. 175 STRUCTURE. A tooth is divided into an internal soft portion, the Den- tal Pulp and an outer solid por- tion. The Dental Pulp.-Within the dentine there is a longitudinal chamber which conforms to the general shape of the tooth with processes extending down each root to its apex, where it is called the apial foramen, and transmits the ves- sels and nerves to the pulp. The dental pulp is contained within the dental chamber. The pulp is of a soft vascular and sensitive myxomatous tissue, with nerves and blood vessels but no lymphat- ics. Odontoblasts of Waldeyer form a layer of columnar cells at the periphery which are projected through into the basic substance of the dentine. Blood vessels form loops internal to the odontoblastic layer. Nerves send numerous non-medual- lary filaments through to the basic substance of the dentine. Matrix cells with their prolonga- tions are found within the pulp body. Solid portion is subdivided into (A) Dentine; (B) Enamel; (C) Cementum. DENTINE forms the principal part of a tooth. A modified osseous struc- ture, differing in having wavy, dental tubuli placed parallel with each other, opening at inner end into pulp cavity. They are spiral and run vertical near crown, oblique in neck, and downward in root. Their size is 1-4500 of an inch. They terminate near peri- phery in dilatations which com- municate with each other, called interlobular spaces of Czermak, or the granular layer of Tomes. Wall is distinct and contains cylin- drical prolongations analogous to canaliculi of bone. Dental Sheath of Neumann found be- tween Tome's fibres and the ivory, around is a tissue markedly re- sistant to acid. Interlobular substance is translu- cent, forming principle part of 176 ANATOMY IN ABSTRACT. earthy matter of the dentine. Fibrile continuous from fibres of Tomes are found here. Incre- mental lines of Salter are paral- lel with fibres of Tomes, and found in dry tooth. The lines of Schreger are other curved lines parallel to surface. Chemical composition.-Animal mat- ter, 28 parts; earthy matter, 72 parts; principally phosphate and carbonate of calcium and trace of fluoride of calcium and phos- phate of magnesia. ENAMEL.-Hardest and most compact part of tooth; thin over crown to the neck. Structure.--Consists of minute hex- agonal rods, columns or prisms lying parallel to one another, the ends resting in depressions. in dentine, with the outer end form- ing surface of the crown. Are vertical on top of crown and hor- izontal on sides. They are 1-5500 of an inch in diameter. Lines of Retzius are brown transverse lines crossing the enamel rods. Chemical composition.-Animal mat- ter 3.5 per cent; earthy matter 96.5 per cent; principally phos- phate and carbonate of calcium; with trace of fluoride of calcium and phosphate of magnesium. CEMENTUM, CORTICAL SUBSTANCE, or (crusta petrosa), is the thin layer entirely enveloping root of tooth, thicker at apex. Structure and chemical composition same as bone except more com- pact. Cental periosteum is continuous from bone and is between tooth and bone. The teeth are developed from the der- moid system. The enamel is de- rived from the epiblast; the den- tine, cementum, and pulp from the mesoderm. A linear thickening' of oral epithelium appears before the sixth week; next follows a lateral (labial) projection, the dental ridge, growing into the mesoderm, forming a furrow on DEVELOPMENT OF THE TEETH. THE TEETH. 177 the oral surface, the dental groove of Goodsir. The positions of the future teeth are marked by local thickenings under the ridge, the dental bulbs which become the enamel organs of the tempo- rary teeth. The dental ridge atro- phies. These primitive enamel or- gans become invaginated like an epithelial cap over a mesodermic dental papilla, embracing about two-thirds of it. The cap shows three layers-the external? of one or two rows of low columnar cells, the outer enamel cells which are reflected to form the inner invaginated layer of the or- gan, the inner enamel cells. These two cells are separated at first by a middle layer, which un- dergoes great changes; a network is formed, reduced to thin plates, fluid collects (enamel pulp), and finally all disappears. At the sides of the primitive organs the sec- ond enamel organ develops the permanent teeth. The inner layer above produces enamel, enamel membrane. The top and sides of dental papillae are covered by odontoblasts, whose processes are dentinal fibres; the canals left are dentinal tubules, homologues of the canaliculi of bone. The central part of a dental papilla remains as pulp tissue. The cementum is formed last of all from an enithelial sheath, but in fetal life, and Increases to old age. By the gradual growth of the cusp the crown produces ab- sorption by pressure upon the overlying bone and mucous mem- brane, when eruption occurs. ERUPTION OF TEETH. The dates at which the eruption usually takes place is as follows for the lower teeth; those of the upper jaw ap- pear a little later: First molars appear about 6th year. Central incisors appear " 7th " Lateral " " " 8th " First premolar " " 9th " Second premolar " " 10th " Canine premolar " " 11th " Second molar " " 12th " Third molar "after 17th " 178 ANATOMY IN ABSTRACT. Temporary Teeth. Central Lateral Cuspid First Molar Second Molar Eruption 6-8 month 7-9 month 17-18 month 14-15 month 18-24 month Completion-One year later. Central Lateral Cuspid First Molar Second Molar Absorption begins 4 years 5 years 9 years 7 years 8 years Permanent Teeth. First Second First Second Third Central Lateral Cuspid Bicuspid Bicuspid Molar Molar Molar Eruption 7 yrs. 8 yrs. 12 yrs. 10 yrs. 11 yrs. 6 yrs. 12 yrs. 16-20 yrs. Completion 10-12 yrs. 11-12 yrs. 15-16 yrs. 13-14 yrs. 13-14 yrs. 10-12 yrh. 15-16 yrs. 19-23 yrs. TABLE SHOWING THE DEVELOPMENT OF THE TEETH. STOMACH. 179 THE PALATE is the roof of the mouth which projects backward into the pharynx. It is divided into the hard, anterior or bony portion, and the soft posterior membran- ous portion. The Hard Palate is within the upper dental arch continuous with the gums. It is formed by maxilla and palate bones and covered with periosteum and mucous mem- brane. The latter is dense and ir- regular, being marked by many ridges. The Soft Palate (velum pendulum pa- lati) continues backward from the hard palate. Its lateral margins blend with the lateral walls of the pharynx. Upper surface is convex and is con- tinuous with nasal cavities. Lower surface is arched and con- tinuous with roof of mouth. Its posterior margin is free and projects backward into the phar- ynx. The uvula projects backward in the median line, it being arched later- ally. It is composed of muscles and mu- cous membrane. The Pauces is the opening from the mouth to the pharynx. Laterally are found the anterior and posterior palatine arches or pillars of fauces between which is found the tonsillar gland. THE STOMACH is the principal organ of digestion and is the most di- lated portion of the alimentary canal. Fundus is dilated upper end to left of esophagus in left hypochondriac region. Greater curve extends from esopha- gus around left end and under- neath duodenum. Lesser curve is from esophagus to duodenum along top of stomach. Anterior surface is flattened. Relations. - Diaphragm, seventh, eighth and ninth ribs on left side, left lobe of liver and an- terior abdominal wall. 180 ANATOMY TN ABSTRACT. Posterior surface. Relations.-Diaphragm, spleen, left suprarenal capsule, upper part of left kidney, pancreas, splenic flexure of the colon, and trans- verse mesocolon. Cardiac portion is upper end with the cardiac orifice leading from the esophagus, in front of tenth or eleventh dorsal vertebra, in front of and slightly to left of aorta and back of seventh left costal cartilage. Pyloric portion is lower end, the ori- fice leading into the duodenum. Is on level with upper border of first lumbar vertebra, back of point one inch below and slight- ly to left of tip of ensiform car- tilage. Pyloric Valve guards opening; an- trum is dilatation near orifice. Shape is pyriform. Size.--Length, 11 inches; greatest di- ameter, four and one-half inches; anteroposterior, three and one- half inches. Capacity, four to eight pints. Weight, four and three-fourths ounces. SMALL INTESTINES, 21 feet long. Convoluted tube, from pylorus to ileocecal valve, gradually dimin- ishes in size from above down- ward. Relations.-In front is omentum, be- hind is mesentery aorta and in- ferior vena cava, lymphatics, and sympathetic nerves. Divisions, (1) Duodenum; (2) Je- junum; (3) Ileum. 1. Duodenum, (12 finger breadths; ten Inches long). Shortest, widest, and most fixed portion of small intestines. Shape is U, divided into four por- tions. (a) Superior, two inches long from pylorus to neck of gall bladder. (b) Descending, four inches long from neck of gall bladder to right side of 4th lumbar vertebra. INTESTINES. 181 (c) Transverse (preaortic), two to three inches long from 4th lum- bar vertebra to left of aorta. (d) Ascending, two inches long, from celiac axis to beginning of jejunum. 2. Jejunum (empty) diameter one and one-half inches, two-fifths of small Intestines (nine feet). Mucous membrane containing val- vulae conniventes, circular folds that can be felt through wall of gut, found principally in upper part. Mesentery is suspensory ligament. 3. Ileum (to twist). Diameter one and one-fourth inches. Most tor- tuous portion. Valvulae conni- ventes, small and disappear to- wards lower end. Terminates in cecum by ileocecal valve. Meckel's Diverticulum. Occasionally found a blind pouch, the remains of the omphalomesenteric duct of fetal life, about three and one- half feet from cecum. Artery, superior mesenteric. LARGE INTESTINES; five feet long, from ileum to anus. Divisions; Cecum, Colon and Rectum. 1. Cecum (blind), large pouch, sec- ond dilation of alimentary canal. Termination of small intestines and beginning of large. Situated in right iliac fossa, next to abdominal wall. Size, two and one-half inches long, and three and one-half broad. Vermiform appendix, a blind worm- shaped tube, usually projected from posterior portion of cecum, outward and inward into the pel- vis. Length, one to nine inches; average, three and one-half; breadth, one- fourth inches; coats same as in- testines. ileocecal valve, (Valvula Bauhini), a valve composed of two semilunar segments which project into cecum. Formed by reduplication of mucous membrane and circu- lar fibres of the intestines. 182 ANATOMY IN ABSTRACT. 2. Colon.-Divisions: Ascending, he- patic flexure, transverse, splenic flexure, descending and sigmoid flexure. Ascending portion is in right lum- bar region. Extends from cecum to liver, retained to posterior ab- dominal wall by fold of periton- eum. (Mesocolon). Is external to and in front of right kidney. Hepatic flexure, is below right lobe of liver and gall bladder, and below free border of the ribs. Transverse portion is parallel with subcostal line, below stomach in front of duodenum, aorta, and vena cava, with small intestines below. Suspensory ligament is mesocolon. In front is ileum, omentum, and abdominal wall. Splenic Flexure, arches upward under the ribs close to spleen where it curves backward and downward toward the left suprarenal cap- sule. Descending portion continues from splenic flexure downward over and external to left kidney through lumbar region. It Is postperltoneal, and has a meso- colon. Sigmoid flexure Is continuous from descending colon, is the narrow- est portion, very tortuous. Prin- cipally in left iliac region but ex- tends into hypogastric as it enters the pelvis to become the rectum. Its suspensory Is the sigmoid mesocolon. 3. Bectum, the terminal of the Intes- tines is continuous from sigmoid. It begins in front of left llio- sacral joint, and reaches median line at third sacral segment. Sec- ond part is from latter point to apex of prostate gland one inch in front of tip of coccyx. Third por- tion is from latter point to anal orifice, and is termed the anal canal. Length is about seven Inches. First part, three inches; second, three inches; third, one and one- half Inches. Very distensible. ABDOMEN. 183 Relations.-Male, behind is found the sacrum, left iliac artery and vein. In front, bladder and prostate. Female, same, except uterus is in front with the cul-de-sac of Douglas between. Laterally are found the Fallopian tubes and ovaries. There are two sphincters, internal and external, composed of volun- tary muscles. ABDOMEN. THE ABDOMEN. The largest cavity of body, oval in shape, larger end upward, formed by Diaphragm. Smaller end downward, formed by Levator ani. Divided into abdomen proper and pelvic cavity. Boundaries of abdominal cavity pro- per: Above by Diaphragm. Below by brim of pelvis. In front and at sides by abdominal muscles with ribs above. Behind, vertebral column, Psoas and Quadratus lumborum muscles. Openings; umbilicus (fetal) for um- bilical vessels. Through Diaphragm are canal for inferior vena cava, aortic for aorta and thoracic duct, esopha- geal for esophagus and tenth nerve. Below for femoral vessels and sper- matic cord in male and round lig- ament in female. 184 ANATOMY IN ABSTRACT. Bight Hypochondrium. Greater part of liver. Gall-bladder. Hepatic flexure of colon. Upper part of kidney. Suprarenal capsule. Epigastrium. Liver, left lobe. Stomach. Duodenum. Pancreas. Vena cava. Aorta. Portion of kidneys. Left Hypochondrium. Greater part of stomach. Spleen. Splenic flexure of colon. Great omentum. Upper part of kidney. Suprarenal capsule. Bight Lumbar. Right kidney. Small intestines. Ascending colon. Umbilical Begion. Transverse Colon. Great omentum. Small intestines. Mesentery. Receptaculum chyli. Portion of kidneys. Left Lumbar. Left kidney. Small intestines. Descending colon. Bight Iliac. Cecum. Appendix. Right ureter. Pubic. Bladder. Rectum. Left Iliac. Part of sigmoid flexure. Left ureter. REGIONS AND CONTENTS OF ABDOMEN. PERITONEUM. 185 THE PERITONEUM is the largest ser- ous membrane in the body. In male it is a closed sac. In female Fallopian tubes form an opening. It is attached to internal surface of abdominal wall in front, (parie- tal), and behind it is reflected over the contained viscera (vis- ceral part). Internal surface is free and cover- ed with endothelial cells. External surface is attached to sur- rounding tissues by subserous areolar tissue. In its reflections over the viscera it has been given various names as follows: (a) Mesentery, forming suspensory ligament of small intestines. (b) Great or gastrocolic omentum, projected downward from stom- ach and colon between abdominal wall, and small intestines in an apron-like fashion. (c) Gastrohepatic or lesser omen- tum forms the suspensory liga- ment from fissure of liver to stomach. (d) Mesocolon forms the suspen- sory ligament and covering of colon throughout its entire length. (e) Mesorectum (in female, form- ing pouch of Douglass) covering rectum. (f) Broad ligament of uterus, re- flected over the ovaries and tubes. (g) Falciform or suspensory liga- ment of liver, attached above to Diaphragm. (h) Anterior and posterior coronary ligaments from these margins of tne liver to Diaphragm above. (i) Gastrosplenic omentum re- flected over spleen. The cavity of the peritoneum is di- vided into a greater and lesser. The greater cavity is in front of liver, stomach and intestines, and the lesser cavity is back of the liver and stomach, and above the mesocolon and colon. The foramen of Winslow through the lesser omentum makes these cavities continuous. PERITONEUM. 186 ANATOMY IN ABSTRACT. Retroperitoneal fossas are divided into three groups: 1. Duodenal fossas; nine separate cul-de-sacs or recesses (according to Moynihan) are found about the duodenum. 2. Perececal fossas. Three or more recesses are found about cecum, viz.: superior, inferior and sub- cecal. 3. Intersigmoidal, marked in early in- fancy, but disappears as age ad- vances. SALIVARY GLANDS. 187 ACCESSORY ORGANS. The accessory organs to the alimentary canal are: (1) Salivary glands. (2) Liver. (3) Pancreas. (4) Spleen. (5) Thyroid gland. SALIVARY GLANDS. SALIVARY GLANDS are compound racemose glands with ducts ter- minating in the oral cavity. They are the parotid, submaxillary (mandibular), and sublingual (lin- gual). 1. Parotid; weight, one-half to one ounce. Boundaries: Above, by zygomatic arch. Below, line from angle of mandible to tip of mastoid process. Anterior, by ramus of jaw and Pterygoid muscles. Posterior, by mastoid process, car- tilaginous meatus, mastoid and Digastric muscles. Internally, by internal cartold ar- tery, internal jugular vein, and tenth nerve. Passing through the gland are: Branches of external carotid, viz.: posterior auricular, temporal, transverse facial, internal maxil- lary, temporal and internal max- illary veins, seventh or facial nerve, and auriculotemporal branch of third division of fifth nerve. Duct, is Stenson's; length, two and one-half inches; size of crow's quill. Coats, external or fibrous, internal or mucous, with short columnar epithelium. Course, forward across external surface of Masseter, to Buccina- tor, passing between latter and mucous membrane. It terminates opposite second upper molar. Artery, external cartoid branches, ▼eins, to external jugular. Iiymphatics, to cervical. Nerves, carotid plexus of sympathet^ ic, facial, auriculotemporal of ninth, and great auricular. 188 ANATOMY IN ABSTRACT. 2. Suomaxillary, or mandibular gland, situated on internal surface of mandible, near angle. Weight, two drachms. Boundaries: Externally, angle of mandible. Internally, Mylohyoid, Hyoglossus, and Styloglossus muscles. Above Mylohyoid. Below, deep cervical fascia. Anterior, ant. belly of Digastric. Posterior, stylomaxillary ligament. Duct, is Wharton's, two inches long. The wall is very thin. Course, forward, between Mylohyoid, Hyoglossus, and Geniohyoglossus muscles; and between hypoglos- sal and lingual nerves. Terminates in one papilla on side of frenum linguae. Vessels, arteries, facial and lingual; veins, same. Nerves, from submaxillary ganglion chorda tympani of facial, lingual branch of inferior maxillary pass- es through gland, mylohyoid branch of inferior dental of fifth, and sympathetic. 