PRACTICAL 
Human Anatomy 
A 
WORKING-GUIDE FOR STUDENTS OF MEDICINE 
AND A 
READY-REFERENCE FOR SURGEONS AND PHYSICIANS 
FANEUIL D. WEISSE, M.D. 
BY 
PROSECTOR (1863 TO 1865) TO THE LATE VALENTINE MOTT, M.D., LL.D., EMERITUS PROFESSOR OF 
SURGERY AND SURGICAL ANATOMY, MEDICAL DEPARTMENT OF THE UNIVERSITY 
OF THE CITY OF NEW YORK. 
PROFESSOR OF PRACTICAL AND SURGICAL ANATOMY, MEDICAL DEPARTMENT OF THE UNIVERSITY 
OF THE CITY OF NEW YORK. 
PROFESSOR OF ANATOMY, NEW YORK COLLEGE OF DENTISTRY. 
ILLUSTRATED BY 222 LETTERED PLATES, CONTAINING 321 FIGURES. 
NEW YORK 
WILLIAM WOOD & COMPANY 
56 and 58 Lafayette Peace 
1886 Copyright, 1886, by 
WILLIAM WOOD & COMPANY 
TROW'S 
PRINTING AND BOOKBINDING COMPANY, 
NEW YORK. ZO 
JOHN A. WEISSE, M.D. 
MY FATHER, 
THIS WORK IS DEDICATED 
WITH THE WARMEST FILIAL AFFECTION, AND A DEEP SENSE OF GRATITUDE 
FOR HIS PERSONAL GUIDANCE OF MY EDUCATION. PREFACE. 
This work was commenced with a desire—after an ex- 
perience of nearly twenty years in study, actual dissections, 
and the teaching of anatomy—to produce a practical working- 
guide for the student at the cadaver, and a ready-reference 
book, which would take the place of the cadaver, for prac- 
titioners of surgery and medicine. 
The plan of the work embraces the following points : 
1st, the division of the body into ‘practical dissections ; 
2d, the giving, in dissection-paragraphs, the progressive 
steps by which the several parts, involved in a dissection, are 
to be systematically displayed ; 
3d, the guidance, by lines across the parts in the Plates— 
called section-lines—to the points where they are to be cut, 
for their reflection, in order to advance to a succeeding stage 
of the dissection ; 
4tli, the indication, by numbering the parts of the dissec- 
tions, of the order in which they are exposed ; 
5th, the description of the parts, in descriptive-anatomy 
paragraphs, as they are brought into view ; 
6th, the adherence, in expressing the relations of parts, to a 
well-defined nomenclature of general and special anatomical 
terms ; 
7th, the illustration of the anatomy of the regions and vis- 
cera of the body by Plates, with the names of the parts printed 
upon them or at the sides of the Figures with indicating 
lines to them—the dead-anatomy is thus presented to the 
student, and the living-anatomy to the surgeon and physician. 
The dissections have been planned, as far as practicable, to 
give all the attachments of included muscles. 
Each dissection has been completely described and illus- VI 
PREFACE. 
trated, irrespective of the contiguous dissections upon which it 
may encroach. 
The bones of the body have not been described in detail; 
their practical relations to the anatomical elements of the sev- 
eral dissections are shown in the Plate illustrations of their 
surfaces with the areas they afford for muscle attachments; 
together with their presentation in the progressive steps of the 
dissections. 
The attachments of muscles are given without any distinc- 
tion as to their being the origin and insertion of the same ; 
it is more natural and clear to enumerate the attachments 
only. 
The illustrations include the following : 
153 full-page, original, Plates ; 
51 Plates, of 132 original Figures ; 
6 full-page Plates selected from standard authors ; 
9 Plates, of 25 Figures selected from standard authors ; 
Plate 56, of one original and two selected Figures ; 
Plate 66, of one original and one selected Figure ; 
15 original text Figures. 
The original Plates and Figures were sketched and drawn 
by Mr. Maximilian Cohn from dissections by the author. 
The illustration and description of the complete distribution 
of the sympathetic nervous system, and of the lymphatic sys- 
tem, have not been given, as they do not come within the scope 
of the work. The dissection of the globe of the eye, and of the 
auditory apparatus have been omitted. 
No reference has been made to surgical and medical or ap- 
plied anatomy, as it is deemed best to do one thing at a time. 
Moreover, the systematic mastery of the anatomy of the body 
places one in a position to make practical applications of the 
same, to the elucidation of surgical, medical, and obstetrical 
problems; and to read, appreciatively, the special works on 
surgical and medical anatomy. 
That which can be demonstrated to the unaided eye is the 
province of anatomy ; therefore, the structure of parts, requir- 
ing the aid of the microscope, lias not been alluded to, as it 
belongs to Histology. 
The practitioner of surgery and medicine, in the absence of 
a cadaver to refer to, has been much in need of illustrations 
of anatomy, that would present him a progressive series of PREFACE. 
vii 
dissections of a region or organ about which he desired in- 
formation. To meet this want has been one of the aims in the 
preparation of this work, special attention having been given 
to those regions and organs which claim frequent surgical and 
medical care. To this end also the Contents and Index have 
been so elaborated as to facilitate the finding of the Plate 
illustrations and text descriptions of any part. 
Too much cannot be said in praise of the comparatively 
wonderful artistic skill displayed by Mr. Maximilian Cohn, in 
his faithful reproductions of nature, given us in the Plates and 
Plate Figures ; and the clearness of his lettering of the same. 
The illustrations are photographic in their representations of 
nature, and are works of art in themselves. 
Thanks are due to the Moss Engraving Co. for the care 
which has been bestowed upon the plioto-engraving and the 
printing of the Plates. 
Nature has been the text-booh, to which reference has 
always been made ; but, a due respect for the labors of our 
fathers and of our contemporaries has been kept in view. 
The original intention was to illustrate this work by selec- 
tions from the illustrations of standard authors, simply adapt- 
ing and lettering the same to fulfil our purpose. After having 
carried out this scheme to the extent of some 300 plioto-Plates 
and 150 electrotypes, the plan was abandoned, because it was 
found impracticable to accomplish the object of the work 
therewith, and the cadaver was resorted to. 
Errors and omissions, no doubt, may be found in the text 
and Plates, but should any, of whatever nature, appear to a 
reader, his personal communication of the same to the author 
will be regarded as a kindness. 
The manifold difficulties and disappointments that have 
been met with, in the evolution of this volume, are only for a 
private ear. The desired end will have been attained, if the 
fruits borne of years of time, thought, and labor are: that 
it enables the student of medicine to acquire, more readily and 
thoroughly, a knowledge of human anatomy ; and proves a 
companion to the surgeon and the physician, to keep them in 
mind of the practical facts of anatomy. 
51 West 22d Street, 
New York City, December, 1885. CONTENTS AND ILLUSTRATIONS. 
INTRODUCTION. 
Plates 1 to 4, inclusive Pages 1-12 
FIRST DISSECTION. 
Male Perineum. 
Plates 5 to 12 inclusive Pages 13-28 
SECOND DISSECTION. 
Female Perineum. 
Plates 13 to 20, inclusive Pages 29-42 
THIRD DISSECTION. 
Antero-lateral Areas of the Abdominal Parietes. 
Plates 21 to 28, inclusive Pages 43-54 
FOURTH DISSECTION. 
Abdominal Viscera in Situ. 
Plates 29 to 38, inclusive Pages 55-72 
FIFTH DISSECTION. 
Abdominal and Pelvic Interiors. 
Plates 39 to 46, inclusive Pages 73-84 
SIXTH DISSECTION. 
Abdominal Viscera out of the Body. 
Plates 47 to 54, inclusive Pages 85-94 
SEVENTH DISSECTION. 
Male Pelvic Viscera out of the Body. 
Plates 55 and 56 Pages 95-100 
EIGHTH DISSECTION. 
Female Pelvic Viscera out of the Body. 
Plates 57 and 58 Pages 101-106 X 
CONTENTS AND ILLUSTRATIONS. 
NINTH DISSECTION. 
Anterior of Thigh. 
Plates 59 to 66, inclusive Pages 107-122 
TENTH DISSECTION. 
Anterior of Leg and Dorsum of Foot. 
Plates 67 to 74 inclusive Pages 123-132 
ELEVENTH DISSECTION. 
Plantar Region of the Foot. 
Plates 75 to 82, inclusive Pages 133-150 
TWELFTH DISSECTION. 
Posterior Region of the Leg and the Popliteal Space. 
Plates 83 to 90, inclusive Pages 151-162 
THIRTEENTH DISSECTION. 
Gluteal Region and Posterior Region of the Thigh. 
Plates 91 to 100, inclusive Pages 163-176 
FOURTEENTH DISSECTION. 
Articulations of Ankle, Foot, Leg, Knee, and Hip. 
Plates 101 to 112, inclusive Pages 177-192 
FIFTEENTH DISSECTION. 
Anterior of Thorax, Axilla, and Arm. 
Plates 113 to 120, inclusive, Pages 193-206 
SIXTEENTH DISSECTION. 
Anterior of Elbow, Forearm, and Hand. 
Plates 121 to 134, inclusive Pages 207-236 
SEVENTEENTH DISSECTION. 
Anterior of the Thoracic Parietes ; Thoracic Viscera in 
Situ ; Interior of the Thoracic Cavity. 
Plates 135 to 140, inclusive Pages 237-250 
EIGHTEENTH DISSECTION. 
Viscera of the Thorax out of the Body. 
Plates 141 to 146, inclusive Pages 251-264 CONTENTS AND ILLUSTRATIONS. 
XI 
NINETEENTH DISSECTION. 
Region of the Back; Spinal Coed in Situ; Vertebral Col- 
umn and its Ligaments. 
Plates 147 to 156, inclusive Pages 265-286 
TWENTIETH DISSECTION. 
Anterior Scapular Muscles ; Posterior of Shoulder and Arm. 
Plates 157 to 162, inclusive Pages 287-294 
TWENTY-FIRST DISSECTION. 
Posterior of Elbow, Forearm, Hand, and Digits. 
Plates 163 to 170, inclusive Pages 295-308 
TWENTY-SECOND DISSECTION. 
Articulations of Hand, Elbow, Forearm, and Shoulder. 
Plates 171 to 176, inclusive Pages 309-316 
TWENTY-THIRD DISSECTION. 
Scalp; Vertex Portion of the Membranes of the Brain; 
Interior of the Base of the Cranium. 
Plates 177 to 180, inclusive Pages 317-326 
TWENTY-FOURTH DISSECTION. 
Superficial Region of the Face ; Orbital Cavity ; Middle 
Fossa of the Cranium ; Deep Region of the Face. 
Plates 181 to 188, inclusive Pages 327-354 
TWENTY-FIFTH DISSECTION. 
Antero-lateral Areas of the Neck. 
Plates 189 to 198, inclusive Pages 355-376 
TWENTY-SIXTH DISSECTION. 
Arteries and Nerves Contiguous to the Pharynx ; Pharynx ; 
Soft and Hard Palate; Tongue and Contiguous Parts; 
Larynx ; Nasal Cavities and Contiguous Parts. 
Plates 199 to 210, inclusive Pages 377-408 
TWENTY-SEVENTH DISSECTION. 
Arteries of the Brain ; Exterior of the Cerebrum ; Parts 
of the Brain. 
Plates 211 to 222, inclusive Pages 409-432 SOURCE OF SELECTED ILLUSTRATIONS. 
Plate 3 : Figs. 1, 2, and 3 , Bourgery. 
“ 4 : Figs. 1 and 2 Bourgery. 
“ 23 Hirschfeld. 
“ 26 Hirshfeld. 
“ 31: drawn from and modified Jamain. 
“ 33 : drawn from Sappey. 
“ 43 Bourgery. 
“ 45 : Figs. 1 and 2 .Bourgery. 
“ 47 : Figs. 1, 2, 3, 4, 5, and 6 Bonamy. 
“ 49 : Fig. 1 Bonamy. 
“ 49 : Fig. 2. Drawn from Jamain. 
“ 50 : Figs. 1 and 2 Bonamy. 
“ 53 : Figs. 1 and 2 Bonamy, 
“ 54 : Figs. 1, 2, 3, and 4 Bonamy. 
Figs. 1 and 2 of Plate 56 Bonamy. 
“ 58 : Figs. 1 and 2 Bonamy. 
Fig. 2 of Plate 66 Bourgery. 
“ 76 : modified Bourgery. 
“ 84 : modified Bourgery. 
“ 92 : modified Bourgery. PRACTICAL HUMAN ANATOMY. 
INTRODUCTION. 
It is, for the following reasons, of the greatest importance 
that the dissector read this introduction, carefully, before com- 
mencing his dissections: first, that he may be prepared to use 
this work to the greatest possible advantage ; second, that he 
may have a general appreciation of the anatomical elements 
that he is to meet with ; third-, that he may obtain a general 
idea of how to dissect the several parts which enter into the 
make-up of the body; fourth, that he may know the relative 
importance of the parts exposed in a given dissection, and 
thereby be guided, as to which to preserve and which to cut 
aivay, as he progresses. 
WORKING PLAN. 
Dissector’s Use of tills Work.—The following course should 
be pursued with a given dissection : first, read, consecutively, 
the numbered descriptive-anatomy paragraphs (in large type), 
referring to the Plates as directed therein ; second, read, con- 
tinuously, the dissection paragraphs (in small type), referring 
to the Plates as indicated therein ; third, dissect in strict ac- 
cordance with the directions given in the dissection paragraphs ; 
fourth, verify dissections by the Plates and by the text of the 
descriptive-anatomy paragraphs. 
Plate References.—When a given Plate, say 51, is referred 
to in a descriptive-anatomy paragraph heading, the dissector 
is to continue to work with Plate 51, until another Plate or 
other Plates, say 52, or 55, 57, and 59, is or are deferred to, 2 
INTRODUCTION. 
in a subsequent descriptive-anatomy paragraph heading ; then, 
it or they become the Plate or Plates to be worked with. 
Of Right and Left Parts.—In the dissection and descrip- 
tive-anatomy paragraphs, and in the Plates, only the parts of 
one side are referred to or illustrated ; the dissector must 
make the necessary transposition, which his dissection may 
require. 
Section Lines on tlic Parts.—Particular attention is called 
to the Mach lines crossing parts in the plates ; they indicate 
the points where parts are to be sectioned, that the same may 
be reflected. A part is only to be sectioned, at that stage of 
the dissection, where it is so directed in a dissection par- 
agraph ; if parts are sectioned out of order, it leads to in- 
completeness in the work done. Dissection directions will 
sometimes state that muscles, etc., are to be reflected, while in 
the Plate, worked by, they are cut short or even cut away. 
The dissection directions are to be followed without regard to 
the Plates; the latter are drawn to show parts to the best 
advantage. 
Reproduction of Plates.—In using the Plates as guides to 
dissection, it must not be supposed by the dissector that he is 
to reproduce them severally on the subject. They are to be 
referred to as indicated in the descriptive anatomy and dissec- 
tion paragraphs. The same part may appear in several Plates, 
from different points of view, but, collectively, they afford a 
clearer idea of the part, and its relations, than could be given 
in a single Plate. 
Abnormalities.—In the descriptive-ana tomy paragraphs no 
references are made (o abnormalities; for these, one of the 
standard text-books on descriptive anatomy may be consulted. 
The Plates present the normal anatomy. 
Terms of Relation.—The general terms used in describing 
the relations of parts in the dissections, are as follows : an- 
terior and 'posterior, refer to those surfaces of the body, re- 
spectively ; superior and inferior, as toward the head or feet; 
external and internal, relatively to the median line of the INTRODUCTION. 
3 
body. Special terms, applicable to special dissections, will be 
given in their proper places. 
DISSECTING INSTRUMENTS. 
Dissecting Instruments, Plate 1.—Experience has proved, 
that the following instruments, etc., will meet all the wants of 
the dissector, and in some respects, better than the contents of 
the conventional dissecting case : a pair of modified Coxeter 
forceps, two scalpels, a pair of sharp-pointed curved scissors, 
chain-hooks, thumb-pins, clasp-pins, two probes, and a scalpel 
strop. As contained in their case (1), they fulfil the ends of 
compactness, usef ulness and economy. 
Forceps.—The forceps (2) is the “ Coxeter forceps,” modified 
by having its head cut square across, so that, when the closed 
blades are held in the hand, it may be used to strip muscles 
apart, etc. 
Scalpcl§.—Each scalpel has a thick handle; a portion of 
the blade forms a shank to the knife, which strengthens the 
instrument, facilitates its manipulation, and limits its cutting 
portion to its available edge. One of the scalpels (8) has a 
rounded end, and a very convex cutting edge, which continues 
to the end of the blade ; this scalpel is adapted for coarse 
work, such as reflecting flaps of skin, etc., and clearing fas- 
ciae and muscles. The pointed scalpel (4) has a very convex 
cutting edge, and is intended for delicate work on nerves and 
vessels. These two knives will fulfill all the requirements of 
dissection. 
Curved Scis§ors.—The sharp-pointed curved scissors (5) pre- 
sents nothing peculiar. As an instrument for the dissector, it 
should be much more used than it is; after a little practice, it 
can with great advantage, in many instances, be made to take 
the place of the scalpel. As a scissors, it answers all the needs 
of a straight pair. 
Chain-Hooks.—The chain-liooks (6) have blunt points, and 
the chain is very strong. 
Thread.—The dissector should provide himself with coarse 
linen thread, and a needle for the same. Flaps may be advan- 4 
INTRODUCTION. 
tageously reflected by threads tied into perforations at their 
borders. Loops of thread passed around vessels, nerves, etc. 
—with their ends tied—will be found useful in holding them off. 
Probes.—These (7) are used to demonstrate ducts, vessels, 
sheaths of tendons, etc. 
Scalpel Strop.—This (8) will be found very convenient ; 
one’s knife is continually dulled, while dissecting; but a few 
passes of the scalpel over the strop will sharpen it. 
A saw, chisel, hammer and hook, costotome, intestine scis- 
sors, etc., required by the dissector, constitute a part of the 
furniture of a practical anatomy room. 
GENERAL RULES FOR DISSECTION. 
Division of a Cadaver.—A cadaver may be divided into sec- 
tions to be worked by five, six, or eight dissectors. A body 
assigned to five, one takes the head and neck, two take the 
upper extremities and thorax, and two the lower extremities, 
the pelvis, and the abdomen. A subject, apportioned to six, 
one works the head and neck, one the trunk (thorax, abdomen, 
and pelvis), two work the upper extremities, and two the lower 
extremities. A body, dissected by eight, there will be two to 
the head and neck, two to the trunk (thorax, abdomen, and 
pelvis), two to the upper extremities, and two to the lower ex- 
tremities. 
Object of Dissection—The object of dissection is to sepa- 
rate parts, not to cut them. With the separation of parts is 
included the removal from their surfaces of fibrous tissue of 
investiture—as membranes, areolar tissue, fasciae, inter-mus- 
cular septa, and vessel-slieaths. 
Rules for Dissection.—There are three rules to be followed 
to make a good dissector : 
First.—Know what you are to tool'for. This knowledge is 
attained by having previously read a description of the parts 
to be found in a given region. 
Second.— Work slowly and thoroughly. To fulfil this rule, 
do not allow yourself to work without system or method, but 
follow the progressive steps of a given dissection, as laid down 
in the book, which you have selected to guide you. INTRODUCTION. 
5 
Third '.—Never let your knife cut when you do not know what 
it is about to divide. 
Review of a Dissection.—When finishing work replace 
parts, as nearly as possible, in their normal relations, so that 
on resuming work, they may be removed in their relative 
order ; this affords repeated reviews of a dissection. 
How to Keep a Dissection.—Re-apply skin flaps ; lay on 
the part the refuse tissue from the dissection ; cover with a 
dampened piece of muslin ; and, outside of all, wrap a piece of 
dry muslin or oil-silk. 
SPECIAL RULES OF DISSECTION. 
Anatomical Elements.—By an anatomical element, borrow- 
ing the term from chemical nomenclature, is to be understood 
a structural part of the body, such as the skin, a muscle, etc. 
The anatomical elements entering into the construction of the 
regions of the body are: epidermis, skin, subcutaneous tis- 
sue, superficial fascia, intermuscular septa, muscles, bur see, 
synovial slieatlis of tendons, deep fascice, arteries, veins, 
lymphatic vessels, lymphatic glands, nerves, viscera, ducts, 
mucous membrane, serous membrane, ligaments, fibro-car- 
tilages, cartilages, and bones. All these elements are not 
present in eveiy region of the body, and some are only found 
in special regions. 
Epidermis.—The epidermis or cuticle claims the respect of 
the dissector as a useful portion of the skin to him : where 
the epidermis is removed, the evaporation, that takes place, 
causes the skin and subjacent tissues to become hard, dry, and 
matted together, so as to interfere materially with dissection. 
Skin.—The skin or derma varies very much as to thickness, 
in the different regions. In making skin incisions, care should 
be taken, that the skin alone is cnt through, as subcutaneous 
vessels, nerves, and even the muscles maybe divided,and mar, 
in consequence, subsequent dissection. 
Dissection.—The position of the knife, in making an incision through the 
skin or any other membrane, should be vertical to the surface (Fig. 1, Plate 6 
INTRODUCTION. 
2); in this jiosition, the knife should be steadied, by the little finger resting upon 
the surface, and driven by the index finger at its shank; it should be drawn, 
as thus held, from the initial point to the terminus of the incision, the point 
only of the knife cutting the tissue. In reflecting flaps of skin, or other mem- 
branes (fascia, etc.), they should be commenced (Fig. 2, Plate 2) by pinching 
up the initial flap with the forceps, and incising the subcutaneous tissue, so as 
to raise the skin alone; as soon as there is sufficient flap to enable it to be 
grasped, it should be held taut in the fingers (Fig. 3, Plate 2) at about two 
inches from its attached margin ; the scalpel should be held lightly with its 
blade flat on the subcutaneous tissue, its cutting edge at a right angle to the 
skin; in this position the strokes should be made in long sweeps, never allow- 
ing the cutting edge to actually touch the skin. It is not a cutting that is 
effected, but a scratching with the edge of the knife, which parts the taut 
fibrous framework of the subcutaneous tissue, thus allowing the skin to be 
raised from the surface beneath. Never cut away a portion of reflected skin, 
as it is the best possible protective covering to dissected parts. 
Subcutaneous Tissue.—The subcutaneous tissue is more or 
less loaded with fat, and has embedded in it vessels and nerves. 
In some regions it can be split into two layers, which may be 
designated as the superficial and the deep layer of the subcu- 
taneous tissue. This nomenclature avoids the confusion, which 
arises, if the subcutaneous tissue is called superficial fascia, 
and its layers superficial and deep fascia, or superficial and 
deep layers of the superficial fascia. 
Subcutaneous Veins.—The veins, found in the subcutaneous 
tissue, occupy a superficial plane, and are distinguished be- 
cause of the dark color, imparted to them by blood clot within. 
Dissection.—The subcutaneous veins should be raised free from the tissue 
in which they are embedded, so as to lie loosely thereon. 
Subcutaneous Nerves.—The subcutaneous nerves lie in a 
plane beneath the veins, and, as a rule, contiguous to and par- 
allel with them. 
Dissection.—They'may be found by scratching through the subcutaneous 
tissue, at a right angle to the course of the nerves (Fig. 4, Plate 2) ; thus the 
subcutaneous tissue is displaced and the resistant nerve-cord becomes appar- 
ent ; once recognized, at a given point, the nerve may be raised with the for- 
ceps and stripped out from its bedding with the point of the scalpel (Fig. 5, 
Plate 2), or with scissors. Having recognized the subcutaneous veins and 
nerves, the subcutaneous tissue, as flap or otherwise, may be cut away from 
the area of the dissection region. The subcutaneous veins and nerves may be 
divided and reflected as may be directed. INTRODUCTION. 
Superficial Fascia, Fig. 1, Plate 3.—The superficial fascia 
of a region is a sheet of fibrous tissue, which covers the super- 
ficies of the muscles ; it is continuous over the whole body, 
and here and there will be seen to form special thickenings, 
annular ligaments, etc., to subserve the office of bands of pro- 
tection and inclusion, to bind down tendons, or insure firm 
packing of subjacent parts. 
Dissection.—Incisions of fascia should be made (the same as skin incisions) 
parallel with the fibres of the subjacent muscles. Flaps of fascia should be re- 
flected, the same as the skin, the strokes of the blade of the scalpel should 
be parallel with the muscle fibres (Fig. 6, Plate 2). In reflecting the fascia 
from off a group of muscles, it will be noted that, at each intermuscular space, 
a continuity of the fascia with fibrous tissue in the intermuscular space exists ; 
it is therefore necessary to cut through this fibrous tissue septum, in order to 
expose the adjacent muscle. In certain regions, the subjacent muscles are at- 
tached to the under surface of the fascia ; at these areas, no attempts should be 
made to raise the fascia, but the same may be left upon the muscle, by cutting 
the fascia at the circumference of the attached portion. Reflections of fascia 
should not be cut away. 
Intermuscular Septa, Figs. 2 and 3, Plate 3.—The inter- 
muscular septa are fibrous tissue walls, recognized above, in 
continuity with the deep surface of the superficial fascia. 
They occupy the interspaces between muscles, forming com- 
partments (Fig. 2) for their lodgement, and completely isolating 
each from the other. In Fig. 3, the intermuscular septa are 
shown in a transverse section of a limb. 
Muscles.—The voluntary muscles invest the bony frame- 
work. being attached to the bones, at both ends, so as to pro- 
duce movements at their articulations, or as in the case of the 
muscles of the face—attached to bone at one end and the skin 
at the other—to produce the facial expressions. Structurally, 
a muscle consists of a framework of fibrous tissue, which is 
continuous between its attachments ; the tendon and the apo- 
neurosis (flat tendon of a broad muscle) are respectively the 
fibrous framework of the muscle continued by itself; the 
fleshy portion of the muscle has, in addition, the muscle 
structure, lodged in the interstices of the fibrous framework. 
Every muscle is supplied with arteries, veins, lymphatics, and 
nerves ; the arteries and nerve or nerves are derived from con- 
tiguous trunks. The arterial and nerve supply should always 
be recognized, and the same traced to where they enter the 8 
INTRODUCTION. 
muscle; their entrance will usually be found at the protected 
surfaces of the muscle. 
Dissection.—In cleaning a muscle, never grasp it with the forceps, but let 
the tissue, to be removed from the muscle, be held off; the scalpel should be 
guided parallel with the muscle fibres (Fig. 6, Plate 2); the handle of the scal- 
pel and the head of the forceps are excellent instruments to strip the sides of 
a muscle free from contiguous parts ; but, in so doing, care must be taken not 
to break off nerves and vessels at their points of penetration into the muscle. 
In unpacking or separating muscles, lying in different planes or in contiguity 
in the same plane, they cannot be regarded as cleaned, until all their surfaces 
are freed of fibrous tissue. 
Bursae: Fig. 1, Plate 4; Plate 60.—A bursa is a fibrous- 
tissue bag, containing fluid, which is lodged upon a bony promi- 
nence, upon which skin or muscle plays ; its object is to obviate 
undue irritation of the skin or muscle by pressure. The sub- 
cutaneous bursa over the patella (Plate 60), and the submus- 
cular bursa? of the gluteus maximus and obturator internus 
(Fig. 1, Plate 4) are examples. 
Dissection.—After recognition, a bursa may be cut away and its relations 
appreciated. 
Sheaths of Tendons, Fig. 2, Plate 4.—Sheaths invest the 
long tendons of the limbs, for the isolation of the same, and 
the play of the tendons is facilitated by the sheaths being 
lined by serous membrane, which secretes synovia upon them 
to lubricate their surfaces. Examples of the synovial sheaths 
are well seen at the wrist and palm. 
Dissection.—In the appreciation of the synovial sheaths of tendon®, they 
should be opened at a given point and a probe inserted into them, along the 
tendon in both directions, to determine the extent of their investiture. After 
recognition, they should be stripped from the tendons with the curved scissors 
or scalpel. 
Deep Fasciae—The deep fascia? are specially thick septa or 
fascise, prolonged between the anatomical elements of a region, 
which form compartments for the grouping of muscles or the 
isolation of contiguous parts. They are also found lining the 
interior of cavities. 
Dissection.—Their extent and points of attachment should be appreciated, 
after which, if they interfere with subsequent dissection, they should be cut 
away. INTRODUCTION-. 
9 
Arteries.—The arteries, when injected with substances such 
as plaster, wax, or rubber, are readily recognized, but when 
not so injected, they appear as flattened empty tubes. The 
smaller arteries are, as a rule, accompanied by two veins, called 
venm comites, the larger ones by a single venous trunk. 
Dissection.—The arterial trunks of a region should be first cleared of 
areolar tissue and sheath investitures ; then their primary branches determined 
in the order of their size. All branches of distribution should be followed to 
the parts to which they distribute, and the anastomoses of branches should be 
recognized, where possible. 
Veins—The veins of the body are subcutaneous and com- 
ites. The subcutaneous veins are lodged, as their name indi- 
cates. The comites or deep veins accompany arteries; some 
of the deep veins are not comites. The venous channels 
(sinuses) within the cranium are not comites of arteries. 
Dissection.—With a few exceptions, which will be noted, the subcutaneous 
veins do not require the dissector’s attention; the venae comites of the small 
arteries do not warrant preservation, as the recognition of the artery carries 
with it the appreciation of its companion veins ; the venae comites of the small 
arteries may therefore he stripped away from them in the cleaning of the latter. 
The large venous trunks run contiguous to the arteries, one to each, and their 
relations should be carefully noted ; special directions will be given, when and 
how they are to be removed. In dissecting arteries and veins the same rule 
holds as with muscles, viz.: that the vessels should not be raised by the forceps, but 
only the adventitious tissue and venae comites (in the case of small arteries) are to 
be drawn away and cut from the surface of the vessel (see the figure illustrating 
the cleaning of a muscle, Fig. 6, Plate 2), the knife cutting parallel with the 
vessel, never across it. 
Serves.—The nerve-trunks of a region will be found to run 
parallel with its vessels. If not immediately contiguous, they 
are not far removed. In appreciating a nerve it must be re- 
membered that it is either motor, sensory, or mixed (contain- 
ing both motor and sensory fibres). If a nerve is motor, its 
distribution will be to muscle only ; if sensory only, it ends at 
an organ of special sense or the skin ; if a mixed nerve, it will 
be found to have a deep distribution of its motor filaments to 
the muscles, and a superficial distribution of its sensory fila- 
ments to the skin. With the exception of a few nerves in the 
region of the head, which are either specially sensory or 
specially motor, the nerves of the body are mixed, having a 
deep muscle and a superficial skin distribution. 10 
INTRODUCTION. 
Dissection.—In exposing a nerve it should be first isolated for a short 
portion of its course, as with a subcutaneous nerve (see Fig. 4, Plate 2); then 
raise the nerve taut with the forceps (see Fig. 5, Plate 2), and with the sharp- 
pointed scalpel, held with its edge from you and cutting parallel with the 
nerve, strip out the nerve from the fibrous tissue, in which it is imbedded ; as 
soon as enough of the nerve has been freed, it should be held in the fingers of 
the left hand and its stripping out continued. Observe the giving off of 
branches, those to the muscles, those communicating with contiguous nerves, 
and those to the skin, as the case may be. All the branches of a nerve should 
be traced to the parts,to which they distribute ; the most delicate nerves, when 
once stripped out, will bear a great deal of handling, and the completeness of 
a dissection will more than reward the extra pains,taken to preserve them. 
The dissector, in liis general work, will be able to find, with but few excep- 
tions, all the nerves shown in the plates. In a few of the plates, not original 
(Plate 33), the nerves were dissected out after the regional sections had been 
preserved, for a long time, in dilute nitric acid. 
Lymphatic Glands.—Lymphatic glands are to be found in 
given situations in the body ; when large they are evidence of 
a pathological condition, as in the perfect organism they may 
escape detection. 
Dissection.—In the course of dissection it is sufficient to recognize the 
lymphatic glands as they may present, but it is needless to preserve them. 
Lymphatic Vessels.—Lymphatic vessels are only recognized 
in special regions, viz.: the vicinity of the receptaculum cliyli 
and along the left lymphatic or thoracic duct. They are, as a 
rule, so small elsewhere as to escape detection. Pictures illus- 
trating them are drawn from specimens, where the lymphatic 
vessels have been injected by special methods necessary therefor. 
Viscera.—The viscera of the body are certain organs, con- 
tained within the trunk and head ; the directions for their dis- 
section will be given in their proper places. 
Dissection.—The anatom}5, of a viscus is complete in itself, therefore it may 
be removed from the body and kept in some preservative fluid—a solution of 
arsenite of soda or of chloride of zinc—for special dissection. Before removal 
of an organ from the body, its relations, the source of its arterial and nerve 
supply, the destination of its vein or veins, and its duct (if it has any) should 
be recognized, as far as practicable. 
Duels.—Ducts are the efferent canals from the secreting vis 
cera, for the conveyance of the products of secretion ; they are 
found only in the trunk and head regions of the body. INTRODUCTION. 
11 
Dissection.—The relation of a duct, in situ, is to be first appreciated; 
then, its point of emergence from the viscus and its destination. 
Mucous Membrane—Mucous membrane lines all canals of 
the body with a surface outlet; at these points the membrane 
will be found continuous with the skin. 
Serous Membrane.—A serous membrane invests all op- 
posed surfaces, which move upon each other, the exception 
being the cartilage surfaces of joints ; it covers all movable 
organs, and lines the interior of the cavities which contain 
them ; it lines the ligaments of the movable joints, and forms 
the sheaths of tendons. It secretes a lubricating fluid to fa- 
cilitate friction and prevent irritating effects therefrom. 
Dissection.—Mucous and serous membranes should be dissected from 
subjacent tissue; a submucous and a subserous plane of areolar tissue may 
sometimes be demonstrated. 
Bones.—The bones, which form the framework of a given 
dissection, should be considered, with reference: first, to the 
relations of their surfaces to the anatomical elements of the re- 
gion ; second, to the areas of attachment of muscles. The 
regional dissections have been planned so as to include all the 
attachments of a given muscle, thereby facilitating the appre- 
ciation of its function. 
Dissection.—After a dissection lias been completed, the muscles should be 
cut from the bones, one by one, noting the areas of their attachments. In so 
doing, not only the situation of a given muscle attachment is to be seen, but 
also its relations to contiguous areas of other muscle attachments. 
Joints.—The joints of the body are the points where bone 
surfaces are in contiguity ; they are complex in their construc- 
tion, including: bones, ligaments, cartilage, synovial (serous) 
membrane, and fibro-cartilage. Joints are movable, partially 
movable, and immovable : a movable joint (elbow-joint) is con- 
structed of bones covered with articular cartilage, and joined 
by ligaments lined by synovial membrane; if the joint is ex- 
posed to concussions (knee-joint), protection is afforded, from 
bone injury by the presence of movable plates of fibro-carti- 
lage (interarticular), between the cartilage-covered articular 12 
IXTRODUCTIOX. 
surfaces of the bones. In other joints (hip-joint) the articu- 
lar cavities are deepened by the rimming of their borders with 
immovable fibro-cartilage (circumferential). In the articula- 
tion of bones, which form partially movable joints (the verte- 
bra?), cartilage and synovial membrane are wanting, and plates 
of immovable, fibro-cartilage (interosseous) are fixed between 
the articular surfaces (intervertebral discs); these latter points 
of bone articulation allow a slight motion of their surfaces 
upon each other. In the immovable joints (cranial and upper- 
jaw regions of the head) the articular surfaces of the bones 
are held in apposition : for the cranium, by the continuity of 
the exterior periosteum and the interior dura mater ; for the 
upper-jaw region, by the continuity of the periosteum ; ulti- 
mately, in both regions, the articulations between the bones 
are obliterated by the development of osseous tissue. 
Dissection.—In tlie dissection of joints it is absolutely necessary that they 
should be moist and pliable ; to keep them so, they should be kept covered by 
refuse tissue, with wrappings of wet muslin, and outside dry muslin or oil-silk. 
If they have dried from neglect, they should be soaked in water till the liga- 
ments are again pliable. The cleaning of the surface of ligaments may be 
effected with curved scissors and subsequent scraping with a scalpel. PLATE 1 
2 
s 
e 
1 
a 
* 
8 
r PLATE 2 
Fig. 1 
Fig. 2 
Fig. 3 
Fig. 4 
Fig. 6 
Fig. 5 
IlCoTirt, aJ notZuram deZ, PLATE 3 
Fia.2 
TXGr.l 
Fin. 3 PLATE 4 
FiG.l 
SPINE Of ISCHIUM 
Tendon of_ 
OBTURATOR 
INTERN U<S 
FlC-2 TRUNK. 
FIRST DISSECTION. 
MALE PERINEUM. 
Position op Body for Dissection.—Bring the subject to the end of the 
table, with the lower extremities hanging over ; place a block under the pelvis 
and a second under the shoulders ; flex the thighs upon the abdomen and the 
legs upon the thighs ; pass a rope under the table and over the separated 
limbs, taking a turn around one or both ; make the rope taut and tie it (Fig- 
ure 1, page 14). Pass a steel sound into the bladder and tie the penis and 
scrotum to it. 
Surface Appearances.—The following points are recognized 
by palpation : posteriorly, the coccyx on the median line; 
laterally, the tuberosities of the iscliia, and extending anteri- 
orly therefrom the rami of the pubic arch ; posteriorly to the 
bis-ischiatic line the anus is located ; in the urethral region, 
on the median line, is a swell formed by the corpus spongi- 
osum of the penis ; the exterior of the os pubis lodges the 
corresponding crus of the corpus cavernosum ; from the area 
of the anterior surfaces of the ossa pubis are suspended the 
scrotum and the penis. 
Terms of Relation.—The general terms (page 2) ; and the 
special terms exterior and interior—relatively to the skin sur- 
face and the pelvic cavity, respectively—will be used. 
Perineum and Its Boundaries, Plate 5.—The perineum in- 
cludes all the soft parts, which close the inferior outlet of the 
pelvis or the space bounded by the bones of the pubic arch 
and the coccyx, and the following ligaments: the inferior 
pubic, anteriorly, and the right and left great sacro-sciatic, 
posteriorly and laterally. 14 
TRUNK. 
Regions of the Perineum.—The perineum is divided by 
a transverse line, the bis-ischiatic, into a posterior and an 
anterior region ; in the male they are called rectal and ure- 
thral; in the female rectal and urethrovaginal. The rectal 
region is bounded by the bis-ischiatic line, anteriorly ; the tu- 
berosities of the iscliia, the great sacro-sciatic ligaments and 
the coccyx, laterally and posteriorly. The urethral (male) or 
Figure 1. 
urethrovaginal (female) region has the bis-ischiatic line, pos- 
teriorly ; the rami of the pubic arch—the ascending rami of 
the iscliia and the descending rami and bodies of the ossa pu- 
bis—and the inferior pubic ligament, laterally and anteriorly. 
Bones and Bone Areas.—The bones are: the coccyx and 
the pubic arch—parts of the os pubis and ischium of the right 
and the left os innominatum. To the internal surface and free MALE PERINEUM. 
15 
borders of a ramus of the pubic arch will be found three lines 
of fascial attachment, which determine three planes of muscle 
attachments. The lines are: to the exterior surface and free 
border, the perineal fascia ; to the interior free border and sur- 
face, the levator fascia (posterior layer of triangular ligament); 
to about the middle of the intervening surface between the 
borders, the triangular ligament (anterior layer). Between the 
perineal fascia and triangular ligament lines the crus penis or 
clitoridis and the ischio-cavernosus and superficial transversus 
perinaei muscles are attached. Between the triangular liga- 
ment and levator fascia lines are found the attachments of the 
deep transversus perinaei and constrictor urethrae muscles. In 
a plane interior to that of the levator fascia, and interior to the 
pubic ramus, the levator ani et prostatae (male) or the levator 
ani et vaginae (female) muscle presents. The osseous attach- 
ments of the compound levator muscle are to the interior sur- 
face of the body of the os pubis, anteriorly ; the spine of the 
ischium, laterally ; and the border of the coccyx near its apex, 
posteriorly. The coccygeus muscle is attached to the spine of 
the ischium and to the interior of the coccyx. The tip of the 
coccyx and its exterior surface afford attachment, respectively, 
to the sphincter ani and gluteus maximus muscles. 
Dissection.—Make the skin incisions marked 1, 2, and 3, Fig. 1, and re- 
flect flaps, laterally, beyond the tuberosities of the iscliia, in which positions 
they may be fixed by thumb-pins. 
1. Subcutaneous Tissue, Plate 6.—A plane of thick subcu- 
taneous tissue, containing more or less fat, underlies the skin : 
it is continuous with that on the thighs and buttocks. 
Dissection.—Clean the surface of the sphincter ani muscle, exposing its 
entire contour. 
2. Sphincter Ant Muscle.—This muscle is in the subcuta- 
neous plane surrounding the anus. It forms an oval muscle 
mass attached posteriorly to the tip of the coccyx ; as it passes 
anteriorly it expands, by the divergence of its fibres, to sur- 
round the anus; it converges again in front of the anus, and 
terminates at the tendinous centre of the perineum. 
Dissection.—Incise the subcutaneous tissue on the median line, anterior 
to the anterior attachment of the sphincter ani muscle, down to a layer of fas- 
cia, the perineal; then diverge incisions along the external borders of the 16 
TRUNK. 
muscle to the coccyx. Deflect flaps of subcutaneous tissue, similar to those 
of the skin ; seek a subcutaneous nerve* on the fascia lata, external to the 
ramus of the pubic arch. 
3. Inferior Pudendal Nerve.—This nerve is a branch of 
the lesser sciatic, that becomes subcutaneous by piercing the 
fascia lata, external to the tuberosity of the ischium ; it con- 
tinues anteriorly, external to the urethral region, to distribute 
to the skin of the external and posterior surfaces of the scro- 
tum. A branch perforates the perineal fascia to communicate 
with the anterior superficial perineal nerve. 
Dissection.—Dig out the fat external to the anterior half of the sphincter 
ani muscle (by scratching through it with the point of the closed curved scis- 
sors and picking out the detached portions with the forceps), so as to deter- 
mine the posterior edge of the perineal fascia. 
4. Perineal Fascia.—This fascia constitutes the third plane 
of the urethral region. It is continued anteriorly from its 
base line, the bis-iscliiatic fascial junction, over the subpubic 
portion of the penis, and is attached laterally to the exterior 
surface and free border of the ramus of the pubic arch. 
Beyond the urethral region it is continued into the dartos tunic 
of the scrotum. In the dissection of the inguinal region, the 
scrotum and the penis, we shall find this plane of fascia con- 
tinued, superiorly, from the scrotum (dartos tunic), as the deep 
layer of the subcutaneous tissue of the groin and also as a 
dartos sheath of the penis. 
Dissection.—Dig out the remaining fat from the iscliio-rectal fossa. All 
strokes, whether of scratching or cutting, should be made at a right angle to 
the median line, as vessels and nerves, which cross the fossa from its ischial to 
its rectal wall, would otherwise be severed. Expose the inferior edge of the 
gluteus maximus muscle. In clearing the fat from the’ anterior portion of the 
levator fascia, be careful not to cut through it, but scrape the fat from it so as 
to preserve its attachment to the bis-iscliiatic fascial junction. 
5. Gluteus Maximus Muscle, Plate 7.—The inferior edge of 
this muscle passes from the side of the coccyx, across to and 
over the exterior surface of the tuberosity of the ischium. 
Over the muscle edge vessels and nerves (small sciatic branches 
and the fourth sacral nerve) curve to its exterior surface, for 
subcutaneous distribution. 
6. Iscliio-Blcctul Fossa.—Tile fossa is located between the MALE PERINEUM. 
17 
ischium, externally, and the rectum, internally. Its actual 
walls are, externally, the inferior portion of the obturator 
fascia, covering the interior of the obturator internus muscle ; 
internally, the levator am portion of the levator fascia, cov- 
ering the exterior of the levator ani portion of the levator ani 
et prostatse muscle. Its superficial limits are, posteriorly, the 
inferior border of the gluteus maximus muscle; anteriorly, the 
base of the perineal fascia. Its shape is that of a wedge with 
its base at the skin, its sloping sides at the obturator and the 
levator fascia, respectively, while the junction of the two fasciae 
forms the apex of the wedge and the bottom of the fossa. 
7. Inferior Hemorrhoidal Artery, Plate 7.—This artery 
(vena comes), sometimes two, springs from the internal pudic 
artery in the external wall of the fossa ; it bridges the fossa and 
breaks up into branches, which distribute to the levator and 
sphincter ani muscles and the skin about the anus. 
§. Inferior Hemorrhoidal Nerve.—This nerve, some- 
times two, arises from that portion of the pudio nerve which 
is located in the external wall of the fossa.; it crosses the fossa 
and distributes to the sphincter ani muscle and the skin of the 
rectal region. 
9. Obturator Fascia—The inferior portion of this fascia 
forms the external wall of the iscliio-rectal fossa, lining the in- 
terior surface of the obturator internus muscle, which, in turn, 
lies upon the interior of the ischium. 
10. Levator Fascia.—Tlie levator ani portion of this plane 
of fascia (anal fascia of authors) covers the exterior of the 
levator ani portion of the levator ani et prostatse muscle, at 
the internal wall of the iscliio-rectal fossa. This fascia is given 
off from the interior surface of the obturator fascia, which lines 
the ischio-pubic portion of the pelvic wall. It is attached an- 
teriorly at the bis-iscliiatic fascial junction, at the base of the 
triangular ligament. 
Dissection.—Introduce tlie finger upon tlie obturator fascia, and distin- 
guish beneath the same, on the obturator internus muscle, the pudic vessels 
and nerve as they pass anteriorly to the urethral region of the perineum. 
Follow the hemorrhoidal artery or nerve to the external wall of the fossa and 
incise the obturator fascia so as to expose the pudic vessels and nerve. 18 
TRUNK. 
ll. Pudic Nerve.—This nerve lies exteriorly to the artenT, 
giving otf the inferior hemorrhoidal nerve as described above. 
Posteriorly to the tuberosity of the ischium it gives otf the pos- 
terior superficial and anterior perineal nerves, which pierce the 
perineal fascia, anteriorly to its base line of junction with the 
triangular ligament, that they may distribute, beneath the fas- 
cia, in and beyond the urethral region. The trunk of the nerve 
continues, anteriorly, interiorly to the triangular ligament. 
12. Pudic Artery.—This artery (vena comes), having re- 
entered the pelvic cavity from the exterior of the spine of the 
ischium, runs in the external wall of the iscliio-rectal fossa, 
where it lies interiorly to the pudic nerve, and passes, anteri- 
orly, into the urethral region, interiorly to the triangular liga- 
ment. In its transit in the wall of the fossa, it gives oflf the 
inferior hemorrhoidal artery ; posteriorly or at times internally 
to the tuberosity of the ischium, it bifurcates into the super- 
ficial and the deep perineal arteries. 
Dissection.—Section the perineal fascia (Plate 6), and reflect flaps of the 
fascia (Plate 7). Determine the superficial vessels, nerves, and muscles, inte- 
riorly to the perineal fascia. 
13. Bfsfscliiatic Fascial Junction, Plate 7, and Fig. 3, 
Plate 8.—This is located along the posterior border of the super- 
ficial transversus perimei muscle. It is formed by the junction 
of the base of the perineal fascia, and the levator fascia, with 
the base of the triangular ligament. 
14. Superficial Perineal Artery, Plate 7.—This artery (vena 
comes), a branch of bifurcation of the pudic, enters the ure- 
thral region of the perineum at its posterior external angle, 
sometimes posteriorly to the base of the triangular ligament, 
perforating the perineal fascia, at others interiorly to the trian- 
gular ligament, perforating it and the perineal fascia. It passes 
anteriorly, giving off the transverse perineal artery and muscle 
branches ; it also distributes to the scrotum. 
15. Superficial Perineal Nerves.—Tile posterior superficial 
and the anterior superficial perineal nerves are branches of the 
pudic nerve ; they enter the iscliio-rectal fossa and reach their 
plane of distribution by perforating the perineal fascia close to 
its base line. They supply the skin of the urethral region MALE PERINEUM. 
and scrotum. The posterior perineal nerve gives off branches 
for muscle distribution, and to supply the bulb of the corpus 
spongiosum. 
16. Superficial Transversus Perinaei Muscle.—This muscle 
extends from the internal surface of the tuberosity of the 
ischium to the tendinous centre of the perineum. 
17. Accelerator Urinae Muscle.—This muscle is attached 
to the tendinous centre of the perineum and to a fibrous raphe 
on the median line. From this raphe its fibres pass externally 
and anteriorly, moulding themselves upon the half of the cor- 
pus spongiosum of the penis. Externally, it is attached to 
the exterior surface of the triangular ligament; anteriorly, its 
fibres pass, over the side of the corpus cavernosum of the penis, 
for attachment on the dorsum of the same. 
18. Tendinous Centre of the Perineum, Plate 7, and Fig. 3, 
Plate 8.—This is a fibrous tissue centre, determined by the con- 
vergence of muscles and fasciae, viz.: the sphincter ani, the 
superficial and deep transversi perinaei, the accelerators urinae 
and the levators ani et prostatae muscles; the right and left 
perineal fasciae, the triangular ligament, and the right and left 
levators fasciae. 
19. Iscliio-Cavernosus Muscle (Erector penis), Plate 7.— 
This muscle is attached to the internal surface of the tuberosity 
of the ischium and to the crus of the corpus cavernosum of the 
penis. 
Dissection.—Section the superficial perineal artery and nerves, and the 
inferior pudendal nerve (Plate 7), and reflect them anteriorly upon the 
scrotum. Section the ischio-cavernosi, superficial transversi perinsei, and ac- 
celeratores urinse muscles (Plate 7), and reflect the portions of each. The 
tendinous centre of the perineum is not to be cut away. 
20. Corpus Spongiosum of the Penis, Plate 8.—The subpil- 
bic portion of the corpus spongiosum of the penis occupies the 
median line of the urethral region. Its posterior portion, 
which expands into what is called the bulb, lies exterior to the 
triangular ligament and is invested by the accelerators urinae 
muscles ; its anterior portion, or body, continues inferior to 
the corpora cavernosa ; it forms the inferior longitudinal cylin- 
der of the penis, and expands into the glans penis. TRUNK. 
21. Crus of tlie Penis, Plate 7, and Fig. 3, Plate 8.—This 
is attached to the free surface of the pubic arch ; it extends 
anteriorly, and internally, upon the exterior of the descend- 
ing ramus and body of the os pubis. At the median line, exte- 
rior to the symphysis pubis, the right and left crus unite to 
form the corpora cavernosa of the penis, which are the superior 
longitudinal cylinders of that organ. 
Dissection.—Hook the bulb of the corpus spongiosum internally and clear 
the surface of the triangular ligament, respecting vessels and nerves, which 
perforate the same. 
22. Triangular Ligament, Fig. 1, Plate 8.—This ligament 
is a triangular sheet of dense librous tissue, attached to the 
rami of the pubic arch (see Bone Areas, p. 14). It occupies a 
plane interior to the muscles, described above, the corpus 
spongiosum and the crura of the penis. Its base has an at- 
tachment to the tendinous centre of the perineum, and with 
the perineal and levator fascim forms the bis-iscliiatic fascial 
junction. It is pierced, near its base, externally, at times, by 
the superficial perineal artery, internally, by the artery of the 
bulb; toward its apex, by the deep perineal artery or its 
terminal branches ; and by the dorsalis penis nerve and vein. 
Dissection.—Cut one of the crura, from its attachment to the pubic arch, 
and hook it internally across the corpus spongiosum, then clear the vessels 
and nerve, that come through the triangular ligament. 
23. Artery to tlie Corpus Cavernosum, Figs. 1 and 2, Plate 
8.—This artery (vena comes) is the largest branch of bifur- 
cation of the deep perineal; it divides into branches, which en- 
ter the deep surface of the crus of the corpus cavernosum. 
24. Deep Dorsalis Penis Artery.—This artery is tile smaller 
branch of bifurcation of the deep perineal; it passes, anteri- 
orly, between the crus of the corpus cavernosum and the body 
of the os pubis. 
25. Deep Dorsalis Penis Xervc—This nerve is a continua- 
tion of the deep perineal nerve, exterior to the triangular liga- 
ment ; it accompanies the artery of the same name. 
20. Deep Dorsal Vein of Hie Penis.—The lateral surface 
of this vein presents, running internal to, and parallel with, the MALE PEEIXEUM. 
21 
dorsal artery and nerve, upon the exterior of the body of the os 
pubis. 
Dissection.—Section the triangular ligament (Fig. 1, Plate 8), and reflect 
its portions; laterally, to the pubic arch; posteriorly, so as to retain its con- 
tinuity with the bis-ischiatic fascial junction ; this will display the deep peri- 
neal vessels, and a portion of the deep perineal nerve. These elements will 
be found to lie upon the exterior surface of the deep transversus perinaei and 
the constrictor urethrae muscles. 
27. Deep Perineal Artery, Fig. 2, Plate 8.—This artery 
(vena comes) is one of the branches of bifurcation of the pudic ; 
it runs parallel with, and internal to, the pubic arch, in a 
plane interior to the triangular ligament; it bifurcates into 
the artery of the crus and the dorsalis penis artery, as described 
above. 
28. Artery of ilie Bulb.—This artery (vena conies) is a 
branch of the deep perineal, which passes internally and 
anteriorly, to perforate the triangular ligament and distribute 
to the corpus spongiosum. As it enters the part it bifurcates 
into a posterior branch to the bulb and an anterior branch to 
the body. 
29. Artery to Cowper’s Claud.—In its course the artery of 
the bulb gives off a branch, which passes, internally and pos- 
teriorly, to a point posterior to the bulb of the corpus spongio- 
sum, where it pierces the deep transversus perinaei muscle to 
distribute to the gland, which lies interior to the muscle. 
30. Deep Perineal Uferve.—This nerve lies between the 
deep perineal artery and the ramus of the pubic arch ; it runs 
for a portion of its course interior to the pubic arch attach- 
ments of the deep transversus perinmi and constrictor urethrae 
muscles ; it is the branch of the pudic nerve, which continues 
the trunk into the urethral region ; piercing the triangular liga- 
ment, it becomes the dorsalis penis nerve, as described above. 
Dissection.—Section the deep perineal artery (Fig. 2, Plate 8), and re- 
flect it and its branches internally across the corpus spongiosum; clear the 
surface of the muscles upon which the artery lies. 
31. I)ecp Transvcrsus Perinaei Muscle.—This muscle con- 
sists of transverse fibres, which run, parallel with and anterior 
to the base of the triangular ligament, from the tuberosity of 22 
TRUNK. 
the ischium, externally, to the tendinous centre of the peri- 
neum, internally. 
32. Constrictor Urethra? Muscle.—This muscle is formed 
of transverse fibres, which are attached, externally, to the free 
surface of the pubic arch, anterior to the attachment of the pre- 
ceding muscle ; internally, at the median line, they meet at 
a, more or less well marked, raphe, the fibres of the muscle 
of the opposite side, and surround the membranous portion 
of the urethral canal. 
Dissection.—Unhook the crus and the corpus spongiosum ; restore the 
crus to its normal position ; hook the bulb of the corpus spongiosum a little 
anteriorly; expose Cowper’s glands, by dissecting off the fibres of the deep 
transversus perinsei muscles, as they converge to the tendinous centre of the 
perineum. 
33. Cowper’s Glands Fig. 3, Plate 8.—These are two bodies, 
located in the urethral region of the perineum, interiorly to the 
fibres of the deep transversi perinaei muscles ; their ducts run, 
superiorly, parallel with, and exteriorly to, the wall of the ure- 
thra, to open at the floor of the bulbous section of the spongy 
portion of the urethral canal (page 2 ; Fig. 2, Plate 55). 
Dissection.—Section the glutens maximus muscle (Plate 7) and reflect 
the flap interiorly. Section the constrictores urethrae and deep transversi 
perinaei muscles, antero-posteriorly, and reflect the portions, laterally; the pubic 
arch attachment may be cut away. In removing this plane of muscle be care- 
ful not to injure a subjacent plane of fascia. 
34. Great Sacro-Sciatic Ligament, Fig. 3, Plate 8, and 
Plate 9.—The inferior edge and a portion of the exterior sur- 
face of this ligament are brought into view ; the ligament ex- 
tends from the border of the coccyx to the tuberosity of the 
ischium, in a plane interior to the gluteus maximus muscle. 
35. Fourth Sacral Nerve.—This nerve perforates the great 
sacro-sciatic ligament, to wind over the inferior border of the 
gluteus maximus muscle, near the coccyx, for distribution to 
the skin of the coccygeal region. 
36. Levator Fascia (anal fascia and posterior layer of the 
triangular ligament), Fig. 3, Plate 8 —This fascia, already par- 
tially shown in Plate 7, now presents as a plane of fascia com- 
mon to both the rectal and urethral regions of the perineum. MALE PERINEUM. 
It will be recognized as including, in one continuous fascia, 
the so-called anal fascia of the rectal region and the so-called 
posterior layer of triangular ligament of the urethral region. 
As the fascia covering the obturator muscle is called obturator 
fascia, this plane of fibrous tissue may be called levator fascia 
as it invests the exterior surface of the levator ani et prostatse 
muscle. The levator fascia, externally, is given off as an in- 
ternal process from the obturator fascia, inferior to the obtu- 
rator fascia attachment of the levator ani et pi'ostatse muscle. 
It is thus given off inferior to “ the white line” or the splitting 
of the pelvic fascia—from the interior of the body of the os 
pubis, anteriorly, to the spine of the ischium, posteriorly—into 
the obturator and recto-vesical fasciae. From its external at- 
tachment it spreads to the median line, exterior to the levator 
ani et prostatae muscle. 
In the rectal region, the levator ani portion of this plane of 
fascia {anal fascia) forms the internal wall of the ischio-rectal 
fossa; it passes from its attachment to the obturator fascia 
and the spine of the ischium, externally ; to the median line 
anterior to the anus—it is here attached to the tendinous cen- 
tre of the perineum—to the wall of the rectum, to the median 
line between the anus and the coccyx, and to the coccyx, in- 
ternally. Its posterior limit is at the inferior edge of the 
coccygeus muscle. 
Continued from the obturator fascia on the interior of the 
pubic arch, the levator prostates portion of the levator fascia 
{posterior layer of triangular ligament) occupies the urethral 
region of the perineum ; externally, it lines the interior surface, 
and springs from the interior lip of the internal free border, 
of the ramus of the pubic arch ; internally, it reaches the me- 
dian line, where it meets its fellow of the opposite side, and the 
two surround and give transit to the prostatic end of the mem- 
branous urethra. At its median line limit it attaches itself 
to the portion of the recto-vesical fascia which forms the pros- 
tatic capsule ; and to the tendinous centre of the perineum. 
At the bis-ischiatic fascial junction the levator fascia is at- 
tached, which attachment divides it into its levator ani and 
levator prostatas portions. 
37. Membranous Portion of tlie Uretlira, Plates 10, 11, 
and 12.—This portion of the urethral canal is located in the in- 
terval between the bulb of the corpus spongiosum, exteriorly, 24 
TRIJXK. 
and the anterior extremity or apex of the prostate, interiorly ; 
it is included between two planes of fascia, the triangular liga- 
ment (anterior layer), exteriorly, and the levator prostatae 
portion of the levator fascia (posterior layer of triangular liga- 
ment), interiorly ; it is surrounded by muscle tissue, contrib- 
uted by the junction of the right and left constrictor urethrae 
muscles. 
Dissection.—Dissect the levator fascia from the exterior surface of the 
levator ani et pro static muscle, leaving a rim of the fascia at the circumference 
of the pelvic outlet (Plate 9) ; distinguish the two portions of the muscle, and 
the convergence of the muscles, the right and the left, at their median-line 
raphe, posteriorly and anteriorly to the anus. 
38. Levator Ani et Prostatae Muscles, Plates 9, 45, and 46. 
—These muscles, tlie right and the left, close the outlet of the 
bony pelvis. A muscle, of a side, is attached, antero-posteri- 
orly, as follows: externally, to the interior surface of an os 
pubis (levator prostatm), to the open angle of the splitting of 
the pelvic fascia (into the recto-vesical and the obturator fas- 
ciae), and to the spine of the ischium (levator ani); internally, 
to a median line raphe and to the tendinous centre of the peri- 
neum (levator prostatae), to the wall of the rectum (levator ani), 
and to the coccyx. The prostata portions of the muscles 
present a subpubic interspace, which gives transit to the ure- 
thra, and then join to form a sling for the prostate. Their ani 
portions are separated for the outlet of the rectum, the anus. 
The levator ani portion of the muscle plane occupies the 
rectal region of the perineum ; externally,it is attached, an tero- 
posteriorly, to the inferior open angle—the “white line”— of 
splitting of the pelvic fascia—from the interior of the body of 
the os pubis to the spine of the ischium—and to the spine 
of the ischium ; internally, its fibres are attached, antero-pos- 
teriorly, to the tendinous centre of the perineum, to the wall 
of the rectum, to a median line raphe from the anus to the 
coccyx, and to the coccyx itself. 
The levator prostata part of the muscle plane is formed 
by its anterior portion. It is attached, anteriorly, to the in- 
terior of the body of the os pubis, from which the fibres pass, 
posteriorly, parallel with the median line, to a point opposite 
the interval between the urethra and the anus ; the fibres then 
curve to a median line raplie, which in turn is attached to the 
tendinous centre of the perineum. This median line junction of MALE PERINEUM. 
the right and left muscle is located inferior to the prostate, 
thus slinging it and elevating it when in action. 
39. Coccygeus Muscle, Fig. 3, Plate 8, and Plates 9 and 
10.—Only a limited portion of the inferior border of this mus- 
cle is brought into view, bridging between the spine of the 
ischium, externally, and the coccyx, internally. It lies in a 
plane interior to the sacro-sciatic ligament, and is met, an- 
teriorly by the posterior border, of the levator ani portion, of 
the levator ani et prostatse muscle. 
Dissection.—The relations of the pelvic viscera, at the outlet of the pelvis, 
may now be determined, by sectioning the levatores ani et prostatse muscles 
(Plate 9). Remove the internal portions of the opposite muscles, leaving 
a fringe of muscle (Plates 10 and 11), projecting external to the sphincter ani 
muscle (thus left, its attachment to the rectum can be appreciated, when the 
latter is specially dissected). 
40. Recto-Vesical Fascia, Plates 10 and 46.—This fascia is 
situated interiorly to the levator ani et prostatse muscle. It is 
given off as an internal process from the pelvic fascia at “the 
white line” or antero-posterior splitting of the pelvic fascia 
into recto-vesical and obturator fascia?; it covers the exterior 
surfaces of the rectum and bladder, forming a sling for their 
support at the outlet of the pelvis ; it forms the lateral and 
anterior true ligaments of the bladder, and surrounds the rec- 
tum inferior to the pelvic portion of the peritoneum. 
Disseotion.—To expose the portions of the viscera at the outlet of the 
pelvis, located exterior to the peritoneum, place a hook in the bulb of the cor- 
pus spongiosum and pull the prostate and bladder anteriorly; dissect the 
rectum from the recto-vesical fascia septum and reflect it, posteriorly, until the 
entire contour of the prostate is exposed. 
41. Recto-Vesical Fascia Septum, Plate 11.—The recto- 
vesical fascia projects a septum between the rectum, posteri- 
orly and interiorly, and the prostate, bladder, etc., anteriorly 
and superiorly. 
Dissection.—Drag the prostate and bladder still more anteriorly, pull 
the rectum further out of the pelvic cavity, by dissecting it from the base of the 
bladder and reflecting it posteriorly. Dissect off the vesical layer of the recto- 
vesical fascia from the prostate (to which it will be found intimately ad- 
herent, as a fibrous capsule) ; reflect the fascia as a flap, posteriorly, from the 
prostate and the base of the bladder, upon the rectum, exposing the vasa de- 
ferentia, the vesicuke seminales, and a venous plexus external to the latter. 26 
TRUNK. 
At the base line of the vesiculse seminales, recognize a thin fibrous tissue, 
peritoneum, bridging from the bladder to the rectum. In reflecting the flap 
of fascia, it will be found but loosely adherent to the base of the bladder; at 
the line of the vas deferens, the fascia splits to include this duct and the vesi- 
cula seminalis; external to the vesicula the fascia again becomes single, in- 
vesting the venous plexus and bladder. Its investiture of both bladder and 
rectum stops at the peritoneal cul-de-sac. 
42. Prostate, Plate 12.—The inferior convex surface of 
this organ presents—having the shape of a heart on a playing- 
card—its apex anteriorly ; its base, posteriorly, with a cleft in 
it, for entrance of the ejaculatory ducts. 
43. Peritoneal Recto-Vesical Cul-de-sac—At tile superior 
limit of the exposed portions of the rectum and bladder, the 
peritoneum will be seen to be reflected from one to the other, 
forming the bottom of a pouch of peritoneum, located between 
the two organs. 
44. Trigone This name is given to a triangular area on 
the exterior surface of the base of the bladder—bounded by the 
peritoneal cul-de-sac at its base, the vasa deferentia laterally, 
and the cleft in the base of the prostate at its apex—because it 
is opposite the trigone area of the interior of the organ. Giving 
the same name to the two surfaces facilitates the appreciation 
of their relations. 
45. Vasa Deferentia.—These ducts form the lateral limits 
of the exterior trigone area ; they pass from the apices of the 
base line of the trigone, to the cleft in the base of the prostate. 
As they enter the prostate they receive the ducts of the ve- 
siculm seminales ; the joining of the two ducts, on either side, 
form the two ejaculatory ducts. 
46. Veslcuiae Seminales.—These organs lie external to, and 
parallel with, the vasa deferentia ; they are club shape, with 
their clubbed ends, posteriorly, at the base line of the trigone ; 
they converge, anteriorly, to the cleft iii the base of the pros- 
tate, where, as seen above, they present ducts, which join the 
vasa deferentia. 
47. Venous Plexus.—A plexus of veins presents, on either 
side, external to, and parallel with, the prostate and vesicnlse 
seminales ; they are united by a transverse vein or veins along MALE PERINEUM. 
27 
the base of the prostate, and they receive the dorsal veins of 
the penis. They are situated between the recto-vesical fascial 
septum and the bladder. 
48. Rectum, Plates 11 and 12.—The third, and the anterior 
surface of the inferior part of the second, portions of the rectum 
are brought into view in the exposure of the viscera at the out- 
let of the male pelvis. The third portion is projected from the 
apex of the coccyx to the anus ; it is surrounded by areolar 
tissue and fat, which are lodged, as we have seen, in the right 
and left ischio rectal fossm (page 16 ; Plate 6). A triangular, 
complex mass of tissue exists between the anterior surface of 
the third portion of the rectum, posteriorly, and the inferior 
surface of the prostate and the membranous portion of the 
urethra, anteriorly : the apex of the space is at the junction of 
the prostate and the rectum ; its base is at the skin area be- 
tween the anus and the scrotum ; this portion is called the 
surgical perineum, as it is involved in perineal operations. 
The antero-superior surface of the second portion of the rectum 
is in contiguity with the prostate, the vesiculse seminales, the 
vasa deferentia, and the bladder. The wall of the rectum 
presents longitudinal muscle-fibres for the entire circumference 
of the canal ; as pulled out from the pelvis it appears, in the 
plates, much too broad at its superior end, thereby distorting 
it as to length. 
49. Middle Hemorrhoidal Arteries, Plate 12.—The ter- 
minal branches of these arteries, the right and the left, are seen 
to distribute to the gut at its lateral surfaces. 
50. Male and Female Inferior Pelvic Outlets.—The infe- 
rior outlet of the male pelvis (Plates 9 to 12 inclusive) presents 
a marked contrast to the same outlet of the female pelvis 
(Plates 17, 18 and 19). The short transverse diameter and the 
narrow arch of the ossa pubis in the male give the effect of a 
greater antero-posterior diameter for the male; this, however, 
is not the case. Plate 5 represents the inferior outlet of a 
female pelvis ; this selection was purposely made, because the 
female pelvic outlet is of more practical importance than the 
male, while it illustrates, for both sexes, the bone areas afford- 
ing attachments to muscles and fasciae. Of the muscle attach- 28 
TRUNK. 
ments in Plate 5 those given for the levator ani et prostatae are 
also those for the levator ani et vaginae. 
Dissection. —Tlie dissection of the perineum, the sub-peritoneal viscera, 
and portions of viscera, at the outlet of the pelvis, being now completed, the 
viscera should be returned to the pelvic cavity; the skin-flaps of the perineum 
should be brought together at the pelvic outlet, and the same sutured, by the 
continued suture, along the median line. PLATE 5 
■AT. OoTin, ad neccnram dczZ, PLATE 6 
dkl. Colijt, ad Xtaiu. -ram del. PLATE 7 
AT. Cofin, czcZ & a: Z it rczr/t c?e<T. PLATE 8 
flG. J 
JFrc. 2 
Prcf. 3 
JPo. •ctTf<rr/ey of 
trianffu/arr {cgr"?* 
final fascia 
'/'sa o/-ccf 
M- CoArt, adna.tcora.rn def. PLATE 9 
■AI. Oai7zxticrum rfcC. PLATE 10 
Al. Co/zn.ezcZTzaturczm cZeZ. plate II 
■d£Oo7/7z,aetTtaZUram etet. PLATE 12 
BtJZohn, art uaticrocm tie/.. SECOND DISSECTION. 
FEMALE PERINEUM. 
Position of the Body for Dissection, Figure 2 (page 31).—Place the sub- 
ject in tlie same position as for dissection of tlie male perineum, page 13. 
Regional Appearances.—Palpation recognizes the same 
bone contours as in the male ; see Male Perineum, page 13. 
As compared with the male, the region presents the following 
differences : in the greater diameters of the pelvic outlet; in 
the anus being located nearer the coccyx ; and in the external 
genitalia. 
Terms of Relation.—See Male Perineum, page 13. 
Perineum and its Boundaries, Plate 5.—The female peri- 
neum includes all the soft parts, closing the outlet of the pelvis. 
It is bounded by bones and ligaments, as in the male; see Male 
Perineum, page 13. 
Regions of tlie Female Perineum.—The transverse or bis- 
ischiatic line of the pelvic outlet divides the female perineum 
into the rectal region, posteriorly, and the urethro-vaginal 
region, anteriorly ; see Male Perineum, page 14. 
Bone-Areas—See Male Perineum, page 14. 
External (exterior) Genitalia. — These parts occupy the 
urethro-vaginal region of the perineum and the anterior sur- 
faces of the ossa pubis ; they collectively form the pudendum, 
which presents, antero-posteriorly, the uro-genital furrow. 
They include : a, Mons veneris ; b, Labia majora ; c, Clitoris ; 
d, Labia minora; e, Vestibule;./, Meatus urinarius; g, Vag- 
inal orifice ; h, Orifices of the ducts of the vulvo-vaginal 
glands ; i, Fourchette ; j, Fossa navicularis ; h, Vulvo-vaginal 
glands and their ducts (described page 38). 30 
TRUNK. 
a. Mons Veneris.—This is the area upon the exterior sur- 
face of the symphysis pubis and the bodies of the ossa pubis ; 
it is a cushion of adipose tissue, covered by skin ; in the adult 
the skin presents a growth of hair. 
b. Labia Majora.—These are two antero-posterior lips, 
analogues of the halves of the male scrotum, which are di- 
vided, on the median line, by the uro-genital f urrow. Pos- 
teriorly, the labia are joined to form the posterior commis- 
sure; anteriorly, they are approximated only, and are, re- 
spectively, continued into the inguinal region of a side. Ex- 
ternally, a labium is covered by skin, which, in the adult, is 
furnished with hair ; internally, or in the uro-genital furrow, 
its surface is covered, exteriorly, by skin, and interiorly, by 
mucous membrane. The skin lining of the furrow is richly 
supplied with sebaceous glands ; the mucous-membrane lining 
is continued into the vagina, urethra, and ducts of the vulvo- 
vaginal glands. 
c. Clitoris—This is located at the anterior of the uro-genital 
furrow; it is the analogue of the male penis, from which it 
differs in size, and in not being tunnelled by the urethra. 
d. Labia Minora.—These are two folds of mucous mem- 
brane, which form the analogue of the skill and prepuce of the 
male penis. Anteriorly, they join upon the anterior of the 
clitoris, to form its prepuce ; posteriorly, they diverge into two 
labia, which merge into the anterior halves of the uro-genital- 
furrow surfaces of the labia majora. 
e. Vestibule.—This is a triangular area of mucous mem- 
brane at the middle of the floor of the uro genital furrow ; it 
has : the clitoris, at its apex, anteriorly ; the vaginal orilice, at 
its base, posteriorly ; the labia minora, at its sides. 
f. Meatus Urinarius.—This, the outlet of the urethra, pre- 
sents on the median line of the vestibule, anteriorly to its base. 
g. Vaginal Orilice.—Tliisis located: posteriorly to the ves- 
tibule ; anteriorly to the posterior commissure of, and between 
the posterior halves of, the labia majora. It may be occluded 
by a membrane—the hymen—or rimmed by the remnants of 
the same—the carunculee myrtiformes. FEMALE PERINEUM. 
31 
Ii. Orifices of the Ducts of the Vulvo-Vaginal Glands.— 
These openings are located exterior to the plane of the hymen 
or carunculse myrtiformes, upon the internal surfaces of the 
labia majora, about opposite the middle of the antero-posterior 
diameter of the vaginal orifice. 
i. The Fourchette.—This is a band of mucous membrane, 
which bridges between the labia majora, exteriorly to the pos- 
terior border of the vaginal orifice. 
j. The Fossa Xavicularis.—This is a depression, located 
between the fourcliette and the posterior commissure of the 
labia majora. 
Dissection.—Distend moderately the rectum and vagina, by stuffing them 
with oakum. Close the labia majora, posterior to the clitoris, by six or eight 
interrupted sutures ; also, the anus by two or three sutures. Make the skin 
incisions 1, 2, 3, and 4, indicated in Fig. 2 ; reflect flaps of skin over the tuber- 
osities of the ischia, pinning them to the thighs. 
Figure 2. 32 
TRUNK. 
1. Subcutaneous Tissue.—A plane of subcutaneous tissue 
presents as in the male (Plate 6), but containing more fat. 
Dissection.—Clear the surface of the sphincter ani muscle. Expose the 
superficial perineal artery and nerves in the urethro-vaginal region ; also, the 
inferior pudendal nerve, external to the region. 
2. Sphincter Ani Muscle, Plate 13.—The muscle presents 
as in the male, except that the muscle mass, constituted by 
the right and left halves, is more circular, making it shorter 
antero-posteriorly ; it is located nearer the coccyx. 
3. Superficial Perineal Artery.—This artery (vena comes) 
differs from the same vessel in the male, in that it is exterior, 
instead of interior, to the perineal fascia ; it perforates the 
triangular ligament and the perineal fascia from within out- 
wards, to distribute to the labium majus and mons veneris. 
Interior to the perineal fascia it gives off the transverse perineal 
artery. 
4. Superficial Perineal Nerves.—The cutaneous portions 
of the posterior superficial and the anterior superficial perineal 
nerves, like the artery, perforate the perineal fascia for distri- 
bution to the same parts as the artery. The posterior super- 
ficial nerve gives off a muscle branch, which distributes in a 
plane exteriorly to the triangular ligament; it also supplies a 
nerve to the bulb. 
5. Inferior Pudendal Nerve—The perineal branch of this 
nerve is exterior to the perineal fascia, otherwise the nerve is 
the same as in the male perineum, see page 16. It distributes 
to the labium majus and the mons veneris. 
Dissection.—Clear the surface of the perineal fascia, noting the points of 
perforation of the superficial vessels and nerves. Dig out the fat from the an- 
terior portion of the iscliio-rectal fossa, as in the male (Plate 6), to expose the 
posterior edge of the perineal fascia; see Male Perineum, page 16. In remov- 
ing the fat, be very careful not to cut through the anterior portion of the leva- 
tor fascia, as it joins the posterior edge of the perineal fascia. 
6. Perineal Fascia.—See Male Perineum, page 16. In the 
female, this fascia, in addition to the lateral and posterior at- 
tachments of the male, forms a layer of the labium majus, and 
passes, anteriorly, into the inguinal region, to be continuous 
with the deep layer of its subcutaneous tissue. Upon the FEMALE PERINEUM. 
33 
labium it presents dartos muscle fibres, thus bearing out the 
analogy of a labium to the half of the male scrotum. Its pos- 
terior border, as it forms the anterior superficial boundary of 
the ischio-rectal fossa, will be noticed to dip more posteriorly 
than in the male, for attachment to the tendinous centre of 
the perineum. 
Dissection.—Section the superficial perineal artery and nerves, also the 
inferior pudendal nerve posteriorly, and reflect them anteriorly. Complete 
the removal of the fat from the ischio-rectal fossa, as in the male perineum, 
see page 16. 
7. Gluteus Maximus Muscle—See Male Perineum, page 16. 
8. Ischio-Rcctal Fossa.—This fossa, in the female, is broader 
and less deep than in the male ; therefore its shape is less that 
of a wedge. See Male Perineum, page 16. 
9. Inferior Hemorrhoidal Artery and Nerve.—See Male 
Perineum, page 17. 
10. Obturator Fascia.—The portion of this fascia that 
forms the external wall of the ischio-rectal fossa, has less 
depth than in the male. See Male Perineum, page 17. 
11. Levator Fascia (levator ani portion or anal fascia).— 
In the female, this fascia is less vertical than in the male, and 
it has a larger area. See Male Perineum, page 17. 
12. Pudic Nerve and Artery.—These parts are similarly 
located, and may be exposed in the same way as in the male. 
See Male Perineum, pages 17 and 18. 
Dissection.—Section and reflect the perineal fascia (Plates 13 and 14). 
13. Bis-Ischiatic Fascial Junction, Plates 14 and 17, and 
Fig. 3, Plate 16.—This transverse line of meeting of the fasciae 
of the perineum differs from the male, in that, it extends more 
posteriorly for attachment to the tendinous centre of the peri* 
neum. See Male Perineum, page 18. 
14. Superficial Transversus Perinaei Muscle, Plate 14.— 
See Male Perineum, page 19. It differs in the female in being 
much less developed, and passes more posteriorly to reach the 
tendinous centre of the perineum. 34 
THUNK. 
15. Sphincter Vaginae Muscle.—This muscle is the ana- 
logue of the accelerator urinae muscle in the male. Examining 
one-half of this (so-called) sphincter, it will be found to extend 
from a broad posterior extremity, at the angle of continuity of 
the bases of the perineal fascia and triangular ligament ; at 
the median line, posteriorly, some of its fibres converge with its 
fellow of the opposite side, to the tendinous centre of the per- 
ineum. Passing anteriorly, it forms a plane of the labium 
majus, at the side of the vaginal orifice, and narrows as it 
advances ; finally, it winds over the lateral surface of the cor- 
pus cavernosum of the clitoris, on the dorsum of which it is 
attached. The relations of the halves of the sphincter vaginae 
muscle to the clitoris determine its being the analogue of the 
accelerator urinae muscle. See Male Perineum, page 19. 
16. Tendinous Centre of the Perineum.—This point is 
situated more posteriorly in the female ; it is, as in the male, 
the common point of convergence of the muscles and fasciae of 
the perineum. See Male Perineum, page 19. 
17. Ischio-Cavernosus Muscle (Erector Clitoridis).—It is 
less developed than its analogue in the male, otherwise it is 
similar to it. See Male Perineum, page 19. 
Dissection.—Section the ischio-cavernosus muscle (Plate 14) at its ischial 
attachment, and reflect it anteriorly. 
18. Crus of the Clitoris.—Same attachments and course as 
the crus of the male penis, though much smaller. See Male 
Perineum, page 20. 
Dissection.—Section the superficial transversus perimei muscle (Plate 
14) and reflect it over the ischial tuberosity. Expose the muscular branch of 
the superficial posterior perineal nerve beneath the muscle. 
19. Muscle Brandi of the Superficial Posterior Perineal 
Nerve.—This branch is given off as the trunk ot the nerve 
passes to its superficial plane of distribution. It distributes : 
exteriorly to the triangular ligament, to the superficial trans- 
versus perinaei, sphincter vaginae, and ischio-cavernosus mus- 
cles ; interiorly to the triangular ligament, to the deep trans- 
versus perinaei, and the constrictor urethrae muscles. 
Dissection.—Section the halves of the sphincter vaginae muscle (Plate 14) 
and reflect them anteriorly, preserving their anterior extremities in relation FEMALE PERINEUM. 
35 
with the corpora cavernosa of the clitoris. Take out the three anterior su- 
tures of the labia ; dissect off the mucous membrane from the vestibule ; cut 
away the labia minora from the labia majora and from the clitoris; cut away 
the anterior halves of the labia majora. 
20. Bulb of tSie Vagina, Fig. 1, Plate 15.—This presents in 
two lateral portions, one on either side of the vaginal orifice ; 
they are nearly as broad as the halves, respectively, of the 
sphincter vaginae muscle ; they extend to about the middle of 
the antero-posterior diameter of the vaginal orifice ; they lie be- 
tween the sphincter vaginae muscle and the triangular ligament. 
The portions are broad posteriorly, narrowing as they advance 
anteriorly, to where they unite in the submucous plane of the 
vestibule of the pudendum, forming what is known as the pars 
intermedia. This vestibular portion of the bulb surrounds the 
meatus of the urethra, reaching to the vaginal margin of the 
vestibule. In the position in which the clitoris is fixed, in 
the illustration, the vestibular portion would seem to continue 
along the inferior surface of the corpora cavernosa of the cli- 
toris, and to cap the same at their extremities, thereby forming 
a glans clitoridis. (The portion of the bulb which passes from 
the pars intermedia to the glans clitoridis, is not, strictly speak- 
ing, continuous in structure with the bulb, but it presents a 
number of vessels, which continue from the pars intermedia 
to the glans.) The bulb of the vagina is the analogue of the 
male corpus spongiosum. In the female it is perforated by the 
urethra in its vestibular portion, and bears somewhat similar 
relations to the clitoris as does the corpus spongiosum to the 
penis. 
Dissection.—Hook half of the bulb of the vagina and the corresponding 
crus of the clitoris (the latter having been detached from the pubic arch) 
across the median line, so as to expose one-half of the triangular ligament; 
note the vessels and nerves that perforate the ligament. 
21. Triangular Ligament, Figs. 1 and 2, Plate 15.—This 
ligament is attached as in the male; see Male Perineum, page 
20. It has a much larger area in the female, owing to the 
greater space between the rami of the pubic arch. Anteriorly, 
it is perforated by the urethra, as in the male ; posteriorly, 
by the vagina, to which it is attached, interior to the plane of 
the bulb of the vagina. Posterior to the vaginal orifice, its 
base line, at the bis-iscliiatic fascial junction, is in continuity 36 
TRUNK. 
with the perineal and levator fasciae ; it is attached to the ten- 
dinous centre of the perineum ; at the latter joint it is more pos- 
terior than in the male. 
22. Artery of tlie Bulb, Fig. 2, Plate 15 ; Fig. 3, Plate 16. 
—This artery (vena comes) perforates the triangular ligament, 
to distribute as its name implies. 
23. Deep Perineal Artery, Fig. 2, Plate 15, and Plate 17.— 
This artery (vena comes) pierces the triangular ligament, 
passes anteriorly, and bifurcates into the artery of the corpus 
cavernosum and the deep dorsalis clitoridis artery. 
24. Artery of the Corpus Cavcrnosuni, Fig. 2, Plate 15.— 
This artery (vena comes) enters the interior surface of the crus 
clitoridis ; it sends a branch to the vicinity of the meatus 
urinarius. 
25. Deep Dorsalis Clitoridis Artery, Fig. 2, Plate 15 ; Figs. 
2 and 3, Plate 10.—This branch passes, anteriorly, between the 
crus and the os pubis, to reach the base of the suspensory liga- 
ment of the clitoris (page 37). 
26. Deep Perineal Verve, Plate 17.—This nerve pierces the 
triangular ligament to become, exteriorly, the deep dorsalis 
clitoridis nerve, which accompanies the last-described artery. 
Dissection.—Restore the crura, the bulb, and the sphincter vaginae mus- 
cles to their normal position; apply a hook into the free end of the clitoris, and 
extend it horizontally. Make a median-line incision through the skin of the 
dorsum of the clitoris and the mons veneris ; then reflect skin flaps. 
27. Superficial Dorsalis Clitoridis Vessels and Nerves, Fig. 
1, Plate 16.—These vessels and nerves are located on the dor- 
sum and lateral surfaces of the clitoris, in its subcutaneous 
plane. A superficial dorsalis clitoridis artery (vena comes) is a 
branch of a superior external pudic artery. A superficial dor- 
salis clitoridis nerve is contributed by an ilio-hypogastric nerve. 
Dissection.—Remove the superficial dorsal vessels and nerves of the cli- 
toris ; trace the anterior tendinous extremities of the sphincter vaginae mus- 
cles to the dorsum of the clitoris, then cut them away and expose the elastic 
suspensory ligament and sheath of the clitoris. FEMALE PERINEUM. 
37 
28. Sphincter Vaginae muscles, Plate 14.—The anterior 
tendinous ends of these muscles wind over the external sur- 
faces of the corpora cavernosa of the clitoris, for attachment 
to the dorsum of that organ. 
29. Elastic Suspensory ligament and Elastic Slieatli of 
the Clitoris, Figs. 1 and 2, Plate 1G.—This triangular, elastic- 
tissue ligament is attached to the symphysis pubis, from which 
it suspends the clitoris ; it is continued upon it as an elastic 
sheath. 
Dissection.—Make a dorsal, median-line, incision through the elastic 
sheath of the clitoris. Reflect lateral flaps of the same, exposing the deep 
dorsalis clitoridis arteries, vein, and nerves. Trace these vessels and nerves 
to the base of the organ. 
30. Deep Dorsalis Clitoridis Artery.—This artery emerges 
upon the dorsum of the clitoris, by a lateral opening in the 
base of the suspensory ligament ; it is lodged between the 
elastic sheath and a corpus cavernosum of the organ. 
31. Deep Dorsalis Clitoridis Vein.—This single vein is 
lodged in the furrow between the corpora cavernosa ; it leaves 
the dorsum of the clitoris by a middle opening in the base of 
its suspensory ligament. 