3. Lingual, or sublingual gland: Smallest of salivary glands, situ- ated on internal surface of body of mandible, near center. Boundaries are as follows: Externally, is mandible. Internally, is Geniohyoglossus and lingual nerve. Behind, is maxillary gland. In front, is side of symphysis of mandible. Above, is mucous membrane of floor of mouth. Below, is Mylohyoid muscle. Ducts, are Rivinus'; from 8 to 20 in number. Some ducts join Whar- ton's duct from maxillary gland, and are called ducts of Bartholin. Arteries, sublingual and submental. Nerves, from lingual. THE LIVER. LIVER is situated principally in the right hypochondriac and epigas- tric regions, but extends into the left hypochondriac region. Con- cave below and convex above. THE LIVER. 189 Relations: Above, Diaphragm. Below, stomach duodenum, trans- verse colon, small intestines and right kidney. Behind, right false ribs and verte- bra. In front, right costal cartilages. Highest point extends to right fourth Intercostal space, and left fifth intercostal space. Lower margin, along free border of ribs. Weight.-Male, fifty to sixty ounces; female, forty to fifty ounces. Dimensions.-Length, eight to nine inches; anteroposterior thickness, four to six inches. Volume.-Ninety to one hundred cubic Inches. Color.-Dark or reddish brown. I>obes.-Five: (1) right, (2) left, (3) quadratus, (4) caudatus, and (5) spigelia. Fissures.-Are five, arranged in shape of H. 1. Transverse fissure for entrance of vessels. 2. Left anterior longitudinal for umbilical vein of fetal life, or round ligament of adult. 3. Left posterior longitudinal for ductus venosus. 4. Right anterior for gall bladder. 5. Right posterior for vena cava. Ligaments.-Five: 1. Suspensory, broad, or falciform from diaphragm at right angle to coronary. 2. Coronary from posterior surface to diaphragm. 3. Round to umbilicus. 4. Right lateral from liver to dia- phragm. 5. Left lateral longer, from liver to diaphragm. Lesser omentum extends to stom- ach. Surfaces.-Five (Symington): right or lateral, anterior, posterior, superior, and inferior. Vessels.-Five: 1. Portal vein from splenic, gas- tric, superior and inferior mesen- teric. 2. Hepatic artery from celiac axis. 3. Hepatic duct for bile. 190 ANATOMY IN ABSTRACT. 4. Hepatic vein from liver to in- ferior vena cava. 5. Lymphatics. Structure.-External coat is periton- eum, beneath which is a fibrous coat investing- entire organ. Substance is composed of lobules held together by areolar tissue, and between which are found the ramifications of the portal and hepatic veins, hepatic artery, hepatic ducts, lymphatics and nerves. Course of vessels through liver is as follows: 1. Interlobular vessels are formed by union of portal veins and hep- atic artery. 2. Intralobular veins continue from former through center of lobule. 3. Sublobular veins are formed by union of intralobular veins, and go to form hepatic vein. 4. Biliary ducts have origin by ramifications beginning between the cells, in intercellular or bili- ary passages, and at margins of lobules the biliary vessels begin. 5. Hepatic duct is formed by two biliary ducts coming from liver through transverse fissure. Common duct (ductus choledochus) is continuous from cystic and hepatic to duodenum. Gall-bladder is pear shaped and is situated in right anterior longi- tudinal fissure on under surface of liver. Length, three to four inches; diameter, one-half to one inch; capacity, one to one and one- half ounces. It is a diverticulum from lower end of hepatic duct. Fundus is base or round end. Body is main portion. Neck is beginning of cystic duct. Valvula Heisteri is screwlike valve that guards orifice of neck. Ampulla of Vetter is opening or pa- pilla leading into duodenum. Capacity, four fluid ounces. THE PANCREAS (all flesh) abdominal salivary gland, compound race- mose, same as salivary glands, in structure. THE PANCREAS. THE PANCREAS. 191 Situated in front of second lumbar vertebra, behind stomach, be- tween duodenum and spleen. Shaped like a dog's tongue, according to Winslow, and a hammer by Mecke], and a cross by Verneuil. Head is to right, within curve of duodenum. Neck is constriction. Body is free portion along stomach. Tail is tapering portion toward spleen. Color is grayish white, during di-, gestion it is rosy hue. Dimensions.-Length, six inches; width one-fourth of length; thickness, three-fourths of an inch. Weight.--Male, three and one-half ounces; female, two and one- fourth ounces. Relations: Posteriorly; aorta, crura of Dia- phragm, left kidney and its ves- sels and suprarenal capsule, in- ferior cava, thoracic duct, and sup. mesenteric artery. Inferior surface; transverse colon, coils of jejunum. Superior and anterior surfaces; stomach and transverse colon. Excretory duct; (canal of Wirsung) begins in various lobules in tail, extends to right, leaving gland downward from head, entering duodenum obliquely with com- mon bile duct. Ductus Santorini or Accessorius, oc- casionally given off from inside duct in neck. Passes horizontally to empty into duodenum an inch above main duct. Duct has two coats; external flbro elastic; internal mucous. It has no muscular coat. Arteries: 1. From celiac axis, pancreatica magna and parvae; from splenic, pancreatica duodenalis superior, from hepatic. 2. From superior mesenteric, pan- creaticoduodenalis inferior. Veins, same as arteries, terminate in portal system. Dymphatics, end in receptaculum Chyli. 192 ANATOMY IN ABSTRACT. Nerves; from splenic plexus of sym- pathetic, and probably from right vagus. SPLEEN is the largest ductless gland. Position,-left hypochondriac region, between axillary lines, below dia- phragm on level with eleventh dorsal vertebra, above fundus of stomach. Its lower end is above free margin of ribs. Dimensions,-Length, five to six inches; breadth, three inches; thickness, one to two inches. Weight,-seven ounces. Color,-dark red. Post mortem, gray- ish red. Shape,-concavoconvex ellipsoid, or tongue shaped. Surfaces and relations; phrenic or ex- ternal, ninth, tenth, eleventh ribs, lung, muscles of back and dia- phragm. Basal or inferior surface, with tail of pancreas and phrenocolic liga- ment (splenic). Internal, at fundus of stomach, left kidney and capsule, and tail of pancreas. Borders or margins,-anterior (margo crenatus); posterior (margo ob- tusus). Ridge across internal surface (mar- go internicdius). Hilus is anterior to ridge and con- tains vessels that pass in and out. Coats,-external serous (peritoneum), and internal fibroelastic. Structure,-cells (connective tissue corpuscles), intercellular sub- stance, and spaces continuous with blood vessels. Malpighian corpuscles are thickening of the lymphoid tissue forming coats of the arterioles. Size, from one one-hundredth to one twenty-fifth of an inch. Vessels,-splenic artery and vein. Nerves,-celiac plexus of sympathetic, and right vagus. THE SPLEEN. THYROID GLAND. 193 THYROID GLAND THYROID GE AND (ductless), classified with thymus, suprarenal cap- sules and spleen. Has no excre- tory duct. Situated in front and sides of neck and before trachea. Weight is usually one ounce. Consists of two lateral lobes, and an isthmus crossing median line con- necting lobes, and third lobe oc- casionally found from upper sur- face of isthmus or from lobes. Structure; external capsule of con- nective tissue. It is brownish red color, and composed of closed vesicles more or less tubular and branched, containing a yellowish gray fluid. The vesicles are lined by epithelium. Arteries are from superior and infe- rior thyroid. Veins are from superior, middle and inferior thyroid. Nerves are from cervical sympa- thetic. Lympathics are numerous and large. THYMUS GLAND is temporary organ, resembling in many respects the thyroid gland. THE ORGANS OF VOICE AND RESPIRATION. THE LARYNX, the. organ of voice, first division of air passage, situated in median line in fore part of neck. Above, is pharynx and base of tongue. Below, is trachea. Behind, is esophagus. In front of fourth, fifth and sixth cervical vertebra. Anteriority, it is subcutaneous. Dimensions in average adult male, as follows: Vertical diameter, 44 millimeters. Transverse diamter, 43 millimeters. Anteroposterior diameter, 36 milli- meters. Circumference, 13b millimeters. Composed of nine cartilages; three single, and three pairs. Single, are thyroid, cricoid, and epi- glottis. 194 ANATOMY IN ABSTRACT. Pairs, are two arytenoid, two corni- cula laryngis, and two cuneiform. Thyroid cartilage (a shield), the largest of larynx, composed of two lateral laminae or alae. Pomum Adami is prominence in front. Outer surface gives attachment to Sternothyroid and Thyrohyoid muscles. Inferior constrictor near posterior border. Stylopharyngeus and Palatopharyn- geus are attached to posterior border. Upper surface is rounded and has thyroid notch in front. Superior cornua (2) project upward from posterior portion, and infe- rior project downward posterior- ily. Lower border is nearly straight. Posterior borders are approximated in the posterior median line, with intrathyroid cartilage (in infancy) interposed. Cricoid Cartilage (a ring) is smaller, thicker and stronger than thy- roid; situated in lower and back part, forming inferior margin. Divided into anterior and poste- rior portions. Anterior portion is narrow and serves for attachment of cricothyroid and Inferior con- strictor muscles. Inferior cornu of thyroid articulates with posterior portion. Posterior portion is deeper and broader. Vertical ridge for long- itudinal fibers of esophagus. The lower border is attached to first ring of trachea. To the upper border in front is at- tached the cricothyroid mem- brane. At sides is attached the cricoaryte- noid muscle. Arytenoid cartilage articulates with this border posteriorily. Inner surface is smooth and lined by mucous membrane. Epiglottis is a thin yellow lamina, shape of a leaf, back of tongue, projecting upward from anterior portion' of thyroid cartilage, form- ing lid of larynx. VOICE AND RESPIRATION. 195 The thyroepiglottic and hyoepiglottlc ligaments are attached to it, as well as the glossoepiglottidean folds. Valleculae are depressions between epiglottis and base of tongue. Arytenoid Cartilages (resemble a pitcher) situated back of larynx between cricoid and thyroid. Have for study, base, apex and three surfaces. True vocal cords are attached to an- terior angle of base. Cornicula laryngis (cartilages of San- torini) are two small conical no- dules back of arytenoid. Aryteno epiglottidean folds are attached to them. Cuneiform (cartilages of Wrisberg) (2) form apex of arytenoid car- tilages, and are along side of arytenoepiglottidean folds. I>igaments of larynx are intrinsic and extrinsic. The intrinsic connect the several cartilages with each other. They are cricothyroid membrane, 3 capsular, 2 posterior cricoarytenoid, and thyroepiglot- tic. The extrinsic extend from the lar- yngeal cartilages to other parts, and are thyrohyoid (middle and 2 lateral), hyoepiglottlc, and crico tracheal ligaments. INTERIOR OF LARYNX: Vestibule is portion of cavity above the true vocal cords. Rima Glottidis is elongated fissure be- tween the inferior or true vocal cords. Inferior or true vocal cords (inferior thyroarytenoid ligaments) pro- duce the voice. Composed of yel- low elastic fiber. Are attached in front between the alae of the thy- roid cartilage, and, behind, to the anterior angle (vocal process) of the base of the arytenoid. Upper border of cords forms lower boundary of ventricles of larynx. Below it continues with the crico- thyroid membrane. It is covered with very thin mucous membrane. Superior or false vocal cords are above true, and do not produce voice. Are thick folds of mucous membrane enclosing the superior thyroarytenoid ligaments. 196 ANATOMY IN ABSTRACT. Ventricle of larynx is the oblong fossa between the true and false vocal cords. Sacculus laryngis (pouch) is above superior cords. MUSCLES or LARYNX. Muscles of vocal cords and rima glottidis: Cricothyroid, Cricoarytenoideus posticus, Cricoarytenoideus later- alis, Arytenoideus. Muscles of the epiglottis are Thyro- epiglottideus, Arytenoepiglottldeus superior, Arytenoepiglottldeus in- ferior. The muscles of the larynx perform two functions. (1) To open the glottis, which are cricoarytenoidei postici; and to close the glottis, which are Arytenoideus, and C'ri- coarytenoidei lateralis. (2) To regulate the tension of the vocal cords. The Cricothyroid elongates the cords, and the Thyroarytenoi- dei relax and shorten them. Mucous membrane of larynx is con- tinuous from mouth and pharynx above, and extends down into the trachea. It lines the cavity throughout. Stratified squamous epithelium covers the fore part of anterior surface, the upper half of the posterior surface of the epiglottis, the up- per part of the arytenoepiglotti- dean folds, and the true vocal cords. Columnar epithelium covers the rest of the larynx. Glands, are muciparous throughout, and are called arytenoid glands in front of this cartilage. Are not on free edge of vocal cords. Arteries, from superior and inferior thyroid. Veins, accompany arteries. Iiymphatics, are two sets, viz.: supe- rior and inferior. THE TRACHEA. THE TRACHEA (windpipe) is a cartil- aginous and membranous cylin- drical tube, flattened posteriorly. THE TRACHEA. 197 It extends from larynx at sixth cer- vical vertebra to fourth or fifth dorsal vertebra, when it bifuri- cates to become the right and left bronchial tubes. Length four and one-half inches. Diameter, side to side, slightly less than an inch. Relations in front from above down- ward. Isthmus of thyroid gland, inferior thyroid vein, Sternohyoid and Sternothyroid muscles, manu- brim, thymus gland, left innomi- nate vein, arch of aorta, innomi- nate and left common carotid ar- tery, and deep cervical plexus. Behind it is membranous and rests against the esophagus. Laterally is found common carotid arteries, lateral lobes of thyroid glands, inferior thyroid arteries, recurrent laryngeal nerves, vagus nerve and deep vessels in thorax. Structure, formed by sixteen to twenty cartilaginous rings, the posterior one-third being membranous. Muscular fibres are longitudinal (ex- ternal) and transverse. (Todd and Bowman.) Mucous membrane is continuous from rest of air passage above and be- low. It is areolar lymphoid tissue, with ciliated columnar epithelium. Glands are abundant along posterior portion and are racemose with mucous secreting cells with ducts. Smaller glands are found laterally. Artery, inferior thyroid; vein same. Nerves, pneumogastric and sympa- thetic. BRONCHIAL TUBES: Right bronchus, wider, shorter, and more vertical than left. Length, one inch, enters right lung opposite fifth dorsal vertebra. Eparterial branch passes upward to upper lobe of lung. Right pul- monary artery is below. Hyparterial branch bifurcates to go to middle and lower lobes. Left bronchus; smaller and longer than right. Length, two inches. Enters left lung opposite sixth dor- sal vertebra. 198 ANATOMY IN ABSTRACT. Passes beneath arch of aorta, in front of esophagus, and thoracic duct. Right pulmonary artery is in front. As bronchial tubes enter the lungs they bifurcate, and become small- er and smaller, extending to all parts of the lungs, terminating in the air cells. THE MEDIASTINUM. MEDIASTINUM is the region In the median portion of the chest be- tween the pleuras. Extends from sternum to spine. Contains entire thoracic contents except the lungs. Divisions: (1) Superior, above level of pericardium. (2) Infe- rior, below this line. 1. Superior above pericardium con- taining origin of Sternohyoid, Sternothyroid and Longus colli muscles; arch of aorta, innomi- nate, left carotid, and subclavian arteries; superior vena cava, in- nominate and superior intercostal veins; pnemogastric, cardiac, phrenic, and left recurrent laryn- geal nerves; the trachea, esopha- gus, thoracic duct, remains of thymus gland, and some lymphatic glands. 2. Inferior, subdivided into anterior, middle and posterior. a. Anterior is between sternum and pericardium, and contains Trian- gularis sterni, loose areolar tissue and some lymphatics. b. Middle is in the broadest part of the interplural region. Contains heart, ascending aorta, lower half of superior vena cava with vena azygos major, bifurcation of tra- chea and bronchi, pulmonary ar- tery and veins, phrenic nerves and lymphatics. C. Posterior is back of pleura along vertebral column. Contains de- scending aorta, greater and lesser azygos veins, pneumogastric and splanchnic nerves, esophagus, thoracic duct and lymphatics. THE LUNGS. 199 THE PLEURA. THE PLEURA is a delicate serous cap- sule of the lung. It is divided into Pulmonic and Costal layers. The Pulmonic or visceral layer en- closes the lungs, dipping into the fissures between the lobes, and is deflected about the root of the lung. The Costal, or parietal layer is con- tinuous from the pulmonic pleura; extends outward to line the inner surface of the chest. The pleural cavity is the space be- tween the two layers. It is a shut sac containing a small quantity of liquid. Endothelial cells line the pleura throughout. Arteries are from intercostal, internal mammary, musculophrenic; phre- nic, pericardiac and bronchial. Veins are same as arteries. Nerves are from phrenic and sympa- thetic. THE LUNGS. THE LUNGS are the essential organs of respiration. Two in number. Situated on each side of the chest. Separated by heart and mediasti- num. Each lung is conical and has for study, apex, base, two borders and two surfaces. Apex is superior conical portion ex- tending into neck, one and one- half inches above first rib. Base on inferior end is broad, concave and rests on Diaphragm. External or thoracic surface is smooth, convex, and conforms to internal surface of ribs. Inner surface is concave, receiving the pericardium below, and the bronchial tubes above. Posterior border is rounded, and is received into concavity at side of spinal column. Anterior border is thin, projecting in front of pericardium. Incisura cardiaca is notch in left an- terior border receiving the heart. Each lung is divided into two lobes. The right upper is partially sub- divided into two. 200 ANATOMY IN ABSTRACT. Root of lung- is formed by bronchial tube, pulmonary artery and veins, bronchial arteries and veins, pul- monary plexus of nerves, lymphat- ics, bronchial glands, areolar tis- sue. and enclosed by the pleura. Weight of lungs: right, 22 ounces, and left, 20 ounces. Specific Gravity; from 0.345 to 0.746, water being 1000. Color, pinkish white, gradually get- ting dark with age. Substance of lung Is light, porous and spongy, containing air, and is highly elastic. Structure, three divisions: 1. Serous (pleura), the capsule. 2. Subserous areolar tissue invests the lungs, and extends between the lobes. 3. Parenchyma, composed of lobes and interlobular substance; bron- chioles, (smaller bronchi), air cells, or alveoli. Bronchioles di- late to become antrim or alveolar passage, from which ramify the infundibulum closely beset by air cells or alveoli. THE KIDNEYS. 201 THE KIDNEYS. Two in number, se- crete the urine. Situated one on either side of lumbar vertebra from upper border of twelfth dorsal to third lumbar. Post peritoneal; right slightly lower. Dimensions: weight, four to six ounces; four inches long, two and one-half inches broad, one inch thick. Relations. Anterior convex, right lobe of liver, duodenum and colon; left, stomach, pancreas, splenic vessels, and small intestines. Spleen and colon on outer border. Posterior convex, Diaphragm, Psoas and Transversalis muscles. Ilio- hypogastric and ilioinguinal nerve. Intestinal arcuate ligament and lumbar aponeurosis. External, convex and on left with spleen. Right. Internal, concave, notch, or hilum for vessels, nerves and ureter. Superior end, has resting upon it the suprarenal capsule. Inferior end approximates within two inches from the iliac crest. Hilum has vessels arranged, vein in front, artery in middle and ureter behind. Structure: (1) Capsule, (2) Cortex and (3) Medullary portion. 1. External, investing capsule, fibres firm and smooth, under which are f^und a wide meshed network of unstripped muscular fibre. Pelvis is sac or cavity of the kid- ney in the hilum which receives urine from the kidney. Calicis or infundibula are two or three tubular divisions of the pel- vis. The Ureter is the duct conducting the urine from pelvis to bladder. THE GENITOURINARY ORGANS. 202 ANATOMY IN ABSTRACT. 2. Cortex, external granular portion of the structure of the kidney. Col- umns of Bertin are arched por- tions of the cortex between the pyramids of the medullary sub- stance. 3. Medullary substance is internal portion between the cortex and pelvis, composed of the pyramids of Malpighi. (From 8 to 18.) Base of pyramid projects into cor- tex and apex projects into pelvis and have terminations of collect- ing tubes, called papilla or mam- milla of kidney. Tubuli uriniferi, constituting the principal part of the kidney are , made up of the following struc- ture in order from within out: 1. Malpighian bodies in cortex one one hundred and twentieth of an inch in diameter, composed of two portions: (a) Tuft or glomeruli, a network of convoluted capillar- ies, receiving the afferent (artery) and giving off the efferent (vein) of kidney. (b) Capsule of Bow- man or Malpighi or pouch like commencement of the uriniferous tubes. 2. Proximal convolution in cortex lead- ing from the Malpighian dapsule is tortuous and becomes spiral as it dips down into the medullary portion. 3. Spiral tube of Schachowa continuous from preceding. 4. Descending limb of Henle is the tube in the medullary portion. 5. The loop of Henle is where it ap- proaches the pelvis and turns to- wards the cortex. 6. Ascending limb of Henle's loop is where it returns to the cortex. Here it is known as the spiral portion. 7. Distal convolution is again in cor- tex. It is larger than the loop of Henle, but not quite as large as the proximal convolution. 8. Curved collecting tube is portion leading to the collecting tube. 9. Collecting or straight tube receive many tubes as above described, and terminating in the apex of a pyramid and discharge the urine into the pelvis of the kidney. THF, URETERS. 203 Minute structure of tubuli uriniferi, composed of basement membrane lined with epithelium, which varies in different portions as fol- lows: Malpighian corpuscle flat- tened cells; proximal and distal convolutions, rodlike polyhedral cells with a striated appearance; Henle's loop, flattened cells; curv- ed tube,, they vary being spindle and polyhedral. Straight tubes, they are columnar, polyhedral and angular. Arteries to kidney are renal direct from abdominal aorta. They enter the hilum in four or five branches, entering the kidney through the columns of Bertin. Two go to each pyramid. (1) Interlobular enter the cortex to become the af- ferent vessel to the Malpighian bodies. (2) Arteria propriae re- nalis, which supply the medullary pyramids. Veins, from three sources. (a) From beneath the capsule from inter- lobular artery and join to form the interlobular veins between the pyramids of Ferrein. (b) Venae Rectae from apex of Medullary pyramids from arteriolae rectae, and join interlobular, (c) Venae porpriae renales unite to accom- pany arteries of same name. They all form renal vein which terminates in the inferior vena cava. Nerves of kidney are small and are about fifteen in number. Derived from renal plexus from solar plexus. Lymphatics, superficial and deep, ter- minate in the lumbar organs. THE URETERS are two tubes which conduct the urine from the kid- neys to the bladder. They com- mence within the sinus of the kidney by a number of truncated branches, the calices or infundi- bula (from 1 to 13) which unite to form a dilated pouch the pelvis, from which the ureters, after passing through the hilum de- scend to the bladder. Ureters begin on line with spinous process of first lumbar vertebra. 204 ANATOMY IN ABSTRACT. Length, sixteen inches, diameter of goose quill. Course, obliquely downward and in- ward into cavity of pelvis to un- der portion of bladder. Relations posteriorly above is Psoas muscle, below it curves in front of iliac artery. It passes under ileum on right, and sigmoid on left side. In pelvis it enters the post, false ligament below vas deferens in male. In female it passes alongside of neck of uterus and vagina. They enter base of bladder one inch from median line, and one and one-half inches from the begin- ning of the urethra. Structure: composed of three coats. 1. Fibrous? continuous from pelvis of the kidney. 2. Muscular, composed of circular and longitudinal fibres, with a third Internal layer near bladder. 3. Mucous, continuouw from kidney to bladder, arranged! in longitudi- nal fold permitting distension. Transitional epithelium is found throughout, arranged in three lay- ers. Arteries are from the renal, spermat- ic, internal iliac, and inferior vesicle. Nerves are from inferior mesenteric, spermatic and pelvic plexuses. SUPRARENAL CAPSULE: Two duct- less glands above kidneys, post- peritoneal. Color, yellowish; weight, one and one- half drachms. Size varies. Usu- ally one to two inches long; two to three lines thick. Shape, cres- centeric. Relations. Below is kidney on both sides. Behind Is Diaphragm on both sides. Left in front is car- diac end of stomach and spleen. Small accessory capsules are often found. Structure, composed of two portions: (a) Cortical, composed of two columns, near surface resemble a net. The zone glomerulosa and deeper the columus are larger, the zona fasciculata, and near medullary portion, then become smaller, the zona rectlcularis. CAVITY OF PELVIS. 205 These trabecula contain unstrip- ped muscular fibre with polyhe- dral cells with spherical nuclei and fat globules interposed. Lymph paths are found between the cells and are the beginning of the lymphatics, (b) Medullary or internal portion composed principally of a plexus of veins with columnar epithelium inter- posed. Arteries from suprarenal, phrenic and renal are numerous and divided into numerous branches before entering capsule.' Veins return blood from medullary plexuses to vena cava on right and to renal on left. lymphatics terminate in the lumbar glands. Nerves are numerous and are from solar plexus. THE CAVITY OF THE PELVIS. This cavity is the lower part of general abdominal cavity below iliopectineal line, and from pro- montory of the sacrum. Boundaries: Behind, sacrum, coccyx, Pyriformis muscles and great sacrosciatic ligaments. In front, pubis and ischium and obturator muscles. Above, it is continuous with abdominal cavity. Below, triangular ligament, Levator ani and Coccygeus muscles and pelvic fascia. Contents: Urinary bladder, rectum, ' some genital organs peculiar to sex, loops of small intestines, blood vessels, lymphatics and nerves. THE BLADDEB is the reservoir of the urine. A musculomembranous sac situated in the pelvis between the os pubis and rectum in male and uterus in female. Capacity, one pint; length, five inches; width, three inches under moderate distension. Has for study, superior, anteroin- ferior and two lateral surfaces, base, or fundus, and summit or apex. 206 ANATOMY IN ABSTRACT. Relations. (a) Superior surface is free, covered with peritoneum throughout, and is in proximity to small intestines. (b) Pubic or anteroinferior surface is in rela- tion with the obturator internus and rectovesical fascia, being separated from os pubis by space of Retzius and area of fat. In distension it ascends above the os pubis and is subperitoneal. (c) Lateral surfaces, almost en- tirely free and covered with peri- toneum. In front are attached the lateral true ligaments, below the vas deferens passes between the ureters and bladder. (d) Fundus or base is downward and back- ward against the rectum. The ureters enter the bladder here and the vas deferens and vesiculae seminales are also found. (In female the vagina and uterus are found instead of above struc- tures.) Neck, or, cervix, is commencement of urethra. The prostate gland sur- rounds neck in the male. The urachus is obliterated remains of the tubular canal of the allantois of embryonic life extended up- ward from apex of bladder to um- bilicus. The obliterated hypogas- tric arteries accompanying the urachus on sides. Ligaments are five true and five false. True ligaments are: (1) Two pubo- prostatic or anterior, from pros- tate to os pubis. (2) Lateral from side of base to rectovesical fascia. (3) Urachus. False ligaments are two posterior, two lateral and one superior, all reflections of the peritoneum. Structure. Four coats, (1) Serous, (2) Muscular, (3) Submucous, (4) Mucous. 1. Serous is peritoneum over the fundus and sides. 2. Muscular: three layers, external longitudinal, middle circular, and internal is longitudinal. 3. Submucous: composed of areolar tissue uniting the muscular with mucous. MALE URETHRA. 207 «. Mucous is thin, smooth and pale rose color. The epithelium is transitory, arranged in two or three layers, polyhedral with two or three nuclei. No glands are found. * On internal surface are found ori- fices of ureters, urethra and the trigone. The trigone is the trian- gular space cornered by the above named orifices. Arteries, from sup., middle and inf. vesicle in male and additional branches from uterus and bladder in female. Veins, terminate in internal iliac. Lymphatics, form the plexuses. One in muscular and another in sub- mucous. Nerves are from pelvic plexus. THE MALE URETHRA extends from the neck of the bladder to the meatus urinarius at the end of the penis. It is a mucous tube eight or nine inches long, divided into three portions, viz.: (1) Fros- tatic, (2) Membranous, and (3) Spongy. 1. Prostatic, within the prostate gland is widest; one and one- fourth inches long and horseshoe shape on transverse section. The caput gallinaginis are longi- tudinal ridges to prevent semen from entering bladder. Prostatic sinuses are on sides with orifices of prostatic duct, terminating in their floor. The ejaculatory ducts terminate in the fore part, the vesicula pros- tat ica. 2. Membranous portion extends from prostate and bulb to the corpus spongiosum. It is narrow and is three-fourth inch long. It is sur- rounded by the Compressor ure- thrae muscle. 3. Spongy portion, six inches long is within the corpus spongiosum. It has a dilatation near meatus known as fossa navicularis, with a constriction at meatus and in- ternal to fossa. The bulbous por- tion is that part within the bulb. Meatus Urinarius is the contracted external orifice. 208 ANATOMY IN ABSTRACT. The Glands of Littre are found along the floor of urethra. The Iiacuna Magna is one large gland in upper surface of fossa navicularis. Cowper's glands terminate in the bul- bous portion. Structure. Practically same as blad- der and ureters. It is lined with columnar epithe1ium except at meatus where it is squamous. MALE ORGANS GENERATION. 209 THE MALE ORGANS OF GENERATION. THE PROSTATE GLAND (to stand before), a firm musculoglandular organ. Situation, about the neck of the blad- der, in pelvic cavity, between pubis and rectum. Shape and size of chestnut. Base is upward, apex downward, posterior sur- face flattened, anterior and later- al surfaces convex, and rest against the Levator ani muscle. Size, one and one-half inches broad at base; one inch thick and one and one-fourth inches from base to apex. Weight, four and one-half drachms. Divided into two lateral and middle lobes. Lateral lobes are to sides of urethra and middle lobe below urethra. The ejaculatory ducts pass between them as they enter urethra. Structure. Capsule is outer covering. The gland is composed of granu- lar substance and muscular tis- sue, which constitutes the proper stroma of the glands, the connec- tive tissue being very scant, form- ing their trabeculae between the muscular fibre in which ramify vessels and nerves. The glandular substance is com- posed of numerous follicular pouches opening into elongated canals, which join to form from twelve to twenty small excretory ducts which terminate in the floor of the prostatic portion of the urethra. Arteries, from internal pudic, vesical and hemorrhoidal; veins form plexus about gland and terminate in the internal iliac. Nerves, from pelvic plexus. COWPER'S GLANDS are two rounded lobulated yellowish bodies size of pea, placed along side membran- ous urethra near bulb, enclosed by fibres of Compressor urethrae muscle. 210 ANATOMY IN ABSTRACT. They ar"' compound lobulated, con-> sisting of a number of acini lined with columnar epithelium, which unite and finally form the excre- tory duct an inch long, which ter- minates in floor of bulbous ure- thra. THE PENIS consists of a root, body, and extremity, the glans penis. 1. The root is anchored above by sus- pensory ligament to symphysis and to rami by two lateral liga- ments. 2. Extremity or glans penis is an ob- tuse cone flattened laterally, per- forated by meatus urinarius. The corona glandis is rounded emi- nence posteriorly. The cervix is constriction back of corona. The Glandulae Tysonii odoriferae have ducts terminating on corona and cervix. 3. The body is cylindrical. Covered with integument attached loosely, and its distal portion which is continuous to the cervix by mu- cous membrane and hangs loosely about the glands and is known as the prepuce. Below is a median fold called frenum preputii. Structure is erectile tissue in three cylindrical compartments. Corpus cavernosum in two cylinders forming principal portions. The corpus spongiosum enclose the urethra and situated in a groove on the under portion of the corpus cavernosum. The bulb is the pos- terior enlargement and anteriorly it terminates in the glans penis. Structure is strong fibrous envelope enclosing trabeculae containing mesh erectile tissue. X*ymphatics are superficial from skin and deep under pubic arch to pel- vis. Nerves are from pelvic plexus. THE TESTES are two glandular organs which secrete the semen. Situated in scrotum, and suspended by spermat'.c cord. In early fe- tal life they are in abdomen, post- peritoneal. Before birth they de- scend through inguinal canal to the scrotum, carrying along the various layers. MALE ORGANS GENERATION. 211 Covering's of testes are: 1. Skin )_ + 2. Dartos /Scrotum. 3. Intercolumnar or ext. spermatic fascia. 4. Cremasteric fascia. 5. Infundibuliform or fascia pro- pria. (Internal spermatic fas- cia.) 6. Tunica vaginalis testes. Scrotum is the cutaneous pouch con- taining testes and cord, divided in median line by raphe from penis to anus. 1. Skin is external layer. 2. Dartos is the erectile internal coat also separating the testes by a median partition. 3. Intercolumnar fascia is derived from pillars of external abdomin- al ring during the descent of the testes. 4. Cremasteric fascia (muscle) are continuous from internal oblique muscle. 5. Infundibuliform fascia is a mem- branous investment of cord con- tinuous from transverse fascia, underneath which is found a loose connective tissue layer, the two being called the fascia propria. Arteries are from the deep external pudic, internal pudic and cremas- teric. Veins, same. Lymphatics terminate in Inguinal glands. Nerves. Ilioinguinal, internal pudic. small sciatic, and genitocrural. SPERMATIC COBB. Extends from in- ternal abdominal ring to the back part of the testicle. Structure. It is made up of sper- matic artery, cremasteric artery, artery of vas deferens, same veins, lymphatics, nerves, and excretory duct of testicle; cre- masteric muscle with its sheath and the infundibuliform fascia. The testes are suspended in the scro- tum by the spermatic cord, the left being slightly lower than right. They are oval, flattened* laterally, and hang obliquely. The anterior lateral surfaces and ends are convex, free, smooth, and are invested by the visceral layer of the tunica vaginalis. 212 ANATOMY IN ABSTRACT. The posterior border has cord at- tached to it, is partially invested. The epididymis is also attached here and is divided into a body or central portion. The head or glo- bus major is the upper portion and the tail or globus minor is the lower end, are invested by the tunica vaginalis. The hydatid of Morgagni are pear shaped bodies attached to upper end of testicle near globus major. Size, one and three-fourths inches long; one inch thick, and one and one-half inches wide. Weight, is about six to eight drachms. Investments are (1) tunica vaginal- is, (2) tunica albuginea, (3) tunica vasculosa. 1. Tunica Vaginalis, divided into vis- ceral layer which is the capsule of the testicle, and covering of the epididymis, and the parietal layer loosely folded about, form- ing internal layer of the scro- tum, with the cavity of the tun- ica between them, which is lined with endothelial cells. 2. Tunica Albuginae is a dense fibrous covering of the testes, internal to the tunica vaginalis, except under the epididymis and cord. It is projected into the gland and near its posterior surface is called the mediastinum, from which project trabeculae, dividing the gland into a number of incomplete spaces, larger at anterior surface of gland. The mediastinum supports the ducts and vessels. 