32. Deep Dorsalis Clitoridis Nerve.—A deep nerve readies 
the dorsum of one side of the clitoris, by the same lateral open- 
ing in the base of the suspensory ligament as does an artery ; 
it advances upon a corpus cavernosum, parallel with the artery, 
to distribute to its glans and prepuce. 
Dissection.—Detacli the suspensory ligament and cut the vessels and nerves 
as they enter its base ; cut away the clitoris and bulb of the vagina. Replace 
the stumps of the deep vessels and nerves of the clitoris upon the exterior of 
the ossa pubis (Fig. 3, Plate 16). Make transverse sections of the clitoris and 
compare its structure with that of the penis, of which it is the analogue, viz.: 
the cylinders of the corpora cavernosa; and the vessels and tissue occupying 
the place of the corpus spongiosum and glans of the male penis (page 98 ; 
Fig. 2, Plate 56). Section the triangular ligament, as the perineal fascia wTas 
sectioned (Plate 13) ; reflect a flap posteriorly, which should preserve its junc- 
tion with the perineal fascia and the tendinous centre of the perineum (Fig. 3, 
Plate 16); reflect the other two flaps to the pubic arch and the vaginal wall, 
respectively. 38 
TRUNK. 
33. Artery of the Bulb, Fig. 3, Plate 16.—This artery (vena 
comes), is a branch of the deep perineal, as it lies (in the female) 
in a deeper plane. It perforates the constrictor urethrae, as well 
as the triangular ligament, to reach its distribution. This 
branch, in turn, gives olf the artery to the mdro-vaglnal gland. 
34. The Deep Perineal Artery and 5fervc.—These perfor- 
ate the constrictor urethrae muscle from an interior plane. 
Dissection.—Clear the subjacent muscles of the urethro-vaginal region. 
35. Deep Transversus Perlnaci Muscle,—See Male Perine- 
um, page 21. 
3«. Constrictor Urethrae muscle.—See Male Perineum, page 
22. Its external attachment is as in the male; the anterior 
portion bridges from one ramus to the other, as a fold of mus- 
cle anterior to the urethral canal; a second portion converges 
to the urethral canal at the meatus, and to the vaginal wall. 
Dissection.—Remove the remaining sutures from the posterior portion of 
the labia majora. Find the orifice of the duct of the vulvo-vaginal gland upon 
the internal surface of the posterior half of the labium majus, and pass a fine 
probe into it; then track the probe to the gland, which in turn may be exposed 
by cutting away a portion of the deep transversus perimei muscle. 
37. Vulvo-vaginal Glands.—These glands {k. External ge- 
nitalia, page 29) are the analogues of Cowper’s glands of the 
male. A gland (the size of a small white bean) is located in 
the plane between the deep transversus perinaei muscle and 
the levator fascia (page 39), externally to the posterior ex- 
tremity of the bulb of the vagina ; its duct passes, internally, 
to its opening at the internal surface of the posterior half of a 
labium majus, exteriorly to the-orifice of the vagina. 
Dissection.—Section and reflect a flap of the gluteus maximus muscle, as 
in the dissection of the male perineum, see page 22. 
38. Great Sacro-Sciatic Ligament.—See Male Perineum, 
page 22. 
39. Fourth Sacral Werve.—See Male Perineum, page 22. 
Dissection.—Section tlie fibres of the deep transversi perinsei and con- 
strictores urethrae muscles, and reflect them to the urethra and vagina, inter- 
nally, and the pubic arch, externally. Preserve the attached portions of the FEMALE PEUHSTEUM. 
39 
perineal fascia and the triangular ligament at the bis-ischiatic fascial junction, 
and also the tendinous centre of the perineum. 
40. Deep Perineal Artery, Plate 17.—This artery (vena 
comes) is located interiorly to the ramus of the pubic arch 
and the plane of the deep transversus perinmi and constrictor 
urethrae muscles. 
41. I>cep Perineal Nerve.—This nerve accompanies the 
last-described artery. 
42. Levator Fascia (Levator ani portion or anal fascia, 
and levator vagime portion or posterior layer of the triangu- 
lar ligament).—This plane of fascia is analogous to that of the 
male (see Male Perineum, page 22); it differs from it in that 
the fascia is perforated, on the median line, by the vagina, to 
the circumference of which it is attached. In the female, the 
meeting of its two portions, at the bis-iscliiatic fascial junction, 
is located more posteriorly than in the male. 
Dissection.—Dissect off the levator fascia, and the tissues forming the bis- 
ischiatic fascial junction, from the muscle plane interiorly to it (Plate 18), tra- 
cing the fascia to the obturator fascia; section and cut away the deep perineal 
artery and nerve. Dissect away the tendinous centre of the perineum, so as to 
display the median-line raphe between the muscles interiorly to it. 
43. Levator Ani et Vaginae Muscles, Plate 18.—These mus- 
cles, right and left, are the analogues of the levator ani et 
prostatae muscles of the male (page 24, Plate 9). The ani por- 
tions or the middle and posterior parts of the muscles are the 
same as in the male (page 24). The vagince portions or the 
anterior parts of the muscles are attached to the interior sur- 
faces of the bodies of the ossa pubis ; they are projected pos- 
teriorly, being separated by a subpubic interval, which gives 
transit to the urethra and the vagina ; their fibres run parallel 
until they approach the interval between the vaginal and rec- 
tal outlets, when they curve, internally, to be attached to a 
fibrous, median line, raphe—the exterior of the raphe is at- 
tached to the tendinous centre of the perineum. The levator 
vaginae portions of the muscles support the posterior wall of 
the vagina, at its outlet, as the levator prostatae supports the 
prostate. 40 
TRUNK. 
Dissection.—Section the levator ani et vaginie muscle (Plate 18) and re- 
flect its internal portion to the median line—anteriorly and posteriorly to the 
rectum—and to the coccyx ; at these points the muscle may be cut away. The 
part of the muscle, that converges to the rectum, may be disposed of as in the 
male (page 25). 
44. Coecygeus Muscle.—See Male Perineum, page 25. 
45. Recto-vesical Fascia, Plate 19.—This plane of fascia is 
nearly the same as in the male (page 25 ; Plate 10). The 
right and left portions of the fascia form, as in the male, a 
sling, at the outlet of the pelvis, to support the viscera there 
presenting. In the female it differs from the male, in that it 
is perforated by the vagina. 
Dissection.—Section the recto-vesical fascia upon the rectal and vaginal 
walls, and reflect it, externally, to the pubic arch and the ischium. Note the 
close union of the rectal and vaginal outlets; also, the same of the urethral 
and vaginal outlets. Display the areolar tissue and vessels between the fascia 
and the presenting viscera. Dissect the visceral outlets apart sufficiently to 
demonstrate the three canals : urethral, vaginal, and rectal. 
46. Outlets of tlie Pelvic Viscera and tlie Perineal Body, 
Plates 13 to 19, inclusive.—Tlie urethra, vagina, and rectum 
present in order, antero-posteriorly (Plate 19). The situation 
of the so-called perineal bod?/, between the vaginal and rectal 
outlets, is occupied by the parts which converge to form the 
tendinous centre of the perineum (Plates 13 to 17, inclusive), 
and the raphe between the vaginas portions of the levatoresani 
et vaginae muscles (Plate 18). Interiorly to these parts the 
outlets of the vagina and rectum are intimately approximated. 
Dissection.—Remove the oakum from the vagina and rectum. Put a hook 
into the urethra and drag it anteriorly ; dissect the antero-superior wall of the 
vagina from it, inferiorly; once started the separation of the two canals is easily 
effected. As the sepai’ation progresses drag upon the urethra, anteriorly, and 
the vagina, posteriorly, until the base of the bladder is brought into view. 
47. Urethra, Fig. 1, Plate 20.—The female urethra or uri- 
nary canal is about one inch and one-half long ; it forms a nip- 
ple-like projection from the bladder. The canal may be dilated 
with the finger, so as to enter the bladder. 
48. Bladder.—The base of this organ is quite thin, as com- 
pared with the opposed vaginal wall; the two will have been FEMALE PERINEUM. 
41 
found loosely adherent by the intervention of a delicate areo- 
lar tissue. Its lateral surfaces present some small arterial 
branches. 
49. Ureters.—These ducts will be seen to enter the bladder, 
approaching the same obliquely from without inwards and for- 
wards ; their points of entrance are about one inch and one- 
lialf apart. Before entering the bladder they are located be- 
tween the superior wall of the vagina and the base of the 
bladder. 
50. Superior Wall of tlie Vagina.—The wall of this canal 
is thick and smooth, and its muscle structure evident ; at its 
lateral borders are the vaginal arteries. 
Dissection.—Restore tlie bladder, urethra, and superior wall of the vagina 
to their normal positions. Insert a hook into the posterior part of the cir- 
cumference of the vaginal outlet, and pull the same anteriorly ; dissect off 
the opposite rectal wall. For a distance of about one inch and one-lialf, in- 
teriorly to the tendinous centre of the perineum, the vagina and rectum are in- 
timately adherent, allowing of no sliding of their applied walls upon each 
other. Beyond their exterior adherent portions the two canals are loosely held 
together by areolar tissue, thus admitting of the sliding of one canal wall 
upon the other. As the dissection progresses the vagina should be pulled 
anteriorly, the rectum posteriorly and out of the pelvis. When about five 
inches of the superior wall of the rectum have been exposed, a septum of 
membrane, peritoneum, will be seen reflected from the rectum to the vagina. 
Note, on either side of the interior portion of the exposed rectum, the middle 
hemorrhoidal arteries; also, the vaginal arteries at either side of the vagina. 
51. Inferior Wall of the Vagina, Fig. 2, Plate 20.—This 
wall of the vagina presents little difference from the superior, 
except that a larger number of veins ramify in its substance. 
52. Rectum (Superior wall).—This wall of the rectum pre- 
sents the peculiar muscular structure of this portion of the 
large intestine, namely, that of longitudinal fibres ; it is quite 
thick, though not as thick as the opposite vaginal wall. 
53. Recto-Vaginal CuI-de-Sac of Peritoneum.—The mem- 
branous cul-de-sac, brought into view, interiorly, at the upper 
part of the exposed portions of the rectum and vagina, is 
formed by the peritoneum ; it is the bottom of the recto-vaginal 
or Douglas’ cul-de-sac. Bypassing the finger into the vagina. 42 
TRUNK. 
the reflection of the peritoneum from the vaginal to the rectal 
wall, one inch or more below the attachment of the vagina to 
the posterior surface of the uterus, is demonstrable; if the 
peritoneal cul-de-sac be opened, and a Anger of the other hand 
introduced at the opening, the two fingers will be separated 
by peritoneum, interiorly, and vaginal wall, superiorly. 
Dissection.—The organs should be crowded back into the pelvic cavity; 
the skin flaps of the perineum ajiproximated and sewed together on the 
median line. PLATE 13 
J\'f.Cb7in%c£cZ nctrur'am c?e£* PLATE 14- 
J&Cofrn,a.astac«ra>r* «?«£, PLATE 15 
JF’jret. 1 
zirinaritis 
jFjrct.2 
<Z)orscrtis etc fori cits n. 
" " art. 
Art. a/" oorpecs 
" ca iter's/ osn jr. 
. -Deep 
perineizt arf. 
•* Cfott/i, act reart a ret 7/1 dal. PLATE 16 
Fig. 1 
Fig. 2 
FlG. 3 
Deep _ 
dors, cfitorzdis d. 
" " o'er. ■ 
" " a. 
Meatus _ 
urinate as 
-Art. to 
tjdccnd 
Vuhco- 
ground, "" 
and diceC 
JjPvato r fascia 
M.Co7in,aoC natue-am. ofel. PLATE 17 
nf. eotin.ucl natziroc/n cteZr PLATE 18 
*22. Co/t/z , <xd /zcccztr'ctTzt PLATE 19 
M*C6}in,a.oLn«turam del. PLATE 20 
F/G.2 
Fia.l 
ad nACitrdm dei. THIRD DISSECTION. 
ANTERO-LATERAL AREAS OF THE ABDOMINAL 
PARIETES. 
Dissection.—The body should be placed lying upon the back, with a 
block under the shoulders and one under the pelvis. 
Terms of Relation.—The following terms will be nsed to 
designate the Areas of the abdominal wall: Anterior, Late- 
ral and Antero-Lateral. The words Interior and Exterior 
will indicate proximity to the abdominal cavity, and to the 
skin, respectively. 
Bones and Cartilages, Plates 21 and 42.—Tlie anterior 
halves of, and the cartilages of, 
the six inferior ribs (right and 
left), the ensiform cartilage of 
the sternum, the crest of the 
ilium and the superior surface 
of the ossa pubis of the right 
and the left os innominatum, 
form the osseous framework of 
this dissection. All these bones 
and cartilages afford attach- 
ments to muscles. 
Dissection.—Extend the penis hori- 
zontally by fixing a hook into the pre- 
puce ; then fix the other two hooks, of 
the chain-hooks, into the lower limbs. 
Make the skin incisions, 1 and 2 of Fig. 
3 ; skin incision 1 will be referred to as 
the Bis-Iliac Incision; skin incision 2 
as the Median-Line Incision. Reflect a 
skin flap, inferiorlv, upon the thigh, to 
which it may be pinned. This form of flap, from this region, will be called 
an Inguinal Flap. Hook the skin sheath of the penis, externally. 
Figure 3. 44 
TRUNK. 
l. Subcutaneous Tissue, Plate 22.—The subcutaneous tis- 
sue is more or less loaded with fat. This plane of tissue passes 
continuously to contribute to the dartos sheath of the penis 
and the dartos tunic of the scrotum. The inguinal area of the 
subcutaneous tissue of the abdominal wall may be easily di- 
vided into two layers, the superficial and the deep, between 
which vessels ramify. Note, the perforation of the superficial 
layer, external to the root of the scrotum and penis, by the 
superficial penile and scrotal branches of the superficial exter- 
nal pudic vessels; also, the perforation of the same, superior 
to the root of the penis, by the superficial penile branches of 
the ilio-hypogastric nerve. 
Dissection.—Make the bis-iliac incision on one side, and the median-line 
incision down to the root of the penis, through the superficial layer of the sub- 
cutaneous tissue. Reflect an inguinal flap of the superficial layer, being care- 
ful to preserve the perforating penile and scrotal vessels and nerves, by slitting 
through the layer, so as to retain their continuity from their trunks to their 
distributions; carry the flap from the face of the anterior superior region of 
the thigh, so as to expose the saphenous opening in the fascia lata. The ves- 
sels between the superficial and deep layers will be found a guide to the sep- 
aration of the two planes of tissue. Note, the continuity of the superficial 
layer with the subcutaneous tissue of the thigh, the dartos tunic of the scrotum 
and the dartos sheath of the penis. Pin the flap to the thigh with the skin. 
2. Subcutaneous Arteries of the Inguinal Region.—Be- 
tween the layers of the subcutaneous tissue of the inguinal 
region are the recurrent branches from the femoral artery, 
which perforate the fascia lata, below the line of the groin: 
the superficial circumflex iliac, extending superiorly and ex- 
ternally over the crest of the ilium ; the superficial epigastric, 
running superiorly and internally ; the superior external pu- 
dic, curving internally to tlie root of the penis or clitoris. 
3. Subcutaneous Veins of the Inguinal Region. — The 
vense comites of the above arteries may be traced to where they 
empty into the internal saphenous vein, before its entrance 
into the saphenous opening in the fascia lata. 
4. Superficial Dorsal Vessels and Nerves of tlie Penis.— 
Between the skin and tlie dartos sheath of the penis the su- 
perficial dorsalis penis artery, branch of the superior external 
pudic, runs longitudinally upon the dorsum of the penis, from 
the base to the glans. The vena conies, sometimes quite large, 45 
ABDOMINAL PARIETES. 
anastomoses with the deep dorsalis penis vein, and continues 
to the superior external pudic vein. The ilio-liypogastric nerve 
distributes dorsal branches to the organ. 
Dissection.—Section the superficial dorsalis penis vessels and nerves at 
the root of the penis, and dissect them off of the dartos sheath. 
5. Dartos Sheath of the Penis.—This sheath is in contin- 
uity with the superficial and deep layers of the inguinal sub- 
cutaneous tissue; it is also continuous with the dartos tunic 
of the scrotum. It differs from the inguinal subcutaneous 
tissue planes, in being free of fat and in having involuntary 
muscular fibres in its structure. It is separated by loose are- 
olar tissue from the subjacent elastic tissue sheath of the organ, 
thus allowing of its sliding upon the latter. 
Dissection.—Expose the suspensory ligament of the penis; make a median- 
line incision on the dorsum of the penis, through the dartos sheath, and reflect 
a flap externally ; follow the suspensory ligament to the penis. 
6. Suspensory Ligament ansi Sheath of the Penis.—This 
so-called ligament, composed of elastic tissue, is attached to 
the median line of the pubes. It passes, interiorly, upon the 
body of the penis, to which it contributes an elastic sheath, 
which is thickest around the root of the organ. 
Dissection.—Make a median-line incision on the dorsum of the penis, 
through the elastic sheath, from the glans to the base of the organ ; dissect off 
the sheath, so as to expose the deep dorsalis penis vessels and nerves, and 
show their relations to the openings at the attached base of the ligament. 
7. Deep Dorsalis Penis Artery.—The artery, of a side, has 
been described in a part of its course (see Male Perineum, page 
20). In the dissection of the male perineum it was left, passing, 
anteriorly, between the exterior surface of the body of the 
os pubis and the crus of a corpus cavernosum (Pigs. 1 and 2, 
Plate 8). It enters upon the dorsum of the penis, through the 
attached base of the suspensory ligament, by an opening at the 
side of the median line ; thence it runs, longitudinally for- 
ward, upon the dorsum of the organ, distributing branches to 
the corpus cavernosum and the glans. 
8. Deep Dorsalis Penis Nerve (see Male Perineum, page 2). 
—This nerve accompanies the last-described artery to the sus- 
pensory ligament; it enters upon the dorsum of the penis by 46 
TRUXK. 
the same opening in the suspensory ligament; it continues to 
the glans, to the mucous membrane of which it is distributed. 
9. Deep Dorsalis Penis Vein.—This vein (sometimes two) is 
lodged on the median line of the dorsum of the penis, passing 
from the glans to the suspensory ligament, where it enters a 
middle opening. It then continues, posteriorly, upon the ex- 
terior of the os pubis ; it enters the pelvic cavity by perforat- 
ing the triangular ligament; it then bifurcates, the branches 
emptying respectively into the venous plexus, right and left, 
at the sides of the prostate and base of the bladder. 
Dissection.—Make tlie bis-iliac and median-line incisions through the 
deep layer of the subcutaneous tissue ; reflect an inguinal flap, inferiorly, upon 
the thigh, carrying the superficial inguinal vessels with it; pin the flap to the 
thigh. 
10. Deep Layer of the Subcutaneous Tissue of tlie Ingui- 
nal Region.—This plane of tissue continues below tlie line of 
Poupart’s ligament, to be attached to the fascia lata, at an 
oblique line from the anterior superior spinous process of 
the ilium to the scrotum; the attachment runs between Pou- 
part’s ligament and the saphenous opening. In the male, it is 
continuous with the dartos tunic of the scrotum and penis ; in 
the female, with that of the labium majus. This plane of tissue 
is continued from the perineal fascia of the perineum ; advan- 
cing, anteriorly, the latter becomes the dartos tunic of the scro- 
tum (posterior and anterior surfaces) or of the labia majora 
(female); from the dartos tunic of scrotum or labium it is di- 
rectly continuous with the layers of the subcutaneous tissue 
of the inguinal region. 
Dissection.—Make skin incisions 3 and 4 of Fig. 3 (page 43), and reflect a 
flap of the skin, externally, well off the lateral area of the abdomen. Incision 
4, with 2, completes the median-line incision. 
11. Subcutaneous Tissue, Plate 24.—The superior antero- 
lateral area of the subcutaneous tissue presents but a single 
layer. It is in this plane of theparietes that the subcutaneous 
nerves of the abdomen ramify. 
Dissection.—Make incision 3 and median-line incision 4, of Fig. 3, in tlie 
subcutaneous tissue plane, and reflect lateral flaps corresponding to those of tlie 
skin ; preserve, as long as possible, the cutaneous nerves and vessels at their 
points of emergence. ABDOMINAL PARIETES. 
47 
12. Cutaneous Nerves of the Abdominal Parietes, Plate 
23.—These nerves, from the inferior intercostal nerves, per- 
forate the superficial fascia. They become subcutaneous at 
the following points: laterally, at the rib attachments of the 
obliquus externus muscle; anteriorly, toward the median 
line. The lateral nerves bifurcate into posterior and anterior 
branches. The anterior present two rows of emergence: the 
external divide as do the lateral; the internal do not divide. 
13. Superficial Fascia.—This plane is a very thin layer of fi- 
brous tissue upon the exterior of the obliquus externus muscle; 
it is continued from the thoracic parietes, superiorly ; it is at- 
tached, inferiorly, to the crest of the ilium, Poupart’s ligament 
and the body of the os pubis. In the inguinal region it is 
strengthened by loops of fibrous tissue, with their convexi- 
ties directed toward the pubes, the arciform or intercolumnar 
fibres. 
Dissection.—Dissect off the superficial fascia from the obliquus externus 
muscle, being careful to preserve the portion of it that springs from the pil- 
lars of the opening in the aponeurosis of the muscle, to invest the spermatic 
cord. Trim away the inguinal flaps of subcutaneous tissue along the line of 
the groin. 
14. Fibrous Tissue Markings of the Abdominal Parietes, 
Plate 24.—These markings are : the linea alba, at the median 
line, from the symphysis pubis to the ensiform cartilage of the 
sternum—upon this line is the umbilicus; the linese semilu- 
nares, curving, superiorly, from opposite the spines of the ossa 
pubis to the anterior extremities of the cartilages of the tenth 
ribs ; the linese transversse cross between the linea alba and the 
linese semilunares, at, and superior to, the umbilicus. 
15. Obliquus Externus Muscle, Fig. 1, Plate 21 and Plate 
24.—This forms the exterior muscle plane of the antero-lateral 
area of the abdominal parietes. Superiorly, it is attached to 
the exterior surfaces of the lateral area of the seven or six in- 
ferior ribs ; the superior four or five attachments interdigitate 
with digitations of the serratus magnus muscle; the inferior 
three attachments interdigitate with digitations of the latis- 
simus dorsi muscle. From the two inferior ribs the muscle 
fibres pass, interiorly, to the crest of the ilium ; from its supe- 
rior four or five rib attachments the fibres pass interiorly and 48 
TRUNK. 
internally. The latter portion of the muscle forms an aponeu- 
rosis at the anterior area of the abdomen, which continues as a 
single plane to the linea alba, from the sternum to the sym- 
physis pubis. Superiorly, the pectoralis major muscle—its in- 
ferior portion—is attached to the exterior of the aponeurosis. 
The inferior edge of the aponeurosis bridges from the an- 
terior superior spinous process of the ilium to the spine of the 
os pubis, forming Poupart’s ligament ; it is also attached to 
the linea ilio-pectinea—on the superior surface of the horizon- 
tal ramus of the os pubis—external to the spine of the os pu- 
bis, forming Gimbernat’s ligament. External and superior to 
the pubic attachment to the spine of the pubis, a deficiency 
presents in the aponeurosis—a slit-like opening—the pubic 
(external) abdominal ring. This opening has a superior and 
an internal border, and an inferior and external border, known 
as the pillars of the ring. A little superior and internal to the 
pubic ring the aponeurosis is perforated by the ilio-'liypogastric 
nerve (Plate 23). 
16. External Spermatic (Intcrcoluinnar) Fascia.— From 
the pillars or borders of the pubic (external) abdominal ring, 
the superficial fascia upon the exterior of the obliquus externus 
muscle projects this fascial investiture upon the spermatic 
cord (male) or round ligament of the uterus (female). 
Dissection.—Incise and open the external spermatic fascia upon the cord, 
exposing the subjacent investiture of the same. 
17. Spermatic Cord (male) or Round Eigamcnt of tlie 
Uterus (female).—The cord or ligament with its investments 
passes through the pubic (external) abdominal ring, also the 
ilio-inguinal nerve. 
Dissection.—Incise the aponeurosis of the obliquus externus (Plate 24) by 
the median-line and bis-iliac incisions (2 and 3, Figure 3 ; page 43) ; reflect an 
inguinal flap of the same (Plate 25). 
18. Pubic (External) Abdominal Ring, Piute 25.—Tile inte- 
rior surface of this so-called ring shows its true character, 
viz. : a splitting or separation of the fibres of the aponeurosis 
of the obliquus externus. The pillars of the ring are well de- 
fined upon this surface. ABDOMINAL PAKIETES. 
49 
Dissection.—Incise the obliquus externus muscle (Plate 24) as follows: at 
its lateral area, from the eleventh rib to the ilium, and along the crest of the 
ilium; at its rib attachments, dissect out its digitations from the interdigita- 
tions of the serratus magnus muscle. Deflect a flap of the superior antero- 
lateral area of the muscle, internally, to a line beyond the linea semilunaris; 
fold the portion of the muscle into a longitudinal roll at the side of the median 
line (Plate 25). 
19. Intermuscular Septum.—A thin layer of fibrous tissue 
separates the obliquus externus from the obliquus internus 
muscle. 
20. Ilio-liypogastric Nlervc.—This nerve emerges through 
the obliquus interims muscle, internal to the anterior superior 
spinous process of the ilium ; it continues exterior to the mus- 
cle, internally, to where it perforates the aponeurosis of the 
obliquus externus muscle, as before shown. 
21. Ilio-inguinal Nerve.—This emerges through the ob- 
liquus interims muscle ; it runs upon the muscle, parallel 
with and nearer to Poupart’s ligament than the last named 
nerve. It emerges at the pubic (external) abdominal ring, with 
the spermatic cord (male) or round ligament of the uterus 
(female). 
Dissection.—Clear tlie intermuscular fibrous tissue from the surface of the 
obliquus interims muscle. 
22. Obliquus Interims Muscle, Fig. 1, Plate 21, and Plate 
25.—This forms the second antero-lateral muscle plane of the 
abdominal parietes. It is attached : posteriorly, to the lumbar 
aponeurosis; interiorly and externally, to the anterior two- 
thirds of the mid-space of the crest of the ilium and to the ex- 
ternal half of Poupart’s ligament; superiorly, to the cartilage 
of the twelfth rib, the eleventh rib, and the cartilages of the 
eleventh, tenth, and ninth ribs ; internally, to the linea alba 
by the aponeurosis of the muscle—this splits at the linea semi- 
lunaris, to sheath the rectus, and then unites at the linea alba. 
Its middle Poupart ligament fibres are attached to the exterior 
of the tendon of the transversal is, externally to the inferior of 
the linea semilunaris. Its inferior Poupart ligament fibres 
(male) loop, interiorly, to invest the spermatic cord upon its an- 
tero-external surfaces, returning, superiorly, to be attached to 
the anterior surface of the body of the os pubis. These looped 50 
TRUXK. 
fibres form wlmt is called tlie cremaster muscle. In the fe- 
male the looping of these inferior fibres of the obliquus in- 
ternus muscle does not occur ; the muscle fibres simply separate 
to give transit to the round ligament of the uterus, and pass, 
internally, to be attached to the conjoined tendon and the os 
pubis. 
Dissection.—Dissect the ilio-hypogastric and ilio-inguinal nerves supe- 
riorly and reflect them externally. Make an incision through the fibres of the 
obliquus internus muscle from the anterior superior spinous process of the ilium 
to the linea semilunaris, a second through its fibres, attached to Poupart’s liga- 
ment (Plate 25). Reflect the included inguinal portion of the muscle to the 
linea semilunaris. In the male trace the middle Poupart ligament fibres to 
the exterior of the conjoined tendon portion of the transversalis abdominis 
muscle; and the inferior fibres as they form the cremasteric loops upon the 
spermatic cord. In the female note the absence of cremasteric loops and 
the unbroken plane of the muscle. Incise the muscle as follows : from the 
eleventh rib to the ilium, and along its crest attachment; also below its at- 
tachments to the eleventh rib and its cartilage. Reflect a flap, internally, of 
the superior antero-lateral portion of the muscle to the linea semilunaris; throw 
the flap over the reflected obliquus externus muscle. The guides to the plane 
of intermuscular fibrous tissue, separating the obliquus internus from the trans- 
versalis abdominis muscle, are the vessels and nerves ramifying between these 
muscles. Remove the fibres of the obliquus internus to the conjoined tendon, 
noting, that they are inserted into the exterior surface of the transversalis por- 
tion of the tendon. Dissect off the cremasteric loops from the spermatic cord. 
23. Intermuscular Septum.—A plane of fibrous tissue forms 
a septum between the obliquus internus and the transversalis 
abdominis muscles, in which vessels and nerves ramify. 
Dissection.—Differentiate the nerves and arteries in the fibrous tissue 
plane, and dissect off the latter from the antero-lateral area of the transversalis 
abdominis muscle. 
24. Deep Vessels and Serves of flic Parietes, Plates 26 and 
27.—These vessels and nerves are the terminal branches of the 
four inferior intercostal arteries and nerves, which continue to 
the median line; they may be traced, internally, to where they 
penetrate the sheath of the rectus abdominis muscle. They 
supply the antero-lateral muscles and skin of the abdominal 
parietes. The ilio-hypogastric and ilio-inguinal nerves, branches 
of the first lumbar nerve, also present. 
25. Deep Circumflex Iliac Artery, Plate 27.—This ar- 
tery (vena comes) is a branch of the external iliac. It per- ABDOMIXAL PARIETES. 
forates the transversaiis abdominis, near the anterior superior 
spinous process of the ilium, to wind, externally and superi- 
orly, over the crest of the ilium, exteriorly to the muscle. 
26. Transversalis Abdominis Muscle, Plates 27 and 42.— 
This forms the third antero-lateral muscle plane of the ab- 
dominal parietes. Its attachments are: to the interior sur- 
faces of the cartilages of the six inferior ribs—interdigitatirig 
with digitations of the diaphragm ; to the lumbar aponeurosis, 
by which it is attached to the transverse processes of the lum- 
bar vertebrae ; to the anterior three-fourths of the interior por- 
tion of the crest of the ilium ; to the external third of Pou- 
part’s ligament; to the linea alba, by the aponeurosis of the 
muscle, which commences at the linea semilunaris ; and to the 
os pubis by the conjoined tendon. 
27. Conjoined Tendon.—This is formed by the converging 
of the inferior Poupart ligament fibres of the transversaiis ab- 
dominis muscle and the middle Poupart ligament fibres of the 
obliquus internus muscle, to a common point of attachment on 
the linea ilio-pectinea, externally and interiorly to the spine, 
and to the superior surface of the body, of the os pubis. The 
fibres of the obliquus internus are attached to the exterior 
of the aponeurosis of the transversaiis. The tendon is located 
externally to the inferior end of the linea semilunaris, in a 
plane interiorly to the spermatic cord (male) or round liga- 
ment of the uterus (female), as it passes through the pubic 
(external) abdominal ring ; at its linea-ilio-pectinea attachment 
it lies interiorly to Poupart’s and Giinbernat’s ligaments. 
Dissection.—Replace the flaps of the obliquus interims and externus mus- 
cles ; make an incision parallel with, and midway between, the linea alba and 
the linea semilunaris, through the aponeurosis of the obliquus externus and 
the exterior layer of the splitting of the aponeurosis of the obliquus internus. 
Reflect lateral flaps to each linea, respectively, exposing the rectus abdominis 
and the pyramidalis abdominis muscles. 
28. Pyramidalis Abdominis Muscle, Plates 28 and 42.— 
This small, triangular, muscle lies exteriorly to the inferior por- 
tion of the rectus abdominis, at the side of the median line. 
At its base it is attached to the superior border of the body 
of the os pubis; its fibres pass, superiorly, to its apex, at the TRUNK. 
linea alba, where it is attached about a third or a half of the 
distance from the symphysis pubis to the umbilicus. 
29. Rectus Abdominis Muscle.—This muscle, as its name 
implies, is straight iibred ; it is attached, interiorly, to the supe- 
rior surface of the body of the os pubis from the symphysis to 
the spine ; superiorly, to the exterior surfaces of the ensiform 
cartilage of the sternum, and the cartilages of the seventh, 
sixth and fifth ribs. The muscle fibres are intersected at and 
above the umbilicus by three fibrous portions, which deter- 
mine the line*© transversal; the latter are attached to the ex- 
terior layer of the sheath of the muscle. 
30. Slicatli of tlic Rectus Abdominis Muscle, Plate 28.— 
This invests the abdominal portion of the muscle, between 
its pubic and thoracic attachments. It is formed by the 
aponeuroses of the antero-lateral muscles of the abdominal 
parietes. The aponeurosis of the obliquus externus continues 
to the linea alba from the ensiform cartilage to the symphysis 
pubis. The aponeurosis of the obliquus interims splits at 
the linea semilunaris into two layers for the superior three- 
quarters of the muscle portion ; one layer passes exteriorly to 
the muscle and interiorly to the aponeurosis of the obliquus 
externus ; the other layer passes interiorly to the muscle. In- 
ternally to the muscle the two layers reunite at the linea alba. 
For the inferior quarter of the abdominal portion of the rectus 
abdominis muscle, the aponeurosis of the obliquus internus 
does not split, but, as a single layer, passes to the linea alba, 
exteriorly to it. The aponeurosis of the transversalis ab- 
dominis, for the superior three-fourths of the abdominal por- 
tion of the muscle, continues to the linea alba, interiorly to the 
muscle and the interior layer of the split aponeurosis of the 
obliquus internus ; for the inferior quarter of the muscle por- 
tion, it passes to the linea alba exteriorly to the muscle. The 
exterior portion of the sheath of the rectus is formed thus: 
from without inward, for its superior portion, by the aponeu- 
rosis of the obliquus externus and the exterior layer of the 
obliquus internus; for the inferior quarter, of its abdominal 
portion, by the aponeuroses—in single layers of each—of the 
obliquus externus and internus, and the transversalis abdominis 
muscles. The interior portion of the sheath is deficient at the 
inferior quarter of the abdominal portion of the muscle; for ABDOMINAL PAIIIETES. 
53 
the superior three-quarters, it is formed—from without inward 
—by the interior layer of the aponeurosis of the obliquus in- 
terims and the aponeurosis of the transversalis abdominis 
muscle. The interior layer of the sheath is attached, superiorly, 
to the inferior borders of the seventh and eighth costal carti- 
lages and the ensiform cartilage of the sternum. 
31. Linea Semilunaris—This fibrous line is contributed to 
by the superposition of the aponeuroses at the external edge 
of the rectus abdominis muscle. 
32. Linea Alba.—This line is formed by the intersection of 
tlie aponeuroses of the three pairs of antero-lateral muscles, at 
the median line, from the symphysis pubis to the ensiform car- 
tilage of the sternum, between the internal borders of the recti 
muscles. 
Dissection.—Remove tlie pyramidalis abdominis muscle. Trace the nerves 
exterior to the transversalis abdominis muscle into the substance of the rectus 
abdominis muscle (Plate 26). Trace the deep epigastric artery and its branches, 
superiorly, through the rectus abdominis muscle, and determine their anasto- 
moses with the superior epigastric branch of the internal mammary; preserve 
these arteries within the sheath, by cutting away the substance of the muscle 
tissue between them (Plate 28). Note the course of the spermatic cord, or of 
the round ligament of the uterus between the inferior edge of the transversalis 
abdominis muscle (Plate 27) and Poupart’s ligament, upon the portion of the 
transversalis fascia there presenting. Cut away the obliquus externus and in- 
terims muscles, external to the linese semilunares; trim the aponeurotic flaps 
of the exterior portions of the sheaths of the recti muscles close to the linepe 
semilunares and the linea alba. Cut the intercostal nerves and vessels close 
to their emergence from between the ribs. Cut the circumflex iliac arteries at 
their points of penetration of the transversalis abdominis muscles. Section 
the transversalis abdominis muscle: along the inferior border of the eleventh 
rib and the borders of the cartilages of the three lowTer ribs ; from the eleventh 
rib to the ilium; along the crest of the ilium; and at its Poupart ligament 
attachment. Reflect an antero-lateral flap of the transversalis abdominis mus- 
cle, internally, to the linea semilunaris, where it may be cut away. 
33. Transversalis Fascia.—This fascia lines the transver- 
salis muscle ; it is thick and well defined at its inguinal por- 
tion, but much less so superiorly ; it continues, internally, to 
the linea alba, interior to the sheath of the rectus abdominis 
muscle. 
34. Iliac (internal) Abdominal Ring.—This so-called ring 
is the point of emergence through the transversalis fascia of the 54 
TRUNK. 
spermatic cord or of the round ligament of the uterus ; it is situ- 
ated superior to the middle of Poupart’s ligament. A process 
of the transversalis fascia is projected, like the tube of a fun- 
nel, interiorly, upon the cord or the ligament, as the internal 
sjyermatic (<infundibuliform) fascia. 
Dissection.—Make an incision through the transversalis fascia from the 
anterior superior spinous process of the ilium to the linea semilunaris. Reflect 
a partial inguinal flap, so as to expose the interior of the iliac (internal) ab- 
dominal ring. The guide to the reflection of this flap of fascia is the deep 
epigastric artery, which lies in the plane of the subserous areolar tissue be- 
tween the fascia and the peritoneum. Note the transit of the elements of the 
spermatic cord into the funnel tube process (internal spermatic fascia) upon 
the cord. 
35. Subserous Areolar Tissue.—This is a plane of loose fib- 
rous tissue, between the transversalis fascia and the peritoneum. 
Inferior to the umbilicus, it allows the peritoneum to be readily 
separated from the transversalis and iliac fascim; superior to 
the umbilicus, it is very little developed, thereby rendering the 
separation of the peritoneum much more difficult. 
30. I>cep Epigastric Artery—This artery (vena comes) is a 
branch of the external iliac, which reaches the anterior parietes 
of the abdomen through the subserous tissue exterior to the 
peritoneum. It runs internal to the iliac (internal) abdominal 
ring, superiorly and internally, to where it enters the sheath 
of the rectus abdominis muscle—about on the bis-iliac line. 
Within the sheath it passes superiorly, through the contained 
muscle, and anastomoses with the superior epigastric artery ; 
the latter artery is one of the terminal branches of the internal 
mammary artery, which enters the superior part of the rectus 
muscle, from the thorax. 
Dissection.—Slit up tlie internal spermatic (infundibuliform) fascia ("Plate 
28), so as to expose the spermatic cord. Distinguish the elements of the 
spermatic cord, and trace the same beneath the peritoneum into the iliac fossa. 
37. Elements of Hie Spermatic Cord.—These are : tile vas 
deferens, a hard, well-defined duct; the spermatic veins, arte- 
ries and nerves. The vas deferens winds abruptly, internally, 
behind the deep epigastric artery, to pass into the pelvic 
cavity beneath the peritoneum; the vessels and nerves con- 
tinue, superiorly, between the peritoneum and the iliac fascia. -F'zg.jZ 
PLATE 21 
OEBBA TCI-S 
MA &/VC/S 
22 /K&OBS'AL, 
VBBJTBBBA 
/.AT/SS/Mt/S BOBS! 
77AIBJIB 
VBBlTBBBIL 
J^XG.2 
JH.Co/tn,a.e£naCuy&.'n atef- PLATE 22 
Af.Co/intGcaZnocticrcc/rc cCeZ* PLATE 23 
-AxiZIaery art.—. 
i.ntZ 
cutaneous' /?. 
Jntercosto hi/lit- 
eral or,2™ainter- 
costal n. 
2s/lumhar cr/l/rrr - 
cor/s' 2rra.nc?i / PLATE 24 
n.aectf'Gc.m. PLATE 25 
-_Z£io ~iiypoya si fie tt. 
■— Jiio-itiyuitzci?n. 
-^oiepart's 
-C’onjoineet tendon. 
'JEy£tla6c£omi?zccZ 
~ rzny 
AT.CoJtn act tcaturrcm ctel. PLATE 26 
Axillary art. 
Lesser intT 
cu taneous »,. 
-llio -hypogast ric 
—Ilio-inguinal 
n. PLATE 27 
<xd 7zat. cieZ. PLATE 28 
\ S'lipTepigrarstric 
I art- 
7V'Ct?z aaer - 
‘W/Z'S'fCZ'S'CeO. 
\Z?eep epz- 
8a das'trie 
A.tz tflayer 
~o/T*sAeti.£J& 
££'Ca7m/ delnatureem cteZ FOURTH DISSECTION. 
ABDOMINAL VISCERA IN SITU. 
Dissection.—Clear the antero-lateral areas of the parietal layer of the 
greater peritoneum, by removing the interior portion of the sheath of the 
rectus abdominis muscle, right and left, and the transversalis fascia. Be care- 
ful in dissecting off the transversalis fascia from the peritoneum, that the lat- 
ter be not torn into; indeed, the superior portion of the fascia may be left upon 
the peritoneum. Dissect out and preserve, in situ, the obliterated foetal ves- 
sels and duct, which lie between the transversalis fascia and the peritoneum. 
1. Obliterated Praelius, Plate 29.—This is located along 
the median line from the umbilicus to the fundus of the blad- 
der, in the plane of the subserous areolar tissue exterior to the 
peritoneum. In adult life it is a fibrous cord, which serves the 
purpose of a superior ligament to the bladder. 
2. Obliterated Hypogastric Arteries.—These are located 
in the same plane of subserous tissue ; they diverge from the 
umbilicus, right and left, interiorly, to the hypogastric region, 
where they dip into the pelvic cavity, exterior to the perito- 
neum, to become continuous with the superior vesical branches, 
right and left, of the anterior trunks of the internal iliac ar- 
teries. 
Greater and Lesser Peritoneum, Plates 29, 30 and 31. 
—These are two distinct serous membranes, which form two dis- 
tinct serous cavities, which invest the sub-diaphragmatic por- 
tions of the digestive apparatus, etc., to insure their mobility 
upon each other in performing their respective functions and 
in their induced motions by respiration, etc. 
Dissection.—Section the antero-lateral or parietal layer of the greater 
peritoneum (Plate 29), to the left of the median line, from the ensiform carti- 
lage of the sternum to a point just below the umbilicus ; make a second section, 
transversely, to the left, from the inferior end of the first; reflect the flap 
upon the exterior of the left lower ribs, to which it may be pinned. Demon- 
strate the cavity of the greater peritoneum by passing the hand and arm into it: 56 
TRUXK. 
to tlie right, superiorly, recognize the broad and round ligaments of the liver ; 
at the middle and to the left is the stomach, with the spleen capping its fun- 
dus ; interiorly, is the great omentum, through which the contour of the trans- 
verse colon may be felt. Introduce the hand beneath the great omentum 
and feel—in the middle—the convolutions of the small intestine and the un- 
der surface of the transverse colon; to the right, the ascending colon and 
caecum; to the left, the descending colon and the sigmoid flexure ; interiorly, 
the superior contours of the pelvic organs. Return the hand out of the cavity 
along the interior of the antero-lateral or parietal layer of the greater perito- 
neum. 
4. Greater Peritoneum and Cavity of tlie Greater Peri- 
toneum, Plates 30, 31, 32, 34, 35, and 37.—The greater peri- 
toneum is spread, and forms its cavity, as follows: it invests 
the anterior of the inferior concave surface of the diaphragm 
(Plate 31); passes from the diaphragm to the stomach, by the 
oesophagus, and to the antero-superior surface of the liver—as 
the broad (Plate 30), the anterior layer of the coronary and the 
lateral ligaments ; from the anterior of the liver it passes to its 
postero-inferior surface ; from the latter surface it bridges to 
the lesser curvature of the stomach, as the antero-superior layer 
of the anterior portion of gastro-liepatic omentum ; thence it 
spreads over the anterior surface of the stomach (Plate 31). 
From the greater curvature of the stomach it bridges to the 
transverse colon—the anterior of two layers of serous mem- 
brane ; from the colon it is dropped (Plate 31), and then returns 
upon itself—great omentum—to the inferior surface of the 
transverse colon, from which it is projected to the posterior 
wall of the abdomen (Plate 31). At the right of the posterior 
wall of the abdomen it covers the duodenum, the ascending 
colon, and caecum (Plate 34)—forming the ascending meso-colon 
and the meso caecum. To the left it is projected, from the line 
of attachment of the mesentery (Plate 34), as its right layer, 
which reduplicates by investing the jejunum and ileum ; it re- 
turns upon itself, to its line of attachment, as the left layer of the 
mesentery. To the left of the mesentery attachment it spreads 
to the descending colon and sigmoid flexure (Plate 35)—forming 
the descending meso-colon and the meso-sigmoid. From the 
meso-caecum, to the right, the meso-sigmoid, to the left, and the 
mid-portion of the posterior of the abdominal wall, it passes into 
the pelvic cavity (Plates 35 and 37), covering the superior por- 
tions of the pelvic viscera—forming the meso-rectum, and liga- ABDOMINAL VISCERA IN SITU. 
57 
ments of the uterus and bladder. From the fundus of the blad- 
der (posteriorly to the urachus and the obliterated hypogastric 
arteries), by the external layer of the meso-csecum and ascending 
meso-colon (at the right), and by the external layer of the 
meso-sigmoid and descending meso-colon (at the left), it is 
reflected to line the interior of the antero-lateral parietes of the 
abdomen (Plate 31) and returns thereby to the inferior surface 
of the diaphragm. 
5. Broad Ligament of the Liver, Plate 30.—This, formed 
by two layers of the greater peritoneum, makes a scythe- 
shaped ligament, attached as follows : by its base to the an- 
terior •convex surface of the liver; by its convexity to the 
diaphragm and the interior of the right anterior wall of the 
abdomen; by its apex to the umbilicus; its concavity is a 
reduplicated free edge, from the umbilicus to the notch at the 
inferior border of the liver. 
6. Round Ligament of tlie Liver.—This, the obliterated 
umbilical vein, is lodged, within the reduplicated free edge of 
peritoneum, at the concavity of the broad ligament, passing 
into the notch at the inferior border of the liver. 
Dissection. —Cut tlie round and broad ligaments at their attachments to 
the abdominal parietes, and allow them to drop back upon the liver (Plate 30). 
Section the peritoneum—parietal antero-lateral portion—transversely to the 
right, and interiorly along the left of the median line and reflect flaps. 
Make a transverse cut through the peritoneum between the greater curvature 
of the stomach and the transverse colon (Plate 30); introduce the hand into 
the cavity of the lesser peritoneum and feel the following: interiorly, the 
transverse colon; posteriorly, the pancreas crossing the vertebral column; 
superiorly and anteriorly, to the left, the entire postero-inferior surface of the 
stomach, to the right, the portion of the lesser peritoneum, which forms the 
postero-inferior layer of the gastro hepatic omentum (Plate 31). Find the for- 
amen of Winslow (the orifice of communication of the cavity of the lesser 
with that of the greater peritoneum, the border of the orifice being the line of 
continuity of the two serous membranes): the left hand in the cavity of the lesser 
peritoneum, its index finger passed to the postero inferior surface of the liver, 
and directed transversely, and to the right, at a point posteriorly to the hepatic 
vessels, will enter the foramen ; the right hand in the cavity of the greater peri- 
toneum posteriorly to the right lobe of the liver, its index finger passed to the 
left, parallel with and posteriorly to the gall-bladder, will enter the foramen 
or meet the finger of the left hand, before introduced. 58 
TRUNK. 
7. Lesser Peritoneum and Cavity of the Same, Plate 31.— 
The lesser peritoneum is spread, and forms its cavity, as fol- 
lows : its anterior portion invests the postero-inferior surface 
of the stomach ; superiorly to the stomach, it forms the pos- 
terior layer of the gastro-hepatic omentum ; interiorly to the 
stomach, it spreads as the posterior layer of the two layers of 
serous membrane between the greater curvature of the stom- 
ach and the transverse colon ; its posterior portion covers the 
anterior surface of the pancreas and the abdominal vessels ; 
and lines the antero-superior surface of the portion of the 
greater peritoneum from the inferior of the transverse colon 
to the posterior wall of the abdomen. 
8. Great Omentum or Peritoneal Apron, Plates 30 and 31. 
—This, reduplication of the greater peritoneum, hangs in the 
cavity of the greater peritoneum from the transverse colon. 
It spreads over the small intestine, hanging lower on the left 
than on the rigltf side. Superiorly, it spreads, to the right and 
left, upon the ascending and the descending portions of the 
colon, respectively. 
9. Liver, Plate 30.—This organ is located interiorly to the 
right lower ribs and the end of the sternum, and projects inte- 
riorly to the left lower costal cartilages. The lower half of its 
left lobe bridges between the right and the left ribs in the epi- 
gastric region, covering the lesser curvature of the stomach. 
10. Gall-Bladder.—The fundus of the gall-bladder presents 
below the free border of the liver, to the right of the notch, at 
about the extremity of the cartilage of the right tenth rib. 
11. Stomach.—This viscus lies posteriorly to the left lobe of 
the liver, and interiorly to the left lower ribs and cartilages. 
Its inferior border projects below the left lobe of the liver. 
12. Small Intestines.—Convolutions of this intestine will be 
found projecting from beneath the inferior border of the out- 
spread great omentum or peritoneal apron. 
Dissection.—Raise the great omentum, and reflect it, superiorly, upon the 
anterior face of the thorax ; carry the transverse colon upward with it. ABDOMINAL VISCERA IN SITU. 
59 
13. Small Intestine, Plate 32.—This, the second portion 
of the subdiapliragmatic part of the alimentary canal, consists 
of three divisions : the duodenum, the jejunum and the ileum 
(respectively, one, eight and twelve feet long). The jejunum 
and ileum, in situ, hang toward the left inguinal region. 
14. Transverse Meso-Coiou.—This is the projection of 
peritoneum from the posterior wall of the abdomen to the 
transverse portion of the colon. 
Dissection.—Collect tlie ileal and jejunal portions of tlie small intestine 
in the hands, and holding them off from the posterior abdominal parietes, the 
portion of the greater peritoneum, the mesentery, by which they are swung in 
the abdominal cavity, is demonstrable. Deflect the ileum and jejunum of the 
small intestine to the left. 
15. Mesentery, Plate 34.—This is formed by two layers, 
right and left, of the greater peritoneum, which are attached 
across the interior of the posterior wall of the abdomen, from 
the left of the body of the second lumbar vertebra to a point 
opposite the right sacro-iliac articulation : the right layer 
spreads from its attachment, to its peripheral investment of 
twenty feet of the small intestine (the jejunum and ileum); the 
left layer returns from the intestine, narrowing to its attach- 
ment. The length of the mesentery between its attachment 
and the intestine varies from one and a half to six inches. 
Between the layers of the mesentery are lodged the superior 
mesenteric artery and its branches to, their venae comites from, 
the lymphatic vessels from, and the nerves to, the jejunum and 
ileum of the small intestine ; also, the mesenteric lymphatic 
glands. 
Dissection.—Incise tlie right layer of the mesentery along the line of its 
attachment, and dissect the same, to the left, from off the superior mesenteric 
vein ; trace the vein and its branches. 
16. Superior mesenteric Vein.—This vein lies to the right 
of and—with the small intestine swung to the left—ante- 
rior to the superior mesenteric artery. It is formed by the 
veins from the ileal and jejunal portions of the small intes- 
tine ; the ileo-colic, colica dextra and colica media veins of 
the large intestine also contribute to it. The trunk, with the 
mesenteric artery, lies upon the duodenum ; both appear be- 
tween the latter and the body of the pancreas. TRUNK. 
Dissection.—Cut the mesenteric vein at the trunk and dissect the branches 
off from the subjacent arteries (leave the stump of the vein as in Plate 34). 
Include a length of eight or ten inches of the small intestine between two 
ligatures, and inflate it with the blow-pipe. Trace the branches of the su- 
perior mesenteric artery; also the intestinal branches of the sympathetic 
nerve. 
17. Abdominal Portion of the Sympathetic Nervous Sys- 
tem, Plate 33.—In the course of the dissection of the arteries 
in the abdominal cavity, the plexuses and branches of this por- 
tion of the sympathetic nervous system will be exposed. (The 
Plate is introduced here, that the dissector may recognize these 
nerves as he meets with them upon the arteries ; except as a 
special dissection it is not necessary to preserve them.) 
18. Superior Mesenteric Artery, Plate 34.—This artery, 
branch of the abdominal aorta, emerges from between the pan- 
creas and duodenum and enters between the layers of the 
mesentery. The trunk is directed obliquely to the right ingui- 
nal region, where it terminates by anastomosing with the ileal 
branch of the ileo-colic artery. From the left of the trunk are 
given off the intestinal branches to the jejunal and ileal por- 
tions of the small intestine; these latter, branching continu- 
ously, become the rami intestini tenuis, which distribute to 
the two surfaces of the intestine, whose walls they penetrate. 
Dissection.—Incise the posterior layer of the peritoneum, forming the 
transverse meso colon, inferior to the raised transverse colon—take the plane 
of the arteries beneath it as the guide of the layer—and dissect off the posterior 
layer of the meso-colon, exposing the colica media artery, branch of the supe- 
rior mesenteric. 
19. Colica Media Artery.—This artery (vena comes) is given 
off from the right side of the superior mesenteric, near its 
emergence from between the pancreas and the duodenum ; soon 
after its origin it gives off the colica dextra branch. The 
trunk bifurcates into a right and left branch, which distribute 
to the transverse colon ; the left branch anastomoses with the 
colica sinistra artery of the descending colon. 
20. Colica Dextra Artery.—This branch (vena comes) of 
the last described artery extends to the right, bifurcating to 
distribute to the ascending colon. The superior branch anas- 
tomoses with the right branch of the colica media. ABDOMINAL VISCERA IN SITU. 
61 
21. ileo-colic Artery.—This is the second artery (vena co- 
mes), given off from the right side of the superior mesenteric 
trunk. It bifurcates into a superior and an inferior branch: the 
superior distributes to the commencement of the ascending 
colon, anastomosing with the inferior branch of the colica 
dextra; the inferior distributes to the caecum and the termi- 
nal portion of the ileum, and anastomoses with the trunk of 
the superior mesenteric artery. 
Dissection.—Tie tlie ileum with two ligatures at about four inches from 
the colon, and section the gut between them ; with the straight scissors the 
ileum and jejunum of the small intestine may be stripped into a basin, by cut- 
ting the rami intestini tenuis and the mesentery, close to and parallel with 
the gut; the duodenum reached, apply two ligatures to the superior end of 
the jejunum, and section the intestine between them. Section the superior 
mesenteric artery the same length as the vein, and remove its trunk and 
branches. Trim away the great omentum or peritoneal apron from the trans- 
verse colon and the superior portions of the ascending and descending colon, 
respectively; also from the greater curvature of the stomach. Dissect away 
the transverse meso-colon (anterior layer) from the transverse colon. Spread 
the large intestine as in Plate 35. Follow' the distribution of the inferior 
mesenteric artery, by dissecting off the peritoneum from the left side of the 
posterior wall of the abdomen, and reflecting the anterior layer of the meso 
of the sigmoid flexure. 
22. Large Intestine, Plates 04 and 35.—This portion of the 
alimentary canal is divided into the caecum, the colon and the 
rectnm. The caecum, lodged in the superior part of the right iliac 
fossa, and completely invested by peritoneum, is inferior to the 
ileo-colic opening—the latter at the junction of the caecum and 
colon. From the caecum is appended a blind tube, the appen- 
dix vermiformis, which curls inferiorly and is suspended by a 
special meso ; as located it has two flexures to the left. The 
colon is subdivided into the ascending, the transverse and the 
descending ; the ascending colon for its first half, is fixed to 
the interior of the right posterior wall of the flank, by the as- 
cending meso-colon. The superior half of the ascending colon, 
the transverse colon and the superior half of the descending 
colon are suspended by the transverse meso-colon and the great 
omentum and have the greatest possible mobility ; the inferior 
half of the descending colon is fixed to the interior of the left 
lumbar region by a meso-colon ; the sigmoid flexure is a coil of 
the descending colon, which is suspended by a long meso, by 62 
TRUNK. 
which it is made susceptible of great mobility and disten- 
tion. The rectum continues the large intestine into the pelvic 
cavity. 
23. Inferior Mesenteric Artery, Plate 35.—This artery (vena 
comes), a branch of the abdominal aorta, lies to the left of the 
vertebral column exterior to the peritoneum. Its colica sinistra 
branch distributes to the descending portion of the colon, bi- 
furcating into an ascending and a descending branch : the 
ascending anastomoses with the left branch of the colica me- 
dia (page 60); the descending anastomoses with the sigmoid 
branch. The sigmoid branch supplies the sigmoid* flexure of 
the colon ; its distribution is similar to that of the rami in- 
testini tenues (seepage 60, and Plate 34). The superior hemor- 
rhoidal is the terminal portion of the trunk ; it distributes to 
the superior part of the rectum, passing into the pelvic cavity 
upon the gut, between the layers of the meso-rectum of the 
pelvic portion of the greater peritoneum. 
Dissection.—Dissect off the posterior layer of the lesser peritoneum from 
the anterior surface of the pancreas, trimming it away at the superior edge of 
the oblique portion of the duodenum ; by this the head of the pancreas will 
be exposed in the curve of the duodenum. Hook up the left lobe of the liver 
against the costal cartilages and sternum ; open the anterior layer of the gas- 
tro-hepatic omentum, and cut it away from the lesser curvature of the stomach, 
and from the opposite posterior inferior surface of the liver. Determine the 
parts, contained between the layers of the gastro-hepatic omentum. 
21. Cceliac Axis, Plates 35 and 36.—This arterial axis pre- 
sents superior to the lesser curvature of the stomach, where it 
trifurcates into: the gastric or coronary, which passes to the 
left and superiorly; the splenic, which is directed to the left 
and inferiorly ; the hepatic, which runs to the right. 
25. Gastric or Coronary Artery.—This artery (vena comes) 
distributes to the stomach. Reaching the left of the lesser 
curvature of that organ, it bifurcates : the left branch dis- 
tributes to the oesophageal extremity of the stomach, anastom- 
osing with the oesophageal arteries ; the right curves along the 
lesser curvature of the stomach, to anastomose with the pyloric 
branch of the hepatic. 
26. Splenic Artery.—Tills artery (vena comes) disappears 
posterior to the stomach in the direction of the organs it sup- 
plies. ABDOMINAL VISCERA IN SITU. 
63 
27. Hepatic Artery.—This trunk is directed to the right, 
superior to the pyloric end of the stomach ; it gives off the 
gastro-duodenal and the cystic (to the gall-bladder) arteries, 
after which it divides into branches, which enter the transverse 
fissure of the liver. 
Dissection.—Trace the cystic artery to the gall-bladder; dissect off the 
peritoneum from the exposed surface of that organ, from its fundus to its 
apex ; find the cystic duct and follow it to the ductus communis choledoclius; 
clear the surface of the exposed portion of the latter duct. Raise the branches 
of the hepatic artery and clean the surface of the vena portae, lodged to the 
left of the ductus communis choledoclius. 
28. Cystic Artery.—This artery (vena comes), branch of the 
hepatic or gastro-duodenal, bifurcates and distributes to the 
gall-bladder, beneath its investiture of peritoneum. 
29. Cystic Duct.—This is a short duct, from the apex of the 
gall-bladder, to the ductus communis choledoclius ; it joins the 
latter at an acute angle. 
30. Ductus Communis Clioledoelms.—The right and left 
hepatic ducts meet and form the hepatic ducts proper ; the latter 
is joined by the cystic duct, and the two determine the ductus 
communis choledoclms. It courses in the right portion of the 
gastro-hepatic omentum, and disappears posterior to the first 
or ascending portion of the duodenum. 
31. stomach.—This organ occupies the left hypochondriac 
region, extending to the right into the epigastric region. It is 
swung in the abdominal cavity : to the left, by the oesophagus 
as the latter pierces the diaphragm, and by a reflection of peri- 
toneum to the diaphragm ; to the right, from the liver, by the 
gastro-liepatic omentum. The mobility and independence of 
the organ is insured, as before shown, by the cavity of the lesser 
peritoneum posterior to it. Its oesophageal extremity, or point 
of continuity with the oesophagus at the diaphragm, is situated 
superiorly and to the left ; its pyloric extremity or the pylorus 
is to the right and continuous with the duodenum. To the left 
of the oesophagus is its fundus or larger end, which tilts su- 
periorly against the diaphragm ; the pyloric valve guards its 
communication with the first portion of the duodenum. Its 
varying calibre and its elevation to the left, superiorly, deter- 64 
TUUXK. 
mine its superior and inferior curvatures : tile former is a con- 
cavity directed superiorly and to the right; the latter is a con- 
vexity directed interiorly and to the left. It will be remembered, 
that its anterior surface is covered by a layer of peritoneum, con- 
tributed by the greater peritoneum, while its posterior surface 
has a peritoneal investiture, furnished by the lesser peritoneum. 
At its fundus the spleen is adapted to the right concave sur- 
face of the latter; the peritoneum bridges between the two 
organs—the gastro-splenic omentum—and invests the free 
convex surface of the spleen. The peritoneal surface invest- 
ments of, and the apposition of the spleen to, the stomach—de- 
termine the absence of serous membrane at the curvatures and 
fundus of the organ. It is at these points, that vessels and 
nerves enter and leave the viscus : along the lesser curvature 
is the anastomosing arterial loop of the gastric and pyloric ar- 
teries ; along the greater curvature is the circuit of the anas- 
tomosing gastro-epiploica dextra and sinistra arteries ; the vasa 
brevia, branches of the splenic artery, are at the fundus. Along 
this circumferential arterial distribution arteries and nerves 
enter the walls of the organ ; veins and lymphatics leave 
them. 
32. Duodenum—This, the first portion of the small intes- 
tine, is continued from the pylorus of the stomach. It is some- 
what the shape of a fish-hook, with its convexity directed to 
the right and interiorly, its concavity open superiorly and to 
the left. The first or ascending portion of the duodenum— 
forming the short barbed end of the hook—is directed from the 
pylorus of the stomach to the right, and is inclined superiorly 
and posteriorly (in Plates it will be observed to have sagged 
interiorly). The second or descending portion—forming the 
curve of the hook—has a direction obliquely from above down- 
wards and to the left. The third, transverse or oblique portion 
—forming the shank of the hook—rises obliquely from right to 
left, crossing the median line just above the bifurcation of the 
abdominal aorta ; at the left of the vertebral column, it is con- 
tinued by the jejunum of the small intestine. Its most de- 
pendent point lies upon the anterior surface of the inferior half 
of the quadratus lumborum muscle, a lit tle above the posterior 
extremity of the crest of the right ilium. In situ, the first 
portion of the duodenum impinges upon the liver and the ABDOMINAL VISCERA IN SITU. 
gall-bladder; tlie posterior surface of the descending portion 
rests upon tlie right kidney ; tlie concavity of this intestinal 
segment receives the head of the pancreas ; the transverse colon 
is superposed upon its anterior surface. 
Dissection.—Inflate tlie stomach and duodenum by means of tlie blow- 
pipe , introduce the latter into the anterior -wall of the duodenum. Pull the 
right half of the stomach superiorly, and to the right, upon the anterior surface 
of the right costal cartilages and the ensiform cartilage of the sternum. Dis- 
sect the first and half of the second portion of the duodenum from the head of 
the pancreas ; in. so doing drag upon the stomach, superiorly, by a loop of string 
around the pylorus, until it and the duodenum assume the position shown in 
Plate 36. Trace the gastro-duodenal artery and its branches, also the ductus 
communis choledoclius. Pull aside the left inferior costal cartilages. Clear 
the anterior surface of the pancreas, noting its relations to the duodenum, 
superior mesenteric vessels, the splenic artery and vein and the spleen itself. 
Remove the anterior portion of the gastro-splenic omentum ; reflect the spleen 
externally, and note the terminal branches of the splenic artery. 
33. Pancreas.—This organ lies transversely and obliquely 
across the abdomen : its right extremity is included in the 
concavity of the duodenum; its body rests upon the mesen- 
teric vessels; its tail crosses over the left kidney, the tip of 
the former impinging upon the spleen. The inferior border of 
its head overlaps the anterior surface of the commencement of 
the third or oblique portion of the duodenum. Anteriorly, the 
stomach and the transverse colon are superposed upon it. 
34. Gastro-Dtiodcnal Artery.—This artery (vena comes) is 
the largest branch of the hepatic. It curves, interiorly, pos- 
terior to the first portion of the duodenum. It gives off the 
pyloric artery, and bifurcates into the gastro-epiploica dextra 
and the superior pancreatico-duodenal arteries. 
35. Pyloric Artery.—This branch (vena comes) of the gastro- 
duodenal or the hepatic artery curves to the left, along the 
lesser curvature of the stomach, and anastomoses with the gas- 
tric or coronary artery. 
36. Gastro-Eplplofca I>extra Artery.—This vessel (vena 
comes) curves to the left, along the greater curvature of the 
stomach, anastomosing with the gastro-epiploica sinistra, 
branch from the splenic artery. 66 
TRUNK. 
37. Superior Pancreatico-IIuodenal Artery, Plate 36.— 
Carving interiorly, from its origin, this artery (vena comes) 
passes along the concavity of the duodenum and the head of 
the pancreas, to anastomose with the inferior pancreatico-duo- 
denal, branch of the superior mesenteric artery. 
38. Inferior I*ancreatico-I>uodenal Artery.—This artery 
(vena comes) passes from the right of the superior mesenteric 
artery, where its trunk lies posterior to the head of the pan- 
creas. It is directed, interiorly and to the right, between the 
pancreas and the oblique portion of the duodenum, to the right 
of the superior mesenteric vein. Between the pancreas and the 
duodenum it anastomoses with the last described artery. 
39. Spleen, Plates 35 and 36.—For the present, the dissec- 
tor should determine the location of the spleen as it caps the 
fundus of the stomach ; its relations to the tail of the pan- 
creas ; and its lodgment anterior and external to the left su- 
prarenal capsule and the superior half of the left kidney. 
40. Splenic Artery.—This trunk, branch of the cceliacaxis, 
runs to the left, posterior to the superior border of the body 
and tail of the pancreas. (In the plate the artery is somewhat 
displaced above the organ, by the sagging of the pancreas 
and the raising of the artery to clean it ) In its course the 
artery distributes branches to the pancreas, and the gastro- 
epiploica sinistra is given off from it. Thence it continues to 
distribute the splenic branches proper, from which, in turn, 
the vasa brevia or its gastric branches pass to the fundus of 
the stomach. 
Dissection.—Hook the superior border of the pancreas anteriorly, to 
discover the splenic vein ; clean the same, noting its contributing branches, 
etc. 
41. Splenic Vein, Plate 48.—This vein will be found poste- 
rior to the body and tail of the pancreas, running to the right 
to meet the superior mesenteric vein to form the vena portse. 
In its course this vein will be seen to receive the trunk of the 
inferior mesenteric vein. 
42. Gastro-Epiploiea Sinistra Artery, Plate 36.—This ar- 
tery (vena comes), branch of the splenic, curves to the right, ABDOMINAL VISCERA IN SITU. 
67 
along the greater curvature of the stomach to anastomose with 
the gastro-epiploica dextra, as before shown (page 65). 
43. Ductus Communis Clioleclochus.—This duct, already 
recognized in a part of its course, can now be followed to where 
it enters the duodenum; if care be taken, the junction of the 
pancreatic duct with it—emerging from the head of the pan- 
creas—may be discovered. 
Dissection.—Restore the stomach and duodenum to their normal positions. 
Raise the cut distal portion of the sigmoid flexure of the colon out of the pel- 
vic cavity, and pin it into the left iliac fossa, making the rectum taut. Remove 
with a sponge any fluid, that may he lodged between the pelvic organs. 
44. Male Pelvic Organs, in situ, Fig. 1, Plate 37.—The 
superior contours of these organs will be found to include the 
rectum, to the left, posteriorly, and the bladder anteriorly. 
Between the two is the recto-vesical cul-de-sac of the perito- 
neum. 
45. Male Pelvic Reflections of the Greater Peritoneum, 
Plate 29 and Fig. 1, Plate 37.—The greater peritoneum is re- 
flected from the interior of the anterior abdominal parietes— 
interior to the obliterated urachus and hypogastric arteries— 
to the middle and sides of the fundus of the bladder (page 55); 
from the fundus of the bladder it continues, posteriorly, over 
its superior and lateral contours to its posterior surface ; it 
descends to the base line of the exterior trigone area of the 
bladder (Male Perineum, page 26, Plate 12), where it is reflected 
to the anterior surface of the rectum, forming the recto-vesical 
cul-de-sac. This cul-de-sac is bounded, laterally, by crescentic 
folds of the peritoneum, the plica? semilunares, which bridge 
between the two organs. The serous membrane rises upon the 
surface of the antero-lateral walls of the rectum—more on its 
right than its left side. To the right of the rectum—the supe- 
rior part of its second portion—it is reflected to the posterior 
wall of the pelvic interior, forming the right portion of the 
meso-rectum, which continues, laterally and superiorly, upon 
the right iliac vessels. From the left side of the rectum—the 
superior part of its second portion—it passes to the left side 
of the pelvic interior, forming the left portion of the meso- 
rectum, which in turn continues, superiorly, over the left iliac 68 
TRUNK. 
vessels into the iliac fossa. The meso-rectum is thus the 
portion of the greater peritoneum, by which the second portion 
of the rectum is fixed to the posterior and left lateral walls 
of the pelvic interior. The first portion of the rectum—from 
a point opposite the left sacro iliac articulation to the anterior 
of the second piece of the sacrum—is swung by the continuation 
of the meso-sigmoid folds of the greater peritoneum (Plate 35). 
It is between the latter layers, that the superior hemorrhoidal 
branch of the inferior mesenteric artery continues to the rec- 
tum (Plate 35). 
46. Rctziu§’ Space, Plate 31.—The anterior surface of the 
bladder is not covered by peritoneum ; the latter is reflected 
from the former posterior to the point of continuity of the 
urachus with the bladder. A space exists bounded, posteri- 
orly, the anterior surface of the bladder ; anteriorly, by the 
interior surfaces of the symphysis pubis and the os pubis, right 
and left. This is Retzius’ space (Adolph Retzius, a Swedish 
anatomist) ; it contains loose areolar tissue, and has, below the 
level of the inferior border of the symphysis pubis, surrounding 
the neck of the bladder, a venous plexus, which continues, pos- 
teriorly, to the sides of the prostate and vesiculse seminales. 
47. Rectum, Fig. 1, Plate 87.—This portion of the large 
intestine continues from the sigmoid flexure of the colon, at a 
point about opposite the left sacro-iliac articulation. Its first 
and the superior part of its second portion present, in situ, 
as we look into the pelvic cavity from above. 
48. Bladder.—This organ varies in its position at different 
ages: in the child, it is almost an abdominal organ, being 
located largely above the brim of the pelvis ; in the adult, it 
becomes a pelvic organ, being lodged below the brim of the 
pelvis. In the adult male—except when distended—it is 
located between the symphysis pubis and the bodies of the 
ossa pubis, anteriorly, and the rectum, posteriorly. 
49. Female Pelvis, Fig. 2, Plate 37.—As compared with 
the male, the female pelvic diameters are all much greater; 
the increased capacity of the pelvic cavity affords lodgment 
for the internal female genitalia, viz.: the vagina, the uterus, 
the Fallopian tubes, the ovaries, etc. ABDOMINAL VISCERA IN SITU. 
69 
50. Peritoneum of the Female Pelvis.—As in the male, 
the peritoneum reaches the fundus of the bladder from the 
interior of the anterior parietes of the abdomen, guided thereto 
by the obliterated urachus (Plate 29). From the fundus of 
the organ it passes to its posterior surface, from which it is 
reflected to the body of the uterus. This reflection determines 
the vesico-uterine cul-de-sac of the peritoneum. The perito- 
neum upon the anterior surface of the uterus spreads laterally 
therefrom—forming the anterior layer of the broad ligament— 
to the interior of the lateral wall of the pelvis. Folding over 
the fundus of the uterus it covers its posterior surface and 
continues interiorly upon the posterior surface of the inferior 
wall of the vagina, from which it is reflected to the anterior 
surface of the superior wall of the rectum, forming the recto- 
vaginal or Douglas’ cul-de-sac of the peritoneum (Female 
Perineum, page 41). From the postero-inferior surface of the 
uterus and vagina the peritoneum spreads laterally, as the 
posterior layer of the broad ligament of the uterus, to the in- 
terior of the lateral walls of the pelvis; from this posterior 
layer of the broad ligament the right and left ovaries swing 
free. Continuing upon the rectum, the peritoneum invests 
it as in the male (page 67). 
51. Female Iaternal Genitalia.—These are the uterus, 
the Fallopian tubes, the round ligaments—included between 
the two layers of the right and left broad ligaments—and 
the ovaries—hanging from the posterior surfaces of the broad 
ligaments. They are all lodged in the pelvis between the blad- 
der, anteriorly, and the rectum, posteriorly. The uterus pro- 
jects superiorly, supported upon the vagina ; the Fallopian 
tubes, the right and the left, curl posteriorly and internally, 
posterior to the uterus, enclosing the right and the left ovary, 
respectively ; from out of the pelvic cavity the right and the 
left round ligaments of the uterus rise over the brim of the 
pelvis, anterior to the uterus, to reach the right and left iliac 
or internal abdominal rings (Abdominal Parietes, page 53). 
52. Female Bladder.—In the female the bladder is broader 
than in the male ; in other respects the organs are alike (page 
68). The special relation of the organ in the female is to 
the uterus posteriorly ; at the. anterior surface of the supra- 70 
TRUNK. 
vaginal portion of the neck of the uterus the bladder is at- 
tached by connective tissue; it is separated from the body 
of the uterus by the vesico-uterine cul-de-sac of the greater 
peritoneum. 
53. Female Itectum.—This is located so much like tlie male 
rectum, that the description of the lodgment of the latter (page 
68) will answer for both. 
Dissection.—Drag down tlie stomach from the left; apply a ligature at its 
oesophageal extremity and cut above the ligature. Turn out the stomach and 
the spleen from the left. Dissect loose the pancreas and duodenum on their 
posterior surfaces. Replace the stomach, duodenum, pancreas and spleen. 
Follow up the vena cava inferior to the posterior surface of the right lobe of 
the liver; apply a ligature to it above the renal veins, and cut the vessel. 
Drag down the liver from the right; determine the antero-superior layer of 
the coronary and the two lateral ligaments of the liver; with the curved 
scissors cut these ligaments close to the diaphragm. Continuing to drag on 
the liver, recognize with the finger the vena cava, as it pierces the diaphragm 
at the caval opening; pass a ligature around it and cut the vessel below 
it. Cut the remaining postero-inferior layer of the coronary ligament with 
the curved scissors, close to the diaphragm. Cut the trunk of the coeliac axis, 
and the stump of the superior mesenteric artery. Remove the stomach, duode- 
num, pancreas and liver, en masse. Remove the peritoneum from the ab- 
dominal aorta, the common, the external and the internal iliac arteries; in so 
doing note the nerves of the plexuses of the sympathetic (Plate 33), which 
ramify upon the arteries. 
54. Abdominal Aorta, Plate 38.—This arterial trunk enters 
the abdominal cavity opposite the body of the twelfth dorsal 
vertebra, between the crura of the diaphragm ; the latter are 
applied to its lateral surfaces. It continues on the vertebral 
column to the fourth lumbar vertebra, where it bifurcates into 
the right and the left common iliac arteries. In its course it 
gives oft* distributing branches: the two phrenic, the coeliac 
axis, the two suprarenal, the superior mesenteric, the tAvo renal, 
the two spermatic or the two ovarian, the inferior mesenteric, 
the four pairs of lumbar and the sacra media. 
55. C<eliac Axis.—This arterial axis springs from the an- 
terior face of the aorta, and trifurcates as before described 
(page 62). 
56. Suprarenal Arteries. — These arteries (venae comites) 
branch, right and left, to the respective suprarenal capsules. ABDOMINAL VISCEEA IN SITU. 
71 
Dissection.—Clear the surfaces of the right and left suprarenal capsules. 
57. Suprarenal Capsules.—These organs are lodged upon 
the surfaces of the right and left crus of the diaphragm, re- 
spectively. They are triangular in shape, their apices tilted 
to the median line, their bases capping the superior convex 
ends of the kidneys. 
58. Superior Mesenteric Artery.—This, like the coeliac 
axis, is a median-line branch of the abdominal aorta; it distri- 
butes as before described (page CO). 
Dissection.—Clear tlie surface of the vena cava from its origin, interiorly, 
to its point of section, superior to tlxe renal veins. Note the veins, that it re- 
ceives in its course ; follow the renal veins from the kidneys. 
50. Vena Cava Inferior.—This venous trunk lies to the 
right of the vertebral column ; it is formed by the junction of 
the right and left common iliac veins, at the right of the fifth 
lumbar vertebra; it receives the sacra media, the lumbar, the 
right spermatic or the right ovarian, the renal, the suprarenal, 
the phrenic and the hepatic veins. 
60. Renal Veins.—These vessels pass from the kidney, 
right and left, to the vena cava; the left, longer than the 
right, receives the left spermatic or the left ovarian vein. 
Dissection.—Hook the renal veins anteriorly, and trace the renal arteries 
to their distribution. Dissect the kidneys free of remaining fat. 
61. Renal Arteries.—These arteries pass, right and left, 
from the aorta to the kidneys, respectively ; their short trunks 
break up into branches, which enter the hilus of the organ ; 
one of the superior branches of each artery distributes a 
branch to the suprarenal capsule of the side. 
62. Kidneys.—These organs are located on either side of 
the vertebral column. The inferior portion of a kidney lies 
upon the superior half of a quadratus lumborum muscle; its 
superior convex end inclines to the vertebral column, and rests 
upon the interior of the ligamentum arcuatum externum (Plate 
48) and the diaphragm above it; where it lies upon the latter 
muscle, it is located opposite the twelfth rib and the eleventh 
intercostal muscle and rib—the right kidney rises to the infe- 72 
TRUNK. 
rior border of the eleventh rib, while the left reaches its supe- 
rior border. Its external border is convex and projects beyond 
the external border of the quadratus lumborum muscle; its 
inferior convex end inclines a little, externally—higher upon 
the left than upon the right side ; its internal and thickest 
border presents an inferior and a superior convexity, divided 
by a concavity—the liilus of the organ—where the arteries and 
nerves enter, and the veins, lymphatic vessels and the ureter 
leave the organ ; its anterior surface is smooth and convex. 
Dissection.—Trace the ureters from the kidneys, inferiorlv, into the pelvis. 
63. Ureters.—These are the ducts of the A ureter 
is about fifteen inches long; it leaves the liilus of a kidney, 
posterior to the plane of the artery ; it continues, interiorly and 
internally, upon the anterior surface of the quadratus lum- 
borum, the psoas magnus and the psoas parvus muscles, pos- 
terior to the spermatic or the ovarian vessels ; it reaches the ex- 
ternal iliac artery, passing across its anterior surface, near the 
bifurcation of the common iliac, and enters the pelvic cavity 
upon the interior of its lateral wall. 
64. Spermatic (of the Male) and Ovarian (of the Female) 
Arteries.—These arteries spring as a pair, in the respective 
sexes, one from either side of the aorta, inferior to the origins 
of the renal branches. A spermatic artery (vena comes) passes, 
interiorly and externally, upon the psoas magnus and parvns 
muscles to the groin, where it leaves the abdominal cavity by 
the iliac or internal abdominal ring. An ovarian artery (vena 
comes) passes interiorly to the iliac fossa; it enters the pelvic 
cavity, crossing the external iliac artery, to reach the interior 
of its lateral wall, between the anterior and posterior layers of 
peritoneum, which form a broad ligament of the uterus. 
65. Spermatic and Ovarian Veins.—The right and left veins 
differ: the right spermatic and ovarian empty, at an acute 
angle, into the vena cava inferior; the left can be traced to 
where it enters, at a right angle, into the left renal vein. 
66. Inferior mesenteric Artery.—This artery (vena comes), 
a single branch, passes to the left of the vertebral column, and 
distributes as before described (page 62). PLATE 29 
Jlf Co/in,<zetS2£ztitrars72 cZeZ. PLATE 30 
CeiiXjad izatio-ckM PLATE 31 
Diaph rag/n 
’WinsZozer Jf foramen - 
Gastro -/innate c 
omentum 
Duodenum: ascend? 
07'portion 
Duodenum : transverse 
or 3 G* portion 
Transverse meso 
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cul-de-sac PLATE 32 
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71. 
Caccifyea? 
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JW. Co?in. Cictsici tier'd m rtet. PLATE 35 
Jtf.C6fcnf ctaL naCura7n. <2el. PLATE 36 
Af. CoS//?, ace 7idt£u.7'Cim otet. PLATE 37 
Fig. / 
J2 
Ohn, at/ ttatu. rant c/el PLATE 38 
-Branches of 
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&£ric afe.—M 
JW'.C'ohn, act ?catu rum, dcZ. FIFTH DISSECTION. 
ABDOMINAL AND PELVIC INTERIORS. 
Dissection.—Take up tlie dissection of the abdominal cavity, as left after 
the completion of the fourth dissection. Section the vena cava, the ureters 
and the spermatic vessels (Plate 38) ; reflect the inferior portions of the 
two latter into the pelvic cavity. Remove the testes from the scrotum and 
place them in the pelvis. Spread the thighs and take out the sutures from 
the perineal flaps. Cut the penis free from the pubic arch, so that it may 
come away in continuity with the bladder. Trace the ureters and the vasa 
deferentia or the ureters, the ovarian vessels, and the round ligaments of the 
uterus as they pass, exterior to the peritoneum, to the interior of the lateral 
walls of the pelvic cavity ; reflect the same, from the respective sides, upon 
the pelvic viscera, toward the median line. Pass the fingers external to the 
reflected ducts and vessels, between the peritoneum and the fascia lining 
the pelvic walls, and free the pelvic organs ; use the curved scissors to cut 
the vesical, middle hemorrhoidal and uterine vesse’s. Remove the viscera— 
bladder, rectum (male), or bladder, rectum, uterus, vagina (female), with at- 
tached vessels, etc.—through the inferior outlet of the pelvis. Empty and 
wash out the rectum and bladder, after which the pelvic viscera, en masse, 
may be placed in preservative fluid for subsequent dissection. Bring together 
the thighs and clean the common, the external and the internal iliac arteries 
and veins. 
1. Common Iliac Arteries, Plates 38 and 39. — These 
trunks pass from their origin, at the bifurcation of the abdom- 
inal aorta upon the body of the fourth lumbar vertebra, to the 
sacro-iliac articulations. The right lies against the internal sur- 
face of the vena cava and the right common iliac vein ; the left 
is between the left psoas magnus muscle, externally, and the 
left common iliac vein, internally. At the sacro-iliac articula- 
tion of a side the artery divides into the external and the in- 
ternal iliac arteries. 
2. External Iliac Artery.—This artery continues, from its 
origin, along the internal surface of the psoas magnus muscle 
to pass beneath Poupart’s ligament into the thigh, where it be- 74 
TRUNK. 
comes the femoral artery. Before passing under the ligament 
it gives off the deep epigastric artery, previously described 
(page 54); also, the deep circumflex iliac artery, which passes, 
externally, superior to and parallel with Poupart’s ligament, 
to perforate the transversalis abdominis muscle and reach the 
lateral area of the abdominal parietes, where it was before re- 
cognized (page 50). 
3. Internal Iliac Artery.— This vessel, given off by the bi- 
furcation of the common iliac artery, passes, interiorly, along 
the posterior portion of the lateral interior of the pelvic cavity. 
It divides into an anterior and a posterior trunk : the anterior 
gives off the obturator, the superior vesical, the uterine and 
the inferior vesical branches,and then divides into the internal 
pudic and the sciatic arteries; the posterior gives off the ilio- 
lumbar and the lateral sacral branches and continues as the 
gluteal artery. 
4. External Iliac Vein.—The femoral vein enters the pel- 
vic cavity, subjacent to Poupart’s ligament; the external iliac 
vein continues it, parallel with and inferior to its artery, to 
where it meets the internal iliac vein. 
5. Internal Iliac Vein.—-This vessel runs external to its 
artery, receiving the comites veins of the branches given off 
from the anterior and posterior trunks of the internal iliac 
artery. 
6. Common Iliac Veins.—These are formed by the junction 
of the right and left external and internal iliac veins, opposite 
the sacro-iliac articulations, inferior to and included in the 
forks of the bifurcations of the common iliac arteries. They 
converge to form the vena cava inferior, posterior to the com- 
mencement of the right common iliac artery. The left vein 
runs internal to its artery, while the right lies posterior to its 
arterial trunk. 
Dissection.—Follow the branches of the anterior trunk of the internal 
iliac artery ; cut away their venae comites. 
7. Obturator Artery, Plates 39 and 46.—Tills artery (vena 
comes) lias a direct course, from its origin, along the interior ABDOMINAL AND PELVIC INTERIORS. 
75 
surface of the obturator interims muscle, to where it leaves 
the pelvic cavity by its foramen in the obturator membrane, 
to distribute in the thigh. 
8. Superior Vesical Artery, Plate 39.—This artery (vena 
comes) distributes as its name implies. There is continued 
from it the obliterated hypogastric artery (page 55). 
9. Uterine Artery.—This vessel (vena? comites) enters be- 
tween the folds of the broad ligament of the uterus, passing to 
the side of the neck of that organ, whence it is distributed to 
the uterus and vagina, as will be shown hereafter. 
10. Inferior Vesical Artery.—In the male, this artery (ve- 
na? comites) distributes to the bladder, rectum, etc.; in the 
female it becomes tliq vaginal artery, which sends branches to 
the vagina, bladder and rectum. 
II. Pudic Artery.—This artery (venm comites), which takes 
its origin from the anterior trunk of the internal iliac artery, 
leaves the pelvic cavity by the great sacro-sciatic foramen, 
posterior to the spine of the ischium, to reach the exterior 
surface of the same. Before leaving the pelvic cavity it gives 
off the middle hemorrhoidal artery. Its return to the pelvic 
cavity anterior to the spine of the ischium, and its course in 
the external wall of the ischio-rectal fossa, etc., was seen in 
the dissection of the perineum (Male Perineum, page 18). 
12. Sciatic Artery.—This artery (venm comites), arising as 
before described (page 74), lies upon tlie interior surface of the 
pyriformis muscle ; it passes between the second and third 
sacral nerves, to leave the pelvic cavity by the great sacro-sciatic 
foramen, inferior to the pyriformis muscle. 
Dissection.—Section tlie common, the external and the internal iliac ar- 
teries ; also, the pudic, sciatic and obturator arteries (Plate 39); remove the 
portions of the arteries between the section lines. Cut the common and the 
external iliac veins (Plate 39) ; remove the common, external and internal iliac 
veins. In removing the portions of these vessels clear away the subjacent 
areolar tissue with care ; disturb as little as possible the bifurcation of the 
common iliac artery. Clean the branches of the posterior trunk of the inter- 
nal iliac artery; also, the sacra media artery. TRUNK. 
13. Sacra Meilia Artery, Plates 38, 39, 40, and 41.—This 
artery (venae comites) continues the trunk of the abdominal 
aorta into the pelvic cavity. It passes to the middle of the 
anterior surface of the sacrum from beneath the left common 
iliac vein, continuing, inferiorly, to the coccyx ; it gives off la- 
teral branches opposite each segment of the sacrum, which 
anastomose with branches of the lateral sacral arteries. 
14. Lateral Sacral Artery, Plates 39 and 40.—This artery 
(venae comites) springs from the posterior trunk of the internal 
iliac, courses, internally, to the external half of the anterior 
surface of the second segment of the sacrum, whence it con- 
tinues, inferiority, to the coccyx. It affords branches to con- 
tiguous muscles; others, which enter the anterior sacral fora- 
mina ; and still others, which anastomose with the sacra media. 
15. liio-Lumhar Artery, Plates 38, 39, 40, and 41.—This 
artery (venae comites), from the posterior trunk of the internal 
iliac, passes, superiorly and externally, posterior to the psoas 
magnus muscle, to distribute upon the interior of the iliacus 
interims and quadratus lumborum muscles, and in the lateral 
planes of the abdominal parietes. Its branches anastomose 
with the inferior lumbar branches of the abdominal aorta, and 
with the deep circumflex iliac branch of the external iliac. 
16. Gluteal Artery, Plates 40 and 46.—This artery (vena 
comes) is the continuation of the posterior trunk of the inter- 
nal iliac. It hooks beneath the lumbo-sacral cord of the sacral 
plexus, to leave the pelvic cavity by the great sacro-sciatic fora- 
men above the pyriformis muscle. 
Dissection.—Section tlie gluteal, lateral sacral and ilio-lumbar arteries 
(Plate 40). Remove tlie bifurcation of the common iliac artery. Clean the 
chain of lumbar sympathetic ganglia and their branches, between the psoas 
magnus muscle and the bodies of the lumbar vertebra;; also the exposed por- 
tions of the lumbar arteries. 
17. Lumbar Sympathetic Ganglia, etc., Plates 33, 38 and 
41.—These four ganglia are lodged as stated in the preceding 
dissection clause. They have branches of communication with 
each other ; interiorly, the chain is continued, to the first sacral 
ganglion of the pelvis ; superiorly, the communicating branch 
from the first ganglion continues to the twelfth dorsal ganglion ABDOMINAL AND PELVIC INTERIORS. 
77 
of the thorax. They will also be found to have branches of 
communication with the contiguous anterior branches of the 
spinal nerves (lumbar). Their distributing branches contribute 
to the aortic and superior hypogastric plexuses. 
1§. Lumbar Arteries.—These are four pairs of arteries from 
the posterior surface of the abdominal aorta ; they pass, later- 
ally, over the sides of the bodies of the lumbar vertebrae into 
the posterior parietes of the abdominal cavity. Their veins 
commence, on either side, the azygos veins, major right and 
minor left. 
Dissection.—Remove fascia and adventitious tissue from the surfaces of 
the psoas magnus, psoas parvus, quadratus lumborum, posterior portions of the 
transversalis abdominis, and the iliacus interims muscles, preserving the nerves 
ramifying upon the interior of the same (Plate 41). 
19. Twelfth Dorsal Intercostal Nerve, Plates 33 and 41.— 
A portion of this nerve runs inferior to the twelfth rib, upon 
the interior surface of the transversalis abdominis muscle. 
Dissection.—Section, on one side, the psoas magnus and parvus muscles 
(Plate 44) ; reflect the portions of the muscles, superiorly and inferiorly, dis- 
secting out from the muscles the nerves of the lumbar plexus; allow the 
latter to remain in situ (Plate 41). 
20. Lumbar Plexus.—This plexus is formed by the ante- 
rior branches of the four superior lumbar nerves. It is lodged 
in the substance of the psoas magnus muscle and upon the 
interior of the quadratus lumborum and the iliacus interims 
muscles. 
21. I lio-Hypogastric and Ilio-Inguinal Nerves, Plates 33, 
38, and 41.—These nerves originate from tlie first lumbar nerve ; 
they cross the anterior surface of the quadratus lumborum 
muscle, continuing upon tlie interior of the transversalis ab- 
dominis muscle, superior to and parallel with the crest of the 
ilium ; they perforate the latter muscle, and pass, as before 
described, into the planes of the antero-lateral areas of the 
abdominal parietes (page 49, and Plates 22, 25, 26, and 27). 
22. External Cutaneous Nerve, Plates 88, 39, 40, and 41.— 
This nerve, branch of the second lumbar, passes, inferiorly, to 
the interior of the posterior extremity of the crest of the ilium ; 78 
TRUNK. 
it then curves, externally and anteriorly, upon the interior of 
the superior portion of the iliacus internus muscle, running in- 
feriorly to, and parallel with, the crest of the ilium, to pass into 
the thigh under Poupart’s ligament, near the anterior superior 
spinous process of the ilium. 
23. Geuito-Crural Nerve, Plates 38 and 41.—This is a branch 
from the second lumbar, which passes, inferiorly, through the 
substance of the psoas magnus muscle ; it emerges at the inter- 
nal and rises to the superior surface of the muscle, and con- 
tinues to Poupart’s ligament. The trunk of the nerve bifurcates 
into a genital and a crural branch ; the genital branch joins 
the spermatic cord at the iliac or internal abdominal ring to 
distribute to the cremaster muscle ; the crural branch leaves 
the pelvic cavity beneath Poupart’s ligament. 
24. Anterior Crural Nerve, Plates 38, 39, 40, and 41.—This 
nerve is contributed to by the second, third and fourth lumbar 
nerves ; the three branches form a single trunk, inferior to the 
posterior portion of the crest of the ilium, lying between the 
iliacus interims and the psoas magnus muscles ; it appears upon 
the iliacus internus, superior to Poupart’s ligament, along the 
external border of the psoas magnus ; it continues, inferiorly, 
passing beneath Poupart’s ligament into the thigh. 
25. Obturator Nerve, Plates 39, 40, 41, and 46.—This 
branch, given off from the third and fourth lumbar nerves, runs 
interiorly and posteriorly to the psoas magnus muscle and the 
external iliac vein. It appears, interiorly to the external iliac 
vein, upon the interior of the obturator interims muscle, where 
it courses superiorly to, and parallel with, the obturator artery ; 
it leaves the pelvic cavity by the same foramen as the artery 
(see page 74). 
26. Accessory Obturator Nerve.—This is given off (when 
present) from the fourth lumbar nerve ; it accompanies the ob- 
turator nerve, but leaves the pelvis under Poupart’s ligament, 
over the horizontal ramus of the os pubis. 
Dissection.—Trace the fifth lumbar nerve and the branch it receives 
from the fourth lumbar; also, the four superior sacral nerves, from the ante- 
rior sacral foramina to the great sacro-sciatic foramen. Determine the sacral ABDOMINAL AND PELVIC INTERIORS. 
79 
ganglia of the sympathetic, the fifth sacral nerve, the coccygeal or sixth 
sacral nerve and the coccygeal ganglion of the sympathetic, or the ganglion 
impar. 
27. Sacral Plexus, Plates 33, 39, 40, and 41.—The anterior 
branch of the fifth lumbar nerve and a branch from the fourth 
(lumbo-sacral cord) form the superior contribution to the sac- 
ral plexus; the plexus is completed by the anterior branches 
of the first, second, third and part of the fourth sacral 
nerves. The above trunks converge to two nerves, the great 
and the small sciatic, which leave the pelvic cavity by the 
great sarco-sciatic foramen, inferior to the pyrifonnis muscle. 
The plexus also affords: interior branches to the pyrifonnis, 
the levator ani, and the obturator internus muscles; and ex- 
terior branches to the gemellus superior, the gemellus inferior, 
and the quadratus femoris muscles. 
28. Anterior Branches of the Fifth Sacral and the Coccy- 
geal Nerves.—These two nerves distribute to the coccygeus 
muscle and the skin of the coccygeal region. 
29. Sacral Ganglia and Coccygeal Ganglion of the Sym- 
pathetic.—These ganglia continue the ganglionic chain of the 
sympathetic, from the lumbar region into the pelvis ; they lie 
upon the anterior surface of the sacrum, internal to the emer- 
gence of the anterior branches of the sacral spinal nerves at the 
sacral foramina. They are united by branches, and also com- 
municate with the sacral nerves. The fourth sacral ganglion 
sends a branch to the single coccygeal ganglion (ganglion im- 
par), upon the anterior face of the coccyx. 
Dissection.—Section the aorta, the vena cava, the ureters, the spermatic 
or the ovarian vessels and the suprarenal branches from the phrenic arteries 
(Plate 38). Note the arrow placed upon the right crus of the diaphragm, in- 
ferior to the renal vein (Plate 38); it points to the receptaculum cliyli upon 
the body of the second lumbar vertebra, posterior to the aorta (Plate 41). 
Raise, en masse, from the interior of the abdominal wall, the suprarenal cap- 
sules, the kidneys, the superior portions of the ureters and the spermatic ves- 
sels, the renal vessels and the portions of the aorta and the vera cava. In rais- 
ing the piece of the aorta be careful to hug its posterior surface, so as not to 
injure subjacent parts. These viscera, attached vessels, etc., should be placed 
in preservative fluid. In the area exposed by the removal of the portion of 
the aorta (Plate 41), find a small vein to the right of the median line—the 
commencement of the vena azygos major—and the receptaculum cliyli along 80 
TRUNK. 
the median line ; the latter has minute vessels—lymphatics—converging to it. 
Note a number of lymphatic glands contiguous to the receptaeulum chyli; 
trace some of the lymphatic vessels from the glands to the receptaeulum chyli. 
30. Receptaeulum Cliyli, Plate 41.—This, the commence- 
ment of the left lymphatic or thoracic duct of the lymphatic 
system, lies upon the anterior surface of the bodj?" of the second 
lumbar vertebra, posterior to the abdominal aorta ; it is about 
the size of a small quill, and receives lymphatic vessels from 
the surrounding lymphatic glands; it continues, superiorly, 
upon the first lumbar vertebra,, and passes into the thorax 
through the aortic opening of the diaphragm. 
Dissection.—Remove the peritoneum from the abdominal surface of the 
diaphragm ; trace, in so doing, the ramifications of the phrenic arteries (Plate 
41), and note the points of perforation of the phrenic nerves and their distri- 
bution. Determine the aortic, the caval and the oesophageal openings in the 
diaphragm ; clean the crura and the ligamenta arcuata externa and interna 
portions of the diaphragm (Plate 43). 
31. Phrenic Arteries, Plates 38 and 41.—These branches 
from the abdominal aorta (page 70), distribute, right and left, 
to the inferior surface of the diaphragm. Each artery gives a 
branch to the suprarenal capsule of its side. 
32. Phrenic Xerves.—These nerves perforate the dia- 
phragm from the thorax, to distribute to the inferior surface 
of the muscle. 
33. Cartilage Areas of the Abdominal Interior, Fig. 2, 
Plate 21.—The cartilage surfaces presenting areas for the at- 
tachments of the diaphragm are: the interior surfaces of the 
ensiform cartilage of the sternum and of the cartilages of the 
six inferior ribs. 
31. Bone Areas of the Abdominal and Pelvic Interiors, 
Plate 42.—Tlie twelfth dorsal vertebra, the twelfth rib, the lum- 
bar vertebrae and the ilial portion of the os innominatum afford 
attachments to muscles, that contribute to the superior and 
postero-lateral walls of the abdominal cavity. 
35. Diaphragm, Fig. 2, Plate 21, and Plates 38, 41, 42, 43, 
and 44.—This muscle forms the septum between the abdominal 
and thoracic cavities. The portions of the muscle are : a ten- ABDOMINAL AND PELVIC INTERIORS. 
81 
dinous centre, a circumferential muscle portion and two crura. 
It is attached as follows : to the interiors of the ensiform car- 
tilage of the sternum and the cartilages of the six inferior ribs, 
right and left; to the ligamenta arcuata externa—arches of 
fibrous tissue, that bridge from the cartilages of the twelfth 
rib to the transverse processes of the first lumbar vertebra; to 
the ligamenta arcuata interna—internal fibrous arches from 
the transverse processes of the first lumbar vertebra to the 
lateral surfaces of the body of the same vertebra ; to the an- 
terior surfaces of the bodies of the four superior lumbar verte- 
brae, by the crura of the muscle. From the abdomen, the fibres 
are seen to converge from their circumferential attachments to 
a fibrous portion—the tendinous centre of the diaphragm. Be- 
fore the removal of the heart from the thorax, the diaphragm 
maintains the shape of an antero-posterior half-arch over the 
abdomen (the arch deficient anteriorly) ; the arch is maintained 
by the parietal layer of the pericardium, being attached to the 
superior surface of the tendinous centre interiorly and to the 
fixed large vessels, projected from the base of the heart, su- 
periorly ; by it the centre of the diaphragm is held up and 
rendered almost immovable, during inspiration and expiration, 
respectively. The muscle presents three large openings of 
communication with the thorax ; the aortic, the oesophageal 
and the caval. The aortic opening is located opposite the 
twelfth dorsal vertebra, between the crura ; it gives transit to 
the aorta, the left lymphatic or thoracic duct and the right 
vena azygos. The oesophageal opening is located a little to 
the left and anterior to the aortic ; it allows the oesophagus 
and the right and left pneumogastric nerves to pass from the 
thorax into the abdomen. The caval opening, is through the 
tendinous centre of the diaphragm, to the right of, and an- 
terior to the vertebral column ; it allows the vena cava inferior 
to pass from the abdomen into the thorax. The right and left 
crus are perforated by the sympathetic nerve-trunks and the 
splanchnic nerves of the sides respectively ; the left crus gives 
transit also to the vena azygos minor vein. 
36. Psoas Parvus Muscle, Plate 44, and Plates 39 to 43 in- 
clusive.—This small muscle, when present, is attached to the 
lateral surface of the body of the twelfth dorsal vertebra 
(Plate 42); it emerges from beneath the ligamentum arcuatum 82 
TRUNK 
internum (Plate 43) ; it continues, inferiorly, upon the interior 
face of the psoas magnus muscle, and is attached, at the brim 
of the pelvis, to the ilio-pectineal eminence. 
37. Psoas Magnus Muscle, Plates 38 to 44, inclusive.—This 
muscle is attached, superiorly, to the lateral surfaces of the last 
dorsal and the lumbar intervertebral discs (Plate 44); it emerges 
inferiorly to the ligamentum arcuatum internum, runs along 
the brim of the pelvis, and blends with the iliacus interims ; 
the two leave the abdomen inferiorly to Poupart’s ligament. 
38. Qiiadratus Lumborum Muscle, Plates 38, 41, 42, 43 and 
44.—This muscle is attached to the inferior border of the twelfth 
rib, the transverse processes of the lumbar vertebrae, and the 
posterior third of the interior lip of the crest of the ilium. It 
emerges from beneath the ligainentum arcuatum externum of 
the diaphragm (Plate 43). It is located in the plane, posterior- 
ly to the psoas magnus muscle; it continues, posteriorly, the 
muscle plane of the transversalis abdominis muscle, of the 
antero-lateral areas of the abdominal parietes. 
39. Iliacus Interims Muscle, Plates 38 to 42, inclusive ; and 
Plates 44, 45, and 46.—This muscle is attached to the interior 
of the ilium, and leaves the pelvic cavity with the psoas mag- 
nus muscle, inferiorly to Poupart’s ligament. 
40. Pelvic Cavity, Plates 42, 45, and 46.—This cavity is en- 
closed : posteriorly, by the bones, sacrum and coccyx, and by 
the ligaments, great and small sacro-sciatic ; laterally, by the 
ischial and ilial portions of the os innominatum and the sacro- 
sciatic ligaments ; anteriorly, by the ossa pubis, the symphysis 
pubis, the ischia, and the obturator membranes ; superiorly, 
it presents an inlet, which makes the cavity continuous with 
the abdominal ; inferiorly, it is closed by the tissue-planes of 
the perineum (Male or Female Perineum). 
41. Bone Areas of ilie Pelvie Cavity, Plates 42 and 45.— 
The interior surfaces of all the bones of the pelvic cavity afford 
attachments to muscles. 
42. Pyriformis Muscle, Plates 39, 40, 42, and 40; Fig. 1, 
Plate 45.—This muscle lias its interior pelvic attachment to 83 
ABDOMINAL AND PELVIC INTERIORS. 
the anterior surface of the lateral mass of the sacrum, external 
to the anterior sacral foramina (Plates 42 and 45). It leaves 
the cavity of the pelvis, at a right angle to its attachment, by 
the great sacro-sciatic foramen ; it goes through the foramen, 
accompanied by vessels and nerves : superior to it are the glu- 
teal vessels and nerve ; inferior to it are the sciatic and pudic 
vessels and nerves. 
43. Coccygens Muscle, Plates 39, 40, and 46; Fig. 1, Plate 
45.—This muscle is attached to the interior of the spine of the 
ischium, externally, and the lateral portion of the interior of 
the coccyx, internally ; it crosses upon the interior of the small 
sacro-sciatic ligament. It is perforated by the fifth sacral and 
the coccygeal nerves, on their way to the skin of the coccygeal 
region. 
44. Levator Ani et Prostatae, or Levator Ani et Vaginae 
Muscle, Plates 45 and 46.—This muscle was described and 
partially dissected in the male and female perinei (pages 24 
and 39 ; Plates 9 and 18). The dissected muscles and fasciae 
of the pelvic interior, as shown in Plate 46, is intended to make 
clear the attachments and fascial relations of these muscles 
(according to sex). (The dissector is not to reproduce this 
sectioned pelvis.) From the spine of the ischium to the 
interior of the os pubis, the line of the splitting of the pelvic 
fascia, into the recto-vesical and obturator fasciae, bridges the 
lateral interior of the pelvis—the pelvic fascia line. The 
levator muscle is attached : to the spine of the ischium, pos- 
teriorly ; the interior of the os pubis, anteriorly ; and along 
the obturator fascia between these points, inferior to the split- 
ting of the pelvic fascia. From these attachments it passes 
interiorly—as the levator ani et prostatae (male) or the levator 
ani et vaginae (female)—to sling the pelvic viscera, by the meet- 
ing of the right and the left muscle, along the median line 
of, and at the outlets of, the pelvic viscera at the perineum 
(Plates 9 and 18). From the obturator fascia, inferior to 
the line of attachment of the levator muscles, the levator 
fascia—jjosterior layer of the triangular ligament and the anal 
fascia—is projected to the median line of the pelvic outlet, ex- 
terior to the compound levator muscle (Male Perineum, page 
22 and Fig. 3, Plate 8; Female Perineum, page 39, and Plate 17). 84 
TRUNK. 
45. Obturator Interims Muscle, Plates 39, 40, 45, and 46. 
—The inferior portion of this muscle was referred to in the 
dissection of the male perineum (page 17). It is attached to 
the interior surface of the obturator membrane and the bony 
circumference surrounding the same (Fig. 1, Plate 45). From 
this attachment its tendon leaves the pelvic cavity by the small 
sacro-sciatic foramen, being projected therefrom into the glu- 
teal region (Plate 100). 
46. Ligaments of tlie Abdominal and Pelvic Interiors, 
Plates 42 and 45.—These ligaments present as follows: upon 
the anterior surfaces of the bodies of the lumbar vertebrae, the 
anterior common ligament of the spinal column; from the 
transverse process of the fifth lumbar vertebra to the posterior 
superior spinous process of the ilium, the ilio-lumbar ligament; 
from the anterior surface of the lateral portion of the sacrum 
to the interior of the ilium, the anterior sacro-iliac ligament; 
from the spine of the ischium to the sacrum and coccyx, the 
small sacro-sciatic ligament; from the sacrum to the body of 
the ischium, the great sacro-sciatic ligament; from the anterior 
surface of the inferior segment of the sacrum to the anterior of 
the coccyx, the anterior saero-coccygeal ligament; at the sym- 
physis pubis the posterior, superior and inferior pubic liga- 
ments. 
Dissection.—If the dissector has the lower extremity assigned to him with 
the abdomen, he should continue his work by dissecting the anterior surface of 
the thigh ; if he has the trunk region—abdomen, pelvis and thorax—he should 
take up the dissection of the anterior parietes of the thorax. The demonstra- 
tion of the abdominal and pelvic viscera will now be given, as they naturally 
complete the abdomen and pelvis; but the dissector should leave them till 
after he has finished the dissection of the lower extremity or thorax, according 
to the assignment of the subject. PLATE 39 
AT. Cohn, acZ naturam deZ. PLATE 40 
rtf. Ccr/in, ctrtZSK efef. PLATE 41 
JBrancfteS pf 
left phretzza 
\Jteecptcrc'- 
s ulum_~ 
I chtylc 
Azyyos 
-mayor K 
Wlio-Jlz/po- 
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\rtio-inazzz 
y.ai 7Z, 
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rar7ZefZc0/t 
i 7enito-cru- 
raC 7Z.. 
ftar/w/ «. 
a tty/tost 
s.csacra 1st-— 
Deep cz ream- 
’lex; iliac —; 
arc. & 
btarator n.-jm 
SOAS'MAG?^, 
Veep epipa- 
trie art —; 
*A .racral | 
attylion | 
i/tsacralk 
st. —-—ft 
Jtf.CoJiceract /nxdrrcrm ateC. PLATE 42 
Or eat sacro - 
sciatic li/".lt 
_ Small.sacro- 
sciatic li(/".ir 
AntTsacro-. 
coccyc/eal hy^c 
JIT. Cohn,adnatura/n de Z. PLATE 43 PLATE 44 
PSOAS MA GN(JS 
~ Sz PA/?!/(/& 
In ter verte- 
bra { discs 
PSOAS 
PAR 1/ US 
JKLCobn,<z<£n<ztc/r<Z77z c2et. PLATE 45 
Ftg.1 
cqccvgeus 
t fytjnaZ 
,W2.ra' o/t/teTS’/rjfir/Jvr 
'Small <racj>o-scia.ttc forar/tten 
EVATON AN/ et PROS TA TAF 
(seu l/A G/NAE) 
-Fig <2 
E/bturaZor fSpremt&n 
/"or apt.&n. 
— ZEVATO/t AN/ et 
{seu I/A GtNAT) PLATE 46 SIXTH DISSECTION. 
ABDOMINAL VISCERA OUT OF THE BODY. 
Dissection.—Commence the dissection of the abdominal viscera with the 
jejunal and ileal portions of the small intestine. Trim the shreds of the mesen- 
tery from the intestine ; stretch out the latter and slit it open from the jejunal 
end, along its line of mesentery attachment. 
1. Jejunum and Ileum of tlie Small Intestine, Figs. 1 and 
2, Plate 47.—The exterior of the small intestine is invested by 
peritoneum, except at the line where the two layers of the mes- 
entery meet; at this line of its circumference its arteries and 
nerves distribute to it, and its veins and tympliatic vessels leave 
it. The mucous membrane, that lines this intestine, presents 
the valvulse conniventes (Fig. 1, Plate 47); these are formed 
by the membrane’s reduplications, which have a velvety ap- 
pearance, due to the villi; in the ileal portion the valvulse con- 
niventes diminish in depth and number, and are absent in its 
inferior third. In the ileum are found, here and there, what 
are known as Peyer’s patches (Fig. 2, Plate 47); these are 
slightly depressed areas of the mucous membrane with ele- 
vated borders, the interiors being somewhat pitted ; they are 
most numerous toward the inferior end of the ileum. 
Dissection.—Cut off from four to six inches of the small intestine and pin 
it out taut upon a dissecting board (Fig. 1, Plate 47). Dissect the layers of the 
intestinal wall; the success of this demonstration -will depend upon the fresh- 
ness of the material. 
2. Coats of the Small Intestine, Fig. 1, Plate 47.—This in- 
testine will be found to present a readily demonstrable mucous 
membrane, a submucous plane not easily determined, a recog- 
nizable muscular coat and a well-defined serous coat. Such 
is the general structure of the subdiapliragmatic portions of 86 
TRUNK. 
the alimentary canal from the oesophageal end of the stomach 
to the anus; special variations will be noted in the different 
portions of the canal. 
Dissection.—Cut the ascending colon about six inches from the junction 
of the ileum with the large intestine. Note the relation of the ileum to the 
caecum and colon, and that of the appendix vermiformis to all three. Demon- 
strate the action of the ileo-colic valve, by filling first the ileum and then the 
colon and caecum with water; note that while the water will flow readily from 
the former into the latter, it is impossible to effect the reverse current. Cut 
away the external side of the large intestine opposite the ileo-colic valve (Fig. 
6, Plate 47). 
3. Caecum of tlie Large Inte§tine, Figs. 4, 5 and 6, Plate 
47.—The caecum is the sac of the large intestine, which is in- 
ferior to the entrance of the ileum of the small intestine into 
the large intestine. At the junction of the caecum with the 
colon the ileum of the small intestine opens ; the two intestines 
are separated by a valve—ileo-colic valve. Upon the surface 
of the caecum its longitudinal muscular fibres are seen so col- 
lected as to form three bands, one anterior, one postero external, 
and one postero-internal; it is these bands that determine its 
sacculated character. The open caecum and colon (Fig. 6, Plate 
47) show the large intestine side of the ileo-colic valve ; it is 
formed by two reduplications of the mucous membrane, which 
determine a button-hole slit of communication. 
Dissection.—Search for the orifice of the canal of the appendix vermiformis 
into the caecum ; pass a probe into the same, and slit open the appendix. 
4. Appendix Vermiforniis, Plates 35 and 37 ; Figs. 4, 5, and 
6, Plate 47.—This is a blind tube, from two to six inches long, 
appended to the caecum ; its relation to the caecum and ileum 
varies, but, as a rule, it is curled interiorly and internally to 
them, having a special meso. Its canal opens into the caecum, 
passing through its wall obliquely, thereby forming a valvular 
opening. Its mucous membrane lining differs from that of 
the caecum. 
Dissection.—Clear the ascending, transverse and descending colon of 
shreds of meso-colon and omentum. 
5. Colon of tlie Carge Intestine, Plate 35.—This portion 
of the large intestine is distinguished as follows : by the appen- ABDOMINAL VISCERA OUT OF THE BODY. 
87 
dices epiploicse (pellets of fat beneath its redundant peritoneal 
investiture) at the clefts between its saccuke; by the continu- 
ous sacculae of which it is formed; and by the three longitudi- 
nal bands, that are present upon its circumference. The latter 
were recognized at their commencement upon the caecum; 
they result from the bundling of the longitudinal muscular 
fibres of the intestine. The bands, taken continuously, are 
about half the length of this portion of the large intestine, 
consequently, the peculiar saccuise of this gut occur in its 
adaptation to the length of these bands. 
Dissection.—Slit open the colon of the large intestine, as was done with the 
small intestine. Dissect out a portion of one of the longitudinal bands and 
determine its structure. 
6. Mucous Membrane of tlie Large Intestine, Fig. 3, Plate 
47.—This surface of the large intestine presents three longi- 
tudinal furrows, corresponding to the exterior muscle bands ; 
between them the mucous membrane is raised into transverse 
prominences. Here and there more or less well defined, small, 
prominent points present—the solitary glands. 
Dissection.—Commence the dissection of the stomach, spleen, duodenum, 
pancreas and liver, en masse, by cutting through the duodenum just beyond 
the pylorus of the stomach, and separating the latter and the spleen from the 
other organs. Place the liver upon its anterior surface, with its inferior border 
upwards, and allow the duodenum and the pancreas to lie upon their posterior 
surfaces, inferior to and parallel with the superior border of the liver (Plate 48). 
Clear the exposed areas of the organs free of adventitious tissue, determining 
vessels and ducts. 
7. Duodenum, Plate 48.—This, the superior portion of the 
small intestine, was described as it presents in situ (page 64). 
In its present dissection, its relations to the ductus communis 
choledochus should be especially determined. 
Dissection.—Cut away the anterior wall of the descending portion of the 
duodenum. Incise the ductus communis choledochus, and enter a fine probe 
through it into the duodenum (Plate 48); note the orifice of the ductus com- 
munis choledochus at the mucous membrane surface of the exposed posterior 
wall of the duodenum. 
8. Ductus Communis Clioledochus, Plates 48 and 49.— 
This duct, before described (pages 63 and 67) and illustrated 88 
TRUNK. 
(Plates 35 and 36) in situ, enters the duodenum through the pos- 
terior wall of its descending portion ; it receives the duct of 
the pancreas, before passing into the wall of the gut; it perfor- 
ates the wall of the latter canal obliquely, thereby determining 
a valve-like opening. 
Dissection.—Trace, the superior mesenteric and splenic veins to the vena 
portae. 
9. Vena Portae, Plates 48, 52, 35 and 36.—-This vein takes 
its origin at the convergence of the superior mesenteric and the 
splenic veins—the latter receiving the inferior mesenteric. The 
trunk of the vena portae receives the gastro-epiploica dextra, 
the pyloric, the gastric and the cystic veins. The vessel is 
from two to three inches long from its origin to where it enters 
the transverse fissure of the liver. 
Dissection.—Eemove the liver by cutting the ductus communis choledo- 
chus and the vena portae, at the section lines (Plate 48). Clear away the su- 
perior mesenteric and splenic veins. 
10. Pancreas, Plates 48 and 49.—This organ was described 
(page 65) and illustrated (Plates 35 and 36) in situ. In this its 
special dissection, it is seen to have somewhat the shape of a 
hammer. Its anterior surface shows its portions to be : a head, 
to the right, included in the concavity of the duodenum ; a 
neck or constricted portion, anterior to the superior mesenteric 
vessels ; a body, extending to the left; while its tip or tail-like 
end terminates at the left. The splenic and inferior mesenteric 
veins lie posterior to the left half of the pancreas. 
Dissection.—Turn over the two organs (duodenum and pancreas) ; deter- 
mine the vessels upon the posterior surface of the head of the pancreas. Dis- 
sect longitudinally into the superior half of the posterior surface of the pan- 
creas, from its tip to its head, and search for the pancreatic duct; start the 
dissection at about the junction of the head and neck of the organ; once 
recognized, follow the duct to the left into the tail of the viscus and to the 
right toward its head. 
11. Inferior Panercatico-Duodciial Artery, Fig. 1, Plate 
49, and Plate 36.—Upon the posterior surface of the pancreas, 
at its head, the inferior pancreatico duodenal branch of the su- 
perior mesenteric artery presents ; it there follows, from left to 
right, the curve of the head of the pancreas, as lodged in the con- 
cavity of the duodenum ; it supplies branches to the pancreas ABDOMINAL VISCERA OUT OF THE BODY. 
89 
and duodenum, and anastomoses with the superior pancreatico- 
duodenal branch of the gastro-duodenal artery. 
12. Pancreatic Duct, Plates 49 and 36. — This duct is 
Lodged in the posterior and superior portion of the gland ; in 
its course from the tail of the organ it receives contributing 
ductlets ; in .the head of the pancreas it may present two por- 
tions, the duct proper and an accessory duct (Fig. 2, Plate 49). 
The duct proper, as previously stated (pages 67 and 8S), joins 
the ductus communis choledochus, before the latter perforates 
the coats of the duodenum, the two emptying into the gut by 
i common opening (Plate 36 and Fig. 1, Plate 49). The acces- 
sory duct may open into the duct proper, or, by a distinct 
opening of its own, into the duodenum ; the pancreatic duct 
proper may, in turn, empty into the duodenum by a special 
orifice, independent of the ductus communis choledochus. 
Dissection.—Separate the spleen from the fundus of the stomach, pre- 
serving the vessels of the former in continuity with it. Clear away the vessels at 
she curvatures and fundus of the stomach, slit the organ from its oesophageal 
irifice along its lesser curvature to within two inches of the pylorus ; invert the 
pylorus and examine its interior appearance. 
13. Interior of tlie Stomach, Fig. 1, Plate 50.—As the in- 
terior of the stomach lies exposed, the mucous membrane, at 
its oesophageal end and at the fundus, is smooth, while that 
pf its body and pylorus is thrown into folds or rugce, which run 
iongitudinally and transversely. The communication of the 
organ with the duodenum is guarded by a valve—the pyloric ; 
the latter is formed by the thickening of the coats of the 
irgan, more especially the mucous membrane ; the opening, 
is seen inverted, is a circular constriction. 
Dissection.—Dissect the pancreas from the duodenum; slit the latter 
>pen from end to end, and lay it out mucous membrane upwards. 
14. Interior of the Duodenum, Fig. 2, Plate 50.—Observe 
pile development of the valvulte conniventes from tlieir com- 
mencement in the descending portion (page 04), to their full 
lefinition in the transverse or oblique portion. In the ascend- 
ng and descending portions, the minute prominences of Brun- 
ler’s glands may be seen. The orifices of the ductus communis 
dioledoclius and of the accessory pancreatic duct appear in 
pile descending portion, as before indicated (page 88 ; Plate 48). 90 
TRUNK. 
Dissection.—Clear the surfaces of the liver, and determine its ligaments, 
fissures, lobes, vessels and ducts. 
15. Liver, Plates 51 and 52.—Tlie liver was described (page 
58) and illustrated (Plates 30, 31, 35, and 36) in situ. It 
is the largest organ of tlie abdominal cavity, weighing from 
forty to sixty ounces. It is suspended by ligaments, formed 
by reflections of the greater and the lesser peritoneum, and 
by the round ligament or obliterated umbilical vein. From 
the interior of the right superior and anterior parietes of 
the abdomen, the broad or suspensory ligament passes to the 
antero-su]Derior surface of the organ (page 56). The round 
ligament was before described (page 56). The coronary liga- 
ment at the postero-superior border of the organ, has a superior 
and an inferior portion : the superior is formed by the spread- 
ing of the broad ligament, right and left, and its reflection to 
the diaphragm ; the inferior is a reflection of the lesser perito- 
neum from the liver to the diaphragm. The two lateral liga- 
ments are the right and left extensions of the portions of the 
coronary ligament, from the superior lateral angles of the liver 
to the diaphragm. 
The postero-inferior surface of the liver is mapped out by 
furrows, which are called fissures. The umbilical fissure and 
tli e fissure for the ductus venosus—named from the parts they 
lodge—are the two portions of a longitudinal furrow, which 
commences at the inferior or free border of the organ—at the 
notch there presenting—and continues across it to its superior 
border. The transverse fissure—about three inches long—runs 
at a right angle from the right of the junction of the two last- 
described fissures. The fissure for the gall-bladder extends 
from near the right extremity of the transverse fissure to the 
inferior border of the viscus. The fissure for the vena cava 
runs obliquely from near the right extremity of the transverse 
fissure to the superior border of the gland. 
The five lobes of the liver are mapped out by the fissures upon 
its postero-inferior surface, as follows: the right lobe to tlie 
right of the fissure for the vena cava, the fissure for the gall- 
bladder and the right end of the transverse fissure ; the lobus 
quadratus by the transverse fissure superiorly, the fissure for 
the gall-bladder to the right and the umbilical fissure to the left; 
the lobus Spigelii by the transverse fissure interiorly, the fis- ABDOMINAL VISCERA OUT OF THE BODY. 
91 
sure for the vena cava to the right and the fissure for the ductus 
venosus to the left; the lobus caudatus extends from the lobus 
Spigelii into the right lobe, between the right extremity of the 
transverse fissure and the inferior end of the fissure for the vena 
cava ; the left lobe to the left of the fissure for the ductus veno- 
sus and the umbilical fissure. 
The liver is partially invested by peritoneum. The greater 
peritoneum projects the two layers of the broad or suspensory 
ligament to the antero-superior surface of the organ, which 
spread therefrom right, left, superiorly and interiorly: supe- 
riorly, it extends to the border of the organ, to become the su- 
perior portion of the coronary and the lateral ligaments ; infe- 
riorly, it reaches the border of the viscus and then passes to its 
postero-inferior face, and, at the inferior limit of the transverse 
fissure, it is reflected to the lesser curvature of the stomach, as 
the anterior layer of the gastro-hepatic omentum. The lesser 
peritoneum invests the postero-inferior surface of the liver su- 
perior to the transverse fissure, and, from the superior limit of 
the fissure, it is reflected as the posterior of the gastro- 
hepatic omentum. At the fissures and the area included by 
the portions of the coronary ligament, the peritoneum is want- 
ing ; at the latter point the organ is in contact with the dia- 
phragm. The cut surface of the liver presents a dull red color 
and a dense somewhat granular structure ; the dilated orifices of 
the hepatic veins appear, while the hepatic arteries are closed. 
16. Hepatic Artery, Plates 52 and 48.—This vessel was de- 
scribed (page 63) and illustrated (Plates 35 and 36) in situ. 
Reaching the transverse fissure of the liver, it divides into a 
right and a left branch, which enter the organ. 
17. Vena Porta?.—Formed as before described (page 88) and 
illustrated (Plates 35 and 36) in situ, this vessel branches, right 
and left, into the transverse fissure of the liver ; at the fissure it 
is lodged inferior to the lobus Spigelii; in the foetus the right 
branch is continuous with the umbilical vein, and the ductus 
venosus ; in adult life the umbilical vein is, at times, pervious 
for a variable distance from the vena portae. 
18. Biliary Ducts.—The right and the left leave the liver 
at the transverse fissure, in a plane inferior to the hepatic 
arteries ; the two unite into a single canal, the hepatic duct, 92 
TRUNK. 
which receives the cystic duct from the gall-bladder ; beyond 
this the canal is called the ductus communis choledochus 
(pages 63, 67 and 87 ; Plates 35, 36 and 49). 
19. Vena Cava Inferior.—This venous trunk impinges 
upon the liver in the fissure for the vena cava ; it continues supe- 
riorly, to the area of the organ not covered by peritoneum, where 
it bridges from the liver to the caval opening of the diaphragm. 
20. Hepatic Veins.—The hepatic veins emerge from the 
liver to empty into the vena cava inferior, in the bed of the 
fissure for the vena cava and the area at the superior border 
of the organ not invested by peritoneum. 
Dissection.—Dissect the gall-bladder free from the fissure, in which it is 
lodged; section the cystic duct close to the hepatic, also the cystic artery at 
the hepatic artery. Open the gall-bladder at its fundus, and slit it open to its 
duct. 
21. Gall-Bladder.—This is a pyriform sac, the duct of 
which is more or less tortuous ; the latter may be straightened 
somewhat by dissecting off the areolar tissue, which invests it. 
Dissection.—Remove any shreds of peritoneum from the spleen. Deter- 
mine the vessels of the spleen at its internal surface ; after which, it may be 
placed upon its convex external surface, with its posterior border toward the 
dissector; then holding the vessels on the stretch toward its posterior border, 
slice away the spleen tissue of the internal portion of the organ from the liilus 
to its anterior border, at a sufficient depth to expose the vessels that pene- 
trate the viscus. 
22. Spleen, Plate 53.—This organ was located (page 66) 
and illustrated (Plates 35 and 36) in situ. It is somewhat 
oval in shape, convex and smooth upon its external sur- 
face, slightly concave upon its internal surface. It weighs 
from four to eight ounces. At its internal surface a vertical 
fissure—the liilus—divides- it into two unequal portions, an 
anterior and a posterior : tlie anterior and larger area is ap- 
plied, in order from above downwards, to the stomach, the 
tail of the pancreas and the splenic flexure of the colon ; the 
posterior and smaller area impinges upon the left suprarenal 
capsule and kidney. At the liilus the splenic artery and 
nerves (sympathetic) enter the organ, and the splenic vein 
and lymphatic vessels leave it. The gastro-epiploica sinistra 
artery is given off to tlie stomach from the splenic artery, ABDOMINAL VISCERA OUT OF THE BODY. 
93 
at the inferior limit of the hilus of the spleen ; the vasa brevia 
to the stomach are supplied by branches of the splenic artery 
opposite the hilus. The slicing away of the spleen tissue, 
from the anterior half of its internal surface, demonstrates the 
penetration of vessels into the viscus, and determines by their 
distribution three portions to the organ : a superior, a middle, 
■and an inferior. Its tissue is darker and much less dense than 
that of the liver. 
Dissection.—Let the kidneys, the suprarenal capsules and the portions of 
the aorta and vena cava, as they were removed from the body (page 79), be 
laid out in their normal relations, upon a dissecting board. Cut the renal and 
suprarenal arteries at the aorta, their veins at the vena cava. Clear the sur- 
faces of the suprarenal capsules and kidneys, and determine the relations of 
the two organs to each other ; after which they may be separated. 
23. Suprarenal Capsules, Fig. 1, Plate 54.—These viscera 
were described (page 71) and illustrated (Plate 38) in situ. 
A capsule will average about one drachm and a half in weight; 
it is triangular in shape, slightly concave at its base, for appli- 
cation to the convexity of the kidney, and presents at its an- 
terior face a hilus for the entrance and exit of its vessels, etc. 
Dissection.—Determine the relations of the vessels and the ureter, that 
present at the internal border of the kidney. Grasp the kidney in the left 
hand, its internal border to the palm, its external convex border projecting 
between the thumb and fingers : as held, section with a scalpel its fibrous 
capsule along the convexity of the organ, then peel it off of its anterior and 
posterior surfaces to its internal border, where it will be found to pass into 
the hilus; trim the capsule away close to the hilus. Trace the vessels 
into a kidney as follows : place the kidney upon its posterior surface (Fig. 4, 
Plate 54), with the renal vein uppermost; hold taut the vessels and ureter, 
and cut away the kidney tissue from the internal to the external border of the 
anterior face of the organ, down to the plane of the renal vein ; this will deter- 
mine the course of both the veins and the arteries. To follow a ureter into a 
kidney, place the organ upon its anterior surface (Fig. 3, Plate 54), and pin 
the ureter and kidney taut ; slice off the posterior half of the kidney, from 
the internal to the external border, down to the plane of the walls of the pelvis 
and the infundibula. Demonstrate the three infundibula which converge to 
the pelvis of the organ : the superior, the middle, and the inferior; open the 
infundibula so as to examine their terminations in the calices, which surround 
the apices of pyramids of Malpighi. 
24. Kidneys, Figs. 2, 3, and 4, Plate 54.—These organs 
were described (page 71) and illustrated (Plate 38) in situ. A 
kidney will average about four and one-half ounces in weight. 94 
TRUNK. 
In shape, the organ is flattened antero posteriorly, with a con- 
vex external border ; it has convex superior and inferior ends, 
which curve in at the internal border ; its internal border pre- 
sents a notch—the liilus—which lodges the pelvis of the organ, 
the supplying artery and nerves, and the outcoming veins and 
lymphatics; these are bedded in interstitial adipose tissue. At 
the liilus (Figs. 2 and 4, Plate 54) the relations of parts are as 
follows : the renal vein is anterior, the ureter posterior, and the 
renal artery in the middle. In structure a kidney presents : a 
capsule ; a peripheral portion—the cortical substance ; an inte- 
rior portion—the medullary ; and an internal portion—the pel- 
vis. The capsule is a fibrous investment, which may be peeied 
off and traced into the liilus, where it is continuous with the 
walls of the calices of the pelvis. The cortical substance is dense 
tissue without distinctive parts, to the unaided eye ; it is con- 
tinued into the medullary portion as the columns of Bertini. 
The medullary portion is made up of the pyramids of Mal- 
pighi—formed by the tubuli uriniferi—separated by the col- 
umns of Bertini—F ougli which vessels and nerves run ; the 
bases of the pyramids are directed toward the cortical portion, 
their apices—presenting the orifices of the tubuli uriniferi—are 
the papillcB projected into the pelvis. The pelvis portion is a 
fibrous sac, with the following parts : the calices—at the bot- 
tom of the liilus—or the coves, so to speak, between the prom- 
ontories of the papillie of the pyramids; the infundibula— 
superior, middle, and inferior—or bays into which the calices 
empty ; and the pelvis proper or lake-like expansion of the in- 
fundibula, whose outlet is the ureter or duct of the organ. 
25. Renal Veins, Plate 38, and Figs. 2 and 4, Plate 54.— 
A renal vein, after being formed by several vessels that leave 
the liilus, empties into the vena cava inferior ; of the renal veins 
the left is the longer of the two. 
26. Renal Artery.—This artery enters the kidney at the 
liilus ; it breaks up into branches, which pass to the cortical 
substance, through the columns of Bertini. 
27. Renal Aeries, Plate 33.—These nerves, derived from 
the renal plexus of the sympathetic nerve, enter the kidney 
upon the renal artery, and its branches. PLATE 47 
Fig.S 
FIG.2, 
Fig. 3 
Fig. g 
Fig. F PLATE 48 PLATE 49 
Hepatic 
duct/ 
Fig. l 
Cystic duct 
9upTmesenteric e%- 
fn/T n //- 
Ductus communis 
choledochus 
|'upTmesentenc 
DostCpancreatico-. 
duodenal brunch 
-Dancreatic-ctuct 
Fia.z PLATE 50 
2?Iff. 2 
FlCt.2 
Drunner's glands 
Accessory pancreatic 
duct opening 
/Ductus communis, 
cfioleotoctius opening PLATE 51 
J\f»Co7tsz. ctd /zertzt.r'acTn. g?gZ. PLATE 52 
<o 
§ t 
% 
ill 
|l| 
kj 
RJ «» 
0 
•>Sl 
S'^ 
iV PLATE 53 
Fig. 2 
FlCr.J PLATE 54 
Stipl'inf'undibuluni 
Column of Bert ini \\ 
Fig. 3 
BIG./ 
SupVsuprarenal 
=— ■ art? 
r.Suprarenal in 
Middle _ 
suprarenal 
art? 
InfPsuprct* 
’renal art? 
Fig. 2, 
Fig. if SEVENTH DISSECTION. 
MALE PELVIC VISCERA OUT OF THE BODY. 
Dissection.—In the dissection of the male perineum, the mutual relations 
of the base of the bladder, the prostate, the vesiculse seminales, the vasa defer- 
entia, and the rectum were recognized (pages 26 and 27) and illustrated (Plate 
12) in situ. At present the viscera, as taken from the pelvis en masse (page 73), 
should be dissected, after which the separate organs will claim special atten- 
tion. The rectum and bladder may be inflated, or better, the rectum may be 
stuffed with oakum from its superior end ; the bladder, opened by a transverse 
incision at the superior portion of its anterior wall, may also be inflated or 
filled with oakum. Clean the exterior of the rectum and bladder of shreds of 
connective tissue ; preserve all arteries and nerves hanging from the organs. 
1. Rectum, Bladder, etc.—The rectum as distended pre- 
sents the double curvature, which determines its three portions ; 
in the concavity of its second portion, the bladder, vesiculm 
seminales, and prostate are lodged. 
2. Peritoneal Investment of Bladder, Plates 12, 31, and 
Fig. 1, Plate 37.—The fundus, the two lateral, and the posterior 
surfaces of this organ are invested by peritoneum. Posteriorly, 
the peritoneum descends to the line of the posterior extremi- 
ties of the vesiculse seminales, where it is reflected to the rec- 
tum, as the recto-vesical cul-de-sac (pages 27 and 67). 
3. Peritoneal Investment of Rectum, Plate 31, and Fig. 
1, Plate 37.—Tlie anterior and the right lateral surfaces of the 
first portion of the rectum, and the anterior and right lateral 
surfaces of the superior part of the second portion are covered 
by peritoneum. 
Dissection.—Cut the peritoneal reflection between the bladder and rectum, 
and dissect the rectum from the bladder, etc. Cut the vasa deferentia at about 
four inches from the prostate, thus detaching the testes. The rectum and testes 
may be returned to the preservative fluid. Cut the ureters about two inches 
from their vesical ends. Open the bladder and pin it and the penis to a dissect- 96 
TRTTNK. 
ing board, with the exterior of the base of the bladder and the inferior surface 
of the penis uppermost. Determine the ureters, the vasa deferentia, the vesi- 
culae seminales, the prostate, the membranous portion of the urethra, Cowper’s 
glands, the bulb of the corpus spongiosum, and the crura of the corpora caver- 
nosa. 
4. Ureters, Fig. 1, Plate 55.—The superior portions of 
these renal ducts were recognized (page 72) and illustrated 
(Plate 38) in situ; their inferior portions were left passing 
into the pelvic cavity upon the interior of its lateral walls ; now 
they are seen perforating the wall of the bladder. 
5. Vasa I>ef'crentia. 6. Vesiculae Seininales. 7. Exterior of 
Trigone. 8. Prostate (inferior surface). 9. Membranous 
Portion of tbe Urethra (inferior surface). 10. Cowper’s 
Glands. 11„ Bulb of the Corpus Spongiosum. 12. Crura of 
the Corpora Cavernosa.—The parts, 5 to 12 inclusive, were de- 
scribed and illustrated in the dissection of the Male Perineum 
(pages 19, 20, 22, 23, 26 ; Plates 10 and 12). 
Dissection.—Section the prostate on the median line from the notch at its 
base toward its apex, so as to expose the ejaculatory ducts, traversing its sub- 
stance. 
13. Ejaculatory Ducts, Plate 55.—These ducts, a right and 
a left, result from the convergence of the right and left 
vas deferens with the duct of the right and left vesicula semi- 
nalis, respectively. The junctions of these ducts take place at 
or within the prostate ; as formed, the ejaculatory ducts con- 
tinue in a channel through the prostate. 
Dissection.—Enter probes or wisps of broom-straw into the ureters and 
rasa deferentia (Fig. 1, Plate 55) ; unfasten the bladder and penis ; then pin 
them again to the dissecting board, with the interior of the former and the 
dorsum of the latter uppermost. Section the penis, a little to one side of the 
median line of its dorsum, from the glans penis to the bladder, so as to separate 
the corpora cavernosa and to open into the urethral canal, from the meatus to 
the bladder (Fig. 1, Plate 56) ; secure the penis, so as to expose the inferior 
wall of the urethra. 
14. Interior of the Bladder, Fig. 2, Plate 55.—The inte- 
rior of this organ lias a smooth, pale mucous membrane : at 
its base are seen to protrude the probes at the orifices of the 
ureters. An interior trigone area appears, which is smaller 
than the exterior one ; the orifices of the ureters are at the an- 
gles of its base line, about one inch and a half apart; the MALE PELVIC VISCERA OUT OF THE BODY. 
97 
opening into the urethra, at the neck of the bladder, forms its 
apex, about one inch and a half from the openings of the ure- 
ters, respectively. The mucous membrane of the trigone area 
differs from that of the rest of the interior of the organ, in that 
it is studded with mucous glands. 
15. Urethra, Fig. 2, Plate 55, and Fig. 1, Plate 56.—Tlie 
urethra extends from the bladder to the meatus urinarius ; it 
is a urino-seminal duct—urinary from the bladder, and seminal 
from the prostatic portion of the urethra. It averages about 
eight inches in length, and has a prostatic, a membranous, and 
spongy portion. It is lined by mucous membrane, continued 
from the bladder and from the ejaculatory ducts ; at the meatus 
(the narrowest part of the canal) the membrane is continuous 
with the skin upon the glans penis. 
The prostatic portion, one inch and a quarter long, pre- 
sents, along the mucous membrane lining of its inferior wall, 
a median-line longitudinal raphe or urethral crest, which con- 
tinues, posteriorly, to the neck of the bladder, and, anteriorly, 
into the membranous portion of the canal. At the highest point 
of the crest is the caput gallinaginis or veru montanum, which 
presents the opening of the sinus pocularis, or male utricle 
(analogue of the uterus of the female); from this sinus the 
probes or wisps entered into the vasa deferentia (page 95), pro- 
trude from the ejaculatory ducts, which open into it. The mu- 
cous membrane at the sides of the urethral crest presents the 
orifices of mucous glands—the prostatic follicles. 
The membranous portion—three-quarters of an inch long— 
is the narrowest portion, and is located between the prostate 
and the corpus spongiosum. The narrowest interior point of 
the urethral canal is the opening through the triangular liga- 
ment (page 20), which is at the junction of the membranous 
and portions. 
The spongy portion, six inches long, tunnels the corpus 
spongiosum cylinder of the penis, and is divided in turn into 
three sections : the bulbous, the body, and the glands or fossa 
navicularis. The Tmlbous is the deepest section; it is about 
one inch in length, has the largest calibre of the three, and pre- 
sents the openings of the ducts from Cowper’s glands. The 
body, about four inches long, is the narrowest part of the 
spongy portion of the urethra. The fossa navicularis, an 98 
TRUNK. 
inch in length, is an expansion of the urethra, which is situated 
just within the meatus urinarius, and is lodged in the glans 
portion of the corpus spongiosum. The mucous membrane of 
the urethra presents the orifices of sinuses, known as lacunae ; 
the largest of these is located in the superior wall of the fossa 
navicularis—the lacuna magna. 
Dissection.—Detach the bladder and penis from the dissecting board. 
Cut through the membranous portion of the urethra. . Cut the vesiculse semi- 
nales at the points of junction of their ducts with the vasa deferentia and dissect 
them from the bladder; straighten the convoluted tube of a vesicula seminalis. 
16. Prostate, Plates 12, 55, and Fig. 1, Plate 56.—This is a 
muscular organ, which encloses two canals : one for the transit 
of the ejaculatory ducts ; the other for the urethra . Its muscu- 
lar structure is continuous with the muscle coat of the neck of 
the bladder, and with that of the membranous portion of the 
urethra. In the prostatic portion of the urethra are mucous 
glands, known as the prostatic follicles, which have led to the 
organ being called the prostate gland ; this appellation is in- 
correct, as its follicles are of but secondary importance. Ante- 
riorljg it is a single organ, but, posteriorly, it is divided by the 
cleft at its base (page 26) into a right and a left lobe. The 
portion inferior to the neck of the bladder forms an isthmus, 
which unites its two lobes; this isthmus may, in old age, be- 
come hypertrophied, which circumstance has led to its being 
called the middle lobe of the prostate; normally the organ has 
no middle lobe. 
17. Vesicular Seminales, Fig. 1, Plate 55.—A vesicula semi- 
nalis will be found upon dissection to be a single convoluted 
tube about six inches long ; from the tube blind sacs are pro- 
jected at intervals. 
18. Penis, Figs. 1 and 2, Plate 56, and Fig. 1, Plate 55.— 
The enveloping sheaths, the vessels and the nerves of this 
organ are presented in the section Fig. 2, Plate 56 ; these 
several parts were described (pages 44, 45 and 46) and illus- 
trated (Plate 22) in situ. The penis is formed by three longi- 
tudinal bodies or cylinders : the right and left corpus caverno- 
sum, and the corpus spongiosum. 
Hie corpora cavernosa are attached by their crura and bjr 
the ischio-cavernosi muscles to the rami of the pubic arch MALE PELVIC VISCERA OUT OF THE BODY. 
99 
(pages 20 and 19); the crura converge over the bulb of the cor- 
pus spongiosum and meet at the median line to form the dorsal 
longitudinal cylinders of the penis ; the corpora have an invest- 
ing fibrous capsule and are separated by a fibrous septum. 
The corpus spongiosum (page 19 ; Plates 8 to 12 inclusive) 
presents three sections: the bulb, the body, and the glans. 
The bulb is lodged between the crura of the corpora cavernosa ; 
the body continues forward inferior to the corpora cavernosa 
as far as the free ends of the latter ; the glans is its expansion, 
capping the ends of the corpora cavernosa. 
Dissection.—A testis, with the scrotal portion of the spermatic cord, should 
be laid upon a dissecting board and pinned thereto—one pin through the body 
of the testis, another through the proximal end of the outstretched spermatic 
cord. Section the sheath (internal spermatic or infundibuliform fascia), in- 
vesting the cord, and reflect the same. Open the tunica vaginalis of the testis 
and reflect it; recognize the testis, the epididymis, the vas deferens, the vas 
aberrans, the artery of the vas deferens, the spermatic artery, the spermatic 
veins, the spermatic nerves (sympathetic) ; the latter are continued to the testis 
upon the artery. 
19. Internal Spermatic Fascia, Fig- 3, Plate 56.—This 
sheath of the spermatic cord and the testis (page 54) is con- 
tinued as an infundibuliform (funnel spout) prolongation of 
the transversalis fascia ; it blends with the tunica vaginalis of 
the testis. It occupies a plane interior to the cremasteric mus- 
cle fibres of the spermatic cord (page 50). 
20. Tunica Vaginalis.—This is the serous investment of 
the testis. It is a closed sac, which is applied to the antero- 
lateral surfaces of the testis ; it has a visceral and a parietal 
layer. It, originally, was a portion of the peritoneum, which 
descended from the abdominal cavity with the testis ; at first 
it has a canal of communication (the canal of Nuck) with the 
cavity of the peritoneum ; later the canal becomes obliterated 
into a fibrous thread. 
21. Te§tes.—A testis is an ovoid body, weighing from fonr 
to eight drachms and suspended from the end of the spermatic 
cord. It is partially invested by the tunica vaginalis ; its pos- 
terior surface (in the illustration the accidental position of the 
testis would make it appear, that it was the superior surface), 
not invested by the tunica vaginalis, presents the liilus of the 100 
TRUNK. 
organ, where vessels, nerves, and ducts pass. The testis has a 
fibrous capsule—the tunica albuginea. Upon section a testis 
presents a grayish pulp which extrudes from compartments of 
the gland. 
22. Vas Deferens, Fig. 3, Plate 56, and Plates 29 and 38.— 
This duct, about two feet in length, commences at the liilus of 
the testis ; it is a recognizable element of the spermatic cord, 
being like a hard cord of about the size of a thick knitting- 
needle. 
23. Epididymis, Fig. 3, Plate 56.—The epididymis is the 
convoluted portion of the vas deferens ; it is lodged posterior 
to, and opposite the liilus of the testis. Its portions are the 
globus major, at the superior end (in the figure at the right 
end); the body parallel with the liilus; the globus minor, at 
the inferior end (in the illustration the left end). From the last- 
named portion the straight part of the vas deferens is continued. 
24. Vas Aberrans.—This is a short blind duct, about one 
and a half to two inches long, which springs from the globus 
minor of the epididymis ; it runs parallel with the vas deferens 
in the spermatic cord. 
25. Artery of tlie Va§ I>cferens.—Tliis artery accompanies 
the vas deferens in the spermatic cord, distributing to it and 
to tlie epididymis. 
26. Spermatic Artery.—This artery is an element of the 
spermatic cord, distributing to the testis, the liilus of which it 
enters. 
27. Spermatic Veins.—These leave the testis at its liilus, 
forming a plexus (the pampiniform) in the scrotal portion of 
the cord ; from the plexus two veins result, which form the 
venae comites of the spermatic artery. PLATE 55 
Fig. 2 
FlG.l 
? 
8 
i 
u 
*; 
£ 
■§ 
a PLATE 56 
FI a, I 
Fig. 2 
Fra. 3 
M.C. nd.nac.dal> EIGHTH DISSECTION. 
FEMALE PELVIC VISCERA OUT OF THE BODY. 
Dissection. —The female pelvic viscera, as taken en masse from the body 
(page 73), may be dissected upon a dissecting board. The rectum and bladder 
should be prepared as in the dissection of the male pelvic organs (page 95); 
the vagina should be moderately distended with oakum. In the dissection of 
these organs as they presented at the pelvic outlet (pages 40, 41; Plates 19 
and 20), the relations of the organs were disturbed; they should now be 
carefully adapted in their normal relations, with one of their lateral surfaces 
uppermost. All connective tissue should be removed from them, being careful 
to preserve their peritoneal investiture, the vessels distributing to them, and 
the broad ligaments of the uterus, with its associated parts. 
1. Lateral View of the Female Pelvic Viscera.—In this 
view of the viscera the rectum presents as a canal with two 
curvatures ; its postero-inferior convexity is for lodgment in 
the concavity of the sacrum; its antero-superior concavity 
receives the postero-inferior convexity of the vagina. The 
uterus protrudes from the superior end of the vagina, with 
a broad ligament projected from its lateral border. The inti- 
mate relations of the contiguous vaginal and rectal walls 
were before recognized (page 41), The vagina presents an an- 
tero-superior concavity, into which is received the postero- 
inferior convexity of the bladder and the urethra. The bladder 
will be found adherent to the anterior surface of the supra- 
vaginal portion of the neck of the uterus. The relations of the 
contiguous urethral and vaginal walls were determined in the 
dissection of the Female Perineum (page 41). 
2. Reflections of tlie Pelvic Peritoneum.—The peritoneum 
may be traced over the fundus of the bladder—the anterior sur- 
face of the organ not being invested by it—whence,it spreads 
over its sides and posterior wall; it is reflected from the latter 
surface to the anterior of the body of the uterus, thereby form- 
ing the vesico-uterine cul-de-sac ; it invests the anterior of the 102 
THUNK. 
body of the uterus, and it folds over its fundus to cover the 
posterior of the same ; it continues upon the posterior surface 
of the superior end of the vagina, from which it is reflected 
to the anterior wall of the rectum, thereby forming the recto- 
vaginal or Douglas’ cul-de-sac (page 41; Fig. 2, Plate 20). 
From the lateral border of the body of the uterus, the perito- 
neum is projected in two layers (from the anterior and the 
posterior surface, respectively) as a broad ligament of the or- 
gan (page 69 ; Fig. 2, Plate 37). 
Dissection.—Section the peritoneum of the vesico-uterine cul-de-sac, and 
dissect the bladder and urethra from the uterus and the vagina. Section the 
recto-vaginal cul-de-sac, and separate the vagina from the rectum. Slit open 
the bladder and urethra along the mid-line of their antero-superior wall and 
spread them open upon a dissecting board. 
3. Bladder and Urethra.—The interior of the female blad- 
der presents the same appearances as the male (page 97). The 
short female urethra, one inch and a half in length, is in 
marked contrast to the male urethra of eight inches; it was 
seen (page 40 ; Fig. 1, Plate 20) forming a conical projection 
from the neck of the bladder ; on section, this projection will 
be found forming a thick wall to the canal. 
Dissection.—Lay the uterus with its broad ligaments and the vagina 
(emptied of oakum) upon the dissecting board, with their antero-superior face 
uppermost (Fig. 1, Plate 57); pin the organs fast. 
4. Broad Ligaments of the Uterus, Fig. 1, Plate 57.— 
These two ligaments are projected one from either side of the 
body of the uterus; they are formed as shown above by two 
layers of peritoneum ; the anterior layer presents a smooth 
unbroken surface. 
Dissection.—Incise and dissect off tlie anterior layer of the right broad 
ligament of the uterus (Fig. 1, Plate 57) ; determine the Fallopian tube, the 
round ligament of the uterus, the ligament of the ovary, and the ramifications 
of the uterine and ovarian arteries between the layers of the ligament. Recog- 
nize the slit in the anterior face of the posterior layer of the ligament, where 
the vessels to, and from, the ovary pass ; the ligament of the ovary also passes 
to the latter through it. 
5. Faiiopinn Tubes.—These canals spring from the superior 
and lateral angles of tlie body of the uterus. A Fallopian tube FEMALE PELVIC VISCERA OUT OF THE BODY. 
103 
is about four inches in length, and terminates by a free fim- 
briated extremity ; one of the fimbriae being pervious. 
6. Round Ligament of the Uterus.—This so-called liga- 
ment springs from the side of the body of the uterus ; it passes 
between the layers of the broad ligament, to emerge from be- 
neath its anterior layer. 
7. Ligament of the Ovary—This so-called ligament is pro- 
jected from the side of the body of the uterus, at a point be- 
tween the giving off of the Fallopian tube and the round liga- 
ment (nearer the former) ; it continues laterally, between the 
layers of the broad ligament, to pass out from between them, 
at the slit in the posterior layer of said ligament (page 102), 
for attachment to the internal end of the ovary. 
§. Uterine Artery, Figs. 1 and 2, Plate 57.—This artery 
enters between the layers of the broad ligament, external to 
and opposite the attachment of the vagina to the uterus. It 
gives off an inferior branch to the exterior of the lateral wall 
of the vagina, and then continues parallel with and external to 
the lateral border of the uterus, toward the fundus of the latter; 
at about opposite the middle of the body of the uterus, it anas- 
tomoses with a branch from the ovarian artery of the side. 
9. Ovarian Artery.—This artery enters between the layers 
of the broad ligament; it runs parallel with, and inferior to, 
the Fallopian tube, toward the body of the uterus. It gives off 
branches to the ovary and the Fallopian tube, of the side, and 
finally anastomoses with the uterine artery, as before shown. 
Its branches to the ovary pass to that organ through the slit in 
the posterior layer of the broad ligament (page 102). 
Dissection.—Detach the uterus, etc.; spread the organs out upon the 
board with their posterior face uppermost and pin them fast (Fig. 2, Plate 57). 
10. Peritoneal Investment of the Uterus, Fig. 2, Plate 57.— 
The greater peritoneum, as before stated (page 102), covers the 
entire posterior surface of the body of the uterus and is con- 
tinued, interiorly, irpon the exterior of the superior end of the 
vagina. From the sides of the uterus it is projected, as the 
posterior layer of the broad ligament. 104 
TRUNK. 
ll. Ovary.—This almond-shaped bodj7 is swung free from 
the posterior face of the posterior layer of the broad ligament; 
it is attached thereto by its long axis. An ovary is about one 
inch and a quarter long, three-quarters of an inch wide, and 
half an inch thick ; it weighs about four scruples. Its arteries 
and nerves reach it, and its veins and lymphatics leave it by 
the slit, seen at the anterior face of the posterior layer of the 
broad ligament (page 102 ; Fig. 1, Plate 57). 
12. Vagina.—This canal, about four inches long, has an 
exterior fibrous, a middle muscular, and an interior mucous 
coat. Its free end, which is its narrowest point, forms a ver- 
tical fissure or opening at the pudendum (pages 30 and 41; 
Plates 19 and 20); at its middle, which is its widest part, its 
transverse diameter is the longest; at its attached or uterine 
end it is almost circular, receiving into its opening the neck of 
the uterus ; the walls of the vagina (page 41) are in apposition. 
Slitting open the vagina along its postero-inferior wall (Fig. 
2, Plate 57), it presents an antero-superior and a postero-inferior 
mid-line ridge of its mucous membrane—the columns of the 
vagina ; between these columns the lateral halves of the mucous 
membrane bridge, forming rugae ; these rugae are best marked 
at the pudendal end of the canal, and become less and less so 
toward its uterine end. 
13. uterus.—The uterus is a cylindrical body, constricted 
at its middle, and somewhat flattened antero-posteriorly ; it 
weighs about ten drachms, and measures two inches and a half 
long, one inch and a half wide, and one inch thick; its supe- 
rior end, the fundus, is globular and larger than its inferior. 
The inferior end is projected into the superior opening of the 
vagina, the latter being attached to the circumference of the 
former. The uterus is a hollow organ, the canals of the Fallo- 
pian tubes open into the cavity of its body, the latter into 
the cavity of its neck, and the cavity of the neck of the uterus 
opens, at the external os, into the vaginal canal. It is about 
equally divided into a body and neck portion. From the 
lateral borders of the body, the Fallopian tubes, the ovarian, 
the round and the broad ligaments are projected, as before 
shown (pages 102 and 103). The inferior portion of the neck 
projects into the vagina, where it presents a short anterior and FEMALE PELVIC VISCERA OUT OF TIIE BODY. 
105 
a long posterior lip, which are determined by the external os 
(mouth of the uterus) between the two. 
Dissection.—Trim away tlie broad, the ovarian, and the round ligaments 
from the border of the uterus; cut the Fallopian tubes two inches from the 
uterus. Slit open the posterior wall of the uterus from the os uteri to the 
fundus ; enter a fine probe into the stump of the Fallopian tube, and cause it 
to emerge into the cavity of the body of the uterus; make two additional 
lateral slits to the uterine openings of the Fallopian tubes; pin out the uterus 
thus opened (Fig. 3, Plate 57). 
14. Interior of tlie Uterus, Fig. 3, Plate 57.—The interior 
! of the uterus shows the organ to be about equally divided into 
a body and a neck portion. The cavity of the neck and the 
| cavity of the body are readily distinguishable by the difference 
in the appearance of their mucous membrane. The cavity of 
the body is somewhat triangular, and has the Fallopian tubes 
opening into it at the angles of its base; at the apex of the 
i cavity of the body is a slightly constricted portion, the in- 
ternal os, through which it opens into the cavity of the neck 
portion of the organ. The cavity of the neck is dilated at 
its mid-portion, and constricted at its ends, the internal os and 
the external os ; its interior presents a median-line longitudinal 
ridge upon the anterior and the posterior walls, between which 
its redundant mucous membrane is laid in transverse pleats 
upon its lateral walls, arbor vitce uterinus. The exterior of 
the uterus is, as before shown (page 104), partially covered by 
peritoneum ; the interior of its cavities are lined by mucous 
membrane, continuous with that of the Fallopian tubes and the 
vagina ; the mid-portion of the wall of the organ, between its 
serous and mucous membrane, is composed of involuntary 
muscular fibre. 
Dissection.—Dissect off loose fibrous tissue from tlie circumference of 
the rectum, preserving its partial investment of peritoneum, and the arteries 
that distribute to it. This portion of the alimentary canal is described here, 
at the end of the dissection of the female jielvic organs, but the description is 
intended to apply to the rectum in both sexes. Remove the oakum from the 
rectum, and expose its interior, by slitting it from its inferior end and folding 
back the two sides of the canal. 
15. Rectum, Figs. 1 and 2, Plate 58.—Portions of the rec- 
tum presented and were described in the dissections of the 
organs at the pelvic outlet, male (page 27; Plates 11 and 106 
TRUNK. 
12) and female (page 41; Fig. 2, Plate 20). This, the terminal 
eight inches of the large intestine, presents two curvatures, 
which form its three portions, viz.: first, second, and third. 
The first portion extends to the first curvature ; the second, be- 
tween the curvatures, lias a postero-inferior convexity and an 
antero-superior concavity ; the third portion, beyond the sec- 
ond curvature, tips posteriorly, and terminates at the anus,; 
where it is surrounded by the sphincter ani muscle. The rec- 
tum dilTers from the colon of the large intestine : first, in the 
absence of the three longitudinal bands of the latter ; second, 
in the absence of appendices epiploicae. 
In unfolding the rectum, as directed, note a contraction at 
the anus, produced by the external and internal sphincters ; a 
dilatation within the anus ; and a bend in the gut at the junc- 
tion of its second and first portions. 
In structure, the walls of the rectum will be found to pre- 
sent an exterior, partial, peritoneal coat (pages G7 and 95), a 
muscular coat, a submucous coat and an interior mucous 
coat. In the muscular coat the fibres are both longitudinal 
and circular : the longitudinal fibres are distributed to the en- 
tire circumference of the canal, presenting lateral thickenings 
of the same, by which an attempt at a right and left muscle- 
band are determined. The sphincter ani muscle surrounds 
the anal orifice, and the fibres of the levator ani portion of the 
levator ani et prostata? or levator ani et vaginae muscle reach 
the wall of the rectum, beneath the plane of the sphincter ani 
muscle (page 25 ; Plates 10, 11, and 12). PLATE 57 
J^IG.l 
ZSterine ai't. / 
I'm*. 2 
Fsa. 3 
Openings- ofjraUopeezn tubes 
ytf.C'oAn.eecleeaeieraTn cZe?. PLATE 58 
FIG.1 
Fig. 2 LOWER EXTREMITY. 
NINTH DISSECTION. 
ANTERIOR OF THIGH. 
Dissection.—Place a block under the pelvis to raise the proximal ends of 
the lower extremities; extend the limbs at full length with the heels upon the 
table. 
Terms of Relation.—Those applied are : the general terms 
anterior and posterior (page 2); the special terms proximal 
and distal (toward and from the trunk, respectively); inner 
and outer (to the respective lateral surfaces); also, the com- 
pound terms antero-inner and outer, and postero-inner and 
outer. 
Rones and Rone Areas, Plate 59 and Fig. 1, Plate 91.—The 
bone surfaces of the dissection are : the anterior 
border of the ilium and the exterior surfaces of 
the os pubis and ischium of the os innominatum ; 
the anterior surfaces of the femur, the patella, 
and of the proximal ends of the tibia and 
fibula. The areas for muscle attachments are : 
of the os innominatum, at the anterior border of 
its ilial and the exterior of its pubic and ischial 
portions ; of the femur, its anterior and postero- 
inner surfaces; of the patella, its borders; of 
the tibia, the antero-inner and outer surfaces 
of its proximal end. 
Dissection.—Tlie skin incisions for this dissection are 
indicated in Fig. 4, lines 1, 2 and 3. When this dissection 
is consecutive to that of the abdomen, skin incision 1 will 
have been made, as the line of the same describes about 
that of Poupart’s ligament. 
1. Subcutaneous Tissue.—This plane of tis- 
sue varies in thickness; it consists of two layers 
—superficial and deep—between which the superficial veins 
and nerves ramify. 
Figure 4. 108 
LOWER EXTREMITY. 
Dissection.—Over the patella determine a bursa. Along the inner area of 
the limb find the internal saphenous vein, and follow its tributary branches. 
Dissect out, when present, the saphenous lymphatic glands in the proximal 
quarter of the dissection area. 
2. Bursa over the Patella, Plate 60.—At the anterior sur- 
face of the patella is a well-marked subcutaneous bursa. 
3. Internal Saphenous Vein.—This is a large subcutaneous 
vein, which has a proximal course from the inner side of the 
knee along the inner side of the thigh, to the saphenous open- 
ing (page 109) in the fascia (lata) of the region, where it enters 
to empty into the femoral vein. In its course it receives tribu- 
tary subcutaneous veins from the anterior and posterior areas 
of the thigh ; also the recurrent subcutaneous veins from the 
inferior antero-lateral areas of tlie abdominal parietes (page 
44 ; Plate 22). 
4. Saphenous Lymphatic Glands—These glands are clus- 
tered about the saphenous opening. They receive lymphatic 
vessels from the areas contributing tributary veins to the in- 
ternal saphenous vein. Their efferent vessels penetrate to the 
deeper glands through the saphenous opening. 
Dissection.—Clear away tlie saphenous lymphatic glands, being careful 
not to destroy the boundaries of the saphenous opening. Determine the points 
of emergence through the fascia lata of the superficial arteries. Cut away 
the tributary veins of the internal saphenous vein. 
5. Subcutaneous Arteries.—The areas of distribution of 
the recurrent branches of the femoral artery have already been 
described (page 44) and illustrated (Plate 22). At this time we 
only desire to recognize, that they—the superficial epigastric, 
the superficial circumflex iliac and the superior external pudic 
—emerge from beneath the fascia lata, through or in the vi- 
cinity of the saphenous opening. The inferior external pudic 
artery perforates the pubic portion of the fascia lata, close to 
the femoro-scrotal groove, for distribution to the scrotum. 
Upon the anterior surface of the thigh small arterial twigs will 
be found to emerge through the fascia lata. 
Dissection.—Trace the cutaneous nerves in their distal course through 
the subcutaneous tissue. ANTERIOR OF TIIIGII. 
109 
6. External Cutaneous Nerve*—This nerve becomes sub- 
cutaneous at a variable point inferior to the anterior superior 
spinous process of the ilium. It distributes to the anterior and 
posterior surfaces of the outer border of the thigh. 
7. Tlie middle Cutaneous Nerve.—This branch of the an- 
terior crural nerve emerges through the fascia at the anterior 
face of the thigh, from which point it continues subcutane- 
ously to the knee. 
8. Tlie Internal Cutaneous Nerve.—This nerve, branch of 
the anterior crural, emerges, by several branches, through the 
fascia lata, at the inner and anterior areas of the thigh. 
Dissection.—Clear the surface of the fascia free of subcutaneous tissue, 
allowing the cutaneous nerves and vessels to remain upon it. 
9. Fascia Lata.—This is the special name given to the fas- 
cia of the thigh. It is a thick sheet of fibrous tissue, which 
swathes the limb; having its proximal attachments to Poupart's 
ligament, the linea-ilio pectinea, the pubic arch, the tuberosity 
of the ischium, the posterior surfaces of the coccyx and sa- 
crum, and the exterior lip of the crest of the ilium ; and its dis- 
tal attachments to the inner and outer tuberosities of the 
proximal end of the tibia, the proximal end of the fibula and 
the fascia of the leg. 
Dissection.—Determine the two anterior proximal planes of the fascia lata. 
Follow the internal saphenous vein to the saphenous opening; define the bor- 
ders of the opening, and also the cribriform fascia, which closes the same. Seek 
the crural branch of the genito-crural nerve, coming through the opening. 
10. Saphenous Opening.—This opening or deficiency in the 
fascia lata results, from the splitting of the fascia, at the inner 
side of the proximal end of the thigh : an outer, superficial 
portion—the iliac—is attached to Poupart’s ligament; an inner, 
deep portion—the pubic—is attached to the superior border of 
the horizontal ramus of the os pubis. The iliac portion lies 
anterior to the femoral vessels, with its inner border upon the 
femoral vein, where it is curved to form the superior, the outer, 
and the inferior limits of the opening—the falciform edge; 
the pubic portion passes posterior to the femoral vessels. The 
two planes meet, and join at the superior and inferior limits of 
an ovoid opening, which affords transit to the internal saphe- 110 
LOWER EXTREMITY. 
nous vein, lymphatic vessels, the crural branch of the genito- 
crural nerve, and some of the recurrent branches of the femo- 
ral artery. From the exterior of the internal saphenous vein 
to the borders of the opening, the deep layer of the subcuta- 
neous tissue closes the same ; this portion of the subcutaneous 
tissue is perforated by vessels and lymphatics, giving it a 
sieve-like character, hence its special name of cribriform fas- 
cia of the saphenous opening. 
11. Genito-Crural Verve.—The crural branch of this nerve 
(page 78) passes beneath Poupart’s ligament, and emerges upon 
the fascia lata, through the saphenous opening, to distribute 
to the skin of the proximal third of the anterior face of the 
thigh. 
Dissection.—Section the saphenous vein about two inches from the saphe- 
nous opening; also cut the nerves in the subcutaneous plane, close to their 
points of perforation of the fascia lata. Clear the surface of the fascia of all 
portions of veins and nerves. Incise the fascia in the same line as the skin 
incisions (Fig. 4, page 107), and reflect lateral flaps of the same. 
12. Sartor I us Muscle, Plates 59 and 61.—This superficial 
muscle crosses obliquely from the outer to the inner side of 
the limb, between its proximal attachment at the anterior 
border of the os innominatum, inferior to the anterior superior 
spinous process of the ilium, to its distal attachment at the 
inner tuberosity of the tibia. 
13. Tensor Vaginae Femoris Muscle, Plate 61.—This is sit- 
uated at the outer side of the proximal third of the thigh. Its 
proximal attachment is to the os innominatum, posterior and 
inferior to the anterior superior spinous process of the ilium; 
its distal end is attached to the fascia lata in the proximal 
half of the thigh. 
14, Rectus Femoris Muscle, Plate 61.—This muscle occu- 
pies a plane deeper than the two previous muscles; it emerges 
upon the anterior face of the thigh into the distal angle formed 
between them and continues to the knee. 
15. Vastus Extern us Muscle.—Tills is the muscle to the 
outer side of the rectus femoris and distal to the tensor va- 
ginae femoris; it swathes around the outer surface of the 
femur down to the knee. ANTERIOR OF THIGII. 
Ill 
1C. Vastus internus Muscle.—The distal angle, formed be- 
tween the sartorius and the rectus femoris, is occupied by this 
muscle ; it winds over the inner surface of the femur down to 
the knee. 
17. Gracilis Muscle, Plates 59 and 61 to 65 inclusive.—This 
flat, ribbon-1 ike muscle extends along the inner face of the 
thigh; its proximal attachment is at the exterior border of the 
pubic arch, its distal at the inner tuberosity of the tibia. About 
the middle of the thigh it becomes contiguous to the sartorius. 
IS. Adductor Longus Muscle, Plates 59, 61, 62 and 63.— 
Occupying the proximal angle, formed by the sartorius and the 
gracilis, is this triangular muscle ; its apex or proximal end is 
attached to the exterior face of the body of the os pubis; its 
fibres have a distal and oblique course, passing beneath the 
inner border of the sartorius to the attachment of its base to 
the shaft of the femur, at the linea aspera (Pig. 1, Plate 93). 
19. Adductor Magnus Muscle, Plate Cl.—In the interval 
between the sartorius, the gracilis and the adductor longus, a 
portion of this muscle appears. 
20. Scarpa’s Triangle.—This name has been given to the 
triangular space, which has its base or proximal limit at Pou 
part’s ligament, its apex or distal limit at the angle of meeting 
of the sartorius and adductor longus, and its outer and inner 
sides formed by these muscles, respectively. The floor of the 
space is formed, at its inner portion, by the anterior surface of 
the pectineus muscle ; at its outer portion, by the anterior sur- 
faces of the thigh portions of the psoas magnus and iliacus in- 
ternus muscles. 
Dissection.—Clear the surface of the pectineus muscle, respecting, in so 
doing, the vessels crossing it. Take up the stump of the internal sajilienous 
vein and follow it to the femoral vein. Open the femoral sheath at the proxi- 
mal ends of the femoral vein and artery, and expose the two vessels and the 
femoral canal. Clear the surface of the iliacus internus muscle (Plate 61), 
that presents to the inner side of the proximal end of the sartorius. Follow 
the stump of the middle and internal cutaneous nerves to the anterior crural 
nerve ; clear the latter nerve as it lies parallel with the femoral vessels, and 
determine its deep branches. 
21. Vessels and Verves in Searpa’s Triangle.—Within this 
triangle are to be found, projected from beneath Poupart’s 112 
LOWER EXTREMITY. 
ligament, the femoral vein, the femoral the femoral 
canal and the anterior crural nerve. The two vessels and the 
canal are contained in the femoral sheath, with only a thin 
fibrous septum between them. At its proximal end the femoral 
vein is to the inner side of the artery ; toward the apex of the 
triangle it passes posterior to the artery. To the outer side of 
the vein is the femoral artery; within the triangle it gives off 
its recurrent branches, which perforate the fascia lata (page 
108), to pass into the subcutaneous plane of the abdominal 
parietes and to the external genitalia—the superficial circum- 
flex iliac, the superficial epigastric, and the superior and in- 
ferior external pudics; the profunda femoris artery is also 
given off from its posterior surface, at a variable distance from 
Poupart’s ligament. To the inner side of the proximal end of 
the femoral vein a short canal exists—the femoral canal; it 
extends as a pouch of the femoral sheath, and is about one 
inch in length. At its proximal limit the femoral canal opens 
into the abdominal cavity by the femoral ring, which is 
bounded, as follows: by the femoral vein, externally ; the 
superior border of the horizontal ramus of the os pubis, inte- 
riorly; Gfimbernat’s ligament, internally; and Poupart’s liga- 
ment, superiorly. The anterior crural nerve lies to the outer 
side of the femoral artery, being separated from it by a slight 
interval; to it can be traced the middle and internal cutaneous 
nerves; the internal saphenous nerve may be followed down 
from it to the femoral artery; its deep or muscular branches 
take a distal course, disappearing beneath the sartorius mus- 
cle ; a branch to the pectineus muscle passes internally, in a 
plane posterior to the femoral vessels. 
Dissection.—Section the sartorius muscle (Plate 61) and reflect its por- 
tions, superiorly and interiorly. (The reflected portions of the sartorius mus- 
cle should not he cut close to their attachments, as is represented in Plate 62). 
Abduct the thigh and semiflex the knee, resting the foot upon its outer border. 
22. Hunter’s Canal, Plate 62.—Beneath the portion of the 
sartorins muscle distal from Scarpa’s triangle, a layer of fibrous 
tissue (a portion of the sheath of the sartorins) stretches from 
the anterior surfaces of the adductor longus and magnus 
muscles to the inner surface of the vastus interims muscle. 
A triangular canal—Hunter's Canal—is formed as follows: by 
the fascia of the sartorius anteriorly and to the inner side; the ANTERIOR OF THIGH. 
113 
adductor longus and magnus muscles posteriorly; the vastus 
internus muscle to the outer side. 
23. Internal or Long Saphenous Nerve.—This nerve is 
given off from the inner side of the anterior crural ; it accom- 
panies the femoral artery into Hunter’s canal. 
Dissection.—Extend the limb; section the tensor vaginae femoris muscle 
at its distal attachment to the fascia lata and reflect it superiorly; in raising it 
from its bed note the branch from the inferior gluteal nerve, that enters its 
deep surface. Clear the muscle surfaces beneath the tensor vaginae femoris, 
preserving the ramifications of arteries. 
21. Gluteus Kledius and minimus muscles, Plates 62, 63, 
64 and 65.—The anterior borders of these two muscles present 
proximal to the trochanter major and to the outer side of the 
proximal end of the rectus femoris muscle. 
25. Rcciiis Femoris Muscle, Plates 59, 61 and 62.—This is 
the superficial, anterior, straight muscle of the thigh; its 
proximal attachments are to the inferior spinous process of 
the os innominatum and by a reflected tendon, from a point 
upon the superior surface of the cotyloid cavity or acetabulum 
of the same bone ; its distal attachment is at the base or proxi- 
mal border of the patella. 
Dissection.—Raise tlie rectus femoris muscle from its bed; be careful not 
to destroy subjacent nerves. Section it (Plate G2) and reflect its halves, 
superiorly and inferiorly. In reflecting its proximal portion, note its supply- 
ing nerve, from the anterior crural; also its arterial supply, from the ex- 
ternal circumflex artery. Slit open the fascial wall of Hunter’s canal and 
distinguish the contained vessels and nerves ; in doing so the femoral artery 
and the internal saphenous nerve may be hooked to the inner side, and the 
nerves to the vastus internus muscle to the outer side, in order to bring into 
view the femoral vein and the profunda femoris artery. 