3. Tunica Vasculosa is vascular layer internal to albuginae, lining also the various spaces. Structure, composed of two hundred and fifty conical shaped lobules; The lobuli testis, bases toward the anterior surface and apex toward the mediastinum. Each contains about three tubuli seminiferi, which are convoluted and about sixteen feet long and one one- hundredth and twentieth inch in diameter. Total number varying from three hundred to eight hun- dred. Their columnar epithelium MALE ORGANS GENERATION. 213 develop the spermatozoa by kar- yokinesis. They terminate in the mediastinum thence to the glo- bus major. Along body of epididy- mis and finally into the vas def- erens of the spermatic cord. The Vas Deferens is a continuation from the globus minor of the epididymis passes upward along this body through the inguinal canal descending into the pelvic cavity to side of the bladder, passes to base of bladder near ureter and vesicula, terminates where it becomes dilated (the am- pulla), again contracting at the base of the prostate uniting with the ducts of the vesiculae semin- alis to form the ejaculatory duct which terminates in the urethra. It is composed of three coats: (a) External areolar; (b) Middle or muscular, made up of circular and longitudinal unstripped fibres, and (c) Internal mucous, covered with columnar epithelium. Vas Aberrans of Haller, occasionally found, connects epididymis with vas deferens. Organ of Giraldes, a body of convol- uted tubes on cord near globus major. Vesiculae Seminalis are two lobulat- ed membranous pouches between bladder and rectum serving as reservoirs for semen, and secret- ing a fluid to be added to the se- cretion from testicles. They are attached to the posterior surface of the bladder. This duct unites with the vas deferens to form the ejaculatory duct. 214 ANATOMY IN ABSTRACT. FEMALE ORGANS OF GENERATION. The external organ is the vulva, and is divided as follows: 1. Mons Veneris, a subcutaneous col- lection of fat in front of pubis covered with hair after puberty. 2. Labia Majora are two prominent longitudinal folds extending downward from mons veneris to perineum, where they disappear. They are larger in front forming anterior commissure, and contain considerable fat. The external surface is covered with skin and hair; the internal being mucous and continuous with urinosexual opening. The forchette is an- terior margin of perineum and the fossa navicularis is depres- sion between it and hymen. > 3. Labia minora, or nymphae, are two smaller lateral folds within the former, beginning anteriorly at the clitoris, forming the frenum, and extending backward to center of vaginal orifice where they dis- appear. The prepuce is a fold ex- tending around the clitoris. 4. Clitoris is an erectile structure, analogous to the corpus caverno- sum of the penis, between ante- rior extremities of labia majora, the glans clitoridis being the free end. It has two muscles, the Erectores Clitoridis, inserted into the two lateral corpora caver- nosa. 5. The vestibule is triangular, smooth surface back of clitoris. 6. Hymen is temporary membranous covering of vaginal orifice, irreg- ularly arranged as circular, semi- lunar, cribriform, etc., usually present before coitus. 7. Glands of Bartholin are two red- dish, yellow bodies situated later- ally internal to hymen, with ducts terminating external to nympha. FEMALE ORGANS GENERATION. 215 8. Bulbi Vestibuli are two oblong masses of veins, one inch long, extending backward from clitoris and attached to cura. The pars intermedia are internal to the bulbi. THE INTERNAL ORGANS ARE: Vagina, uterus, Fallopian tubes, Ovaries and Mammary Glands. Vagina is a musculomembranous tube extending from vulva to uterus, two and one-half inches along an- terior wall and three and one-half inches from behind, forming a pouch back of the uterus. It curves backward, then upward. Is constricted at the ends. Relations. Anterior is bladder and urethra; posterior is rectum be- low, with cul-de-sac of Douglas above. Laterally are found the Levator ani muscles. Structure. It has three coats. (1) Mucous, internal, redundant, ar- ranged in furrows and ridges, lined with squamous epithelium. It contains mucous crypts but no true glands. Underneath is found loose areolar tissue contain- ing plexuses of veins. (2) Mus- cular coat consists of external or longitudinal and internal or cir- cular layers. Fibres are unstrip- ped except at lower end, the sphincter vaginae. (3) Erectile layer between other layers, com- posed of loosely arranged un- stripped muscular fibres, areolar tissue and veins. The Uterus is the organ of gestation, receiving the fecundated ovum in its cavity, retaining and support- ing it during the development of the fetus, and becoming the principle agent in its expulsion at the time of parturition. Situated 'in pelvic cavity between bladder and rectum. Size, three inches long; two inches broad; one inch thick. Weight, one and one-half ounces. Consists of (1) body; (2) cervix or neck. 1. Body is large upper end, on a line with brim of pelvis. Its upper free end is fundus. It gradually 216 ANATOMY IN ABSTRACT. tapers downward to a constriction which marks beginning of neck. Anteriorly is uterovesical pouch. Posterior is Douglas's pouch. Laterally are attached the Fallopiar. tubes, broad and round ligaments. Cavity is triangular, base up- ward, angles outward, marking termination of Fallopian tubes. Lower angle terminates in os in- ternum. 2. The Cervix is lower constricted segment, continuous from body, beginning- above in internal os and terminating below in the ex- ternal os uteri. Cavity is fusi- form flattened from before back- ward, larger in center than at either os, and containing the arbor vitae uterina, which become indistinct after first labor. Structure. Uterus has three coats. (1) External, serous peritoneum, investing the fundus, anterior and posterior surfaces. (2) Muscular unstripped, constituting principal portion of organ, very dense, thickest, and in unpregnated state is shown in (a) external longitudinal, passing transversely across fundus, extending down to cervix, (b) Middle, irregular, ob- lique, transverse and longitudinal, and (c) internal or circular fibres. (3) Mucous or internal coat is thin, smooth, closely adher- ent to muscular coat, pale red, lined with columnar ciliated epi- thelium, with nuclei and numer- ous lymphatics, with internal glands, single and bifid. In cer- vix mucous membrane is arranged in ridges, the arbor vitae and glandular follicles, and smaller crypts the ovula Nabothi. Epi- thelium above is cylindrical and ciliated, and below it is squamous. Iilgaments are (1) broad or lateral containing Fallopian tubes, round ligaments, ovary, and its liga- ments, organ of Rosenmuller, con- nective blood vessels and nerves; (2) sacrouterine ligament which pass from upper end of cervix to sacral segment. (3) Round liga- ment within broad. FEMALE ORGANS GENERATION. 217 Arteries. Internal iliac and ovarian from aorta are tortuous and free- ly anastomose. Veins, are large size, and same as ar- teries. During pregnancy they form uterine sinuses. lymphatics, from body terminate in lumbar glands, from cervix in pelvic glands. Nerves, are from inferior hypogastric and ovarian plexuses. APPENDAGES OF THE UTERUS are the Fallopian tubes, ovaries and their ligaments, and the round ligaments. Fallopian tubes, or oviducts, are two tubes four inches long beginning at the superior angles of the uterus, extending laterally within the fold of the broad ligament, and consists of (a) Isthmus, next to uterus; (b) Ampulla or outer dilated portion, and (c) Infundibulum, with its Ostium abdominale from which project the fimbria ovarica, to which are frequently attached vesicles, the hydatids of Morga- gni. Structure. The tubes have three coats. External peritoneal, mid- dle or muscular, and internal mu- cous, continuous with cavity of uterus, and lined with columnar ciliated cells. OVARIES (testes muliebres), analogous to testes in male, are two oblong bodies to sides of uterus below the Fallopian tubes and within the broad ligament, attached to the uterus by the ovarian liga- ments and at its outer end to the fimbria of the Fallopian tube. Size of last joint of thumb; weight, one and one-half drachms. Structure. It consists of a number of Graafian vesicles imbedded in the meshes of a stroma covered by peritoneum. Serous covering is derived from the peritoneum but made up of col- umnar cells, the germinal epithe- lium of Waldeyer. Stroma is composed of spindle cells, blood vessels and connective tis- sue with fusiform cells on the surface. 218 ANATOMY IN ABSTRACT. Graafian vesicles are numerous, trans- parent vesicles studded through- out the ovary, in size from one one-thousandth of an inch up, Corpora luta are the atrophed re- mains of a burst vesicle. The larger follicles have a stroma and an internal coat ovicapsule, which is lined by the membrana granulosa, in which is contained an albuminous fluid with discus proligerus in which is imbedded the ovum. The ova are developed from the germinal epithelium on surface of ovary, the larger being the primordial ova. They con- tinue to grow up to puberty when they burst from surface of ovary and escape into the Fallo- pian tube, thence to the uterus, and are capable of fecundation. The Bound Ligament is 1% in. long, extending from the ovary to the side of the body of the uterus. Arteries of the ovary are the ovarian from the internal iliac. The veins accompany the arteries, and form the pampiniform plexus. Nerves are from hypogastric plexus. THE MAMMARY GLANDS secrete the milk and are accessory to the genital system. Found both in male and female, but rudimentary in former. Are two hemispher- ical masses in pectoral region from third to sixth ribs. They are uniformly convex with a con- ical prominence in center, the nipple, darker than skin, with a tinted areola about. The nipple is perforated by numerous lactif- erous ducts which secrete the milk during lactation. Structure. The mamma is composed of numerous lobes connected by fibrous tissue with fat interposed, and numerous glands, from which pass ducts that unite to form the ampulla. This contracts to form the lactiferous ducts, fifteen to twenty, which terminate in the apex of the nipple. The mucous lining is covered with epithelium varying during stage of activity. During pregnancy they enlarge FEMALE ORGANS GENERATION. 219 and multiply, and are colostrum corpuscles from which are form- ed the milk globules. Arteries to mamma are from thoracic branch of axillary, intercostal and Internal mammary. Veins around nipple are circulus veno- sus and return with arteries. Nerves are from cutaneous of thorax. Dissedtor in Abstract (81 Illustrations) Appendix to Anatomy in Abstract Sy STEWART L. McCURDY, A.M., M.D. PITTSBURGH, PA. SECOND EDITION 222 DISSECTOR IN ABSTRACT. TWENTY RULES FOR DISSECTION. 1. No student should be permitted to dissect until he has a knowledge of the skeleton. It is a sacrilege to mutilate dissecting material-it is provided for scientific study. 2. Never cut a tissue unless you know what it is. 3. Review landmarks on the skeleton. 4. Locate landmarks through the skin. 5. Locate all the superficial muscles and tendons through the skin. 6. Outline all the skin incisions with chalk or crayon before using the knife. 7. To remove the skin dissect up the angles of two cross incisions first and proceed thereafter in the desired direc- tion. 8. Do not remove the skin entirely; it must be preserved and replaced to keep the parts moist. 9. To expose a muscle cut the fascia over Its center from end to end, taking care not to cut the fibers. In this way the fascia is removed and the muscle can be traced from origin to insertion. 10. In removing adipose and areolar tissue under the skin, preserve the su- perficial veins and nerves to the skin found underneath the muscle toward the center of the body. 11. When a muscle is exposed read up its origin, insertion, nerve and blood supply and relationship to other muscles and parts. 12. Follow carefully a fascia or muscle, teasing out the areolar tissue and fat with a forceps or the fingers rather than a knife. 13. Look carefully for lymphatics, nerves, arteries and veins. 14. Never cut a muscle until you have cleaned it from its origin to its Inser- tion, taking care to preserve the arteries and nerves entering It. 15. When it is necessary to remove a superficial muscle, sever through the DISSECTOR IN ABSTRACT. 223 middle at right angle with the fibers, so that they may be returned to their nor- mal position. 16. At the end of every period muscles, fascia, skin, etc., should be returned to their normal position. 17. To preserve material between pe- riods, wrap the parts with a damp mus- lin bandage. Toilet paper may be used next to the skin, or the parts may be sprayed with glycerine solution. 18. Have a skeleton before you while dissecting. 19. Charts should be used to aid the student in outlining muscles. 20. Two students may be assigned to each part with advantage, one to read while the other dissects. When this is done they should alternate every period; i. e., A cuts while B reads; the next pe- riod A reads while B cuts. The following is a list of the instru- ments and appliances that are usually necessary to make an ordinary dissec- tion:- Scalpels. Forceps. Chain and hooks. Tenaculum. Scissors. Gloves (if desired). In making a dissection of the vertebral column and removing the brain addition- al instruments are necessary. 224 DISSECTOR IN ABSTRACT. THE STUDY OF OSTEOLOGY. The method of placing half a skeleton in a box and loaning it to a student on a deposit of five dollars was introduced by the author twenty years ago, and has been in practice continually ever since. For the past five years the plan of permitting students to study bones in classes has been used. A table top five feet in diameter is placed on the dis- secting table; screw eyes are screwed into the top of the table and the bones are held in position with bath tub chains, which are locked into position. The bones are perforated by the use of a drill. (See illustration). There should be half as many sets of bones as there are students in the osteological class. This permits two students to study to- gether, which is a great advantage. It will be observed that the bones of a given extremity are joined together, as shown in the illustration. The in- nominate, femur, tibia, and fibula are in one group; and for the upper extremity, the scapula, humerus, radius and ulna are in another group. An entire vertebra is strung on a screen door spring, the upper end secured to the atlas and the lower end to the sacrum. These are also secured by a chain as the other bones. The bones of the skull are used in the same way. The author desires to emphasize the importance of having a thorough knowl- edge of osteology before a dissection is begun, as a means of saving time dur- ing the dissection and preparing the student to appreciate better the under- lying osseous framework to which mus- cles are attached before dissecting out these muscles. DISSECTOR IN ABSTRACT 225a A-B A & B-The long bones of the extremities, chained together. These bones belong to the same subject, so that articulations are perfect. 225b DISSECTOR IN ABSTRACT C-The bones of a foot so wired, that oscalcis and astragalus are adjustible. D-Bones of the hand wired. E-Skull,' showing improvement in mandible wiring. F-Vertebra, jwired on screen door spring. DISSECTOR IN ABSTRACT 225c G G-Osteological room, showing sets of bones chained and locked to tables. H H-Skulls chained and locked to table. 226 DISSECTOR IN ABSTRACT. UPPER EXTREMITY. Dorsal surface of forearm and hand. Study landmarks. (Figs. 1.) Outline skin incisions. (Fig. 6.) Remove skin from dorsum of wrist, band, thumb and fingers. Preserve the annular ligament until nine tendons have been exposed above and below it. First layer. Expose the tendons of Extensor indicts to index. Extensor minimi digiti to little finger. Extensor communis digitorum to all fingers. Thumb extensors, 3. Extensor longus pollicis to last pha- lanx of thumb. Extensor brevis pollicis to first pha- lanx of thumb. Extensor ossis metacarpi pollicis to metacarpal of thumb. Carpal extensors, 3. Extensor 'carpi radialis longior to base of second metacarpus. Extensor carpi radialis brevior to base of third metacarpus. Extensor carpi ulnaris to base of fifth metacarpus. Remove skin to elbow. Trace the above nine tendons to their muscular attachment from forearm and humerus. Supinator longus from external con- dyle of humerus to styloid process of radius. Observe the musculo-spiral nerve back of the external condyle of the humerus to the extensor muscles. UPPER EXTREMITY. 227 Fig. 1. Landmarks on the Dorsum of Upper Extremity. (Cunningham.) 228 DISSECTOR IN ABSTRACT. Fig. 2. Landmarks on Anterior Surface of Upper Extremity. (Cunningham.) UPPER EXTREMITY. 229 Fig. 3. Diagram showing attachments of muscles of forearm and hand. Posterior aspect. The origins and insertions of the dorsal inter- ossei muscles are omitted. (Gray.) 230 DISSECTOR IN ABSTRACT. Fig. 4. 1. Tendon of the triceps. 2. Origin of the supinator longus or brachio- radialis. 3. Extensor carpi radialis longior. 4. Insertion of this muscle. 5. Extensor radialis brevior. 6. Insertion of this muscle. 7. Extensor ossis metacarpi pollicis. 8, 8. Extensor brevis pollicis. 9, 9. Extensor longus pollicis. 10, 10. Posterior annular ligament. 11. Extensor communis digitorum. 12, 12. Attachments of the tendons of this muscle to the middle and distal pha- langes of the four fingers. 13. Tendons of the extensor indicis uniting with the tendon of the communis digi- torum indicis. 14. Tendon of the extensor minimi digiti min- gling posteriority with the tendon of the communis to the little finger. 15. Extensor carpi ulnaris. 16. Its insertion into the metacarpal bone. 17. Anconeus. 18. Flexor carpi ulnaris attached to the poste- rior border of the ulna by the aponeu- rosis. 19. Border of ulna. 20. Olecranon process. 21. Epicondyle of humerus. UPPER EXTREMITY. 231 Fig. 4. Superficial Extensors of the Forearm. (Holden.) 232 DISSECTOR IN ABSTRACT. Fig. 5 1. Brachialis anticus. 2. Cephalic vein. 3. Biceps 4. Median cephalic vein. 5. Tendon of biceps. 6. Musculo-spiral nerve. 7. Posterior interosseous nerve. 8. Supinator longus. 9. Radial nerve. 10. Radial artery. 11. Tendon of flexor carpi radialis. 12. Base of styloid precess. 13. Radial artery. 14. Deep palmar arch. 15. Brachial artery 16. Basilic vein. 17. Brachialis anticus. 18. Median basilic vein. 19. Bicipital fascia. 20. Ulnar nerve. 21. Ulnar artery. 22. Median nerve. 