26. Contents of Hunter’s Canal, Plate 63.—Tlie femoral 
artery continues from Scarpa’s triangle to the inner side of 
the shaft of the femur, entering Hunter’s canal, where it lies 
upon the anterior surfaces of the adductor longus and magnus 
muscles; as lodged in the canal, it gives off two or three 
branches to the vastus interims muscle. At the distal end of 
the canal the artery passes through the femoral opening in the 
adductor magnus muscle. The femoral rein takes the same 114 
LOWER EXTREMITY 
course as the artery ; at first it lies posterior to and then passes 
to the outer side of the artery, where it lies against the vastus 
internus muscle. The internal saphenous nerve accompanies 
the femoral vessels through the canal, upon the anterior and 
outer surface of the femoral artery ; it leaves the artery at its 
distal end, anterior to the adductor magnus muscle, to join the 
internal saphenous vein, at the distal side of the knee. 
Dissection.—Expose the profunda femoris artery and its vein, at the proxi- 
mal side of the adductor longus muscle, in a plane posterior to the femoral 
vessels. Note how this artery and vein pass posterior to the adductor lon- 
gus muscle. Cut away the venae comites of the profunda femoris artery and 
its branches. 
27. Profunda Femoris Artery.—This artery (vena comes) 
is a branch from the posterior surface of the femoral artery, at 
a variable point in the course of the latter through Scarpa’s 
triangle. It takes a distal course in a plane posterior to its 
parent trunk, having its vein to its inner side ; it passes to the 
plane posterior to the adductor longus muscle. Its branches 
are the external circumflex, the internal circumflex, and the 
three perforating. 
Dissection.—Clear the surfaces of the vastus extemus, the crureus, and the 
vastus internus muscles, respecting, in so doing, the nerves and arteries, which 
enter their proximal portions. Trace the muscle branches of the anterior crural 
nerve and the distribution of the external circumflex artery; trim away the 
venae comites of the arteries. 
28. Vastus Externus Muscle, Plate 59, Pig. 1, Plate 93, and 
Plates G1 to G5 inclusive.—The anterior surface of this muscle 
was before referred to (page 111) ; it is now fully exposed (Plate 
63). It is attached to the femur, from a point posterior to and 
distal from the trochanter major, to the entire length of the 
outer lip of the linea aspera down to the external condyle ; 
it winds around the outer surface of the shaft of the femur, 
having an anterior free border; it blends, at its distal end, with 
the tendon of the rectus femoris. 
29. Crureus Muscle, Plates 59 and G3.—This is the an- 
terior, deep, straight muscle of the thigh ; it is attached to the 
proximal two-thirds of the anterior surface of the shaft of the 
femur ; at its distal end, it blends with the tendon of the rectus 
fern oris. ANTERIOR OF TIIIGII. 
115 
30. Vastus Internus Muscle, Fig. 1, Plate 93, and Plates 59, 
61, 62 and 63.—This muscle occupies the inner face of the 
shaft and inner condyle of the femur; it is attached to the 
inner lip of the linea aspera, from which it winds around the 
inner surface of the femur, to fuse with the crureus, and blend, 
at its distal end, with the tendon of the rectus femoris. Com- 
pared with the vastus externus : it is the smaller of the two— 
that is, it does not rise as high upon the shaft of the femur; 
it covers the inner condyle of the femur, forming a cushion of 
muscle upon it, while the vastus externus does not cover the 
condyle of its side. 
31. Quadriceps Extensor Femoris Muscle and its Com- 
pound Aponeurosis, Plates 59 and 61 to 65, inclusive.—The 
rectus femoris, the vastus internus, the crureus, and the vas- 
tus externus blend at their distal extremities, thus forming a 
quadriceps (four headed) muscle, which is attached to the base 
and borders of the patella. Distal to the patella the quadri- 
ceps tendon is continued as a compound aponeurosis, which 
caps the anterior and the two lateral areas of the knee-joint, 
attaching itself to the tubercle of the patella (the so-called 
ligamentum patellae) and to the inner and outer tuberosities of 
the proximal end of the tibia. The proximal portion of the 
aponeurosis is lined by the anterior ligament of tlie knee-joint; 
it is separated from it, opposite the joint, by a layer of fat. 
32. External Circumflex Artery, Plate 63.—This artery, 
branch of the profunda femoris, distributes distal branches 
to the muscles of the quadriceps group ; a proximal branch 
winds around the outer surface of the hip to the muscles of 
the gluteal region. 
33. Muscle Branches of tlie Anterior Crural Nerve, Plates 
61, 62 and 68.—From the deeper portion of tlie trunk of the 
anterior crural nerve, where the same is lodged in Scarpa’s 
triangle, branches are given off, which may be traced to the 
following muscles: the sartorius, the pectineus (page 112), the 
rectus femoris, the vastus interims, the crureus and the vastus 
externus. 
Dissection.—Section the aponeurosis of the quadriceps muscle by a curved 
incision to the distal side of the patella (Plate 63) ; be careful not to cut into 
the joint, but expose a layer of fat, present between the aponeurosis and the 116 
LOWER EXTREMITY. 
anterior ligament of the joint. Make a longitudinal incision through the sub- 
stance of the vastus externus muscle, down to the shaft of femur, as shown in 
Plate 64. Semiflex the knee-joint and abduct the thigh. Reflect the aponeu- 
rosis from the inner side of the knee-joint proximally, and to the outer side, 
cutting the anterior ligament of the joint at the circumference of the articular 
surface of the patella. Continue the proximal reflection of the vastus internus, 
the crureus, and the vastus externus (inner portion of) muscles, being careful 
to leave, in situ, the proximal portion of the redundant anterior ligament of the 
joint, with the attachment to it of the subcrureus muscle ; trace the latter 
muscle to its proximal attachment. Cut the reflected muscles, and portion of 
muscle (vastus externus), from the shaft of the femur ; cut the branches of the 
anterior crural nerve and those of the external circumflex artery, at their trunks, 
respectively. Carefully cut away the vastus internus muscle from its linea 
aspera attachment (Fig. 1, Plate 91). 
34. Subcrureus Muscle, Plates 59, 64, and 65.—This is a 
small muscle attached, at its proximal end, to the anterior sur- 
face of the distal third of the shaft of the femur; at its distal 
end, to the anterior ligament of the knee-joint. 
35. Proximal Portion of the Anterior Ligament of the 
Knee-Joint, Plates 64 and 65.—This ligament lines the tendon 
and aponeurosis of the quadriceps extensor femoris muscle ; 
it is adapted to the two conditions of the joint, flexion and 
extension: in the position of flexion it is drawn taut over the 
anterior surface of the condyles of the femur; in extension 
it appears redundant, at the proximal side of the base of the 
patella, where it is drawn up by the subcrureus muscle. 
Dissection.—Section the femoral artery and vein distal to their profunda 
femoris branches (Plate 63); cut them also at the proximal side of the femoral 
opening in the adductor magnus muscle (Plate 64). Section the adductor lon- 
gus muscle (Plate 63), and reflect its proximal portion to its pubic attachment, 
where it may be cut or, better, turned off upon the symphysis pubis ; in raising 
it do not disturb the branches of the anterior portion of the obturator nerve 
beneath it; recognize the branch of this portion of the obturator nerve, that 
supplies the adductor longus muscle—entering its posterior surface. Reflect 
the distal portion of the adductor longus to its femoral attachment (Fig. 1, 
Plate 93) and cut it close to the bone. Trace the profunda femoris artery and 
its internal circumflex branch; its perforating and its muscle branches ; cut 
away their venae comites. 
36. Profunda Fcmoris Artery, Plates 64 and 65.—This 
artery was before recognized as a branch of the femoral in 
Scarpa’s triangle, as passing posterior to the adductor longns 
muscle (page 114), and as giving off the external circumflex ANTERIOR OF TIIIGII. 
117 
artery (page 115). At present it is exposed in its course upon 
the anterior surfaces of the adductor brevis and magnus mus- 
cles ; it lies close to, and parallel with the femur, and gives off 
three branches ; the first, the second, and the third perforating. 
They are called perforating, because they pass through open- 
ings in the adductor brevis and magnus muscles, to distribute 
in the posterior plane of the thigh ; the terminal end of the ar- 
tery also perforates the adductor magnus muscle. In its course 
the artery affords muscle branches to the adductor magnus 
muscle, some of which also pass to the posterior plane of the 
limb. 
Dissection.—Turn off the femoral vein over Poupart’s ligament; deter- 
mine the interspace between the pectineus and the psoas magnus muscles ; 
make a longitudinal cub through the pectineus, and reflect its proximal por- 
tion to its attachment to the horizontal ramus of the os pubis, where it may 
be cut or turned off. Restore the femoral vein to the surface of the psoas 
magnus muscle. In reflecting the portion of the pectineus muscle, respect 
the anterior portion of the obturator nerve and the obturator artery. Trace 
the branches of the anterior portion of the obturator nerve; clear the obtu- 
rator artery; look for the accessory obturator nerve, which, when present, 
passes beneath the pectineus muscle. 
37. Internal Circumflex Artery, Plates 63 and 64.—This 
artery is a branch, from the inner side of the profunda femoris ; 
it passes to the inner side of the limb, posterior to the adduc- 
tor longus muscle, to distribute to the adductor muscles. 
38. Pectineus Muscle, Plates 59, 61 to 64 inclusive, and 
Fig. 1, Plate 93.—This muscle has its proximal attachment to 
the exterior and superior surfaces of the horizontal ramus of 
the os pubis of the os innominatum ; thence it has a distal 
and oblique course, forming the inner portion of the floor of 
Scarpa’s triangle (page 111), to its distal attachment to the 
femur, at the inner side of the proximal open angle of the 
linea aspera. 
39. Obturator Nerve, Plates 64 and 65.—This nerve, from 
the lumbar plexus (described page 78, and illustrated Plates 
39, 40, 41 and 46), emerges from the pelvis, under cover of the 
pectineus muscle, at the anterior and inner angle of the thy- 
roid foramen, and anterior to the border of the obturator ex- 
ternus muscle. It divides into two portions, an anterior and a 118 
LOWER EXTREMITY. 
posterior, which are in contact, respectively, with the an- 
terior and posterior surfaces of the adductor brevis muscle. 
The anterior portion affords branches as follows: to the ad- 
ductor longus, the gracilis, and the adductor brevis muscles; a 
communicating branch to the internal cutaneous nerve (of the 
anterior crural), which at times (as in Plate 64) has a special 
cutaneous distribution to the inner face of the leg ; an articular 
branch, which perforates the adductor magnus muscle on its 
way to the knee-joint. 
40. Obturator Artery.—This artery enters the thigh from 
the pelvis with the nerve. It distributes to the obturator ex- 
ternus and the adductor muscles, and the liip-joint. 
Dissection.—Clear the surfaces of the adductor brevis and magnus muscles. 
Define the femoral opening in the distal portion of the adductor magnus. Trace 
the femoral vein and artery through the opening. Recognize and follow the 
anastomatica magna branch of the femoral artery. 
41. Adductor Brevis Muscle, Plates 59 and 64, and Fig. 1, 
Plate 93.—This muscle is the third of the adductor group ; it 
is attached to the exterior surface of the pubic arch and to the 
linea aspera of the femur. It presents openings, close to the 
shaft of the femur, for the first and second perforating arteries 
from the profunda femoris. 
12. Femoral Opening in tlie Adductor Magnus Muscle, 
Plates 64 and Go.—This opening is in the tendinous portion 
of the distal half of the adductor magnus; through it the 
femoral artery passes into the popliteal space, becoming the 
popliteal artery, and the popliteal vein, having a reverse course, 
becomes the femoral. 
43. Anasloinolica Magna Artery.—This artery (venm coal- 
ites) is given off from the femoral, before the latter enters the 
opening in the adductor magnus muscle. It has a distal course 
along the inner surface of the knee ; it distributes to muscles 
and anastomoses with the internal articular branches of the 
popliteal artery. 
Dissection.—Section tlie perforating brandies of and tlie terminal portion 
of the profunda femoris artery; cut tlie proximal ends of the femoral artery, 
the femoral vein, and the anterior crural nerve close to Poupart’s ligament 
(Plate 64). Remove the profunda artery with the stumps of the femoral vessels AXTERIOR OF THIGH. 
119 
and the anterior crural nerve. Cut tlie internal circumflex artery at its origin 
from the profunda and leave its posterior branch in situ. Section the anterior 
portion of the obturator nerve (Plate 04), the distal ends of its gracilis and 
articular (knee) branches, and remove the nerves. Section the adductor brevis 
muscle and reflect its parts; in reflecting its proximal part respect the pos- 
terior portion of the obturator nerve posterior to it, and recognize its branch 
to the muscle, which enters the posterior surface of the same ; the distal por- 
tion of the muscle should be cut at its attachment at the linea aspera of the 
femur, trimming out the perforating arteries from their points of muscle perfo- 
ration. Reflect the distal portion of the pectineus muscle and cut it at its 
femoral attachment. Cut the obturator artery. Trace branches from the pos- 
terior portion of the obturator nerve and from the internal circumflex artery 
to the adductor magnus muscle. Clean the anterior surface of the adductor 
magnus and the exposed portions of the obturator externus, the quadratus 
femoris, the iliacus internus, the psoas magnus, and the semimembranosus 
muscles; also the exposed area of the capsular ligament of the liip-joint. 
44. Posterior Portion of tlie Obturator Nerve, Plate 65 and 
Fig. 2, Plate 66.—This portion of the obturator nerve supplies 
the adductor brevis, the adductor magnus and the obturator 
externus muscles; sometimes the articular branch to the 
knee-joint is derived from this portion of the nerve, instead of 
the anterior portion (page 118 ; Plate 64). 
45. Internal Circumflex Artery.—Branches from this artery 
distribute upon the anterior surface of the proximal portion of 
the adductor magnus muscle. Two branches of it pass poste- 
riorly; one to the hip-joint, the other between the contiguous 
borders of the adductor magnus and the quadratus femoris 
muscles, to emerge into the posterior plane of the thigh. 
46. Adductor Magnus Muscle, Plates 59, 64 and 65 ; Fig. 
2, Plate 66, and Fig.l, Plate 91.—From its proximal attachment, 
to the exterior of the ischium of the os innominatum, this mus- 
cle spreads to its distal attachment to the entire length of the 
linea aspera of the femur, along the outer side of the inner 
lip of the same, and to the inner condyle of the femur. It ex- 
tends as a septum of muscle from the inner surface of the 
femur, dividing the inner mass of the thigh into an anterior 
and a posterior plane, the respective surfaces of the muscle 
forming the floor of each. It presents openings close to its 
femoral attachment: three or four proximal ones for the per- 
forating arteries from the profunda femoris (page 117) ; and a 
large distal opening—the femoral—for the femoral artery and 
vein (page 118). 120 
LOWE It EXTREMITY. 
47. Iliacus Internus muscle, Plates 59, 61 to 65 inclusive, 
and Fig. 1, Plate91.—The abdominal portion of this muscle was 
described (page 82), and illustrated (Plates 38 to 41 inclusive, 
and Plate 44), in situ ; its abdominal attachment was before 
shown (Plate 42, and Fig. 1, Plate 45). The muscle is projected 
from the abdominal cavity, beneath Poupart’s ligament, into 
the anterior plane of the thigh. It bridges over the hip-joint, 
exterior to the anterior portion of its capsular ligament, and it 
is attached to the antero-inner surfaces of the proximal end of 
the shaft of the femur, near the trochanter minor. 
48. Psoas magnus muscle: Plates 59, 65 ; Fig. 1, Plate 66 ; 
Fig. 1, Plate 91.—The abdominal portion of this muscle was 
described (page 82), and illustrated (Plates 38 to 41 inclusive) 
in situ; its abdominal attachment was before shown (Plates 
42, 43, and 44). The muscle enters the thigh to the inner side, 
and parallel with, the iliacus internus, and is attached to the 
femur at the posterior surface of the trochanter minor. 
49. Quadratus Fcmoris muscle : Plates 59. 65 ; Fig. 2, Plate 
66 ; and Fig. 1, Plate 91.—A portion of the anterior face of this 
muscle appears proximal to, and in a plane posterior to, the 
border of the adductor magnus muscle. Between it and the 
adductor magnus a branch from the internal circumflex ar- 
tery passes to the posterior plane of the thigh. 
50. Semimembranosus muscle, Plates 64 and 65.—At the 
inner side of the distal third of the thigh, a portion of the an- 
terior surface of this muscle appears in the distal angle between 
the gracilis and the adductor magnus muscles. 
Dissection.—Section tlie iliacus internus and the psoas magnus muscles 
close to their attachments to the femur; reflect them, superiorly, to the brim 
of the pelvis, -where they may be cut; note a large bursa beneath them which 
should be preserved. Clear the surface of the obturator externus muscle, and 
determine the proximal portions of the obturator vessels and nerve. 
51. Bursa of the Psoas and Iltaeus Muscles, Fig. 1, Plate 
66.—A large bursa presents between the psoas magnus and 
iliacus interims muscles and the capsular ligament of the liip- 
joint ; it sometimes communicates with the interior of the joint. ANTERIOR OF TIIIGH. 
121 
52. Obturator Externus Muscle, Plates 59, 64, 65 and 66.— 
This muscle is attached, internally, to the exterior face of 
the internal and inferior borders of the obturator foramen, 
and from the internal half of the obturator membrane (Plate 
59); its course is externally, its tendon passing posterior to 
the liip-joint (Fig. 1, Plate 66). 
53. Obturator Nerve, Plate 66.—The posterior portion of 
this nerve sometimes perforates the obturator externus muscle ; 
more commonly, the anterior and posterior portions of the 
nerve form a single trunk, which passes out of the pelvis su- 
perior to the muscle. 
Dissection.—Clean the exterior of the anterior portion of the capsular liga- 
ment of the hip-joint. Cut the ilial attachment of the rectus femoris muscle 
close to the hone. 
54. Capsular Ligament of tlie Hip-joint, Fig. 2, Plate 66, 
and Plates 64 and 65.—'The anterior portion of the capsular liga- 
ment of the liip-joint has its proximal attachment at the ante- 
rior and inner surfaces of the rim of the cotyloid cavity of the os 
innominatum and its distal attachment to the trochanters and 
the anterior intertrochanteric line of the femur. This area of 
the capsular ligament presents three thick longitudinal por- 
tions, which may be designated as follows : the ilio-femoral 
ligament, the ilio-femoral band, and the pubio-femoral band. 
The ilio-femoral ligament has its proximal attachment at the 
antero-inner border of the rim of the cotyloid cavity of the os 
innominatum, and the superior surface of the wall of the coty- 
loid cavity, up to the anterior inferior spinous process of the 
ilium ; its distal attachment is to the inner portion of the an- 
terior intertrochanteric line. The ilio-femoral band has its 
proximal attachment to the superior surface of the wall of the 
cotyloid cavity, extending up to the anterior inferior spinous 
process of the ilium ; its distal attachment is to the outer por- 
tion of the anterior intertrochanteric line of the femur upon the 
face of the great trochanter. These two fibrous bands, thus 
diverging interiorly, form an inverted Y-shaped ligamentous 
structure, which has been designated by Bigelow as the Y liga- 
ment of the hip-joint (“The Mechanism of Dislocation and 
Fracture of the Hip, etc.” By Professor Henry J. Bigelow, 
M.D., pages 17 and 18). In the interval between the fibrous 122 
LOWER EXTREMITY. 
bands, an articular branch of the external circumflex artery 
perforates the capsular ligament of the joint. Manipulating 
the joint by external and internal rotation, and by forced exten- 
sion, these two bands of the Y ligament are made more evident. 
The pubio-femoral band is a sweep of fibrous tissue, that 
bridges from the exterior face of the horizontal ramus of the os 
pubis to the trochanter minor. PLATE 59 
I ANT?SZTP?SPIxrO(T& 
t process 
SARTOR/ US 
*— RECTUS FEMUR/S 
AWT7?TATE?SPTATO US’process 
A DDUCTOR / O/VGUS- 
A DDOCTOR BREV/S — 
GLUTEUS M/N/MUS 
/ROC/TAWTE R ATAJOR 
» ATT ATOM 
VASTUS EXTERNUS 
GR AC / E/S 
A DO ?MA GA/US 
•PSOAS MAGN US (k ILIACi/S INT. 
CRUREUS & REC TUS REM OR IS 
VASTUS fNTERHUS 
igramentu/n patellae 
Aponeurosis of qua dr/c eps ext$ 
' “ P E M O R/S 
SARTORM/S 
GRA CIL/S 
SEMI TENOINQSUS 
M.Cohn ad naturam del. PLATE 60 
vein, 
SuperficiaZ epigastric art\ 
d // " ** 
Superior extipuetic art, 
Ptiac portion of fasciaZata 
- Gent to-crurut n. 
lira/i cit cs of 
iuticutan'in- 
A7~.Oohn.adratitram del. PLATE 61 
an S.SE/MOZTS 
process 
GLUTEUS MEO/US ' 
.\ntTcrurat n. 
jY. to PE C E/ME OS - 
1—-Inf. 'ex t fpu etrc it 
'/ // sf Gf7'fa 
Jut!scrp/ienous n. 
Profa niter./emoris 
art. 
Af. Co,S n, ad nata. ram dot. PLATE 62 
- a nt7? sup?spinous process 
- .Ext?cutaneous n. 
— SA RTO H / U S 
— TENSOR VAGIN/E FEM OR IS 
An.t.rcrural n. 
-PSOAS MAGNUS 
-GLUTEUS MINIMUS 
— JFJxt/ circumflex, art. 
N?tO I/A S TC/S 
/NT£RNUS 
SA N T O A? / O' ■S' 
SAM/ TA/ZA/NOSt/S 
J>f.Co?cn,cicZnaturam del. PLATE 63 
UntVorurctZ n 
M to RECTUS 
Jf./O SARTOR/OS 
WftoVASrUS EXT Eft ft US- 
CapsaZar ZeZ/"/*'— 
~2ntTcircu.m/‘Zesc art. 
*£xt!circum/Zex art. 
JV.stO CRUREUS — 
~JV'?tO VASTUS fNTE RNUS 
IsitZ saphea/ous 7i. 
Znt*sap7tenous a 
- sr s' 71, 
Jf.(?o7t7i.act Tzaturarrr rteE PLATE 64- 
OBTUfiA TOB £KT. 
Caps a tar tigr *ff I 
AntTport/oa of 
oDtaratorn. 
Obturator' art / 
f£CT/M? 
ADD? 
/.OMDO-S 
M.Cohn,actnatr.ram deZ. PLATE 65 
yL/iZrcrzeraf 
art. I 
" / 
C'rt/jste/ezj' 
061 a racer? r 
ar,£. . I 
J!{. Cohn, act nacturacm. ,<Ze£* PLATE 66 
Articular branch 
QUA ORA TfrcMOR-? 
Tnticircumftex 
art. 
A ATT?StrpPS'T’IN 
- OOP' process • 
- Tens OR l/A G/A/PZ 
r emor/s 
- SA R rOR/OS 
061 urator n.T 
an t rport ton. 
-postr " 
r of PSOA S MAG-. 
& /t/ACt/S /A/r. 
jsfperforat- 
' irzcf art. 
Rec ros 
Jlf.Coh n, a at. ncci~. <£e7. 
Fto. / 
FT0.2, TENTH DISSECTION. 
ANTERIOR OF LEG AND DORSUM OF FOOT. 
Dissection.—For this dissection the two limbs should be supported at the 
ankles on blocks; tie the great toes together, so as to expose the outer antero- 
lateral area of the leg and foot. 
Terms of Relation.—The terms applicable to both regions 
are : the general, inferior ; the special, proximal and distal 
(toward and from the trunk). Those for the 
leg are: anterior, posterior, outer, and inner 
surfaces; outer antero-lateral and inner antero- 
lateral areas (including both anterior and outer 
or inner surfaces, respectively). Those to the 
foot are: dorsum or dorsal surface; plantar 
surf ace ; inner or pollex border or side; outer 
or minim border or side. Those to the toes are : 
dorsal, plantar, and lateral digital surfaces. 
The regions of the foot will be spoken of as tar- 
sal, metatarsal, and digital. 
Bones and Bone Areas, Plates 67 and 68.— 
The outer and inner surfaces of the tibia and 
fibula of the leg ; the dorsal surfaces of the bones 
of the tarsal region of the foot—calcaneum, as- 
tragalus, scaphoid, cuneiform (internal, middle, 
and external), and cuboid ; the dorsal surfaces 
of the bones of the metatarsal region—the five 
metatarsals ; and the dorsal surfaces of the four- 
teen bones of the digits * form the osseous frame- 
work of the dissection. All of these bones, ex- 
cept the astragalus, the scaphoid, the cuboid, and the three 
Figure 5. 
* The bones of the digits will be called by the special French names given to 
them by Chaussier, anglicized as follows: phalanx (s.), phalanges (pi.), to the five 
bones of the proximal row ; phalangine (s.), phalangines (pi.), to the four of the mid- 
dle row; phalangette (s.), phalangettes (pi.), to the five of the distal row. 124 
LOWER EXTREMITY. 
cuneiform, afford attachments to muscles. Each metatarsal 
and each digital bone has a base (proximal end), a shaft, and 
a head (distal end). 
Dissection.—Make the skin incisions 1, 2, 3, and 4, 4, 4, 4, 4, of Figure 5; 
reflect flaps well off of the inner and outer borders of the tarsal and meta- 
tarsal regions of the foot, and the dorsal halves of the lateral digital surfaces 
(Plate 71). Facilitate the turning off of the flaps from the foot by additional 
skin incisions from the tips of the malleoli, respectively, to the heel. 
1. Subcutaneous Tissue of tlie Dorsum of the Foot and 
Digits, Plates 69, 70, and 71.—In this tissue subcutaneous veins 
will be found in a superficial plane, while subcutaneous nerves 
lie in a deeper one. 
Dissection.—Dissect out the saphenous arch of veins, their tributary and 
resultant trunks ; expose the subcutaneous distribution of the external saphen- 
ous, the musculo-cutaneous, the anterior tibial, the internal saphenous, and 
the internal calcaneal nerves, upon the dorsum and borders of the foot and the 
lateral digital surfaces. Clear the fascia of the dorsal surfaces of the foot and 
digits of subcutaneous tissue, preserving the above veins and nerves, in situ. 
2. Saphenous Arch.—This venous arch crosses the dorsum 
of the foot in the distal third of the metatarsal region. At the 
outer side it is continued by the external saphenous vein (Plate 
69), which ascends to the posterior surface of the leg, by wind- 
ing interiorly to the external malleolus ; at the inner side of 
the foot, the arch is continued by the internal saphenous vein, 
which has a proximal course to the inner surface of the distal 
end of the tibia (Plate 70). The convexity of the arch receives 
the dorsal collateral digital veins. A variable number of 
branches leave the concavity of the arch, having a proximal 
course to the leg. 
3. External Saphenous Nerve, Plate 69.—This cutaneous 
nerve enters the outer border of the foot, interiorly to the dis- 
tal end of the fibula. It distributes a dorsal collateral digital 
branch to the outer lateral digital surface of the fifth digit, 
and similar branches to the fifth and fourth digits. 
4. Musculo-Cutaneous Nerve, Plates 69, 70, and 71.—The 
cutaneous branch (sometimes two) of this nerve enters upon 
the dorsum of the foot, at the middle of the ankle. It breaks 
up into branches: the dorsal collateral digital nerves of the ANTERIOR OF LEG AND DORSUM OF FOOT. 
125 
fourth and third, the third and second digits, and that of the 
inner lateral digital surface of the pollex digit (Plate 70). It 
anastomoses with the external saphenous and the anterior tibial 
nerves. 
5. Anterior TiSnal Nerve, Plates 69 and 71.—The terminal 
portion of this nerve perforates the fascia at the middle of the 
first intermetatarsal space; it divides into the dorsal collateral 
digital nerves of the second and first digits. 
6. Internal Saphenous Nerve, Plate 70.—This cutaneous 
nerve accompanies the vein of the same name, distributing to 
the skin of the inner border of the tarsal region. 
7. Internal Calcaneal Nerve.—This nerve, branch of the 
posterior tibial, perforates the fascia to distribute to the skin 
of the inner side of the heel. 
Dissection.—Untie the great toes. Make the skin incisions 5 and 6, of 
Figure 5 (page 123), and reflect flaps well off the antero-inner and outer lateral 
areas of the leg. Expose the subcutaneous veins and nerves. 
8. Internal Saphenous Vein.—This subcutaneous vein may 
be followed, in its proximal course along the inner surface of 
the leg to the inner side of the knee, where it was before de- 
scribed (page 114; Plate 63). It receives tributary branches 
from the anterior and posterior surfaces of the leg. 
9. Internal Saplienons Nerve.—This nerve accompanies the 
last-described vein ; it has a distal course from where it enters 
the proximal limit of this dissection. It distributes patellar 
and other branches to the anterior and posterior (Plate 84) sur- 
faces of the leg. 
10. Musculo-Cutaneous Nerve, Plate 69.—The cutaneous 
branch (sometimes two) of this nerve, pierces the fascia of the 
leg, at a variable point, in the distal half of its outer antero- 
lateral area, continuing therefrom to the foot (page 124). 
11. Cutaneous Brandies of the External Popliteal Nerve. 
--Branches of this nerve distribute in the proximal half of the 
outer antero-lateral area of the leg. 
12. Fascia of the Eeg and Foot, Plates 69 and 70 ; Figs. 2 
and 3, Plate 3.—The fascia of the dissection area is attached to 126 
LOWER EXTREMITY. 
tlie anterior border of the tibia and the anterior surface of tlie 
fibula (Plate 72) ; it isolates the muscles, which are lodged in 
the anterior tibio-fibular interosseous space (Plate 3). A spe- 
cial fascia, at the outer surface, isolates the peroneus longus 
and brevis muscles (Plate 8). At the ankle it forms the ante- 
rior annular ligament, from the distal border of which it is 
continued upon the dorsum of the foot ; it is continuous at the 
borders of the foot with the plantar fascia (Plate 76). 
Dissection.—Cut away the subcutaneous veins and nerves from the dorsum 
of the foot. Incise the fascia, longitudinally, upon the several tendons, and 
discover their synovial sheaths, by introducing probes into them (as with the 
palmar tendons in Fig. 2, Plate 4). Remove the fascia from the dorsum of the 
foot, clearing the tendons and defining the distal border of the anterior an- 
nular ligament. 
13. Tendons upon tlie Dorsum of tlie Foot, Plates 71 and 
72.—Between the malleoli four tendons enter from the leg upon 
the dorsum of the foot. They are from the inner to the outer 
side : that of the tibialis anticus, the extensor proprius pol- 
licis, the extensor longus digitorum (initial tendon), and the 
peroneus tertius muscles. The initial tendon of the extensor 
longus digitorum gives off four terminal tendons, which have a 
longitudinal course to the digits, second to fifth, inclusive. 
Dissection.—Clear away the subcutaneous veins and nerves from the fascia 
of the outer antero lateral area of the leg ; incise the fascia along the outer side 
of the anterior border of the tibia, and reflect the same to the outer side of the 
leg, as far as its fibular attachment (Plate 72). Allow the fascia to remain upon 
the proximal portion of the tibialis anticus muscle (Plate 72). Preserve that 
portion of the fascia, which forms the anterior annular ligament, by defining 
its proximal border. 
14. Anterior Annular Ligament.—This is a dense portion 
of the fascia, opposite the anterior surface of the distal ends of 
the tibia and fibula ; it is attached to the internal malleolus to 
the external malleolus and the dorsum of the distal portion of 
the calcaneum. It binds in place the outer antero lateral mus- 
cles of the leg, as they pass to the dorsum of the foot. A loop 
of the ligament isolates the tendons of the extensor longus 
digitorum (initial) and the peroneus tertius muscles. 
15. Tii>ialis Anticus Muscle, Plates 67, 71, and 72.—This 
is attached to the proximal two-thirds of the outer surface of ANTERIOR OF LEG AND DORSUM OF FOOT. 
127 
the shaft of the tibia ; its tendon commences at the distal third 
of the leg, passing upon the outer surface of the distal end of 
the tibia. It is included in a special compartment of the ante- 
rior annular ligament, posteriorly to which it enters upon the 
inner side of the dorsum of the foot, where it is continued into 
the plantar plane of the foot, at the distal third of the tarsal 
region. 
16. Extensor Longus Digitorum Muscle, Fig. 1, Plate 67 ; 
Plates 68, 71, and 72.—This muscle is attached to the proxi- 
mal three-fourths of the inner surface of the fibula ; its initial 
tendon passes posteriorly to the anterior annular ligament; 
upon the dorsum of the tarsal region it divides into four ter- 
minal tendons, which pass to be attached to the dorsal surfaces 
of the bases of the plialangines and phalangettes of the digits, 
second to fourth, inclusive. The latter attachments will be 
dissected later (page 150 ; Figs. 2 and 3, Plate 82). 
17. Peroneus Tertius Muscle.—This muscle has its proxi- 
mal attachment to the distal portion of the inner surface of the 
fibula (it seems like a continuation of the last-described mus- 
cle) : its tendon passes posteriorly to the anterior annular liga- 
ment, to the outer side of the outer terminal tendon of the ex- 
tensor longus digitorum. It has a distal course, along the 
outer side of the tarsal region, to its distal attachment to the 
dorsal surface of the fifth metatarsal bone. 
18. Extensor Proprius Pollicls Muscle.—This muscle lias 
its proximal attachment to the middle of the inner side of the 
fibula ; at the distal third of the leg it emerges from between 
the tibialis anticus and the extensor longus digitorum muscles. 
Its tendon passes, posteriorly to the anterior annular ligament, 
to the dorsum of the foot; it then has a distal course—upon 
the astragalus, the scaphoid, the internal cuneiform, the first 
metatarsal, and the phalanx of the first digit—to its distal at- 
tachment at the dorsal surface of the base of the phalangette 
of the first or pollex digit. 
Dissection.—Expose the pollex tendon of the extensor brevis digitornm 
muscle, the dorsalis pedis artery and veins, and the anterior tibial nerve, as 
lodged in the inner intertendinous space—between the tendon of the extensor 128 
LOWEIt EXTREMITY. 
proprius pollicis muscle and tlie inner terminal tendon of tlie extensor longus 
digitorum muscle—upon the dorsum of the tarsal and metatarsal regions. 
19. Pollex Tendon of tlie Extensor Brevis Digitoriun 
Muscle, Plates 71 and 72.—This, the inner tendon of the mus- 
cle, has a distal, and oblique, course from the second digit (ter- 
minal) tendon of the extensor longus digitorum muscle, to its 
attachment to the dorsal surface of the base of the phalanx of 
the first digit. 
20. Dorsalis Pc«lis Artery, Plates 71 to 74, inclusive.—This 
artery (venae comites) enters upon the dorsum of the foot, from 
the posterior of the anterior annular ligament; it continues 
along the outer side of the tendon of the extensor propriua 
pollicis muscle, to where it bifurcates into the metatarsal and 
the second dorsal digital arteries. The second dorsal digital 
artery has a distal course, between the first and second meta- 
tarsal bones, giving off the first dorsal digital artery, to the 
inner lateral digital surface of the first digit ; it is crossed upon 
its dorsal surface by the pollex tendon of the extensor brevis 
digitorum muscle. 
21. Anterior Tibial Xerve.—This nerve is continued from 
the leg, to the dorsum of the foot, accompanying the dorsalis 
pedis artery, along its outer side. It gives off a branch from 
its outer side, which passes beneath the extensor brevis digi- 
torum muscle. The nerve-trunk continues into the first in- 
termetatarsal space, receives an anastomotic branch from the 
musculo-eutaneous nerve (Plate 69), and distributes as before 
described (page 125). 
Dissection.—Incise and remove the fascia from the peroneus longus and 
peroneus brevis muscles, upon the outer or fibular surface of the leg. Trace 
their tendons posteriorly, and inferiorly, to the external malleolus and along 
the outer border of the foot. 
22. Peroneus Longus Muscle, Fig. 2, Plate 67 ; Plates 71 to 
74, inclusive.—This, the superficial muscle at the outer sur- 
face of the leg, is attached to the proximal half of the fibula, 
About the middle of the leg its tendon commences and con- 
tinues upon the peroneus brevis muscle to the posterior of the 
external malleolus ; it then winds inferiorly to the malleolus, 
where it is lodged in the inferior groove upon the outer surface ANTERIOR OF LEG AND DORSUM OF FOOT. 
129 
of the calcaneum. It runs along the outer border of the tarsal 
region, to where it passes into the plantar region, into a groove 
in the cuboid bone. 
23. Peroneus Brevis Muscle, Plates 67, 68, and 71 to 74, 
inclusive.—This muscle is attached to the distal half of the 
outer surface of the fibula, where it is lodged beneath the last- 
described muscle. Its tendon commences posteriorly to the 
external malleolus, interiorly to which it winds to the outer 
side of the tarsal region, where it is lodged in the superior 
groove upon the outer surface of the calcaneum, and is con- 
tinued to its distal attachment to the base of the fifth meta- 
tarsal bone. The two grooves upon the outer surface of the 
calcaneum, for the tendons of the peroneus longus and brevis 
muscles, are separated by the peroneal tubercle (Plate 101). 
Dissection.—Section the tendons of the extensor longus digitorum and the 
peroneus tertius muscles (Plate 72), and reflect their distal portions. Do not 
dissect the extensor tendons from the dorsal surfaces of the digits, but leave 
them to be worked and studied at page 149. Clear the surface of the extensor 
brevis digitorum muscle. 
24. Extensor Brevis Digitorum Muscle, Plates 68, 71, 72, 
and 73.—This muscle is located upon the dorsum of the foot. 
Its proximal attachment is to the dorsal surface of the distal 
end of the calcaneum, where the muscle forms a point; it then 
expands into a flat muscle, whose distal limit projects four 
tendons to the dorsal surfaces of the digits, first to fourth, in- 
clusive (described page 150; illustrated Figs. 2 and 3, Plate 
82). The pollex tendon was before described (page 128). 
Dissection.—Cut the tendon of the extensor proprius pollicis muscle (Plate 
72). Reflect the proximal portions of the extensor longus digitorum, the pero- 
neus tertius, and the extensor proprius pollicis muscles to the outer side; also, 
the tibialis anticus muscle to the inner side (Plate 73). Expose the anterior 
tibial vessels and nerve between the reflected muscles; trace the artery and 
nerve, and note their muscle branches. 
25. Anterior Tibial Artery, Plate 73.—This artery (venae 
comites) lies between the tibialis anticus muscle, to its inner 
side, and the peroneus tertius, extensor proprius pollicis, and 
extensor longus digitorum muscles, to its outer side. It affords 130 
LOWER EXTREMITY. 
muscle branches to the contiguous muscles, gives off at the 
ankle-joint the external and internal malleolar branches, and is 
continued to the foot as the dorsalis pedis artery (page 128). It 
is lodged upon the anterior surface of the tibio-fibular inter- 
osseous ligament. 
26. Anterior Tibial Nerve.—This nerve joins the last- 
described artery in the proximal third of the interosseous 
space; at first it lies to its outer side, then crosses to its inner 
side. It affords branches to the tibialis anticus, the extensor 
proprius pollicis, the extensor longus digitorum, and the pero- 
neus tertius muscles (the latter descending in the substance of 
the extensor longus digitorum muscle). 
Dissection.—Section tlie extensor brevis digitorum muscle (Plate 73); re- 
flect its proximal portion to its attachment, at which it may be cut; turn off its 
tendons to the toes and cut them (do not dissect them at the dorsal surfaces of 
the digits, second to fourth, inclusive). Find the nerve and artery supplying 
the muscle—they enter its deep surface. Trace the branches of the dorsalis 
pedis artery; the dorsal digital, the dorsal collateral digital, and the perforat- 
ing arteries. 
27. Branches of the Dorsalis Pedis Artery, Plate 74.— 
These are the tarsal, and the branches of bifurcation—the 
metatarsal and the second dorsal digital. The tarsal crosses to 
the outer side of the tarsal region, supplying the extensor brevis 
digitorum muscle and the tarsal joints, and anastomosing with 
the external malleolar, of the anterior tibial, and the meta- 
tarsal. The metatarsal crosses, to the outer side of the tarsal 
region, upon the dorsal surface of the bases of the metatar- 
sal bones—second, third, and fourth ; it anastomoses as just 
stated. 
28. Dorsal Digital Arteries, Plates 71 and 74.—These are 
six arteries (vena) comites), as follows: the first is a branch 
of the second, which runs upon the dorsal surface, and 
along the inner side of the distal portion, of the first meta- 
tarsal bone ; the second is one of the branches of bifurca- 
tion of the dorsalis pedis, and is lodged in the first inter- 
metatarsal space (page 128); the third, fourth, and fifth are 
distal branches from the metatarsal, having a distal course 
in the second, third, and fourth intermetatarsal spaces; the ANTERIOR OF LEG AND DORSUM OF FOOT. 
131 
sixth is a branch of the fifth, and runs along the outer side 
of the fifth metatarsal bone. 
29. Dorsal Collateral Digital Arteries, Plates 71 and 74.— 
These ten arteries are branches of bifurcation or the continua- 
tion of the dorsal digital arteries : the first and tenth are the 
continuations of the first and sixth digital arteries, respectively; 
the second to ninth, inclusive, arise from the terminal bifur- 
cations of the digital arteries, second to fifth, inclusive. They 
ramify in the dorsal halves of the lateral digital surfaces of the 
digits, as shown upon the second digit in Plate 71. 
30. Perforating Arteries, Plates 68 and 74 ; Fig. 1, Plate 
82.—These four arteries (vente comites) perforate from the 
plantar region, between the proximal ends of the dorsal inter- 
ossei muscles, to anastomose with the dorsal digital arteries, 
second to fifth, inclusive. The first (the communicating branch 
of the anterior tibial, of authors) anastomoses with the second 
dorsal digital ; the second, third, and fourth are branches from 
the plantar digital arteries (page 148). 
31. Dorsal Interossei muscles, Plates 68 and 74.—The dor- 
sal surfaces of these four muscles appear in the intermeta- 
tarsal spaces, first to fourth, inclusive. 
Dissection.—Cut away the extensor longus digitorum, the peroneus tertius, 
and the extensor proprius pollicis muscles from their fibular attachments ; 
preserve the attachment of the fascia and intermuscular septum to the fibula, 
at the outer side of these muscles. Trace the musculo-cutaneous nerve be- 
tween the peroneus longus and brevis muscles (Plate 74). Cut the peroneus 
longus muscle, at the head of the fibula, as required in tracking the musculo- 
cutaneous nerve to its origin from the external popliteal nerve (Plate 74); follow 
the branches of the musculo-cutaneous nerve to the peroneus longus and brevis 
muscles. Trace the anterior tibial nerve through the proximal portions of the 
extensor longus digitorum and the peroneus longus muscles, to its origin from 
the external popliteal nerve. 
32. External Popliteal Nerve, Plates 72 and 74.—This 
nerve winds around the head or proximal end of the fibula, 
from the popliteal space. It enters the proximal portion of 
the peroneus longus muscle, where it gives off the recurrent 
articular branch, and bifurcates into the musculo-cutaneous 
and the anterior tibial nerves. 132 
LOWER EXTREMITY. 
33. Musculo-Cutaneous Merve, Plate 74.—This nerve, given 
off from the external popliteal, has a muscle distribution to 
the peroneus longus and brevis muscles ; and a cutaneous dis- 
tribution as before described (pages 124 and 125) and illustrated 
(Plates 69 and 70). 
34. Anterior Tibial Nerve.—This nerve passes from the ex- 
ternal popliteal, through the proximal portions of the peroneus 
longus muscle, the intermuscular septum, and the extensor 
longus digitorum muscle, to reach the anterior surface of the 
tibio-fibular interosseous ligament, where it was before de- 
scribed (page 130). 
Dissection.—Trace the anterior tibial artery to its proximal limit; follow 
its anterior tibial recurrent branch. Find, at the opening in the distal por- 
tion of the tibio-fibular interosseous ligament, the anterior peroneal artery; 
follow it to its anastomosis. 
35. Anterior Tibial Artery.—The proximal end of this ar- 
tery (veme comites) emerges, from the posterior to the ante- 
rior region of the leg, by a deficiency in the proximal portion 
of the tibio-fibular interosseous ligament. 
36. Anterior Tibial Recurrent Artery.—This artery (venm 
comites) is given off from the proximal end of the anterior 
tibial ; it has a recurrent course through the proximal portion 
of the extensor longus digitorum muscle, to contribute to the 
peri-articular network of anastomosing arteries upon the outer 
antero-lateral area of the knee. 
37. Anterior Peroneal Artery.—This artery (vena? comites), 
branch of the peroneal artery of the posterior region of the leg, 
emerges, to the anterior of the leg, by an opening in the distal 
portion of the tibio-libular interosseous ligament. It takes a 
distal course along the outer side of the ankle-joint, to the tar- 
sal region of the foot, where it anastomoses with the external 
malleolar branch of the anterior tibial artery. 
Dissection.—After this dissection, be careful to keep the leg and foot wet; 
more especially the toes, dorsum of the foot, ankle, and knee. PLATE 67 
I’la.E 
BICEPS - 
.Lig/mtpatellae 
-SARTOR/US 
ORA C/US 
SEM/ TEND/NOSUS 
Fra. 2 
E XT?PROPR/US POCl/C/S 
PERONEL/S TERTUJS- 
IN -E OL ITS 
JSX T? MALLE OL ITS 
pproneus bps i//s 
PERONBUS TERT/US- 
Common attachments o/~ 
XTCl.OA/GUS& £XT?B/iEl//S 
a/G/TO/rt/M 
eXrR propr/ c/s poll /c/s 
Cohn,ac<dncctu-ra/n del. PLATE 68 
lN E OB ITS 
TtIA.EE BOB ITS 
EXT* BREVJS OJG/TORUM 
RE RONE US BREV/S- 
•' TERT/USv 
foil ex tendon of 
EXT ?BRE Vf D/G/TO RUM 
EXT * PROP RI US PO LL/C/S 
- Common attachments of 
£XT ?LONGUS&BREV/S 
D/G/ TO RUM 
&l.Cohn,udna.tu.ram. del. PLATE 69 
jVTusculo-cutaneous n 
Exit saphenous n 
Jt. Cohn, act naturam. cZez. PLATE 70 
Ar.Cohn,aafrcaturam PLATE 71 
TNr?WA TEE or. uE 
xxrf mat. ceot. vs — 
AntT tibia? rt. 
JTtOEXT?BNEU/S D/GtroRUM 
- Tarsal art. 
PEROHEl/S LONG OS 
2'encton of peronzC/s 
TEN TJOS 
Metatarsal art* 
/*ftperfo rating o r 
COTnm.lLnoting art. 
Dorsal digital art? 
Dors? digital 
art? ' 
Dors?collaterdl 
digital n? 
Dorsal collateral 
digital art? 
Jtf.Cohn,cu£noettcr-esL/n- oiel., PLATE 72 
M.Cohn,ad naturum deZ. PLATE 73 
S^MtorxrP 
I £OA/G.p/G*r 
peponeus 
f TCP T/US 
-JZto ext t1 
prop. poll. 
JV.toT/B/AL/S 
ANT/CUS 
z/rr?ata.z.z Eozzrx 
Irt.1 ma/leo/qr art. 
ExrPp/top/ai/s poel /c/s - 
Oorsafts peats art. 
Ext? malZeotar art. — 
PERONEUS TERT/US 
■ AntTperoreaZart, 
7ez7-sce? art. 
JV.tOEXT?BREV. DIG-IT'? 
Jtfetatxzrs’al art.— 
- extZ atalz.egz.t7& 
PERONEUS EONGUS 
PEROR EUS BREWS 
- pt/io/veus Ttpr/e/s 
Jlf. GbJkfz, cz<£TzatztrtZTn. t&ez* PLATE 74 
Hxtipopliteal n. 
— 71 ecurren t articular branches 
A n tr tibia l recurren t art. 
AntC tibial n. 
Intermuscular sept urn 
JVItO TIB/ A LIS ANT/ CBS 
— 21. to P£FtQNCUS arc V/S 
7ntermusua lar septu/n 
, /u 7-f mal r. r o^ir-S" 
Tntf malleolar art. 
7. ntlprroaeal art. — 
Is.1 perforating or, 
\communicating art. 
' Zn.aetorsal cticfital art 
w 
7?xt/malleolar art. 
zrxrl AT A T. Z. POT. (/S’ 
7stdossal 
//NTtSOSS? 
/ 
/ /tigitaf art 
Tarsal art. 
Aletararsal art. 
re a on £ us reef r/us 
Aerfura1ingr art? 
TJorsal (7/cri7a/ art? 
3'.u.4-r.'i .S<A N Ce/‘ 
Af. Oo?t n, cut 77 a tu ra77t del. ELEVENTH DISSECTION. 
PLANTAR REGION OF THE FOOT. 
Dissection.—Raise the foot and lodge the heel on a block, so as to bring 
the sole on a convenient level for the dissector standing in front of it. Steady 
the foot by chain-hooks or strings. 
Terms of Relation.—The special terms 'proximal (toward 
the heel), distal (from the heel), outer side, inner side, plan- 
tar surface, and dorsal surface will apply to the entire area 
of the dissection ; pollex border and minim border to the tarsal 
and metatarsal regions; plantar and lateral 
digital surfaces to the digits. 
Bone Areas, Plate 75.—The plantar surface 
of the following bones forms the osseous plane 
of the sole of the foot: the calcaneum ; the as- 
tragalus ; the cuboid; the scaphoid; the three 
cuneiform—internal, middle, and external; the 
five metatarsal; the fourteen bones of the digits 
—five phalanges, four phalangines, and five 
phalangettes (see page 123). With the excep- 
tion of the astragalus and the middle cuneiform, 
they all afford attachments to muscles. 
Dissection.—Make the skin incisions 1, 2, and 3 of 
Figure 6, and reflect flaps as indicated. Where the dorsum 
of the foot has been previously dissected the flaps will have to be cut away; 
otherwise they can be tied over the dorsum of the foot by strings. 
Figure 6. 
1. Subcutaneous Tissue.—This plane of tissue is thick and 
dense over the heel and outer half of the dissection area, with 134 
LOWER EXTREMITY. 
large areolm for the lodgement of fat ; over the inner half it is 
thinner, especially at the hollow of the sole of the foot. 
Dissection.—Remove the subcutaneous tissue from the plantar fascia, 
being careful to preserve the vessels and nerves superficial to it. Determine 
the portions of the plantar fascia and the distal slips of its middle portion. 
Make the skin incisions 4, 4, 4, 4, 4, of Figure 6, and reflect flaps from the re- 
spective plantar and lateral digital surfaces of the digits; expose the plantar 
collateral digital nerves and vessels, and the sheaths of the fiexor tendons. 
2. Plantar Fascia, Plate 76.—This fascia is a thick plane 
of fibrous tissue, which stretches from the heel to the toes. It 
consists of three portions : the middle, the inner, and the outer. 
The middle portion, the thickest of the three, has a proxi- 
mal attachment to the calcaneum ; in the metatarsal region it 
spreads laterally and divides into five slips, which pass to the 
sheaths of the fiexor tendons—on the digits—and to the sides 
of the heads of the metatarsal bones ; at the distal ends of the 
slips, transverse fibres bridge across the foot from one to the 
other—the superficial transverse ligament. The inner portion 
has a proximal attachment to the calcaneum and along the 
inner border of the middle portion of the fascia ; it spreads to 
the pollex border of the foot, where it is continued to the dorsal 
surface of the same. The outer portion is attached to the calca- 
neum and the outer border of the middle portion of the fascia ; 
it spreads to the minim border of the foot, where it is continued 
to the dorsal surface of the same. At the junctions of the mid- 
dle with the respective inner and outer portions septa are pro- 
jected between the muscles, which determine three longitudinal 
compartments, for muscles, etc. 
3. Cutaneous Arteries and Nerves.—Small plantar cutane- 
ous arteries and nerves perforate to the subcutaneous plane 
of the region, along the borders of the middle portion of the 
plantar fascia. 
4. First Digital Nerve, Plates 76 and 77.—This nerve, branch 
of the interna] plantar, perforates the fascia near the pollex 
border of the foot, opposite the first metatarsal bone ; it con- 
tinues as the inner plantar collateral digital nerve of the pollex 
digit. PLANTAR REGION OF THE FOOT. 
135 
5. Sixth Digital Artery.—This artery (vense comites), branch 
of the fifth digital, crosses opposite the inner half of the head 
of the first metatarsal bone, to become the inner plantar col- 
lateral digital artery of the pollex digit. 
6. Internal Plantar Artery.—The terminal portion of this 
artery (vense comites) perforates the inner portion of the plantar 
fascia to the outer side of, and a little distal to, the point of 
perforation of the first digital nerve ; it accompanies the nerve, 
along its outer side, and anastomoses with the sixth digital 
artery. 
7. First Digital Artery and Its Anastomotic Branch.— 
This artery (venae comites), branch of the external plantar, 
perforates the outer portion of the plantar fascia, near the 
outer border of the middle portion of the plantar fascia. It 
gives off an anastomotic branch to the second digital artery. 
The first digital artery is continued to the fifth digit, as its 
outer plantar collateral digital artery. 
8. Sixth Digital Nerve.—This nerve perforates the fascia 
near the point where the first digital artery emerges. It ac- 
companies the artery, along its inner side, becoming the outer 
plantar collateral digital nerve of the fifth digit. 
9. Second, Third, Fourth, and Fifth Digital Nerves.—These 
four nerves present, for a portion of their course, in the meta- 
tarsal region, between the slips of the middle portion of the 
plantar fascia. 
10. Branches of the Anastomotic Artery from the Inter- 
nal Plantar Artery.—These arteries (venae comites) are seen, 
for a part of their course, at the inner sides of the slips of the 
middle portion of the plantar fascia, accompanying the por- 
tions of the digital nerves there lodged. 
11. Plantar Collateral Digital Nerves.—These nerves 
emerge, from the dorsal surface of the superficial transverse 
ligament, into the subcutaneous tissue of the lateral digital 
surfaces. 
12. Plantar Collateral Digital Arteries, Plates 76 and 77. 
—These arteries (vense coinit.es) appear in the subcutaneous 136 
LOWER EXTREMITY. 
tissue of the webbing between the digits ; they have a distal 
course in the subcutaneous tissue of the lateral digital sur- 
faces, upon the dorsal surface of the last-described nerves. 
13. Digital Sheath of the Flexor Tendons, Plate 76.—A 
fibrous sheath invests the flexor tendons, upon the plantar sur- 
face of each digit; it is attached to the lateral borders of the 
phalanx and the phalangine, and to the plantar surface of the 
phalangette of the digit. Its longitudinal fibres are continued 
from the plantar fascia. Opposite the flexures of the joints 
its texture is so modified as to allow flexion and extension of 
the digit. The plantar collateral digital vessels and nerves lie 
superficial to it. 
Dissection.—Make a transverse incision through the middle portion of 
the plantar fascia (Plate 76), and reflect its distal portion with the superficial 
transverse ligament; preserve the digital nerves and the branches of the anas- 
tomotic artery, from the internal plantar artery, between the slips of the fascia. 
Deflect its proximal portion, and note the existence of an intermuscular septum 
at its outer and another at its inner limit; also, that it is attached to the sub- 
jacent flexor brevis digitorum muscle, from which it should not be removed 
(Plate 77). Trace the digital branches of the internal plantar nerve; also 
their muscle branches. Follow7 the distribution of the anastomotic branch of 
the internal plantar artery. Slit up the sheaths of the flexor tendons and 
clear the plantar plane of the flexor brevis digitorum muscle. 
14. Digital Branches of the Internal Plantar Nerve, Plate 
77.—The internal plantar nerve emerges at the distal angle of 
divergence of the flexor brevis digitorum and the abductor pol- 
licis muscles. The first digital nerve is given off from its inner 
side; it was before described in the distal part of its course 
(page 134). The second and third come off as one trunk, which 
bifurcates into the two nerves. The fourth is the terminal por- 
tion of the internal plantar nerve. The second, third, and 
fourth digital nerves have a distal course to where they bifur- 
cate, respectively, into the plantar collateral digital nerves of 
the first and second, second and third, and third and fourth 
digits. 
15. Serves to the Flexor Brevis Pollieis Muscle.—Tile first 
digital nerve, near its proximal end, supplies a branch to the 
inner head of this muscle ; the outer head receives a branch 
from the internal plantar nerve, before the giving off of the 
second and third digital nerves. PLANTAR REGION OF THE FOOT. 
137 
16. Nerves to the First and Second Lumbricalcs Muscles.— 
The first lumbricalis muscle is supplied by the third digital 
nerve; the second lumbricalis receives its nerve from the 
fourth digital nerve. 
17. Anastomotic Branch of the Internal Plantar Artery. 
—This artery (venae comites), branch of the internal plantar, 
emerges from the inner intermuscular septum, to the plantar 
surface of the flexor brevis digitorum muscle ; it takes a distal 
course, breaking up into three branches, which accompany— 
lying in a deeper plane—the second, third, and fourth digital 
nerves, before referred to (page 135). The branches anas- 
tomose, respectively, with the fifth, fourth, and third digital 
arteries. 
18. Flexor Brevis Digitorum Muscle, Plates 75, 77, and 78. 
—This muscle occupies the middle of the plantar area: its 
proximal attachment is to the calcaneum and the dorsal sur- 
face of the proximal third of the middle portion of the plantar 
fascia ; in the metatarsal region it projects four tendons to the 
digits, second to fifth, inclusive ; opposite the phalanx of a 
digit the tendon splits and reunites again, thereby forming a 
button-hole opening for the transit of a terminal tendon of the 
flexor longus digitorum muscle ; after having provided this 
point of transit of a longus tendon, the brevis tendon splits 
again for attachment to the borders of the plantar surface of 
the phalangine of a digit. 
Dissection.—Dissect off the inner portion of the plantar fascia. Preserve 
the first digital nerve and the sixth digital artery (pages 134 and 135). Fol- 
low the internal plantar artery in a proximal direction to where it emerges 
from a deeper plane. Clear the surface of the abductor pollicis muscle. 
19. Internal Plantar Artery, Plate 77.—The terminal por- 
tion of this artery (venrn comites) emerges, from a deep plane, 
in the angle of divergence of the llexor brevis digitorum and 
the abductor pollicis muscles. It accompanies, along its outer 
side, the first digital nerve ; at its distal end it anastomoses 
with the sixth digital artery. It runs along the plantar sur- 
face of the outer head of the flexor brevis pollicis muscle. 
20. Abductor Pollicis Muscle, Plates 77 and 78.—This 
muscle occupies the inner border of the tarsal and metatarsal 138 
LOWER EXTREMITY. 
regions of the plantar area of the foot. Its proximal attach- 
ment is to- the inner tuberosity of the calcaneum and to the 
plantar ligaments ; in the metatarsal region it forms a tendon, 
which joins the inner head of the flexor brevis pollicis muscle ; 
the two muscles have a common point of attachment to the 
inner side of the base of the phalanx of the pollex digit. In 
its course it covers the tendons of the tibialis posticus and anti- 
cus muscles. 
Dissection.—Remove the outer portion of tlie plantar fascia; track, in a 
proximal direction beneath the fascia, the fifth and sixth digital nerves, and 
the first digital artery (Plate 77), to where they emerge from a deeper plane. 
Clear the plantar surface of the abductor minimi digiti muscle. 
21. Fiflli and Sixth Digital Merves, Plate 77.—These nerves, 
branches of the superficial branch of the external plantar 
nerve, appear in the distal angle of divergence of the flexor 
brevis digitorum and the abductor minimi digiti muscles : the 
fifth digital nerve bifurcates into the plantar collateral digital 
nerves to the fourth and fifth digits; the sixth digital nerve 
has been before described (page 135). 
22. First Digital Artery. — This artery (venae comites), 
branch of the external plantar, accompanies the sixth digital 
nerve, lying to its outer side; its distal portion has already 
been described (page 135). Its anastomotic branch to the sec- 
ond digital artery passes to the dorsal surface of the minim 
flexor tendons. 
23. Abductor Minimi Digiti Muscle, Plates 75,77, and 78. 
—This muscle extends along the minim border of the foot; its 
proximal attachment is to the calcaneum, and to the plantar 
ligaments; its distal attachment is to the outer side of the 
proximal end of the shaft of the phalanx of the fifth digit. 
Dissection.—Cut away the slieatlis of the flexor tendons and expose the 
tendon of the flexor longus pollicis muscle, and the digital ends of the terminal 
tendons of the flexor longus digitorum muscle. Clear the surfaces of the ex- 
posed areas of the flexor brevis pollicis, the lumbricales, and the flexor brevis 
minimi digiti muscles. Determine the distal portions of the second, third, 
fourth, and fifth digital arteries. 
24. Tendon of tlic Flexor Longus Pollicis Muscle, Plates 
77 and 78.—The tendon of this muscle emerges from the dorsal PLANTAR REGION OF THE FOOT. 
139 
surface of the inner border of the flexor brevis digitorum muscle, 
and runs through the pollex metatarsal (upon the plantar sur- 
face of the flexor brevis pollicis muscle) and digital areas. 
25. Terminal Tendons of the Flexor Longus Digitoruin 
Muscle.—The distal ends of these tendons appear on the plan- 
tar surfaces of the digits, second to fifth, inclusive, distal to the 
button-hole openings in the tendons of the liexor brevis digi- 
torum muscle (page 137). 
26. Flexor Brevis Pollicis Muscle.—The plantar surface of 
the first metatarsal bone lodges this muscle ; the tendon of the 
longus pollicis muscle runs, on its plantar surface, in a furrow 
between its heads (Plate 81). Its inner head and a portion of 
its outer head appear at this stage of the dissection. 
27. Digital Arteries, Plates 77 and 79.—The distal por- 
tions of the second, third, fourth, and fifth digital arteries ap- 
pear to the outer sides of, and parallel with, the flexor tendons. 
They pass into the webbing between the toes, and there bifur- 
cate into the plantar collateral digital arteries (page 135.) 
Dissection.—Section (Plate 77) the proximal ends of the exposed portions 
of the first digital, the internal plantar, and the fifth and sixth digital nerves. 
Cut the nerves to the flexor brevis pollicis and those to the first and second 
lumbricales muscles. Reflect the digital nerves, first to sixth, inclusive, off from 
the toes. Section the proximal ends of the anastomotic artery from the internal 
plantar, the terminal portion of the internal plantar artery, and the first digital 
artery. Reflect the first digital artery (cutting its anastomotic branch) and the 
internal plantar artery over the toes ; turn off the branches of the anastomotic 
artery from the internal plantar artery to the anastomoses of its branches with 
the digital arteries—third, fourth, and fifth—and cut them away. Section 
(Plate 78) the flexor brevis digitorum, the abductor pollicis and the abductor 
minimi digiti muscles ; reflect their distal portions and cut them away (Plate 
79); turn off their proximal portions, noting their artery and nerve supply; cut 
the nerves close to the muscles and then cut away the muscles near their cal- 
caneal attachments (Plate 79). Follow to their proximal ends, at the inner side 
of the calcaneum, the internal plantar nerve and artery. Trace the external 
plantar artery in its distal course from the inner surface of the ankle. Follow 
the external plantar nerve in its distal course from the inner surface of the 
ankle, and determine its muscle branches ; note that the distal ones cross upon 
the plantar surface of the external plantar artery. 
28. Internal Plantar Artery, Plate 79.—This artery (venrn 
comites) arises, at its proximal end, from the bifurcation of the 
posterior tibial artery, at the inner side of the calcaneum. 140 
LOWER EXTREMITY. 
The artery has a distal course, in the longitudinal axis of 
the pollex digit, through the inner intermuscular septum; it 
emerges for superficial distribution as already stated (page 
137). Its proximal and deep portion supplies the flexor brevis 
digitorum and the abductor pollicis muscles, and gives off its 
anastomotic artery (page 137). 
29. Internal Plantar Nerve.—This nerve accompanies the 
internal plantar artery, lying to its dorsal surface; its proxi- 
mal portion supplies the flexor brevis digitorum and the ab- 
ductor pollicis muscles. Its metatarsal and digital portions 
were before described (page 136). 
30. Nerve to the Flexor Brevis Digitorum Muscle.—In 
reflecting the proximal portion of this muscle this nerve, 
branch from the outer side of the internal plantar nerve, ap- 
pears entering its inner side. 
31. Nerve to the Abductor Pollieis Muscle.—From the 
inner side of the internal plantar nerve a branch is given to 
this muscle, which enters its outer surface. 
32. Nerve to the Abductor Minimi Digiti Muscle.—The 
external plantar nerve gives olf, opposite the inner surface of 
the calcaneum, a branch to this muscle; it crosses the foot, 
on the plantar surface of the proximal end of the flexor acces- 
sorius muscle, to reach the deep surface of the proximal half 
of the muscle it supplies. 
33. External Plantar Artery, Plates 79 and 81.—This artery 
(vena? comites) originates from the bifurcation of the posterior 
tibial artery, at the inner side of the calcaneum ; it passes ob- 
liquely across the proximal third of the sole of the foot, upon 
the plantar surface of the flexor accessorius muscle, and enters 
the outer intermuscular septum ; through which it runs, in the 
longitudinal line of the fourth digit. The plantar surface of the 
distal third of the artery is crossed by branches of the external 
plantar nerve. Opposite the base of the fourth metatarsal bone 
the artery curves to the inner side and passes to the dorsal 
surface of the outer border of the terminal tendon, to the fifth 
digit, of the flexor longus digitorum muscle. In the exposed 
portion of its course it gives off muscle branches and the first PLANTAR REGION OF TIIE FOOT. 
141 
digital artery; the latter has been described (page 135) and 
illustrated (Plates 76 and 77). 
34. External Plantar Nerve.—This nerve appears in the 
sole of the foot parallel with, and to the inner side of, the exter- 
nal plantar artery ; it crosses, as does the artery, to the minim 
half of the region. It bifurcates into a superficial and a deep 
branch : the superficial branch bifurcates, in turn, into the 
fifth and sixth digital nerves, before described (page 138); the 
deep branch follows the course of the external plantar artery, 
lying to its inner side, and passes with it into the metatarsal 
region. The trunk of the nerve and the exposed portion of its 
deep branch give off nerves to muscles of the tarsal and meta- 
tarsal regions. 
35. Nerve to the Flexor Accessorius muscle, Plates 79 and 
81.—The external plantar nerve gives off a distal branch to this 
muscle as it crosses its plantar surface. 
36. muscle Branches from the Beep Branch of the Exter- 
nal Plantar Nerve, Plate 79.—The deep branch of the external 
plantar nerve gives off the following distal branches from its 
outer side : the first, to the flexor brevis minimi digiti and the 
third plantar interosseous muscles ; the second, to the fourth 
dorsal interosseous muscle ; the third and fourth disappear in 
their distal course, beneath the minim terminal tendon of the 
flexor longus digitorum muscle. These nerves pass upon the 
plantar surface of the external plantar artery. 
Dissection.—Clear the tendons at the pollex border of the tarsal region; 
the initial and terminal tendons of the flexor longus digitorum muscle ; and the 
tendon of the flexor longus pollicis muscle. Expose the accessorius, the lum- 
bricales, and the flexor brevis minimi digiti muscles ; also portions of the trans- 
versus pedis, the adductor pollicis, the third plantar interosseous, the fourth 
dorsal interosseous, and the second plantar interosseous muscles. Determine 
the tendons at the minim border of the tarsal region. 
37. Tendon of the Tibialis Posticus muscle, Plates 75, 79, 
80, and 81.—This tendon enters the pollex border of the tarsal 
region, distal to the internal malleolus, and continues to its 
attachment to the tubercle of the scaphoid bone. 
38. Tendon of the Tibialis Anticus muscle.—The proximal 
portion of this muscle occupies the anterior surface of the leg, 142 
LOWER EXTREMITY. 
and was before described (page 127) and illustrated (Plates 67, 
and 71 to 74, inclusive); its distal tendon enters the pollex 
border of the plantar surface, from the dorsum of foot, to reach 
its distal attachment, at the plantar surfaces of the internal 
cuneiform bone and of the base of the first metatarsal bone. 
39. Initial and Terminal Tendons of the Flexor Longus 
Digitorum Muscle.—The initial tendon of this muscle enters 
the plantar region, from the posterior surface of the leg, at a 
point distal to the internal malleolus of the ankle ; it takes an 
oblique course therefrom to about the middle of the proximal 
limit of the metatarsal region, where it gives off four terminal 
tendons to the digits, second to fifth, inclusive; in the digital 
regions the terminal tendons pass through the button-hole 
openings in the tendons of the flexor brevis digitorum muscle 
(page 137; Plates 77 to 80, inclusive) to their distal attach- 
ments, to the plantar surfaces of the bases of the phalangettes 
of the digits, second to fifth, inclusive. 
40. Tendon of tlie Flexor Longus Pollicis Muscle, Plates 
75, and 77 to 81, inclusive.—This tendon enters the sole of the 
foot by a groove at the posterior border of the astragalus ; it 
runs in a groove upon the sustentaculum tali of the calca- 
neum, to the outer side of the initial tendon of the flexor 
longus digitorum muscle. It takes a distal and straight 
course to the pollex digit, passing to the dorsal surface of the 
initial tendon of the flexor longus digitorum muscle ; in the 
metatarsal region it lies between the heads of the flexor brevis 
pollicis muscle ; it has its distal attachment to the plantar sur- 
face of the base of the phalangette of the pollex digit. 
41. Flexor Accessorius Muscle, Plates 75, 79, and 80.— 
This muscle lias two points of proximal attachment—an inner 
and an outer—upon the plantar surface of the calcaneum ; they 
are united by fibrous tissue. The two portions unite into a 
Hat muscle, which has its distal attachment to the outer border 
of the initial tendon of the flexor longus digitorum muscle, 
proximal to its division into its four terminal tendons. 
42. Lumbricalcs muscles, Plates 77 to 80, inclusive.—These 
muscles are lodged to the inner sides of the terminal tendons 
of tlie flexor longus digitorum muscle. Their proximal ends PLAXTAK KEGIOX OF THE FOOT. 
143 
are attached to the contiguous terminal tendons ; their distal 
ends form tendons, which pass over the inner sides of the 
metatarso-plialangeal articulations, second to fifth, inclusive. 
43. Flexor Brevis Minimi Digiti Muscle, Plates 75 and 77 
to 81, inclusive.—This muscle occupies the plantar surface of 
the fifth metatarsal bone. Its proximal attachment is to the 
plantar surface of the base of the fifth metatarsal bone and 
the contiguous portion of the sheath of the peroneus longus 
muscle; it has a distal and slightly oblique course to its 
attachment, at the outer side of the base of the phalanx of the 
fifth digit. 
44. Transvcrsus Pedis Muscle, Plates 79 and 80.—Por- 
tions of the plantar surface of this muscle appear between the 
distal ends of the lumbricales muscles and the terminal tendons 
of the flexor longus digitorum muscle. 
45. Adductor Pollicis Muscle, Plates 77 to 80, inclusive.— 
Between the first lumbricalis and the outer head of the flexor 
brevis pollicis muscles a small area of this muscle presents. 
46. Interosseous Muscles, Plates 79 and 80.—Between the 
inner border of the flexor brevis minimi digiti muscle and the 
outer border of the minim terminal tendon of the flexor longus 
digitorum muscle portions of the third plantar, the fourth dor- 
sal, and the second plantar interosseous muscles appear. 
47. Tendons of the Peroneus Longus and Peroneus Bre- 
vis Muscles, Plates 79 and 80.—Along tlie minim border of 
the tarsal region these two tendons present: the longus tendon 
running in its sheath along the outer border of the flexor ac- 
cessorius muscle ; the brevis tendon along the outer border of 
the longus tendon. 
Dissection.—Cut the proximal ends of the internal plantar artery and 
nerve (Plate 79), and dissect away their distal portions. Section the initial 
tendon of the flexor longus digitorum muscle, the tendon of the flexor longus 
pollicis muscle, and the flexor accessorius muscle (Plate 80) ; reflect the distal 
portions of the tendons over the toes, carrying the lumbricales muscles with 
the terminal digitorum tendons. Determine the slip of communication be- 
tween the tendon of the flexor longus pollicis muscle and the distal portion of 
the initial tendon of the flexor longus digitorum muscle ; after which the slip 
may be cut. In raising the fourth and third lumbricales muscles note the 
nerves that enter their dorsal surfaces; trace the nerves to the second plantar 144 
LOWER EXTREMITY. 
interosseous and the transversus pedis nerves ; the two latter nerves are in turn 
given off from the deep branch of the external plantar nerve. Find the nerves 
to the first plantar and the third dorsal interosseous muscles. Follow the deep 
branch of the external plantar nerve, and the external plantar artery, into the 
metatarsal region. 
4§. Tendinous Slip between the Tendon of the Flexor 
Longus Pollicis and the Initial Tendou of the Flexor Longus 
Digit or ii in Muscles.—At the crossing of these tendons (Plates 
79 and 80) a tendinous slip passes from the pollicis to the digi- 
torum tendon. 
49. Nerve to the Fourth Eumbricalis Muscle, Plate 81, and 
Fig. 1, Plate 82.—In reflecting this muscle its nerve will be 
seen to enter its dorsal surface; the same may be traced to 
where it is given off from the nerve to the second plantar in- 
terosseous muscle. 
50. Nerve to the Second Plantar Interosseous Muscle, 
Plates 79, 81, and Fig. 1, Plate 82.—This is the third nerve 
given off from the deep branch of the external plantar nerve. 
51. Nerve to the Third Eumbricalis Muscle, Plate 81, and 
Fig. 1, Plate 82.—As the muscle is reflected this nerve is seen 
to enter its dorsal surface; it can be followed to its origin from 
the nerve to the transversus pedis muscle. 
52. Nerve to the Transversus Pedis Muscle, and its 
Branches to the First Plantar and the Third Dorsal Interos- 
seous Muscles.—The nerve to the transversus pedis muscle— 
from the deep branch of the external plantar—enters its proxi- 
mal side. It gives a branch to either side: the inner to the 
lirst plantar interosseous muscle ; the outer to the third dorsal 
interosseous muscle. 
53. Deep Branch of the External Plantar Nerve, Plate 
81.—After having given off the nerve to the transversus pedis 
muscle, this branch is continued, at the outer border of the ad- 
ductor pollicis muscle, to the dorsal surface of the latter muscle. 
54. External Plantar Artery.—This artery curves toward 
the inner side of the metatarsal region of the foot, accompany- 
ing the last-described nerve branch. 
Dissection.—Expose the tarsal grooves for the tendon of the flexor 
longus pollicis muscle and the initial tendon of the flexor longus digitorum PLANTAR REGION OF TIIE FOOT. 
145 
muscle. Note the expansions of the tendon of the tibialis posticus muscle 
from the tubercle of the scaphoid bone. 
55. Tarsal Grooves for the Long Flexor Tendons, Plates 
75 and 81.—Between the tendon of the tibialis posticus and the 
inner border of the flexor accessorius muscle two longitudinal 
grooves present: the outer one upon the plantar surface of the 
sustentaculum tali of the calcaneum (Plate 75) for the tendon 
of the flexor longus pollicis muscle ; the inner one for the ini- 
tial tendon of the flexor longus digitorum muscle. 
56. Expansions of tlie Tendon of the Tihialis Posticus 
muscle, Fig. 1, Plate 82.—This tendon is not only attached to 
the tubercle of the scaphoid bone but it sends expansions 
across the area included by the tibialis anticus and the pero- 
neus longus tendons, and the inner border of the flexor acces- 
sorius muscle. 
Dissection.—Clean (Plate 81) the plantar surface of the transversus pedis 
muscle ; determine the relations of the digital arteries to the slips of the mus- 
cle ; and expose the adductor pollicis and the flexor brevis pollicis muscles. 
57. Transversus Pedis muscle, Plates 75, 79, 80, and 81.— 
This muscle crosses the plantar surfaces of the heads of the me- 
tatarsal bones, having a slip from the inner side of the head 
of each of those bones, from the fifth to the second, inclusive. 
These slips unite into a transverse muscle, which, at its inner 
end, has an attachment, in common with the adductor pollicis 
muscle and the outer head of the flexor brevis pollicis muscle, 
to the outer side of the plantar surface of the base of the pha- 
lanx of the pollex digit. Openings present between its slips 
and the plantar surfaces of the heads of the fourth, third, and 
second metatarsal bones. 
58. Digital Arteries, Plates 77, 79, and 81.—The second, 
third, and fourth digital arteries lie upon the dorsal surface of 
the transversus pedis muscle; they emerge from the openings 
between the slips of that muscle and the heads of the metatar- 
sal bones, into the webbing between the toes. The fifth digital 
artery emerges between the distal tendons of the flexor brevis 
pollicis muscle, gives off the sixth digital artery, and then 
continues to the webbing between the first and second toes, 
over the plantar surface of the outer portion of the compound 
flexor brevis pollicis tendon (page 147). LOWER EXTREMITY. 
59. Adductor Pollicis Muscle, Plates 75, 81, and Fig. 1, 
Plate 82.—This muscle has its proximal attachment at the 
plantar surface of the bases of the third and fourth metatarsal 
bones and the contiguous portion of the sheath of the tendon 
of the peroneus longus muscle. It takes an oblique course 
to the outer surface of the base of the phalanx of the pollex 
digit, its fibres running parallel with those of the outer head 
of the flexor brevis pollicis muscle ; it contributes to the com- 
pound flexor brevis pollicis tendon (page 147). 
60. Flexor Brevis Pollicis Muscle, Plates 77 to 81, in- 
clusive.—This muscle has an inner and an outer portion, or 
head, determined by the plantar surface of the muscle being 
furrowed (Plate 81), for the transit of the tendon of the flexor 
longus pollicis muscle (Plates 77 to 80, inclusive). The inner 
'portion of the muscle has its proximal attachment to the ex- 
pansion of the tendon of the tibialis posticus muscle (page 145); 
as it advances to its distal end it fuses with the tendon of the 
abductor pollicis muscle (page 137). The outer portion has its 
proximal attachment to the cuboid bone and the sheath of the 
tendon of the peroneus longus muscle. The two portions form 
a muscle upon the plantar surface of the first metatarsal bone ; 
opposite the head of the bone, it divides into two distal tendons, 
which are united by fibrous tissue. The distal attachment of 
this muscle is by a compound tendon, which is described at 
page 147. 
Dissection.—Section the nerve to the flexor brevis minimi digiti muscle 
(Plate 81); detach the proximal attachments of the muscle and reflect it to its 
distal end, where it may be cut (Fig. 1, Plate 82). Cut the slips of the trans- 
versus pedis muscle from their metatarsal attachments; note its nerve and cut it 
close to the muscle ; turn off the muscle over the pollex digit. Cut the digital 
arteries (riate 81) and clear the plantar collateral digital arteries from the 
lateral digital surfaces. Detach the proximal end of the adductor pollicis 
muscle; turn over its outer border so as to determine the entrance of its nerve 
at its dorsal surface ; follow the nerve to its origin from the external plantar 
nerve, then cut it close to the muscle; continue the reflection of the muscle 
upon the pollex digit. 
<51. Nerve to the Adduetor Pollicis Muscle, Fig. 1, Plate 
82.—This nerve is given off from that portion of the deep 
branch of the external plantar nerve which is situated on the 
dorsal surface of the adductor pollicis muscle. 147 
PLANTAR REGION OF THE FOOT. 
Dissection.—Cut tlie proximal attachments of tlie flexor brevis pollicis 
muscle and reflect it, in a distal direction, from the plantar surface of the first 
metatarsal bone and the fifth digital artery. Section the muscle into its two 
heads, through the furrow for the flexor longus pollicis muscle. Raise the 
fifth and sixth digital arteries and turn them upon the tarsus. Determine 
the compound flexor brevis pollicis tendon as formed by the heads of the flexor 
brevis pollicis muscle, the abductor pollicis, the adductor pollicis, and the 
transversus pedis muscles. Note the sesamoid bones included in the com- 
pound tendon ; and, the ligament that attaches the proximal border of these 
bones to the plantar surface of the head of the first metatarsal bone. 
62. Compound Flexor Brevis Pollicis Tendon, Plates 75, 
81 ; Fig. 1, Plate 82.—The heads of the flexor brevis pollicis 
muscle have two distal tendons, which are united by fibrous 
tissue : the inner is joined by the tendon of the abductor 
pollicis muscle; the outer receives the adductor pollicis and 
the transversus pedis muscles. Each compound tendon con- 
tains a sesamoid bone ; the two bones being lodged, respec- 
tively, upon the inner and outer tuberosities of the plantar sur- 
face of the head of the first metatarsal bone. To the distal side 
of the sesamoid bones the compound tendon is attached to the 
plantar and lateral digital surfaces of the base of the phalanx 
of the pollex digit. To the borders of the sesamoid bones is 
attached the plantar metatarso-phalangeal ligament (page 180). 
Dissection.—Section the muscles near the sesamoid bones; cut the liga- 
ment from the latter to the first metatarsal bone, and turn the bones on end 
upon the base of the phalanx of the pollex digit (Fig. 1, Plate 82). Trace the 
terminal portion of the deep branch of the external plantar nerve. 
63. Serves to the Second and First Dorsal Interosseous 
muscles, Pig. 1, Plate 82.—The terminal portion of the deep 
branch of the external plantar nerve lies upon the plantar sur- 
face of the interosseous muscles, where it bifurcates to supply 
the second and first dorsal interosseous muscles. 
Dissection.—Trace the plantar arcli through the metatarsal region and 
note its branches. Replace the fifth and sixth digital arteries. 
64. Plantar Arch of the External Plantar Artery, Plate 82. 
—Tlie plantar arcli is formed by the deep branch of the external 
plantar artery; the artery curves as it enters the metatarsal re- 
gion, opposite the base of the fourth metatarsal bone, and con- 
tinues to the proximal end of the first intermetatarsal space, 148 
LOWER EXTREMITY. 
where it anastomoses with the communicating artery from the 
bifurcation of the dorsalis pedis artery (page 128 ; Plate 74). 
65. Digital Arteries, Fig. 1, Plate 82.—The first digital ar- 
tery has been described (pages 135 and 138) ; the second, third, 
fourth, and fifth digital arteries are given off from the convex- 
ity of the plantar arch, having a distal course therefrom : the 
second, between the fourth dorsal and the second plantar in- 
terosseous muscles; the third, between the third dorsal and 
the first plantar interosseous muscles ; the fourth, between the 
second and the first dorsal interosseous muscles ; the fifth, 
upon the outer side of the first metatarsal bone. The fifth 
digital artery gives off the sixth (page 145); the latter crosses, 
the plantar surface of the distal end of the inner head of the 
flexor brevis pollicis muscle, to the inner side of the pollex digit. 
66. Perforating Branelics of the Digital Arteries, Plate 
74 and Fig. 1, Plate 82.—From the second, third, and fourth 
digital arteries perforating branches are given off, respectively, 
which pass to the dorsum of the foot, between the proximal 
ends of the attachments of the dorsal interosseous muscles 
(Plate 68). (These branches are at times given off from the 
plantar arch.) 
Dissection.—Clear and determine the plantar surface of the plantar and 
dorsal interosseous muscles. 
67. Plantar Interosseous Muscles, Plate 75 and Fig. 1, 
Plate 82.—These muscles, three in number, present at the 
plantar surface of the foot and are lodged to the outer sides of 
the second, third, and fourth intermetatarsal spaces. Their 
proximal attachments are to the inner sides of the third, 
fourth, and fifth metatarsal bones (Plate 75), respectively; 
their distal ends form tendons, which wind, severally, over 
the inner sides of the third, fourth, and fifth metatarso-pha- 
langeal joints. 
68. Dorsal Interosseous Muscles, Plates 68, 74, and Fig. 
1, Plate 82.—These four muscles occupy the four intermetatar- 
sal spaces, appearing at both the dorsal and plantar surfaces of 
the foot. The first and second are to either side of the second 
metatarsal bone ; the third and fourth are to the outer sides 
of the third and fourth metatarsal bones, respectively. Their PLANTAIi REGION OF THE FOOT. 
149 
proximal attachments are to the opposite dorsal-plane surfaces 
of the five metatarsal bones (Plate 68). Their distal ends form 
tendons, which cross the inner sides of the metatarso-plialan- 
geal joints : the first over the inner side of that of the second 
digit; the second, third, and fourth over the outer sides of 
those of the second, third, and fourth digits. 
Dissection.—Cut away the sesamoid bones and clean their surfaces. Be- 
place the flexor longus pollicis and flexor longus digitorum tendons; suture 
their cut ends together. Extend the foot so as to see the dorsal and lateral digi- 
tal surfaces of the toes. Becognize the distal attachments of the lumbricales 
muscles. Determine the double distal attachments of the dorsal and plantar 
interosseous muscles ; also the construction of the compound digital extensor 
aponeuroses. The distal ends of the tendons of the extensor longus and brevis 
digitorum muscles were left, in situ, on the dorsal surface of the digits, second 
to fifth, inclusive (pages 129 and 130) ; they may now be dissected. 
69. Sesamoid Bones, Fig. 1, Plate 82.—These are two ob- 
long bones included in the compound flexor brevis pollicis 
tendon (page 147), with their dorsal surfaces articulating with 
the plantar surface of the head of the first metatarsal bone. 
70. Lumbricales Muscles, Fig. 3, Plate 82.—The lumbri- 
cales muscles have their distal attachments to the inner sides 
of the bases of the phalanges of the digits, second to fifth, in- 
clusive. 
71. Distal Attachments of the Dorsal Interosseous Muscles, 
Fig. 2, Plate 82.—The distal tendon of each dorsal interos- 
seous muscle may be determined to have two attachments : 
one to the lateral digital surface of the base of the phalanx 
of the digit to which it belongs (the first muscle to the inner 
side of the phalanx of the second digit ; the second, third, and 
fourth muscles to the outer sides of the phalanges of the re- 
spective second, third, and fourth digits); another by a fibrous 
expansion, which contributes to the compound digital extensor 
aponeurosis of the digit. 
72. Distal Attachments of the Plantar Interosseous Muscles, 
Figs. 2 and 3, Plate 82.—The distal attachment of each of these 
muscles is also double : one to the inner surface of the base 
of the phalanx of the digit—third, fourth, and fifth; the other, 
by a fibrous expansion, to the inner borders of the terminal 150 
LOWER EXTREMITY. 
tendons of the extensor longus digitorum muscle of the third, 
fourth, and fifth digits. 
73. Compound Digital Extensor Aponeuroses, Fig. 1, 
Plate 67; Plate 68 ; Figs. 2 and 3, Plate 82.—Upon tlie dor- 
sum of each digit, second to fifth inclusive, a compound 
digital extensor aponeurosis is formed, by the fusion of a 
terminal tendon of the extensor longus digitorum muscle, a 
tendon of the extensor brevis digitorum muscle, and fibrous 
expansions from dorsal and plantar interosseous muscles. 
The terminal tendon of the extensor longus digitorum of the 
second digit receives at its inner border the expansion from 
the first dorsal interosseous ; at its outer border the second 
tendon of the extensor brevis digitorum and the expansion 
from the tendon of the second dorsal interosseous. The ex- 
pansion from the first plantar interosseous blends with the 
inner border of the longus terminal tendon of the third digit; 
the third tendon of the extensor brevis digitorum and the 
expansion from the third dorsal interosseous joins its outer 
border. For the fourth digit, the inner border of the third ex- 
tensor longus terminal tendon receives the expansion from the 
second plantar interosseous ; to the outer border of the same 
comes the fourth tendon of the extensor brevis muscle and the 
expansion from the fourth dorsal interosseous muscle. For 
the fifth digit, the expansion from the third plantar interosse- 
ous muscle fuses with the inner border of the fourth longus 
terminal tendon. The compound extensor digital aponeurosis 
of a digit has three attachments: a middle one to the dorsal 
surface of the base of the phalangine ; two lateral, which unite 
for attachment, to the dorsal surface of the base of the pha- 
langette. These aponeuroses lie upon the dorsal ligaments of 
the digital joints. 
Dissection.—After the dissection of the dorsal and plantar regions of the 
foot be careful to keep the foot wrapped in wet cloths, so that the ligaments 
of the foot and ankle do not become too dry for subsequent dissection. PLATE 75 
FLEXOR LONG US O/G/TORUM. 
to BREVIS >< 
FL EX 9LONG US POL L LC/S 
RERONEUS LONGLSS 
TLB LA ELS.A NTLCUS 
A D DC/CTOJ*OLL /C/S 
rt£XZLB/rEVSS MTNTMf 
D/GJTJ 
i REROJVEUSRRE IVS 
for tendon of 
REROrVECtS ZOAfGOS 
RL EXOR SREV/S ROLL/C/S 
-TfBLAUS ROST/CUS 
TUB BRUTE} 
TEPOSTAL TUBER CLE 
■SZ/STEXTTA.crtn. T7M. 
TAX.Z 
FLEXOR ACCESSORLUS 
GroouefoR tendon of 
EL EX 9 LONG US ROLLLCLS 
Out r TUBER OLE 
A BDUCTOR MJNLML DJG/TL 
FLEXOR BREV/S DLG/TORLLM 
Jjiner.TUBER ceb 
JHCo/in,aduaturam- eteL. PLATE 76 
b’ Plantar 
t collateral 
* digital art l 
Plantar 
collateral digital 
Plan tar collateral 
5» digital a? 
Plan tar collateral^ 
digital nt V; =d 
ll'C'A digital arl. 
jg I*.t,2n.a,3r.a& 4’*.h 
1 Digital nffrom 
Tin ilplan tar n. 
-Jnt/plantar art. 
sdicGtb 
Digital n f from 
ext lplan tar n. 
Anastomotic 
dranch of " 
tli gi la l art. 
1st digital art. 
Branches ofanasto- 
moticart. from inti 
plantar art. 
Cutaneous plantar 
5 ranch of post ft iSi at n. PLATE 77 
Tertnin&Z 
tendon of ft-er xon 
ZQA'ddS c/G/ronc/M 
Plantar collateral 
etzgrztal ftp 
fZantar caZZateraZ, 
tZzijrZZaZ zzrZ? * 
&<%, eZzr/Jfa/ 
rst.2n.a& 3 ra 
cttry/tat arts 
; fS*2net3rtfg.4,th. 
T~e?za/ zzzt? 
i plzzzztar zz. 
-abductor roll ic/s 
eZzfztaZm? —= 
from extZpZantezr 71. 
ATiar&tomotzc . 
HreiTzcSz ofA.f*e£zjgrJar£. 
&&£>ofrsA£. /Mr£nos&?- 
~JZ.StOZ.tr/nBP/CA Z tS 
BREWS ROLL ? 
A n as tom otzc art .from 
z zzt.zplan far are. 
PntZpZantctr tz. 
jK.CaAn,ad7za£xr<Z7rz cteZ. PLATE. 78 
Terminal 
ten don of XL £~ X on- 
io/vcrt/S o/G/ronuM 
Jif.CmK. adnatzaram. del- PLATE 79 
col- 
lateral ainr.t 
art? 
Zn.*cZip/art. jp 
2”<* PtAprAB — 
/r/rsaosstoos ® 
AZ.eo2P.Sp.ypr. < 
* ~‘ft.MOOftSHZZT.~ 
r-3’tiPLAP'/zrr.- 
’■’■rLEXt&BeV'S- 
M/H/Ptr J31G/TJ 
/st diaitaf art. - 
St* " vi.— 
fft/t. // "•— 
JT.to 
ABD ?MJA//M/ DIZfJT/ - 
cl ex ?bb£W& otG/ro/t ?— 
A BOC/CTOB BO/Lt /C/S 
a bo 5m/NW/ n/G/r/ 
AZ.OoBti .yreZ.7z atu-rarc. ctts-L. PLATE 80 
r PA RS VSRSRS 
pe a/B 
a gocsc tor 
A7//V/M/ 0/G. 
2r’.‘*PLAN TAR 
/HTCROSSe0l/S 
S*./’meta TAf/.rAz. 
PCRO//SUS BREIT/S 
flex ? BBS T/S D/C-J TO# ?- 
A BOOCTOR POl L /C/S 
A0O?M//V/M/ B/&/T/ 
M.Co/err, aoC pcziurtzm PLATE 81 
Tendons of 
A OMBR/CA L ES 
-Digital art-s* 
ABOL/CTOR 
At/AS AM! DAS-. 
JRioTRA A/S SO/?. 
sus pea/s' j 
AA.tO Zs.fRLANTAR INTZROSSZOVS ! 
jr.eo3Ka£>0RSAL' 
AA/rCROSS£Ol/S 
fZROA/EOS EXE ILLS 
Ten tXOB of XL EX OB 
XL O/VOUSROLL/C/S 
. Tendon of 'fLEXOR 
\s LOa/GUS D/G/rORUM 
Jr./OXLEX ?A CCESSOR/OS- 
fntfpZantarart 
'Postftitzdt act. 
JT.toRZRX n/G/TR/rf- 
TL CX f&RR VJS £>/B/ TON f- 
A SOt/CTOR rollsc as- 
A Bn tscrOR M/AA.mB/TZ. 
/fEEafrrz,iZdnezLzznam EeZ PLATE 82 
JTia.J 
Compound n iron 
BPE V/S P OIL /C/S 
— te net on 
T"e n a arts o/ 
l. VO>3 U / CA L ES 
SESAMOID Zones 
3r.<* 
Digital art? 
Digital art? 
■?/.tOZS.fDOPSAL /NTEPOSSEOUS 
■Tendon ofr/B/AL/SANT/cus 
~JV. to A D DO crop POL L. /C/S 
PL EXOP BPE It/S POL L /C/S 
Expansions of ton or on of 
T/B/A L /S POST/COS 
Z)eep Oranc/c ofext.ep/antam. 
*Euperficf" " " " ' "- 
x/b/al/s posr/cos 
Fxcr.2 
JTscf.3 
Tendon of ExrENSOP_ 
bpep/s d/c/popc/ao 
SKd 
ME TA TARSAE. 
Cootpound t/io’fextenS.r 
aponeurosis 
Concpounct c/ig.r. ex- 
-lens? aponeurosis 
3rteJ?UAZ. AJVJC 
3r.ap/fj1 z. a sr ajnu 
■ jPJpA C A MGE T TE 
Jf.Caftn.actncziu.rart del. TWELFTH DISSECTION. 
POSTERIOR REGION OF THE LEG AND THE POP- 
LITEAL SPACE. 
Dissection.—Extend the limb with its posterior surface uppermost; place 
blocks under the pelvis, thigh, and ankle, respectively secure the foot at a 
right angle to the leg. 
Terms of Relation —Proximal (toward the trunk), distal 
(from the trunk), inner side, outer side, anterior surface, and 
posterior surface will be used to indicate the relations of parts. 
Bone Areas, Plate 83.—Tile posterior surface of the calca- 
neum, the astragalus, the tibia, the fibula, and the 
distal end of the femur form the osseous plane of 
this dissection ; with the exception of the astrag- 
alus, all these bones afford attachments to muscles 
presenting in this dissection. 
Dissection.—Make the skin incisions 1, 2, and 3 of Figure 
7, and reflect lateral flaps as indicated. When the dissection of 
the posterior surface of the leg is consecutive to that of the an- 
terior, the skin flaps will have to be removed. Determine the 
saphenous veins and nerves. 
1. Subcutaneous Tissue, Plate 84.—This plane 
of tissue presents the ramifications of superficial 
veins and nerves. 
2. External Saphenous Vein.— At about the 
middle of the leg this vein perforates the fascia ; it 
runs, through the distal half of the dissection area, 
to the external malleolus, where it passes, distal to 
the same, into the minim half of the dorsal surface of the foot 
(page 124 ; Plate 69). 
Figure 7. 152 
LOWER EXTREMITY. 
3. Internal Saphenous Vein.—This vessel appears, for a 
short distance, along t-lie inner side of the proximal third of 
the leg. 
4. External Saphenous Nerve.—The inner and outer roots 
of this nerve perforate the fascia, distal to the point of emer- 
gence of the external saphenous vein, and unite to form the 
nerve proper ; it accompanies the latter vein. 
5. Internal Saphenous Nerve.—This nerve sends branches 
to the inner half of the posterior area of the leg. 
6. Small Sciatic Nerve.—Branches of this nerve perforate 
the fascia in the popliteal space and the proximal portion of 
the leg. 
Dissection.—Section the external saphenous vein and the roots of the ex- 
ternal saphenous nerve, where they perforate the fascia (Plate 84). Clear the 
surface of the fascia free of subcutaneous tissue, veins, and nerves. 
7. Superficial Fascia.—This fascia invests tile leg, and 
closes in the popliteal space, by bridging between the muscles 
which border the same. 
Dissection.—Incise the superficial fascia, in the same lines as the skin in- 
cisions (page 151), and reflect flaps, corresponding to those of the skin, from 
the subjacent muscles, nerves, etc. Trace the popliteal branches of the small 
sciatic nerve, that perforate the fascia, to the trunk of the nerve, and follow 
the ramifications of the terminal branches of the latter; expose the proximal 
portions of the external saphenous vein, the inner and outer roots of the ex- 
ternal saphenous nerve, and the cutaneous branch of the external popliteal 
nerve. 
8. Small Setatie Nerve, Plate 85.—The distal end of this 
nerve enters the proximal portion of the leg from the thigh. Its 
proximal end appears upon the biceps muscle and breaks up 
into branches, which distribute to the skin of the proximal 
third of the posterior region of the leg, as shown above ; one 
branch accompanies the external saphenous nerve, with which 
it anastomoses. 
9. External Saphenous Vein, Plates 85 and 86.—This vein 
may be traced, proximally, between the heads of the gas- 
trocnemius muscle, into the popliteal space. POSTERIOR REGION OF LEG AND POPLITEAL SPACE. 
153 
10. Inner Root of the External Saphenous Nerve.—This 
nerve has a proximal course along the inner side of the last- 
described vein ; it can be traced to the popliteal space, to where 
it is given off from the internal popliteal nerve. 
11. Outer Root of the External Saphenous Nerve.—This 
root can be traced upon the outer head of the gastrocnemius 
muscle, to its proximal origin from the cutaneous branch of 
the external popliteal nerve. 
12. Cutaneous Brandi of the External Popliteal Nerve. 
—This nerve lies upon the outer head of the gastrocnemius 
muscle, emerging from the outer side of the popliteal space, 
where it is given off from the inner side of the external pop- 
liteal nerve. Its branches perforate the fascia to distribute to 
the outer side of the leg; some of its branches are projected 
into the outer antero-lateral area of the leg (page 125 ; Plate 69). 
Dissection.—Clear the surface of the gastrocnemius muscle, preserving 
the ramifications of the four last-described nerves, and the proximal end of the 
external saphenous vein. 
13. Gastrocnemius Muscle, Plates 83, 85, and 86.—This 
muscle occupies the proximal half of the posterior region of 
the leg. At its proximal end it presents two diverging por- 
tions—the outer and the inner heads—which pass to be attached 
to the posterior surface of the femur, at the proximal side of 
the condyles of that bone. Its posterior surface presents a lon- 
gitudinal-median furrow, which lodges the external saphenous 
vein, the inner root of the external saphenous nerve, and the 
terminal branch of the small sciatic nerve. At its distal end 
the muscle forms a Hat tendon, which fuses with the tendon of 
the soleus muscle to form the tendo Achillis. 
Dissection.—Section the small sciatic nerve (Plate 85) and remove its dis- 
tal portion. Clear the muscles forming the proximal boundaries of the pop- 
liteal space. Trace the external popliteal nerve, also the internal saphenous 
nerve and vein. 
14. Biceps muscle, Fig. 2, Plate 67 ; Plates 85 to 88, inclu- 
sive, and Plate 90.—The distal portion of this muscle forms 
the outer boundary of the proximal half of the popliteal 
space ; it may be traced to its attachment to the proximal end 
of the fibula. 154 
LOWER EXTREMITY. 
15. Vastus Externus Muscle, Plates 85 to 88, inclusive, and 
Plate 90.—A portion of the distal end of this muscle presents 
to the outer side of the exposed part of the biceps muscle 
16. Semimembranosus Muscle, Plates 83, 85 to 88, inclusive, 
and Plate 90.—Proximal to the inner head of tlie gastrocne- 
mius muscle the distal portion of this muscle appears, forming 
the inner boundary of the proximal half of the popliteal space. 
17. Scmitcmlinosus Muscle, Fig. 1, Plate 67 ; Plates 85 to 
88, inclusive, and Plate 90.—The distal portion of this muscle 
lies upon the posterior surface of the last-described muscle, 
winding, anteriorly, between the inner head of tlie gastrocne- 
mius and the semimembranosus muscles. 
18. Gracilis Muscle.—The distal end of this muscle runs 
along the inner side of the semimembranosus muscle. 
19. Sartorius Muscle.—The distal portion of this muscle 
presents, anterior to the last-described muscle. 
20. Internal Saphenous Nerve, Plate 86.—This nerve, be- 
fore described (page 125 ; Plate 70), lies along the inner side of 
the proximal portion of the dissection area, appearing at the 
posterior border of the distal end of the sartorius muscle. 
21. Internal Saphenous Vein.—This vein, before described 
(page 125) and illustrated (Plate 70), joins the internal saphen- 
ous nerve at the inner side of the leg, lying anterior to it. It 
enters the leg opposite the anterior border of the distal end of 
the sartorius muscle. 
Dissection. —Section (Plate 86) tlie proximal ends of the cutaneous branch 
of the external popliteal nerve, the external saphenous vein, the inner root of 
the external saphenous nerve, and the internal saphenous vein and nerve. Cut 
away the distal portions of these nerves and veins. Semiflex the knee-joint 
and draw the muscles bounding the popliteal space to either side ; determine 
the nerves and vessels contained in the popliteal space. In cleaning the ex- 
posed portion of the plantaris muscle preserve its nerve. 
22. Popliteal Space.—Tliis space approaches the shape of 
the diamond-figure on a playing card. Its distal boundaries 
are : to the inner side, the inner head of the gastrocnemius 
muscle ; to the outer side, the plantaris muscle and the outer POSTERIOR REGIOX OF LEG AXD POPLITEAL SPACE. 
155 
head of the gastrocnemius muscle. Its proximal boundaries 
are : the semimembranosus muscle to the inner side ; the biceps 
muscle to the outer side. The floor of the space is formed by 
the posterior surface of the distal end of the shaft of the femur, 
and the exterior surface of the posterior ligament of the knee- 
joint. 
23. External Popliteal Nerve, Plates 85 to 88, inclusive, 
and Plate 90.—This nerve emerges from the popliteal space, in 
the groove between the outer head of the gastrocnemius muscle 
and the distal end of the biceps muscle, giving off a cutaneous 
branch (page 153 ; Plates 85 and 86). It winds round the proxi- 
mal end of the shaft of the fibula, through the substance of 
the peroneus longus muscle, where it divides into the anterior 
tibial and the musculo-cutaneous nerves (page 131 ; Plates 72 
and 74) ; followed to its proximal end, it is seen to arise from 
the bifurcation of the great sciatic nerve. 
24. Internal Popliteal Nerve, Plates 85 and 86.—This, the 
largest of the two popliteal nerves, arises from the bifurcation 
of the great sciatic nerve ; it has a longitudinal course through 
the posterior plane of the popliteal space. It gives off, from 
its posterior surface, the inner root of the external saphenous 
nerve (page 153). 
25. Nerve to the Plantarfs Muscle.—This nerve is given 
off from the outer side of the internal popliteal nerve; it 
passes directly to the inner face of the muscle. 
26. Nerves to the Gastrocnemius Muscle, Plate 87.—A 
branch from the posterior surface of the internal popliteal nerve 
is projected between the heads of the gastrocnemius muscle: 
from its sides the heads of the muscle are supplied ; the branch 
itself is continued to the anterior surface of the gastrocnemius 
muscle, to supply the soleus muscle. 
Dissection.—Hook the internal popliteal nerve aside, and dissect out the 
popliteal vein and its tributary branches. 
27. Popliteal Vein, Plate 86.—This vein takes a longitu- 
dinal course, through the popliteal space, in a plane anterior 
to the internal popliteal nerve ; it enters at the middle of the 
distal limit of the space, and passes toward the inner side of 156 
LOWER EXTREMITY. 
its proximal limit. It receives the external saphenous vein 
(Plates 85 and 86) and the vena? comites of the branches of 
the popliteal artery. It leaves the popliteal space, at its 
proximal limit, by the femoral opening in the tendon of the 
adductor magnus muscle (page 118 ; Plates 64 and 65); at the 
latter opening it lies to the outer side of the popliteal artery. 
Dissection.—Section the veins tributary to the popliteal vein, and cut 
them away. Raise and hook aside the vein from the popliteal artery. 
28. Popliteal Artery, Plates 86, 87, 88, and 90.—This artery 
(vena comes) has a longitudinal and oblique course, through 
the popliteal space, in a plane anterior to the popliteal vein ; it 
enters the space at the femoral opening in the adductor magnus 
muscle (page 118 ; Plates 64 and 65); it lies upon the posterior 
surface of the distal end of the shaft of the femur, the exterior 
surface of the posterior ligament of the knee-joint, and the 
posterior surface of the popliteus muscle. 
29. Muscle Brandies of the Popliteal Artery.—Superior 
and inferior muscle branches are supplied by the popliteal 
artery: the superior to the muscles bordering the proximal 
half of the popliteal space ; the inferior to the gastrocnemius, 
the plantaris, and the soleus muscles. 
30. Superior Internal and External Articular Arteries.— 
These arteries (vente comites) are lateral branches from the 
proximal portion of the popliteal; they wind around the sides 
of the femur to contribute to the peri-articular plexuses of 
arteries, at the antero-lateral areas of the knee. 
Dissection.—Clear tlie superficies of the portions of the muscles and ten- 
dons in the distal part of the dissection area. 
31. Soicus Muscle, Plate 85.—This muscle presents at the 
sides of the gastrocnemius muscle ; at its distal end its tendon 
forms the greater part of the tendo Acliillis. 
32. Tendon of the Plantaris Muscle.—This tendon runs 
along the inner border of the tendo Acliillis. 
33. Peroneus Longue and Peroneus Brevis Muscles, Plates 
85 and 87.—The posterior surface of these muscles present POSTERIOR REGION OF LEG AND POPLITEAL SPACE. 
157 
along the fibular border of the soleus and flexor longus poliicis 
muscles. 
34. Flexor Longus Pollicis Muscle.—This muscle appears 
between the peroneus brevis muscle and the tendo Achillis. 
Dissection.—Expose the tendons and the posterior tibial vessels and 
nerve, which are located upon the posterior surface of the distal end of the 
tibia. 
35. Tendon of the Tibialis Posticus Muscle.—Upon the 
inner portion of the posterior surface of the internal malleolus 
is lodged this tendon. 
36. Tendon of the Flexor Longue Digitorum Muscle.— 
This tendon runs to the outer side of the last-described tendon, 
and is superposed upon it. 
37. Posterior Tibial Artery.—A portion of this artery 
(veme comites) appears along the outer side of, and parallel 
with, the last-described tendon. 
38. Posterior Tibial tferve.—A portion of this nerve runs 
along the outer side of the last-described artery, and to the 
inner side, though in a deeper plane, of the tendo Acliillis. 
Dissection.—Section the gastrocnemius muscle (Plate 85), and reflect its 
proximal portion; cut away the middle portion of the muscle, by cutting its 
respective heads distal to the points of entrance of their nerves (Plate 87) ; 
follow the nerves from their origins to the heads of the muscle. Clear the 
plantaris muscle, preserving its nerve and artery. Determine the nerves and 
vessels to the soleus muscle, and clear the surface of the muscle. 
39. Plantaris Muscle, Plates 83, 85, 86, and 87.—This pre- 
sents a short muscle portion at its proximal end, which is at- 
tached to the posterior surface of the distal end of the femur, 
at the proximal side of the attachment of the outer head of 
the gastrocnemius muscle. Its long slender tendon has a dis- 
tal course: for its first portion upon the posterior surface of 
the inner half of the soleus muscle ; for its second portion to 
the inner side of, and anterior to, the tendo Acliillis to its at- 
tachment to the calcaneum. 
40. Soleus Muscle, Plates 88, 85, and 87.—This, the largest 
muscle of the posterior region of the leg, has, at its proximal 158 
LOWER EXTREMITY. 
end, two attachments: an outer, to the posterior surface of the 
proximal end of the shaft of the fibula ; an inner, to the oblique 
line on the posterior surface of the proximal third of the shaft 
of the tibia. Between these proximal attachments the internal 
popliteal nerve and the popliteal vein and artery pass into the 
leg, anteriorly to the soleus muscle. The gastrocnemius and 
soleus muscles (page 153) form the tendo Acliillis, which is at- 
tached to the posterior surface of the calcaneum 
41. Nerves to the Soleus Muscle, Plate 87.—These nerves 
are supplied from the internal popliteal: the inner, the branch 
from which the gastrocnemius muscle is supplied (page 155), 
passes, posteriorly to the plantaris muscle, to enter the proxi- 
mal end of the tibial portion of the muscle, at the outer side 
of the tendon of the plantaris muscle; the outer, directly from 
the internal popliteal nerve, passes, anteriorly to the plantaris 
muscle, to enter the proximal end of the fibular portion of the 
muscle. 
Dissection.—Section, as in Plate 88, the inner nerve to the soleus muscle; 
cut the plantaris muscle distal to the entrance of its vessel and nerve, as in Plates 
88 and 90; reflect the tendon of the muscle to its attachment to the calcaneum, 
where it may be cut away. Section the tendo Acliillis (Plate 87) and reflect the 
soleus muscle to its proximal attachments, where they may be cut away, the 
tibial near the bone, the fibular distal to the point of entrance of its nerve and 
vessels, as in Plates 88 and 90. Clear the surface of the popliteus muscle. 
Trace the distal portions of the internal popliteal nerve, the popliteal vein, and 
the popliteal artery; note the muscle branches of the nerve. 
42. Popliteus Musele, Plates 83, 87, 88 and 90.—This mus- 
cle winds from its proximal attachment, at the side of the 
outer condyle of the femur, to the posterior face of the knee- 
joint ; it widens as it passes to its distal attachment to the 
tibia, proximal to the oblique line of that bone. 
43. Nerves from tlie Distal Portion of the Internal Pop- 
liteal Nerve, Plate 88.—The distal portion of this nerve gives 
off the following muscle branches : to the popliteus and flexor 
longus digitorurn muscles, from its inner side; to the tibialis 
posticus muscle, from its outer side. 
44. Nerve to tlic Popliteus Muscle, Plates 88 and 90.—This 
nerve is given off from the inner side of the internal popliteal 
nerve and passes directly to the muscle. POSTERIOR REGION OF LEG AND POPLITEAL SPACE. 
159 
45. Intermuscular Fascia.—A layer of fascia separates the 
deep muscles, vessels, and nerves of the posterior region of the 
leg from the soleus muscle. It is attached as follows: to 
the fibula, between the flexor longus pollicis and the pero- 
neus longus and brevis muscles; to the tibia, along the inner 
side of the flexor longus digitorum muscle. 
Dissection.—Remove the intermuscular layer of fascia from the subjacent 
vessels, nerves, and muscles. 
46. Posterior Tibial Xerve, Plate 88.—This nerve is the 
distal continuation of the internal popliteal nerve ; it extends 
from the distal border of the popliteus muscle to the inner 
side of the calcaneum, where it bifurcates into the internal 
and the external plantar nerves. In the proximal quarter of 
its course it gives off, from its outer side, a branch to the 
flexor longus pollicis muscle ; and in its distal quarter, a plan- 
tar cutaneous branch. 
Dissection.—Extend the foot upon the leg (Plate 89). Clear (Plate 88) the 
surfaces of the flexor longus pollicis and the flexor longus digitorum muscles; 
trace them into the plantar region of the foot (Plate 89). Follow the nerves 
to these muscles from the distal portion of the internal popliteal nerve, and the 
posterior tibial nerve. 
47. Flexor Longus Pollicis muscle, Plates 83, 75, 88 and 
89.—This muscle is attached to the distal two-thirds of the 
posterior surface of the shaft of the fibula. Its distal, tendi- 
nous, portion passes over the ankle (Plate 89), to enter the 
plantar region of the foot, by a groove in the posterior border 
of the astragalus (Plate 75.) Its course, relations, and distal 
attachments, in the plantar region, were before described (pages 
138,142, and 144) and illustrated (Plates 79 and 80). 
48. Serves to the Flexor Longus Pollicis muscle, Plate 88. 
—The origin of the trunk of these nerves was described above ; 
the nerves can now be traced to the muscle. 
49. Flexor Longus Digitorum muscle, Plates 83, 75, 88 and 
89.—The proximal end of this muscle is attached to the poste- 
rior surface of the distal two-tliirds of the shaft of the tibia. 
Its distal end presents its initial tendon upon the posterior 
surface of the internal malleolus, where it enters the plantar 
region of the foot, distal to the malleolus (Plate 89); its plan- 160 
LOWER EXTREMITY. 
tar course, relations, division into four terminal tendons, and 
the digital attachments of the latter, were before described 
(pages 139 and 142) and illustrated (Plates 79 arid 80). 
50. Nerves to tlie Flexor Longus Digitorum muscle, Plate 
88.—These nerves may now be traced to the muscle : one from 
the internal popliteal nerve (page 158); the other from the pos- 
terior tibial branch to the flexor longus pollicis muscle. 
Dissection.—Hook the posterior tibial nerve to the inner side; dissect 
away the (venae comites) of the posterior tibial and peroneal arteries ; note the 
branches of the distal portion of the popliteal artery and its bifurcation at the 
lower border of the popliteus muscle. Follow the anterior tibial, the posterior 
tibial, and the peroneal arteries. 
51. Popliteal Artery, Plates 88 and 90.—The distal ter- 
mination of this artery is at the distal border of the popliteus 
muscle, where it bifurcates into the anterior and the posterior 
tibial arteries. 
52. Inferior Internal and External Articular Arteries.— 
These arteries (vense comites) are given olf from the sides of 
the distal portion of the popliteal artery. They wind around 
the sides of the proximal ends of the tibia and fibula, respec- 
tively, to contribute to the peri-articular plexuses at the antero- 
lateral areas of the knee. 
53. Anterior Tibial Artery, Plates 88, 90, 73, and 74.—This 
artery passes to the anterior surface of the tibio-fibular inter- 
osseous ligament, through the deficiency at the proximal end 
of the ligament (pages 130 and 132). 
54. Posterior Tibial Artery, Plate 88.—This artery (venrn 
comites) has a distal course to the inner side of the calcaneum, 
where it bifurcates into the internal and the external plantar 
arteries (pages 139 and 140; Plates 79 and 81). It is lodged be- 
tween the flexor longus pollicis and the flexor longus digitorum 
muscles. 
55. Peroneal Artery.—This artery (venm comites) is given 
off from the last-described artery, between the origin of the 
latter and the proximal end of the flexor longns pollicis mus- 
cle ; it runs parallel with, and to the outer side of, its parent 
trunk ; it passes to the anterior surface of the pollicis muscle. POSTERIOR REGIOX OF LEG AXD POPLITEAL SPACE. 
161 
Dissection.—Clear the posterior surface of the peroneus longus and brevis 
muscles; determine the continuity of the two muscles from the outer side of 
the leg into the plantar region of the foot (Plate 89). 
56. Peroneus Longus Muscle, Fig. 2, Plate 67 ; Plates 75, 
80, 88, 89, and 90.—The anterior surface of this muscle has 
been described (page 129) and illustrated (Plates 72, 73, and 74). 
The posterior surface of the muscle occupies the proximal half 
of the outer side of the leg. It is attached to the proximal 
half of the outer side of the shaft of the fibula ; its tendon 
commences at about the middle of the leg and is continued 
to the posterior surface of the external malleolus, distal to 
which it winds to the minim border of the tarsal region of 
the foot, where it enters a groove at the outer side of the cu- 
boid bone ; by this groove it is directed obliquely across the 
bases of the metatarsal bones, to its distal attachment to the 
outer side of the base of the first metatarsal bone (Plates 75, 
and 79 to 82, inclusive). Where lodged in the groove of the 
cuboid bone the tendon contains a sesamoid bone. In the 
plantar region, the tendon of the muscle is held in its osseous 
groove by a fibrous sheath, which is formed by the distal end 
of the long calcaneo-euboid ligament. 
57. Peroneus Brevis Muscle.—The anterior surface of this 
muscle lias been described (page 129) and illustrated (Plates 
72, 73, and 74). It is attached to the distal half of the outer 
side of the shaft of the fibula. Its tendon lies upon the poste- 
rior surface of the external malleolus, distal to which it winds 
(Plate 89) to the minim border of the tarsal region, where it 
passes to its distal attachment, at the base of the fifth meta- 
tarsal bone. 
Dissectton.—Cut the sutures uniting the cut tendons of the flexor longus 
pollicis and the flexor longus digitorum muscles (pag i 149). Reflect the prox- 
imal portions of these muscles and cut them away from their areas of bone 
attachment (Plate 83). Cut the posterior tibial nerve opposite the tibial at- 
tachment of the soleus muscle (Plate 90). Section the posterior tibial arteiy, 
distal to its giving off of the peroneal artery (Plate 90). Trace the peroneal 
artery and its branches. 
58. Peroneal Artery, Plates 88 and 90.—This arteiy (venae 
comites) has a distal course parallel with, and to the inner side 
of, the fibula, between the fiexor longus pollicis muscle, pos- 162 
LOWER EXTREMITY. 
teriorly, and the tibialis posticus muscle, anteriorly. It affords 
branches to contiguous muscles, and terminates, at the distal 
limit of the tibio-fibular interosseous space, by bifurcating into 
the anterior and the posterior peroneal arteries. 
59. Anterior Peroneal Artery, Plate 90. — This artery 
(venm comites) was seen at the anterior surface of the leg (page 
132), and illustrated (Pig. 1, Plate 73 and Plate 74). It passes 
to the anterior surface of the leg, through a deficiency at the 
distal end of the tibio-fibular interosseous ligament. 
60. Posterior Peroneal Artery. — This artery (vena3 C0- 
mites) is a small vessel upon the posterior surface of the ankle- 
joint, between the tendo Acliillis and the tendons of the 
peronei muscles. 
Dissection.—Clear tlie posterior surface of the tibialis posticus muscle and 
follow its tendon into the plantar region of the foot. 
61. Tibialis Posticus Muscle, Plates 75, 79 to 82 inclusive, 
83, and 87 to 90, inclusive.—This muscle occupies the posterior 
surface of the tibio-fibular interosseous ligament (Plate 90) ; it 
is attached to the proximal half of the ligament and the ad- 
joining surfaces of the tibia and fibula (Plate 83). Its tendon 
lies upon the posterior surface of the internal malleolus (Plates 
85, 87, 88 and 89), distal to which it winds to reach the pollex 
border of the tarsal region of the foot (Plate 89). It is at- 
tached, primarily, to the tubercle of the scaphoid bone (Plates 
75, 79 to 82, inclusive, and 89) ; secondarily, by outer and 
distal expansions, which are described at pages 182 and 183, 
and illustrated Plate 105, and Pig. 1, Plate 106. PLATE 83 
PLANTS p/s 
Inner head of3-ast roc- 
NEM/US 
PO PL/TENS 
B/CEPS 
SEMIMEMBRANOSUS 
Opening forantltihiaiart. 
Opening/ /or antlperoneaZ art 
Groove for fl ex op longus 
D/(r/TOPUM & 77B/AL/S POST/C US 
XN~ T? ATALEJEOE US' 
Groove /or pl EX ? long us POL l /C/s 
EX.T?JUALEEOL US 
— PLANTAR/S 
Tendo AcJii/Iis 
M..Cchn,aariatu-ram deL PLATE 84 
■23ranches ofs/naui 
sciatica. 
Branches ofcutaneoi/s 
(jranch ofext!jjoplit}/i. 
Sranches of 
int tsaphe/i fn.. PLATE 85 
*S*nvaZZ sciatic tl 
2Zxt'popZz tear/ 7z. 
J71n // 
Cuta.7L.ee/us dra/zetz 
Jimerr root <7/ €*x£/sa/?7t&Ti€/Z7S 72 
0/c£e7~ " " " " '* 
PerztZo/i of PL. A// TA P/S 
- /?L£XO/? Z. 07/a US B/G fTOBUHT 
— T/BJAL/S BOST/CUS 
—PostT£r &iezZ <Z7~t. 
// //■ n. 
EXTZ'ATAZZEOE Z/aT 
E E OX US’ 
VT.CcSzk. /z<z£*£7'<a.77z ctcZ. PLATE 86 
-jS’jnaZL. SKEat/crz. 
. Great sciatic jz. 
ariz calccr 
Ct f t. 
SupText?articular 
IV.tORLA NT AXIS 
■JiftO GASTROCNEMIUS' 
Jjziisajjhenozcs tz 
farter root of exefsa/jJteaous 
71. 
_Oist er root of 
~ex/i.sajoAenou.s Jt~ 
p£fehnta&rtatura'm PLATE 87 
jPoft/iteat it. 
tS’upfextfarticular art. 
-J’ojoliteal art. 
JV. tOt*L A /V TA /t/S 
. inner/lead o/'OA s TROC/vcnf? 
JVftO OAST A OCttCM/US 
Outer 7zeactofOA s r/zoc/V£M/os 
JVfto sol £ us 
fz/ffext? articit/ar art 
POfL/re US 
f/antar cutaneous n£ 
7’eneto7i of 
r/s/AL/s rosr/cvs 
-jF>of£ r e£6raf art. 
Jlf.Cc?: natllram UrZ. PLATE 88 
jTrzt*/?o/7?££&&t n. 
a 
r*/?rex£*certicuZa. r cert. 
tv/- to g-a s r a o c aSMi as 
Asef/"ext*artieutar art. • 
-Tri ner freeze* ofG-A ST&OCA/EAf/(/$ 
i nCi' ccrtt cuZat- a.7*£. 
OuterJeead o/~OA S TPOC/V ElUlas 
JVZtonaiALIS POST/ cos 
/V. to popl / r£ us 
T/B/a l is pos n c as 
■ Attar/i7ne7zt of SOL £ C/S 
JV?torLCX?L onsfaiG-iroz/aA/ 
■ ArftO PLEX?LO HGOS POL L !C/S 
Teneton of tibialis post/cc/S 
Post/"tidial art. 
// n. 
5Tertdo A.e7iLCZZs 
M.ChhttjatfetaCctran deZ. PLATE 89 
Z.EOI. ITS 
r.vT'f-ATAT.z. gams’ 
•S-CAmOTO 
S(.h ATS TAJ-A RSA.L 
M. CeteZ; cceCJtAfuram PLATE 90 
Popliteal k 
A*upfex ti articular art. 
■Ex tfpopliteal n. - 
Outer Acad ofoAtrnocssEM/at 
Tn/Texlf articular art. 
AT?to tot tat 
-■fnffiat.z articzt/ar art. 
Jlfto 7-/3/A l/S 3os r/ c OS 
ai ntftiiial art. 
AT.tortEX.Ft o/vtT n/t/rorOM 
Attachment of sot cos 
~ JV. tOPl EX *t O/VOlPOi t / c/s 
fnterosseous lig™^ 
— Anlfperoneal art. 
- jx us1 
Tootfper osteal art. 
eaxtI-jhaz.ee on i/& — 
AT. CoAn, adnatu-rurz. det. THIRTEENTH DISSECTION. 
GLUTEAL REGION AND POSTERIOR REGION OF 
THE THIGH. 
Dissection.—Place a block under the anterior of the pelvis; extend the 
limb, rotate the thigh inwards, and let the knee, leg, and foot rest upon the 
table. 
Terms of Relation.—To the gluteal region the general 
terms of relation are applicable (page 2) ; to the thigh region 
the terms proximal, distal, inner side, 
outer side, anterior surface and posterior 
surface will be applied. 
Bone Areas, Plate 91.—The exteriors of 
the os innominatum, the sacrum, and the 
coccyx, and the posterior surfaces of the 
femur and the proximal ends of the tibia 
and fibula form the osseous plane of the 
dissection. All these bones afford areas 
for muscle attachments. 
Dissection.—Make the skin incisions 1, 2, and 3 
of Figure 8, and reflect lateral flaps as indicated. 
Where the dissection of the anterior of the thigh has 
been made, the skin may be dissected off. 
1. Subcutaneous Tissue.—This tissue 
is thicker and denser than that of the ante- 
rior of the thigh ; the veins and nerves are 
much smaller and less numerous. 
Dissection.—Clear away the subcutaneous tissue 
from the fascia, preserving, as far as possible, the subcutaneous nerves and 
veins. 
2. Subcutaneous Nerves, Plate 92.—Branches of the ex- 
ternal cutaneous nerve, from the lumbar plexus (page 109; 
Figure 8. 164 
LOWER EXTREMITY. 
Plate 60), wind over the outer border of the thigh. Branches 
of the small sciatic nerve perforate the fascia, in the outer and 
inner halves of the posterior region of the thigh; branches of 
the latter nerve also wind over the inferior border of the glu- 
teus maximus muscle, to ramify superiorly. Terminal branches 
of the twelfth dorsal, the ilio-liypogastric and the lumbar spinal 
nerves enter the gluteal region at its superior limit ; posterior 
branches of the sacral spinal nerves appear near the median 
line. 
3. Fascia Lata.—The posterior portion of the fascia lata 
forms the fascial plane of the gluteal region and the posterior 
region of the thigh ; its anterior portion, with which the pos- 
terior is continuous, was before described (page 109) and illus- 
trated (Plate 60). 
Dissection.—Abduct the limb, so as to bring the inner side of the leg 
against the border of the table. Incise and dissect off the fascia lata of the 
gluteal region, parallel with the fibres of the gluteus maximus muscle, thereby 
exposing the latter. 
4. Gluteus Maximus Muscle, Plates 91, 98, and 94.—This is 
an oblong muscle, which lies obliquely across the gluteal region, 
constituting the principal mass of the buttock. Inferior to its 
inferior border is the gluteal fold, which forms the proximal 
limit of the posterior region of the thigh. The muscle is in- 
cluded between two layers of the fascia lata: at its superior 
border the fascia splits to include the muscle, and unites again 
into a single layer at its inferior limit; upon the trochanter 
major (Plate 94) the muscle is attached to the fascia. 
Dissection.—Make an incision through the fascia lata of the posterior 
surface of the thigh, corresponding to the line of skin incision 3, of Figure 8 
(page 163); reflect lateral flaps from the subjacent muscles. Be careful to 
preserve the small sciatic nerve. 
5. Small Sciatic Kerve, Plates 92 and 94.—This nerve 
emerges into the posterior region of the thigh, at the inferior 
border, and from the anterior surface, of the gluteus maximus 
muscle ; it takes a distal course between the fascia lata and 
the surface of the biceps muscle (long head), giving off lateral 
branches, described above, which perforate the fascia, to reach 
the subcutaneous tissue. Its branches continue into the sub- GLUTEAL AND POSTERIOR THIGH REGIONS. 
165 
cutaneous plane of the proximal portion of the posterior region 
of the leg (page 152 ; Plate 84). 
Dissection.—Replace tlie limb upon the table. Section the small sciatic 
nerve at its proximal end (Plate 91) ; cut its distal portion away. 
6. Vastus Externus Muscle, Plates 91 and 94.—The pos- 
terior surface of this muscle occupies the outer border of the 
posterior of the thigh—from the trochanter major to within a 
short distance of the outer condyle of the femur ; it is attached 
to the outer lip of the linea aspera of the femur. 
7. Biceps Muscle, Plate 94.—The long head of this muscle 
is projected into the posterior region of the thigh, from the 
anterior surface and inferior border of the gluteus maximus 
muscle; it takes an oblique course to the outer side of the 
knee. A part of the attachment of its short head—to the linea 
aspera of the femur—is seen between its long head and the vas- 
tus externus muscle. 
8. Semitendinosus Muscle.—This muscle appears from the 
anterior surface of the gluteus maximus muscle, at the inferior 
border of the latter ; it runs along the inner side of the long 
head of the biceps, to which it is apposed, to about the distal 
third of the thigh, where the two diverge—the semitendinosus 
passing to the inner side of the knee. 
9. Gracilis Muscle.—This muscle presents at the internal 
surface of the thigh (page 111; Plates 61 to 65, inclusive). 
Its posterior edge forms the inner border of the posterior sur- 
face of the thigh; its distal end may be traced to its attach- 
ment to the inner tuberosity of the tibia and the fascia of the 
leg. 
10. Semimembranosus Muscle.—This muscle is lodged in 
a plane anterior to the biceps (long head) and the semimem- 
branosus muscles. It is projected from the anterior surface 
of the gluteus maximus muscle : the proximal half of its in- 
ner portion occupies the interval between the semitendinosus 
and the gracilis muscles ; its distal portion appears in the 
divergence of the semitendinosus and biceps muscles. *A por- 
tion of its anterior surface appeared in the dissection of the an- 166 
LOWER EXTREMITY. 
terior region of the thigh, between the adductor magnus and 
the gracilis muscles (page 120; Plates 64 and 65). 
11. Adductor Magnus Muscle.—This muscle, though in a 
plane anterior to the three last-described muscles, presents at 
two points distal to the inferior border of the gluteus maximus 
muscle : in the proximal angle formed by the gracilis and the 
semimembranosus muscles; and in the proximal angle be- 
tween the long and the short heads of the biceps. 
12. Popliteal Space.—The popliteal space, with its con- 
tents, in situ, is described (page 154) and illustrated (Plates 
85 and 86); it is reproduced in this dissection to enable the ap- 
preciation of the continuity of parts from the thigh to the leg. 
Dissection.—Section the gluteus maximus muscle (Plate 93) and reflect its 
portions, externally and internally. In raising the portions of the muscle, note 
the bursae beneath the muscle ; also the vessels and nerves that enter its 
deep surface. Cut away the inferior part of its external portion, close to its 
femoral attachment, and the superior part thereof with the fascia lata, to 
which it is attached ; cut the vessels and nerves entering its anterior surface. 
13. Gluteus Maximus Muscle, Plates 91, 93, 94, and 95.— 
The reflection of the external portion of this muscle will deter- 
mine its attachment to the fascia lata of the thigh, superiorly, 
and to the femur, interiorly—at the inner side of the proximal 
portion of the outer lip of the linea aspera. Its internal at- 
tachments are : to the exterior surfaces of the postero-in- 
ternal border of the os innominatum, and the external borders 
of the sacrum and coccyx ; to the posterior surfaces of the 
sacro-iliac and great sacro-sciatic ligaments. 
Dissection.—Abduct tlie limb, so as to bring the inner side of the leg 
against the border of the table. Clear the area anterior to the gluteus maximus 
muscle, so as to expose the bursae under the muscle, the great sacro-sciatic 
ligament, the pyriformis muscle, the proximal portion of the small sciatic 
nerve, the inferior gluteal nerve, the great sciatic nerve, the sciatic artery and 
its branches, the superficial branch of the gluteal artery, and the posterior 
surface of the gluteus medius muscle. Cut away the internal portion of the 
gluteus maximus muscle, as in Plate 95. 
14. Bursae Beneath the Gluteus Maximus Musele, Plate 
96; and Fig. 1, Plate 4.—Two large bursae present beneath the 
gluteus maximus muscle : one on the tuberosity of the ischium ; 
the other upon the trochanter major of the femur. GLUTEAL AND POSTERIOR THIGH REGIONS. 
167 
15. Great Sacro-Sciatlc Ligament, Plates 95, 99, and 100. 
—This ligament extends from the exterior of the tuberosity of 
the ischium to the posterior surfaces of the sacrum, near its 
external border, and of the posterior inferior spinous process 
of the ilium portion of the os innominatum. 
16. Pyriformis Muscle, Plates 91 and 95 to 100, inclusive.— 
The internal attachment of this muscle, at the interior of the 
pelvis, was before described (page 82) and illustrated (Plate 
42 ; Fig. 1, Plate 45 ; and Fig. 1, Plate 46). The muscle is pro- 
jected from the pelvis into the gluteal region, through the great 
sacro-sciatic foramen ; it has an attachment to the superior 
border of the foramen. It takes a somewhat oblique course, 
externally, to its attachment to the antero-superior part of the 
internal surface of the trochanter major of the femur. 
17. Small Sciatic Nerve, Plates 95 to 100, inclusive.—The 
proximal portion of this nerve, anterior to the gluteus maxi- 
mus muscle, may be traced to its point of emergence into the 
gluteal region, from the anterior of, and at the inferior border 
of, the internal half of the pyriformis muscle. It gives off the 
inferior pudendal nerve, which winds inferiorly to the tuber- 
osity of the ischium to reach the external genitalia (pages 16 
and 32 ; Plates 6 and 13). 
18. Inferior Gluteal Werve.—This nerve emerges into the 
gluteal region with the last-described nerve. It breaks up into 
a number of branches, which enter the anterior surface of the 
superior part of the gluteus maximus muscle ; so close is the 
relation of the proximal end of this nerve and the small sciatic 
nerve, that it requires care to separate them. 
19. Sciatic Artery.—In the reflection of tile portions of the 
gluteus maximus muscle arterial branches were cut, which 
entered the inferior part of its anterior surface ; the stumps 
may be followed to the sciatic artery (venae comites), which 
enters the gluteal region at the inferior border of the pyri- 
formis muscle; at the latter point it is internal to, and in 
close relation with, the small sciatic nerve. Besides affording 
branches to the gluteus maximus muscle, the trunk of this ar- 
tery gives off an articular branch (to the hip-joint), which runs, 
externally, along the inferior border of the pyriformis muscle. LOWER EXTREMITY. 
The trunk of the artery continues, inferiorly, into the prox- 
imal part of the posterior region of the thigh ; its course is, 
externally to the tuberosity of the ischium, parallel with, and 
superficial to, the great sciatic nerve ; to the latter nerve it 
gives a branch, the comes nervi ischiadici (Plates 90 and 97), 
which enters the nerve. Muscle branches are afforded to con- 
tiguous muscles ; and terminal branches anastomose with the 
internal circumflex and the first perforating branch of the pro- 
funda femoris artery. 
20. Superficial Branch of the Gluteal Artery, Plates 9f> and 
99.—Stumps of arteries present, which were cut as they entered 
the anterior surface of the superior part of the gluteus maxi- 
mus muscle; they may now be traced to this branch of the 
gluteal artery (venae comites), at the superior border of the in- 
ternal portion of the pyriformis muscle, between the latter and 
the gluteus medius muscle. 
21. Gluteus ncdfuK muscle, Plates 91 and 95 to 100, inclu- 
sive.—This muscle occupies the interval between the trochanter 
major of the femur and the anterior two-thirds of the crest of 
the ilium. The internal third of its posterior surface is over- 
lapped by the gluteus maximus muscle (Plate 93); its external 
border is covered by the tensor vaginae femoris muscle (Plate 
01). Upon the removal of the latter muscle, its external border 
presents at the outer side of the proximal portion of the ante- 
rior surface of the thigh (Plates 02 to 05, inclusive ; and Fig. 2, 
Plate 0G). It is attached, superiorly, to the exterior of the 
ilium of the os innominatum, between its superior and middle 
curved lines, being continued to the anterior border of the 
bone ; inferiorly, it narrows to be attached to the superior and 
external surfaces of the trochanter major of the femur. 
Dissection.—Section the inferior gluteal nerve, the small sciatic nerve, and 
the sciatic artery at their superior ends (Plate 97), and dissect away their in- 
ferior portions; cut the articular branch of the artery at its origin and leave it 
in situ. Separate the long head of the biceps muscle from the semitendinosus 
muscle, being careful not to cut away the nerves and arteries that supply them. 
22. Head of tlie Biceps Miaele, Fig. 1, Plate 91 ; 
Plates 93 to 98, inclusive.—The biceps is the outer, superficial 
and longitudinal muscle of the posterior surface of the thigh ; 
its proximal portion having two heads: the long head is at- GLUTEAL AND POSTERIOR TIIIGII REGIONS. 
169 
tached to the tuberosity of the ischium, in common with the 
semitendinosus muscle, taking an oblique course therefrom 
toward the outer side of the knee; the short head lies ante- 
riorly to the long head. 
23. Semitendinosus muscle.—The proximal end of tills mus- 
cle is fused, for about three or four inches, with the last-de- 
scribed muscle ; the two muscles having a common attachment 
to tlie postero-inferior border of the tuberosity of the ischium. 
The muscle takes its course parallel with, and to the inner side 
of, the long head of the biceps. At about the distal third of the 
thigh its tendon commences, which diverges from the biceps 
muscle and passes to the inner side of the knee; it may be 
traced to its attachment to the inner tuberosity of the tibia 
(Pig. 1, Plate 67). 
Dissection.— Flex the log slightly, and steady it in that position; hook 
the long head of the biceps muscle to the outer side, and the semLendinosus 
and semimembranosus muscles to the inner side. Trace the great sciatic nerve 
through the gluteal region and the posterior region of the thigh ; dissect out the 
muscle branches of the nerve and its terminal bifurcation. 
24. Great Sciatic Nerve, Plates 95 to 97, inclusive.—This 
nerve, the largest in the body, is derived from the sacral plexus ; 
it is projected into the gluteal region, through the great sacro- 
sciatic foramen, appearing from the anterior of the inferior 
border of the pyriformis muscle, a little external to the emer- 
gence of the inferior gluteal and the small sciatic nerves. In 
the gluteal region it is lodged upon the posterior surface of the 
gemellus superior, the obturator in tern us, the gemellus infe- 
rior, and the quadratus femoris muscles; on the latter muscle 
it lies between the ischium of the os innominatum and the 
trochanter major of the femur—nearest the former. In the pos- 
terior region of the thigh it has a distal course, anterior to the 
superficial muscles (biceps, semitendinosus, and semimem- 
branosus) and the muscle floor of the posterior region of the 
thigh—the adductor magnus. At a point to the proximal side 
of the popliteal space, the nerve bifurcates into the external 
and the internal popliteal nerves, which have been described 
(page 155) and illustrated (Plates 85 and 86). 
25. Nerves to the Biceps Muscle, Plates 96 and 97.—Two 
branches are given off from the great sciatic nerve to the heads 170 
LOWER EXTREMITY. 
of this muscle : to the long liead a branch from the inner side 
of the nerve; to the short head a branch from its outer side, 
which bifurcates before entering the muscle. 
26. Nerve to the Adductor Magnus, the Semimembran- 
osus, and the Semitendinosus Muscles.—Distal to the biceps 
branches, a nerve is given off from the inner side of the great 
sciatic, which bifurcates: the short branch supplying the ad- 
ductor magnus muscle; the long one taking a longitudinal 
course, and dividing, to supply the semimembranosus and the 
semitendinosus muscles. 
27. Nerve to the Semitendinosus Muscle.—This, the most 
distal and shortest branch from the great sciatic nerve, passes 
directly from the inner side of the nerve to the muscle. 
Dissection.—Cut the proximal ends of the long head of the biceps and the 
semitendinosus muscle (Plate 96) ; reflect the muscles, in a distal direction, 
and cut the nerves and vessels supplying them. Section the long head of the 
biceps near its junction with the short head ; and the semitendinosus near its 
distal attachment (Plate 96;. Clear the surfaces of the short head of the 
biceps muscle and the semimembranosus muscle. 
28. Sliort Head of the Biceps Muscle, Plates 94, 96, 97, 
and 98 ; Fig. 1, Plate 91; Fig. 2, Plate 67.—This head of the 
biceps muscle is located in a plane anterior to the long head 
(Plate 94); and in part to the outer side of the latter. It has 
a longitudinal course, being attached to the linea aspera, along 
the inner side of the distal two-tliirds of its outer lip (Fig. 1, 
Plate 91). In the distal quarter of the thigh, the two heads 
of the biceps unite; they then pass as a single muscle over 
the outer side of the knee, to be attached to the proximal end 
of the fibula. 
29. Semimembranosus Muscle, Plates 94, 96, and 97; Fig. 
1, Plate 91.—This muscle, the largest in the posterior region 
of the thigh, lies to the inner side of the thigh, anterior to the 
long head of the biceps and the semitendinosus muscles. Its 
proximal attachment is to the inferior and external surfaces of 
the tuberosity of the ischium; the muscle takes a longitudinal 
course to the inner side of the posterior surface of the knee, 
where it may be traced to a short thick tendon, which is in part 
attached to the proximal end of the tibia, at the posterior plane GLUTEAL AND POSTERIOR THIGH REGIONS. 
171 
of its inner tuberosity ; it also contributes to tlie posterior lig- 
ament of the knee-joint. 
Dissection.—Out the proximal ends of the great sciatic nerve and the 
semimembranosus muscle (Plate 97) ; make a distal reflection of the nerve 
and muscle; cut the nerve to the adductor magnus muscle ; cut the semi- 
membranosus muscle near its distal attachment (Plate 97). Out the per- 
forating arteries and the popliteal artery and its branches, as in Plate 98. 
Dissect away all arteries of the posterior region of the thigh and popliteal 
space. Clear the surface of the adductor magnus muscle. Determine the fem- 
oral opening, and the openings for the perforating branches and terminal por- 
tion of the profunda femoris artery, through the adductor magnus muscle. 
Find the anastomotica magna artery and the long saphenous nerve at the inner 
side of the distal portion of the thigh. 
30. Adductor Magnus Muscle, Plate 59 ; Fig. 1, Plate 91 ; 
Plates 93 to 100, inclusive.—The anterior surface of this mus- 
cle, described (pages 111 and 119) and illustrated (Plates 61 to 
65 inclusive ; and Fig. 2, Plate 66), forms the floor of the ante- 
rior region of the thigh ; its posterior surface constitutes the 
floor of the posterior region of the thigh. Its proximal attach- 
ment is to the exterior of the body and of the anterior ramus 
of the ischium ; its distal attachment is to the inner side of the 
external lip of the linea aspera of the femur for its whole 
length from the trochanter major; it is also attached to the 
inner condyle of the femur. It is perforated by the femoral 
artery and vein, and by the perforating branches of the pro- 
funda femoris artery. 
31. Femoral Opening in tlie Adductor Magnus Muscle, 
Plates 96, 97, and 98.—The anterior of this was described (page 
118) and illustrated (Plates 64 and 65) ; its posterior view pre- 
sents in the distal third of the muscle. It transmits, in a dis- 
tal direction, the femoral artery to become the popliteal; and 
in a proximal direction, the popliteal vein to become the fem- 
oral. The vein is to the outer side of the artery. 
32. Openings in the Adductor Magnus Muscle for flic 
Brandies and Terminal Portion of the Profunda Femoris 
Artery, Plates 63, 64, and 98.—Close along the femoral attach- 
ment of the adductor magnus muscle four openings present, at 
about equal distances, for the transit of the three perforating 
branches and the terminal portion of the profunda femoris 
artery ; muscle branches also perforate the muscle. 172 
LOWER EXTREMITY. 
33. Anastomotica Magna Artery, Plate 98.—This artery 
(venae comites) has been described (page 118) and illustrated 
(Plates 64 and 65) in the anterior region of the thigh. If the 
dissection of the anterior region of the thigh has not preceded 
that of the posterior region, this artery will present at the inner 
side of the tendinous portion of the adductor magnus muscle, 
to the proximal side of the inner condyle of the femur. 
34. Internal Saphenous Aerve.—This nerve was before de- 
scribed (pages 113 and 114), as seen in the anterior region of the 
thigh. It is now seen, from its posterior aspect, in that portion 
of its course where it accompanies the last-described artery. 
Dissection.—Determine the articular branches of the popliteal artery and 
follow them to the antero-lateral areas of the knee. 
35. Articular Brandies of the Popliteal Artery.—The ar- 
ticular branches of this artery are five in number : the superior 
and inferior external articular, the superior and inferior in- 
ternal articular, and the azygos articular. The four first wind, 
respectively, to the antero-lateral areas of the knee-joint, to 
form with the anastomotica magna, from the femoral, and the 
anterior tibial recurrent (page 132 ; Plate 74), from the anterior 
tibial, the deep and superficial peri articular plexuses of the 
antero-lateral areas of the knee. The azygos articular branch 
perforates the posterior ligament of the knee-joint. 
Dissection.—Clear the surface of the quadratus femoris muscle and find 
the emergence of the internal circumflex artery at the internal portion of its 
inferior border. 
36. Quadrants Femoris Muscle, Plate 59 ; Fig. 1, Plate 91 ; 
Plates 95 to 100, inclusive.—A small area of the anterior sur- 
face of this muscle appeared in the anterior region of the thigh 
(page 120 ; Plate 65, and Fig. 2, Plate 66). Its posterior surface 
presents as an oblong muscle, running transversely, from the 
anterior surface of the posterior ramus of the ischium (Plate 
59), internally, to the posterior surface of the trochanter major 
of the femur, externally. It has the gemellus inferior muscle 
superiorly, and the adductor magnus muscle interiorly. 
Dissection.—Section the gluteus medius muscle (Plate 95) and reflect its 
portions, superiorly and interiorly, to their attachments, where they may be cut 
away, as in Plate 99 ; note the vessels entering the anterior surface of the mus- GLUTEAL AND POSTERIOR TIIIGII REGIONS. 
173 
cle. Follow tlie ramifications of the deep branches of the gluteal artery and 
the superior gluteal nerve, from their emergence into the gluteal region to 
their distribution. Clear the surface of the gluteus minimus muscle. 
37. Internal Circumflex Artery, Plate 98.—The terminal 
portion of this artery (venae comites) enters the inner side of 
the proximal portion of the posterior region of the thigh, be- 
tween the quadratus femoris and adductor magnus muscles. 
38. Deep Branches of the Gluteal Artery, Plate 99.—This 
artery (venae comites) appears in the gluteal region superior 
to the internal portion of the pyriformis muscle, between it 
and the gluteus minimus muscle ; it presents a superior and 
an inferior portion, which ramify between and supply the 
gluteus medius, and gluteus minimus muscles; the inferior 
portion also supplies the tensor vaginae femoris muscle. 
39. Superior Gluteal Nerve.—This nerve appears at the 
superior border of the pyriformis muscle ; between it and the 
gluteus minimus muscle. Its emergence is external to that of 
the last-described artery. It divides into a superior and an 
inferior portion ; they ramify between the gluteus medius and 
minimus muscles, and supply the same. The inferior portion 
also supplies the tensor vaginse femoris muscle. 
40. Gluteus minimus Muscle, Plates 59, 91, 99, and 100.— 
This muscle is located upon the exterior surface of the ilial por- 
tion of the os innominatum, to which it is attached between the 
middle and the inferior curved lines of that bone (Fig. 1, Plate 
91); inferiorly, it is attached to the anterior border of the 
trochanter major of the femur (Plate 59). Its internal border 
overlaps the superior border of the pyriformis muscle ; its an- 
tero-external border is covered by the tensor vaginse femoris 
muscle (Plate 61); on the removal of the latter it appears at the 
outer side of the proximal portion of the anterior surface of 
the thigh (Plates 62 to 65, inclusive ; and Fig. 2, Plate 66). 
Dissection.—Expose the internal pudic vessels and nerve, also the nerve to 
the obturator internus and the gemellus superior muscles, in the interval be- 
tween the internal ends of the pyriformis muscle and the great sacro-sciatic 
ligament. Clear the surfaces of the gemellus superior, the obturator internus, 
and the gemellus inferior muscles ; expose the proximal portion of the great 
sciatic nerve. 174 
LOWER EXTREMITY. 
41. Pudic Artery, Plates 95 to 100, inclusive.—In the dis- 
section of the interior of the pelvis this artery is described 
(page 75) and illustrated (Plates 39 and 40 ; Fig. 1, Plate 46). 
Emerging from the anterior surface of the internal portion of 
the pyriformis muscle it runs over the exterior of the spine 
of the ischium, and then enters the pelvic cavity by the small 
sacro-sciatic foramen ; after it enters the pelvis, it ramifies upon 
the obturator interims muscle, along the interior of the external 
wall of the iscliio-rectal fossa; this portion of its course has 
been described (pages 18 and 33) and illustrated (Plates 7, 13, 
and 14. 
42. I*udie tferve.—This nerve, branch from the sacral 
plexus, appears with the last-described artery and accompa- 
nies it upon the exterior face of the spine of the ischium ; it 
enters the pelvic cavity, with the artery, by the small sacro- 
sciatic foramen. Its subsequent course with the artery, along 
the interior of the external wall of the iscliio-rectal fossa, is de- 
scribed (page 18) and illustrated (Plates 7, 13, and 14). 
43. Xerve to llie Obturator Interims and the Gemellus 
Superior Muscles.—This nerve arises from the sacral plexus, 
and accompanies the pudic artery and nerve across the exterior 
surface of the spine of the ischium ; running external to them. 
It re-enters the pelvis by the small sacro-sciatic foramen to 
supply the obturator interims muscle ; before entering the fora- 
men it sends a branch to the gemellus superior muscle. 
44. Obturator Interims Muscle, Fig. 2, Plate 91, and Plates 
95 to 100, inclusive.—The internal attachment of the obturator 
interims muscle and its portion within the pelvic cavity has 
been described (pages 17 and 84) and illustrated (Plates 39 and 
40 ; and Fig. 1, Plate 46). It is projected into the deep plane 
of the gluteal region through the small sacro-sciatic foramen ; 
it continues, externally, to its attachment to the trochanter 
major of the femur (Fig. 2, Plate 91). 
45. Gemellus Superior Muscle.—This muscle is attached, 
internally, to the exterior surface of the spine of the ischium ; 
it continues therefrom, externally, between the obturator in- 
terims and the pyriformis muscles, to where it fuses with the 
tendon of the obturator in tern us muscle. GLUTEAL AND POSTERIOR TIIIGII REGIONS. 
175 
46. Gemellus Inferior Muscle.—This muscle is attached, 
internally, to the exterior surface of the body of the ischium ; 
it continues, externally, between the obturator internus and 
the quadratus femoris muscles, to where it blends with the 
tendon of the obturator internus muscle. 
47. Compound Tendon of the Obturator Internus, Gemel- 
lus Superior, and Gemellus Inferior Museles.—These three mus- 
cles join, at their external ends, forming a compound tendon, 
which is attached to the anterior portion of the internal face of 
the trochanter major of the femur (Fig. 2, Plate 91). 
Dissection.—Section tlie quadratus femoris muscle (Plate 98), and reflect 
the portions of the muscle to the tuberosity of the ischium and the trochan- 
ter major of the femur, respectively; cut them away, as in Plate 99. Find 
the nerve and artery entering the anterior surface of the inner portion of the 
muscle ; cut the nerve close to the muscle. Clear the posterior surface of the 
obturator externus muscle, and determine the internal circumflex artery and 
its branches. 
48. Internal Circumflex Artery, Plates 98, 99, and 100.—This 
artery (venae comites), branch of the profunda femoris (pages 
117 and 119 ; Plates 63, 64, and 65 ; and Fig. 2, Plate 66), pre- 
sents anterior to the quadratus femoris muscle, and there bifur- 
cates ; one branch is projected to the posterior region of the 
thigh between the quadratus femoris and the adductor magnus 
muscles (page 173); the other is an articular branch, which 
takes an external, and superior, course to the liip-joint. 
49. Obturator Externus Muscle, Plates 95 to 100, inclusive ; 
Plates 59, 66, and 91.—The anterior face of this muscle has 
been described (page 121) and illustrated (Plates 64, 65, and 
66); the posterior face of its external portion is shown, as it 
appears upon the removal of the quadratus l'emoris muscle 
(Plate 99). Internally, it comes from the anterior surface of the 
pelvis (Plate 59); externally, it passes, parallel with, and inte- 
riorly to the compound tendon of the obturator internus and 
the gemelli muscles, to its attachment, at the digital fossa on 
the internal face of the trochanter major of the femur. 
Dissection.—Section the compound tendon of the obturator internus, the 
gemellus inferior, and the gemellus superior muscles (Plate 99); reflect the 
muscles internally. In reflecting the gemellus inferior muscle note its nerve 
supply. Determine the bursa anterior to the inner portion of the obturator 176 
LOWER EXTREMITY. 
internus muscle. Cut the obturator internus muscle at the small sacro-sciatic 
foramen and the gemelli muscles from their internal attachments, as in Plate 
100. Section the obturator externus muscle (Plate 99) ; reflect it internally and 
cut it where it passes anterior to the tuberosity of the ischium, as in Plate 100. 
50. Nerve to the Gemellus Inferior Muscle, Plates 99 and 
100.—The nerve to this muscle enters its anterior face; it is a 
branch of the nerve to the quadratus femoris muscle. 
51. Bur§a of the Obturator Internus Muscle, Fig. 1, Plate 
4.—This large bursa is anterior to the obturator interims mus- 
cle, near the small sacro-sciatic foramen. 
Dissection.—Section the gluteal artery and the superior gluteal nerve 
(Plate 99) and clear away their branches; cut the gluteus minimus muscle 
(Plate 99) and reflect it, superiorly, to its ilial attachment, from which it may be 
cut away, as in Plate 100. Section the pyriformis muscle (Plate 99) and reflect 
it internally; cut it close to the great sacro-sciatic foramen, as in Plate 100. 
Follow the nerve to the quadratus femoris muscle, superiorly (Plate 99). De- 
termine the parts passing through the great and small sacro-sciatic foramina. 
52. Nerve to the Qiiatlratus Femoris Muscle, Plates 99 and 
100.—This nerve, from the sacral plexus, emerges from the pel- 
vic cavity by the great sacro-sciatic foramen, from the anterior 
of the pyriformis muscle; it continues inferiorly, upon the 
bone (ischium), anterior to the gemellus superior, obturator in- 
terims, and gemellus inferior muscles; it sends a branch to the 
gemellus inferior muscle, and its terminal portion enters the 
anterior surface oP the quadratus femoris muscle. It is accom- 
panied by a small branch from the sciatic artery. 
53. Parts Emerging at the Great Sacro-Sciatic Foramen, 
Plate 100.—The parts emerging from this foramen are : the 
pyriformis muscle; the pudic, the gluteal, and the sciatic ar- 
teries, with their comites veins ; the great sciatic, the inferior 
and superior gluteal, the small sciatic, and the pudic nerves; 
also the nerves to the obturator interims and the quadrates 
femoris muscles. 
54. Parts Passing through the Small Sacro-Sciatic Fora- 
men.—The parts passing through this foramen are : from within 
outwards, the obturator interims muscle; from without in- 
wards, the pudic artery and vein, the pudic nerve, and the 
nerve to the obturator interims muscle. PLATE 91 
FlG.l 
SPINE of th el VCHI ITM 
QUADRA TUS EEMOR/S — 
TROCHANTER MINOR 
SEM/ M EMBRANOSUS 
FIG. 2 
BICEPS — 
SEMI MEM BRA NOS US 
M.Cohn.aOt naturam. del. PLATE 92 
Branches of lumharnl 
-Branch of ilio-hi/fograstric 
Mranc7zofdorsal n. 
Branch CS of 
sacral nf 
Branches of small 
sciatic n. 
Jbranches of 
exfi cutaneous n. 
of smalt 
sciatic 7t- 
Branches of small 
sciatic at. PLATE 93 
2? Cch7:; ad 71 a eu r<zm c£e£t PLATE 94 
ADDUCTOR If A ONUS 
istperfaratincp art. 
Cutaneous- Iranc/i 
If. to PI A Mr A P /& 
Ou-terroot ofejctfsapSierz? 
71 • 
del. PLATE 95 
J-ftperforatingf art. 
JtCohr.ace szaturam ct*Z- PLATE 96 
r\ N.toOBTURAV 
\ INTERN US 
Sciatic art. 
TUBEROSITY 
\of the ISCHIUM 
Bursa 
Inffpudepdaln. 
SnzalZsciaticn. 
2 n.<* 
perforatin g 
AtltO B/CEE'S - 
&f. Cohn, adtna tureen del. PLATE 97 
Sciatic art. 
- Infrgluteal 7i 
-rtl.tO OBT US AT. I NT. 
Articular branch 
Audio art. 
-Small sciatic 
Comes 
nervi isch zadici 
-J/i ffpi/dendat 
Is* 
perforateart. 
BICEPS & SEMtTCND/NOSi/S 
JV.to ADDUCTOR MAGNUS 
J/'ftOSEMt TENO/NOSUS 
iV/tO S £ PI IM EMBRANOSUS 
J?rofunda fern or is art* 
-OEMITEHDIA/OSUS 
J14\ Coh n-, ad deZ. PLATE 98 
TxocuAfrrEn. MA.aofi - 
OB TUX A TOX EX TEBXUS 
imperforating art. 
V B / C E BS Sa 
EEAf/ T EA/O/NOSUE 
" SEM/ ME MB BA /V. 
■f/i t.lc£ rcuj/iffex 
art. 
3 *laperforating art. 
3 r.aperforatin g art. 
Profit nda 
fe/noris art. 
Supfext i art 
tcuiar art. 
xlaxta f?/S~. 
Out fA cad of 
a a sr/?oc/YtAf. 
3nf.rextf art 
icular a/'t. — 
Cohn.ctc£ncttz£r<z??z cZeZ.. PLATE 99 
„ „ .Deep branch of gluteal art 
SupTbranch of » nx v 
Snff " " » 
[.Superficial branch of glutealart. 
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Jtf.Cohn.ad>mturcvn ctet. FOURTEENTH DISSECTION. 
ARTICULATIONS OF ANKLE, FOOT, LEG, KNEE, 
AND HIP. 
Dissection.—At this stage of the dissection of the lower extremity the 
vertebral column should be disarticulated, between the fourth and fifth lum- 
bar vertebrae, so as to allow the limbs to be turned, as the dissection of their 
articulations may require. (The dissectors of the back will by this time have 
completed their work.) 
ARTICULATION OF THE ANKLE. 
Dissection.—Eaise the knee by blocks so as to flex it over them, and allow 
the foot to rest on the table. 
Terms of Relation.—The terms distal (from the trunk), 
proximal (toward the trunk), anterior surface, posterior sur- 
face, inner side, and outer side will be used. 
Bones of the Ankle-Joint, Plates 68 and 83.—The bones 
directly concerned in the construction of this joint are: the 
astragalus at its distal side ; the articulated tibia and fibula 
(by the inferior (distal) tibio-fibular articulation) at its proxi- 
mal side. The calcaneum contributes to this joint, in affording 
partial attachments to its lateral ligaments. 
Dissection.—Clear the surfaces of the external lateral, the internal lateral, 
and the anterior ligaments. 
1. External Lateral Ligament, Plates 101 and 103.—This 
ligament lias its proximal attachment to the distal end of the 
fibula (external malleolus); it spreads, by three slips, to its 
distal attachments: an anterior, to the outer side of the neck 
of the astragalus ; a middle, to the outer surface of the cal- 
caneum ; a posterior, to the outer side of the body of the 
astragalus. 
2. Internal Lateral Ligament, Plates 102 and 103.—This 
ligament has its proximal attachment to the distal end of the 178 
LOWER EXTREMITY. 
tibia; it spreads, deltoid-shaped, over the inner side of the 
ankle-joint to its distal attachment, to the astragalus and the 
border of the sustentaculum tali of the calcaneum (Plate 75). 
3. Anterior Ligament, Plates 101 and 103 ; Fig. 1, Plate 
102.—This ligament has its proximal attachment to the ante- 
rior borders of the distal ends of the tibia and fibula ; it 
bridges across the joint, to its distal attachment to the inner, 
the dorsal, and the outer surfaces of the distal portion of the 
neck of the astragalus. Some of its superficial fibres are con- 
tinued to the dorsal surface and the inner side of the scaphoid 
bone, blending with the dorsal astragalo-scaphoid ligament. 
At its inner side it meets the internal lateral ligament; at its 
outer side is the anterior slip of the external lateral ligament. 
Dissection.—Turn the limb so as to bring the posterior surface of the 
ankle-joint uppermost; flex the foot. Clear the ligaments at the posterior face 
of the joint. 
4. External and Internal Eatcral Ligaments of the Ankle- 
Joint, Fig. 2, Plate 102.—At the outer side of the posterior face 
of the ankle-joint is seen the posterior slip of the external 
lateral ligament; at its inner side the posterior border of the 
internal lateral ligament presents. 
5. Posterior Ligament.—This ligament consists of scattered 
fibres that pass from the outer lip of the groove on the poste- 
rior surface of the distal end of the tibia (for the tendons of 
the flexor longus digitorum and the tibialis posticus muscles), 
to the posterior surface of the body of the astragalus. 
ARTICULATIONS OF THE FOOT. 
Dissection.—Place tlie limb in the same position as for the dissection of 
the ankle-joint (page 177). Cut the tendons of the tibialis posticus and the 
tibialis anticus muscles, as in Plate 103 ; reflect their proximal portions to the 
proximal side of the ankle, where they may be cut. 
Terms of Relation.—The terms 'plantar surface, dorsal 
surface, outer side, inner side, proximal (toward the heel), 
and distal (from the heel) will be applied to indicate position 
and direction of ligaments. The regions of the foot will be 
designated as digital, metatarsal, and tarsal. ARTICULATION'S OF THE FOOT. 
179 
Bones of the Foot, Plates 68 and 75.—Twenty-six bones 
enter into the construction of the foot. In the digital region 
there are fourteen (page 128). In the metatarsal region five : 
the fire metatarsals. In the tarsal region seven : the three 
cuneiform—internal, middle, and external; the cuboid; the 
scaphoid; the calcaneum; and the astragalus. The dorsal, 
the plantar, and some of the lateral surfaces of the bones 
present areas for the attachments of ligaments. 
Articulations of tlie Foot.—The twenty-six bones of the foot 
form the following articulations : the nine digital, by which 
the fourteen bones of the digital region are arranged into 
the five digits ; the five metatar so-phalangeal, which join the 
digits to the heads of the metatarsal bones; the cuneo-meta- 
tarsal, or the joining of the first, second, and third metatarsals 
with the internal, middle, and external cuneiform, respectively ; 
the cubo-metatarsal, the contiguity of the fourth and fifth 
metatarsals with the cuboid; the inter cuneiform, the three 
cuneiform with each other; the cubo-cuneiform, the cuboid 
with the external cuneiform ; the scapho-cuneiform, the three 
cuneiform with the scaphoid ; the scapho-cuboid, the cuboid 
with the scaphoid; the calcaneo-cuboid, the cuboid with the 
calcaneum ; the astragalo-scaphoid, the scaphoid with the 
distal end of the astragalus; the astragalo-calcaneal, the su- 
perior surface of the calcaneum to the inferior surface of the 
astragalus. 
Dissection.—Clear the dorsal, the plantar, and the lateral surfaces of the 
digital articulations ; expose the ligaments at these surfaces respectively. 
1. Articulations of the Digits, Plates 104 and 101 ; Fig. 1, 
Plate 102.—These nine articulations have each four ligaments: 
two lateral, a dorsal, and a plantar. The lateral ligaments 
are situated one at either side of each joint, in the dorsal half 
of the lateral surfaces of the digit. The dorsal ligament oc- 
cupies the dorsal surfaces of the joint between the dorsal 
borders of the lateral ligaments. (Some authors ignore this 
ligament, others regard it as the dorsal portion of the syno- 
vial membrane of the joint.) The plantar ligament (Fig. 2, 
Plate 104) fills the space between the plantar borders of the 
lateral ligaments, bridging between the plantar surfaces of the 
bones forming the joint. It includes a plate of fibro-cartilage, 180 
LOWER EXTREMITY. 
whose plantar surface is covered by the sheath of the flexor 
tendons of the digit. 
Dissection.—Clear the surfaces of the metatarso-plialangeal articulations. 
Expose the four distal intermetatarsal interosseous ligaments. 
2. Metatarso-Phalangeal Articulations.—These joints, five 
in number, have the same construction as the digital. The 
plantar ligaments (Figs. 2 and 3, Plate 104) differ from those 
of the digits in that the plates of fibro-cartilage are much 
thicker. The two sesamoid bones opposite the joint of the 
first digit take the place of the fibro-cartilage plates of the 
joints of the other digits (page 149 ; Fig. 1, Plate 82). 
3. Distal Intermetatarsal Ligaments, Figs. 1 and 2, Plate 
104.—These four interosseous ligaments bridge between the 
plantar halves, of the opposed surfaces, of the distal ends of 
the metatarsal bones. 
Dissection.—Expose the dorsal ligaments: intermetatarsal; cuneo-meta- 
tarsal ; cubo-metatarsal; intercuneiform ; cuneo-cuboid ; scapho-cuneiform ; 
and scaplio-cuboid. 
4. Dorsal Intermetatarsal Ligaments, Plates 101 and 103.— 
These ligaments, three in number, pass between the dorsal sur- 
faces of the proximal ends of the second, third, fourth, and 
fifth metatarsal bones. 
5. Dorsal Cuneo-Mctatarsal Ligaments, Plates 101 and 
103 ; Fig. 1, Plate 102.—These ligaments pass from the dorsal 
surfaces of the first, second, third, and fourth metatarsal bones 
to the dorsal surfaces of the three cuneiform bones : from the 
first and second to the internal cuneiform ; from the second to 
the middle cuneiform ; from the second, third, and fourth to 
the external cuneiform. At the inner side of the articulation 
of the first metatarsal with the internal cuneiform the dorsal 
cuneo-metatarsal ligament passes to the plantar plane of the 
joint, to become continuous with its plantar ligament. 
6. Dorsal Cufoo-Metatarsal Ligaments, Plates 101 and 103. 
—These ligaments bridge from the bases of the fourth and 
fifth metatarsal bones to the cuboid bone. ARTICULATIONS OF TIIE FOOT. 
181 
7. Dorsal Intercmieiform and Cunco-Cuboid Ligaments. 
—These ligaments are three in number: two intercuneiform, 
between the three cuneiform bones ; one cuneo-cuboid, between 
the cuboid and the external cuneiform. 
8. Dorsal SeapUo-Cuneiforin Ligaments, Plates 101 and 
103 ; Fig. 1, Plate 102.—These ligaments, three in number, 
pass from the internal, middle, and external cuneiform bones 
to the scaphoid. The internal dorsal scapho-cuneiform liga- 
ment continues over the inner border of the foot to the plantar 
region, where it meets the internal plantar scapho-cuneiform 
ligament. 
9. Dorsal Scaplio-Cuboid Ligament, Plates 101 and 103.— 
This ligament bridges from the inner side of the cuboid to the 
scaphoid bone. 
Dissection.—Section the tendons of the peroneus brevis and longus mus- 
cles (Plate 103); depress the longus tendon so as to expose its entrance into the 
groove on the plantar surface of the cuboid bone (Plate 101). Reflect the 
proximal ends of the peronei muscles to the posterior surface of the fibula, 
where they may be cut. 
10. Tendons of the Peroneus Brevis and the Peroneus 
Longus Muscles.—These tendons appear along the outer side 
of the tarsal region of the foot, from the posterior surface of 
the distal end of the fibula ; they pass to their respective at- 
tachments, as before described (page 129). 
Dissection.—Expose the dorsal calcaneo-cuboid ligament; also, the outer 
borders of the short and long calcaneo-cuboid ligaments of the plantar region. 
11. Dorsal Calcaneo - Cuboid Ligament.—This ligament 
passes from the dorsal surface of the cuboid bone to that of 
the distal end of the calcaneum. Its fibres are continued 
upon the outer side of the opposed bones into the plantar 
region of the foot, where they meet the fibres of the short cal- 
caneo-cuboid ligament. 
12. Dorsal Calcaneo-Scaphoid Ligament.—This ligament 
bridges from the outer side of the scaphoid to the dorsal sur- 
face of the distal end of the calcaneum. 
13. External Astragalo-Calcaneal Ligament, Plates 101 and 
103 ; Fig. 2, Plate 106.—This ligament is located at the outer 182 
LOWER EXTREMITY. 
side of the astragalus, from the dorsal surface of the distal, and 
inner, portion of the calcaneum to the outer side of the neck of 
the astragalus. 
14. Dorsal Astragalo-Scaplioid Ligament, Plates 103 and 
101 ; Fig. 1, Plate 102.—This ligament crosses from the dorsal 
surface and the inner side of the scaphoid to the same sur- 
face and side of the head of the astragalus. The superficial 
fibres of the anterior ligament of the ankle-joint fuse with this 
ligament, so as to make it appear as if the anterior ligament 
was attached to the scaphoid bone (page 178). The inner por- 
tion of this ligament winds ujjon the inner face of the joint be- 
tween the two bones, to the plantar region, where it meets the 
plantar calcaneo-scaphoid ligament (Fig. 1, Plate 106). 
Dissection.—Extend tlie foot, with its plantar surface uppermost. Clear 
tlie surface of the ligaments and tendons of the plantar region, cutting away all 
muscles, vessels, etc. 
15. Plantar Intermctatarsal Ligaments, Plate 105 ; Fig. 1, 
Plate 106.—These ligaments, three in number, bridge between 
the plantar surfaces of the proximal ends of the second, third, 
fourth, and fifth metatarsal bones. 
16. Long Calcanco-Cuboid Ligament.—This superficial lig- 
ament, of the plantar region, has a proximal attachment to the 
distal half of the plantar surface of the calcaneum. Its distal 
attachments are: its deep fibres, to the proximal border of 
the peroneal groove of the cuboid bone; its superficial fibres 
spread as expansions across the plantar surface of the tendon 
of the peroneus longus muscle, which are attached to the proxi- 
mal ends of all the metatarsal bones—the strongest being those 
to the third, fourth, and fifth metatarsal bones. The plantar 
surface of the metatarsal expansions of this ligament affords 
attachments to the adductor pollicis and the flexor brevis 
minimi digiti muscles. 
17. Tendon of tlie Tibialis Posticus muscle, Plate 105.— 
The plantar portion of the tendon of this muscle was referred 
to in the eleventh and twelfth dissections (pages 145 and 162)„ 
It passes directly to its primary attachment to the tubercle of 
the scaphoid bone—on its way thereto it projects an attachment 
to the sustentaculum tali of the calcaneum. Superficial fibres ARTICULATION'S OF THE FOOT. 
183 
of the tendon expand : a direct slip passes to the plantar sur- 
face of the internal cuneiform bone ; a deflected portion passes, 
to the outer side, to the dorsal surface of the long calcaneo- 
cuboid ligament, and distally, to the dorsal surface of the ten- 
don of the peroneus longus muscle. 
18. Tendon of the Tibialis Anticus Muscle, Fig. 1, Plate 
102 ; Plate 105 ; Fig. 1, Plate 106.—The tendon of this muscle 
winds over the inner border of the tarsal region, to its plantar 
attachments, to the internal cuneiform bone and the proximal 
end of the first metatarsal bone. 
Dissection.—Section the long calcaneo-cnboid ligament (Plate 105); re- 
flect the distal portion to its cuboid and metatarsal attachments, and the prox- 
imal portion to the calcaneum; cut the ligament away, as in Fig. 1, Plate 
106. Demonstrate the course, lodgement, and attachment of the tendon of 
the peroneus longus muscle, and cut it away (Fig. 1, Plate 106). Cut the 
tendon of the tibialis posticus muscle; clear away its calcaneal and internal 
cuneiform expansions ; section its outer and distal expansions and trace them 
to their several attachments. Clear the surfaces of the plantar scaplio-cuboid, 
the short calcaneo-cuboid, and the plantar calcaneo-scaphoid ligaments. 
19. Fibro-Osseous Canal for the Tendon of the Peroneus 
Longus Muscle, Plate 105 ; Fig. 1, Plate 106.—The plantar por- 
tion of this tendon passes from the outer border of the tarsal 
region, at the cuboid bone, to its attachment to the outer side 
of the proximal end of the first metatarsal bone. In its first 
portion, it is lodged in the plantar groove of the cuboid bone ; 
in its second portion, it lies between the expansions of the long 
calcaneo-cuboid ligament, at its plantar surface, and the ex- 
pansions of the tibialis posticus tendon, at its dorsal surface. 
As lodged it is invested by a synovial sheath, which is closed 
at its outer end (Plate 101). 
20. Expansions of the Tendon of the Tibialis Posticus Mus- 
cle, Fig. 1, Plate 106.—The plantar attachments of this tendon 
have been partly described above—to the scaphoid, the cal- 
caneum, and the internal cuneiform bones. The deflected por- 
tion may now be traced : to the cuboid bone; to the middle 
and external cuneiform bones ; and to the proximal ends of 
the metatarsal bones, second to fifth, inclusive. 
21. Plantar Scaplio-Cuboid Ligament. — This ligament 
passes from the cuboid to the scaphoid bone. 184 
LOWER EXTREMITY. 
22. Short Calcaneo-Cufoold Ligament, Plate 105 ; Fig. 1, 
Plate 106.—This ligament is located at the dorsal surface of the 
long ligament. It is a short band of fibres between the plantar 
surfaces of the two bones. At its outer side it meets the fibres 
of the dorsal calcaneo-cuboid ligament (page 181; Plate 101), 
that are continued over the outer border of the tarsus. 