23. Flexor carpi ulnaris. 24. Flexor sublimis digitorum. 25. Pisiform bone. 26. Anterior annular ligament. 27. Superficial palmar arch. UPPER EXTREMITY. 233 Fig. 5. Bend of Elbow, Front of Forearm, and Palm of Hand. (Cunningham.) 234 DISSECTOR IN ABSTRACT. Palmar surface of forearm and hand. Study landmarks. Outline skin incisions. (Fig. 6.) Remove the skin from the wrist, hand and fingers, extending incisions from dorsal cuts. Expose and preserve the annular liga- ment. Expose palmaris longus tendon to pal- mar fascia. Radial (external) and ulnar (internal) arteries must be preserved. Muscles of dorsal forearm. Superficial layer, 5 muscles. Pronator radii teres from internal con- dyle of humerus to outer lower part of radius. Palmaris longus. (See above.) Flexor carpi radialis from internal condyle to index metacarpal. Flexor carpi ulnaris, 2 heads, inne" condyle and olecranon to fifth meta- carpal and pisiform. Flexor sublimis digitorum, 3 heads, condyle, coronoid and radius, by 4 tendons to second phalanges. Sever the annular ligament to expose: UPPER EXTREMITY. 235 1. Dissection of Pectoral Region and Axilla. 3. Dissection of Shoulder and Arm. 2. Bend of Elboio. 4. Forearm. 5. Palm of Hand. Fig. 6. (Gray.) 236 DISSECTOR IN ABSTRACT. Deep layer, 3 muscles. Flexor profundus digitorum from shaft of ulna by 4 tendons to last phalanges. Flexor longus pollicls from shaft of radius to thumb. Pronator quadratus near wrist under tendons from ulna to radius. Arteries, radial and ulnar, are to be preserved to the palm of the hand, where they become the deep and su- perficial arches respectively. Trace branches to the fingers. Six (6) muscles cross the wrist joint to the hand. Two of this group are pronators and do not cross wrist joint. Trace all tendons from the annular ligament upward to their origin from the radius, ulna and internal condyle of the humerus. UPPER EXTREMITY. 237 Fig. 7. Diagram Showing Attachments of the Muscles of the Forearm and Hand. Ante- rior Aspect. The Origins and Insertions of the Palmar Interosseous Muscles are Omitted. (Gray.) 238 DISSECTOR IN ABSTRACT. Fig. 8. 1. inferior part cf the biceps. 2. Aponeurosis of the biceps. 3. Tendon by which it is attached to the bi- cipital tuberosity of the radius. 4, 4. Brachialis anticus. 5. Internal head of the triceps. 6. Pronator radii teres. 7. Flexor carpi radialis. 8. Palmaris longus. 9. Inferior extremity of this muscle expanding into the palmar fascia. 10. Flexor carpi ulnaris. 11. The attachment to the pisiform bone. 12. Supinator longus or brachio-radialis. 13. Inferior attachment of this muscle. 14, 14. Extensor carpi radialis longior. 15. Extensor carpi radialis brevior. 16. Extensor ossis metacarpi pollicis. 17. Tendon of the same inserted into the meta- carpal bone. 18. Tendon' of the extensor secundi internodii pollicis. 19, 19. Flexor sublimis digitorum. 20, 20. Tendons of insertion dividing to allow the tendons of the flexor profundus digitorum to pass to their insertion. 21, 21. Insertion of the flexor sublimis digi- torum to the lower part of the mid- dle phalanges. 22, 22. Attachment of the flexor profundus digi- torum to the distal phalanges. 23, 23. Lumbricales. 24. Abductor pollicis. 25. Its attachment to the proximal phalanx of the thumb. 26, 26. Flexor longus pollicis. 27. Flexor brevis digitorum. 28. Abductor minimi digiti. UPPER EXTREMITY. 239 Fig. 8. Superficial Muscles on the Anterior Surface of the Left Forearm. (Holden.) 240 DISSECTOR IN ABSTRACT. REGION OF THE ELBOW Remove the skin. Preserve the fol- lowing: Veins Cephalic Radial Median cephalic Median Median basilic Basilic Ulnar Arteries. Brachial artery becomes radial and ulnar at elbow. Nerves. Median nerve is just internal to the brachial artery. Internal cutaneous, 2 branches, are over the internal condyle. Musculospiral, radial and musculocu- taneous are external to the bicipital tendon. Tendon of biceps found just under skin. Brachialis anticus from anterior part of shaft of humerus to the coronoid process of ulna. UPPER EXTREMITY. 241 Fig. 9. Nerves and Arteries of the Left Upper Extremity. Anterior Surface. (Gray.) 242 DISSECTOR IN ABSTRACT. Fig. 10. 1. Biceps. 2. Brachialis anticus. 3. Tendon of biceps. 4. Semilunar fascia of biceps. 5. Radial recurrent artery. 6. Supinator longus. 7. Radial nerve. S. Radial artery. 9. Flexor longus pollicis. 10. Pronator quadratus. 11. Radial artery winding to back of wrist, under extensors of thumb. 12. Superflciales volae. 13. Superficial palmar arch. 14. Brachial artery. 15. Basilic vein. 16. Ulnar nerve. 17. Median nerve. IS. Anastomotica magna. 19. Brachial artery. 20. Internal condyle. 21. Ulnar artery. 22. Pronator radii teres. 23. Flexor carpi ulnaris. 24. Flexor sublimis digitorum. 25. Flexor aarpi radialis. 26. Palmaris longus. 27. Median nerve. 28. Flexor sublimis digitorum. 29. Ulnar artery. 30. Pisiform bone. 81. Anterior annular ligament. 32. Palmaris brevis. UPPER EXTREMITY. 243 Fig. 10. The Arteries of the Forearm with the Superficial Palmar Arch. (Morris.) 244 DISSECTOR IN ABSTRACT. MUSCLES OF THE HAND. Thumb Group. (Four short thumb flexors.) Adductor pollicis from os magnum to first phalanx. Opponeus pollicis from trapezius to metacarpal. Abductor pollicis from trapezius to first phalanx. Flexor brevis pollicis from trapezius trapezoid and os magnum to first phala.nx. Little Finger Group. Adductor minimi digiti from pisiform to first phalanx. Flexor brevis minimi digiti from un- ciform to first phalanx. Opponens minimi digiti from unciform to fifth metacarpal. Palmaris brevis on ulnar side of hand extends from annular ligament to the skin of palm of hand. The four lumbricales, four dorsal in- terossei and three palmar interossei are of minor importance. Anterior shoulder and arm. Study landmarks. (Fig. 2.) Outline skin incisions. (Fig. 6.) Remove the skin and fat, exposing the following in order: Biceps from shoulder to radius on an- terior surface. Pectoralis major, covering anterior thoracic region from sternum to hu- merus. Deltoid, capping the shoulder from clavicle and acromion to outer sur- face of the humerus. Coracobrachialis under biceps, from coracoid process to shaft of hu- merus. Brachialis anticus. (See above.) Sever pectoralis major from middle of clavicle to axillary border, ex- posing pectoralis minor from third, fourth and fifth rib to the coracoid process. Subclavius from first rib to clavicle. Axillary space should be studied. Boundaries. Contents. Remove fat and expose. Extend arm to right angle with body. Brachial x artery, which becomes the axillary at lower border of pector- UPPER EXTREMITY. 245 Fig. 11. Diagram Showing Attachments of Muscles of the Shoulder and Ann. Ante- rior Aspect. (Gray.) 246 DISSECTOR IN ABSTRACT. Fig. 12. 1. Pectoralis minor. 2. Coraco-brachialis. 3. Long head of triceps. 4. Biceps. 5. Inner head of triceps. 6. Brachialis anticus. 7. Semilunar fascia. 8. Tendons of insertion of pectoralis major and deltoid. 9. Outer head of triceps. 10. Brachialis anticus. 11. Extensor carpi radialis longior. 12. Biachio-radialis. alis major and the subclavian artery at the first rib. Study branches. (Page 104.) Cephalic vein becomes axillary and subclavian at same points as artery. Study tributaries. (Page 111.) Nerves. brachial plexus and its branches (see Page 143), median, ulnar, musculospiral, musculocu- taneous and smaller branches should be preserved. Serratus magnus is now seen attached to eight upper ribs, along anterior axillary line to the internal border of scapula. Subscapularis covers the anterior sur- face of scapula; is inserted into the lesser tuberosity. Latissimus dors! tendon is along ex- ternal border of scapula; is inserted into the bicipital groove, between the pectoralis major and teres ma- jor. (See Fig. 15. Page 251.) UPPER EXTREMITY. 247 Fig. 12. Superficial View of the Front of the Upper Arm. (Morri*.) 248 DISSECTOR IN ABSTRACT. Subject is Now Turned on Face. Posterior Shoulder and Arm. (Fig. 15.) Study landmarks of shoulder and arm. (Fig. 2.) Outline skin incisions. (Fig. 14.) Remove skin and fat, exposing follow- ing in order: (Sever the deltoid and turn back.) Supraspinatus from above the spine of scapula to the greater tuberosity under acromion. Teres minor from axillary border of scapula to greater tuberosity of teres major, from angle of scapula to posterior bicipital ridge. Latissimus dorsi from ilium, sacrum, lumbar and six lower dorsal spines to bicipital groove. It lies over trapezius. Triceps from below glenoid cavity and posterior surface of shaft of humer- us to olecranon of ulna. Trapezius covering thorax above latis- simus dorsi has origin from all dor- sal spines, ligamentum nuchae to su- perior curved line of occipital bone to the clavicle, acromion and spine of scapula. Rhomboideus major and minor have origin from last cervical and five dorsal spines to the border of scapula. See Fig. 15, Page 251. UPPER EXTREMITY. 249 Fig. 13. Diagram Shewing Attachment of Muscles of Shoulder and Arm. Posterior Aspect. (Gray.) 250 DISSECTOR IN ABSTRACT. Fig. 14. Dissection of Back. (Gray.) Fig. 15. a. Trapezius. b. Latissimus dorsi. c. Levator anguli scapulae. d. Rliomboideus minor. e. Rhomboideus major. f. Splenius. g. Serratus posticus inferior. h. Teres major. i. Supra-spinatus. j. Infra-spinatus. k. Serratus magnus. 1. Obliquus externus. m. Deltoid. n. Complexus. o. Spine of scapula. p. Acromion process. UPPER EXTREMITY. 251 Fig. 15. Muscles of the Back. (Ellis.) Left, first layer; right, second layer. 252 DISSECTOR IN ABSTRACT. Fig. 16. 1. Complexus. 2. Splenius capitis. 3. Levator anguli scapulae. 4. Serratus posticus superior. 5. Rhomboideus minor. 6. Splenius colli. 7. Rhomboideus major. 8. Supraspinatus. 9. Teres minor. 10. Infraspinatus. 11. Teres major. 12. Serratus magnus. 13. Serratus posticus inferior. 14. Obliquus interims. UPPER EXTREMITY. 253 Fig. 16. The Levator Anguli Scrpulae Rhom boidei and Muscles of Shoulder. (Morris.) 254 DISSECTOR IN ABSTRACT. LOWER EXTREMITY Anterior Surface of the Leg and Dorsum of the Foot. Outline the skin incisions (Fig. 20) with crayon or chalk. Remove the skin and fat on the dor- sum of the foot and ankle. Preserve the annular ligament. (Fig. 22.) While dissecting preserve a. Long saphenous vein. b. Anterior tibial and peroneal arteries above the annular ligament and dorsalis pedis below. (Fig. 23.) c. Anterior tibial nerve on leg and foot. (Fig. 23.) First Layer. Expose the following tendons, named in order from within, both above and below the annular ligament: a. Tibialis anticus over navicular. b. Extensor proprius hallucis. c. Extensor communis digitorum, cen- ter of foot. d. Peroneus tertius, outer side of foot. Second Layer. Extensor brevis digitorum from out- side of os calcis inward under other tendons to the phalanges of great toe and tendons of extensor longus. Fig. 17. 1. Poupart's ligament. 2. Sartorius. 3. Rectus femoris. 4. Quadriceps tendon. 5. Patella. 6. Tubercle of tibia. 7. Subcutaneous surface of tibia. 8. Femoral artery. 9. Scarpa's triangle. 10. Adductor muscles. 11. Vastus internus. 12. Muscles of calf. 18. Ankle joint. 14. Abductor and flexor brevis hallucis. LOWER EXTREMITY. 255 Fig- 17. Antero-Median Surface of Right Leg, Showing Modelling on Living Subject. (Heisler.) 256 DISSECTOR IN ABSTRACT. Fig. 18. Landmarks on Surface of Region of the Knee and Leg. (Cunningham.) LOWER EXTREMITY. 257 1. Gracilis. 2. Rectus femori s. 3. Sartorius. 4. Vastus externus. 5. Vastus internus. 6. Quadriceps extensor tendon. 7. Upper border oi patella. 8. Patella. 9. llio-tibial band. 10. Internal condyle. 11. Internal semilunar cartilage. 12. Ligamentum patellae. 13. Pad of fat. 14. Internal tuberosity of tibia. 15. Head of fibula. 16. Tubercle of tibia. 17. Inner border of tibia. 18. Crest of tibia. 19. Gastrocnemius. 20. Soleus. Fig. 18. Third Layer. Dorsal interossei between the meta- tarsal bones. Remove the skin to the knee. Trace the four muscles upward to their origin from the tibia, fibula and interosseus membrane. (Anato- my in Abstract, Page 87.) Trace the anterior tibial artery and nerve upward to where they pass forward between the bones. (See Anatomy in Abstract, Page 88, for description of above muscles.) 258 DISSECTOR IN ABSTRACT. Fig. 19. Landmarks on External Surface of Leg. (Cunningham.) LOWER EXTREMITY. 259 1. Ilio-tibial band. 2. Biceps tendon. 3. External condyle. 4. Head of fibula. 5. Gastrocnemius. 6. Soleus. 7. Peroneus longus. 8. Peroneus brevis. 9. Tendo Achillis. 10. External malleolus. 11. Tip of external malleolus. 12. Vastus externus. 13. Quadriceps extensor tendon. 14. Patella. 15. External tuberosity of tibia. 16. Ligamentum patellae. 17. Tubercle of tibia. IS. Tibialis anticus. 19. Peroneus tertius. Fig. 19 260 DISSECTOR IN ABSTRACT. 1. Dissection of femoralhernia, and Scarpa s triangle. 2. Front of thigh. 3. Front of leg. 4. Dorsum of foot. Fig. 20. Dissection of Lower Extremity. Front View. (Gray.) LOWER EXTREMITY. 261 Fig. 21. Diagram Showing the Attachments of the Muscles of the Leg. Anterior. (Gray.) 262 DISSECTOR IN ABSTRACT. Fig. 22. Branches of the External Popliteal Nerve. (Morris.) LOWER EXTREMITY. 263 Fig. 22. 1. Ligameutum patellae. 2. Gastrocnemius. 3. Soleus. 4. Extensor proprius hallucis. 5. Dorsal interossei. 6. Peroneus longus. 7. Tibialis anticus. 8. Peroneus tertius. 9. Extensor longus digitorum. 10. Peroneus tertius. 11. Extensor brevis digitorum. 264 DISSECTOR IN ABSTRACT. Fig. 23. 1. Superior internal articular artery. 2. Inferior internal articular artery. 3. Anterior tibial recurrent artery. 4. Anterior tibial artery. 5. Tibialis anticus muscle. 6. Anterior tibial nerve. 7. Extensor longus hallucis. 8. Internal malleolar artery. 9. Anterior annular ligament. 10. Dorsalis pedis artery. 11. Innermost tendon of extensor brevis digi- torum. 12. Communicating branch. 13. Dorsalis hallucis artery. 14. Superior external articular artery. 15. Inferior external articular artery. 16. Extensor longus digitorum. 17. Extensor longus digitorum turned back. 18. Peroneus tertius. 19. Anterior peroneal artery. 20. External malleolar artery. 21. Peroneus brevis muscle. 22. Extensor brevis digitorum, cut. 23. External tarsal branch. 24. Metatarsal branch. 15. Dorsal interosseous artery. LOWER EXTREMITY. 265 Fig. 23. The Anterior Tibial Artery, Dorsal Artery of the Foot, aiftl Anterior Peroneal Artery, and Their Branches, Left Side. (Morris.) 266 DISSECTOR IN ABSTRACT. Fig. 24. Landmarks on Inside of Foot. (Cunningham.) LOWER EXTREMITY. 267 Fig. 25 Landmarks on Outside of Foot. (Cunningham.) 268 DISSECTOR IN ABSTRACT. SOLE OF FOOT. Study landmarks. Extend skin incision over internal malleolus to heel. (See Fig. 32.) Remove skin from Inside of foot and sole to outer border, leaving it at- tached. Plantar fascia is now ob- served. Free it from muscles, sever across foot and reflect toward heel and toes. Expose the three tendons passing back of internal malleolus to sole of foot: Flexor longus pollicis to great toe. Flexor longus digitorum to phalanges. Tibialis posticus to scaphoid and in- ternal cuneiform. Back of the external malleolus are found tendons of Peroneus longus to metatarsal of great toe. Peroneus brevis to base of fifth meta- tarsal. Back of the internal malleolus, with the above tendons, will be found the plantar nerve and artery continu- cus from the posterior tibial nerve and artery. Short muscles on sole of the foot .are arranged in four layers. First Layer. Adductor hallucis in center from 3 metatarsal bones to great toe. Flexor brevis digitorum from os cal- cis to phalanges of lesser toes. Adductor minimi digiti from os calcis to little toe. Second Layer. Flexor accessorius (2 heads) from os calcis to tendons of flexor longus digitorum. Lumbricales, four, from tendons of flexor longus digitorum to second phalanges of lesser toes. Third Layer. Flexor brevis hallucis, from cuboid and ext. cuneiform to great toe. Transverse pedis, across heads of me- LOWER EXTREMITY. 269 Fig. 26. View of the Third Layer of Muscles of the Foot. (Holden.) a. Abductor hallucis. b. Flexor brevis digitorum. c. Abductor minimi digiti. d. Tendon of peroneus longus. e, n. Flexor longus hallucis. f. Tendon of flexor longus digitorum. g. Flexor accessorius. h. Flexor brevis minimi digiti. i. Adductor hallucis. k. Flexor brevis hallucis. 1. Interossei. m. Transversalis pedis. o. Tibialis posticus. 270 DISSECTOR IN ABSTRACT. tatarsal bones from fifth bone to phalanx of great toe. Adductor hallucis in center of sole from os calcis to great toe. Flexor brevis min. dig. outside of foot from base of third metatarsal to phalanx of little toe. Fourth Layer. Plantar interossei, from shafts of third, fourth and fifth metatarsals to first phalanges of same. LOWER EXTREMITY. 271 Anterior Femoral Region. Outline skin incisions. (Fig. 20.) Remove the skin and fat from anterior half of the thigh to Poupart's liga- ment. Saphenous vein. Tensor vagina femoris and fascia lata (tensor fascia femoris) from crest of ilium to the outer surface of knee. Sartorius., from superior iliac spine obliquely downward to internal hamstring. Rectus femoris, from inferior iliac spine to patella. Gracilis, from pubis to internal ham- string. Adductor longus, from pubis to linea aspera near condyle. Scarpa's triangle. Boundaries. Contents. Floor. Hunter's canal. Study contents. Trace from Poupart's ligament to the arch through adductor magnus at the linea aspera. Anterior crural nerve. Carefully ex- pose from Poupart's ligament down- ward along branches over thigh. (Fig. 31.) Pectineus, floor of Scarpa's triangle. Adductor magnus from pubis to linea aspera. Adductor brevis from pubis to linea aspera above longus. Vastus externus, from entire external surface of shaft of femur to patella. Vastus internus, from entire internal surface of shaft of femur to patella. Crureus, on anterior surface of the shaft of the femur between and con- tinuous with the vasti muscles to patella. Subcrureu^ under crureus. Patella ana patella tendon. Poupart's ligament from anterior in- ferior spine of ilium to the pubic spine. Gimber nat's ligament under lower end of former. Psoas and iliacus muscles pass under Poupart's ligament. (Fig. 35.) Study bony landmarks. (See Anatomy in Abstract, Page 85, for description of muscles named above.) 272 DISSECTOR IN ABSTRACT. Fig. 27. Position of Parts Under the Crural Arch. Vertical Section. (Holden.) Fig. 28. 1. Psoas. 2. Iliacus. 3. Pectineus. 4. Adductor brevis. 5. Adductor longus. 6. Gracilis. 7. Adductor magnus. 8. Vastus interims. 9. Tendon of sartorius. 