23. Plantar Calcaneo-Scaphoid Ligament.—This is a strong 
band of fibrous tissue, which bridges from the calcaneum to 
the scaphoid bone ; on its dorsal surface is lodged the head of 
the astragalus. At its inner border it is met by the fibres of the 
dorsal astragalo-scaphoid ligament (page 182 ; Fig. 1, Plate 102), 
that are continued over the inner border of the tarsal region. 
Dissection.—Dissect away the metatarsal expansions of the tendon of the 
tibialis posticus muscle (Fig. 1, Plate 106). Expose the plantar cubo-metatarsal, 
cuneo-metatarsal, intercuneiform, cuneo cuboid, and scapho-cuneiform liga- 
ments. 
24. Plantar Cnbo-Hetatarsal Ligaments, Fig. 1, Plate 106.— 
These ligaments unite the fifth and fourth metatarsal bones to 
the cuboid bone. 
25. Plantar Cunco-Metatarsal Ligaments. — These liga- 
ments pass from the plantar surfaces of the proximal ends of 
the first, second, and third metatarsal bones to those of the in- 
ternal, middle, and external cuneiform bones. 
26. Plantar Intcrcnnclform Ligaments.—These ligaments, 
two in number, bridge between the plantar surfaces of the 
three contiguous cuneiform bones, as do the dorsal ligaments 
(Plate 103); they are not as well marked as the dorsal. 
27. Plantar Cuneo - Cuboid Ligament. — This ligament 
crosses from the plantar surface of the cuboid to the same of 
the external cuneiform bone. 
28. Plantar Scaplio-Cuneiform Ligaments. — These liga- 
ments, three in number, bind the three cuneiform bones to the 
scaphoid bone. 
Dissection.—Disarticulate the metatarsal bones from the three cuneiform 
and the cuboid bones; cut apart the bases of the metatarsal bones ; disarticu- 
late the cuboid and scaphoid bones from the calcaneum and astragalus; sep- ARTICULATIONS OF THE FOOT. 
185 
arate the scaphoid from the cuboid ; stand the three cuneiform and the cuboid 
bones upon their distal surfaces, clear away their plantar ligaments, and 
spread the bones apart (Fig. 3, Plate 106); section the ligaments of the ankle- 
joint ; turn off the astragalus from the calcaneum (Fig. 2, Plate 106). In mak- 
ing these disarticulations note the interosseous ligaments that present passing 
between the opposed surfaces of the bones. 
29. Interosseous Ligaments of tlie Metatarsus and Tarsus. 
—Between the surfaces of the bases of the metatarsal bones 
are four proximal interosseous ligaments (Fig. 3, Plate 104). 
Ligaments unite the internal cuneiform to the second meta- 
tarsal, and the external cuneiform to the fourth metatarsal. 
At the opposed angles of the scaphoid and cuboid bones a 
ligament passes, and an offshoot from it joins them to the con- 
tiguous angle of the calcaneum. Between the plantar halves of 
the opposed surfaces of the three cuneiform and the cuboid 
bones ligaments bridge (Fig. 3, Plate 106). A posterior astrag- 
alo-calcaneal ligament passes from the dorsum of the calca- 
neum to the posterior border of the astragalus (Fig. 2, Plate 
102). The opposed surfaces of the calcaneum and the astrag- 
alus are united by an interosseous ligament (Fig. 2, Plate 106). 
ARTICULATIONS OF THE TIBIA AND FIBULA. 
Terms of Relation.—Same as for the description of the 
ankle-joint (page 177). 
Bones and Articulations, Fig. 1, Plate 67 ; Plate S3.—The 
bones are : the tibia and the fibula. The articulations are : the 
inferior (distal) tibio-fibular and the superior (proximal) tibio- 
fibular ; the shafts of the bones are bound to each other by an 
interosseous ligament. 
Dissection.—Clear the anterior and posterior surfaces of the inferior (dis- 
tal) tibio-fibular articulation. Dissect away the posterior (inferior) distal 
tibio-fibular ligament, so as to expose the interosseous ligament of the joint. 
1. Inferior (Distal) Tifoio-Fllmlar Articulation, Plates 101 
and 103 ; Fig. 2, Plate 102.—This articulation is formed by the 
distal ends of the fibula and tibia. Its ligaments are : anterior, 
posterior, and interosseous. The anterior inferior (distal) tibio- 
fibular ligament extends, obliquely, from the anterior and 
inner border of the distal end of the fibula to the anterior and 186 
LOWER EXTREMITY. 
outer border of the distal end of the tibia. The posterior infe- 
rior (distal) tibio-fibular ligament bridges, obliquely, from the 
inner lip of the groove (for the tendons of the peroneus longus 
and brevis muscles) on the posterior surface of the distal end of 
the fibula, to the posterior surface of the distal end of the 
tibia. Cutting away tlie last-described ligament the inferior 
{distal) interosseous tibiofibular ligament is seen between the 
opposed surfaces of the bones. 
Dissection.—Clear the anterior and posterior surfaces of the shafts of the 
tibia and fibula, and those of the tibio-fibular interosseous ligament between 
them. Note the areas of the muscle attachments. 
2. muscle Attachments to tlie Shafts of the Tibia and 
Fibula and to the Interosseous Ligament, Plates 67 and 83.— 
To their posterior surfaces are attached : the flexor longus digi- 
torum, the tibialis posticus, the soleus, and the popliteus, to the 
tibia; the flexor longus pollicis, the tibialis posticus, and the 
soleus, to the fibula; tlie tibialis posticus, to the interosseous 
ligament. To tlie outer surface of the fibula: the peroneus 
longus and the peroneus brevis muscles. To the anterior and 
inner surfaces of the fibula the extensor longus digitorum, 
peroneus tertius, and flexor proprius pollicis muscles. To tlie 
outer surface of the tibia : the tibialis anticus muscle. 
3. Tibio-Fibular Interosseous Ligament, Fig. 1, Plate 67 ; 
and Plate 83.—This ligament bridges from the inner border of 
the shaft of the fibula to the outer border of the shaft of the 
tibia. It presents a distal opening for the transit of the an- 
terior peroneal artery (page 162 ; Plate 90) ; a proximal one 
for the anterior tibial artery (page 132 ; Plate 74) ; and in- 
termediate ones for branches of the anterior tibial artery. 
Dissection.—Clear tlie antenor and posterior surfaces of the superior 
(proximal) tibio-fibular articulation. Preserve the stumps of the attachments 
of the soleus and biceps muscles, to the fibula ; also, the external lateral and 
posterior ligaments of the knee-joint. 
4. Superior (Proximal) Tibio-Fibular Articulation, Plate 
107; Fig. 2, Plate 108; Fig. 1, Plate 109.—This joint is formed 
by the opposing of the proximal end of the fibula to the facet 
on the distal surface of the outer tuberosity of the tibia. The 
ligaments are: an anterior and a posterior. The anterior ARTICULATION OF THE KNEE. 
187 
superior (proximal) tibiofibular ligament passes from the 
inner border of the anterior surface of the proximal end of the 
fibula to the outer tuberosity of the tibia. The posterior supe- 
rior (proximal) tibiofibular ligament bridges from the border 
of the posterior surface of the proximal end of the fibula to the 
outer tuberosity of the tibia. The external lateral ligament of 
the knee-joint, by its distal attachment to the proximal end 
of the fibula, is accessory to this joint (Fig. 1, Plate 107). 
ARTICULATION OF THE KNEE. . 
Terms of Relation.—The terms in the description of this 
articulation are those used for the ankle (page 177). 
Bones of the Knee-joint, Plates 59, 83, and 91.—The bones 
which enter into the construction of the knee-joint are : the 
tibia, the femur, and the patella, directly ; with the fibula, in- 
directly, in its affording attachment to a ligament of the joint. 
Dissection.—Clear tlie posterior, the lateral, and the anterior surfaces of 
the knee-joint, preserving the muscle attachments in its vicinity. 
1. Muscle Attachments to tlie Surfaces of the Knee, Plates 
59, 67, 88, 107,108, and 109 ; Figs. 1 and 2 of Plate 110.—To 
the tibia are attached : the quadriceps extensor femoris muscle 
(page 115), at the tubercle of the bone (ligamentnm patellae) 
and at the antero-lateral surfaces of the tuberosities (lateral 
expansions of the aponeurosis); the compound aponeurosis of 
the sartorius, the semitendinosus, and the gracilis muscles to 
the antero-lateral face of the inner tuberosity ; the semimem- 
branosus and the popliteus, to the posterior surface of the 
inner tuberosity. To the fibula: the biceps and the soleus. 
To the patella: included as this bone is (sesamoid bone) in the 
compound aponeurosis of the quadriceps extensor femoris 
muscle, it receives, at the anterior surface of its proximal and 
lateral borders, the four muscles contributed to the aponeuro- 
sis (Plate 59); the latter projects from its distal tip and lateral 
borders as the ligamentnm patellm and lateral expansions of 
the aponeurosis. To the femur: the plantaris and gastroc- LOWER EXTREMITY. 
nemius (outer head), to the proximal side of the outer con- 
dyle ; the adductor magnus and gastrocnemius (inner head), 
to the proximal side of the inner condyle ; the popliteus, to 
the outer face of the outer condyle (Fig. 2, Plate 110). 
2. Posterior Ligament, Fig. 2, Plate 108.—This ligament 
has its distal attachment to the tibia ; its proximal attachment 
is to the femur, at the proximal side of its condyles. It meets on 
either side the posterior borders of the respective lateral liga- 
ments of the joint. At its inner side it is contributed to by the 
tendon of the semimembranosus muscle (page 171). At its 
middle it is perforated by the azygos articular branch of the 
popliteal artery, and by the articular branches from the inter- 
nal popliteal and obturator (page 118 ; Plate 64) nerves. 
3. External Lateral Ligament, Fig. 1, Plate 107.—This, a 
short, round ligament, bridges from the proximal end of the 
fibula to the outer condyle of the femur. 
4. Tendon of tlie PopIIteus muscle, Fig. 1, Plate 107 ; Fig. 
2, Plate 108 ; Fig. 1, Plate 109 ; Fig. 2, Plate 110.—The proxi- 
mal attachment of this muscle is to the outer condyle of the 
femur, within the ligaments of the joint; its tendon winds to 
the posterior surface of the knee, where it emerges from within 
the ligaments, at a point between the external lateral ligament 
and the border of the outer fibro-cartilage of the joint; in its 
course it is attached to the convex border of the latter. The 
muscle expands, as it passes to its distal attachment, to the 
posterior surface of the proximal end of the tibia (Plates 88, 
90, and 98). 
5. Internal Lateral Ligament, Fig. 2, Plate T07.—This lig- 
ament bridges from the inner tuberosity of the tibia to the 
inner condyle of the femur; some of its fibres wind round to 
be attached to the posterior surface of the tuberosity of the 
tibia. 
6. Anterior Ligament, Plates 64, 65, and 107 ; Fig. 1, Plate 
108 ; Fig. 2, Plate 109.—This ligament was cut at the circum- 
ference of the patella, and partly described, at page 116. It 
is attached to the anterior of the femur proximally to its con- ARTICULATION OF THE KNEE. 
189 
dyles ; the borders of the patella ; and the anterior borders of 
the tibial tuberosities and the lateral ligaments. Interiorly it 
is lined by the synovial membrane of the joint. 
Dissection.—Section the popliteus muscle and the external lateral liga- 
ment (Fig. 1, Plate 109); then dissect up the proximal end of the tendon of the 
popliteus muscle and cut it to the proximal side of its attachment to the con- 
vexity of the outer fibro-cartilage (Fig. 1, Plate 110). Cut, transversely, 
through the internal lateral ligament, the posterior ligament, and the anterior 
ligament of the joint. Manipulate the joint so as to expose the anterior and 
posterior surfaces of the two crucial ligaments, in situ. Section the crucial 
ligaments ; display their portions, following them to their distal and proximal 
attachments, respectively. Expose the fibro-cartilages, their transverse and 
coronary ligaments. 
7. Crucial Ligaments, Figs. 1 and 2, Plates 109 and 110. 
—Flexing the knee-joint, the anterior surfaces of these two 
ligaments are seen crossing each other between the tibia and 
femur (Fig. 2, Plate 109); extending the joint, their posterior 
surfaces are exposed (Fig. 1, Plate 109). The anterior or ex- 
ternal bridges from the depression anterior to the spine— 
between the articular surfaces—of the tibia, to the outer wall 
of the intercondyloid notch of the femur. The 'posterior or 
internal passes from the depression posterior to the spine— 
between the articular surfaces—of the tibia, to the inner wall 
of the intercondyloid notch of the femur. Besides the attach- 
ments given of these ligaments, they are, respectively, attached 
to the contiguous tips of the fibro-cartilages. 
8. Fiforo-Cartilages, Fig. 1, Plate 110; Fig. 2, Plate 109.— 
These are two semilunar plates of fibro-cartilage, which are thick 
at their convex and thin at their concave borders; they are 
lodged upon the articular surfaces of the inner and the outer 
tuberosity, respectively, of the tibia ; the inner being the larger 
of the two. The horns of these fibro-cartilages approach 
each other, at the depressions anterior and posterior to the 
spine of the tibia, where they are attached. As before stated, 
the tibial attachments of the crucial ligaments intervene be- 
tween the fibro-cartilages ; some of the ligament fibres are 
attached to their tips. The tendon of the popliteus muscle 
is attached to the convex border of the outer fibro-cartilage 
(page 188). 190 
LOWER EXTREMITY. 
9. Transverse Ligament, Fig. 1, Plate 110.—This ligament 
passes between the anterior borders of the fibro-cartilages. 
10. Coronary Ligament.—This is a circumferential liga- 
ment, that bridges from the convexities of the fibro-cartilage 
plates to the border of the tibia; anteriorly and posteriorly, 
fibres of the crucial ligaments are continued to it. 
AKTICULATION OF THE HIP. 
Dissection.—Eaise the pelvis on a block with its posterior surface upper- 
most. Cut away all the muscles attached to the surfaces of the os innominatum 
and the proximal end of the femur. 
Terms of Relation.—The general terms of relation (page 
2) will be used in the description of the hip-joint. 
Bones of the Articulation, Plates 59 and 91.—The femur— 
head and neck—and the os innominatum—cotyloid cavity 
(acetabulum)—are the bones forming the ilio-femoral articula- 
tion or liip-joint. 
Dissection.—Clear the posterior surface of the capsular ligament of the 
joint. 
1. Posterior Portion of the Capsular Ligament, Fig. 1, 
Plate 111.—The posterior portion of the circumference of the 
neck of the femur, internal to the muscle attachments to the 
trochanter major and minor of the femur (Plates 99 and 100), 
affords attachment to the external end of this portion of the 
capsular ligament. Its internal attachment is to the posterior 
part of the rim and of the exterior surface of the cotyloid cav- 
ity of the os innominatum. 
Dissection.—Turn the pelvis upon the block with its anterior surface up- 
permost. 
2. Anterior Portion of the Capsular Ligament, Plate 112, 
and Fig. 1, Plate 66.—The capsular ligament is continued cir- 
cumferentially from its posterior portion, around the neck of ARTICULATION OF THE IIIP. 
191 
the femur and the exterior of the cotyloid cavity of the os in- 
nominatum. The anterior portion presents a complete sheet of 
fibrous tissue, in which can be defined three bands: the ilio- 
femoral band, the ilio-femoral ligament, and the pubio-femoral 
band. The ilio-femoral band forms the superior portion of the 
capsular ligament, from the internal face of the trochanter 
major, to the exterior surface of the superior portion of the 
cotyloid cavity of the ilium. The iliofemoral ligament passes 
from the anterior surface of the neck of the femur—along the 
anterior intertrochanteric line—to the anterior portion of the 
exterior surface of the cotyloid cavity—as high as the anterior- 
inferior spinous process of the ilium. The pubiofemoral band 
bridges from the neck of the femur, externally and superiorly 
to the trochanter minor, to the anterior surface of the horizon- 
tal ramus of the pubic portion of the os innominatum, inter- 
nally to the attachment of the ilio-femoral ligament. 
Dissection.—Section tlie anterior, the superior, and the inferior portions 
of the capsular ligament, circumferentially; fold its inferior and external por- 
tions back, like the sleeve of a coat, upon the trochanters of the femur; slit its 
superior part, as in Fig. 2, Plate 111, and reflect the portions, internally. Dis- 
locate the head of the femur from the cotyloid cavity, and allow the femur to 
hang by the ligamentum teres and the posterior portion of the capsular liga- 
ment. 
3. Cotyloid Fiforo-Cartilage (Cotyloid Ligament), Fig. 2, 
Plate 111; Fig. 3, Plate 110.—This is a circumferential libro- 
cartilage, that rims the border of the cotyloid cavity. When 
the head ot‘ the femur is lodged in the cotyloid cavity, it ap- 
plies itself to it—like a tight india-rubber band—and holds 
the ball-like head of bone into the socket of the joint. 
4. Ligamentum Teres.—This is an interosseous ligament, 
that passes from a depression in the inferior half of the con- 
vexity of the head of the femur, to the internal portion of the 
cotyloid cavity of the os innominatum. 
5. Transverse Ligament.—This is the name given to that 
portion of the cotyloid fibro-cartilage, that bridges across the 
notch at the internal border of the cotyloid cavity. Its interior 
surface is articular, being applied to the circumference of the 
head of the femur. 192 
LOWER EXTREMITY. 
Dissection. —Section tlie ligamentum teres and the posterior portion of the 
capsular ligament, thus removing the femur and exposing the cotyloid cavity. 
Cut the transverse ligament from its superior attachment to the cotyloid notch 
and reflect it, interiorly, as in Fig. 3, Plate 110 ; demonstrate the cotyloid at- 
tachment of the ligamentum teres to the interior surface of the transverse lig- 
ament. Expose the articular branch of the obturator artery and nerve, respec- 
tively, that pass through the cotyloid notch, into the ligamentum teres ; also 
the articular branch of the internal circumflex artery. 
6. Cotyloid Cavity.—This is a half-egg shaped cavity, at 
the exterior of the os innominatum, having an articular and a 
non-articular portion. The articular portion occupies the cir- 
cumference of the interior of the cavity, from the free border 
thereof, inwardly—with a deficiency at the notch ; it is ap- 
plied, when articulated, to the circumference of the head of the 
femur. The non-articular portion is at the internal part of 
the cavity, forming an oval depression; when the head of the 
femur is articulated, this portion of the cavity allows the liga- 
mentum teres to be lodged without being compressed. 
7. Cotyloid Attachment of the Ligamentum Teres.—This 
attachment of the ligament is to the non-articular part of the 
cotyloid cavity and to the interior of the transverse ligament, 
directly opposite the foramen formed by the notch and the 
transverse ligament. 
8. Cotyloid Notch, Plate 59 ; Fig. 3, Plate 110.—This notch 
is a gap in the internal wall of the cotyloid cavity, which the 
transverse ligament portion of the cotyloid fibro-cartilage con- 
verts into a foramen. The concavity of the notch is at the level 
of the non-articular portion of the cotyloid cavity. 
9. Articular Arteries and Nerve, Fig. 3, Plate 110.—The 
obturator and the internal circumflex arteries have, each, an 
articular branch, which supply the joint, entering the coty- 
ioid notch to reach the ligamentuin teres ; one is larger than or 
may take the place of the other. The obturator nerve supplies 
an articular branch, which accompanies the articular vessels 
into the joint. PLATE 101 PLATE 102 
FlG.J 
Fig. 2 
7tt<z<£ rzctCzt/'tzfn- €6. PLATE 103 
JZxt? asirac/ttfo* 
i:uZcct/ie*JZ Zitf*7** 
JSxti'caZean eo- - 
.■scapZiozaC lief"?* 
JZorxfscapZio - - 
cuZzozol 
Dors! ca Zccz 7t eo - 
ctzboici ZigrnZt " 
Dorsal scaph o- 
cuneiform li<f"‘.ts 
Trt tfscapho-cunei- 
for/ft lig"lt 
Dorsal inter- 
r— cuneiform lt<fm.ts 
Middle CllPDlDOXAf. 
Dorsal inter 
cu/ieo- 
metatarsal Zcy’,its 
M-Cohnyadnaturam deZ. PLATE 104 
Fig. 1 
Fig. 2 
Fig. 3 
Proximal in term. eta. Zarsi 
Zigrmt 
Z a. ter a? liqmf* 
Jf-C0?inra.<2 naturam get. PLATE 105 
Groove for EL EXf 
LON CUE POLL/C/S 
Expansions of 
tendon ofT/B/AL/S. 
POST/ COS \ 
scapho in 
Plantar cubo- 
metatarsal liyr'l11' 
PE RON E US 
/ BPEtt/S 
Attachments of 
FLEX ? BRE It. POL L 
Attachment of% 
ADD* POLL/C/S _ 
f Attachments 
o/FLEX? BREV. 
MINIMI DIG / 77 
Plantar citneo- ‘ 
metatarsal lit?-- 
Plantar inter- 
'metatarsal 
li(f'r,/s 
J£Cohn,adna.iu.ram del. PLATE 106 
Ftg. i 
Expansion of tendon 
TIBIA l IS COST/COS 
Dorsf astro, galo-^caphoid^ 
It ant Iscaptzo-cuneiform 
li gazes ' -a 
Middle cumjctb on m 3 
Uxtl /- « 
1*1 an tfcuneo -metatarsi 
lityrtnts 
Fj-g. 2 
Fig. 3 
hf. Co.zrz, aatnctturczm cteZ. PLATE 107 
ttG.2 
Fia. z 
JiZ.Ce/zn, adnaturam deZ. PLATE 108 
J’SG.Z 
M.Cohn.acirza(ur<zm del- 
J'lG. 1 PLATE 109 
M".Cohn,ac(rzaturam eiei. 
Fra. 2 
Jia.l PLATE 110 
Fig. 2 
Fig. 2 
2<LCctTzjz.cuZ. rzatiLram del. PLATE 111 
Fig. 2 
Fig . 1 
J'LOoh’i, adnatdraiti del, PLATE 112 
Af.(?0sin,a.ci natzzrazn <£&£- UPPER EXTREMITY. 
FIFTEENTH DISSECTION. 
ANTERIOR OF THORAX, AXILLA, AND ARM. 
Dissection.—The subject lying upon the back, place a block under the 
thorax ; upon the block lay a board, five inches wide and long enough to reach 
beyond the tips of the fingers of the outstretched limbs. The two upper ex- 
tremities should be extended, upon their dorsal surfaces, on the board and the 
ends of the fingers tacked thereto. 
Terms of Relation.—To the anterior of the thorax and the 
axilla the general terms of relation (page 2) are applied. For 
the anterior of the arm are used the general terms anterior and 
Figube 9- 
'posterior; the special terms proximal (toward the trunk), dis- 
tal (from the trunk), inner side, and outer side to its respec- 
tive lateral surfaces. 
Bone Areas, Plate 113.—The anterior surfaces of the follow- 
ing bones, parts of bones, and cartilages form the framework 
of this dissection, and afford attachments to muscles: the 
sternum ; the six superior costal cartilages and ribs ; the infer 194 
UPPER EXTREMITY. 
rior border of the clavicle ; the body (anterior surface and ex- 
ternal border) and the coracoid process of the scapula; the shaft 
and condyles of the humerus ; the proximal ends of the radius 
and ulna. 
Dissection.—Make the skin incisions 1, 2, 3, 4, and 5 of Figure 9 (page 
193) ; reflect skin flaps as indicated, thereby exposing the anterior of the 
thorax and arm; make a circular incision around the nipple. Expose the 
mamma (especially in the female) and its vessels; dissect the gland from 
the superficial fascia and section it so as to see its structure. As the mamma 
is removed, section its supplying vessels, at the points where they emerge 
through the thoracic parietes and wind over the anterior fold of the axilla. 
l. Mamma, Plate 114.—This is one of two glands, lodged, 
between a superficial and a deep lajTer of the subcutaneous tis- 
sue, upon the fascia of the anterior parietes of the thorax. At 
the nipple the orifices of the lactiferous tubes appear, which 
may be demonstrated, at times, by the introduction of bristles ; 
it presents, on section, a dense, milk-white structure. 
Dissection.—Remove the subcutaneous tissue from the fascia of the an- 
terior of the thorax and the anterior of the arm. Expose and preserve the 
vessels and nerves emerging at the interspaces between the costal cartilages; 
note the thoracic attachment of the platysma myoides muscle ; also the ends 
of the sternal, clavicular, and acromial nerves, from the cervical plexus. 
2. Perforating Branches of the Internal Mammary Artery, 
Plates 114 and 115.—At the interspaces between the costal 
cartilages branches (venm comites) from the internal mammary 
artery perforate to the subcutaneous plane of the thoracic 
parietes. In females these arteries are larger than in males. 
3. Anterior Cutaneous Branches of the Intercostal UJerves. 
—The anterior cutaneous branches of the intercostal nerves 
emerge through the thoracic parietes, with the last-described 
arteries. 
4. Platysma Myoides Muscle, Plate 115.—This subcutane- 
ous muscle lias its thoracic attachment to the superficial fascia 
interiorly to, and parallel with, the clavicle. 
5. Sternal, Clavicular, and Acromial Nerves of tlie Cer- 
vical Plexus.—The terminal portions of these nerves emerge 
into the subcutaneous tissue of the respective areas of their 
distribution. ANTERIOR OF THORAX, AXILLA, AND ARM. 
195 
Dissection.—Trace the subcutaneous veins of the anterior of the arm and 
elbow. 
6. Cephalic Vein.—This vein has a longitudinal and proxi- 
mal course, in the outer half of the anterior of the arm. It re- 
sults from the confluence of the radial and median-cephalic veins. 
At its proximal end it perforates the fascia at the intermuscu- 
lar space between the deltoid and pectoralis major muscles. 
7. Basilic Vein.—This vein is subcutaneous for the distal 
third of the inner half of the anterior of the arm. At its dis- 
tal end it is formed by the joining of the ulnar and the median- 
basilic veins ; at its proximal end it perforates the superficial 
fascia, at about the middle of the inner side of the arm. 
8. Median Vein.—This vessel appears at the middle of the 
proximal third of the anterior surface of the forearm, where it bi- 
furcates into the median-cephalic and the median-basilic veins. 
Dissection.—Find tlie cutaneous nerves of the anterior and inner side of 
the arm. 
9. Internal Cutaneous Nerve.—This nerve perforates the 
fascia of the arm, in company with the basilic vein ; it has a 
distal course posteriorly to the basilic vein, and continues into 
the ulnar side of the forearm ; a branch runs along the outer 
side of the basilic vein, continuing into the forearm posteriorly 
to the median-basilic vein. 
10. Small Internal Cutaneous Nerve.—This nerve comes 
through the fascia near the exit of the internal cutaneous 
nerve ; it distributes to the skin of the distal half of the inner 
side of the arm. 
11. Axillary Fascia.—This is that portion of the superficial 
fascia, which bridges between the folds of the axilla. It is per- 
forated by the intercosto-humeral (second intercostal) and the 
lateral cutaneous branches of the third, fourth, fifth, and sixth 
intercostal nerves. 
12. Intercosto-Humeral Nerve.—This nerve is the lateral 
cutaneous branch of the second intercostal nerve, which per- 
forates the axillary fascia and communicates with the lateral 
cutaneous branch of the third intercostal nerve; it supplies 
the skin of the proximal half of the inner side of the arm. 196 
UPPER EXTREMITY. 
13. Inferior Cutaneous Branch of the Musculo - Spiral 
Nerve.—This nerve appears, for a portion of its course, at the 
outer side of the radial vein ; it is continued to the radial side 
of the forearm. 
Dissection.—Remove the fascia from the pectoralis major muscle and. the 
humeral ends of the latissimus dorsi and teres major muscles; expose the 
serrations of the serratus magnus muscle. Dissect out of the adipose tissue in 
the axilla the arteries and nerves upon the axillary surfaces of these muscles. 
Display the boundaries of the axilla. 
14. Pectoralis Major Muscle, Plates 113 and 116.—This is 
the superficial muscle of the anterior thoracic parietes. It ex- 
tends from the sternum, the costal cartilages—second to sixth, 
inclusive—and the internal half of the antero-inferior border 
of the clavicle. It is attached, externally, to the outer lip of 
the bicipital groove of the humerus ; an interval presents be- 
tween its sternal and clavicular portions. Its inferior border 
forms the anterior fold or border of the axilla. 
15. Latissimus Dorsi Muscle, Plates 113, and 116 to 120, in- 
clusive.—The superior end of this muscle winds from the pos- 
terior of the trunk, to reach its humeral attachment. Its an- 
terior free border, from the thorax to the humerus, forms the 
posterior fold of the axilla. 
16. Teres Major Muscle.—This muscle lies posteriorly to 
the humeral end of the latissimus dorsi muscle, extending from 
the posterior surface of the scapula, near its angle, to the hu- 
merus. It contributes to the posterior fold of the axilla. 
17. Serratus Magnus Muscle, Plate 116.—The exteriors of 
the third, fourth, fifth, and sixth serrations of this muscle form 
the thoracic floor of the exposed portion of the axilla between 
the pectoralis major and the latissimus dorsi muscles. Those 
to the fifth and sixth ribs form an interdigitation with the su- 
perior digitation of the obliquus externus muscle. 
18. Lateral Cutaneous Branches of the Intercostal Nerves 
and Arteries.—The lateral cutaneous branches of the second, 
third, fourth, fifth, and sixth intercostal nerves emerge between 
the serrations of the serratus magnus muscle. They are ac- 
companied by the lateral branches of the corresponding inter- 
costal arteries. ANTERIOR OF THORAX, AXILLA, AND ARM. 
197 
19. Axilla ami its Boundaries.—The axilla is a pyramidal 
space, inferior]y to the slioulder-joint; its anterior wall is 
formed by the pectoralis major and pectoralis minor muscles; 
its posterior wall is contributed to by a portion of the latissi- 
mus dorsi, the teres major, and the subscapularis muscles. 
Its internal wall is the lateral thoracic parietes, covered by 
the serratus magnus muscle. Superiorly, it is bounded by 
the coraco-bracliialis and the biceps (short head) muscles, the 
scapulo-humeral joint, and the deltoid muscle. The folds of 
the axilla bound its outlet ; the anterior is formed by the infe- 
rior border of the pectoralis major muscle ; the posterior is con- 
tributed to by the latissimus dorsi and the teres major muscles. 
Between these folds bridges the axillary fascia, through which 
lateral cutaneous branches of intercostal nerves pass. Within the 
axilla are lodged the axillary artery and vein with their branch- 
es ; also the axillary portion of the brachial plexus of nerves. 
Dissection.—Section the cephalic vein (Plate 115) and reflect it upon the 
forearm. Remove the fascia from the anterior portion of the deltoid muscle ; 
trace into the shoulder the proximal end of the cephalic vein ; find the humeral 
branch of the acromio-tlioracic artery. 
20. Deltoid Muscle, Plates 113, and 116 to 120, inclusive.— 
The anterior or clavicular portion of this muscle covers the 
anterior and outer face of the shoulder-joint; its fibres extend 
from the external half of the antero-inferior border of the clav- 
icle to the outer side of the shaft of the humerus, at about the 
junction of its proximal and middle thirds. 
21. Cephalic Vein, Plate 116.—This vein continues its prox- 
imal course, from the point where it perforates the fascia (Plate 
115), in the intermuscular space between the pectoralis major 
and the deltoid muscles. 
22. Humeral Branch of tlie Acromlo-TIioraclc Artery, 
Plates 116 and 117.—This artery (vena comes) has a distal 
course, in company with the proximal end of the cephalic vein. 
Dissection.—Remove the fascia from the arm, thereby exposing the ante- 
rior surfaces of portions of the biceps, bracliialis anticus, supinator longus, and 
extensor carpi radialis longior muscles. 
23. Biceps Muscle, Plate 116.—This muscle is continued 
into the arm from the posterior of the pectoralis major muscle; 198 
UPPER EXTREMITY. 
it has a longitudinal course through the arm, to the elbow, 
where its tendon and the fascial expansion of the same (bicipi- 
tal fascia) pass to the forearm. 
24. Bracliialis Anticus Muscle.—A portion of this muscle 
appears to the outer side of the distal half of the biceps muscle. 
25. Supinator Longus Muscle.—The proximal portion of 
this muscle is located to the outer side of the brachialis anticus 
muscle. It is continued to the forearm upon the outer side of 
the anterior surface of the elbow. 
26. Extensor Carpi Radialis Longior Muscle.—At tile 
elbow a portion of this muscle appears, along the outer side 
of the supinator longus muscle. 
Dissection.—Expose the nerves, artery, and veins at the inner side of 
the biceps muscle ; also portions of the triceps and coraco-bracliialis muscles; 
find the musculo-cutaneous nerve at the outer side of the distal portion of the 
biceps muscle (Plate 11G). 
27. Basilic Vein.—This vein has a proximal course to the ax- 
illa, which it enters posteriorly to the pectoralis major muscle. 
28. Median Nerve.—This nerve emerges from the axilla, 
from the posterior surface of the pectoralis major muscle; it 
takes a distal course along the inner side of the arm, between 
the basilic vein and the inner border of the biceps muscle. 
29. Brachial Artery.—Posteriorly to the median nerve this 
artery (venae comites) will be found, having a longitudinal and 
distal course, from the distal border of the humeral end of the 
teres major muscle along the inner side of the arm, posteriorly 
to the inner third of the biceps muscle. 
30. Internal Cutaneous Nerve.—This nerve comes out of 
the axilla, posteriorly to the pectoral is major muscle; it runs 
along the inner side of the arm, posteriorly to the basilic vein. 
It perforates the fascia, as before shown (page 195 ; Plate 115), 
to become subcutaneous ; it sends off branches, which are 
continued into the forearm. 
Si. Small Internal Cutaneous Nerve.—This nerve accom- 
panies tlie last-described nerve from the axilla, running pos- ANTERIOR OF THORAX, AXILLA, AND ARM. 
199 
teriorly to it; it perforates the fascia and distributes as before 
shown (page 195 ; Plate 115). 
32. Triceps Muscle.—The inner surface of this muscle 
presents posteriorly to the biceps. The two last-described 
nerves and tlie basilic vein lie upon its surface. 
33. Coraco-Bracliialis Muscle.—A portion of this muscle is 
brought into view in the triangular interval between the pec- 
toralis major muscle, the biceps muscle, and the median nerve. 
Dissection.—Section tlie pectoralis major muscle (Plate 116) and reflect its 
external portion over the outer surface of the arm; note its attachment to the 
outer lip of the bicipital groove of the humerus (Plate 113). Clear the surface 
of the proximal ends of the biceps muscle and that of the coraco-bracliialis 
muscle. Section the small internal cutaneous and the intercosto-humeral 
nerves (Plate 116). 
34. Biceps Muscle, Plates 113, 116, 117, 119, and 120. 
—The proximal end of this- muscle presents two portions or 
heads: the long or outer head, lodged in the bicipital groove 
of the humerus, passes over the head of the humerus, within 
the capsular ligament of the shoulder-joint; the short or inner 
head passes to the coracoid process of the scapula, where it 
has a common attachment with the coraco-bracliialis muscle. 
35. Coraeo-Bracliialis Muscle, Plates 113, and 116 to 120, 
inclusive.—This muscle lies along the inner side of the short 
head of the biceps; it has a proximal attachment to the cora- 
coid process of the scapula, in common with the short head of 
the biceps; its distal attachment is to the inner side of the shaft 
of the humerus, a little to the proximal side of its middle. 
Dissection.—Reflect tlie internal portion of the pectoralis major muscle 
(Plate 116); turn it off toward its respective sternal and clavicular attachments 
(Plate 117). Find the branches of the short and acromio-thoracic arteries and 
the anterior thoracic nerves entering its deep surface ; cut the same as they en- 
ter the muscle. Expose the costo-coracoid membrane and the fascia of the pec- 
toralis minor muscle ; note how the latter is perforated by vessels and nerves. 
36. Costo-Coracold Membrane, Plate 117.—This is a double 
layer of fibrous tissue, which encloses the subclavius muscle: 
one layer is posterior, the other anterior to the muscle. Their 
attachments are: to the clavicle, superiorly ; the first rib and 
coracoid process of the scapula, inferiorly. 200 
UPPER EXTREMITY. 
37. Fascia of the Pcctoralis Minor Muscle.—This layer of 
fascia springs from the anterior layer of the costo-coracoid 
membrane, passing interiorly, to the exteriors of the two supe- 
rior ribs and costal cartilages and the superior and internal 
border of the pectoralis minor muscle ; it splits into an anterior 
and a posterior layer to include the muscle ; at the inferior and 
external border of the muscle the two layers unite again, to 
blend with the axillary fascia. Superiorly to the pectoralis 
minor muscle, it is perforated by branches of the short and 
acromio-tlioracic arteries, and those of the anterior thoracic 
nerves. 
Dissection.—Clear the anterior surfaces of the pectoralis minor and the 
subclavius muscles. 
3§. Pectoralis Minor Muscle, Plates 113 and 117.—This 
muscle lias ail oblique and inferior course : its superior and 
external attachment is to the coracoid process of the scap- 
ula ; its inferior and internal attachments are to the exteri- 
or surfaces of the anterior ends of the third, fourth, and fifth 
ribs. 
30. Subclavius Muscle, Plates 119 and 120.—This is a short 
muscle, located parallel with and inferiorly to the clavicle. 
It has an internal attachment to the exterior surface of the 
cartilage of the first rib ; and an external one to the inferior sur- 
face of the clavicle, externally to the middle of the bone. 
Dissection.—Clear away tlie adipose tissue from tlie axillary area between 
the borders of tlie pectoralis minor muscle, anteriorly, and the latissimus dorsi 
and teres major muscles, posteriorly. Expose and follow, superiorly, the long 
thoracic and subscapular arteries; strip them of their venae comites, and note 
the muscles they supply. Demonstrate the anterior circumflex artery. Trace, 
superiorly, the posterior thoracic and the subscapular nerves—from the serratus 
magnus, the latissimus dorsi, the teres major, and the subscapularis muscles. 
Display, in part, the anterior surface of the subscapularis muscle. 
40. Long; Thoracic Artery, Plates 116, 117, 119, and 120.— 
This artery (venae comites) has an inferior course from its origin 
from the axillary artery, appearing along the external border 
of the pectoralis minor muscle ; it sends branches to the latter 
and to the serratus magnus muscle. 
41. Subscapular Artery.—This vessel (vena comes) is given 
off from the axillary artery ; it has an inferior course, ante- ANTERIOR OF THORAX, AXILLA, AND ARM. 
201 
riorly to the external fold of the axilla, giving off the dorsal 
scapular artery ; it also affords muscle branches to the sub- 
scapularis, teres major, latissimus dorsi, and serratus magnus 
muscles. 
42. Dorsal Scapular Artery.—This artery (vense comites) is 
the first and largest branch given off from the subscapular ; it 
winds to the dorsum of the scapula, through the space between 
the subscapularis and teres major muscles. 
43. Anterior Circumflex Artery, Plates 117, 119, and 120. 
—This artery (vena comes) arises from the superior surface of 
the axillary artery ; it passes posteriorly to the coraco-braclii- 
alis and the biceps (its two heads) muscles, disappearing pos- 
teriorly to the anterior border of the deltoid muscle. 
44. Posterior Thoracic Nerve, Plates 116, 117, 119, and 
120.—This nerve has an inferior course, into the axilla, from 
the cervical portion of the brachial plexus ; it lies upon the 
surface of the serratus magnus muscle, distributing branches 
to it. 
45. Subscapular Nerves (First and Second) to tlie Sub- 
scapularis and Latissiinus Dorsi Muscles.—These nerves can 
be traced, superiorly and internally, from the axillary sur- 
faces of the muscles, toward the axillary portion of the brachial 
plexus. 
Dissection.—Clear the surfaces of the portions of the triceps and pronator 
radii teres muscles at the inner side of the arm; expose the long and the 
inner heads of the former muscle. Display the axillary vein, the median, the 
ulnar, the internal cutaneous, the small internal cutaneous, and the intercosto- 
humeral nerves through the portion of the axilla externally to the pectoralis 
minor muscle. Trace the axillary vein and the nerves into the arm. 
46. Triceps Muscle, Plates 113, and 116 to 120, inclusive. 
—The inner side of the long and the inner heads of this muscle 
present at the posterior part of the inner side of the arm. 
The long head comes out, from the direction of the shoulder 
(Plate 113), posteriorly to the humeral end of the teres major 
muscle. 
47. Pronator Radii Teres Muscle, Plates 113, 116, and 
118.—The proximal portion of this muscle appears at the inner 202 
UPPER EXTREMITY. 
side of the anterior of the distal end of the humerus ; it con- 
tinues into the forearm upon the inner portion of the anterior 
of the elbow. 
48. Axillary Vein, Plates 117 and 118.—This vein runs 
through the axilla, inferiorly to the axillary artery and the 
nerves of the axillary portion of the brachial plexus. It is 
formed by the confluence of the basilic vein and the venae 
comites of the brachial artery ; it receives the venae comites of 
the branches of the axillary artery. 
49. median Nerve.—This nerve, before spoken of (page 
198), can be traced from the arm into the axilla, where it is 
seen to divide into two branches, called legs/ the latter pass, 
respectively, to the outer and inner sides of the axillary artery. 
At its distal end the nerve gives off branches to muscles of the 
forearm. 
50. Ulnar Nerve.—This nerve can be followed in a proxi- 
mal direction to the external border of the pectoralis minor 
muscle, inferiorly to, and to the inner side of, the axillary artery; 
it is given off from the inner cord of the axillary portion of the 
brachial plexus, which bifurcates into the ulnar nerve and the 
inner leg of the median nerve. The nerve is continued into 
the arm, posteriorly to the axillary and brachial arteries; in 
the proximal third of the arm it diverges from the brachial 
artery, to be continued upon the inner surface of the long and 
inner heads of the triceps muscle (Plates 118 and 119), in a 
direction toward the inner condyle of the humerus. 
51. The Internal Cutaneous Nerve.—This nerve can be 
traced internally, interiorly to the last-described nerve, to 
where it disappears, posteriorly to the pectoralis minor 
muscle. 
52. Small Internal Cutaneous Nerve.—This nerve may be 
followed into the axilla, parallel with, and interiorly to, the 
last-described nerves. 
53. Intcreosto-IIiuneral Nerve.—This nerve may now be 
demonstrated as formed by the lateral cutaneous branch of 
the second intercostal nerve and an anastomotic branch from 
the small internal cutaneous nerve. ANTERIOR OF THORAX, AXILLA, AND ARM. 
203 
Dissection.—Section the biceps muscle (Plate 116) and reflect its portions 
as in Plate 118; find the vessels and nerves entering its deep surface; trace 
them to their parent trunks and cut them short. Clear the surface of the 
brachialis antieus muscle; trace the musculo-cutaneous nerve and its branches. 
54. Bracliialis Amicus Muscle, Plates 113, 116, and 118. 
—This muscle lies between the biceps muscle and the distal 
half of the humerus. Its proximal attachment is to the an- 
terior of the distal half of the shaft of the humerus ; its distal 
attachment is to the anterior of the proximal end of the shaft 
of the ulna. 
55. Musculo-Cutaneous IVerve, Plates 116 to 119, inclusive. 
—This nerve comes out from the posterior surface of, and at 
the inferior border of, the pectoralis minor muscle, superiorly, 
and externally, to the axillary artery and the outer leg of the 
median nerve. It sends a branch to the coraco-brachialis mus- 
cle, then passes through the muscle, to emerge from the an- 
terior of its distal half. It is continued through the arm 
between the biceps and the brachialis antieus muscles, entering 
between them at the inner side of the biceps ; it appears from 
the posterior surface of the distal portion of the biceps muscle, 
at its outer side. In its course between the muscles (Plate 118) 
it gives them their nerve supply. From the arm, at the outer 
half of its distal end, it is continued into the subcutaneous 
plane of the forearm. 
Dissection.—Replace the biceps muscle, in situ, and sew its cut ends to- 
gether. Hook the median nerve to the outer side, and the basilic vein to the 
inner side (Plate 118); expose the external portion of the axillary artery and 
the brachial artery, with the venae comites of the latter. 
56. Axillary Artery, Plates 117, 118, and 119.—The external 
portion of this artery is continued from the posterior surface of, 
and at the inferior and external border of, the pectoralis minor 
muscle, to its terminus at the distal border of the humeral 
end of the teres major muscle : anteriorly, is the median nerve 
and the fork of its legs ; externally, the musculo-cutaneous 
nerve; inferiorly, the ulnar, the internal cutaneous, and the 
small internal cutaneous nerves, and the axillary vein. 
57. Brachial Artery, Plates 117 and 118.—This artery (venae 
comites), before referred to (page 198), is continued from the 204 
UPPER EXTREMITY. 
terminus of the axillary artery. It lies along the inner side 
of the coraco-bracliialis and biceps muscles. In its course it 
gives off the superior profunda, the inferior profunda, the 
anastomotica magna, and muscle branches. Its proximal por- 
tion has the median nerve to its outer side ; at its mid-portion 
it is crossed by the nerve; for its distal third the nerve lies to 
its inner side. 
Dissection.—Section the pectoralis minor muscle (Plate 117) ; reflect its 
superior portion as in Plate 119, and its inferior portion to its thoracic attach- 
ments, where it may be cut away. Clear the exterior surfaces of the external 
intercostal muscles between the ribs, and the fibrous tissue plane between the 
costal cartilages. Cut the axillary vein, as in Plate 119 ; dissect its distal por- 
tion away, also the basilic vein and the venae comites of the brachial artery. 
Demonstrate the outer and inner cords of the axillary portion of the brachial 
plexus ; also, the nerves projected from them into the upper extremity. 
58. External Intercostal Muscles and their Anterior Inter- 
costal Aponeurosis, Plates 113 and 120.—These muscles form 
the exterior plane in the intercostal spaces, to the anterior ends 
of the ribs ; in the intercliondral spaces, the plane is continued, 
by aponeurosis, to the border of the sternum. 
50. Outer Cord of the Axillary Portion of the Brachial 
Plexus, Plate 119.—This nerve trunk lies superiorly to, and 
parallel with, the internal third of the axillary artery ; it 
terminates by bifurcating into the musculo-cutaneous nerve 
and the outer leg of the median nerve. 
60. Inner Cord of the Axillary Portion of the Brachial 
Plexus.—This nerve trunk runs parallel with, and inferiorly to, 
the internal third of the axillary artery ; it gives off the small 
internal cutaneous and the internal cutaneous nerves, which 
run inferiorly to the nerve cord ; the cord terminates by bifur- 
cating into the ulnar nerve and the inner leg of the median. 
Dissection.—Hook the median nerve and the brachial artery to the outer 
side; find the superior profunda, the inferior profunda, and the anastomotica 
magna arteries. 
61. Superior Profunda Artery, Plates 118 and 110.—This 
artery (venae comites) is the first and largest branch of the 
brachial artery ; it is given off from the inner side of, and 
close to, the commencement of the brachial from the axillary 
artery. It has a distal course upon the inner surface of the ANTERIOR OF THORAX, AXILLA, AND ARM. 
205 
long head of the triceps muscle, and passes in between the long 
and inner heads of that muscle, in company with the musculo- 
spiral nerve and its branches. 
62. Inferior Profunda Artery.—This artery (venae comites) 
is the second branch from the inner side of the brachial artery ; 
it is smaller than the last-described branch. It has a distal 
course upon the surface of the inner head of the triceps mus- 
cle joining the ulnar nerve, which it accompanies to the elbow. 
6tf. Anastomotlca Magna Artery.—This artery (venae com- 
ites) is given off from the inner side of the distal third of the 
brachial artery ; it runs to the inner side of the anterior of 
the elbow. 
64. Inner Intermuscular Septum, Plate 119.—This is a 
fibrous tissue septum between the brachialis anticus muscle 
and the inner head of the triceps muscle ; it defines the ante- 
rior and posterior regions of the inner side of the arm. 
Dissection.—Section the axillary artery (Plate 119) and its branches; also, the 
outer and inner cords of the axillary portion of the brachial plexus, the musculo- 
cutaneous, internal, and small internal cutaneous nerves (Plate 119). Reflect 
the axillary artery and the cords of the brachial plexus, with their branches, 
distallv, upon the arm. (Do not cut away these reflected parts, as they are to 
be replaced, in situ.) Display the posterior cord of the axillary portion of the 
brachial plexus, and its branches. Note the posterior circumflex artery. 
65. Posterior Cord of the Axillary Portion of the Brachial 
Plexus, Plate 120.—This cord of the plexus runs through the 
axilla, parallel with, and in a plane posteriorly to, the axillary 
artery and the outer and inner nerve cords. It gives off the 
first and second subscapular nerves, which may now be traced, 
superiorly, to its inferior side : the first is a short nerve, to the 
subscapularis muscle ; the second is a long nerve, to the latis- 
simus dorsi muscle. The cord terminates by bifurcating into 
the circumflex and inusculo-spiral nerves. 
66. Circumflex Xerve.—This nerve lies upon the anterior 
surface of the subscapularis muscle ; at the external border 
of this muscle, in the space between it and the teres major 
muscle, it winds to the posterior surface, and outer side, of the 
proximal end of the shaft of the humerus—the surgical neck. 206 
UPPER EXTREMITY. 
6T. Musculo-Spiral Nerve, Plates 119 and 120.—This nerve, 
near its origin, runs superiorly to, and parallel with, the cir- 
cumflex nerve ; it lias a distal course into the arm, lying, con- 
secutively, upon the anterior surfaces of the subscapularis 
muscle, the humeral ends of the latissimus dorsi and teres 
major muscles, and the inner side of the long head of the tri- 
ceps muscle. It enters between the long and inner heads of 
the triceps muscle, to be continued, through the middle third 
of the arm, in the spiral groove on the posterior surface of the 
shaft of the humerus ; its latter portion is accompanied by the 
superior profunda artery. Its branches are: the third sub- 
scapular nerve and branches to the triceps muscle. 
68. Third 8ubscapular Nerve.—This nerve, a branch of the 
musculo-spiral, has an inferior and external course to distrib- 
ute to the subscapularis and teres major muscles. 
69. Serves to the Triceps Muscle. — The musculo-spiral 
nerve gives off a number of blanches: the first distributes 
to the long head of the triceps ; the second divides and sup- 
plies the inner head of the same muscle; the other branches 
enter, with the trunk of the nerve, between the long and inner 
heads of the muscle. 
TO. Posterior Circumflex Artery, Plate 120.—Tills artery 
(veme comites), branch from the posterior of the axillary artery, 
accompanies the circumflex nerve from the axil-la (page 205). 
Dissection.—Replace the axillary and brachial arteries, the sectioned cords 
of the brachial plexus, and the branches of the plexus, before proceeding to 
the dissection of the anterior region of the forearm. PLATE 113 
JUT.Cdhn,acl7uzturam del. PLATE 114 
MLCohn, ad natziram del. PLATE 115 
Perforating? branches 
of in ti/na/nmary art. 
JJ/I Cohn ,czd7zcztu.ra.7n otef. PLATE 116 
Af. Co/i n, act si at u r*ctm o'el. PLATE 117 
JM.Cohn,adnatccra/n del, PLATE 118 
Jvr.CoTlK.actnaturam cZeZ. PLATE 119 
JHECbTin, etc? rzczt zererm <ZeZ+ PLATE 120 
Jl£Cahn, ad natziram del. SIXTEENTH DISSECTION. 
ANTERIOR OF ELBOW, FOREARM, AND HAND. 
Dissection.—The upper extremity is placed in tlie same position as for tlie 
fifteenth dissection (page 193). 
Terms of Relation.—To the elbow and forearm: the general 
terms anterior and posterior ; with the special terms proximal 
and distal; outer and inner sides. To the palm of the hand 
(carpus and metacarpus), the special terms 'proxi- 
mal and distal; palmar and dorsal surfaces; 
outer or pollex and inner or minim sides. To 
the digits, the special terms proximal and distal; 
palmar and dorsal surfaces; and the lateral 
digital surfaces. The regions of the hand will be 
referred to as the carpal (carpus), the metacarpal 
(metacarpus), and the digital (digits). 
Bones and Bone Areas, Plates 121 and 122.— 
The anterior surfaces of the following bones form 
the osseous framework of this dissection : the dis- 
tal end of the humerus ; the radius; the ulna ; 
the seven bones of the carpus—scaphoid, semilu- 
nar, cuneiform, pisiform, trapezium, trapezoid, os 
magnum, and unciform ; the bones of the meta- 
carpus—first to fifth, inclusive; the fourteen 
bones of the digits—five phalanges, four phalan- 
gines, and ive phalangettes (page 123). All these 
bones afford attachments to muscles, except the 
scaphoid, the semilunar, and the cuneiform. 
Each meta jarpal and digital bone has : a base, a shaft, and a 
head. 
Figure 10. 
Dissect'on.—Make the skin incisions 1, 2, and 3, of Figure 10, and reflect 
flaps as indicated. Expose the veins and nerves in the subcutaneous plane of 
the dissection. 208 
UPPER EXTREMITY. 
1. Subcutaneous Tissue and Veins of the Anterior of the 
Elbow and Forearm, Plates 123 and 115.—The subcutaneous 
tissue of the anterior of the elbow and forearm presents a net- 
work of veins and nerves. The veins are not comites to arteries ; 
they occupy a plane superficial to the nerves, and they are sub- 
ject to many variations. To the inner side is the anterior ulnar 
vein, which has a longitudinal and proximal course to the 
elbow ; toward its proximal end it receives the posterior ulnar 
vein. from the posterior of the forearm ; the resultant vein is 
the common ulnar vein at the inner side of the elbow. At the 
outer side of the forearm is the radial vein, which has a proxi- 
mal course to the elbow. At the middle of the forearm is a 
more or less well-developed vein, the median: it commences 
at the wrist, from which it has a proximal course to the elbow, 
where it bifurcates into the median-basilic and the median- 
cephalic veins ; near or at its point of bifurcation it gives off an 
anastomotic branch, which perforates the fascia to anastomose 
with the deep or comites veins of the region. At the anterior 
surface and outer side of the elbow the radial and the median- 
cephalic veins join to form the cephalic vein of the arm (page 
195). At the anterior surface and inner side of the elbow the 
common ulnar and the median-basilic veins, by their conflu- 
ence, form the basilic vein of the arm (page 195). 
2. Internal Cutaneous Nerve.—This nerve is continued, by 
several branches, from the inner side of the arm (page 195 ; 
Plate 115) into the forearm ; the proximal one passes to the 
posterior of the forearm, along the inner side of the elbow ; 
the others pass, posteriorly to the median-basilic vein, into the 
inner half of the anterior surface of the forearm, as far as the 
wrist. 
3. Museulo-Cutancous Nerve.—This nerve enters from the 
arm (page 203; Plates 116 and 118) into the outer half of the 
anterior of the forearm, passing, as it crosses the elbow, poste- 
riorly to the median-cephalic vein ; it is continued to the palm 
of the hand, and anastomoses with the radial nerve. 
4. Inferior External Cutaneous Branch of the Musculo* 
Spiral Nerve.—At the outer side of the elbow this nerve enters 
from the arm, and is continued to the posterior of the forearm ; ANTERIOR OF ELBOW, FOREARM, AND HAND. 
209 
in its course it runs parallel with, and posteriorly to, the radial 
vein. 
Dissection.—Clear the subcutaneous tissue from the fascia of the elbow 
and forearm, preserving the subcutaneous veins and nerves. 
5. Fascia of tlie Forearm.—This fascia is continuous with 
that of the arm. 
6. Palm, Plate 124.—Three areas present to the palm: a 
middle depression, the palmar fossa; an outer elevation, the 
pollex (thenar) eminence ; an inner elevation, the minim (hypo- 
thenar) eminence. 
Dissection.—Make the skin incisions of the palm, 4, 5, 6, and 7, of Figure 
10 (page 207), and reflect flaps as indicated. Expose the palmaris brevis mus- 
cle, and find the palmar cutaneous branches of the median, the ulnar, and the 
musculo-cutaneous nerves. 
7. Pal mar is Brevis Muscle.—This flat, subcutaneous mus- 
cle is located at the proximal portion of the minim eminence 
of the palm. It is attached to the inner border of the palmar 
fossa portion of the palmar fascia, and to the skin along the 
minim side of the hand. Its degree of development varies, 
from a few stray fibres to a well-defined plane of muscle. 
8. Palmar Cutaneous Branch of the Median Nerve.—This 
branch of the median nerve perforates the fascia at the wrist 
and distributes in the subcutaneous plane of the proximal por- 
tion of the palmar fossa. 
9. Palmar Cutaneous Branch of the Ulnar Nerve.—This 
branch of the ulnar nerve distributes in the subcutaneous 
plane of the minim eminence of the palm. 
10. Palmar Branch of the Musculo-Cutaneous Nerve.— 
A terminal branch of this nerve is continued, from the an- 
terior of the wrist, to the surface of the pollex eminence. 
Dissection.—Clear the surface of the palmar fascia and note the superficial 
transverse ligament. Find, at the distal limit of the palm, the palmar digital 
arteries with their bifurcations and continuations into the palmar collateral 
digital arteries ; also, the palmar collateral digital nerves. 210 
UPPER EXTREMITY. 
11. Palmar Fascia.—This is formed by the fascia con- 
tinued from the forearm, which is specially thickened for the 
needs of the palm. When present, the palmaris longus tendon 
contributes to it. The middle or palmar fossapoi'tion com- 
mences at the proximal limit of the palmar fossa ; it widens as 
it advances to the distal third of the metacarpus. At its distal 
limit it divides into four slips : their central fibres are projected 
to the palmar surfaces of the digital sheaths of the flexor ten- 
dons, on the digits, second to fifth, inclusive ; their lateral fibres 
pass to the transverse metacarpal ligament and the lateral sur- 
faces of the heads of the metacarpal bones, second to fifth, in- 
clusive. Transverse fibres bridge across the distal divisions of 
the palmar fossa portion of the palmar fascia—the superficial 
transverse ligament of the fingers. The outer or pollex emi- 
nence portion of the fascia invests the eminence, and extends 
around the pollex side of the metacarpal region to its dorsal 
surface. The inner or minim eminence portion occupies that 
eminence, with the palmaris brevis muscle on its palmar sur- 
face ; it winds to the dorsal surface of the metacarpal region, 
over its minim side. 
12. Palmar Digital Arteries.—These arteries (veil* comites), 
second to sixth, inclusive, appear at the distal limit of the 
palm. The third, the fourth, and the fifth are projected be- 
tween the distal divisions of the palmar fossa portion of the 
palmar fascia, from the dorsal surface of the same, into the 
webbing between the digits, second to fifth, inclusive ; they 
there bifurcate into the palmar collateral digital arteries, fourth 
to ninth, inclusive ; before bifurcation, they each receive an 
interosseous artery, from the deep palmar arch. The second 
digital (radialis indicis) appears opposite the pollex side of the 
distal end of the second metacarpal bone, where it is con- 
tinued, as the third palmar collateral digital artery, to the 
outer lateral digital surface of the second digit. The sixth 
digital is projected along the minim side of the palm, to be 
continued, as the tenth palmar collateral digital artery, to the 
inner lateral digital surface of the fifth digit. 
1£. Palmar Collateral Digital Nerves.—These nerves pass 
from the dorsal surface, of the palmar fossa portion, of the 
palmar fascia ; they join the palmar collateral digital arteries, 
entering the lateral digital surfaces. AXTEEIOR OF ELBOW, FOREARM, AND IIAXD. 
211 
Dissection.—Section (Plate 123) tlie proximal ends of the internal cutane- 
ous and musculo-cutaneous nerves, and strip them from the fascia of the fore- 
arm ; section the radial, the ulnar, the median, the median-cephalic, and the 
median-basilic veins ; then clear away the veins from the anterior of the fore- 
arm, reflecting their proximal portions on the arm. Follow the palmar cuta- 
neous branch of the median nerve, to the latter, by slitting the fascia. Incise 
the fascia of the forearm in the same lines as the skin incisions 1, 2, and 3, of 
Figure 10 ; reflect flaps of the fascia to the inner and outer sides of the limb, 
exposing the subjacent muscles, etc. 
14. Flexor Carpi Radialis Muscle, Plates 121,125, and 127. 
—This muscle has a longitudinal, and slightly oblique, course, 
from the anterior surface of the internal condyle of the hu- 
merus, to the palmar surface of the base of the second meta 
carpal bone ; to reach the latter point, its tendon passes, to 
the dorsal surface of the anterior annular ligament and the 
proximal ends of the muscles of the pollex eminence. 
15. Palmaris Longus Muscle.—This muscle (sometimes ab- 
sent) has a proximal attachment to the anterior of the inner 
condyle of the humerus. Its course is parallel with, and to 
the inner side of, the last-described muscle ; its distal end ex- 
pands into the palmar fascia (page 210 ; Plate 124). 
1.6. Flexor Carpi Ulnaris Muscle.—This muscle is located 
along the inner side of the forearm, from the inner condyle of 
the humerus, to its distal attachment to the pisiform bone. 
17. Supinator Longus Muscle, Plates 121 and 125.—This 
muscle lies along the outer half of the anterior surface of the 
forearm : its proximal attachment is to the external condyloid 
ridge of the humerus ; its distal to the outer side of the distal 
end of the radius, proximal to its styloid process. 
18. Extensor Carpi Radialis Longior Muscle.—This muscle 
runs parallel with, but posteriorly to, the last-described mus- 
cle ; at about the distal third of the forearm, its tendon passes 
to the posterior of the limb. 
19. Radial Nerve, Plate 125.—At a variable point, at the 
outer side of the supinator longus muscle, this nerve is pro- 212 
UPPEH EXTREMITY. 
jected from its posterior surface ; it has a distal course to the 
dorsal surface of the carpus. 
20. Extensor Ossis Metacarpi Pollicis Muscle, Plates 121, 
125, and 127.—The distal end of the tendon of this muscle winds, 
from the posterior surface of the forearm, to the anterior of 
the outer side of the carpus, to reach its attachment at the 
anterior surface of the base of the first metacarpal bone. 
21. Radial Artery, Plates 125, 127, and 134.—This artery 
(venae comites) has a longitudinal course through the radial 
half of the anterior region of the forearm. At its proximal end 
it emerges, from the posterior of the bicipital fascia, to the ante- 
rior surface of the tendon of the biceps, where it is located to the 
outer side of the proximal end of the supinator longus muscle ; 
it then passes to the posterior surface of the latter muscle; at 
the distal and tendinous portion of the muscle, it emerges 
from its posterior surface, to run parallel with it, and to its in- 
ner side, as far as the carpus, where it winds to the posterior 
surface of the latter. From its proximal portion, the radial 
recurrent is given off, from its outer side ; from its distal por- 
tion, the superficialis volse and the anterior radial carpal 
branch from its inner side. 
Dissection.—Clear the surface of the distal portion of the biceps muscle, 
its tendon, and the bicipital fascia. (Where the dissection of the arm has pre- 
ceded this dissection this will have been done ; the same is here directed, and 
described, to give completeness to the present dissection.) 
22. Biceps Muscle, Plates 125 and 126.—The distal quar- 
ter of this muscle is located anteriorly to the distal end of the 
humerus ; its tendon is projected into the proximal portion of 
the forearm, where it disappears posteriorly to the proximal 
border of the pronator radii teres muscle. The bicipital fascia 
is a process of fascia from the inner side of the tendon, which 
spreads as a fascial investment of the pronator radii teres mus- 
cle, and is attached to the intermuscular septum between the 
latter and the flexor carpi radialis muscle. 
Dissection.—Section the bicipital fascia (Plate 125) ; dissect it off of the 
pronator radii teres muscle. 
23. Pronator Radii Tores Muscle, Plates 121, 125, and 126. 
This muscle has an oblique course along the outer side of the ANTERIOR OF ELBOW, FOREARM, AND HAND. 
213 
proximal portion of the flexor carpi radialis muscle. Its prox- 
imal attachments are to the anterior surface of the internal con- 
dyle of the humerus, proximally to the compound flexor 
attachment thereto, and to the inner side of the coronoid pro- 
cess of the ulna ; its distal end passes to the outer side of the 
shaft of the radius, a little proximal to its middle. 
Dissection.—Display the boundaries of tbe anconeal space, and the divis- 
ion of the same, into inner and outer portions, by the distal end of the biceps 
muscle. 
24. Anconeal Space, Plates 125 and 126.—This space is lo- 
cated anteriorly to the elbow-joint, including the adjoining 
quarters of the arm and forearm ; it is the analogue of the 
popliteal space of the lower extremity. The distal boundaries 
of the space are formed by the proximal, and opposite, bor- 
ders of the pronator radii teres and supinator longus muscles. 
Its proximal boundaries are not as well defined, extending as 
they do to about three finger-breadths from the elbow-joint : on 
the outer side is the supinator longus muscle; on the inner side 
is the inner intermuscular septum, with the distal end of the 
inner head of the triceps muscle, posteriorly to it. The distal 
end of the biceps muscle, as projected into the proximal por- 
tion of the forearm, divides the anconeal space into two por- 
tions : the inner and the outer. 
25. Inner Portion of tlie Anconeal Space.—This is 
bounded at its outer side by the biceps muscle and its tendon ; 
at its inner side by the pronator radii teres muscle and the 
inner intermuscular septum. 
Dissection.—Insert a hook into the proximal border of the pronator radii 
teres muscle and turn it off inferiorly (Plate 126). Expose the nerves and ves- 
sels in the inner portion of the anconeal space ; clear the muscle area of its 
floor. 
26. Median IVerve.—A part of the trunk of this nerve has 
a longitudinal course through the inner portion of the anco- 
neal space ; its proximal end appears from the posterior sur- 
face of the inner side of the biceps muscle, its distal end 
passes into the forearm between the superficial and deep por- 
tions of the pronator radii teres muscle. 214 
UPPER EXTREMITY. 
27. Nerves to the Pronator Radii Teres, Flexor Carpi 
Radialis, Palniaris Uongus, and Flexor 8ul>liinis Digitorum 
Muscles, Plate 126. — Three nerves, the proximal branches of 
the median nerve, are distributed to these muscles. They are 
given off from the inner side of the nerve, at the anconeal 
space portion of its course: the first, to the pronator radii 
teres, bifurcates, one branch supplying the anterior, the other 
the posterior portion of that muscle; the second and third, 
pass into the forearm, posteriorly to the posterior portion of 
the pronator radii teres muscle, to reach their respective mus- 
cles (the second, to the second and third muscles ; the third, 
to the fourth muscle). 
28. Braclital, Radial, and Ulnar Arteries, Plates 125 and 
126.—The distal part of the brachial artery (venae comites) en- 
ters the proximal end of the inner portion of the anconeal 
space, from the posterior surface, and at the inner side, of 
the biceps muscle ; it has a distal course, between the median 
nerve, to the inner side, and the biceps muscle, to the outer 
side, to where it bifurcates into the radial and ulnar arteries. 
The radial artery (venae comites) runs along the inner side of 
the tendon of the biceps and is continued through the forearm, 
as before described (page 212). The proximal portion of the 
ulnar artery (venae comites) curves to the inner side, and leaves 
the distal limit of the anconeal space, posteriorly to the poste- 
rior portion of the pronator radii teres muscle. 
29. Anastomotiea Magna Artery.—This artery (venae com- 
ites) is a branch from the inner side of the brachial, as the 
latter enters tlie anconeal space. It is distributed to the inner 
side of the elbow, where it anastomoses with the anterior and 
posterior ulnar recurrent arteries, thus contributing to tlie peri- 
articular plexus. 
30. Bracliialis Anticus Muscle, Plate 126.—The anterior 
surface, of the inner two-thirds, of the distal portion of this 
muscle forms the floor of the inner portion of the anconeal 
space. 
31. Inner Intermuscular Septum.—This is a strip of 
fibrous tissue, which is attached to the inner condyloid ridge ANTERIOR OF ELBOW, FOREARM, AND HAND. 
215 
of the humerus; it separates the brachialis anticus muscle 
from the inner head of the triceps muscle. 
32. Triceps Muscle.—A portion of the inner head of this 
muscle lies posteriorly to the inner intermuscular septum. 
33. Ulnar Nerve and Inferior Profunda Artery.—A short 
segment of this nerve, accompanied by this artery, lies upon 
the surface of the inner head of the triceps muscle, to the 
proximal side of the inner condyle of the humerus, and poste- 
riorly to the inner intermuscular septum. 
34. Outer Portion of the Anconeal Space.—This portion 
of the space is bounded : to the inner side, by the biceps mus- 
cle and its tendon ; to the outer side, by the supinator longus 
muscle. 
Dissection.—Section the supinator longus muscle (Plate 125) and hook its 
proximal portion to the outer side. Find and display the musculo-spiral, the 
radial, the posterior interosseous nerves—with the branches of the first and 
third—also, the musculo-cutaneous nerve. Expose the radial recurrent and the 
superior profunda arteries. Clear the areas of the portions of the muscles 
forming the floor of the outer portion of the anconeal space. 
35. Musculo-Sptral Nerve.—The distal end of this nerve 
appears at the proximal limit of the outer portion of the an- 
coneal space, between the brachialis anticus and the supinator 
long us muscles. From its outer side it gives off one branch 
to the supinator longus muscle, and two branches to the ex- 
tensor carpi radialis longior muscle. 
36. Radial Nerve.—This nerve arises from the bifurcation 
of the musculo-spiral nerve; it is projected into the forearm 
through the outer portion of the anconeal space. It has a 
course to the outer side of the tendon of the biceps and the 
radial artery. 
37. Posterior Interosseous Nerve.—This, the largest of the 
branches of bifurcation of the musculo-spiral nerve, has a dis- 
tal course from its origin to its point of transit through the 
supinator brevis muscle, by which it reaches its distribution at 
the posterior region of the forearm. The anconeal portion of 216 
UPPER EXTREMITY. 
this nerve lies parallel with, and to the outer side of, the radial 
nerve. It gives off two branches: an outer, to the extensor 
carpi radialis brevior muscle ; an inner, to the supinator brevis 
muscle. 
38. Radial Recurrent Artery.—This artery (venae comites) 
Is given off from the outer side of the radial artery ; it crosses 
upon the anterior surface of the tendon of the biceps muscle, 
and is projected into the outer portion of the anconeal space, 
through which it has a proximal course parallel with, and 
posteriorly to, the radial nerve. Branches from it distribute 
to contiguous muscles. 
£9. Superior Profunda Artery.—The distal end of this ar- 
tery (venae comites) presents at the proximal limit of the outer 
portion of the anconeal space, accompanying the musculo- 
spiral nerve. It anastomoses with the last-described artery. 
40. muscles Contributing to tlie Floor of the Outer Por- 
tion of the Anconeal Space.—The outer border of the distal 
portion of the brachialis anticus muscle, the anterior surfaces 
of the proximal portions of the extensor carpi radialis longior 
and brevior muscles, and a part of the anterior surface of the 
supinator brevis muscle, contribute to form the floor of this 
portion of the anconeal space. 
Dissection.—Replace tlie pronator radii teres and the supinator longus 
muscles, in situ. Clear the three forearm intertendinous spaces, at'the distal 
third of the anterior of the region (Plate 125) ; loop the tendons of the pal- 
maris longus and the flexor carpi ulnaris muscles to the inner side. Find the 
radial artery (venae comites), the median nerve, the ulnar artery (venae comites), 
and the ulnar nerve ; display the portions of the pronator quadratus, flexor lon- 
gus pollicis, and flexor sublimis digitorum muscles, which form the floors of 
these spaces. 
41. Forearm Intertendinous Spaces, Plates 125 and 127.— 
Three intertendinous spaces present at the distal third of the 
anterior of the forearm : the outer, the middle, and the inner. 
The outer intertendinous space has the tendons of the su- 
pinator longus and the extensor ossis metacarpi pollicis mus- 
cles to the outer side ; and the tendon of the flexor carpi radi- 
alis muscle to the inner side ; it contains the distal end of the 
forearm portion of the radial artery (venae comites), which ANTERIOR OF ELBOW, FOREARM, AND HAND. 
217 
gives off the superficialis volae and anterior radial carpal 
arteries from its inner side, before passing to the dorsum of the 
carpus. It has for its floor portions of the flexor longus pol- 
licis and the pronator quadratus muscles. 
The middle intertendinous space is between the tendons of 
the flexor carpi radialis and palmaris longus muscles; it con- 
tains the median nerve, giving off its palmar cutaneous branch 
(page 209); the tendon of the flexor longus pollicis muscle 
forms its floor. 
The inner intertendinous space is located between the 
tendons of the palmaris longus and the flexor carpi ulnaris 
muscles; along the outer side of the latter tendon is lodged the 
ulnar artery (veme comites), the ulnar nerve, and the palmar 
cutaneous branch of the latter ; the floor of the space is formed 
by the tendons of the flexor sublimis digitorum muscle. 
Dissection.-—Remove the pollex eminence portion of the palmar fascia; 
expose the muscles and vessels of the eminence (Plate 127). 
42. Abductor Pollicis Muscle, Plates 122, 127, and 129.— 
This is the superficial muscle of the pollex eminence, extend- 
ing from the palmar surface of the scaphoid bone and the ante- 
rior annular ligament, to the outer side of the base of the pha- 
lanx of the first digit. 
43. Superficialis Volae Artery, Plate 127.—This artery (ve- 
nae comites), is given off from the inner side of the distal end 
of the forearm portion of the radial artery ; it enters the 
proximal portion of the pollex eminence, to the dorsal surface 
of the abductor pollicis muscle, and appears at the inner side 
of the muscle, where it completes the superficial palmar arch, 
by anastomosing with its ulnar artery portion. 
44. Flexor Brevis Pollicis Muscle (outer head), Plates 122, 
127, and 129.—This head of the muscle has a proximal attach- 
ment to the palmar surface of the trapezium and the anterior an- 
nular ligament; a distal one to the outer tubercle, at the pal- 
mar surface of the base of the phalanx of the first digit (pollex), 
to the inner side of that of the last-described muscle. It is lo- 
cated parallel with, and to the inner side of, the abductor pol- 
licis muscle. It lies in a plane dorsal to the latter muscle. 218 
UPPER EXTREMITY. 
45. Slicatlied Tendon of the Flexor Longus Pollieis Mus- 
cle, Plate 127.—This is lodged to the inner side of the outer 
head of the flexor brevis pollieis muscle. 
Dissection.—Dissect away the palmaris brevis muscle and. the minim emi- 
nence portion of the palmar fascia (Plate 127), exposing the muscles, nerves, 
and vessels at the palmar surface of the eminence. 
40. Abductor minimi Digiti Muscle, Plates 122, 127, and 
129.—This muscle is located at the minim border of the palm : 
it extends from its proximal attachment to the pisiform bone, 
to its distal attachment to the inner side of the base of the 
phalanx of the fifth digit. 
47. Ulnar Nerve, Plate 127.—At the distal end of the fore- 
arm portion of this nerve, where it approaches the outer side 
of the pisiform bone, it bifurcates into the deep and the super- 
ficial palmar nerves. The deep palmar nerve is continued 
along the outer side of the pisiform bone, giving off two mus- 
cle branches from its inner side. These branches, with the deep 
palmar nerve, pass to a deep plane of the palm, by an interval 
between the proximal ends of the abductor and the flexor brevis 
minimi digiti muscles. The superficial palmar nerve is con- 
tinued to the palmar surface of the proximal end of the flexor 
brevis minimi digiti muscle, where it bifurcates into the fifth 
and the sixth digital nerves. The fifth digital nerve has a 
distal course, passing to the dorsal surface of the sixth digital 
artery, and entering the palmar fossa region of the palm ; it 
runs parallel with, and to the inner side of, the commencement 
of the superficial palmar arch. The sixth digital nerve has 
a distal course, upon the palmar surface of the flexor brevis 
minimi digiti muscle, and the sixth digital artery. 
48. Ulnar Artery.—This artery (vena? comites) enters the 
palm to the outer side of the ulnar nerve. At the carpal por- 
tion of the minim eminence, it is lodged at the inner side of the 
palmar surface of the anterior annular ligament of the carpus. 
It gives off the deep palmar artery, which joins the deep pal- 
mar nerve, described above, on its way to a deep plane of the 
palm. The trunk of the artery (palmar arch) curves to the outer 
side, upon the palmar surface of the proximal end of the flexor 
brevis minimi digiti muscle, and enters the palmar fossa; be- 
fore leaving the minim eminence it gives off the sixth digital ANTERIOR OF ELBOW, FOREARM, AND HAND. 
219 
artery. The latter branch has a distal course, upon tlie palmar 
surface of the flexor brevis minimi digiti muscle and the fifth 
digital nerve, and is continued to the inner lateral digital sur- 
face of the fifth digit. 
49. Flexor Brevis Minimi Digiti Muscle, Plates 122, 127, 
and 129.—This muscle is located between the abductor minimi 
digiti muscle and the minim or fourth tendon of the flexor 
sublimis digitorum muscle. It has a proximal attachment to 
the process of the unciform bone ; at its distal end it is at- 
tached to the inner side of the base of the phalanx of the fifth 
digit, in common with the abductor minimi digiti muscle. 
Upon its palmar surface are lodged the sixth digital artery and 
nerve. Between the proximal portions of it and the abductor 
minimi digiti muscle a triangular interval presents, for the 
transit, to a deep plane of the palm, of the deep palmar artery 
(page 218) and nerve, with tlie inner muscle branches of the 
latter. 
Dissection.—Remove the middle portion of the palmar fascia, working 
from the pollex to the minim side, and in a distal direction to the digits, sec- 
ond to fourth, inclusive. Clear the tendons of the flexor sublimis digitorum 
muscle, longitudinally, from where they emerge from the dorsal surface of the 
anterior annular ligament to the digits. Note and probe their synovial sheaths 
(Fig. 2, Plate 4). 
50. Anterior Annular Ligament, Plate 127.—This is a 
transverse stretch of fibrous tissue across the anterior of the 
carpus, between the proximal limits of the pollex and minim 
eminences of the palm—from the scaphoid and trapezium 
bones, on the outer side, to the unciform and pisiform bones, 
on the inner side. It forms, with the anterior surface of the 
bones of the carpus a channel, for the run of the tendons of the 
flexor sublimis and flexor profundus digitorum muscles and 
the median nerve, from the forearm into the palmar fossa 
region of the palm. 
51. Superficial Palmar Arcli.—This arterial arch (venae 
comites) is the palmar curve of the ulnar artery, from the 
palmar surface of the proximal portion of the minim eminence 
to the inner border of the pollex eminence, where the arch is 
completed by anastomosing with the superficialis volae branch 
of the radial artery (page 217). The arch lies upon the palmar 220 
UPPER EXTREMITY. 
surface of the flexor tendons, with its convexity at about the 
line of junction of the proximal and middle thirds of the palm. 
52. Sheathed Tendons of tlie Flexor Sublimis Digitorum 
Muscle (second to fifth digit, inclusive), Plate 127, and Fig. 2, 
Plate 4.—Four tendons emerge into the palmar fossa, from the 
dorsal surface of the anterior annular ligament; they are en- 
closed in a common synovial sheath in the palm. The tendons 
diverge to pass to the palmar surfaces of the digits, second to 
fifth, inclusive, where they are contained in the digital synovial 
sheaths. The common palmar sheath may be opened and 
probed, to show : its prolongation into the distal portion of 
the forearm, posteriorly to, and to the proximal side of, the 
annular ligament; also, its independence of the digital sheaths, 
with the exception of that of the fifth digit. 
53. Palmar Intertendinous Spaces, Plate 127.—Four lon- 
gitudinal, intertendinous spaces are present in the palm. 
Tilq first, between the tendon of the flexor longus pollicis and 
the first (second digit) tendon of the flexor sublimis digitorum 
muscle—it includes the parts upon the outer side of the second 
metacarpal bone. The second, between the first (second digit) 
and second (third digit) tendons of the flexor sublimis muscle— 
it leads to the webbing between the second and third digits. 
The third, between the second (third digit) and third (fourth 
digit) tendons of the flexor sublimis muscle—it leads to the 
webbing between the third and fourth digits. The fourth, be- 
tween the third (fourth digit) and fourth (fifth digit) tendons of 
the flexor sublimis muscle—it leads to the webbing between the 
fourth and fifth digits. The webbings between the proximal 
ends of the digits lead to the palmar lateral digital surfaces 
of the digits. The palmar intertendinous spaces are bridged by 
the superficial palmar arch, and at these points the arch jyfives 
off the digital arteries—third, fourth, and fifth. 
Dissection.—Expose the vessels, the nerves, and the muscle in the first 
palmar intertendinous space. 
54. Adductor Pollicis Muscle, Plates 127 and 129.—The dis- 
tal border of this muscle bridges between the pollex digit 
(phalanx of) and the palmar fossa ; it has a muscle branch 
from the superficial palmar arch ramifying upon its palmar 
surface. 221 
ANTERIOR OF ELBOW, FOREARM, AND HAND. 
55. Second Digital Artery, Plate 127.—This artery (ven;e 
comites), branch of the deep palmar arch, appears from the 
dorsal surface of the last described muscle, along the outer 
side of the distal portion of the first dorsal interosseous mus- 
cle. It receives an anastomotic branch from the superficial 
palmar arch, and is projected to the outer lateral digital sur- 
face of the second digit. . 
56. Second Digital Nerve.—This nerve emerges from the 
dorsal surface of the outer head of the flexor brevis pollicis 
muscle, running parallel with, and to the outer side of, the 
first (second digit) tendon of the flexor sublimis digitorum 
muscle; it passes to the dorsal surface of the superficial pal- 
mar arch, and to the palmar surface of the anastomotic branch, 
from the arch, to the second digital artery. It occupies the 
palmar surface of the first lumbricalis muscle, to which, from 
its proximal end, it gives a branch. 
57. First Funibrtcalis Muscle.—This muscle lies upon the 
palmar surface of the adductor pollicis muscle, and to the 
outer side of, and parallel with, the first (second digit) tendon 
of the flexor sublimis digitorum muscle ; it winds over the 
outer side of the metacarpo-phalangeal articulation of the 
second digit, to the dorsal surface of that digit. Its palmar 
surface receives its nerve, from the second digital nerve. 
Dissection.—Expose the parts in the second palmar intertendinous space. 
58. Third Digital Nerve.—This nerve emerges from the 
dorsal surface of the anterior annular ligament, into the second 
palmar intertendinous space ; it has a distal course, to the 
dorsal surface of the superficial palmar arch. It bifurcates 
into the fourth and fifth palmar collateral digital nerves. At 
its proximal end, it supplies a branch to the second lumbricalis 
muscle. 
59. Third Digital Artery.—This artery (rente comites) is a 
branch of the superficial palmar arch, where the latter bridges 
the second space ; it has a distal course, to the dorsal surface 
of the third digital nerve, to the webbing between the proximal 
ends of the second and third digits, where it bifurcates into the 
fourth and fifth palmar collateral digital arteries. 222 
UPPER EXTREMITY. 
60. Second Lumbricalis Muscle.—This muscle is lodged in 
this space ; the third digital nerve and artery being lodged 
upon its palmar surface. At its proximal portion it receives 
its nerve from the third digital nerve. Its distal end presents 
its tendon, which passes over the outer side of the metacarpo- 
phalangeal articulation of the third digit, to the dorsal surface 
of said digit. 
Dissection.—Display tlie anatomical elements of the third palmar inter- 
tendinous space. 
61. Fourth Digital Nerve.—This nerve has a distal course, 
from where it emerges, into this space, from the dorsal surface 
of the anterior annular ligament; it passes to the dorsal sur- 
face of the superficial palmar arch, distal to which it bifurcates 
into the sixth and seventh palmar collateral digital nerves. 
62. Fourth Digital Artery.—This artery (veme comites) is 
given off from the superficial palmar arch, where the latter 
bridges the third palmar intertendinous space ; it has a distal 
course, along the inner side of the last-described nerve, to the 
webbing between the third and fourth digits, where it bifurcates 
into the sixth and seventh palmar collateral digital arteries. 
63. Third Lumbricalls Muscle.—This muscle is located in 
the third palmar intertendinous space, having the fourth digi- 
tal nerve and artery upon its palmar surface. Its tendon 
passes to the dorsal surface of the fourth digit, along the outer 
side of its metacarpo-plialangeal articulation. 
Dissection.—Expose the parts occupying the fourth palmar intertendinous 
space. 
64. Fifth Digital Nerve.—This nerve was described from its 
origin, from the superficial palmar branch of the ulnar nerve 
(page 218), to where it enters the palmar fossa. In this inter- 
tendinous space it bifurcates into the eighth and ninth palmar 
collateral digital nerves. 
65. Fifth Digital Artery.—This branch (venae comites) of 
the superficial palmar arch has a distal course in this space, 
to the webbing between the fourth and fifth digits, where it 
bifurcates into the eighth and ninth palmar collateral digital 
arteries. It runs to the dorsal side of the last-described nerve. ANTERIOR OF ELBOW, FOREARM, AND HAND. 
223 
66. Fourth Lumbricalts Muscle.—This muscle forms the 
floor of the fourth palmar intertendinous space, with the last- 
described nerve and artery upon its palmar surface. Its ten- 
don passes over the outer side of the metacarpo-phalangeal ar- 
ticulation of the fifth digit, to the dorsal surface of the same. 
Dissection.—Make the skin incisions 8, 8, 8, 8, 8, of Figure 10 (page 207), 
on the digits, first to fifth, inclusive ; reflect skin flaps well off the lateral digi- 
tal surfaces; trace the palmar collateral digital nerves, and arteries, and clear 
the digital sheaths of the flexor tendons ; open the latter and probe the same 
(Fig. 2, Plate 4). 
67. Palmar Collateral Digital Xerves, Plate 127. These 
nerves, ten in number, are located in the palmar halves of the 
lateral digital surfaces ; they are continued from (second and 
sixth), and result from the bifurcation of (first, third, fourth, 
and fifth), the digital nerves. Each digit has two nerves, one 
at each palmar half of a lateral digital surface. Each nerve 
sends a dorsal digital branch to the dorsal surface of the pha- 
langine and phalangette segments of the digit. 
68. Palmar Collateral Digital Arteries, Plates 127,131,132, 
and 133.—These arteries (venae comites), ten in number, accom- 
pany the last-described nerves, and run at their dorsal surfaces. 
They are given off (first, second, fourth, fifth, sixth, seventh, 
eighth, and ninth), from the bifurcation of the first, third, 
fourth, and fifth digital arteries ; the third and tenth are con- 
tinued from the second and sixth digital arteries, respectively. 