10. Glutens medius. 11. Gluteus minimus. 12. Tensor vaginae femoris. 13. Sartorius. 14. Rectus femoris. 15. Ilio-tibial band of fascia lata. 16. Vastus externus. 17. Ligamentum patellae. LOWER EXTREMITY. 273 Fig. 2 8. Muscles of the Front of the Thigh. (Morris.) 274 DISSECTOR IN ABSTRACT. Fig. 29. Diagram Showing the Attachments of. the Muscles of the Ihigh. Anterior Aspect. (Giay.) LOWER EXTREMITY. 275 Fig. 30. The Femoral Artery and Muscles of Anterior Femoral Region. (Gray.) 276 DISSECTOR IN ABSTRACT. Fig. 31. 1. The crural. 2. Branch to the iliacus. 3. Filament to the psoas magnus. 4. Three branches of the crural to the skin, divided to show the deeper branches. 5, 6. Muscular filaments of the superficial por- tion. 7. Internal cutaneous, which pierces the fascia lata. 8. Anastomosing branch of the internal cuta- neous. 0. Branch to the rectus femoris. 10. Branch to the vastus externus. 11, 11. Branch to the vastus internus. 12, 12. Internal, or long, saphena nerve. 13. Patellar branch of this nerve. 14. Its vertical branch. 15. Obturator nerve. 16. Its branch to adductor longus. 17. Its branch to the adductor brevis. 18. Its branch to the gracilis. 19. Its branch to the adductor magnus. 20, Lumbo-sacral trunk. 21. Union of this trunk and the first sacral nerve. 22, 22. Lumbar and sacral portion of the sym- pathetic. 23. External cutaneous nerve. LOWER EXTREMITY. 277 Fig. 31. Nerves on the Anterior or Ventral Part of the Thigh. (Holden.) 278 DISSECTOR IN ABSTRACT. POSTERIOR SUBFACE OF THE LEG. Study bony landmarks. (Fig. 35.) Outline skin incisions. Remove the skin, extending incisions from anterior cuts and dissect from inner side of leg, leaving skin at- tached along fibula so it can be re- placed between periods. Superficial Calf Group. Gastrocnemius (2 heads). From the femur, forming entire calf. Soleus, from tibia underneath the former. Plantarls, from external condyle of femur. These three muscles form the tendo Achilles to os calcis. Deep Calf Group. Flexor longus pollicis, from tibia. Flexor longus digitorum, from tibia. Tibitlis posticus, from tib. and fib. The tendons of these three muscles pass back of the internal malleolus to the sole of the foot. Posterior tibial artery and nerve ac- company these tendons back of the internal malleolus to the sole of the foot, where they become the plantar artery and nerve with branches. (See Fig. 34.) Posterior Fibular Group. Peroneus brevis from lower part of fibula. P< roneous longus from middle Of the fibula, both back of the external malleolus to the sole of the foot. Popliteal space back of knee. Boundaries and contents. (Abstract, Page 95.) Popliteal artery from femoral to the posterior tibial. Popliteal nerve from greater sciatic to posterior tibial. Popliteal vein and tributaries. Popliteal muscle from external con- dyle of femur to tibia across joint. Hamstring* Tendons. External; tendon of biceps. Internal; tendons of sartorius, gracilis, semimembranosus and semitendin- osus. Observe where anterior tibial artery and nerve pass forward between the tibia and fibula. 280 DISSECTOR IN ABSTRACT. 1. Dissection of gluteal region. 3. Back of thigh. 2. Popliteal space. 4. Back of leg. 5. Sole of foot. Fig. 32. (Gray.) LOWER EXTREMITY. 281 Fig. 33. Diagram Showing the Attachments of Muscles of the Leg. Posterior Aspect. (Gray.) 282 DISSECTOR IN ABSTRACT. Fig. 34. 1. Superior external articular artery. 2. Popliteal nerve, 3. External lateral ligament. 4. Inferior external articular artery. 5. Popliteus. 6. Muscular branch to soleus. 7. Soleus. S. Anterior tibial artery. 9. Peroneus longus. 10. Peroneal artery. 11. Branch of posterior tibial nerve to flexor longus hallucis. 12. Flexor longus hallucis. 13. Cutaneous branch of peroneal artery. 14. Peroneus brevis. 15. Continuation of peroneal artery. 16. Os calcis. 17. Superior internal articular artery. 18. Popliteal artery. 19. Posterior ligament of knee. 20. Azygos articular artery. 21. Semimembranosus. 22. Inferior internal articular artery. 23. Muscular branch. 24. Tibialis posticus. 25. Posterior tibial nerve. 26. Muscular branch of posterior tibial nerve to flexor longus digitorum. 27. Flexor longus digitorum. 28. Posterior tibial artery. 29. Tibialis posticus. 30. Communicating branch. 31. Internal annular ligament. 62. Internal calcaneal artery. LOWER EXTREMITY. 283 Fig. 34. Relations of the Popliteal Artery to Bones and Muscles. Left Side. (Morris.) 284 DISSECTOR IN ABSTRACT. POSTERIOR PEMOKAL REGION. Study bony landmarks. Extend skin incisions from those in front. (Fig. 32.) Remove the skin from ilium to knee. Eirst layer of muscles on thigh. Biceps. Outer side, forming external hamstring tendon. Semimembranosus. On inner side from tuberosity of ischium to inter- nal hamstring. Semitendinosus. In center to internal hamstring. Gluteus maximus. From sacrum and posterior iliac crest to femur and fascia lata. Gluteus medius. From ilium to great- er trochanter (posterior). Gluteus minimus. From ilium to greater trochanter (anterior). Dissect maximus and medius from origin to insertion, sever through middle and expose the second layer back of hip joint. They are named in older, from above downward. Do not remove gluteus minimus. Second layer. Pyriformis, from sacrum through great sciatic notch to greater tro- chanter. G« melius superior, from ischiatic spine to greater trochanter. Obturator internus, from obturator foramen and membrane to greater trochanter. Gemellus inferior, from tuberosity of ischium to greater trochanter. Quadratus femoris, from tuberosity of ischium to quadrate line of femur. (Fig. 37.) Obturator externus, under obturator internus and gemellic muscles to digital fossa of greater trochanter. Great sciatic nerve is found under- neath the gluteii muscles °nd above the second layer, lying between the tuberosity of the Ischium and great- er trochanter. LOWER EXTREMITY. 285 Study blood and nerve supply to the knee and hip. Observe bony landmarks. Other nerves exposed are small sciatic, pudic, superior gluteal and inferior gluteal. 286 DISSECTOR IN ABSTRACT. Fig. 35. Surface Anatomy of the Gluteal Re- gion and the Posterior Aspect of the Thigh and Knee. (Heisler.) LOWER EXTREMITY. 287 Fig. 35. 1. Rima natium. 2. Gluteo-femoral sulcus or fold. 3. Inner condyle. 4. Crest of ilium. 5. Trochanter major. 6. Sulcus, due to tension of ilio-tibial band. 7. Popliteal space. 288 DISSECTOR IN ABSTRACT. Fig. 36. Superficial Muscles of the Back of the Thigh and Leg. (Morris.) LOWER EXTREMITY. 289 Fig. 36. 1. Gluteus medius. 2. Aponeurosis of gluteus maximus. 3. Biceps. 4. Vastus externus. 5. Plantaris. 6. Gastrocnemius. 7. Soleus. 8. Peroneus longus. 9. Gluteus maximus. 10. Semimembranosus. 11. Semitendinosus. 12. Gracilis. 13. Tendon of semimembranosus. 14. Sartorius. 15. Flexor longus digitorum. 16. Tendo Achillis. 290 DISSECTOR IN ABSTRACT. Fig. 37. Muscle Beneath the Gluteus Maximus. (Holden.) 1. Origin of gluteus maximus divided. 2. Ils insertion into the oblique line. 3, 3. Its insertion into the fascia lata. 4. Gluteus medius. 5. Its insertion. 6. Fascia lata, showing continuity, with inser- tion of the gluteus maximus. 7. Pyriformis. 8. Obturator internus. 9. Gemellus superior or cephalad. 10. Gemellus inferior. 11. Quadratus femoris. 12. Semimembranosus. 13. Biceps. 14. Adductor magnus. 15. Gracilis. 16. Vastus externus. Fig. 37. LOWER EXTREMITY. 291 Fig. 38. Diagram Showing the Attachments of the Muscles of the Thigh. Posterior Aspect. (Gray.) 292 DISSECTOR IN ABSTRACT. Fig. 39. The Great Sciatic Nerve, with Its Col- lateral and Terminal Branches. (Holden.) DOWER EXTREMITY. 293 Fig. 39. 1. Superior gluteal nerve. 2. Inferior gluteal or lesser sciatic. 3, 3, 3. Its branch to the gluteus maximus. 4. Branch to the pyriformis. 5. Genital branch of the lesser sciatic. 6. Femoro-popliteal of the same nerve. 7, 7. Trunk of the great sciatic. 8, 9. Branch to the long and short heads of the biceps. 10, 10. Branch to the semitendinosus. 11, 11. Branches to the semimembranosus. 12, 12. Branch to the adductor magnus. 13. External popliteal or peroneal. 14. Internal popliteal. 15. Filament to the plantaris muscle. 16, 16. Branches to the gastrocnemius. 17. Origin of the external saphenous nerve. 294 DISSECTOR IN ABSTRACT. ABDOMEN Study landmarks. (Fig. 42.) Outline the nine divisions on the skin with crayon, and read over the structures found in each region. (Abstract, Page 184.) Observe the umbilicus, hernial rings, furrow for Poupart's ligament, en- siform cartilage, linea alba, linea semicircularis and transversae. (Fig. 41.) Remove the skin and study the above landmarks and muscles forming the abdominal wall before entering the peritoneal cavity. Muscles. Superficial group to be studied first and deep group last. Superficial group (5). Obliquus, externus and internus and transversalis form the wall exter- nal to the linea semicircularis, and the rectus and pyramidalis form the wall in the median region with- in these lines. Obliquus externus. Origin from 8 lower ribs. Fibers run downward and forward to median line, Pou- part's ligament and iliac crest. Obliquus internus. Fibers have origin from lumbar fascia, iliac crest and Poupart's ligament upward and for- ward to four lower ribs, linea alba, pubic crest and pectineal line. Transversalis. Fibers running trans- versely. Origin from Poupart's ligament, iliac crest, six lower ribs and lumbar vertebrae, to linea alba, pubic crest and pectineal line. (The fibers of these muscles do not ex- tend to the median line, but their fasciae do.) Rectus abdominis. From pubic crest to cartilages of fifth, sixth and sev- enth ribs. Pyramidalis. from pubis to linea alba, between recti muscles, and ending below umbilicus. THORAX AND ABDOMEN. 295 Fig. 40. Incision in Dissection of Abdomen. (Gray.) 296 DISSECTOR IN ABSTRACT. Fig. 41. 1. Pectoralis major. 2. Its clavicular fasciculus. 3. Fasciculus attached to abdominal aponeu- rosis. 4, 4. External oblique. 5, 5. Serratus magnus. 6, 6. Anterior border of latissimus dorsi. 7. Decussation of tendinous fibers of pectorales majores. S. Ensiform cartilage. 9, 9. Abdominal aponeurosis. 10, 10. Linea alba. 11. Umbilicus. 12, 12, 12. Tendinous intersections of rectus abdominis. 13, 13. External abdominal ring. 14. Pyramidalis. 15, 15. External border of rectus abdominis. 16. Sterno-hyoid. 17. Omo-hyoid. 18. Sterno-mastoid. 19. Cervical portion of trapezius. 20. Deltoid. 21. Biceps brachialis. 22. Pectineus. 23. Sartorius. 24. Rectus femoris. 25. Tensor vaginae femoris. THORAX AND ABDOMEN. 297 Fig. 41. Muscles of the Anterior Aspect of the Body. (Eckley.) 298 DISSECTOR IN ABSTRACT. Fig. 42. Surface of Anterior Abdominal Wall (Living Model). (Heisler.) 1. Line of lower costal cartilages. 2. Lineae transversae. 3. Ant. sup. iliac spine. 4. Fold of groin (position of Poupart's liga ment). 5. Ensiform cartilage. 6. Linea alba. 7. Lir.ea semilunaris. 8. Spermatic cord emerging through ext. abdom inal ring. Fig. 43. 1. Levator anguli scapulae. 2. Subscapularis. 3. Pectoralis minor. 4. Latissimus dorsi. 5. Serratus magnus. 6. Internal oblique. 7. Rectus. 8. Pyramidalis. 9. Conjoined tendon. THORAX AND ABDOMEN 299 Fig. 43. The Pectoralis Minor, Obliquus Inter- nus, Pyramidalis and Rectus Abdominis. (Morris.) 300 DISSECTOR IN ABSTRACT. Fig. 44. 1, 1. Rectus abdominis. 2, 2. Internal oblique. 3, 3. Anterior leaflet of aponeurosis of in- ternal oblique. 4, 4. Divided external oblique. 5, 5. Spermatic cords. 6, 6. Inferior portion of aponeurosis of exter- nal oblique. 7. Lower portion of left rectus abdominis; upper portion removed. 8, 8. Muscular portion of transversalis ab- dominis. 9. Aponeurotic portion. 10. Umbilicus. 11. Supra-umbilical portion of linea alba. 12. Infra-umbilical .portion. 13. Serratus magnus. 14. Divided right latissimus dorsi. 15. Divided left latissimus dorsi. 16. Divided serratus magnus. 17, 17. External intercostals. 18, 18. Femoral aponeurosis. 19. Divided internal oblique. THORAX AND ABDOMEN. 301 Fig. 44. Abdominal Muscles. (Eckley.) 302 DISSECTOR IN ABSTRACT. ABDOMINAL CAVITY To open the peritoneal cavity make an incision from ensiform to pubis through linea alba. Greater omentum is first seen. It is a sero-adipose apron between the intes- tines and abdominal wall; is attached to the stomach and transverse colon above, its lateral and inferior margins being free. Small intestines are exposed by turning the omentum upward or removing it. Locate the stomach, liver, spleen, cecum, appendix and colon without disturb- ing their position. Small intestines should next be traced from the pyloric end of the stomach through duodenum, jejunum and ilium to iliocecal valve. Mesentery attach- ments. Cecum and appendix should be exam- ined. Colon, from the cecum to rectum, should be carefully examined, locating the ascending, hepatic flexure, transverse, splenic flexure, descending, and sig- moid flexure in order. Observe that parts of the colon are post-peritoneal and not entirely sur- rounded by this membrane. Stomach should be now exposed by re- moving the omentum. Cardiac end with the esophagus from the diaphragm to the stomach can be traced. The fundus, greater and less lesser curves, must be observed. Pyloric end beginning the duodenum. Costal cartilages must be removed over the spleen and liver to see these or- gans in situ. Pancreas in back of and above the stomach between the two layers of the peritoneum. It is opposite the second lumbar vertebra. It extends from the spleen on the left to the duo- denum. (See Abstract, Page 191.) The stomach should be freed from above to permit a proper study of the pancreas. Peritoneum should be traced, showing the greater and lesser cavities. (Fig. 45.) THORAX AND ABDOMEN. 303 Fig. 45. Diagram Showing the Peritoneum as Seen in a Vertical Section. (Allen Thomson.) (Morris.) 1. Liver. 2. Gastro-hepatic omentum. 3. Stomach. 4. Transverse colon. 5. Mesentery. 6. Small intestine. 7. Uterus. 8. Bladder. 9. Foramen of Winslow. 10. Pancreas. 11. Duodenum. 12. Transverse meso-colon, 13. Aorta. 14. Rectum, 304 DISSECTOR IN ABSTRACT. Spleen is below the diaphragm, above free margin of ribs, and between the extended axillary lines. Study size, relationship and the splenic artery from coelic axis and returning vein. Liver, with its various important struc- tures, must be studied in position about as fellows: Gall bladder with duct from transverse Assure of liver and pancreas to duo- denum. Gastro-hepatic, or lesser omentum, from liver to stomach. Foramen of Winslow, or foramen of communication from greater to lesser peritoneal cavities is through this structure. The Ave ligaments, viz.: 1. Suspensory, or broad, from dia- phragm to coronary. 2. Coronary, from diaphragm to pos- terior surface. 3. Round, to umbilicus (originally the urachus). 4. Right lateral, from outer end to di- aphragm. 5. Left lateral, from left lobe to dia- phragm. Remove small intestines by freeing from mesentery from pylorus to ce- cum, preserving aorta, inferior vena cava and thoracic duct. Remove the large intestines, studying the various folds of the peritoneum. (Abstract, Page 185.) Aorta and its branches below the dia- phragm must be exposed. (Abstract, Page 106.) Trace iliac arteries to femoral. Celiac axis and splenic, hepatic and gas- tric branches are to be traced to these organs. Portal circulation should be preserved from the mesentery and the omental folds to the liver. Inferior vena cava from the femoral veins to lilac must be exposed. Receptaculum chyll and thoracic duct can, with care, be found on body of THORAX AND ABDOMEN. 305 second lumbar vertebra; the duct goes upward through the diaphragm with the aorta. The liver, spleen and stomach may be carefully removed, preserving the kid- neys, suprarenal capsules, ureters, vena cava, aorta and branches. Kidneys are now separated from their attachment to the vertebrae back of the peritoneum. (Description, see Abstract, Page 201.) The ureters should be traced downward to where they pass over the common iliac arteries to the pelvic cavity, back of the bladder, the cavity which they enter. Lumbar plexus of nerves will be found about and within the psoas muscle. Locate the trunks as they emerge from the intervertebrae foramina, and fol- low them downward, separating the fibres of the psoas. Branches. (7.) From anterior branches of the first four lumbar nerves named in order. Iliohypogastric to gluteal and hypogas- tric region. Ilioinguinal to inguinal region, upper thigh and genitals. Genito-crural, to genitals and upper part of thigh. External cutaneous to the integument of outer and posterior part of thigh to knee. Anterior crural, the largest branch, passes under Poupart's ligament (see Fig. 27) and is distributed to anterior muscles of thigh. Skin anterior sur- face to knee and inner surface to ankle. Obturator to hip and knee joints and adductors of thigh. Accessory obturator to pectineus, and skin of thigh and leg. 306 DISSECTOR IN ABSTRACT. Fig. 46. 1. Stomach. 2. Liver. 3. Spleen. 4. Pancreas. 5. Left kidney. 6. Aorta at the celiac axis and its three branches. 7. Inferior vena cava. 8. Right kidney. a. Gastrohepatic omentum. b. Cavity of great omentum. c. Gastrosplenic omentum. d. General peritoneal cavity. Arrow indicates its communication through foramen of Winslow with b. THORAX AND ABDOMEN. 307 Fig. 46. A Transverse Section in the Upper Region of the Abdomen. (Modified from Heath's Anatomy.) (Haynes.) 308 DISSECTOR IN ABSTRACT. Fig. 47. a. Falciform ligament of liver. b. Left lateral. c. Right lateral ligaments of liver. d. Inferior vena cava. e. Gastrophrenic ligament. f. Esophagus. g. Gastrosplenic omentum. h. Splenic artery. i. Costocolic ligament. j, j. Transverse mesocolon. k, k. Descending colon. 1. Sigmoid mesocolcn. m. Mesorectum. n. Bladder. o, o. Mesentery. p, p. Ascending colon. q. Caecum. r. Vermiform appendix. s Inferior vena cava. t. Duodenum. u. Duodenum. v. Abdominal aorta. 1. Cavity of great omentum. 2. Foramen of Winslow. muscz.es of the deep abdomi- nal GROUP. Psoas magnus already mentioned in connection with the lumbar nerves. Or. From bodies and transverse pro- cesses of last dorsal and all lumbar vertebrae; is inserted into the lesser trochanter of the femur. Psoas parvus (sometimes absent) from last dorsal vertebra to iliopectineal eminence and fascia. Iliacus from iliac fossa and base of sacrum to lesser trochanter with psoas. Quadratus lumborum from crest of ili- um, transverse processes of lower 3 lumbar vertebrae to the last rib and transverse process of upper 4 lumbar vertebrae. THORAX AND ABDOMEN. 