Each digit has two arteries, one in the palmar half of each lat- 
eral digital surface. Each artery of the digits, second to fifth 
inclusive, gives off a dorsal branch, opposite the phalangine of 
those digits (Plate 127). The two arteries of a digit anasto- 
mose at the palmar surface of its phalangette. 
69. Digital Sheaths of the Flexor Tendons, Plate 127 ; 
Fig. 2, Plate 4.—The palmar surface of each digit, second to 
fifth inclusive, presents a sheath of investment of the flexor 
tendons there lodged. They are attached to the lateral digital 
surfaces of the phalanx and phalangine of the digit. If opened 
and probed they will be found to be limited to the digit (sec- 
ond, third, and fourth); that of the fifth digit being continued 
into the common sheath of the long flexor tendons, in the 224 
UPPER EXTREMITY. 
palmar fossa. The sheath of the flexor longus pollicis ten- 
don is continued into the pollex eminence, and even to the 
carpal portion of the tendon, and to the distal end of the fore- 
arm portion of the tendon. 
Dissection.—Section the two proximal branches of the median nerve (Plate 
126), the flexor carpi radialis, and the palmaris longus muscles (Plate 125). 
Turn off the distal portions of the muscles, with that of the supinator longus, 
to the outer side. Cut the anterior portion of the proximal half of the pro- 
nator radii teres muscle (Plate 125), and reflect it, with the proximal portions 
of the flexor carpi radialis and palmaris longus muscles, off of the inner side of 
the elbow. Note the compound flexor attachment, of the superficial flexor 
muscles of the forearm, to the internal condyle of the humerus. 
70. Compound Flexor Attachment (of tile superficial 
flexor muscles), Plates 121,128, 129, 130, and Fig. 1, Plate 134. 
—The flexor carpi‘radialis, the palmaris longus, and the hu- 
meral attachments of the flexor sublimis digitorum, and the 
flexor carpi ulnaris muscles become fused to form the com- 
pound flexor attachment to the anterior and inner surfaces of 
the internal condyle of the humerus. The proximal ends of 
the two first may now be traced thereto, and left hanging 
therefrom. 
71. Pronator Radii Teres Muscle, Plates 121, 125, 126, 128, 
129, 130; and Fig. 1, Plate 134.—This muscle lias an ob- 
liquety longitudinal course across the elbow and the proximal 
third of the forearm. Its proximal half has two portions, an 
anterior and a posterior: the anterior portion has its proximal 
attachment to the internal condyle of the humerus, to the 
proximal side of that of the compound flexor attachment; the 
ptosterior portion has its proximal attachment to the inner side 
of the anterior surface of the coronoid process of the ulna. In 
the distal half of the muscle the two portions fuse into one 
muscle, which is continued to the outer side of the radius, 
where it winds over the same, for attachment to the postero- 
lateral surface of the shaft of the bone, at about the junction 
of its proximal and middle thirds (Plate 169). Between the 
proximal portions of the muscle the median nerve passes into 
a deep plane of the forearm (Plate 126). 
Dissection.—Trace the radial artery and nerve through their forearm por- 
tions. Section the posterior portion, of the inner part, of the pronator radii ANTERIOR OF ELBOW, FOREARM, AND HAND. 
225 
teres muscle; raise it from beneath the median nerve; and reflect it off of 
the inner side of the elbow; turn the distal portion of the muscle off of the 
outer side of the forearm. Display the proximal border of the flexor sublimis 
digitorum muscle ; also its radial and ulnar attachments. Follow the median 
nerve, to where it passes to the posterior surface of the flexor sublimis digi- 
torum muscle ; note its branch to the latter muscle, also its anterior interos- 
seous branch, with the muscle branches of the latter nerve. Expose the proxi- 
mal portion of the ulnar artery, to where it passes to the posterior surface of 
the flexor sublimis digitorum muscle; also, its anterior ulnar recurrent, poste- 
rior ulnar recurrent, and common interosseous branches. 
72. Radial Artery, Plates 128 and 130.—This artery (venm 
comites) has been partially described (page 212) ; at present its 
whole course through the forearm is exposed, from its origin, 
from the bifurcation of the brachial, to its winding to the dorsum 
of the carpus, at the outer side of the latter. It lies, succes- 
sively, upon the anterior surfaces of the tendon of the biceps, 
the flexor sublimis digitorum, flexor longus pollicis, and pro- 
nator quadratus muscles, and upon the anterior surface of the 
distal end of the radius. Its branches, the radial recurrent 
(page 216) and the superficialis volte (page 217), have been de- 
scribed ; near the latter branch, it gives off the anterior radial 
carpal artery, to the anterior of the carpus (Fig. 2, Plate 134). 
73. Radial Nerve.—This nerve may now be followed from 
its origin, at the bifurcation of the musculo-spiral nerve, across 
the anterior of the elbow, and through the forearm, to where it 
passes to the dorsal surface of the limb, at its distal quarter. 
It runs parallel with, and to the outer side of, the tendon of 
the biceps muscle and the radial artery, upon the anterior sur- 
faces of the supinator brevis, flexor sublimis digitorum, and 
the flexor longus pollicis muscles. 
74. Median Nerve.—This nerve, which was seen passing 
between the anterior and posterior proximal portions of the 
pronator radii teres muscle (Plate 126), gives off the anterior 
interosseous nerve and the nerve to the flexor sublimis digi- 
torum muscle. The nerve-trunk passes to a deep plane, pos- 
teriorly to the latter muscle. 
75. Anterior Interosseous Nerve and Its Muscle Branches. 
—This nerve, branch from the outer side of the median, gives 
off muscle branches to the flexor profundus digitorum and the 226 
UPPER EXTREMITY. 
flexor longus pollicis muscles ; the trunk and branches pass to 
a deep plane, posteriorly to the flexor sublimis digitorum 
muscle. 
76. IVTerve to tlie Flexor Sublimis Digitorum Muscle.—This 
nerve is given off from the inner side of the median ; it enters 
the proximal portion of the muscle. 
77. Flnar Artery.—The proximal end of this artery (venae 
comites) is exposed from its origin, to where it passes to the pos- 
terior surface of the flexor sublimis digitorum muscle. In this 
portion of its course it gives off the anterior and the posterior 
ulnar recurrent (from its inner side) and the common interos- 
seous (from its outer side). 
Dissection.—Section the anterior annular ligament (Plate 127) and cut it 
away at its attachments ; note the attachments to it, of the pollex and minim 
eminence muscles. Section the following parts (Plate 127) : the ulnar and the 
superficialis vola3 arteries, also, the anastomosing branch from the superficial 
palmar arch to the second digital artery; the first and second palmar collateral 
digital nerves ; the second, third, and fourth digital nerves; the superficial 
palmar nerve from the ulnar nerve. Reflect the superficial palmar arch and 
its digital branches ; also, the digital nerves upon and between the digits. Clear 
away the digital sheaths of the flexor tendons. Clear the anterior surface of 
the flexor sublimis digitorum muscle, tracing its tendons through the carpal, 
metacarpal, and digital regions. 
78. Flexor Sublimis Digitorum Muscle, Plates 121,128, and 
129.—This muscle forms the second muscle plane .of the an- 
terior of the forearm. Its proximal attachments are: to the 
humerus, by the compound flexor attachment to the internal 
condyle ; to the ulna, at the inner side of the anterior surface 
of its coronoid process; to the radius, at the oblique line on 
its anterior surface. The muscle separates into four portions, 
each of which has a tendon ; the tendons cross the carpal region, 
posteriorly to the anterior annular ligament; from there, the 
four are projected into the palmar fossa of the hand, from 
which they are continued upon the palmar surfaces of the 
phalanges and phalangines of the digits, second to fifth, in- 
clusive. Between the humeral and ulnar attachments, on the 
inner side, and the radial, on the outer side, a fibrous edge of 
the muscle bridges: to the posterior surface of this the median 
nerve, and the anterior interosseous nerve and its branches, ANTERIOR OF ELBOW, FOREARM, AND HAND. 
227 
also, the ulnar and tlie anterior interosseous arteries pass to a 
deeper plane (Plate 128). 
Dissection.—Section the tendons of the flexor sublimis digitorum muscle, 
and reflect the proximal portion of the muscle, cutting it from its radial attach- 
ment (Plate 129), then turn it off to the inner side of the proximal portion of 
the forearm and the elbow (Plate 130) ; cut its nerve from the median (Plate 
128) ; reflect its distal portions (tendons’) off of the digits. Cut the radial artery 
and nerve, each at two points (Plate 128), and remove their included portions. 
Trace the median nerve through the forearm (Plate 130) to its carpal portion, 
where it breaks up into its four terminal branches (Plate 131). Section the ab- 
ductor pollicis muscle (Plate 127) and reflect its portions; trace the outer ter- 
minal branch of the median nerve to the muscles of the pollex eminence (Plate 
131). Display the three inner terminal branches of the median nerve (Plate 
131). Clear the opponens pollicis muscle; the outer and part of the inner 
head of the flexor brevis pollicis muscle. 
79. Median Nerve, Plates 130 and 131.—This nerve has a 
distal course through the forearm, from where it passes to the 
posterior surface of the flexor sublimis digitorum muscle, to 
reach the anterior surface of the flexor profundus digitorum 
muscle. At the carpus it ends in four branches, as follows: 
the first or outer branch enters the proximal portion of the 
pollex eminence and bifurcates, the outer branch supplying 
the abductor and the opponens pollicis muscles, the inner go- 
ing to the outer head of the flexor brevis pollicis muscle ; the 
second, is the first palmar (pollex) digital nerve, to which may 
be traced the first and second palmar collateral digital nerves ; 
the third is the second digital, a branch from which supplies 
the first lumbricalis muscle ; the fourth bifurcates into the 
third and fourth digitals—the third supplying a branch, to the 
second lumbricalis muscle. 
80. Opponens Pollicis muscle, Plates 122, 131, and 132.— 
This muscle of the pollex eminence has a proximal attachment 
to the palmar surface of the trapezium, a distal one to the 
outer side of the palmar surface of the first metacarpal bone. 
Dissection.—Cut the flexor brevis minimi digiti muscle from its proximal 
attachment and turn it off of the minim border of the metacarpal region (Plate 
131). Trace the muscle branches of the deep palmar nerve, and clear the op- 
ponens minimi digiti muscle. 228 
UPPER EXTREMITY. 
81. Muscle Branches of tlie Deep Palmar Nerve, Plate 
131.—From its inner side the deep palmar nerve gives off two 
branches : the first distributes to the flexor brevis minimi 
digiti and the abductor minimi digiti muscles ; the second, to 
the opponens minimi digiti muscle. 
82. Opponens Minimi Digiti muscle, Plates 122, 131, 132, 
and 133.—This muscle, the deepest of the muscles of the minim 
eminence, has its proximal attachment to the process of the 
unciform bone ; its distal to the inner portion of the palmar 
surface of the fifth metacarpal bone. To the inner side of its 
proximal end the deep palmar artery and nerve pass to their 
deep plane of distribution in the palm. 
Dissection. —Follow the ulnar artery through the forearm (Plate 130) to 
its bifurcation at the carpus (Plate 131). Trace the ulnar nerve, through the 
forearm, from its proximal entrance into the region, to its bifurcation into the 
superficial and deep palmar nerves. Find its branches to the flexor profundus 
digitorum and flexor carpi ulnaris muscles, also its dorsal and its palmar cuta- 
neous branches. Clear the surfaces of the forearm portions of the flexor carpi 
ulnaris, the flexor profundus digitorum, and the flexor longus pollicis muscles 
(Plates 129 and 130). Follow the anterior interosseous nerve and its branches 
(Plate 130). 
83. Ulnar Artery, Plates 128,130,131,132, and Fig. 2, Plate 
134.—This artery (vena) comites) has a distal course, from 
where it passes to the posterior surface of the flexor sublimis 
digitorum muscle (page 226); it lies upon the anterior surface 
of the flexor profundus digitorum muscle, and along the outer 
side of the flexor carpi ulnaris muscle ; it continues to where 
it divides into the (superficial palmar) palmar arch and the 
deep palmar artery (page 218). It supplies branches to contig- 
uous muscles, and near its bifurcation sends off the anterior 
ulnar carpal branch (Fig. 2, Plate 134). 
84. Ulnar Nerte, Plates 125, 127, 128, 130. 131, 132, 133 ; 
Figs. 1 and 2, Plate 134.—This nerve enters the forearm region, 
from the groove on the posterior surface of the inner condyle 
of the humerus, passing to the plane between the flexor subli- 
mis and profundus digitorum muscles ; at its proximal end it 
supplies the flexor profundus digitorum muscle from its outer 
side, and the flexor carpi ulnaris muscle from its inner side. 
It has a distal course upon the anterior surface of the flexor ANTERIOR OF ELBOW, FOREARM, AND HAND. 
229 
profundus, and to the outer side of the flexor carpi ulnaris 
muscles ; for the distal half of the forearm it runs to the inner 
side of the ulnar artery. In its distal third it gives off: a dor- 
sal branch, which winds around the inner side of the fore- 
arm to the dorsum of the hand ; and a palmar cutaneous 
branch, which passes to the hand, upon the anterior surface of 
the ulnar artery. At its carpal portion it bifurcates as before 
shown (page 218). 
85. Flexor Carpi ITlnaris Muscle, Plates 121, 125, and 127 
to 134, inclusive.—The proximal attachments of this muscle 
(page 211) are : to the inner condyle of the humerus, by the 
compound flexor attachment thereto (page 224) ; to the inner 
side of the olecranon process of the ulna ; by an aponeurotic 
portion, which invests the flexor profundus digitorum muscle, 
to the internal and posterior ridge of the shaft of the ulna. 
86. Anterior Interosseous Nerve and its Muscle Brandies, 
Plates 128 and 130.—This nerve, branch of the median (page 
225), has a distal course from its origin, to where it passes to a 
deep plane between the flexor profundus digitorum and the 
flexor longus pollicis muscles. It gives off, from its inner side, 
two branches to the former muscle, which pass posteriorly to 
the median nerve ; from its outer side, three branches are af- 
forded : two to the flexor longus pollicis muscle; and one to 
the flexor profundus digitorum muscle. 
Dissection.—Clear the palmar surface of the tendons of the flexor profun- 
dus digitorum muscle. Expose the relations, of the digital portions, of the 
tendons of the flexor sublimis and profundus digitorum muscles. Display the 
palmar surfaces of the four lumbricales muscles ; also, the tendon of the flexor 
longus pollicis muscle. 
87. Flexor Profundus Digitorum Muscle, Plates 121, 130, 
and 131.—This muscle has a proximal attachment to the ante- 
rior surface and inner side of the shaft of the ulna, and, also, to 
the anterior surface of the radio-ulnar interosseous ligament; 
the distal forearm portion of the muscle projects four tendons 
into the metacarpal region, which are continued to the palmar 
surfaces of the digits, second to fifth, inclusive. 
88. Relations of the Digital Portions of the Tendons of 
the Flexor 8ublimis and Flexor Profundus Digitorum Muscle§, 
Plates 121, 129, 131, and 132.—A tendon of tlie flexor sublimis 230 
UPPER EXTREMITY. 
digitorum (perl'oratus) muscle splits opposite the phalanx of 
a digit ; the portions continue distally, curling so as to bring 
their dorsal surfaces uppermost, and then unite ; the splitting 
and reunion of the tendon forms a button-liole-like channel 
(Plate 131); the reunited portions split again, the slips pass- 
ing to be attached to the halves of the palmar surface of the 
phalangine of a digit. A tendon of the flexor profundus 
digitorum (perforans) muscle enters upon the palmar surface 
of the phalanx of a digit to the dorsal surface of a sublimis 
tendon, it then passes through the opening in a tendon of the 
flexor sublimis digitorum (perforatus), and is continued, upon 
the phalangine, to its attachment to the palmar surface of the 
base of the phalangette. The tendons, as lodged in tlieir 
sheaths (page 223), are held to the phalanges and phalangines 
of the digits, by folds of synovial membrane lining the sheath 
of, and covering, the tendons—vincula accessoria tendinum; 
by these, vessels pass to and from tendons. 
89. Fumbricales Muscles, Plates 127, 129, 131, 132, and 
133.—These four muscles were located in the palmar interten- 
dinous spaces (pages 221, 222, and 223) ; they have their prox- 
imal attachments to the outer sides of the metacarpal portions 
of the tendons of the flexor profundus digitorum muscle ; they 
pass in a distal direction to the webbing between the digits, 
where they have been described (pages 221, 222, and 223) pass- 
ing to the dorsal surfaces of the phalanges of the digits, sec- 
ond to fifth, inclusive. 
90. Flexor Longus PoIIicis Muscle, Plates 121, and 127 
to 131, inclusive.—This muscle extends, from its proximal at- 
tachment to the anterior surface of the shaft of the ulna, 
through the forearm ; its tendon crosses the carpus, posteriorly 
to the anterior annular ligament, into the pollex eminence, 
where it is lodged between the heads of the flexor brevis polli- 
cis muscle ; from there, it is projected upon the palmar surface 
of the first or pollex digit, to its distal attachment to the palmar 
surface of the base of the phalangette of the same. 
Dissection.—Section tlie tendons of the flexor profundus digitorum mus- 
cle, also the lumbricales muscles (Plate 131); reflect the tendons and the 
lumbricales muscles off of the digits. In reflecting the third and fourth lum- 
bricales muscles find their nerves, from the deep palmar nerve, entering their 
dorsal surfaces (Plate 132) ; leave the nerves in situ for appreciation later on ANTERIOR OF ELBOW, FOREARM, AND HAND. 
231 
(page 233). Cut the tendon of the flexor longus pollicis muscle (Plate 131). 
and reflect it off of the pollex digit. Cut the median nerve to the proximal 
side of its terminal branches (Plate 131), and dissect away the branches, as in 
Plate 132. Clear the palmar surfaces of the flexor brevis (outer and inner 
heads), the adductor, and the opponens pollicis muscles. 
91. Flexor Brevis Pollicis Muscle, Plates 122, 127, 129, 
131, and 132. This muscle, of the pollex eminence, has two por- 
tions or heads, the outer and the inner. The outer head has 
proximal attachments to the trapezium and the annular liga- 
ment ; its distal end is attached, primarily, to the outer sesa- 
moid bone, opposite the palmar surface of the metacarpo-plia- 
langeal articulation of the first (pollex) digit; secondarily, to 
the palmar surface of the outer tubercle of the base of the 
phalanx of the first digit, to the inner side of the attachment 
of the abductor pollicis muscle. The inner head has a proxi- 
mal attachment to the palmar surfaces of the trapezoid and 
os magnum of the carpus, and the base of the third metacarpal 
bone; its distal end is attached, primarily, to the inner sesa- 
moid bone, opposite the metacarpo-phalangeal articulation of 
the first digit; and, secondarily, to the palmar surface of the 
inner tubercle of the base of the phalanx of the same digit, in 
common with the adductor pollicis muscle. A furrow exists 
at the palmar surface, between the two heads of the muscle, for 
the lodgment of the tendon of the flexor longus pollicis muscle 
(Plates 127, 129, 131, and 132). 
92. Adductor Pollicis Muscle.—This muscle has an inner 
attachment to the palmar surface of the third metacarpal bone 
(Plate 122); it crosses the second intermetacarpal space, the 
second metacarpal bone, and the first intermetacarpal space, to 
reach its outer attachment, to the inner tubercle on the palmar 
surface of the base of the phalanx of the first or pollex digit 
(Plate 122). in common with the distal end of the inner head of 
the flexor brevis pollicis muscle. 
93. Opponent Pollicis Muscle, Plates 122, 131, and 132.— 
This muscle, at the outer side of the flexor brevis pollicis, and 
the dorsal surface of the abductor pollicis, is attached : proxi- 
mally, to the trapezium and anterior annular ligament; dis- 
tally, to the palmar surface of the first metacarpal bone. 232 
UPPER EXTREMITY. 
Dissection.—Section the abductor minimi digiti muscle (Plate 131) ; re- 
flect its portions and cut them away with the flexor brevis minimi digiti 
muscle, as in Plate 132. Section the opponens, the flexor brevis (outer and 
inner heads), and the adductor pollicis muscles (Plate 132) ; reflect their por- 
tions and cut them away, as in Plate 133. In reflecting the flexor brevis and 
the adductor pollicis muscles find their supplying nerves from the deep pal- 
mar nerve, and cut them where they enter the muscles; dissect the distal 
ends of the heads of the flexor brevis pollicis muscle from the sesamoid 
bones, leaving the latter in situ (Plate 133). Display the deep palmar arch 
and its branches; also, the deep palmar nerve and its branches (Plates 132 
and 133). 
94. Serves to tlie Inner Head of the Flexor Brevis Polli- 
cis and the Adductor Pollicis Muscles, Plate 133.—In reflecting 
the proximal portion of the former and the inner portion of 
the latter muscle, their nerves, from the deep palmar branch 
of the ulnar nerve, enter the inner border of the former and the 
dorsal surface of the latter. 
95. Deep Palmar Areli, Plates 132 and 133.—The deep 
palmar arch is formed by the entrance of the radial artery into 
the deep plane of the palm, at the proximal end of the first in- 
termetacarpal space. The arterial arch (venae comites) crosses 
the proximal ends of the metacarpal bones (second to fifth, 
inclusive), and the interossei muscles, dorsal and palmar. At 
its inner end the arch is completed by anastomosing with the 
deep palmar branch of the ulnar artery, which enters the deep 
plane of the palm, from the dorsal surface of the proximal end 
of the opponens minimi digiti muscle. 
96. Branches of the Deep Palmar Areli.—The branches of 
the deep palmar arch are distal, dorsal, and proximal. The 
distal branches are : the first and the second digital, the first, 
the second, and the third interosseous. The first digital ar- 
tery (veme comites) lias a distal course between the palmar 
surface of the first metacarpal bone (Plate 133) and the flexor 
brevis pollicis muscle, to a point opposite the distal end of 
the bone, where, between the heads of the muscle, it bifur- 
cates into the palmar collateral digital arteries (first and sec- 
ond) of the first (pollex) digit. The second digital artery 
(venre comites) runs upon the palmar and outer surfaces of the 
first dorsal interosseous muscle, to a point opposite the meta- 
carpo-plialaiigeal articulation of the second digit, where it be- ANTERIOR OF ELBOW, FOREARM, AND HAND. 
233 
comes its outer palmar collateral digital artery (the third). 
The first, the second, and the third interosseous arteries (venae 
comites) are given oif from the arch opposite the intermeta- 
carpal spaces, second to fourth, inclusive; they have a distal 
course, upon the palmar surfaces of the interossei muscles (first 
palmar, third dorsal, and fourth dorsal, respectively) to their 
anastomoses with the third, fourth, and fifth digital arteries, 
respectively, before the distal bifurcation of the latter (page 
210) ; they supply contiguous muscles in the deep plane of the 
palm. The dorsal ox 'perforating branches (venae comites) are 
given off opposite the proximal ends of the second, third, and 
fourth dorsal interossei muscles ; they perforate the muscles to 
reach the dorsal surface of the metacarpal region. The proxi- 
mal branch or recurrent carpal, has a recurrent course, to the 
palmar surface of the carpus. 
97. Deep Palmar Werve.—This nerve, branch of the ulnar 
(page 218), enters the deep plane of the palm, to the dorsal 
surface of the proximal end of the opponens minimi digit! 
muscle, with, and to the proximal side of, the deep palmar 
artery. It crosses the palm : for its first half, it lies to the 
proximal side of the deep palmar arch; opposite the base of 
the third metacarpal bone it passes, at the dorsal side of the 
arch, to the distal side of the outer portion of the arch ; oppo- 
site the proximal portion of the second intermetacarpal space 
it has its terminal bifurcation. It lias five distal and two ter- 
minal muscle branches. The five distal muscle branches are : 
tliq first (Plate 132) bifurcates to distribute to the third palmar 
interosseous and the fourth lumbricalis; the second, to the 
fourth dorsal interosseous ; the third bifurcates to supply the 
second palmar interosseous and the third lumbricalis; the 
fourth, to the third dorsal interosseous; tliq fifth, to the second 
dorsal interosseous; the sixth (Plate 133), to the adductor pol- 
licis (page 232). Of the two terminal muscle branches: the 
proximal one distributes to the inner head of the flexor brevis 
pollicis (page 232); the distal one bifurcates to supply the first 
palmar and the first dorsal interosseous (Plate 133). 
Dissection.—Follow the distal portion of the flexor carpi radialis muscle 
to its attachment. Clear the fascia from the palmar surfaces of the inter- 
osseous muscles, palmar and dorsal; display the transverse metacarpal liga- 
ment. Then, cut the ligament away so as to expose the distal ends of the 
latter muscles. 234 
UPPER EXTREMITY. 
98. Flexor Carpi Radialis Muscle, Plates 121, 125, and 
128 to 133, inclusive.—This muscle (page 211) may now be fol- 
lowed to its distal attachment to the palmar surface of the 
base of the second metacarpal bone (Plate 121). It will be 
found lodged, in a special compartment, at the outer side of 
the space, posteriorly to the anterior annular ligament. 
99. Transverse Metacarpal Ligament, Plates 132 and 133. 
—This is a transverse stretch of fibrous tissue uniting the 
palmar metacarpo-phalangeal ligaments, thereby binding them 
together. They cover the palmar surfaces of the distal ends of 
the tendons of the interosseous muscles, palmar and dorsal. 
100. Interosseous Muscles, Plates 122, 132, and 133.—These 
seven muscles—three palmar and four dorsal—are located in 
the four intermetacarpal spaces : the lirst dorsal interosseous 
muscle occupies the first intermetacarpal space; the first pal- 
mar and’ the second dorsal interosseous muscles are located 
in the second intermetacarpal space ; the third dorsal and the 
second palmar interosseous are in the third intermetacarpal 
space ; the fourth dorsal and the third palmar interosseous ap- 
pear in the fourth intermetacarpal space. The three palmar 
appear only at the palmar surface of the metacarpal region; 
the four dorsal present at both the palmar and the dorsal sur- 
faces. The palmar interosseous have their proximal attach- 
ments, as follows: the first, to the inner side of the palmar 
surface of the second metacarpal bone ; the second and third, 
to the outer sides of the palmar surfaces of the fourth and fifth 
metacarpal bones, respectively. The dorsal interosseous have 
palmar surface attachments, as follows: the first and second, 
to the outer sides of the palmar surfaces of the second and 
third metacarpal bones, respectively ; the third and fourth, to 
the inner sides of the palmar surfaces of the third and fourth 
metacarpal bones, respectively. (The complete dissection of 
the dorsal interosseous, and of the distal ends of the palmar 
interosseous and the lumbricales muscles are left, until the dis- 
section of the dorsum of the hand.) 
Dissection.—Section (Plate 130) the median nerve and its branches, the 
ulnar artery, the ulnar nerve, and its branch to the flexor carpi ulnaris muscle. 
Cut the nerves of the flexor profundus digitorum and the flexor longus pollicis 
muscles (Plate 130); section the former of these muscles longitudinally, as it 
is in Fig. 1, Plate 134, and dissect its outer portion from the anterior surfaces of ANTERIOR OF ELBOW, FOREARM, AND HAND. 
235 
the ulna (Plate 121), the radio-ulnar interosseous ligament, and the pronator 
quadratus muscle; be careful to preserve the interosseous artery and its 
branches; also, the anterior interosseous nerve upon the anterior surface of 
the radio-ulnar interosseous ligament. Cut away the flexor longus pollicis 
muscle from the radius (Plate 121) and the pronator quadratus muscle. Cut 
away the proximal portions of the pronator radii teres, the flexor carpi ra- 
dialis, the flexor sublimis digitorum, and the palmaris longus muscles, as in 
Fig. 1, Plate 134. 
lOl. Interosseous Arteries, Plate 130, and Fig. 1, Plate 134. 
—The ulnar gives off the common interosseous artery (page 
225 and 226), which divides into the posterior and the anterior 
interosseous arteries. The posterior interosseous artery (venae 
comites) perforates the radio-ulnar interosseous ligament to 
reach the posterior region of the forearm. The anterior inter- 
osseous artery (venae comites) has a distal course, reaching the 
anterior surface of the radio-ulnar interosseous ligament, be- 
tween the flexor profundus digitorum and the flexor longus 
pollicis muscles (Plate 130) ; it runs parallel with the nerve of 
the same name, and passes to the dorsal surface of the prona- 
tor quadratus muscle. Its branches supply contiguous mus- 
cles, and some of them perforate to the posterior region of the 
forearm. 
102. Anterior Interosseous Xerve.—This nerve, branch of 
the median nerve (page 225), after having passed between the 
flexor longus pollicis and the flexor profundus digitorum mus- 
cles (Plate 130), to reach the deep plane of the anterior of the 
forearm, has a distal course, upon the radio-ulnar interosseous 
ligament, to where it passes to the posterior surface of the 
pronator quadratus muscle. It accompanies the last-described 
artery. 
103. Pronator Quadratus muscle, Plates 121, 128, 129, 130 ; 
and Figs. 1 and 2, Plate 134.—This muscle is located, trans- 
versely, across the distal portion of the anterior surface of the 
forearm. It is attached (Plate 121) to the anterior surfaces of 
the radius and the ulna, respectively, well over the inner side 
of the former. 
104. Biceps muscle, Plates 121, 128, 129, 130, and Fig. 1, 
Plate 134.—The distal end of the tendon of this muscle passes, 
around the inner side of the tubercle of the radius, to reach its 236 
UPPER EXTREMITY. 
attachment to the posterior surface of the same (Fig. 1, Plate 
174). A bursa is located upon the anterior surface of the 
tubercle, between it and the tendon (Plate 121). 
105. Brachialis Anticus Muscle, Plates 121, 126, 128, 129, 
130 ; and Fig. 1, Plate 134.—The distal end of this muscle is 
attached to the anterior surface of the proximal end of the 
ulna, distal to its coronoid process. 
106. Supinator Brevis Muscle.—The anterior surface of 
this muscle presents between the tendon of the biceps and 
the extensor carpi radialis brevior muscle, being attached 
to the anterior surface, and outer side, of the radius, between 
the head and oblique line of the bone. It also has an an- 
terior attachment to the outer side of the coronoid process of 
the ulna. 
Dissection.—Section the pronator quadratus muscle, and reflect its por- 
tions (Fig. 2, Plate 134). Trace the anterior interosseous artery : its branches 
to the pronator quadratus muscle ; and its anastomoses with the arteries at 
the anterior of the carpus. Expose the distribution of the anterior interos- 
seous nerve to the pronator quadratus muscle and to the carpus. 
107. Anterior Carpal Arteries, Plate 134.—At the anterior 
of the carpus there are the free anastomoses of the anterior ra- 
dial carpal, the anterior ulnar carpal, the recurrent carpal, and 
the anterior interosseous (terminal branches) arteries. 
108. Terminal Distribution of the Anterior Interosseous 
!¥erve, Fig. 2, Plate 134.—This nerve has a terminal distribu- 
tion to the pronator quadratus muscle and to the anterior of 
the joints of the carpus. 
Dissection.—Keep the anterior surfaces of the hand, forearm, elbow, and 
shoulder articulations, thoroughly moist and soft, for their subsequent dissec- 
tion. PLATE 121 
AntVportron of 
PRONA TOR RA DU TERES - 
CompoundflexVattach 
Of EL EX? CA RR/ RADJAL 
PA L MA R/S L ON GUS, „ 
EL EXESUBL/M? D/G/T ■ & 
EL EXPCARP/ ULNARIS 
uohonoidprocess ■ 
EX TENSOR CA RP/ RADJA L /S LONG/OR 
of rrona rfts' 
RAD// TERES 
BRACR/AL/S A AIT/ CDS 
TL EX ?SUBL /M/S D/G/TORUM 
Location of 
bursa for B/c eps 
FL EXOR SUBL/M/S D/GITORUM 
SUP/NATOR LONG-US 
stxz, otd processes 
FLEXOR CARP/ ULNAR/S 
EXT?OSS/S META CARP/ POLL? 
El EX OR CARP/ RADIAL? 
FI EX?LONG US 
POLL/C/S 
EL EX *SOBE /MLS D/&JTORUM 
" PROFUNDUS " 
TV/. Co fin, adnaturam Uel, PLATE 122 
ABDUCTOR M/N/M! DI&ITI 
FLFX?BRey? " " — 
PLPXOR BRPV/S POL Lie IS 
OPPONBNO 
-A BDUC TOR POL L ? 
-~FLEX?BREV? "OUtVhd. 
~~ " _" " innr » 
r—ADO? POLL? 
/4 BO *M/A/. O/G-. 
8c PL EX d BRE V. 
At/A/. 0/0/ r/ - 
M.Cohn,czcina/Luram c/e£. PLATE 123 
2fra/Tc7tes of 
zjitfcutusieau-s si 
Common uZnar re-. 
_ cutaneous,Granc/r 
ofsnuscuZo -spircrZ 71. 
-JfuscuZo-cutaneous n* 
A.nastomot£c zr. 
HaeZiaZ n. 
ir.CeArr.adnataram <Zee. PLATE 124 
jPafmotr6rctnc7i of mu-yculo- 
. cu.tcz/ieou.'S 7i- 
k 
out an Oorts’ . 
ttrasic/i ctf /nectean n. 
Palmar 
cutaneous Grand* 
a/-' /atn ar n. 
ds* to 
J^almVcollater? 
fdiryitat 
Cffl to IO*?' 
JF’atmar- coZ/ateiyrt- 
diryitaZ jrt? 
Jrl.Cohyi, aeZ Ttcrutrczm. etet. PLATE 125 
rtf/ce es 
InffprofuncZa art. 
Ulnar n. 
In ner in ter muscular septum 
Anastomotica /natf/ia art.' 
EMU? DO ATDYE. t: — 
Hicipital fascia 
Jllusculo-cutaneoiis n. 
MculiaZ recurrent 
art. 
Zllsteer n. 
Palmar cutaneous dranc/2 of 
ulnar n. 
Dadial n. 
Uorscrl branch of ul/iar n 
PL Erxon L ONGUS POLL/C/S 
- Pctimrcutaneous tjranefc of 
median n. 
eftONA rot? quads?a rus 
EXT?OSS!S M ETA CA RPi POLL. 
Super/iciaZis iso Zee art. 
MiCohn, act7z<ztura/n cteL. PLATE 126 
MtoSt/R/H? 
\ SR £ V/S 
ET.CoAn.adncztu.ra7n del. PLATE 127 
PaZmar cutaneous 
branch of ulnar n— 
23eep pa/mar tz 
Super/i czaZ 
pa/TTiar n. 
J/.tO ABDUCTOR M/N/M/ 
O/O.&ELEX.BEE/.M/N. I 
0/0. /< 
A~to OR RON EH. MIN. ' 
D/G-/T/ t-f 
JJeep pa/mar. 
art. 
digital n. 
IS -Z-CC4. CfC* 
// 
S*h * 
d‘ttl 7! 
'dsM2”f4palmar 
collatiaig.l a j> 
\2-?*&2n.apaZmar 
• 'c-o/lattdlgiart? 
2n.a digital 
"art. 
-3taetiaital 
art. 
i^aoasAl 
\JAfTERQSS? 
'DorsaZ digital branch ? 
of’ n? & ar t? 
act /za£ttrcz.77z cZeZ. PLATE 128 
Znner i/iter muscular septum 
ZSlnar ?/. — 
Jt/ffy/rof/t/Lda, art. 
/Tusculo - cutaneous n 
jLnasio/n ol icct maffrta art. 
JWuscuio - spiral n.. 
SupFpro/unda art. 
PostTinterosseous n. 
AntP » " 
tf.totx t?ca ftr/ ft a o. Bftr rf 
- Jiadiul recztrrent 
art. 
—Mto son/At A rot? stt£ V/S 
SostSport/on of 
r/fO/VATOtf/ZAO// TEtfES 
A ntPuZn ar reczerr.art. 
/Posts n » 
JVZtarLEXOft SUBL /m/s 
£>/&/ TOO OAA 
tZttu Ft ex ?rtrororza ?E>/a P - 
Common interosf art. 
Posterior " " 
Anterior j> // 
-jy?cort-EX fEOA/oz/s 
SOtE'C/S 
POOH ATOP PAD/! TEPES 
ZJ orsatt/ranctzo/ utnar 77. -~ 
_Pa7//i rc/Uan $ " " a ■* — 
y/ 1, „ d mediatztn. . 
If ltzar jz. ■ 
'°AC.MAP/S i- Of/GUS 
PPOUA TO ft at/A OPA TOS 
J£Co2mj act natztram UeZ. PLATE 129 
JPostfportion of 
PRONATOR RAO// TERES 
PLEXOR PROPUNDUS O/G/T'f 
PRONATOR RAO/r TERES 
SUP/NA TOR L ONGUS 
PRONATOR <pC/A DR A PC/S 
EX TENSOR OSS/S META CA RP/ 
POLL! C/S 
PLEXOR CARP! RAO/AL/S 
OPPONENT MIN/MI O/o/T/ 
J/iner he/zct 
Outer " 
Tc a arts of el ex ox 
f*EOE/JA/na<S £>/G/TOf?(JM 
3'e/icton.s ofPL E XOR PROEl/NDUS 
D/G/TORUM 
Jtf. Coh 71, ad n<zZp ram its/. PLATE 130 
Inf?profunda. art. 
l/lziarn. 
J~j?ner intermuscular septum 
Ac to SUP/RA TOR L OUGUS 
JTuseulo-spiral rt. 
-A nastomotlcez magma art. — 
Afusculo-cutaneous rt 
JfftoEX T* CA PPt PA 0. 
i. OAK?/OP 
jy.toEXTPCARR/ RADIAL? 
BR Elt/OP 
■J-tadiaZrecurrent art. 
~JV.tOSUP/NA TOR BRE t/S 
Post mart Aon op 
PPOPA TOP PA D. TEPES 
Ji ntfulnrrecurrfartr 
S’ostr >' >' " — 
-Ji/ztTinterosseous n 
Common interosfart. 
— j>osrr " " 
-A.ntl‘ // " 
JY.tort- e:xop capp/ 
UL PA P/E 
■JTftOPt £X?L OPGfPOLL? 
If?ton. ex’ Appoeupo. 
O/G/TOPOOt 
-plexor subl/m/s o/gt 
rrona tor ra a// teres 
-Palm!'rut an •?branch of ulnar n. 
JJorsal " " " " 
cutaneous 
branch of median n. 
Mad rat n. 
Jladial art. 
EXT?OSS/S METACAPPl 
— POLLtCtf 
Jlf.CoTirt, actnaturam o/el. PLATE 131 
s Vincula accessories 
tendin-u/n 
Jlt.De/tn, adnaeu-mnt del. PLATE 132 
palmar n. 
Xleep rr " ■ 
JV.toOPPO. mr/V/M/ O/Cr/T/ 
-Deep palmar art. 
Jlecurrenl carpal— 
art. 
JV. tal’fpDOtfS±WT£&OSS. 
J'er/oratiagr art? 
jy^eo3r/'PA t Mf/A/rraos - 
Jt.to2n.ee/>Aittl/Nreftos. — 
Jrr3o3'yz - 
JKt03'Sel- UMBH/CA L /S —7 
// /■/ ,, y 
Deep palmar* 
arch. 
Tnteroeeeoae am .-'V^ 
.ls.t&2n.dpalmr 
collect* deal 
art? 
Jlf Oohn.acf ntztzs.rcirrr cZeZ. PLATE 133 
JW.Cohn,a<£ 7Z<xttcr<xs7Z PLATE 134 
FlrG.I 
In/fprofumta 
art. 
Inner intermuscu- 
lar septum > 
Antfportionof ? 
POOH, HAD-TIRES\ | 
Compoun a flexf\J 
attachment of )p 
Tl£X. CA HP. PA D. / > 
PALM. LONG- fv| 
ELtX. SOBL/M.D/G ' iS 
EJ-EX.CANP, C/LHV J M 
Musculo - cutaneous n. 
-N.toSUP/NATOH L ONGUS 
Musculo - spiral //. 
-N.stOEX r*CA RP/ HA DIAL. LONG/OH 
— JRostf interosseous n. 
to EX T R C A HP/ HA O/AL /S BN £ it/OH 
%.N.to SURJA/ATOR BREVIS 
jtactial recurr- 
ent art. 
Postrportzon of f 
PNONATOH f 
HAD// TIRES '& 
Fig. 2 
Common 
osseous cert. 
teros-s? 
/*/?0/VA TOR RA O/f 
'M.CoTin.a.drzatura-m. TRUNK. 
SEVENTEENTH DISSECTION. 
ANTERIOR OF THE THORACIC PARIETES ; THORACIC 
VISCERA IN SITU; INTERIOR OF THE THORACIC 
CAVITY. 
Dissection. —The thorax and upper extremities should remain as placed for 
the fifteenth dissection (page 193). Dissect away the pectoralis major muscle 
from its sternal and costal cartilage attachments (Plate 120). 
Terms of Relation.—The general terms (page 2); and the 
special terms exterior and interior (relatively to those respec- 
tive surfaces of the thoracic parietes) are used in locating and 
describing the anatomical elements of this dissection. 
Bones and Cartilages; muscle Areas of Bones and Carti- 
lages, Plates 113 and 135.—The sternum, the superior six pairs 
of costal cartilages, the antero-lateral portions of the superior 
nine pairs of ribs, and the dorsal vertebras, form the skeleton 
of the included portion of the thoracic parietes. All the costal 
cartilages and all the bones—with the exception of the anterior 
surfaces of the bodies of the eight inferior dorsal vertebrae— 
afford areas for the attachments of muscles. 
ANTERIOR OF THE THORACIC PARIETES. 
Dissection.—Clear the anterior surface of the sterno-clavicular articulation 
(Plate 113), and demonstrate its anterior ligaments. Open the anterior of the 
joint and expose its fibro-cartilage (Plate 136), and its posterior ligament. 
1. Sterno-CIavicular Articulation, Plates 113 and 136.— 
This articulates the internal end of a clavicle with the facet 
at an angle of the base of the sternum. Its anterior ligaments 238 
TRUNK 
are : tlie anterior sterno-clavicular, which passes across the 
joint, from the edge of the internal end of a clavicle to the 
border of the facet, at an angle of the base, of the sternum ; the 
inter clavicular ligament bridges the interclavicular notch at 
the base of the sternum, between the superior borders of the 
internal ends of the clavicles, right and left; the costo-clavic- 
ular ligament binds the inferior border of the internal end of 
a clavicle to the exterior surface of the first costal cartilage of 
its side. The opening of the joint brings into view the inter- 
articular fibro-cartilage (Plate 136); also, the posterior sterno- 
clavicular ligament, from the posterior border of the internal 
end of the clavicle to the posterior border of the clavicular 
facet of the sternum. 
Dissection.—Section carefully—with a knife—the six superior pairs of cos- 
tal cartilages near their external ends, as shown on the third costal cartilage in 
Plate 120; cut through the muscles of the right and left sixth intercostal 
spaces, close along tlie inferior borders of the sixth pair of costal cartilages, as 
far as the sternum ; section the sternum, on the line of the inferior borders of 
the sixth pair of costal cartilages. In sectioning the cartilages, and cutting 
the intercostal muscles, be very careful not to cut into the interior serous 
membranes—pleurae and pericardium—and viscera. When the sixth pair of 
costal cartilages are freed, raise one side, with the fingers of one hand, and 
turn off the sternal plate (sternum, costal cartilages, etc.), superiorly, from 
the right and left pleurae, the pericardium, and the contents of the anterior 
mediastinum, by cutting, with a knife or curved scissors in the other hand, 
the following parts : the right and left internal mammary arteries, at their 
inferior and superior ends, also their branches into the mediastinum; the at- 
tachments of the sterno-hyoid, and thyroid muscles (right and left) at the 
interior of the superior end of the sternum; the attachments of the fascial 
slips (right and left) of the omo-liyoid muscles, to the cartilages of the first 
ribs ; also, the sternal attachments of the sterno-cleido-mastoid muscles (right 
and left) at the exterior of the superior end of the sternum. Place the sternal 
plate with its exterior surface uppermost and clear: the exterior surfaces of 
the sternum and the costal cartilages; the anterior sterno chondral ligaments ; 
the perforating arteries; and the anterior intercostal aponeuroses. Dissect 
away the anterior intercostal aponeuroses of the second and third intercliondral 
spaces; expose the anterior surfaces of the internal intercostal muscle planes 
of those spaces ; trace the anterior intercostal arteries of the spaces, and follow 
them to their origins from the internal mammary artery, by cutting away por- 
tions of the internal intercostal muscles (Fig. 1, Plate 135). Dissect away an 
anterior sterno-chondral ligament, and display a superior and an inferior sterno- 
chondral ligament. Turn the sternal plate with its interior surface uppermost; 
clear the interior of the sternum, noting the attachments of the sterno-hyoid 
and sterno-thvroid muscles (right and left), near its superior end. Display the 
interior surface of the triangularis sterni muscles and the interior branches of ANTERIOR OF THE THORACIC PARIETES. 
239 
the internal mammary arteries. Dissect away the triangularis sterni muscles 
and trace the internal mammary artery, where it runs exteriorly to this muscle. 
Demonstrate a posterior sterno-chondral ligament. 
2. Sterno-Cliondral Articulations, Plate 135.—The costal 
cartilages in contiguity with the facets at the borders of the 
sternum form these joints. The ligaments of each joint are: 
an anterior, a superior, an inferior (Fig. 1, Plate 135) and a 
posterior (Fig. 2, Plate 135) sterno-cliondral. 
3. External Intercostal Muscles, Plates 113,120 ; and Fig. 
1, Plate 135.—The exterior musculo-aponeurotic plane of an 
intercostal space is formed (page 204): by an external intercos- 
tal muscle—to the anterior ends of the ribs ; and an anterior 
intercostal aponeurosis—in the interchondral space. 
4. Internal Intercostal Muscles, Figs. 1 and 2, Plate 135.—■ 
The interior muscle plane of the antero-lateral portion of an in- 
tercostal space is formed by an internal intercostal muscle ; the 
same being continued to the sternum in the intercliondral space. 
5. Triangularis Sterni Muscle, Fig. 2, Plate 135.—This 
muscle is located at the interior of the sternal plate ; it is at- 
tached to the inferior portion of the sternum, interiorly ; it 
expands, superiorly and externally, to be attached to the in- 
terior surfaces of the costal cartilages and ribs (anterior ends), 
sixth to second, inclusive. 
6. Internal Mammary Artery.—This artery (venae comites) 
runs upon tlie interior of the anterior thoracic parietes, ex- 
ternally to, and parallel with, the border of the sternum. Its 
inferior portion lies between the costal cartilages and the in- 
ternal intercostal muscles, exteriorly, and the triangularis sterni 
muscle, interiorly. At its superior end it gives off the comes 
nervi phrenici artery, which accompanies the phrenic nerve to 
the diaphragm. In each of the six superior interchondral spaces, 
it gives off its exterior branches as follows : the anterior inter- 
costal arteries, which perforate the internal intercostal muscle 
to ramify in the anterior portion of the intercostal space, be- 
tween the external and the internal intercostal muscles ; the 
perforating arteries, which pass through the interchondral 
planes of tissue, the pectoralis major muscle, and the fascia, to 
reach the subcutaneous plane of the thoracic parietes. Its in- 240 
TRUNK. 
terior branches—sternal, mediastinal pericardial—pass in- 
teriorly, to distribute to the triangularis sterni muscle (sternal), 
to the areolar tissue of the anterior mediastinum (mediastinal), 
and to the pericardium (pericardial). 
THOEACIC YISCEEA IN SITU. 
Dissection.—Display the anterior reduplications of the parietal layers of 
the right and left pleurae, and the anterior portion of the parietal layer of tho 
pericardium. Preserve the mediastinal, and the pericardial branches of the 
internal mammary arteries. 
7. Pleurae, Plate 136.—These are two serous membranes, 
which invest the lungs, right and left, by two layers: the 
parietal and the visceral, The parietal layers line the interior 
of the thorax, and are reflected anteriorly and posteriorly to 
the roots of the lungs ; the visceral layers are expansions of 
the parietal layers, from the right and left lung-roots, over the 
lungs, respectively. The antero-internal limits of the parietal 
layers of the pleurm advance to the borders of the interior 
of the sternum, where they are reduplicated, posteriorly, upon 
the lateral surfaces of the parietal layer of the pericardium, to 
reach the anterior surfaces of the roots of the lungs. The 
dotted lines in Plate 136 indicate the limits of the antero- 
internal projections of the pleura? during inspiration. (These 
limits may be shown by inflation of the lungs, by a bellows 
introduced, and tied, into the inferior end of the sectioned 
trachea.) From the interior of the circumference of the in- 
ferior of the thoracic parietes the parietal layers of the pleune 
are reflected to the superior surface of the diaphragm. From 
the interior of the posterior parietes of the thorax, the parietal 
layers of the pleune, right and left, are reduplicated, anteriorly, 
from the lateral surfaces of the bodies of the dorsal vertebra?, 
upon the oesophagus and aorta, to reach the posterior surfaces 
of the roots of the lungs, right and left. 
8. Pericardium, Plates 136 and 137.—The anterior portion 
of the parietal layer of this serous membrane investment of 
the heart occupies the interval between the right and left 
pleurae. Inferior!}7, it is reflected to the superior surface of the 
diaphragm. It is reflected upon the large vessels, superiorly 
to the base of the heart. THORACIC VISCERA IN SITU. 
241 
9. Branches of the Internal Mammary Arteries, Plate 136. 
—The branches of these arteries present in the mediastinum, 
where they distribute to the pericardium, the anterior portions 
of the pleurse, the thymus gland, etc. 
Dissection.—Cut away the anterior portions of the right and left pleurae, 
thereby exposing the antero-internal borders of the lungs, right and left. 
(Owing to the collapse of the lungs and the position of the body, the lungs 
fall, laterally, into either half of the thorax.) Note the anterior portion of 
the superior surface of the diaphragm. Hold off, by loops, the borders of 
the lungs, so as to find and trace the right and left phrenic nerves, from the 
superior of the thorax, to where, interiorly, they perforate the diaphragm; 
find and follow the comes nervi phrenici arteries, which accompany the nerves. 
Clear away the areolar tissue from the thymus gland, the vena cava superior, 
and the right and left innominate veins. 
lO. Diaphragm, Plates 137 and 138.—The superior sur- 
face of this muscle forms the floor of the thorax, anteriorly 
to, and to the right and left from, the pericardium. It is 
covered by the parietal layers of the pleurae, right and left. 
11. Lungs, Plate 137.—The anterior borders of the lungs, 
right and left, appear at the sides of the pericardium ; of the 
right, its superior and middle lobes are seen; of the left, its 
superior lobe. The dotted lines, in Plate 137, indicate the limits 
of the internal projections of the antero-internal borders of the 
lungs during inspiration. (This may be produced by inflation 
of the lungs, by bellows introduced into the trachea.) 
12. Phrenic Nerves.—These nerves, the right and left, en- 
ter the thorax from the neck, lying internally, and posteri- 
orly, to the internal mammary arteries ; they run, interiorly, 
between the pericardium and the right and left pleurae, to 
the diaphragm, which they perforate. They are accompanied 
by the comes nervi phrenic i arteries (page 239). 
13. Thymus Gland.—This ductless gland lies upon the an- 
terior surface of the arch of the aorta, interiorly to the left 
innominate vein, and to the left of the vena cava superior. It 
varies very much at different ages, and in different subjects ; 
in the young it is larger than in the adult. In the adult its 
longest diameter is from right to left; its inferior border is ir- 
regular ; its left end is thicker than the right; and, from the 
left half of its superior border, it projects a portion into the 
neck, over the anterior surface of the left innominate vein. 242 
TRUNK. 
14. Right and Left Innominate Veins.—The right innomi- 
nate vein, a short and almost vertical vessel, is projected into 
the thorax, posteriorly to the internal end of the right clavicle. 
The left vein is long, and emerges from the posterior of the 
internal end of the left clavicle ; it crosses the median line, to 
unite with the right, to form the vena cava superior. 
15. Vena Cava Superior.—This short, large, venous trunk, 
as formed by the junction of the two last-described veins, is 
continued, inferiorly, to where it is invested by the pericar- 
dium, being lodged between the right lung and the thymus 
gland. 
Dissection.—Section the vena cava superior (Plate 137), and the right and 
left innominate veins ; dissect away the thymus gland and the portions of the 
veins between the section lines. Find the right and left pneumogastric nerves ; 
also, the right and left recurrent laryngeal nerves. Display the right and left 
cervical cardiac nerves, and the right and left thoracic cardiac nerves, noting 
their relations to the transverse portion of the arch of the aorta and the innomi- 
nate artery. Expose the anterior surfaces of the transverse portion of the arch 
of the aorta ; the innominate artery (and its bifurcation into the right common 
carotid and right subclavian arteries); the left common carotid artery; and 
the left subclavian artery. Clear the portions of the trachea, superiorly to, 
and of the right bronchus, posteriorly to, the arch of the aorta. 
16. Pneumogastric Nerves, Plate 138.—These nerves, right 
and left, enter the thorax from the neck. The right appears, 
in the thorax, anteriorly to the right subclavian artery, con- 
tinuing, inferiorly, to where it disappears posteriorly to the 
right bronchus. The left passes into the thorax, anteriorly to 
the left half of the transverse portion of the arch of the aorta ; 
inferiorly to the aorta, it is continued posteriorly to the left 
bronchus. Each nerve gives off: a recurrent laryngeal nerve ; 
and thoracic cardiac nerves, to the cardiac plexus. 
17. Recurrent Laryngeal Nerves.—These nerves, the right 
and left, are given off from the pneumogastric nerves, right and 
left, respectively : the right, interiorly to the right subclavian 
artery, posteriorly to which it winds, to take its course, superi- 
orly, into the neck; the left, takes its origin inferiorly to the 
transverse portion of the arch of the aorta, to the posterior sur- 
face of which it winds, to take its course, superiorly, into the 
neck, where it appears, to the left of the trachea, upon the an- 
terior surface of the oesophagus. THORACIC VISCERA IX SITU. 
243 
18. Cervical Cardiac Nerves.—These nerves to the cardiac 
plexuses, from the cervical ganglia of the sympathetic nerve, 
right and left, and from the inferior of the cervical portions of 
the pneumogastric nerves, right and left, vary in their relations 
to the transverse portion of the arch of the aorta, the innomi- 
nate, the right and left common carotid, and the right and left 
subclavian arteries. On the right side, they run, with but few 
exceptions, posteriorly to the arteries, on their way to the car- 
diac plexuses ; a variable number of branches pass anteriorly 
to the same. On the left side, while some of the nerves pass 
anteriorly to the transverse portion of the arch of the aorta, 
looping inferiorly to it, to reach the cardiac plexuses, the 
greater number run posteriorly to the aorta. 
19. Thoracic Cardiac Nerves.—These nerves are branches 
of the right and left pneumogastric nerves, inferiorly to the 
giving off, from those trunks, of the right and left recurrent 
laryngeal nerves. The latter nerves (especially the left one) 
contribute, at times, some of the thoracic cardiac branches. 
The right thoracic cardiac nerves pass posteriorly to the arch 
of the aorta ; the left, posteriorly to the pulmonary artery. 
20. Cardiac Plexuses.—These plexuses, formed by the right 
and left cervical and thoracic cardiac nerves, are located be- 
tween the concavity of the aorta, the common and right pulmo- 
nary arteries, and the anterior surface of the bifurcation of the 
trachea. (The cardiac plexuses are not illustrated, because 
they require to be dissected out on specially prepared pieces, 
which would interfere with the exposure of parts of more 
practical importance.) 
21. Transverse Portion of the Arch of the Aorta and its 
Branches.—This portion of the arch of the aorta is continued 
from right to left, and obliquely posteriorly, into the supe- 
rior of the left half of the thorax. Three large arteries are 
projected from it superiorly, viz.: to the right, the innomi- 
nate : to the left, the left common carotid and the left sub- 
clavian. 
22. Innominate Artery.—This, the largest branch from the 
transverse portion of the arch of the aorta, is projected to the 
right. It crosses, in a plane anteriorly to the trachea, to a 
point posteriorly to the right sterno-clavicular articulation, 244 
TRUNK. 
where it bifurcates into the right common carotid and right 
subclavian arteries. The former is continued, superiorly, into 
the neck, along the right of the trachea ; the latter passes into 
the root of the neck, arching over the right first rib, to be con- 
tinued as the right axillary artery (page 203, Plate 119). 
23. Left Common Carotid Artery.—This artery has a supe- 
rior course into the neck, to the left side of the oesophagus and 
trachea. Its origin, within the thorax, from the arch of the 
aorta, makes its trunk much longer than the right common 
carotid. 
24. Left Subclavian Artery.—This artery, to the left of the 
last-described artery, is projected, superiorly, into the root of 
the neck. Its trunk is much longer than the right subclavian, 
because of its aortic origin. It arches over the left first rib, 
that it may be continued as the left axillary artery. 
25. Trachea.—A portion of the trachea, and of the right 
bronchus, appear in a plane posteriorly to the arch of the aorta 
and the innominate artery. $ 
26. (Esophagus.—A portion of this canal lies in a posterior 
plane between the trachea and the left common carotid artery. 
Dissection.—Pass the hand into the thorax, right and left, and free the 
right and left lungs from the thoracic parietes. Dissect the diaphragmatic por- 
tion of the parietal layer of the pericardium from the superior surface of the 
diaphragm. Section (see Plate 138) the following parts: the innominate, left 
common carotid, and left subclavian arteries (cutting therewith the right and 
left cervical cardiac nerves) ; the phrenic nerves and the comes nervi phrenici 
arteries at their superior and inferior ends, removing their intervening por- 
tions ; the left recurrent laryngeal nerve at its origin, and where it appears 
anteriorly to the oesophagus; the thoracic cardiac branches of the pneumogas- 
tric nerves (right and left); and the trachea. Pass the hand into the superior 
of the thorax, grasping the cut inferior portion of the trachea and the arch of 
the aorta ; drag the heart and lungs anteriorly, and inferiorly ; with the curved 
scissors cut the trachea, and the bronchi, from the oesophagus, and the descend- 
ing portion of the arch of the aorta from the thoracic parietes ; cut also the 
pulmonary branches of the right and left pneumogastric nerves, so as to leave 
the trunks of the two latter nerves, in situ, upon the oesophagus. Cut the vena 
azygos major as it enters the posterior surface of the extra-pericardial portion 
of the vena cava superior—leave the vena azygos major upon the right lateral 
surface of the vertebral column. Section the descending portion of the arch 
of the aorta, at its junction with the thoracic aorta, leaving the latter as in 
Plate 139. Finally, section the vena cava inferior, as it comes through the 
caval opening of the diaphragm, and remove the thoracic viscera, en masse INTERIOR OF TIIE THORACIC CAVITY. 
245 
(place them in a solution of arsenite of soda for subsequent dissection). 
Pleuritic adhesions may make it difficult to remove the thoracic viscera, re- 
quiring the pleurae to be torn away from the interior of the thoracic parietes ; 
at times, even, the lung tissue may have to be cut through with scissors oppo- 
site the adherent areas. 
INTERIOR OF THE THORACIC CAVITY. 
Dissection.—Clear the surface of the thoracic portion of the oesophagus, 
tracing the right and left pneumogastrie nerves, inferiorly, upon it; note the 
branches of these nerves to the oesophagus. 
27. CEsophagus, Plate 139.—This portion of the supra-dia- 
phragmatic part of the alimentary canal enters the thorax from 
the neck. It leaves the thorax by the oesophageal opening of 
the diaphragm, where it is continued into the abdomen (page 
63). In its course, through the thorax, it is located : supe- 
riorly, in a plane posteriorly to the transverse portion of the 
arch of the aorta ; in its mid-portion, it advances along the 
right of the descending portion of the arch of the aorta, and is 
then projected to the anterior surface of the superior half of 
the thoracic aorta; inferiorly, it passes to the left of the in- 
ferior half of the thoracic aorta. 
28. Pneumogastrie Nerves.—These nerves, right and left 
(page 242; Plate 138), are continued, inferiorly, through the 
thorax upon the oesophagus, sending branches of distribution 
to it. They leave the thorax with the oesophagus at the oesopha- 
geal opening of the diaphragm. 
Dissection.—Trace the vena azygos major vein and its tributary branches, 
the right intercostal veins. Expose the thoracic or left lymphatic duct, be- 
tween the inferior halves of the oesophagus and the vena azygos major vein. 
29. Vena Azygos Major, Right Intercostal Veins, and Right 
Superior Intercostal Vein, Plate 139, and Fig. 1, Plate 140.— 
The vena azygos major has a course, superiorly, from where it 
enters the thorax through the aortic opening of the diaphragm, 
upon the anterior surface of the right half of the bodies of the 
dorsal vertebrae. In its course it receives the right intercostal 
veins from the right inferior nine intercostal spaces. At its 
superior end it receives the right superior intercostal vein, a 
small vessel formed by the intercostal veins of the right supe- 
rior three intercostal spaces. The azygos major trunk loops, 246 
TRUNK. 
anteriorly, superiorly to the root of the right lung, to empty 
into the vena cava superior, before the latter receives its peri- 
cardial investment. (This point of junction of the vena azygos 
major with the vena cava superior was seen, when the former 
was sectioned, in removing the thoracic viscera, see page 244.) 
30. Thoracic or Left Lymphatic Duct, Plate 139.—The in- 
ferior third of the thoracic portion of this duct will be found 
passing, superiorly, from the aortic opening of the diaphragm, 
to where it disappears posteriorly to the superior two-thirds of 
the thoracic portion of the oesophagus. In this portion of its 
course it lies anteriorly to the right intercostal arteries, and be- 
tween the thoracic aorta, to the left, and the vena azygos major 
to the right—nearer the former than the latter. 
Dissection.—Expose the dorsal portion of the right sympathetic nerve ; its 
branches of communication with the right intercostal nerves, and its splanch- 
nic branches. 
31. Dorsal Portion of the Riglit Sympathetic ]\Tcrve, Plate 
139.—This portion of the right sympathetic nerve consists of 
twelve ganglia, each located opposite the anterior surface of 
the head of a rib, upon an anterior costo-central or stellate 
ligament. Each ganglion is united to the ganglion superiorly 
and inferiorly to it, by interganglionic branches ; each presents 
two external branches, which communicate with the anterior 
division of the dorsal spinal or intercostal nerve, inferiorly to 
it; and each sends off an internal branch of distribution. 
32. Great Splanchnic and other Branches of Distribution 
of the Dorsal Portion of the Right Sympathetic Nerve.—The 
dorsal ganglia, sixth to ninth, inclusive, distribute branches, 
internally, which unite to form the right great splanchnic 
nerve; it passes into the abdomen by perforating the right 
crus of the diaphragm. The superior six dorsal ganglia give 
off internal branches: to the posterior pulmonary plexus, 
to the thoracic aorta, and to other contiguous parts. (The 
branches of distribution of the six superior dorsal ganglia, of 
the right side, were cut away in the removal of the thoracic 
viscera.) 
Dissection.—Clear the thoracic aorta and find the oesophageal arteries. 
Trace the right intercostal vessels and nerves in the intercostal spaces, adjacent 
to the vertebral column. INTERIOR OF THE THORACIC CAVITY. 
247 
33. Thoracic Aorta and its Branches, Plate 139, and Fig. 
1, Plate 140.—The thoracic aorta has an inferior course, par- 
allel with, and in a plane posteriorly to, the oesophagus, to 
where it passes through the aortic opening of the diaphragm, 
to be continued as the abdominal aorta. Its branches are the 
oesophageal, to the oesophagus, and the right and left nine or 
ten intercostal arteries, which are continued, anteriorly, inte- 
riorly to the nine or ten inferior pairs of ribs. 
34. Right Intercostal Serves, Arteries, and Veins.—In each 
intercostal space, adjacent to the vertebral column, will be 
found an intercostal nerve, an intercostal artery, and an inter- 
costal vein ; all three lie upon the interior surface of the pos- 
tero-internal portion of an external intercostal muscle, and are 
continued anteriorly, between the external and internal inter- 
costal muscle planes of an intercostal space, along the inferior 
border of the superior rib-boundary of the space. The rela- 
tions of the three in the intercostal space are : the nerve in- 
teriorly, the vein superiorly, and the artery between the two. 
The intercostal nerves are the anterior divisions of the dor- 
sal spinal nerves, each having two communicating branches 
from the dorsal sympathetic ganglion superiorly to it. 
The intercostal arteries are nine or ten branches from the 
thoracic aorta, the right being longer than the left. 
The intercostal veins are, on the right side, tributary to 
the azygos major vein and the right superior intercostal vein. 
Dissection.—Expose, by dissecting away the posterior intercostal aponeu- 
rosis and the posterior portion of an internal intercostal muscle of one or more 
intercostal spaces, the relations of the external and internal intercostal muscles 
at the postero-internal or vertebral end of an intercostal space. 
35. Relations of the External and Internal Intercostal 
Muscles, at- the Vertebral End of an Intercostal Space.— 
The relations of the posterior portions of these muscle planes 
are as follows : an external intercostal muscle forms the ex- 
terior plane of the postero-internal portion of an intercostal 
space, commencing, internally, opposite the tubercles of the 
adjacent ribs ; an internal intercostal muscle forms the interior 
plane of the same portion of an intercostal space, commencing 
at about the angles of the adjacent ribs. Internally to the pos- 
terior limit of an internal intercostal muscle, the anterior sur- 248 
TRUNK. 
face of an external intercostal muscle, lodging the intercostal 
vessels and nerve, is covered by tlie continuation of tlie internal 
intercostal muscle plane by a plane of fibrous tissue—the pos- 
terior intercostal aponeurosis. 
Dissection.—Section (Plate 139) the oesophagus, and the right and left pneu- 
mogastric nerves, at their superior and inferior ends, and remove their included 
portions. Slit open the segment of the oesophagus and demonstrate its struct- 
ure. Cut the thoracic aorta superiorly to the aortic opening of the diaphragm, 
as in Fig. 1, Plate 140 ; also each of its intercostal branches, leaving the latter, 
in situ. Remove the thoracic aorta, being careful not to injure the azygos minor 
vein, and its tributary branches (the left intercostal veins), posteriorly to it. 
Expose the vena azygos minor and the left superior intercostal vein. Trace the 
left intercostal nerves, arteries, and veins. Display the dorsal portion of the 
left sympathetic nerve. 
36. Structure of tlie CLsopliagus.—This canal will be found 
to have a mucous membrane lining, a submucous plane, a thick 
muscular coat, and a thin exterior fibrous coat. As slit open, 
its mucous membrane forms longitudinal folds. 
37. Vena Azygos minor and tlie Left Inferior Intercostal 
Veins, Fig. 1, Plate 140.—The vena azygos minor enters the 
thorax through the left crus of the diaphragm ; it runs, supe- 
riorly, for a variable distance along the left side of the bodies 
of the inferior dorsal vertebra (in the Plate, to the ninth) ; it 
receives, in its thoracic course, the left inferior intercostal 
veins; and it crosses the anterior surface of the body of a 
dorsal vertebra (in the Plate, the ninth), to anastomose with 
the vena azygos major. 
38. Left Superior Intercostal Vein and tlie Left Superior 
Intercostal Veins.—The left superior intercostal vein, larger 
than the right (page 245), has a variable length ; it has an infe- 
rior course, receiving the left superior intercostal veins; it 
anastomoses with the vena azygos minor, and by a branch, 
which crosses the anterior surface of the body of a dorsal 
vertebra, with the vena azygos major. 
39. Left Intercostal Nerves, Arteries, and Veins.—These 
anatomical elements are lodged in the left intercostal spaces, 
adjacent to the vertebral column, in the same manner as are 
those of the right side (page 247 ; Plate 139). INTERIOR OF THE THORACIC CAVITY. 
249 
40. Dorsal Portion of the Left Sympathetic Nerve and 
Its Branches.—This portion of the left sympathetic nerve is the 
counterpart of that of the right (page 246). 
Dissection. —Expose the superior part of the thoracic portion of the left 
lymphatic or thoracic duct. Trace the duct to where it enters the neck. 
41. Thoracic or Left Lymphatic Duct.—The thoracic por- 
tion of this duct has been partly described (page 246), and illus- 
trated (Plate 139). It enters the thoracic cavity at the aortic 
opening of the diaphragm, along the right of, and in a plane 
posteriorly to, the aorta ; it has a superior, and slightly oblique, 
course upon the anterior surfaces of the bodies of the ten in- 
ferior dorsal vertebrae ; it is continued, superiorly, from the 
third dorsal vertebra, upon the anterior surface of the inferior 
portion of the left longus colli muscle. It enters the neck, 
upon the latter muscle, to the left of the oesophagus, and be- 
tween the left common carotid and subclavian arteries. 
42. Mediastinum.—This is the space between the sternum, 
anteriorly, the bodies of the dorsal vertebrae, posteriorly, and 
the right and left lungs, laterally. It is occupied by the fol- 
lowing anatomical elements : the thymus gland ; the heart, in- 
vested by the pericardium ; the arch of the aorta; the common 
pulmonary artery; the superior and the inferior venae cavae ; 
the bifurcation of the trachea and the roots of the lungs, right 
and left; the cardiac and pulmonary plexuses ; the right and 
left phrenic, pneumogastric, and great splanchnic nerves; the 
oesophagus ; and the thoracic duct. 
Dissection.—The dissector of the head and neck section of the body should, 
in conjunction with the dissector of the thorax, follow the thoracic or left lym- 
phatic duct into the cervical region, to where it empties into the left subclavian 
vein. Pull out, to the right, from the posterior of the internal end of the left 
clavicle, the stump of the left innominate vein (by an attached thread), thus 
making taut the left subclavian and internal jugular veins; loop, internally, the 
left common carotid artery and left pneumogastric nerve. 
43. Cervical Portion of the Thoracic or Left Lymphatic 
Duct, Fig. 2, Plate 140.—Having entered tlie neck from the 
thorax, as above described and illustrated (Fig. 1. Plate 140), 
this duct lies on the anterior surface of the left longus colli 
muscle ; it arches to the left, passing between the left pneumo- 250 
TRUNK. 
gastric nerve, anteriorly, and the left vertebral artery, pos- 
teriorly ; it runs parallel with, and superiorly to, tlie external 
and superior part of the first portion of the left subclavian 
artery ; at this point it passes anteriorly to the left inferior 
thyroid artery, near the origin of the latter from the thyroid 
axis ; it enters between the left internal jugular vein, ante- 
riorly, and the scalenus anticus muscle, posteriorly ; it curves 
abruptly, interiorly, at the external border of the left internal 
jugular vein ; it is then continued to where it opens into the 
left subclavian vein, externally to the junction of the latter 
with the left internal jugular vein. In the latter portion of 
its course it lies anteriorly to the left phrenic nerve, the left 
supra-scapular artery, and the left scalenus anticus muscle. 
Dissection.—Dissect tlie pleurae, right and left, from the superior surface 
of the diaphragm, and locate its caval, oesophageal, and aortic openings. 
44. Diaphragm, Fig. 1, Plate 140.—Tlie superior surface 
of this muscle has, when the abdominal viscera are in situ, an 
antero-posterior and a lateral convexity ; it rises higher on the 
right side than the left ; its circumferential muscle portion 
and its tendinous centre are easily defined. It slopes to its 
circumferential attachments to the interior of the inferior por- 
tion of the thoracic parietes and (crural attachments) to the 
interior of the posterior parietes of the abdomen (page 81). Its 
caval, oesophageal, and aortic openings are located, as follows : 
the first, to the right of the median line, and somewhat an- 
teriorly; the second, to the left of the median line, and some- 
what anteriorly ; the third, on the median line, and posteriorly, 
opposite the body of the twelfth dorsal vertebra. 
Dissection.—Tlie thoracic viscera may now be dissected or left till later, 
at the option of the dissector; they will be demonstrated next in order. Care 
should be taken to keep the interior of the posterior wall of the thorax moist, 
so as to facilitate the dissection of the articulations of the dorsal vertebrae with 
each other, and those of the ribs with the dorsal vertebrae. PLATE 135 
Fig. 2 
FlGc.2 
M.Cahn.act na.tu.rain PLATE 136 
TJost fsternss - cta tr ie 
litas' tig snt . 
Tsit era re zest tar ' 
fzbro -cartilage \ 
Jnit mate mars/ 
art. rtMt 
I/[.Cohn,aalszaturam del. PLATE 137 
Comes nerirl. 
phrenic i art. 
Inti mam mart/ 
art. x v 
JtfjCo?fn,atZrzatzirtzm dei. PLATE 138 
Af.Cohn, adraturam det. PLATE 139 
Trachea . 
Tnnomizzate art.. 
Might recarr. largag/n ■. \ 
M. saprintercostai a \ \ 
.LON G-US COLL / 
/ Zj eft recurrent Zargageal n. 
/ Jh .common carotid art. 
/ / ,M. sabcZazrian art. 
Thoracic c/act 
<L. sap rzrz ter cost fa. 
'Jipnearzogastrictz. 
/ ./^. // 
JatercostaZ a. 
„ art. 
„ n-- N 
Jntergangti- 
oaic iraactz \ 
JVT.Cohrz,actnatura/Tz. eieZ. PLATE 140 
F'rG. 1 
L.recurrent laryng- 
eal n 
(Esophagus 
Trachea 
/?. recurr. laryngl n 
JZ. sup fin t ere os t.1 a. 
T- 7' " 
Intercostal zz. v \ 
" art.-Csg/M 
n.^ 
Fig. 2, 
Vena uz7/yos 
minor 
Inflllzyroict art. — 
I1 neumo gas trie zz. ~ 
Vertebral art. 
T/zorczcic (tact — 
Subclao Vart. — 
SCAT. ENOS ANT I COS 
Supra scapular arc. 
Ext.jug alar a. 
r—Su&claitian zr. 
Innominate a. 
Af.Colzn.aU naturam del. EIGHTEENTH DISSECTION. 
VISCERA OF THE THORAX OUT OF THE BODY. 
LUNGS AND HEART TOGETHER. 
Dissection.—The thoracic viscera as taken out of the body, en masse (pages 
244 and 245), should be placed upon a dissecting board, with their anterior 
surfaces uppermost. The right and the left lung are to be held off, by loops, 
laterally, so as to expose the pericardial investment of the heart. Slit the 
parietal layer of the pericardium, from the apex of the heart to the anterior 
surface of the ascending portion of the arch of the aorta ; make two transverse 
incisions, on a level with the base of the heart. Deflect the four flaps and hold 
them off, by loops, from the surface of the heart and the cardiac ends of the 
large vessels from its base. 
1. Pericardium, Plate 141.—This membrane invests the 
heart by two portions : a parietal and a visceral. The parietal 
portion—consisting of an exterior fibrous and an interior serous 
layer—was partially described (page 240) and illustrated (Plates 
136 and 137); its superior attachments, anteriorly, are to the 
ascending portion of the arch of the aorta, the common pul- 
monary artery, and the vena cava superior. The visceral por- 
tion is the reflection of the serous layer of the parietal portion, 
interiorly, upon the cardiac ends of the above vessels and the 
heart. 
2. Anterior Surface of tlie Heart and the Large Vessels 
at its Base.—The portions of the heart that contribute to its 
anterior surface are: at the right and anteriorly, the right ven- 
tricle surmounted by the appendix of the right auricle, the 
latter to the right of, and anteriorly to, the cardiac end of the 
aorta; at the left border, a portion of the left ventricle sur- 
mounted by a small portion of the appendix of the left auricle— 
the latter to the left of the cardiac end of the common pulmo- 
nary artery. From the base of the heart, between the ap- 
pendices of the auricles, are projected the aorta and the com- 252 
TRUNK. 
moil pulmonary artery ; to the right of the aorta is the vena 
cava superior. 
3. Arcli of tl»e Aorta.—This large arterial trunk is pro- 
jected superiorly from the base of the heart; it arches to the 
left and posteriorly. It has three portions : the ascending, the 
transverse, and the descending. The ascending portion ex- 
tends, superiorly, from the heart, a little toward the right; it 
is located between the common pulmonary artery, to the left, 
and the vena cava superior, to the right. The transverse por- 
tion was before described (page 243) and illustrated (Plate 138). 
The descending portion continues the transverse portion, infe- 
riorly, posteriorly to the root of the left lung. 
4. Vena Cava Superior.—This large venous trunk passes, 
interiorly, along the right side of the ascending portion of the 
arch of the aorta ; on its way to the right auricle, it receives 
its investment of pericardium (page 251). 
5. Common Pulmonary Artery.—This vessel is projected 
from the base of the heart, superiorly, and to the left; its car- 
diac end occupies a plane anteriorly to the ascending portion 
of the arch of the aorta, between the latter and the appendix of 
the left auricle. It curves to the right into the concavity of 
the arch, where it bifurcates into the right and left pulmonary 
arteries. 
6. Left Pulmonary Veins.—These two vessels converge to 
the left side of the heart, in a plane posteriorly to the appen- 
dix of the left auricle. 
7. Left Pulmonary Artery.—The superior border of this 
vessel is seen superiorly to, and in a plane anteriorly to, the 
last-described veins. 
Dissection.—Unfasten the loops, which hold aside the lungs and flaps of 
pericardium, to display the anterior surface of the heart and large vessels. 
Turn the thoracic viscera, en masse, so as to present their posterior surface 
uppermost. Cut away the descending portion of the aorta, sectioning it be- 
tween the left common carotid and left subclavian arteries. Trim away the 
posterior portions of the parietal layer of the right and left pleurae; loop 
the lungs aside so as to expose the heart, the large vessels, the trachea, and 
the right and left bronchi. Trace the posterior of the parietal portion of the 
pericardium to its superior line of reflection to the heart, as the posterior of 
the visceral portion of the same. Demonstrate the portions of the heart that 
contribute to its posterior surface. VISCERA OF TIIE THORAX OUT OF THE BODY. 
253 
8. Pericardium, Plate 142.—At the posterior surface of the 
heart the parietal portion of the pericardium (fibrous layer with 
interior serous layer) is reflected to the heart as its visceral 
portion (formed by the serous layer of the membrane): along 
the superior border of the left auricle, superiorly ; upon the 
right and left pulmonary veins, laterally ; and upon the vena 
cava inferior, interiorly. 
9. Posterior Surface of the Heart.—The portions of the 
heart that contribute to its posterior surface, when the organ is 
in its normal position, are: the greater part by the left ventricle 
surmounted by the left auricle; at the right border, a part of 
the right ventricle surmounted by a portion of the right auricle. 
lO. Vena Cava Inferior.—With the heart in its normal po- 
sition, this large venous trunk enters the posterior face of the 
right auricle, at its inferior angle. 
11. Pulmonary Veins.—These veins, two from each lung, 
converge, right and left, to open into the left auricle. 
Disskction. — Clear the posterior surfaces of the trachea, and of the right 
and left bronchi. Preserve the branches of the bronchial arteries, portions of 
the posterior pulmonary plexus or nerves therefrom, upon the bifurcation of the 
trachea and the bronchi. Pull out, superiorly and to the right of the trachea, 
the vena cava superior ; note the stump of the vena azygos major at the poste- 
rior surface of the vena cava superior. 
12. Trachea and Right and Left Bronchi.—The trachea 
presents posteriorly to the transverse portion of the arch of the 
aorta. It bifurcates into the right and left bronchi ; each of 
these, in turn, bifurcate, before they enter the right and left 
lungs. The posterior walls of these canals present their mem- 
branous portions ; anteriorly, and laterally, they are con- 
structed of incomplete cartilaginous rings united by fibrous 
tissue. 
13. Bronchial Arteries.—Branches of these arteries, from 
the concavity of the arch of the aorta, ramify upon the bifur- 
cation of the trachea, and npon the bronchi ; they may be 
traced into the lungs, right and left, upon the bronchi. 
14. Anterior and Posterior Pulmonary Plexuses, and the 
Pulmonary Nerves.—Tliese plexuses are contributed to by the 254 
TRUNK. 
right and left pneumogastric nerves ; also, by the right and left 
superior dorsal ganglia of the sympathetic nervous system. 
The anterior is spread upon the anterior surfaces of the bifur- 
cation of the trachea and the roots of the lungs ; tliq posterior 
upon the posterior surfaces of the same. (These plexuses are 
not illustrated, as they require to be dissected upon specially 
prepared organs, as special dissections.) Nerves from these 
plexuses may be followed along the bronchi, to where they 
enter the lungs, right and left. 
15. Vena Cava Superior and Vena Azygos Major.—The 
stump of the vena cava superior is lodged anteriorly to the 
trachea. As brought into view, to the right of the trachea, 
the vena azygos major presents, hanging from the posterior 
face of the cava ; the trunk of this azygos vein is situated pos- 
teriorly to the root of the right lung, and loops superiorly to 
the latter and anteriorly to reach the cava. 
Dissection.—Expose the right pulmonary artery, interiorly to the bifurca- 
tion of the trachea, and in a plane anteriorly to the same ; display the left 
pulmonary artery, projected to the left, in a plane anteriorly to the left bron- 
chus, and trace it to where it branches and enters the left lung ; find the duc- 
tus arteriosus between the left pulmonary artery and the concavity of the arch 
of the aorta. 
16. Right Pulmonary Artery.—This artery is projected to 
the right, from the bifurcation of the common pulmonary 
artery. It lies between the bifurcation of the trachea and the 
left auricle of the heart, in a plane anteriorly to the bronchi 
and pulmonary veins. It bifurcates before entering the right 
lung. 
17. L.eft Pulmonary Artery.—This artery is projected to the 
left, from the bifurcation of the common pulmonary artery, 
superiorly to, and in a plane anteriorly to, the left bronchus ; 
it bifurcates before entering the left lung. 
18. Ductus Arteriosus.—This obliterated vessel of foetal life 
passes, as a fibrous cord, superiorly and to the left, from the 
superior of the left pulmonary artery—close to the origin of 
the latter, from the bifurcation of the common pulmonary 
artery—to the inferior of the transverse portion of the arch of 
the aorta. VISCERA OF THE THORAX OUT OF THE BODY. 
Dissection.—Examine the anatomical elements entering, and coming from, 
the lungs, which constitute the roots of those organs. 
19. Roots of tlie Lungs.—The following parts, at the in- 
ternal surface of a lung, collectively, form the, so-called, root of 
a lung : first, a bronchus and its divisions ; second, a pulmo- 
nary artery and its branches ; third, two pulmonary veins 
with their tributary branches ; fourth, the branches of a bron- 
chial artery \ fifth, nerves from the pulmonary plexuses ; sixth, 
lymphatic glands receiving lymphatic vessels from the organ ; 
seventh, connective tissue lodged between the anatomical ele- 
ments of the root of the organ. Of these parts : the branches 
of the pulmonary and the bronchial arteries, and the nerves 
from the pulmonary plexuses, enter the lung ; the branches 
converging to the two pulmonary veins, and the lymphatic 
vessels emerge from the lung. 
LUNGS. 
Dissection.—Section (Plate 142) the right and left pulmonary arteries, and 
the pulmonary veins, right and left; then separate the heart from the trachea 
and bronchi. Cut the pulmonary arteries, veins, and nerves close to the lungs, 
right and left. 
1. Lungs, Plate 143.—These organs, two in number, a right 
and a left, weigh from 36 to 42 ounces, varying according to 
sex ; the right being about 2 ounces heavier than the left. 
They have a mottled appearance, purple and black (pink in the 
young) ; and they crepitate on pressure between the fingers. 
The right lung is larger than the left, because the left lung, in 
situ, has to be so shaped as to admit of the lodgement of the 
heart, which occupies much more of the left than of the right 
half of the thorax. 
Dissection.—Place the lungs on a dissecting board with their anterior sur- 
faces uppermost. 
2. Anterior Surface of the Lungs, Fig. 1, Plate 143.— 
The anterior surface of these organs was referred to (page 241) 
and illustrated (Plates 137 and 138). Restored to their normal 
relations this surface presents: the right lung, three lobes; the 
left, two lobes. The lobes of a lung are marked off by fissures 
in the substance of the organ, which do not penetrate its entire THUNK. 
mass. The right superior lobe is conical in shape, with a sharp 
apex, superiorly, and a well-marked curved fissure, inferiorly. 
The middle lobe is an oblong portion of the right lung, located 
at the inferior portion of the anterior face of the organ ; it does 
not include the whole antero-posterior thickness of the lung, 
but is located inferiorly to the superior lobe, and is appended 
from the anterior face of the inferior lobe ; it is bounded, supe- 
riorly, externally, and inferiorly, by fissures that isolate it 
from the superior and inferior lobes. The right inferior lobe 
presents but a small portion anteriorly ; its inferior surface is 
moulded to the superior face of the right half of the dia- 
phragm. The left superior lobe is a conical-shaped portion 
which forms the anterior face of the lung. Opposite the mid- 
dle lobe of the right lung, the antero-internal border of the left 
lung is deeply notched, thereby forming an inferior tongue of 
lung tissue, which is projected to the right. This deficiency of 
the antero-internal border of the left lung is for the exposure 
of the heart, where it applies itself, with only the parietal por- 
tion of the pericardium intervening, against the thoracic wall. 
The left inferior lobe is applied to the superior surface of the 
left half of the diaphragm. 
Dissection.—Turn tlie lungs upon the dissecting board, with their pos- 
terior surface uppermost. 
3. Posterior Surface of tlic Lungs, Fig. 2, Plate 143.— 
This face of these organs presents them united by the bifur- 
cated trachea. The posterior of each lung presents two lobes : 
a superior and an inferior. Of the right lung: the superior 
lobe is conical in shape with its apex directed superiorly ; the 
inferior lobe is also conical in shape, with its apex applied to 
the surface of the superior lobe; adapted as the inferior sur- 
face of this lobe is to the superior surface of the diaphragm, 
its postero-inferior border presents a sharp edge for lodgement, 
between the diaphragm and the parietes of the thorax, supe- 
riorly to the postero-inferior attachments of the diaphragm. 
Of the left lung: the superior lobe is conical like the right, 
larger, and more rounded at its apex; the inferior lobe has the 
shape of the right, but it is smaller than it; it has a similar 
inferior surface and postero-inferior border, for adaptation to 
the superior surface of the diaphragm. VISCERA OF THE THORAX OUT OF THE BODY. 
257 
4. Orifices of the Pulmonary Vessels.—The orifices of the 
pulmonary arteries and veins, present at tlie internal surfaces 
of the lungs, right and left, in the vicinity of tlie points of 
entrance of the bronchi, right and left. 