309 Fig. 47. The Partietal, Peritoneal Attachments of the Abdominal Viscera. (Cunningham in Morris's Anatomy.) 310 DISSECTOR IN ABSTRACT. 1. XII. rib. 2. XII. thoracic nerve. 3. Quadra tus lumborum. 4. Psoas magnus. 5. External oblique. 6. Lateral cutaneus branch of XII. dorsal nerve. 7. Internal oblique. 8. Transversalis. 9. Ilio-hypogastric nerve. 10. Ilio-inguinal nerve. 11. Iliac branch of ilio-hypogastric. 12. Lateral cutaneous branch of XII. dorsal nerve. 13. External cutaneous nerve. 14. Anterior crural nerve. 15. Genital branch of genito-crural nerve. 16. Crural branch of genito-crural nerve. 17. Branches of middle cutaneous nerve. 18. I. lumbar ganglion. 19. Rami communicantes. 20. Aorta. 21. IV. lumbar nerve. 22. V. lumbar ganglion. 23. V. lumbar nerve. 24. Part of V. lumbar ganglion. 25. Genito-crural nerve. 26. I. sacral nerve. 27. II. sacral nerve. 28. IV. sacral ganglion. 29. Obturator nerve. 30. Accessory obturator nerve. 31. Hypogastric branch of ilio-hypogastric nerve. 32. Ilio-inguinal nerve. 33. Branch of internal cutaneous nerve. Fig. 48. THORAX AND ABDOMEN. 311 Fig. 48. Deep Dissection, Showing Nerves Arising from Lumbar Plexus and Lower Part of Sympathetic Gangliated Cord. (Heisler.) 312 DISSECTOR IN ABSTRACT. Fig. 49. 1. Aorta. 2. Superior vena cava. 3. Upper right pulmonary vein. 4. Right pulmonary artery. 5. Superior vena cava. 6. Left innominate vein. 7. Innominate artery. 8. Right innominate vein. 9. Subclavius muscle. 10. Clavicle. 11. Internal mammary artery. 12. Subclavian vein. 13. Suprascapular artery. 14. Transverse cervical artery. 15. Vertebral artery. 16. Inferior thyroid artery. 17. Internal jugular vein. 18. Common carotid artery. 19. Superior thyroid artery. 20. Sterno-thyroid muscle. 21. Omo hyoid muscle. 22. Sterno-hyoid muscle. 23. Platysma. 24. Sterno-hyoid muscle. 25. Sterno-thyroid muscle. 26. Sterno-mastoid muscle. 27. Phrenic nerve. 28. Vagus nerve. 29. Vertebral artery. 30. Inferior thyroid artery. 31. Thoracic duct. 32. Left subclavian artery. 33. Subclavius muscle. 34. First rib. 35. Left common carotid artery. 36. Aorta. 37. Ligamentuin arterlosum. 38. Left pulmonary artery. 39. Upper left pulmonary vein. 40. Pulmonary artery. DISSECTOR IN ABSTRACT. THORAX AND ABDOMEN. Fig. 49. The Pulmonary Arteries and Veins and Their Relations. Parts of the Ascending Aorta and Superior Vena Cava Have Been Renoved. (Cunningham.) 316 DISSECTOR IN ABSTRACT. THE CAVITY OF THE PELVIS. This cavity is the lower part of general abdominal cavity below iliopectineal line, and from promontory of the sacrum. Boundaries. Behind, sacrum, coccyx, pyriformis muscles and great sacro- sciatlc ligaments; in front, pubis and ischium and obturator muscles; above, it is continuous with abdominal cav- ity; below, triangular ligament, leva- tor and coccygeus muscles and pelvic fascia. Contents. Urinary bladder, rectum, some genital organs peculiar to sex, loops of small intestines, blood ves- sels, lymphatics and nerves. Bladder is seen back of the pubic arch, covered with peritoneum. The ureters may be further traced backward to points of entrance. The cavity may now be opened; the trigone formed by the ureters and urethra observed. Fundus, back and neck are located. (See Abstract, Page 205.) Prostate gland is enucleated. Urethra may now be traced to the penis. Observe the membranes and prostatic portions and study corpus caverno- sum, spongiosum, glands and meatus. Cowper's glands are two yellow bodies, size of a pea, on sides of membranous urethra. The testes, spermatic cords, vas defer- ens and other structures may be lo- cated. (For description see Anatomy in Abstract, Pages 210-11,-12-13.) In female subjects the organs peculiar to this sex must be studied. (For de- scription see Anatomy in Abstract, Page 214.) Rectum is back of other viscera, imme- diately next to the sacrum. It is about seven inches long, but runs a tortuous course, terminating in the anus. Sacral plexus of nerves is exposed after removal of the pelvic contents. (See Fig. 48.) Its origin is from the an- terior trunks, passing forward through the sacral foramina, except the first or sacro-lumbar cord from between the last lumbar and first sacral seg- ment. THORAX AND ABDOMEN. 317 Fig. 50. Muscles of the Floor of the Pelvis. (Morris.) 318 DISSECTOR IN ABSTRACT. THORAX. Study landmarks. (See Fig. 51.) Outline skin incisions and remove skin. (At this time the classes dis- secting the upper are expected to study landmarks, skin incisions, the pectoral muscles and thorax with the visceral class). THOBAX. The general region within the ribs. Intercostal spaces. Boundaries. Laterally, by ribs. In front sternum and costal cartilages. Behind, in center, by vertebrae. Below, by diaphragm. Above, by first ribs, clavicle and muscles of neck. Divisions. Two lateral or pulmonic. Middle, or mediastinum. To Open Thoracic Cavity. Remove skin and pectoralis 'major. With cartilage knife sever costal cartilages from clavicle to free margin from ribs. Carefully dis- sect sternum from below upward, bending over face, where it is held with hooks and chain. Pericardium is first observed in the median region. Laterally the lungs are found. Observe the internal mammary artery. Study pericardium and its relationship with the pleural membranes and diaphragm. Study the divisions of the inferior mediastinum. Observe relationship of heart to lungs, aorta, vena cavae, tracheae Fig. 51. (Heisler.) THORAX AND ABDOMEN. 319 and bronchial tubes. Locate pneu- mogastric and other nerves and thoracic duct. Open the pleura and trace the costal pulmonic layers to the root of the lungs, which contain bronchial tubes, pulmonic and systemic ar- teries and veins, nerves and lym- phatics. Open the pericardium and study the heart in situ, size, position, weight, relationship. Locate ventricles and auricles; supe- rior and inferior vena cava, aorta and pulmonary artery, and four veins as they leave and enter the pericardium. Mediastinum-Divisions. Superior. Above heart and peri- cardium. f Anterior, in front of heart. Inferior. < Middle, region of heart. ( Posterior, back of heart. (See Anatomy in Abstract, Page 198.) Nerves. Pneumogastric. Between common carotid and internal jugular, pass- ing downward over the subclavian artery and under the left innomi- nate vein. About the same on both sides. Phrenic. Both external to the inter- nal jugular veins and passes down- ward between the subclavian veins and arteries. Recurrent laryngeal nerves are be- tween the common carotid and trachea running backwards. They are given off from the pneumogas- tric left below arch of aorta and right near subclavian. Remove the heart and lungs, taking care to preserve the root of the lungs, the large vessels from the heart and the diaphragm. Heart should be opened. Mitral, tri- cuspid, aortic and pulmonic valves are to be studied. Openings (ten) must be located. Lungs. Make section and study smaller bronchi and air vesicles. (See Abstract, Page 199.) Back of heart, in posterior mediasti- num, are to be found esophagus, inferior vena cava, aorta, thoracic duct, pneumogastric nerve and vena azygos major and minor. 320 DISSECTOR IN ABSTRACT. Fig. 52. 1. Recurrent laryngeal nerve. 2. Inferior thyroid vein. 3. Right vagus nerve. 4. Bifurcation of innominate artery. 5. Right subclavian vessels. 6. Internal mammary artery. 7. Right innominate vein. 8. Right lobe of thymus gland. 9. Upper lobe of right lung. 10. Middle lobe of right lung. 11. Basal lobe of right lung. 12. Sterno-hyoid muscle. 13. Sterno-thyroid muscle. 14. Sterno-mastoid muscle. 15. Thyroid body. 16. Internal jugular vein. 17. Phrenic nerve. 18. Scalenus anticus. 19. Subclavian artery (left). 20. Left vagus nerve. 21. Subclavian vein (left). 22. Common carotid artery. 23. Left innominate vein. 24. First rib. 25. Aortic arch. 26. Left lobe of thymus gland. 27. Left lung. 28. lieart. 29. Pulmonary fissure. 30. Pericardium. THORAX AND ABDOMEN. 321 Fig. 52. Dissection of Thorax and Root of the Neck From the Front, to Show the Relations of the Lungs, Pericardium and Thymus Gland. (Cunningham.) 322 DISSECTOR IN ABSTRACT. Five muscles in this region. Intercostal. Between all ribs. External. (11 pairs.) Running down- ward and forward. Internal. (11 pairs.) Running down- ward and backwards at right angle with the former. Infracostals. (10 pairs.) Within the thorax, from inner surface of ribs to second or third rib below. Triangularis sterni from ensiform cartilage and costal cartilages to lower ribs and sternum. Levator costarum. (12 pairs.) From transverse processes to ribs below. Diaphragm. The diaphragm is a mus- cular, membranous partition be- tween the thorax and abdomen. Study this muscle carefully. Note relationship to lungs, heart, liver, spleen and stomach, and its points of attachment. Note the openings for esophagus, aorta and vena cava. (Fig. 55.) Fig. 63. Peculiar Vertebra. a. Atlas. b. Axis. c. Vertebra prominens. d. One and one-half facet on 1st dorsal. e. Half facet on all from 2d to 8th dorsal vertebra. f. 9th half facet. g. 10, 11, 12, one full facet. h. 5th lumbar. Wedge body. THORAX AND ABDOMEN. 323 Fig. 53. Lateral View of the Spine. 324 DISSECTOR IN ABSTRACT. Fig. 54. View of the Deeper Abdominal Viscera. (Rudinger.) (Morris.) 1. Superior vena cava. 8. Left bronchus. 2. Thoracic duct. 9. Esophagus. 3. Inferior vena cava. 10. Spleen. 4. Pancreas. 11. Kidney. 5. Kidney. 12. Duodenum. 6. Ascending colon. 13. Descending colon. 7. Aorta. 14. Sigmoid flexure. 15. Bladder. THORAX AND ABDOMEN. 325 Fig. 55. Diaphragm. 326 DISSECTOR IN ABSTRACT SKULL Note-Figs. 56, 57, 58, 59, 64, 75 should be studied with osteology. Page 28. 1. Mental protuberance. 2. Body of lower jaw. 3. Ramus of'lower jaw. 4. Anterior nasal spine. 5. Canine fossa. C. Infraorbital canal. 7. Malar canal. 8. Orbital surface of superior maxilla. 9. Temporal fossa. 10. Os planum ethmoid. 11. Sphenoidal fissure. 12. Lachrymal bone and groove. 18. Optic foramen. 14. Orbital foramina. 15. Temporal ridge. 16. Supraorbital notch. 17. Glabella. 18. Frontal eminence. 19. Superciliary ridge. 20. Parietal bone. 21. Fronto-nasal suture. 22. Pterion. 23. Great wing of sphenoid. 24. Orbital surface of great wing oi sphenoid. 25. Squamous temporal. 26. Left nasal bone. 27. Malar bone. 28. Spheno-maxillary fissure. 29. Zygmotic arch. 30. Anterior nasal aperture, displaying nasal septum and inferior and middle turbinat- ed bones. 31. Mastoid process. 32. Incisor fossa. 33. Angle of jaw. 84. Mental foramen. 35. Symphysis. HEAD AND NECK. 327 Fig. 56. Landmarks on Anterior Surface of Skull. (Cunningham.) 328 DISSECTOR IN ABSTRACT. Fig. 57. 1. Mental foramen. 2. Body of lower jaw. 3. Superior maxilla. 4. Ramus of lower jaw. 5. Zygomatic arch. 6. Styloid process. 7. External auditory meatus. 8. Mastoid process. 9. Asterion. 10. Superior curved line of occipital bone. 11. External occipital protuberance. 12. Lambdoid suture. 13. Occipital bone. 14. Lambda. 15. Obelion placed between the two parietal foramina. 16. Parietal bone. 17. Lower temporal ridge. 18. Upper temporal ridge. 19. Squamous part of temporal bone. 20. Bregma. 21. Coronal suture. 22. Stephanion. 23. Frontal bone. 24. Pterion. 25. Temporal fossa. 26. Great wing of sphenoid. 27. Malar bone. 2b. Malar canal. 29. Lachrymal bone. 30. Nasal bone. 31. Infraorbital canal. 32. Anterior nasal aperture. HEAD AND NECK. 329 Fig. 57. Landmarks of Lateral Surface of Skull. (Cunningham.) 330 DISSECTOR IN ABSTRACT. Fig. 58. 1. Transmits left nasopalatine nerve. 2. Transmits anterior palatine vessel. 3. Transmits right nasopalatine nerve. 4. Accessory palatine foramina. 5. Posterior nasal spine. 6. Azygos uvulae. 7. Hamular process. 8. Sphenoid process of palate. 9. Pterygopalatine canal. 10. Tensor tympani. 11. Pharyngeal spine for superior constrictor. 12. Situation of Eustachian tube and canal for tensor tympani. 13. Tensor palati. 14. Canal for Jacobson's nerve. 15. Aquaeductus cochleae. 16. Foramen lacerum posterins. 17. Canal for Arnold's nerve. 18. Auricular Assure. HEAD AND NECK. 331 Fig. 5S. Base of the Skull. External Surface. (Gray.) 332 DISSECTOR IN ABSTRACT. 1. Groove for superior sagittal sinus. 2. Grooves for anterior meningeal artery, 3. Foramen caecum. 4. Crista galli. 5. Slit for nasal nerve. 6 Groove for nasal nerve. 7. Anterior ethmoidal foramen. 8. Orifices for olfactory nerves. 9. Posterior ethmoidal foramen. 10. Ethmoidal spine. 11. Olfactory grooves. 12. Optic foramen. 13. Optic groove. 14. Olivary process. 15. Anterior clinoid process. 16. Middle clinoid process. 17. Posterior clinoid process. 18. Groove for 6th nerve. 19. Foramen lacerum medium. 20. Orifice of carotid canal. 21,. Depression for Gasserian ganglion. 22. Meatus auditorius internus. 23. Flocculus fossa. 24. Superior petrosal groove. 25. Foramen lacerum posterius. 26. Anterior condyloid foramen. 27. Aquaeductus vestibuli. 28. Posterior condyloid foramen. 29. Mastoid foramen. 30. Posterior meningeal grooves. Fig. 59. HEAD AND NECK. 333 Fig. 59. Base of the Skull. Inner or Cerebral Surface. (Gray.) 334 DISSECTOR IN ABSTRACT. Fig. CO. Lateral Landmarks of Head and Neck. (Cunningham.) HEAD AND NECK. 335 Clip hair from scalp and face. Identify landmarks as follows: First, on side of head and face. (See Fig. 60.) Second, on region of neck and shoul- ders. (See Fig. 61.) Make incisions as shown in Fig. Remove scalp and expose the following parts: Occipito frontalis: Frontal portion from above eyes to hair line. Occipital portion from occipital pro- tuberance upward for 2 or 3 inches. Aponeurosis over top of skull, unit- ing the above muscles. The three muscles of the ear: Retrahens aurem, posterior. Attrahens aurem, anterior. Attolens aurem, superior. These muscles have their origin in the fascia about the ear and are inserted into the cartilaginous ear. Nerves exposed are: Supra-trochlear and orbital. Facial and auriculo-temporal. Arteries exposed are: Temporal, passing upward in front of ear. Supra-orbital, from same foramen above orbit. Frontal. Occipital and posterior auricular back of ear. Observe the temporal fascia attached to the temporal ridge with the fibers of the temporal muscle converging down- ward to pass underneath the zygo- matic arch. Enumerate the landmarks as seen upon the bones. HEAD FACE Extend median incision fi'om forehead along the median line to the mandible, and from this point along the lower border of this bone to the lobe of the ear. Remove the skin from the face, care being taken to preserve the muscles of the face, which are inserted into it. especially the orbicularis oris, risor- ius, orbicularis palpebrarum and buc- cinator. (Do not destroy the contents of the or- bital cavity.) 336 Study the following structures while they are being exposed from above downward: Orbicularis palpebrarum, sphincter of eyelids. Tarsal cartilages, within margins of eyelids. Levator palpebrarum, attached to upper cartilage. Corrugator supercilii over frontal eminence. Tensor tarsi near internal canthus on side of nose. Supraorbital notch with the artery and nerve already mentioned. The following muscles in order from above downward (see Fig. 65.) Fyramidalis nasi. Levator palpebrae superioris. Levator labii superioris. Zygomaticus major. Zygomaticus minor. Levator anguli oris. Orbicularis oris. Masseter muscle; its origin from the zygomatic arch and its inser- tion into the ramus of the man- dible. Preserve the buccinator muscle with its extensive attachment to the maxillary bones. Expose the parotid gland, preserving the facial nerve as it passes through the gland and sends its branches to all parts of the face, supplying the muscles with motion. Remember that Stenson's duct passes from the paro- tid gland over the masseter muscle through the buccinator, entering the mouth opposite the second upper molar tooth. Arteries to be preserved are: Facial, passing over the mandible at the anterior margin of the masseter. Temporal, passing directly upward over Stenson's duct. Infra-orbital. Transverse facial. Preserve facial veins as far as possible. Facial vein beginning below the orbit posterior to the facial artery curves under the mandible passing through the platysma muscle. Muscles below the mouth are as follows: Levator menti. Depressor anguli oris. Depressor labii inferiorls Expose mental foramen from external surface of the mandible as well as the nerve and artery passing through it. DISSECTOR IN ABSTRACT. HEAD AND NECK. 337 NECK Carry skin incision from the mandible to the suprasternal notch. Extend second incision along- clavicle to acromion process. Remove the skin from within outward, preserving the platysma myoides. Platysma myoides muscle covers the en- tire region of the neck from the face to the clavicle. Remove the platysma muscle, preserving the nerve supply which is found un- derneath. This will expose the stern- ocleidomastoid and trapezius which are found after the removal of the superficial cervical fascia. Veins, external and anterior jugular and facial, are the first structures of im- portance seen in this region. Trace them from above downward as they dip into the fascia above the clavicle into the thorax. The following two , muscles form the principal boundaries of the triangles of the neck and must be preserved: Sternocleidomastoid muscle from the mastoid process to the stern- um and clavicle. Trapezius from the occiptal bone to the clavicle. Superficial nerve should also be pre- served. Locate the hyoid bone, preserving all of the muscles leading to it. Submaxillary gland internal to the angle of the mandible can now be exposed. Digastric runs forward toward the chin and backward to the mastoid process. The sternohyoid and omohyoid pass downward. The stylohyoid passes upward to the styloid process of the temporal bone. The mylohyoid passes outward to the mandible. The sublingual gland is found immedi- ately above the lateral muscle on the internal surface of the mandible, an- terior to the submaxillary gland un- derneath the side of the tongue. Preserve the following arteries: Com- mon carotid, external carotid with its 8 branches (see Abstract. Page 102), 338 DISSECTOR IN ABSTRACT. Fig. 61. Landmarks on Neck and Shoulders. (Cunningham.) HEAD AND NECK. 339 the internal carotid as it passes up- ward to the base of the skull. Veins are the Internal jugular with its tributaries passing downward to the base of the neck, where it is joined by the super- licial jugular veins mentioned above. Nerves: Pneumogas trie. Glossopharyngeal. Spinal accessory. Cervical sympathetic with the cervical ganglia. Recurrent laryngeal nerve. Phrenic. Subclavian vein and artery as they pass over the first rib back of the clavicle may now be seen. Bound triangles of neck and study con- tents. (See Abstract, Page 93.) Scalenus anticus muscle between sub- clavian artery and vein attached to the first rib. Thyroid axis with its 3 branches. Vertebral artery as it passes upward to enter the vertebral foramen of 7th cervical vertebrae. Internal mammary artery from inferior surface of the subclavian should be located as it passes into the thorax. Note: Sternomastoid and trapezius muscles should be severed in the cen- ter and deflected so as to expose the deep structures. Observe muscles of deep region of the neck as follows: (See Abstract, Page 71, Group 7 and 8). Name these muscles. While exposing the muscles, carefully observe the nerves leaving the inter- vertebral foramen bifurcating to form the anterior and posterior cervical trunks distributed to the muscles of the neck. The brachial plexus of nerves, which is formed from the anterior trunks, be- ginning with the fifth cervical verte- bra, must be carefully preserved for the benefit of the class dissecting the upper extremity. These nerves pass underneath the clav- icle, toward the shoulder joint. 340 DISSECTOR IN ABSTRACT. Fig. 62. Dissection of the Head. (Gray.) 1. Dissection of scalp. 2, 3. Of auricular region. 4, 5, 6. Of face. 7,8. Of neck. Fig. 63. Section Through the Temporo- MandibUlar Joint. HEAD AND NECK. 341 Fig. 64. Anterolateral Region of the Skull. (Gray.) Internal Wall of Orbital Cavity and Muscular Attachments. 342 DISSECTOR IN ABSTRACT. 1. Frontal muscle. 2. Occipital muscle. 3, 3. Epicranial aponeurosis. 4. Temporal muscle. 5. Retrahens aurem. 6. Orbicularis palpebrarum. 7. Levator albii superioris et alaeque nasi. 8. Dilator naris. 9. Compressor naris. 91. Pyramidalis nasi. 10. Zygomatic minor. 11. Zygomatic major. 12. Masseter. 13. Levator anguli oris. 14. Levator labii superioris. 15. Orbicularis oris. 16. Buccinator. 1 61. Depressor anguli oris. 17. Depressor labii inferioris. 18. Levator labii inferioris. 19. Sterno-mastoid. 20. Trapezius. 21. Digastric and stylo-hyoid. 22. Anterior belly of digastric. 23. Pulley for tendon of digastric. 2 4, 24. Omo-hyoid. 25. Sterno-hyoid. 26. Thyro-hyoid. 27. Mylo-hyoid. 28. Splenius capitis. 29. Splenius colli. 30. Levator anguli scapulae. 31. Scalenus posticus. 32. Scalenus anticus. Fig. 65. HEAD AND NECK. 343 Fig. 65. Muscles of the Face and Neck. (Eckley.) 344 DISSECTOR IN ABSTRAST. Fig. 66 1. Right anterior cerebral. 2. Internal carotid. 3. Right posterior cerebral. 4. Occipital. 5. Princeps cervicis. 6. External carotid. 7. Superficial branch of princeps cervicis. 8. Deep branch, 9. Ascending cervical. 10. Deep cervical. 11. Superficial cervical. 12. Transverse cervical. 13. Posterior scapular. 14. Acromial branch. 15. Subscapular branch. 16. Supraspinous branch. 17. Anterior circumflex. 18. Infraspinous branch. 19. Posterior circumflex. 20. Long thoracic. 21. Subscapular. 22. Dorsal scapular. 23, Infrascapular. 24. Subscapular. 25. Left anterior cerebral. * 26. Anterior communicating. 27. Posterior communicating. 28. Left posterior cerebral. 29. Basilar. 30. Anterior spinal. 31. Vertebral. 32. Facial. 3-3. Lingual. 34. Superior thyroid. 35. Inferior thyroid. 36. Common carotid. 37. Thyroid axis. 38. Superior intercostal. 39. Innominate. 40. Superior intercostal. 41. Left common carotid. 42. Left subclavian. 43. Short thoracic. 44. Internal mammary. 45. Anterior intercostal. 46. First aortic intercostal. 47. Second aortic intercostal. 48. Anterior intercostal. 49. Third aortic intercostal. " . . HEAD AND NECK. 345 Fig. 66. The arterial circulation from the arch of the aorta, upper extremity, neck, head and brain, showing the two routes for the blood to the circle of Willis. 346 DISSECTOR IN ABSTRACT. Fig. 67. A Diagram of the Sinuses of the Skull, Vertical-Antero-Posterior. ( Haynes.) 1. Superior longitudinal. 2. Inferior longitudinal. 3. Straight. 4. Lateral. 5. Cavernous. ■6. Superior petrosal. 7. Inferior petrosal. ■8. Internal jugular vein, formed below the skull by the junction of the inferior petrosal and lateral sinuses. 9. Right and left veins of Galen. 10. Common vein of Galen. 11. Occipital. 12. Foramen magnum. 13. Jugular foramen. HEAD AND NECK. 347 Fig. 68. A Diagram of the Sinuses at the Base of the Skull. (Haynes.) 1. Cavernous. 2. Superior petrosal. 3. Inferior petrosal. 4, 5. Lateral. 6. Circular. 7. Transverse (more of a plexus). 8. Communicating between the lateral and 9. Occipital sinuses. 10. Foramen magnum. DISSECTOR IN ABSTRACT. HEAD AND NECK. Fig. 69. The Common Carotid, the External and Internal Carotid and the Subclavian Arter- ies of the Right Side and Their Branches. (Morris.) (From a dissection by Dr. Alder Smith in the Museum of St. Bartholomew's Hospital.) 350 DISSECTOR IN ABSTRACT. REGION OF THE TONGUE. The head should be thrown well back over a block under the shoulders. Wharton's duct, leading from the sub- maxillary gland, and Rivinus and Bartholin ducts, leading from the sub- lingual gland, should be preserved and traced to the orifices of termination in the mucous membrane near the fren- um. Carefully dissect out the following muscles attached to the tongue (Ab- stract, Page 69), tracing their origin, insertion and nerve supply: Geniohyoglossus. Hyoglossus. Chrondroglossus. Palatoglossus. Styloglossus. Lingualis, or tongue. Hypoglossal nerve, which supplies the 4 muscles in this group, should be traced back into the deep structures of the neck, where it makes its exit through the base of the skull. The tongue itself, known as the lingu- alis muscle, should be carefully out- lined. (See Abstract, Page 167.) Carefully study at this point the nerve supply to tongue. (See Abstract, Page 168.) The muscles of mastication should again be carefully studied, outlining the in- ternal and external pterygoid, muscles which are between the mandible and pterygoid process of the sphenoid bone and come into view at this point of the dissection. HEAD AND NECK. 351 Fig. 70. Salivary Glands With Their Ducts. (Gray.) . Arteries and veins of the tongue, viewed from the right side. (Testut.) Fig. 71. The Tongue. 352 DISSECTOR IN ABSTRACT. 1. Tendon of Zinn. 2. External rectus divided. 3. Internal rectus. 4. Inferior rectus. 5. Superior rectus. 6. Superior oblique. 7. Pulley for superior oblique. 8. Inferior oblique. 9. Levator palpebrae superioris. 10, 10. Its anterior expansion. 11. Optic nerve. Fig. 72. ORBITAL CAVITY AND CONTENTS. In studying the orbit, refer to Page 154. For the muscles of this region see Pages 64 and 65. For description of the orbital wall see Page 54 and Fig. 64. HEAD AND NECK. 353 Fig. 72. Muscles of the Eye. (Eckley.) 354 DISSECTOR IN ABSTRACT. 1. Optic nerve. 2. Sclera. 3. Cornea. 4. Spaces of Fontana. 5. Choroid. 6. Ciliary muscle. 7. Ciliary processes. 8. Iris. 9. Retina. 10. Jacob's membrane. 11. Anterior chamber. 12. Posterior chamber. 13. Pupillary area. 14. Aqueous humor. 15. Hyaloid membrane. 16. Canal of Stilling. 17. Canal of Petit. 18. Vitreous humor. 19. Capsule of the lens. 20. Fluid of Morgagni. 21. Lens. Fig. 73 HEAD AND NECK. 355 Fig. 73. Antero-I'osterior Section of Eye-Ball. (Leveille.) (Ball.) 356 DISSECTOR IN ABSTRACT. I. External ear. 2. Middle ear. •3. Internal ear. 4. Pinna. 5. Helix 6. Antihelix. 7. Fossa navicularis. 8. Fossa innominata. 9. Tragus. 10. Antitragus. 11. Concha. 12. Lobe. 13. Meatus auditorius externus. 14. Tympanic membrane. 15. Promontory. 16. Foramen rotundum. 17. Posterior wall of the tympanum. 18. Ossicula auditus. 19. Eustachian tube. 20. Narrow canal. 21. Vestibule. 22. Semicircular canals, the superior, posterior and horizontal. 23. Ampullae. 24. Cochlea. 25. Prominence caused by the scala vestibuli. 26. Scala tympani. Fig. 74. HEAD AND NECK. 357 Fig. 74. External, Middle and Internal Ear. (Boenning.) For description of ear, see Pages 59, 60- 1-2-3-4-5. 358 DISSECTOR IN ABSTRACT. 1. Superior turbinated bone. 2. Middle turbinated bone. 3. Nasal septum. 4. Inferior turbinated bone. 5. Posterior ethmoidal cells. 6. Superior meatus. 7. Middle meatus. 8. Antrum of Highmore. 9. Inferior meatus. Fig. 75. NASAL CAVITY. For description, see Anatomy, Page 165. For description of bony wall, see I'age 52. HEAD AND NECK. 359 Fig. 75. Coronal Section Through Nasal Fos- sae; Anterior Half of Section Viewed From Be- hind. (Cunningham.) 360 DISSECTOR IN ABSTRACT. LARYNX. Study carefully Abstract, Pages 193-4. For description of larynx, study Pages 195-6. For muscles of larynx, study Pages 69-70. Soft palate. (See Abstract, Page 179.) For description of muscles, see Page 70. Fig. 76. Mesial Section Through Larynx to Show the Outer Wall of the Right Half. (Cun- ningham.) The 70,000 mark has been reached List of Abstracts 1. Anatomy and Dissector (81 Illustrations) 5. L. McCurdy, M.D. 2. Physiology . . F. ,/L Rhodes, M.D. 3. Chemistry .... John Inglis, M.D. 4. Materia Medica . Chas. A. Orr, M.D. 5. Histology (Illustrated) (New) A. B. Wallgren, M.D. 6. First Aid to the Sick and injured (Illustrated) S. L. McCurdy, M.D. 7. Diagnosis . . H. P. Kohberger, M.D. 8. Obstetrics . . . Wm. D. Inglis, M.D. 9. Medicine . . . H. P. Kohberger, M.D. 10. Gen. U. and Ven. . T. L. Disque, M.D. I I. Dermatology . W. H. Robinson, M.D. 12. Visceral Surgery . Acheson Stewart, M.D. 13. Arthrosteopedic Surgery S. L. McCurdy, M.D. 14. Pathology . . . A. B. Wallgren, M.D. 15. Bacteriology (Illustrated) (New) A. B. Wallgren, M.D. DISSECTOR IN ABSTRACT. HEAD AND NECK. Fig. 77. Schematic Drawing of the Fifth Nerve. (Potter.) DISSECTOR IN ABSTRACT. HEAD AND NECK. Fig. 78. Diagram Showing the Areas of Distribution of Cutaneous Nerves. (Morris.) 366 DISSECTOR IN ABSTRACT. G. Glabella. 0. Inion. M. Mid-point between G and 0. T. Mid-point between M and O. S. Mid-point between T and O. E. External angular process. P. Root of zygoma (pre-auricular point). N. Mid-point of EP. R. Mid-point of PS. C. Mid-point of AB. CD is drawn parallel to AM. Z. Post-auricular point. VW. Guide to anterior limit of lateral sinus. Y. Mastoid antrum. *1. Site at which subarachnoid space may be opened. *2. Site for draining lateral ventricle (Kocher). *3. Site for draining lateral ventricle (Keen). Fig. 79. HEAD AND NECK. 367 Fig'. 79. Cranio-Cerebral Topography. (Cunningham.) Shows Relations of the Motor and Sensory Areas to the Convolutions and to Chiene's lines. 368 DISSECTOR IN ABSTRACT. 1. Olfactory bulb. 2. Optic nerve. 3. Anterior perforated space. 4. Optic tract. 5. Crus cerebri. 6. Third cranial nerve. 7. Fourth nerve. 8. Fifth nerve. 9. Sixth nerve. 10. The pyramid. 11. Olivary body. 12. Vertebral artery. 13. Anterior spinal artery. 14. Anterior cerebral artery. 15. Optic chiasm. 16. Middle cerebral artery. 17. Infundibulum. 18. Corpora albicans. 19. Posterior perforated space. 20. Posterior cerebral artery. 21. Subcerebellar. 22. Pons Varolii. 23. Anterior cerebellar. 24. Seventh and eighth nerves. 25. Ninth, tenth and eleventh nerves. 26. Twelfth nerve. 27. Cerebellum. Fig. 80. HEAD AND NECK. 369 tig. 80. Under Surface of the Brain, Show- ing the Origin of the Twelve Cranial Nerves and the Circle of Willis. (Young ) 370 DISSECTOR IN ABSTRACT. i'ig. 81. Diagrammatic Representation of the Roots and Ganglia of the Spinal Nerves, Show ing Their Position in Relation to the Spinal Column. The Nerves Are Shown as Thick Black Lines on the Left Side. (Cunningham.) INDEX Abdomen. cross section of, 307. incisions, 295. landmarks, 298. muscles of. 77, 294, 297, 299, 301. regions of, 184. Abdominal aorta, 106. Agminated glands, 170. Alimentary canal, 168. Antrum of High- more, 43. Aorta, 101, 324. Arachnoid, 117. Artery, axillary, 105. basilar, 104. carotid, 103, 345. celiac axis, 106. femoral, 108. gastric, 106. hepatic, 106. iliac, 107. innominate, 101. Intercostal, 101. lumbar, 106. mesenteric, 106. popliteal, 108. pulmonary, 99. radial, 105. renal. 106. splenic, 106. subclavian, 104. suprarenal. 106. uterine, 107. vertebral. 104. Arteries of leg, 265, 283. thigh, 275. thorax, 314. upper extremity, 241. Articulations, 57. Auditory canal, 34. Bone, classification of, 3. atlas, 8. axis, 8. clavicle, 10. coccyx, 9. ethmoid, 39. femur, 20. fibula, 23. of foot, 23. frontal, 28. humerus, 11. hyoid, 5. ilium, 17. innominate, 16. ischium, 17. lachrymal, 44. mandible, 47. malar, 40. maxilla, 42. nasal, 40. occipital, 29. palate, 45. parietal, 31. patella, 21. pubis, 17. radius, 13. ribs, 6. sacrum, 9. scapula. 10. sphenoid, 36. spine, 7. sternum, 5. temporal, 32. tibia, 21. turbinated, 41. ulna, 14. vomer, 46. Brain. 119, 367 369. sinuses of, 346, 347. Bronchi, 197. Canal. Hunter's, 94. inguinal, 94. Capillaries. 96. Carotid artery, 345 Cerebellum, 132. Cecum, 181. Basal ganglia, 1 25. Bladder. 205. Choroid plexus, 131. Clitoris, 214. Colon, 182. Conjunctiva, 158. Cornea, 155. Corpus callosum, 122. spongiosum, 207. striatum, 127. Corti, organs of, 164. Course of study, 222. Cowper's gland, 209. Cranium, 28. Crural arch, 272. Cystic duct, 190. of cerebellum, 132. Glaserian, 34. of liver, 188. of Rolando, 119. of Sylvius, 119. Flat bones, 4. Foramen, 1 a c e r u m me- dium, 52. lacerum poste- rius, 52. magnum, 52. of Ma j e n d i e, 137. of Monro, 124. ovale, 37. rotundum, 37. spinosum, 37. s t y 1 omastoid, 35. of Winslow, 185. Foot, land marks of, 266, 267. muscles of, 268, 269, 270. Fornix, 123. Fossa, anterior, 57. middle, 51. s p h e n omax- illary, 50. temporal. 50. zygomatic, 50. Funiculus cunea- tus, 136. gracilis, 136. of Rolando, 135. Dentine, 175. D i a p hragm, 77, 325. Dissection. instruments for, 224. rules for, 223. u p p e 1- extrem- ity, 226. Duct of Bartolin, 188. common bile, 190. ejaculatory, 213. hepatic, 189. nasal, 166. of Rivinius, 188. Stenson's, 187. Wharton's, 188. Duodenum. 180. Dura mater, 116. sinuses of, 117. Gall b 1 a d d e r, 190. Glands, lingual. 1S8. mammary. 218. parotid, 187, 351. prostate. 209. m a n d i b ul a r, 1S8. salivary, 351. thymus, 193. thyroid, 193. Glands of, Brunner's, 170. Glans penis, 210. Great sciatic nerve, 283, 292. Ear, 158, 357. appendages of, 157. Elbow, veins at, 240. Endocardium, 97. E p e n c ephalon. 129 Epiglottis, 194. Esophagus. 169. Expression, muscles of, 343. Eye, 154. muscles of, 353. Eyeball, 355. Fissure, of cerebrum, 121. Hand, lan dmarks of, 233. muscles of, 244. Head, lan dmarks of 334. Heart, ' 319, 314, 315. valves of, 98. mitral, 100. pulmonary, 99. semilunar, 100. tricuspid, 99. weight, 97. Hemispheres, cerebellar, 132. cerebral, 119. Hernia, 95. Hindbrain, 129. H i p (Posterior), 290. foot, 266, 267. hand, 233. head, 384. lower extremity. 255, 256, 258, 286. neck, 338. thorax, 318. upper extremity, 227, 228, 233. Larynx, 193, 360. Leg, 262. arteries of, 283. Ligaments, Poupart's 272. tempero - man- dibular, 340. Lips, 170. Liver, 188. Lobes of cere- brum, 119. cerebellum, 132. weight, 134. Lower extremity. d i s s e ction of, 254. landmarks, 255, 256, 260, 286. Lungs, 319. Lymphatic duct, 115. right glands, 114. Lymphatic spaces, 114. vessels, 114. valves of, 114. Ileum, 181. Incisions for dis- section of ab- domen, 295. back, 250. head, 340. lower extremity, 260, 280. upper extremity, 235. luguinal canal, 94. Interbrain, 124. Intestine, large, 181. small, 180. Meckel's diver- ticulum, 181. m e s e n tery of 185. structure of, 169. Mammary glands, 218. Medias tinum, 198, 319. Medulla oblon- gata, 135. Meibomian glands, 158. Membrana t y m- pani, 161. Meninges, 116. M e s e ncephalon, 127. Mete ncephalon, 135. Midbrain, 127. Mouth, 170. Muscles, 63. abdomen. 77, 294, 297, 299, 301. arm. 81, 247. back, 73, 251, 253. Jejunum, 181. Joints, 55. classification of, 55. ankle, 61. elbow. 59. enarthroldal, 56. of foot, 61. of hand, 59. hip, 60. knee. 60. mandible, 58. shoulder, 58. of trunk, 57. Kidneys, 201. Landmarks of abdomen, 298. dorsum of up- per extremity, 227. ear, 64. eyeball, 64, 353. face, 66, 343. foot, 89, 268, 269, 270. forearm, 81, 231, 239. hand, 84, 244. head, 63. hip (posterior), 290. larynx. 272. leg, 88, 262. leg and thigh (post.), 284, 288. mastication, 92. neck, 67, 343. orbit, 65. pelvis, 317. perineum, 79. pharynx, 69. respiration, 90. scalp, 63. shoulder. 80. thigh, 85, 273. thorax, 79, 297, 299. tongue, 69. upper extrem- ity, 241, 243. Nervous system, 116. Nose, 165. Omentuum, 185. optic thalamus, 125. Orbit, 54. Orbital cavity, 341, 352. Osteology, study of, 225. arm and thorax. 245, 249. foot, 261, 281. forearm, 229, 237. leg, 261, 267. pelvis, 274, 291. skull, 326, 335. thigh, 274, 291. vertebrae, 323. Ovary, 217. Ovum, 218. Palate, 179. Pancreas, 190, 302. Parotid gland, 351. Pelvis, 205, 316. muscles of, 317. Penis, 210. Peri cardium, 96, 321, 324. Peritoneum. 185. 302, 303. cavities, 303. posterior attach - ment, 309. Pharynx, 169. Pia mater, 118. Pleura,. 199. Popliteal space, 95. Nares, 53. Nasal aperture, 53. bone, 40. fossa, 53. oriAces in. 53. septum, 54. Nasal cavity, 358, Neck, 337. land marks of, 338. muscles of, 343. triangles of, 93. Nerves, cranial, 149. cutaneous d i s- tribution, 364, 365. Afth, 362. great sciatic, 283, 292. lumbar plexus, 311. roots of. 140. sciatic, 147. spinal, 140, 370. s y m p a thetic, 151. taste. 168. thigh. 277. tongue, 167. Rectum, 182. Ribs, 6. Rules for dissec- tion, 223. Salivary glands, 187. Sinuses of brain. 346, 347. Skull, 326-335. Spine, nerves of, 370. Spinal cord. 138. Assures of, 139. gray matter of, 139. membranes of. 138. nerve cells of, 139. nerves, of, 370. Spleen, 192. Stomach, 179, 302. Study, course of, 222. Sutures of skull, 49. Sympathetic sys- tem, 151. Ureter, 203. Urethra, 207. Uterus, 215. Vagina, 215. Valve of Vieus- sens, 134. Valvula c o n n i- ventes, 170. Veins or vein, hepatic, 189. portal, 112. subclavian, 111. valves of, 113. Vena cava, 111, 302. Ventricles, cere- bral, fourth, 136. lateral, 123. third, 124. Ventricles of heart, 99. Vermiform appen- dix, 181. Vertebra, 7, 323. cervical, 8. coccygeal, 9. dorsal, 8. lumbar, 8. number of, 7. sacral, 9. typical, 6. Viscera, abdominal, 324, 303, 304. thoracic, 321, 324. Vocal cords, 195. Vulva, 214. Teeth, 171. Testes, 210. Temper oman- dibular 1 i g a- ment, 340. Thigh, arteries of, 275. muscles of, 273. nerves of, 277. Thoracic duct, 114. Thorax, 318. arteries of, 312. boundaries, 318. landmarks, 318. muscles, 297, 299. Tongue, 167, 350, 351. Tonsils, 179. Trachea, 196. Triangles, 93. Upper extremity, 226. arteries of, 241. d i s s e c tion of, 226. land marks of, 227, 228, 233. nerves of, 241, 243. Willis, circle of, 345.