Dissection.—The bronchial tubes, pulmonary arteries, and pulmonary 
veins should be slit open and traced into the substance of the lungs, to note 
their respective bifurcations, etc. 
HEART. 
1. Heart? Plate 144.—This organ is a hollow muscular or- 
gan, having a characteristic conical shape; it has a base, and an 
apex ; an anterior and a posterior surface—when spoken of in 
situ (Plates 141 and 142); a right-heart and a left-heart surface 
(Plate 144)—when the organ is considered structurally. The 
adult heart has an average weight of about ten ounces, varying 
as to sex. Septa partition off four cavities within the walls of 
the heart: a longitudinal septum determines the, so-called, 
right and left hearts ; a transverse septum is common to both 
sides of the organ. Of the transverse septum: its right por- 
tion—the right auricula-ventricular septum—sets off a superior 
cavity, the right auricle, from an inferior cavity, the right ven- 
tricle ; its left portion—the left auriculo-ventricular septum— 
separates a superior cavity, the left auricle, from an inferior 
cavity, the left ventricle. Of the longitudinal septum: its 
superior portion—inter auricular septum— separates the right 
from the left auricle ; its inferior portion—interventricular 
septum—partitions between the right and the left ventricle. 
A subpericardial areolar tissue, with more or less adipose tis- 
sue along the cardiac vessels (coronary), lies between the vis- 
ceral portion of the pericardium and the muscle wall of the 
organ. The base of the heart presents eight vessels: six con- 
verging to it, the vena cava superior, the vena cava inferior, 
and the four pulmonary veins; two projected from it, the 
pulmonary artery and the aorta. The apex of the heart is 
formed by the inferior portion of the left ventricle. 
Dissection.—Place the heart on a dissecting board, with the right-heart 
surface (right auricle and right ventricle) uppermost. Dissect off the visceral 
portion of the pericardium from the right-heart surface; clear the right auric- 
ulo-ventricular, and the right and left interventricular furrows free of adipose 258 
TRUNK. 
tissue, tracing and preserving the portions of, and the branches of, the coronary 
arteries. Follow the right coronary artery to its origin from the aorta and 
display its branches. Expose the anterior surface of the cardiac ends of the 
aorta, the pulmonary artery, the vena cava superior, and the vena cava inferior. 
(The last three vessels may be stuffed with oakum or cotton.) 
2. Exterior of the Right Heart, Fig. 1, Plate 144.—This 
heart surface is contributed by the anterior and the right 
antero-lateral surfaces of the organ when in situ (Plate 141). 
It presents: the right auriculo-ventricular and the right and 
left interventricular furrows; the right auricle, with its con- 
verging cavae—superior and inferior; the right ventricle and 
its projected common pulmonary artery ; the right coronary 
artery and a branch of the left coronary artery. 
3. Right Auriculo-ventricular and Right and Left Inter- 
ventricular Furrows.—The right auriculo-ventricular furrow is 
between the right auricle and ventricle, lodging the trunk of 
the right coronary artery. The right and left interventricular 
furrows are at either side of the right ventricle, separating it 
from the left ventricle ; they curve to, and meet at, the apex of 
the heart; they lodge, respectively, terminal branches of the 
right and left coronary arteries. 
4. Right Auricle.—This portion of the heart is located 
superiorly to, and obliquely upon, the right half of the base 
of the right ventricle. It has two portions: a cavity, to the 
right, and an appendix, to the left. In its collapsed condition 
it has about one-fourth of the area of the right ventricle. Its 
shape is somewhat triangular: its base to the right; its apex 
(the appendix) to the left; its inferior border along the right 
auriculo-ventricular furrow ; its superior face free. 
5. Vena Cava Superior and Vena Cava Inferior.—The su- 
perior enters the superior wall of the right auricle ; the inferior 
opens into the right auricle at its right wall or base. 
6. Right Ventricle.—The area of this cavity of the heart, 
as undistended, is about four times that of the empty right au- 
ricle ; it is bounded by the right auriculo-ventricular and the 
right and left interventricular furrows; its left superior angle 
is free; the right auricle surmounts, obliquely, the right half VISCERA OF THE THORAX OUT OF THE BODY. 
of its base. The left ventricle projects beyond its borders and 
its apex. 
7. Common Pulmonary Artery.—This, the largest artery 
in the body, is projected from the left superior angle of the 
right ventricle. 
8. Right Coronary Artery.—This artery (vena comes) arises 
from the anterior surface of the ascending portion of the arch 
of the aorta, close to the cardiac origin of the same. It is pro- 
jected anteriorly, between the appendix of the right auricle, to 
the right, and the common pulmonary artery, to the left. Its 
course is to the right, in the right auriculo-ventricular furrow ; 
it sends branches, inferiorly, upon the exterior surface of the 
right ventricle, from which, in turn, branches enter the wall of 
the ventricle. Small branches are given off from it, superiorly, 
which enter the wall of the right auricle. Its terminal branch 
is continued into the right interventricular furrow. 
9. Eeft Coronary Artery.—The terminal branch of this ar- 
tery (vena comes) is lodged in the left interventricular furrow. 
Its branches anastomose with branches of the right coronary 
artery. 
Dissection.—Place the heart upon the dissecting board, with its left-heart 
surface (left auricle and left ventricle) uppermost. Dissect off the visceral 
portion of the pericardium from the auricular and ventricular areas ; clear the 
left auriculo-ventricular furrow, displaying, and preserving, in so doing, the 
coronary vein. Follow the left coronary artery from its origin from the aorta, 
and trace its branches. Expose the posterior surfaces of the cardiac ends of 
the aorta and the common pulmonary artery. 
10. Exterior of the Eeft Heart, Fig. 2, Plate 144.—This 
heart surface is formed by the posterior and the left postero- 
lateral surfaces of the organ, in situ (Plate 142). It presents : 
the left auriculo-ventricular furrow, lodging the coronary vein 
and the left coronary artery; the left auricle, with its four con- 
verging pulmonary veins ; the left ventricle with its projecting 
aorta; the posterior surface of the ascending portion of the aorta, 
giving off the left coronary artery ; the posterior surface of the 
common pulmonary artery ; and that of the vena cava superior. 
11. Eeft Auriculo-ventricular Furrow.—This furrow has a 
transverse course, between the left auricle and the left ventricle. 260 
TRUNK. 
12. Coronary Vein.—This vein is formed by the confluence 
of the comites veins of the right and left coronary arteries and 
their branches. It is lodged in the left auriculo-ventricular 
furrow, wherein its course is to the right, to empty into the 
right auricle. It is accompanied by the right branch of the 
right coronary artery. 
13. L.eft Auricle and Interauracular Furrow.—This por- 
tion, of the left-heart surface, is located at the right half of 
the base of the organ; it surmounts the left ventricle, and has 
the right auricle, the vena cava superior, and the ascending 
portion of the arch of the aorta, in a plane anteriorly to it. It 
consists of a cavity portion, to the right, which is somewhat 
quadrangular in shape; and an appendix portion, to the left. 
In its collapsed condition it is about one-tifth the size of the 
undistended left ventricle. A slight furrow, to the right of it 
—the inter auricular furrow—separates its cavity portion from 
the right auricle ; to the right of the furrow is the opening into 
the right auricle of the vena cava inferior. 
14. Pulmonary Veins.—The four pulmonary veins two 
from the right and two from the left lung—converge to the left 
auricle : the right veins, open into the right superior angle of 
the cavity portion of the auricle ; the left enter at its left supe- 
rior angle. 
15. Left Ventricle.—The area of this region of the heart, 
when undistended, is about live times that of the collapsed 
left auricle, and is located inferiorly to the latter. It is tri- 
angular in shape : its base is directed ; being larger 
than the right ventricle, its lateral borders and its apex project 
beyond the limits of that ventricle. Its apex forms the apex 
proper of the organ. It is separated from the left auricle by 
the left auriculo-ventricular furrow; and from the right ven- 
tricle by the right and left interventricular furrows. 
16. Ascending Portion of tlic Arcli of tlic Aorta.—This por- 
tion of the arcli of the aorta is projected, superiorly, from the 
base of the left ventricle. It is located in a mid-plane: the 
appendix of the left auricle, posteriorly; and the right pul- 
monary artery, anteriorly. From the posterior surface of its 
cardiac end, the left coronary artery takes its origin. VISCERA OF THE THORAX OUT OF THE BODY. 
261 
17. Left Coronary Artery.—This artery (vena comes) arises 
from the posterior surface of the ascending portion of the arch 
of the aorta, close to the origin of the latter from the heart. 
It bifurcates into a right and a left branch: the right branch 
passes anteriorly to the appendix of the left auricle, into the 
left auriculo-ventricular furrow and supplies the left auricle 
and ventricle ; the left branch terminates by lodgement in the 
right interventricular furrow (page 258; Fig. 1, Plate 144); 
other branches ramify upon the surface of the left ventricle, 
which it supplies. Branches of the left anastomose with those 
of the right coronary artery. 
Dissection.—Open the cavity of the right auricle by the section lines 
shown upon its exterior (Fig. 1, Plate 144). Raise the flap of the auricular 
wall by loops of thread, to expose the interior of the cavity. 
18. Interior of the Right Auricle, Fig. 1, Plate 145.—Tile 
interior of this cavity presents: a lining of serous membrane 
—endocardium; sub-endocardial muscle fibres, which form 
ridges upon the collapsed anterior wall of the cavity portion 
and of the appendix—musculi pectinati; the openings into 
the cavity—for the incoming of blood—of the vena cava supe- 
rior, the vena cava inferior, the coronary vein, and the vence 
Thebesii (the latter are the orifices of veins in the wall of the 
auricle); the right side of the inter auricular septum, with 
the fossa ovalis (a membrane within a thickened annulus or 
border) of adult life (the foramen ovale—the interauricular 
communication, of foetal life); the ridge of reduplicated endo- 
cardium, Eustachian valve, extends from the margin of the 
orifice of the vena cava inferior to the border of the fossa ovalis 
(by this, during foetal life, the blood entering this cavity, by 
the vena cava inferior, is guided to the foramen ovale to pass 
into the left auricle); the reduplicated endocardium at the 
opening of the coronary vein—the coronary valve; the right 
auriculo-ventricular orifice—for the outgoing of blood—open- 
ing into the right ventricle. 
Dissection.—Open the cavity of the right ventricle by the section lines 
upon its exterior (Fig. 1, Plate 144). Enter the cavity toward the apex of the 
organ, then, with the scissors, make the diverging cuts : the right, as far as the 
musculi papillares which afford attachments to the chordae tendinse of the cusps 
of the tricuspid valve; the left, out through the wall of the common pulmo- 
nary artery. liaise the flap of the ventricular wall by loops of thread. 262 
TRUNK. 
19. Interior of the Right Ventricle, Fig. 2, Plate 145.—■ 
This cavity is lined by serous membrane—endocardium; it 
presents the right side of the interventricular septum. Its 
interior is irregular from sub-endocardial ridges of muscle tis- 
sue—columnce carnece ; some of these masses of muscle tissue 
have free ends—musculi papillares. The openings into the 
cavity are: the right auriculo-ventricular orifice—for the in- 
coming of blood; the orifice of the commoripulmonary artery— 
for the outgoing of blood. 
20. Tricuspid Valve.—This valve is formed by three cusps 
—flaps of fibrous tissue covered by reduplicated endocardium— 
from the ventricular face of the border of the right auriculo- 
ventricular orifice. These cusps—rigid, left, and posterior—- 
hang free in the cavity of the right ventricle ; from their edges 
fibrous cords—chorda tendince—are projected for attachment 
to the musculi papillares. 
21. Common Pulmonary Artery.—This vessel receives the 
blood from the right ventricle. The ventricular orifice is fur- 
nished with, the three pulmonary semilunar valves : they are 
a right anterior, a left anterior, and a posterior ; they are con- 
structed of fibrous tissue covered by reduplicated endocardium, 
and are attached to the circumference of the orifice. The centres 
of the edges of the ventricular face of the valves present small 
fibro-cartilaginous prominences—corpora Arantii. Where the 
valves open against the artery, the wall of the latter forms 
outward pouchings, the sinuses of Valsalva, which are located 
as are the semilunar valves, viz., a right anterior, a left an- 
terior, and a posterior. 
Dissection.—Lay open (with the scissors) the cavity of the left auricle by 
the section lines upon its exterior (Fig. 2, Plate 144). Hold off, by loops of 
thread, the flaps of the auricular wall, to expose the cavity for inspection. 
22. Interior of tlie L.eft Auricle, Fig. 1, Plate 146.—The 
sectioned wall is thicker than that of the right auricle. The 
cavity has a lining of thick serous membrane—endocardium. 
It has musculi pectinati ridges, which are limited to the ap- 
pendix portion. The four openings—for the ingress of blood— 
of tliv pulmonary veins, two right and two left, appear at the. 263 
VISCERA OF THE THORAX OUT OF THE EODY. 
superior angles, respectively, of tlie cavity. Tlie left side of 
tlie inter auricular septum presents the left side of the fossa 
ovalis. At the floor of the cavity is the left auriculo-ventricu- 
lar orifice—for egress of blood—into the cavity of the left 
ventricle. 
Dissection.—Close over tlie flaps of the left auricle. Cut into the cavity of 
the left ventricle, along the section lines upon its exterior (Fig. 1, Plate 144). 
Enter the cavity at the apex, then continue the diverging cuts toward the base 
of the organ : the right one as far as the bases of the papillae, which receive the 
chordae tendinae of the anterior cusp of the mitral valve ; the left one is con- 
tinued out through the wall of the aorta (in making this cut turn aside the 
appendix of the left auricle). Hold off the flap of the ventricular wall by loops 
of thread. 
23. Interior of tlie Cavity of the Left Ventricle, Fig. 2, 
Plate 146.—The wall of this cavity is very much thicker than 
that of the right ventricle. Its interior presents : a lining 
of endocardium (thicker than that of the right ventricle); 
the left side of the interventricular septum; well-marked 
columnar carnece, more numerous and more prominent than 
those of the right ventricle (page 262); musculi papillares 
which are much larger than those of the right ventricle; the 
left auriculo-ventricular orifice—for entrance of blood from 
the left auricle ; the aortic orifice—for exit of blood into the 
aorta. 
24. Mitral (Bicuspid) Valve.—This valve lias an anterior 
(right) cusp and a posterior (left) cusp, which are attached to 
the ventricular face of the border of the left auriculo-ventricular 
orifice. These cusps—reduplications of the endocardium— 
hang in the cavity of the ventricle ; from their free edges 
chordae tendince are projected, which are attached to the mus- 
culi papillares at the interior of the cavity. 
25. Aortic Orifice.—This orifice is furnished with three 
valves, aortic semilunar, which are, respectiveiy, anterior, right 
posterior, and left posterior. They are constructed of fibrous 
tissue plates covered by reduplicated endocardium, and are at- 
tached to the circumference of the orifice. Their corpora 
Arantii and sinuses of Valsalva are the counterparts of those 
of the pulmonary semilunar valves (page 262). The sinuses 264 
TRUNK. 
of Valsalva have the same relative positions as the aortic valve, 
viz., anterior, right posterior, and left posterior. At the an- 
terior and the left posterior sinuses of Valsalva the orifices of 
the right or anterior and left or posterior coronary arteries 
present, respectively. PLATE 141 
JW. Cohn, ad nczZuranz deZ. PLATE 142 
M.Cohrt, adnaturam. tZeZ. PLATE 143 
Fig >2 
Fig 1 
M.Cohn, OeZ. PLATE 144 
Fig. 2 
ATCoUn.,acinociuram del. 
Fia.l PLATE 145 
/S'in uses of 
\ Valsa/vtz 
M.Cohn, aaC naturam cZeZ. PLATE 146 
L,, cii/ricuZe? - 
rtrentricutar 
L- orifice 
JW. OoTzrz, cx.c£ nac e cc r CZ771 cicZ. NINETEENTH DISSECTION. 
REGION OF THE BACK; SPINAL CORD IN SITU; 
VERTEBRAL COLUMN AND ITS LIGAMENTS. 
Dissection.—Place the subject with the back uppermost; with a block 
under the thorax, and one under the pelvis. The head should hang to the 
table; while the upper extremities hang over the sides of the table. (The dis- 
sectors of the two upper-extremity and the liead-and-neck sections should 
work together upon the first part of this dissection.) 
Terms of Relation.—The general terms (page 2), and the 
special terms exterior and interior (toward the skin and the 
cavities of the trunk, respectively) will be used, in describing 
this dissection. The regions of the back are the sacral, the 
lumbar, the dorsal, and 
the cervical. 
Rones and Rone Areas, 
Plate 147.—The bones are 
the posterior surfaces of 
the following : the twenty- 
four vertebrae, sacrum, and 
coccyx ; the occipital; the 
twelve pairs of ribs; the 
scapulae ; the clavicles ; 
and the ossa innominata. 
They all present areas for 
the attachments of mus- 
cles. 
REGION OF THE BACK. 
Dissection.—Make the skin 
incisions 1, 2, 3, and 4, of Fig- 
ure 11; reflect skin flaps, on 
either side of the median line, 
as indicated. Trace the nerves 
and the arteries ramifying in the subcutaneous tissue plane (Plate 148) ; then 
clear the fascial plane free of subcutaneous tissue, leaving the arteries and 
nerves in situ. 
Figure 11. L6G 
TI1UNK. 
l. Occipital Artery, Plate 148.—This artery (venae comites) 
emerges from the superior portion of the muscles of the neck, 
and passes to the subcutaneous plane of the occipital region of 
the scalp. 
2. Occipitalis major Nerve.—This, the internal (cutaneous) 
branch of the posterior division of the second cervical spinal 
nerve, appears at the external border of the occipital portion of 
the trapezius muscle, and ramifies superiorly in the subcu- 
taneous plane of the scalp. 
3. Internal (Cutaneous) Branch of the Posterior Division 
of tlie Third Cervical Spinal Nerve.—This nerve emerges in- 
feriorly to the last-described nerve, and has the same course. 
4. Oeeipitalis minor Nerve.—This nerve, a branch from the 
cervical plexus, runs superiorly, along the posterior border 
of the sterno-cleido-mastoid muscle ; it enters the subcutane- 
ous plane of the scalp. 
5. Internal (Cutaneous) Branches of the Posterior Divis- 
ions of the Spinal Nerves.—These nerves emerge to the subcu- 
taneous plane of the back, as follows : the fourth and fifth cer- 
vical, the first to eleventh dorsal, and the sacral appear close 
to the median line, while the twelfth dorsal and the first to 
fifth lumbar perforate farther from it. They are at a variable 
distance from each other, and have a course externally. (The 
regularity of the emergence of these nerves varies in different 
subjects.) 
6. Arteries of the Subcutaneous Plane.—These small ar- 
teries appear with, and accompany, the last-described branches 
of the posterior divisions of the spinal nerves. 
7. Twelfth Intercostal. Ilia-hypogastric, and Ilio-inguinal 
Nerves.—Portions of these nerves appear at tlie inferior area 
of the lumbar region, superiorly to, and parallel with, the crest 
of the ilium. The lateral cutaneous branch of the former and 
the iliac branches of the tw’o latter pass into the subcutane- 
ous plane of the gluteal region. 
§. Superficial Fascia.—A continuous layer of fascia invests 
the first muscle plane of the back ; the same is continued to 
the external surfaces of the neck, thorax, and abdomen. EEGIOJST OF THE BACK. 
267 
Dissection.—Dissect away the fascia from the first plane of muscles of the 
back; cut the nerves and arteries of the subcutaneous plane, preserving the 
stumps of the same. 
9. Trapezius muscle, Plates 147 and 149.—This muscle is 
attached : internally, to the spinous processes of the twelve 
dorsal and the seventh cervical vertebne, to the ligamentum 
nuchse, and to the internal portion of the superior curved line 
of the occipital bone ; externally, to the postero-superior por- 
tion of the surface of the spine of, and the border of the 
acromion process of, the scapula, and to the postero-superior 
border of the external third of the clavicle. The fibres of the 
muscle have a variable direction : the inferior pass superiorly 
and externally ; the middle are directed externally ; the supe- 
rior run inferiorly, externally, and anteriorly. Along its ver- 
tebral border it presents an aponeurotic portion of variable 
breadth—broadest at the inferior cervical and superior dorsal 
regions. It is perforated, near its median-line attachments, 
by small arteries and the internal (cutaneous) branches of the 
posterior divisions of the cervical and dorsal spinal nerves 
(page 266). 
10. L<atis§imu§ Dorsi muscle, Plate 149.—This muscle is at- 
tached : internally and inferiorly, to the spinous processes of 
the six inferior dorsal vertebrae, to the fascia of the erector 
spinae muscle, to the internal quarter of the exterior lip of the 
crest of the ilium (os innominatum), and to the exterior sur- 
faces of the three inferior ribs (between the attachments of the 
serratus posticus inferior and the obliquus externus muscles, 
where it interdigitates with the three inferior digitations of 
the obliquus externus muscle) ; externally and superiorly, 
by a narrow tendinous portion, to the bed of the bicipital 
groove of the humerus (page 196 ; Plates 113, and 116 to 
120, inclusive). The fibres of the muscle have a variable 
direction : the inferior pass superiorly, externally, and an- 
teriorly ; the superior are directed externally, superiorly, 
and anteriorly. The muscle is thus swathed about the pos- 
tero-lateral areas of the abdomen and thorax. Its superior 
portion, lying in a plane anteriorly to the inferior portion of 
the trapezius, is projected, externally, from the latter muscle, 
and overlaps the inferior angle of the scapula. Along its line 
of attachment to the fascia upon the erector spinee muscle, it 268 
TRUNK. 
is perforated by small arteries and the internal (cutaneous) 
branches of the posterior divisions of the twelfth dorsal and 
the first to fifth lumbar spinal nerves (page 266). 
11. Scapular Fascia.—In tlie angle between the superior 
border of the latissimus dorsi muscle and the external border 
of the trapezius muscle, a deep fascia appears investing the 
surfaces of the posterior scapular and the rliomboideus major 
muscles. 
Dissection.—Section the trapezius muscle along its median-line attach- 
ments, as in Plate 149, and turn it off externally, so as to hang from its scapu- 
lar and clavicular attachments ; cut out the arteries and nerves that perforate 
it. Section the latissimus dorsi muscle, as in Plate 149, and reflect it from the 
posterior and lateral areas of the abdomen and thorax ; in so doing, it must 
be cut from its rib attachments. Cut out the arteries and nerves, that per- 
forate the internal portion of the latissimus dorsi muscle, leaving the stumps 
of the same. Dissect out the artery and nerve, that enter the anterior face of 
the reflected trapezius muscle. Clear the posterior surfaces of the rliomboideus 
major, the rliomboideus minor, and the levator anguli scapulae muscles. Dis- 
play the arteries, that emerge, posteriorly, from between these three muscles. 
12. Superficial Cervical Artery and Spinal Accessory Serve. 
—This artery and nerve enter the anterior face of the trapezius 
muscle. 
13. Rhomboideus Major Muscle.—This muscle, of the sec- 
ond plane of muscles of the back, is attached : internally, to the 
spinous processes of the four superior dorsal vertebrae, and the 
supraspinous ligaments that bridge between the same; exter- 
nally, to the posterior lip of the internal border of the infra- 
spinous portion of the scapula. Its internal portion is aponeu- 
rotic, and perforated by the internal (cutaneous) branches of 
the posterior divisions of several dorsal-spinal nerves. 
14. Rhomboideus Minor Muscle.—This muscle lies in the 
same plane with, superiorly to and parallel with, the last- 
described muscle. It is attached : internally, to the spinous 
process of the seventh cervical vertebra, and the supraspinous 
ligament between the latter and the spinous process of the first 
dorsal vertebra ; externally, to the posterior lip of the posterior 
border of the body of the scapula, opposite the spine of that 
bone. REGION OF THE BACK. 
269 
15. Levator Anguli Scapulae Muscle.—This muscle occu- 
pies the same plane as the two last-described muscles ; it has 
a more oblique course, interiorly. It is attached: internally 
and superiorly, to the posterior tubercles of the transverse 
processes of the three or four superior cervical vertebrae ; ex- 
ternally and interiorly, to the posterior lip of the internal bor- 
der of the supraspinous portion of the scapula. 
16. Posterior Scapular Artery.—This artery appears, pos- 
teriorly, in the space between the levator anguli scapulae and 
the rliomboideus minor muscles. It is continued internally 
to, and parallel with, the internal border of the scapula. It 
has an inferior course anteriorly to the scapular ends of the 
rliomboideus minor and major muscles. It distributes branches 
to the rliomboidei, and the serratus magnus muscles. 
Dissection.—Clear the surfaces of the serratus posticus inferior muscle, 
and of the postero-internal portions of the oblitpius externus and the obliquus 
internus muscles. 
17. Scrratus Posticus Inferior Muscle, Plates 149 and 151. 
—Tliis, one of the second-plane muscles of the back, is located 
upon the exterior of the inferior portion of the thoracic parie- 
tes. It is attached : internally, to the spinous processes and 
supraspinous ligaments of the two inferior dorsal and the two 
or three superior lumbar vertebrae, and to the fascia of the erec- 
tor spinae muscle at its inferior dorsal and superior lumbar 
portions ; externally, to the exterior surface of the four in- 
ferior ribs. 
18. Obliquus Externus and Obliquus Intcrnus Muscles, 
Plate 149.—The postero-internal portions of these muscles ap- 
pear, in their respective exterior and interior relations, between 
the inferior ribs and the crest of the ilium (os innominatum). 
They contribute to the posterior parietes of the abdomen. 
Dissection.—Cut the rliomboideus major, the rliomboideus minor, also the 
levator anguli scapulae muscles from their vertebral attachments. Reflect the 
three muscles, externally, upon the scapula. Clear the surface of the serra- 
tus posticus superior muscle. 
19. Serratus Posticus Superior Muscle, Plate 149 ; Fig. 1, 
Plate 150 and Plate 151.—This muscle, of the third plane, is at- 
tached : internally, to the spinous processes of the seventh cer- 270 
TIIUXK. 
vieal and the first, second, and third dorsal vertebrae, and the 
supraspinous ligaments bridging between the same ; exter- 
nally, by four serrations, to the exterior surfaces of the ribs, 
second to fifth, inclusive. The internal portion of the muscle 
is aponeurotic ; the aponeurosis being perforated by the inter- 
nal branches of the posterior divisions of the three superior 
dorsal spinal nerves. It binds down the splenius capitis and 
splenius colli muscles. 
Dissection.—Dissect away the serratus posticus superior muscle. Clear 
the surfaces of the splenius capitis and splenius colli muscles. 
20. Splcnius Capitis Muscle, Plate 149 ; Fig. 1, Plate 150.— 
This muscle, of the third plane, is attached : internally and in- 
to the spinous processes of several superior dorsal and 
the seventh cervical vertebrae, and to the inferior portion of the 
ligamentum nuchae ; externally and superiorly, to the external 
portion of the superior curved line of the occipital bone, and 
to the mastoid process of the temporal bone. 
21. Splenius Colli Muscle.—This muscle, of the third plane, 
is attached as follows : internally and inferiorly, to the spinous 
processes of several superior dorsal vertebrae, inferiorly to those 
affording attachment to the splenius capitis; externally and 
superiorly, to the posterior tubercles of the transverse processes 
of several superior cervical vertebrae. The fibres of this and the 
last-described muscle strap down or retain in place the cervical 
supplementary portions of the erector spinae muscle. 
Dissection.—Dissect away the splenius capitis, the splenius colli, and the 
serratus posticus inferior muscles from their attachments. Expose and then 
clear away the fascia upon the erector spinse muscle from the sacral region to 
the cranium. 
22. Fascia upon tlie Erector Spinae Muscle, Plate 149.— 
This is a layer of fascia investing the surface of the erector 
spinae muscle, its divisions and supplementary muscles, from 
the sacrum to the cranium, through the lumbar, dorsal, and 
cervical regions. In the sacral region it is attached : to the 
spines of the sacrum, internally ; to the posterior spinous pro- 
cesses (inferior and superior) of the ilium (os innominatum), ex- 
ternally. In the lumbar region it is attached : to the spinous 
processes and supraspinous ligaments of the vertebrae, inter- 
nally ; to the exterior surface of the posterior aponeurosis of REGION" OF THE BACK. 
271 
the transversalis abdominis muscle, externally ; it is strength- 
ened by the fusion of the aponeuroses of the latissimus dorsi 
and the serratus posticus inferior muscles. (This portion 
is sometimes described as the posterior layer of the lumbar 
fascia.) In the dorsal region it is attached : internally, to the 
spinous processes and supraspinous ligaments of the dorsal 
vertebrae ; externally, to the exterior of the ribs, externally to 
tlieir angles. (This portion is usually described as the vertebral 
aponeurosis.) In the cervical region it presents as a thin layer 
of fascia between the splenius capitis and the splenius colli 
muscles posteriorly, and the complexus muscle, anteriorly ; in- 
ternally, it is attached to the ligamentum nuchae; externally, 
at the external border of the splenius colli muscle, it blends 
with the deep cervical fascia. 
Dissection.—Remove the fascia of the erector spinse muscle, exposing the 
latter muscle, with its divisions and supplementary muscles—through the lum- 
bar, dorsal, and cervical regions. Trace to their superior attachments the 
sacro-lumbalis and longissimus dorsi divisions of the erector spinae muscle. 
23. Erector Spinae Muscle and its Sacro-Eumlmlis and 
Longissimus Dorsi Divisions, Plates 147 and 151.—This mus- 
cle with its divisions and their supplementary muscles are of 
the fourth muscle plane of the back. The erector spince muscle 
occupies the sacral and lumbar regions and is attached as fol- 
lows : to the spines and the external portion of the posterior 
surface of the inferior half of the sacrum ; to the postero-inter- 
nal portion of the middle,of the crest of the ilium (os innomi- 
natum) ; and to the spinous processes of the live lumbar and the 
twelfth dorsal vertebrae. In the lumbar region it divides into 
the sacro-lumbalis and the longissimus dorsi divisions. 
The Sacro-lumbalis division is projected, superiorly and ex- 
by six tendons which are attached to the exterior of 
the six inferior ribs (at their angles), respectively. 
The Longissimus dorsi division is continued superiorly, 
parallel with the vertebral column, having two lines of attach- 
ments : an external, to the exterior surfaces of the inferior ten 
ribs (between their angles and tubercles) ; an internal, to the 
transverse processes of the dorsal vertebrm. 
Dissection.—Reflect the superior portion of the sacro-lumbalis division 
externally ; expose the mnsculus accessorius from its inferior to its superior 
attachments ; then reflect the latter externally, and display the cervicalis 
ascendens from its inferior to its superior attachments. 272 
TRUNK, 
24. Musculus Accessorius.—This muscle is the first sup- 
plementary muscle of the sacro-lumbalis division of the erector 
spinae muscle. It lies upon the exterior of the ribs and the 
external intercostal muscles, having the followingattachments : 
inferiorly, to the six inferior ribs (their angles), internally to the 
attachments of the sacro-lumbalis ; superiorly, to the six supe- 
rior ribs (their angles). 
25. Cervicalis Asccndcns Muscle.—This is the second sup- 
plementary muscle of the sacro-lumbalis division of the erector 
spinae muscle. It is attached : interiorly, to the six superior 
ribs (their angles), internally to the superior attachments of the 
musculus accessorius ; superiorly, to the posterior tubercles of 
the transverse processes of several inferior cervical vertebrae. 
Dissection.—Cut away tlie musculus accessorius and the cervicalis ascen- 
dens muscles, from tlieir inferior and superior attachments. Display the 
transversalis cervicis, trachelo-mastoid, complexus, and spinalis dorsi muscles. 
26. Transversal is Cervicis Muscle.—This muscle is the pri- 
mary, lateral, supplementary muscle of the longissimus dorsi 
division of the erector spinae muscle. It is attached : interi- 
orly, to the transverse processes of several superior dorsal verte- 
brae ; superiorly, to the posterior tubercles of the transverse 
processes of the middle cervical vertebrae. 
27. Tracliclo-Mastoid Muscle.—ffliis muscle is the second- 
ary, lateral, supplementary muscle of the longissimus dorsi 
division of the erector spinae muscle. It is attached : interiorly, 
to the transverse processes of several superior dorsal vertebrae 
and to the articular processes of some of the inferior cervical 
vertebrae ; superiorly, to the posterior surface of the mastoid 
process of the temporal bone. 
28. Complcxus Muscle, Plates 147, 149, 150, and 151.—Tins 
is tlie longitudinal supplementary muscle of the longissimus 
dorsi division of the erector spinae muscle. It is attached : 
interiorly, to the transverse processes of the superior dorsal 
vertebrae, and the articular processes of some of the inferior 
cervical vertebrae ; superiorly, to the exterior of the occipital 
bone, between its superior and inferior curved lines. Its in- 
ternal portion is intersected by a fibrous portion (sometimes REGION OF THE BACK. 
273 
described as a separate muscle, under the name of the biven- 
ter cervicis). 
29. Spinalis Dorsi Muscle, Plate 151.—This muscle, of 
the fourth plane, is attached: -interiorly, to the spinous pro- 
cesses of a few inferior dorsal vertebrae; superiorly, to the 
spinous processes of several superior dorsal vertebrae. 
Dissection.—Cut away the complexus, the trachelo-mastoid, and the trans- 
versalis cervicis muscles from their attachments. Cut (page 271), progressing 
interiorly, the longissimus dorsi division of the erector spinse muscle, from 
its dorsal vertebrae and rib attachments; also the sacro-lumbalis division from 
its rib attachments. Cut away the erector spime muscle proper from the lum- 
bar vertebrae and from the ilium (os innominatum), as in Plate 152. In dis- 
secting away these muscles be careful to leave, in situ, the posterior divisions 
of the spinal nerves and their accompanying arteries. Dissect away the spina- 
lis dorsi muscle and clear the surfaces of the semispinalis dorsi and the semi- 
spinalis colli muscles. 
30. Semispinalis Dorsi and Semispinalis Colli Muscles, Plate 
152, Fig. 2, Plate 150.—These muscles form the fifth muscle 
plane of the back. The semispinalis dorsi is attached: in- 
teriorly, to the spinous processes of some of the superior 
lumbar and inferior dorsal vertebrae, also to the transverse 
processes of the inferior dorsal vertebrae ; superiorly, to, the 
spinous processes of the superior dorsal and several inferior 
cervical vertebrae. The semispinalis colli is attached : interi- 
orly, to the transverse processes of the superior dorsal vertebrae; 
superiorly, to the spinous processes of the middle cervical ver- 
tebrae. 
Dissection.—Dissect away tlie semispinalis dorsi and the semispinalis colli 
muscles. Clear the surfaces of the following muscles of the sixth plane of the 
back : the multifidus spinse in the sacral, lumbar, dorsal, and cervical regions ; 
the intertransversales and interspinales ; the posterior aponeurosis of the trans- 
versalis abdominis; and the levatores costarum. Trace the posterior divisions 
of the lumbar and dorsal spinal nerves to the intervertebral foramina ; find also 
the small arteries accompanying the nerves. 
31. Multifldus Spina; Muscles, Plate 152.—These muscles, 
of the sixth plane of muscles, occupy the longitudinal groove 
between the lines of the spines and lateral tubercles of the 
sacrum, the spinous and articular processes of the lumbar and 
cervical vertebrae, the spinous and transverse processes of the 274 
TKUNK 
dorsal vertebrae ; the floor of the groove is formed bjr the pos- 
terior surface of the sacrum, the laminae of the vertebrae, and 
the ligamenta subfiava between the laminae. The muscles 
consist of oblique fibres which are attached : inferiorly, in 
their groove of lodgment through the sacral region, to the 
mamillary processes in the lumbar region, to the transverse 
processes in the dorsal region, and to the articular processes 
in the cervical region ; superiorly, to the lateral surfaces of the 
spinous processes of the lumbar, dorsal, and cervical (as high 
as the second) vertebrae. These fibres are laid down in layers 
of varying length (crossing from one to four vertebral laminae); 
the long fibres are posterior to the short ones. 
32. Intertransversales muscles.—These muscles extend be- 
tween the transverse processes of the vertebrae. In the lumbar 
region they are best developed. In the dorsal region they are 
wanting, but are replaced by the inter transverse ligaments. 
33. Intcrspinalcs muscles.—These are short longitudinal 
muscles, which bridge between the spinous processes of the 
vertebrae. They are developed in the lumbar and cervical re- 
gions, and are absent in the dorsal region. 
34. Posterior Aponeurosis of tlie Transversalis Abdominis 
Muscle, Plates 151 and 152.—This aponeurosis passes to the 
transverse processes of the lumbar vertebrae, between the erec- 
tor spinae muscle, posteriorly, and the quadratus lumborum 
muscle, anteriorly. (This is usually described as the middle 
layer of the lumbar fascia.) 
35. Levatores Costarum Muscles, Plate 152.—These twelve 
pairs of muscles are located at either side of the dorsal region 
of the vertebral column. The muscles, of a side, are attached : 
superiorly, to the transverse processes of the vertebrae, seventh 
cervical to eleventh dorsal, inclusive ; inferiorly, to the superior 
borders of the ribs (first to twelfth), internally to their angles. 
36. Posterior Divisions of tlic Lumbar and Dorsal Spinal 
Nerves.—These nerves are projected, posteriorly, from the bi- 
furcations of the spinal nerves. In the lumbar region they are 
lodged posteriorly to the intertransversales muscles. In the 
dorsal region they emerge anteriorly to the dorsal intertrans- KEGIOX OF TIIE BACK. 
275 
verse ligaments, and run internally to, and parallel with, the 
levatores cost-arum muscles. They bifurcate, respectively, into 
an internal (cutaneous) and an external (muscular) branch. 
37. Arteries Accompanying: the Posterior Divisions of the 
Lumbar and Dorsal 8pinal Aerves.—These arteries are : in the 
lumbar region, posterior branches of the lumbar arteries ; in the 
dorsal region, posterior branches of the intercostal arteries. 
Dissection.—Clear tlie posterior surfaces of the cranio-vertebral muscles 
of the sixth plane of muscles, which pass from the second and first cervical 
vertebrae to the occipital bone. In exposing these muscles be careful to pre- 
serve the nerves and arteries, which are contiguous to them. 
38. Rectus Capitis Posticus Minor, Plate 147 and Pig. 2, 
Plate 150.—This internal, and longitudinal, muscle is attached; 
inferiorly, to the superior surface of the posterior arch of the 
first cervical vertebra; superiorly, to the internal portion of 
the inferior curved line of the occipital bone. 
39. Rectus Capitis Posticus Major Muscle.—This external, 
and oblique, muscle is attached : inferiorly, to the lateral sur- 
face of the spinous process of the second cervical vertebra ; 
superiorly, to the inferior curved line of the occipital bone, 
externally to the attachment of the last-described muscle. 
40. Obliquus Inferior Muscle.—This oblique muscle lies 
inferiorly to, and parallel with, the last-described muscle. It 
is attached: internally, to the lateral surface of the spinous 
process of the second cervical vertebra ; externally, to the pos- 
tero-inferior surface of the transverse process of the first cervi- 
cal vertebra. 
41. Obliquus Superior Muscle.—This muscle is attached : 
inferiority and to the superior surface of the trans- 
verse process of the first cervical vertebra ; superiorly and in- 
ternally, to the occipital bone, between its superior and inferior 
curved lines, externally to the attachment of the complexus 
muscle. 
Dissection. —Trace the deep cervical and the cervicalis princeps arteries; 
also, the posterior branches of the vertebral artery. Display the posterior di- 
visions of the cervical spinal nerves. 276 
TRUXK. 
42. Deep Cervieal Artery, Fig. 2, Plate 150.—This artery, 
branch of the first intercostal branch of the subclavian, ap- 
pears, posteriorly, from between the transverse processes of the 
sixth and seventh cervical vertebrae. It has a superior course, 
supplying contiguous muscles. 
43. Cervicalis Princeps Artery.—This artery, branch of the 
occipital, is given off opposite the obliquus superior muscle. 
It passes inferiorly, upon the posterior surface of the obliquus 
inferior muscle. It distributes to contiguous muscles and 
anastomoses with the last-described artery. 
44. Posterior of the Vertebral Artery.—These 
branches appear, posteriorly, from between the transverse pro- 
cesses of the cervical vertebrae ; they distribute to contiguous 
muscles and anastomose with the two last-described arteries. 
45. Posterior Divisions of the Cervical Spinal Serves.— 
These nerves are eight in number; the posterior divisions of 
the second, third, fourth, and fifth bifurcate into external 
(muscular) and internal (cutaneous) branches. 
The first or suboccipital nerve appears, posteriorly, between 
the obliquus inferior and the rectus capitis posticus major mus- 
cles, supplying them and also the obliquus superior and the 
rectus capitis posticus minor muscles. 
The second appears inferiorly to the obliquus inferior mus- 
cle, where its bifurcation takes place. Its internal (cutaneous) 
branch, the largest of the cervical nerves, becomes the great 
occipital nerve; it has an oblique course, internally and supe- 
riorly, upon the posterior surface of the obliquus inferior and 
the rectus capitis posticus major muscles, to where it perforates 
the complexus muscle (page 26G ; Plate 149). 
The third appears inferiorly to the second and bifurcates. 
Its internal (cutaneous) branch runs inferiorly and internally 
to, and accompanies, the great occipital nerve ; it also per- 
forates the complexus muscle (page 266 ; Plate 149). 
The fourth and fifth distribute their internal (cutaneous) 
branches by perforating the muscle planes of the neck (page 
266 ; Plate 148). 
The sixth, seventh, and eighth distribute both their external 
and internal branches to the deep posterior muscles of the 
neck. VEKTEBKAL COLUMN AND ITS LIGAMENTS. 
277 
Dissection.—Dissect away tlie multifidus spina), the obliquus inferior and 
superior, and the rectus capitis posticus major and minor muscles. Clear the 
surfaces of the vertebras, the sacrum, and the coccyx ; also those of the pos- 
terior intervertebral and costo-transverse ligaments. 
46. Posterior Surfaces of the Bones of tlie Vertebral Col- 
umn, Plates 147 and 155.—Of the twenty-four vertebrae—seven 
cervical, twelve dorsal, and five lumbar—their spinous pro- 
cesses (one to each), their right and left laminae (two to each), 
their articular processes (two superior and two inferior to each), 
and their transverse processes (two to each) form the superior 
portion of the posterior surface of the vertebral column. In- 
teriorly to them are the posterior surfaces of the sacrum and 
coccyx. 
47. Posterior Ligaments of the Ceriieal Vertebrae, Fig. 1, 
Plate 155.—Tlie posterior occipito-atlantal bridges between the 
superior border of the posterior arch of the atlas (first cervical 
vertebra) and the occipital bone. The posterior atlanto-axial 
passes from the superior border of the laminae of the axis (sec- 
ond cervical vertebra) to the inferior border of the posterior 
arch of the atlas. The ligamentum subjlavum stretches from 
the superior border of the laminae of an inferior vertebra to 
the inferior border of the laminae of the vertebra superiorly to 
it. The capsular ligaments eapsulate the facets of the opposed 
articular processes—the two superior of an inferior vertebra 
and the two inferior of the vertebra to it. 
48. Posterior Ligaments of the Dorsal Vertebrae, Fig. 2, 
Plate 155.—The supraspinous extends continuously from tip 
to tip of the spinous processes, from that of the seventh cervi- 
cal to that of the twelfth dorsal vertebra. The interspinous 
bridge between the opposite superior and inferior borders of 
the spinous processes. The inferior portions of the capsular of 
the articular processes, right and left, are demonstrable. The 
ligamenta sub/lava are not seen posteriorly, as in the cervical 
region, because of the over-lapping of the laminae of the ver- 
tebrae. 
49. Posterior Ligaments of the Lumbar Vertebrae, Fig. 3, 
Plate 155.—The supraspinous is continued from the spinous 
process of the twelfth dorsal vertebra to the tips of the pro- 278 
TRUNK. 
cesses of the lumbar vertebrae and the rudimentary spinous 
processes of the sacrum. The interspinous are similar to 
those of the dorsal region. The ligamenta sub/lava are de- 
monstrable, but blend with the interspinous and capsular liga- 
ments. The posterior portions of the capsular of the articular 
processes appear ; as do also the capsular of the lumbo-sacral 
articular-process articulations. 
Dissection.—Expose the posterior costo-transverse ligaments between the 
transverse process of a dorsal vertebra and the neck and tubercle of a rib (Fig. 
2, Plate 155). 
50. Posterior Costo-Trausverse Ligaments, Plate 152, and 
Fig. 2, Plate 155.—Three ligaments—superior, middle, and pos- 
terior—present posteriorly : tlie superior costo-transverse (Fig. 
2, Plate 155), from the inferior portion of the posterior surface 
of the transverse process of a dorsal vertebra to the superior 
border of the neck of the rib immediately inferior to it ; the 
middle costo-transverse (Fig. 2, Plate 155), from the anterior 
surface of tlie transverse process of a dorsal vertebra to the 
posterior surface of the neck of the rib opposed to it; the pos- 
terior costo-transverse (Plate 152, and Fig. 2, Plate 155), from 
the tip of the transverse process of a dorsal vertebra to the 
contiguous posterior surface of the rib articulated with it. 
SPINAL CORD IN SITU. 
Dissection.—Saw through the posterior portion of the occipital bone, 
right and left (section lines on Fig. 1, Plate 155) obliquely into the foramen 
magnum ; dissect away the included piece of the occipital bone. Saw, by 
two parallel section lines (including the cut internally), through the poste- 
rior wall of the vertebral column: for the cervical vertebrae internally to their 
articular processes (Fig. 1, Plate 155, and Plate 153) ; for the dorsal and lum- 
bar vertebrae at the roots of their transverse processes (Figs. 2 and 3, Plate 155, 
and Plates 153 and 154) ; for the sacrum internally to its posterior foramina 
(Plates 147 and 154). As the posterior portions of the vertebra) are sawed 
through, progressing inferiorly, the pieces may be removed by the hook and 
forceps. Display the dura mater, sheathing the spinal cord and the cauda 
equina ; also the roots of the spinal nerves, which are projected from the dura 
mater to their foramina of exit from the spinal canal. 
51. Spinal Canal, Plates 153 and 154.—This canal, as opened, 
presents the sheath of the spinal cord and cauda equina, from 
the foramen magnum of the occipital bone to the sacral region 
of the spinal column. The sheathed spinal cord is separated SPINAL CORD IN SITU. 
279 
from the bony walls of the spinal canal by loose connective tis- 
sue, in which ramifies a network of veins. Laterally and infe- 
riorly to the sheathed spinal cord and cauda equina sixty-two 
pairs of roots of spinal nerves are projected, to form the thirty- 
one pairs of spinal nerves, which leave the spinal canal by the 
intervertebral foramina of the cervical, dorsal, and lumbar re- 
gions, and by the anterior and posterior foramina of the sacral 
region. 
52. Dura Mater of the Spinal Cord.—This is the outer of 
three membranes that invest the spinal cord and the cauda 
equina. It projects sheaths upon the sixty-two pairs of roots 
of the spinal nerves. It is attached: superiorly, to the circum- 
ference of the foramen magnum of the occipital bone ; laterally, 
to the circumferences of the foramina of exit from the canal of 
the twenty-five pairs of spinal nerves, and the anterior and pos- 
terior divisions of the five pairs of sacral and one pair of coc- 
cygeal spinal nerves ; inferiorly, to the posterior surface of the 
coccyx. 
Dissection.—Slit open tlie dura mater, along the median line, from the 
level of the foramen magnum of the occipital bone to its inferior end (Plates 
153 and 154). 
53. Subdural Space.—The dura mater being a loose invest- 
ment of the spinal cord, a subdural space presents between it 
and the arachnoid membrane. 
54. Spinal Cord Invested by the Arachnoid and Pia Mater 
Membranes.—Tlie spinal cord, in situ, invested by its sheaths 
of arachnoid and pia mater membranes, is an elongated mass 
extending from the foramen magnum of the occipital bone, 
superiorly, to the level of about the first lumbar vertebra, inte- 
riorly. It is large in the cervical region—the cervical enlarge- 
ment; small in the superior two-thirds of the dorsal region ; 
and large in the inferior third of the dorsal region—the lumbar 
enlargement. Its inferior end tapers to a point—the conus 
medullaris; from the latter a slender portion, the jilum 
terminate, is continued interiorly. Interiorly to the conus 
medullaris of the spinal cord, the dura mater contains the 
lilum terminale and a leash of twenty pairs of roots of spinal 
nerves—eight lumbar (second to fifth, inclusive), ten sacral, and 
two coccygeal—these form the cauda equina of the spinal cord. 280 
TRUNK. 
Dissection.—Make a median-line incision through the arachnoid membrane 
of the spiual cord ; reflect lateral flaps, and expose the pia mater upon the cord. 
55. Arachnoid Membrane, and Subaraclinoidean Space. 
—This is the second sheath of the spinal cord ; it is separated 
from the pia mater to a variable degree at different points, the 
intervening space being the subaraclinoidean space—it is in 
this space that the large vessels of the spinal cord ramify. 
This membrane projects sheaths upon the roots of the spinal 
nerves to their points of exit through the dura mater. 
56. Pia Haler and Ugaincnta Dcnticulata.—Tliis is tile 
inner, and third, sheath of the spinal cord ; it invests it 
intimately, dipping into its fissures. The arteries, to be dis- 
tributed to the cord, have their primary distribution in this 
membrane, where they break up into minute vessels. From 
the lateral surfaces of the cord the pia mater is projected by 
points, invested by arachnoid—ligamenta denticulata—to the 
interior of the dura mater, in the spaces between the pairs of 
roots of the cervical and dorsal spinal nerves. 
Dissectton.—Trace the roots of the spinal nerves from their emergence 
from the spinal cord to their exits through the dura mater ; cut away the cer- 
vical portion of the dura mater, at one side (Plate 153), so as to recognize the 
anterior and posterior roots of the spinal nerves, respectively. Display the 
roots, the ganglion, the mixed nerve, and the anterior and posterior divisions 
of the mixed nerve, of the second cervical spinal nerve. (Other spinal nerves 
may be traced in a similar manner by cutting away with the saw and bone 
forceps, the obstructing portions of the contiguous vertebrae.) Find and trace 
into the foramen magnum the spinal accessory nerve. 
57. Roots of the Spinal Nerves.—From the lateral surfaces 
of the spinal cord and from its conus medullaris sixty-two pairs 
of roots of spinal nerves—thirty-one pairs of anterior (motor), 
and thirty-one pairs of posterior (sensory)—are projected 
to sixty-two pairs of perforations of the dura mater. Each 
nerve root has an investment from the arachnoid and pia 
mater membranes. In the cervical region they are projected 
almost at a right angle from the cord ; interiorly, they become 
progressively more vertical, until those from the conus medul- 
laris run parallel with the longitudinal axis of the cord. This 
variation, in the direction of the roots of the spinal nerves, re- SPINAL CORD IN SITU. 
281 
suits in a corresponding variation of the relation of the levels 
of the points of exit of the nerves from the spinal canal, with 
the origins of their roots from the spinal cord ; the distances 
between these levels increasing as you advance to the inferior 
spinal nerves. 
58. Ganglia on tlie Posterior Roots of Spinal Nerves, Plate 
153.—The second cervical spinal nerve, as traced, shows a gan- 
glion upon its posterior (sensory) root, just before the fusion of 
that root with the anterior (motor) root of the nerve, to form the 
mixed (containing both motor and sensory iibres) spinal nerve. 
(The second cervical nerve may be taken as a of the thirty- 
one pairs of spinal nerves.) The other ganglia of the cervical 
region, and those of the dorsal and lumbar regions are close 
to, or within the intervertebral foramina of exit of the nerves 
from the spinal canal. In the sacral region the ganglia appear 
within the sacral canal, together with the resultant mixed 
sacral nerves ; the latter bifurcate, within the canal, into their 
anterior and posterior divisions; these anterior and posterior 
divisions leave the sacral canal by the anterior and posterior 
sacral foramina, respectively. 
59. Spinal Accessory Nerve.—This nerve, of a side, is seen 
at the lateral surface of, and taking origin from, the cervical 
portion of the spinal cord. It has a superior course, between 
the anterior and posterior roots of the cervical spinal nerves, 
to its entrance into the cranium by the foramen magnum of 
the occipital bone. 
VERTEBRAL COLUMN AND ITS LIGAMENTS. 
Vertebral Column, Plates 42, 147, 155, 156, and 189.—This 
column contains twenty-six bones (adult), viz. : seven cervical, 
twelve dorsal, and five lumbar vertebrae, the sacrum, and the 
coccyx. 
A vertebra is a signet-ring shaped bone with two portions : 
the signet and the hoop. The signet portion, called the body 
(Fig. 3, Plate 155 ; Figs. 2 and 4, Plate 156), is located anteri- 
orly ; the hoop portion, called the arch, is located posteriorly, 
and is formed by two symmetrical halves, each consisting of a 
pedicle and a lamina : the pedicles (Fig. 3, Plate 155 ; Figs. 3 
and 4, Plate 156) spring, right and left, from the posterior or 282 
TRUNK. 
postero-lateral surface of the vertebra—they have notches supe- 
riorly and inferiorly ; the lamince (Fig. 1, Plate 155), right and 
left, close the hoop posteriorly, passing from the pedicles to 
their median-line junction. The body and arch enclose the 
vertebral foramen, and support seven processes, as follows: 
four articular, two superior and two inferior (Plate 155 and 
Figs. 1, 3, and 4, Plate 156); two transverse, a right and left 
(Plates 155 and 156); and one spinous (Plate 155). 
The sacrum consists of five incompletely developed verte- 
brae fused into one bone. 
The coccyx is four rudimentary vertebrae fused into a single 
bone. 
The vertebral column is constructed by the articulation of 
the above twenty-six bones, whereby the vertebral canal 
(from the foramen magnum of the occipital bone to the in- 
ferior end of the sacrum) results, which lodges the spinal 
cord, with its membranes, vessels, and roots of nerves (Plates 
153 and 154). Intervertebral foramina (Fig. 4, Plate 156), for 
the transit of nerves and vessels, are formed by the apposition 
of the notches superior and inferior—of the pedicles of the 
arches of the vertebrae ; while anterior and posterior sacral 
foramina (Plates 42, 147, and 154) open out of the sacral por- 
tion of the vertebral canal. 
60. Posterior Cervical, Dorsal, and Ligaments. 
—These include the supraspinous, interspinous, ligamenta sub- 
Hava, and capsular ligaments of the respective regions of the 
vertebral column ; they are described at pages 277 and 278, 
and illustrated Plate 155.. 
Dissection.—Cut the roots of the spinal nerves, right and left (Plates 
153 and 154), and remove the cord from the vertebral canal. Disarticu- 
late between the fourth and fifth cervical vertebrae, and display the pos- 
terior common ligament of the vertebral column (Fig. 1, Plate 156). Saw the 
ribs, right and left, at about two inches from their articulations with the trans- 
verse processes of the dorsal vertebrae ; also through the bodies of the fourth 
and seventh dorsal vertebrae. Expose the anterior common ligament of the 
dorsal vertebrae and their intervertebral discs. Disarticulate between the first 
and second, and between the fourth and fifth lumbar vertebrae (page 177) ; ex- 
pose the anterior common ligament and intervertebral discs of the lumbar ver- 
tebrae. Note the intervertebral foramina and the parts which pass through 
them (Fig. 4, Plate 156). 283 
VERTEBRAL COLUMN AND ITS LIGAMENTS. 
61. Articulations of tlie Bodies of tlie Vertebrae, Plates 
42, 156, and 198.—The elements entering into these articula- 
tions (except that of the first and second cervical vertebrae) are : 
the opposed surfaces of the bodies of the vertebrae (Plates 156 
and 198); intervertebral discs of fibro-cartilage (Plates 156 and 
198)—these are pulpy at their centres and dense at their cir- 
cumferences (Pig. 3, Plate 156) ; an anterior common ligament 
(Plate 42 ; Figs. 2 and 4, Plate 156 ; Plate 198) extends from 
the anterior surface of the second cervical vertebra (axis) to 
the anterior surface of the sacrum—it bridges between the an- 
terior borders of the intervertebral discs ; a posterior common 
ligament (Pig. 1, Plate 156) passes upon the anterior wall of 
the vertebral canal or the posterior surfaces of the bodies of 
the vertebrae, from the anterior border of the foramen magnum 
of the occipital bone, superiorly, to the anterior wall of the 
sacral canal, inferiorly; its fibres stretch from the posterior 
surface of one intervertebral disc to the other. 
Dissection.—Dissect away tlie superior portion of the posterior common 
ligament, and expose (Fig. 1, Plate 156) : tlie crucial ligament; the right and 
left oceipito-odontoid and atlanto-axial ligaments. Cut away (Fig. 1, Plate 
156) the superior part of the vertical portion of the crucial ligament, and dis- 
play : the odontoid process of the axis (second cervical vertebra), in situ ; and 
the superior oceipito-odontoid ligament. Demonstrate the occipito-atlantal 
capsular ligaments, opening one of them. 
62. Crucial Ligament, Fig. 1, Plate 156.—This ligament, 
as its name implies, has two portions, a vertical and a trans- 
verse. The vertical portion extends from the posterior surface 
of the body of the axis to the anterior border of the foramen 
magnum ; it binds in place, by covering its posterior surface, 
the odontoid process of the axis. The transverse portion, the 
principal part of the ligament, bridges between the internal 
surfaces of the lateral masses of the atlas crossing the posterior 
of the odontoid process of the axis. 
63. Oceipito-odontoid Ligaments.—These, also called check 
ligaments, are three in number—right and left lateral, and su- 
perior. The lateral pass from the sides of the odontoid process 
of the axis to the internal surfaces of the right and left con- 
dyles of the occipital bone. The superior bridges from the 
tip, or superior end, of the odontoid process to the anterior bor- 
der of the foramen magnum of the occipital bone. 284 
TRUNK. 
64. Occipito-atlantal Capsular Ligament. — These liga- 
ments capsulate the joint formed by the articular facets upon 
the superior surfaces of the lateral masses of the atlas, and the 
condyles of the occipital bone. 
65. Articulations of tlie Dorsal Vertebrae and Ribs, Fig. 
3, Plate 155 ; Figs. 2 and 3, Plate 156.—A rib forms two artic- 
ulations with the vertebral column (the eleventh and twelfth 
ribs excepted): the costo-vertebral, where the bodies of two 
vertebrae and an intervening intervertebral disc are apposed to 
the head of a rib ; the costo-transverse formed by the trans- 
verse process of a vertebra and the neck and tubercle of a rib. 
66. Posterior Costo-transverse Ligaments, Fig. 2, Plate 
155.—These ligaments—the superior, middle, and posterior 
costo-transverse—have been described (page 278). 
Dissection.—Clear the anterior surfaces of the costo-vertebral articulations, 
of the portion of the dorsal region with ribs attached (Fig. 2, Plate 156), and 
display the anterior costo-vertebral ligaments. Dissect away one of the last- 
named ligaments and expose the interartieuiar ligament. Expose the anterior 
costo-transverse ligament and the anterior divisions of the dorsal-spinal nerves. 
67. Anterior Costo-vertebral Ligament, Fig. 2, Plate 156. 
—This ligament, of which there is one for each of the twelve 
pairs of costo-vertebral articulations, bridges from the lateral 
surfaces of the bodies of two contiguous vertebra?, and the inter- 
vertebral disc between them, to the anterior surface of the head 
of the rib (in the case of the first, tenth, eleventh, and twelfth 
dorsal, only from the respective bodies of these vertebrae). 
68. Interartieuiar Ligament, Figs. 2 and 3, Plate 156.—- 
This ligament, covered in by the anterior costo-vertebral, passes 
from the ridge dividing the articular face of the head of the 
rib (the first, tenth, eleventh, and twelfth excepted) to the op- 
posed border of the intervertebral disc. 
69. Anterior Costo-transverse Ligament, Fig. 2, Plate 156. 
—This ligament spans between the inferior border of a trans- 
verse process of a dorsal vertebra to the superior border of the 
neck of the rib interiorly to it. 
70. Anterior Divisions of Dorsal-spinal Nerves, Plate 139; 
Fig. 1, Plate 140 ; Figs. 2 and 3, Plate 156.—These nerves ap- VERTEBRAL COLUMX AXD ITS LIGAMENTS. 
285 
pear from the intervertebral foramina between the pedicles of 
the articulated dorsal vertebrae; they are continued, as the 
intercostal nerves, parallel with the inferior borders of the 
ribs, as before described (pages 247 and 248) and illustrated 
(Plate 139, and Fig. 1, Plate 140). 
Dissection.—Disarticulate the superior and inferior half vertebrae, and the 
inferior rib of the dorsal segment of vertebral column and articulated ribs (Fig. 
2, Plate 156). Disarticulate and turn off the middle rib of the same piece, so 
as to display the interiors of the costo-vertebral and costo-transverse articula- 
tions of a vertebra and a rib (Fig. 3, Plate 156). 
71. Interior of the Costo-vertebral Articulation, Fig. 3, 
Plate 156.—The interior of this articulation presents the follow- 
ing elements: two contiguous half facets of two vertebrm, 
separated by the border of an intervertebral disc ; the articular 
face of the head of a rib divided by a ridge into two half facets ; 
and an interarticular ligament (page 284). The articulations of 
the first, tenth, eleventh, and twelfth ribs are exceptions to the 
above : in the articulation of a single facet on the lateral sur- 
faces of the bodies of the vertebrce, with undivided articular 
facets on the heads of the ribs. 
72. Interior of the Costo-transverse Articulation.—For 
the pairs of ribs first to tenth, inclusive, the elements present- 
ing of the interior of these articulations are: the transverse 
process of the dorsal vertebra, with its articular facet; the neck 
and tubercle of the rib, with the articular facet on the latter; 
the interior surfaces of the superior, middle, and posterior costo- 
transverse ligaments (page 278; Fig. 2, Plate 155) ; and the 
capsular ligament, which capsulates the opposed facets of the 
transverse process of the vertebra and the tubercle of the rib. 
Dissection.—Clear the surfaces of the ligaments of the sacro-vertebral and 
sacro-coccygeal articulations ; also the direct and indirect ligaments of the 
sacro-iliac articulation. 
73. Sacro-vertebral Articulation, Plates 42 and 147.—The 
body of the fifth lumbar vertebra articulates with the base of 
the sacrum, being bound by an intervertebral disc, and the con- 
tinuance of the anterior and posterior common ligaments of the 
vertebral bodies ; the inferior lumbar and the sacral articular 286 
TRUNK. 
processes are held opposed by capsular ligaments ; a ligamen- 
tum subfiavum bridges between the laminae of the fifth lumbar 
vertebra and the superior border of the posterior wall of the 
sacral canal. 
74. Sacro-coccygeal Articulation.—This joint is formed 
by: the coccyx and sacrum; an intervertebral disc of fibro- 
cartilage ; an anterior sacro- coccygeal ligament (page 84) ; a 
posterior sacro-coccygeal ligament from the posterior surface 
of the coccyx to the margin of the inferior orifice of the sacral 
canal; inter articular ligaments between the cornua of the 
coccyx and sacrum ; lateral ligaments bridge between the con- 
tiguous borders of the two bones. 
75. Sacro-iiiac Articulation, Plate 42 ; Fig. 1, Plate 45 ; 
Plate 147.—This articulation includes tlie following elements: 
bones, direct ligaments, and indirect ligaments. The bones 
are : the ilium portion of the innominate bone ; the sacrum ; 
the fifth lumbar vertebra (transverse process); the ischium 
portion of the innominate bone ; and the coccyx. The direct 
ligaments are : the posterior sacro iliac (Plate 147), from the 
posterior surface of the internal portion of the ilium to the 
posterior surface of the sacrum ; the anterior sacro-iiiac, before 
described (page 84) and illustrated (Plate 42 and Fig. 1, Plate 
45). The indirect ligaments include : 
Plates 42 and 147); the great sacro-sciatic and the small sacro- 
sciatic (page 84 ; Plate 42 ; Fig. 1, Plate 45 ; and Plate 147). PLATE 147 
R£C TUS CAPITIS LA TER A LIS 
OBLIQUUS SUPERIOR 
» INTERIOR 
CER VICA L IS ASCENDENS 
ft/* CER VICAR VER TE BRA 
1** non■S’AE 
Smalt sacro-seiatic 
coccmc 
JH. Cahrij adCnaturam del. PLATE 148 
2nt?(cutan.) &ranch 
ofI2f/*ciors!<spin? n..~ 
- 
22 tjLjJOR Sf ITETi TEE HA 
A 77 tr2iirzsz on of 22 
ct orsispinaZ n. \ 
-/3j*(znc7i ofzZzo- 
7zgpo gas trie n- 
In £?fcz/tan sJbranc7? - 
of S& lumilfpintn. 
latifcutan Pbrch f 
ofsacrtspiain? ■<) 
3f.Cohn,ad naticram deZ. PLATE 149 
loti (cutaneous)?? rand? o/2n.a 
cerofspinln. or, occlp. mayor n. - 
In t Ijcutanf/brcft. 
ofJ2r/‘dorslspinln 
J2 ‘foonsi- rejz r. 
J££okn.4Z<Znaturam del. PLATE 150 
Fig. 2 
Fig. 1 
J/L.Ccj/i7i.ac£naturam deZ. PLATE 151 
jfigamentum nu.cfi.ae 
- tpachsco-masto/d 
-f/t’cERVZCAL VERTEBRA 
BO ft SAB " 
SCAB £ N US POST/CUS 
CERV/CAL/S ASCENDENS 
SSRRATUS POST/CUS SUP? 
J2*f'Z)ORSAZ. VERTEB 
EZTMBAR " 
•S Eft RATUS 
POSTICUS INF? 
of TEA N.S VERSA L . A BOOM. 
M. Coh n, a cCn aturam det. PLATE 152 
1stCERVICAL, VERTEBRA. 
SE /vT/SP/NAL/S COLL/ 
_ Intf(cutan.jbranch n, 
Ext’/'muscular,■) « * ■■ " * 
Is.*DOR SAL. VERTEBRA 
Postrbranch of 
intercostal art. 
Post!'division of 
7'fciorsf spinal n. 
-Dorsal inter-, 
transverse leg)'? 
PostTcosto- 
~ transverse tig.* 
W^Post!V/ivision of 
W fsflum6rspinaln- 
f Inti (cutaneous) 
~dranch of2 •s'tlun If 
spittaln. 
- Dxtifmztsczcla r) 
dranc2z 
Post! bra nch of 
l umbar art. 
2&.Cohn,adna.turam. del. PLATE 153 
Zhira mater 
Verteb ral art. 
isfceraical-spinal n. 
PostTrootof 2 nfccra. spr.nl 
AntT '• " " " " 
- Ganglion of posti'root 
Antr division- 
jPOStf " 
— Spinal accessory 
, Posti'root of 8tll cerrical n 
■An.tr '• '< ‘i " » 
Postrroot of dorsal n. 
Pia mater 
'O t?1 dcrrs?spinhl» 
M.Cotin.adncuurani cteZ PLATE 154 
Poslfroot of 
jo*/1 dorsfspcnut n. 
Gang??of * " 
/21?1 dorsal spinal n. 
J?e lumbar- spinal n. 
-J£n<2 op spinal cord,or, 
conus jneclullaris 
Sfylu/niar spinal 
W , 
—sacra/ spizial 
-Gcrnqlion spintn. 
- PosZT dixs." " " " 
Anti » " ” " «• »• 
5 tysacrjtfpinftz. 
Crangrtio/zof " " >' 
Cocct/greaZ n. 
GcznyZion of " " 
MCoftn, adnaturam. deZ. PLATE 155 
Fig. 3 
Fig. 1 
Fig. 2 
HCohn, adnaricvam leZ. PLATE 156 
Fig. 2 
Fig. 2 
AntTcosto- 
etertehral ligr*?* 
Inter articular iiplt 
Fig. I 
Lumbar 
■spinaZn. 
JNZCt.3 
jH[Cohn,<xdraturamcZet. UPPER EXTREMITY. 
TWENTIETH DISSECTION. 
ANTERIOR SCAPULAR MUSCLES; POSTERIOR OP 
SHOULDER AND ARM. 
ANTERIOR SCAPULAR MUSCLES. 
Dissection.—The subject should be in the same position as for the nine- 
teenth dissection, and the latter dissection should have been completed. Re- 
flect the upper extremity so as to apply its posterior surface to the posterior 
surface of the thorax. 
Terms of Relation.—These are the general terms (page 2), 
and special terms, applied to the thorax, of exterior and antero- 
lateral. 
Bones and Bone Areas, Plate 113.—The anterior surface of 
the scapula, and the exterior surfaces of the antero-lateral area, 
of the eight or nine superior ribs, form the osseous framework 
of the region occupied by the anterior scapular muscles. 
Dissection.—Expose the exterior surface of the serratus magnus muscle, 
and the anterior surface of the subscapularis muscle. 
1. Serratus Magnu§ Muscle, Plates 113 and 157.—This mus- 
cle is attached : anteriorly, by nine serrations, to the exterior 
surfaces of the nine superior ribs ; posteriorly, to the anterior 
edge of the posterior border of the body of the scapula. It 
swathes the antero-lateral area of the thorax, where a portion 
of it forms the inner wall of the axilla (page 196 ; Plates 116, 
117, 119, and 120). 
2. Sub§capulari§ Muscle.—This muscle is lodged in the 
subscapular fossa ; it crosses the anterior surface of the capsu- 288 
UPPER EXTREMITY. 
lar ligament of the shoulder-joint. It is attached : internally, 
to the ridges on the anterior surface of the scapula ; externally, 
to the inner tuberosity of the humerus. 
Dissection.—Section the serratus magnus muscle (Plate 157); the anterior 
of the thorax, the anterior of the neck, and the region of the back having been 
dissected, this section of the serratus magnus muscle will sever the upper ex- 
tremity from the trank. 
POSTERIOR OF THE SHOULDER AND ARM. 
Dissection.—Extend the upper extremity—detached from the trunk—with 
its posterior surface uppermost. Flex the elbow, so as to put the muscles of 
the posterior of the arm upon the stretch. 
Terms of Relation.—The general terms anterior and poste- 
rior (page 2); and the special terms proximal and distal (to- 
ward, and from, the trunk), and inner and outer, are used to 
locate parts in this portion of the dissection. 
Bones and Bone Areas of Muscle Attachments, Plate 
158.—The posterior surfaces of the scapula, the clavicle, the 
FiGtrnE 12. 
humerus, and the proximal end of the ulna, form the osseous 
framework of this portion of the dissection. All of these bone 
surfaces afford areas for muscle attachments. 
Dissection.—When the dissections of the anterior of the arm and of the 
back have preceded that of this dissection, make skin incisions 1 and 2 of Fig- 
ure 12, and dissect away the skin from the arm. Where the anterior of the arm 
and the back have not been dissected make the skin incisions 1, 2, and 3, of 
Figure 12, and reflect flaps as indicated. Find and trace the nerves in the sub- 
cutaneous plane, and clear the surface of the fascia. POSTERIOR OF SHOULDER AND ARM. 
289 
3. Cutaneous Branch of Circumflex Nerve, Plate 159.— 
This nerve appears at the distal half of the posterior border of 
the deltoid muscle ; from the internal surface of the muscle. 
It distributes to the distal portion of the deltoid region and 
to the proximal portion of the arm. It is accompanied by a 
small branch from the posterior circumflex artery. 
4. Intereosto-liumeral Merve.—1This nerve emerges, poste- 
riorly, from the axilla, along the inner side of the proximal por- 
tion of the arm ; its branches have a distal course along the 
inner border of the arm. 
5. Superior and Inferior External Cutaneous Brandies of 
tlie Museuio-spirai Merve.—These nerves perforate the fascia 
at tlie outer side of the distal portion of the arm, and are con- 
tinued into the forearm. 
6. Fascia.—A lajmr of fascia covers the muscles of the pos- 
terior of the arm, which is continued to the anterior of the arm 
and to the posterior of the forearm. 
Dissection.—Section the nerves in the subcutaneous plane (Plate 159). 
Clear the fascia from the subjacent muscles, cutting out the nerves that per- 
forate it. 
7. Deltoid Muscle, Plate 113 ; Fig. 1, Plate 158 ; and Plate 
160.—This triangular, coarse-tibred muscle caps the shoulder. 
Its base or proximal end conforms to the bony contour of the 
shoulder by its attachments: anteriorly, to the outer third of 
the antero-inferior border of the clavicle (Plate 113); exter- 
nally, to the border of the acromion process of the scapula ; 
and, posteriorly, to the inferior half of the external two-thirds 
of the posterior face of the spine of the scapula (Fig. 1, Plate 
158). Its apex or distal end is attached to a rough, triangular, 
area at the antero-external face, of about the middle, of the 
shaft of the humerus (Plate 113). 
8. Triceps Muscle, Plate 113 ; Fig. 1, Plate 158; and Plates 
160, 161, and 162.—This muscle, as its name implies, lias three 
heads: a long head from the superior portion of the external 
border of the scapula (Plates 113 and 162); an order head, 
along the outer side of the long head (Plates 160, 161, and 162), 
is attached to the outer side of the shaft of the humerus, be- 290 
UPPER EXTREMITY. 
tween its spiral groove and its outer tuberosity (Plate 158); an 
inner head, located to the inner side of the distal portion of 
the long head, is attached to the inner side of the posterior 
surface of the shaft of the humerus, distal to its spiral groove 
(Plate 158). The long and the outer heads are projected, in a 
distal direction, from the anterior surface of the posterior por- 
tion of the deltoid muscle (Plate 160); in the distal half of the 
arm they are joined by the inner head ; the three heads form- 
ing a common tendon at the proximal side of the elbow-joint. 
The distal attachment of the muscle is by an aponeurotic ex- 
pansion to the olecranon process of the ulna, at its tip and 
sides ; while the outer portion of the aponeurosis fuses with 
the fascia of the forearm ; the latter is attached to the pos- 
terior border of the shaft of the ulna. Between the outer and 
inner head attachments of the muscle to the humerus a spiral 
groove presents, on the outer side of the middle of the shaft of 
that bone (Plate 158). 
Dissection.—Clear the surface of the snpraspinatus muscle, tracing it to 
where its external end disappears inferiorly to the acromion process of the 
scapula. 
9. Siipraspinatus Muscle, Plates 158, 160, and 161.—This 
muscle is lodged in, and has its internal attachment to, the 
supraspinous fossa of the scapula ; it has an external course, 
inferiorly to the acromio-clavicular articulation, and the acro- 
mion process of the scapula. Its external portion crosses the 
superior face of the capsular ligament of the scapulo-humeral 
or slioulder-joint, to reach its external attachment to the su- 
perior facet of the outer tuberosity of the humerus (Fig. 2, 
Plate 158). 
Dissection.—Section the deltoid muscle, as in Plate 162 ; reflect the pos- 
terior portion of the muscle anteriorly. Clear the surfaces of the infraspinatus 
and teres minor muscles. 
10. Infraspinatus Muscle.—This muscle is lodged in, and 
lias its internal and inferior attachment to, the infraspinous 
fossa of the scapula. Its fibres have an external and superior 
course, the muscle narrowing to where it crosses the posterior 
face of the capsular ligament of the shoulder-joint. Its supe- 
rior and external end is attached to the middle facet upon the 
outer tuberosity of the humerus (Fig. 2, Plate 158). POSTERIOR OF SHOULDER AND ARM. 
291 
11. Teres Minor Muscle.—This muscle lias an inferior and 
internal attachment to the external and superior portions of 
the infraspinous fossa of the scapula. It lies in a plane pos- 
teriorly to the proximal end of the long head of the triceps 
muscle, and it crosses the posterior face of the capsular liga- 
ment of the shoulder-joint, to reach its superior attachment to 
the inferior facet of the outer tuberosity of the humerus (Fig. 2, 
Plate 158). 
Dissection.—Follow tlie long head of the triceps muscle to its proximal 
attachment (Plate 113), and display the outer head of the same muscle. Ex- 
pose the teres major muscle ; also the external and superior portion of the 
latissimus dorsi muscle. 
12. Triceps Muscle, Plate 113 ; Fig. 1, Plate 158 ; Plates 
160,161, and 162.—The long liead of this muscle passes between 
the teres minor muscle, posteriorly, and the teres major mus- 
cle, anteriorly, to its proximal attachment to the superior por- 
tion of the external border of the scapula (Plate 113). The 
proximal attachment of the outer head extends from the spiral 
groove of, to the outer tuberosity of, the humerus. 
13. Teres Major Muscle.—The inferior and internal attach- 
ment of this muscle is to the external portion of the inferior 
half of the infraspinous fossa of the scapula (Fig. 1, Plate 158); 
from this point the muscle has a superior, external, and slightly 
distal course (page 196 ; Plates 116 to 120, inclusive), ante- 
riorly to the long head of the triceps. Its superior and ex- 
ternal attachment is to the posterior lip of the bicipital groove 
of the humerus (Plate 113). 
14. L.atissimus Dorsi Muscle, Plates 113, 160, 161, and 162. 
—The postero internal and inferior portions of this muscle were 
before described (page 267) and illustrated (Plates 147 and 149). 
Its external and superior end winds anteriorly to the teres 
major muscle in the posterior fold of the axilla (page 196 ; 
Plates 116 to 120, inclusive); its fiat tendon, about half the 
breadth of the tendon of the teres major, enters the bicipital 
groove of the humerus, where it is attached, posteriorly to the 
tendon of the long head of the biceps muscle (Plate 113). 
Dissection.—Find the musculo-spiral nerve and its branches, between the 
long and the outer heads of the triceps muscle, distal to the teres major mus- 
cle. Expose the superior profunda branch of the brachial artery. Put a loop 292 
UPPER EXTREMITY. 
of thread through the outer border of the long head of the triceps muscle, and 
hold off the same to the inner side. Taking the musculo-spiral nerve and the 
superior profunda artery as guides, cut through the triceps muscle, so as to 
expose' the course of the nerve and artery through the spiral groove of the 
humerus. Cut away the triceps muscle to enable the tracing of the branches 
of the musculo-spiral nerve into its heads. 
15. Musculo-spiral Nerve, Plate 161.—The proximal por- 
tion of this nerve was before described (page 206) and illus- 
trated (Plates 119 and 120), as it presents at the antero-inter- 
nal face of the proximal portion of the arm. It appears at 
the posterior of the arm, and, after giving off branches to the 
heads of the triceps and to the anconeus muscles, it enters the 
spiral groove of the humerus ; in this groove it has a distal, 
and anterior, course to the outer side of the distal portion of 
the arm, where it was before described (page 215) and illus- 
trated (Plate 126). 
16. Mcrves to tlie Triceps and Anconeus IHiisclcs.—These 
nerves, branches of the musculo-spiral nerve before its entrance 
into the spiral groove of the humerus, have a distal course to, 
and enter the substance of, the three heads of the triceps mus- 
cle. One of the branches is continued, through the outer head 
of the triceps, to the anconeus muscle. 
IT. Brachial Artery.—The posterior surface of the prox- 
imal portion of this artery appears, anteriorly to the musculo- 
spiral nerve, where it gives off the superior profunda artery. 
18. Superior Profunda Artery.—This artery (venae com- 
ites), the first and largest branch of the brachial artery, was 
before described (page 204) and illustrated (Plates 118 and 119), 
as it presents at the antero-internal face of the arm. Pos- 
teriorly, it accompanies the musculo-spiral nerve, through the 
spiral groove of the humerus. It supplies the triceps muscle, 
and terminates at the outer side of the distal portion of the 
anterior of the arm (page 206 ; Plate 216). 
Dissection.—Find and trace the circumflex nerve and its branch to the 
teres minor muscle ; also the posterior circumflex artery. 
if). Circumflex Nerve.—Plates 161 and 162.—The proximal 
portion of this nerve was described (page 205) and illustrated 
(Plate 120), where it presents, anteriorly, at tlie posterior of the POSTERIOR OE SHOULDER AXD ARM. 
axilla. It appears, posteriorly, in the space bounded by the 
humerus, the teres minor muscle, the long head of the triceps 
muscle, and the teres major muscle ; after winding around the 
external surface of the proximal end of the shaft of the 
humerus its terminal branches distribute to the deltoid muscle 
entering its internal surface. Its cutaneous branch has been 
described (page 289) and illustrated (Plate 159). 
20. liiervc to tiie Teres Minor Muscle.—This nerve is given 
off from the last-described nerve, near the point where the lat- 
ter appears posteriorly. It takes an internal course to the 
muscle it supplies, running posteriorly to the proximal end 
of the long head of the triceps muscle. It is accompanied by 
a branch from the posterior circumflex artery. 
21. Posterior Circumflex Artery.—Tliis artery (venae com- 
ites), a branch from the external portion of the axillary artery 
(page 206 ; Plate 120), appears, posteriorly, to the distal side 
of the circumflex nerve. It distributes to contiguous muscles, 
but mainly to the deltoid. 
Dissection.—Section the supraspinatus muscle (Plate 160), and reflect its 
internal portion, internally, as in PlaLe 162. Find and trace the suprascapular 
artery and nerve. 
22. Suprascapular Artery, Plate 162.—This artery (venae 
comites) presents posteriorly, at the suprascapular notch of 
the scapula, where it enters the supraspinous fossa. It dis- 
tributes to the supraspinatus muscle, and is continued into 
the infraspinous fossa. 
23. Suprascapular IVerve.—This nerve appears, posteriorly, 
at the suprascapular notch, accompanying the last-described 
artery. It supplies a branch to the supraspinatus muscle, and 
a second to the shoulder-joint. It sends a branch into the 
infraspinous fossa. 
Dissection.—Section the infraspinatus and the teres minor muscles (Plate 
161). Dissect away their infraspinous fossa portions, and reflect their external 
and superior portions upon the head of the humerus. Trace the dorsal scapu- 
lar artery into the infraspinous fossa, also the suprascapular artery, noting their 
anastomoses. Find and trace the branch of the suprascapular nerve into the 
infraspinous fossa. 294 
UPPER EXTREMITY. 
24. Dorsal Scapular Artery, Plates 161 and 162. — This 
artery (venae comites), branch of the subscapular artery (page 
201 ; Plates 116, 117, 119, and 120), presents, posteriorly, in the 
interval between the long head of the triceps muscle, the teres 
major muscle, and the external border of the body of the 
scapula. It ramifies in the infraspinous fossa, and along its 
external border, distributing to the muscles of the fossa, and 
anastomosing with the infraspinous branch of the suprascapu- 
lar artery. 
25. Suprascapular Artery, Plate 162.—This artery (venae 
comites) projects a branch, around the great scapular notch into 
the infraspinous fossa, which anastomoses with the last-de- 
scribed artery. 
26. Nerve totlie Infraspinatus Muscle.—This nerve, branch 
of the suprascapular nerve (page 293), enters the infraspinous 
fossa with the last-described artery. PLATE 157 
jM. Cohrz. etc?7za.titTctmd.eZ. PLATE 158 
Fia.l 
Fig. 2 
JH.Co7t7ijC*GZrzatur<Z7n. cZ&Z. PLATE 159 
M.Co?in,ad naturam. deZ. PLATE 160 
JIf.Cohn. aaC nceturczm PLATE 161 
M. Cohn, adnxticra:m cZeZ. PLATE 162 
AT.Co?in.tacl n<ztu.r-am afe/. TWENTY-FIRST DISSECTION. 
POSTERIOR OF ELBOW, FOREARM, HAND, AND 
DIGITS. 
Dissection.—Extend the elbow, supinate the forearm, extend the wrist and 
digits, and place the forearm and hand with their posterior surfaces uppermost. 
Terms of Relation.—Those used in describing the elbow 
and forearm are the general terms (page 2) anterior and pos- 
terior / and the special terms proximal, distal, 
inner, and outer. For the hand and digits the 
following special terms are used : proximal, 
distal, dorsal, inner, outer, and lateral. 
Rones and Rone Areas for Muscle Attach- 
ments, Plate 163.—The posterior surfaces of the 
distal end of the humerus, of the ulna and ra- 
dius, and those of the bones of the carpus, meta- 
carpus, and digits (phalanges, plialangines, and 
phalangettes) form the osseous plane of this dis- 
section. The posterior surfaces of all these bones, 
except those of the carpus, present areas for 
muscle attachments. 
Dissection.—Make skin incisions 1, 2, 3, 4, 5, 6, and 7 of 
Figure 13 (if the dissection of the posterior of the arm has 
preceded, this dissection incision 3 will not be required); 
reflect flaps as indicated. If the anterior of the forearm 
and hand has been dissected, the skin will have to be re- 
moved ; otherwise, the skin flaps may hang off from the 
sides of the limb. Find a bursa upon the olecranon process 
of the ulna; trace the veins and nerves in the subcutaneous 
plane of the forearm and hand. 
1. Bursa, Plate 164.—A bursa presents at the surface of 
the olecranon, which varies in size in different subjects. 
Figuke 18. 296 
UPPER EXTREMITY. 
2. Posterior Ulnar and Itadial Veins.—A variable number 
of subcutaneous veins present upon the dorsal surface of the 
hand, which receive tributary veins from the digits. 
terior ulnar vein has a proximal course from the dorsal veins 
of the hand through the inner half of the forearm ; its proximal 
end winds to the anterior surface of the elbow, where it joins 
the median-basilic vein (page 208 ; Plate 123). The posterior 
radial vein has a proximal course from the dorsal veins of the 
hand, through the outer half of the forearm ; its proximal end 
winds to the anterior surface of the elbow, where it joins the 
median-cephalic vein (page 208 ; Plate 123). 
3. Posterior Cutaneous Kerves of the Forearm, Hand, and 
Digits.—Along the inner side of the forearm posterior bl anches 
of the internal cutaneous nerve present (page 208 ; Plate 123). 
In the proximal portion of the outer side of the forearm the 
superior and inferior external cutaneous branches of the 
musculo-spiral nerve ramify. In the distal third of the outer 
side of the forearm the radial nerve appears posteriorly; it 
has a distal course over the carpus to the dorsal surface of the 
metacarpus, where it breaks up into the first, second, and third 
dorsal digital nerves. The latter nerves are distributed as fol- 
lows : the first dorsal digital nerve is projected along the 
outer side of the first metacarpal region, to become the first 
dorsal collateral digital nerve; the second digital nerve 
bifurcates into the second and third dorsal collateral digital 
nerves ; the third digital nerve is continued to where it bifur- 
cates into the fourth and fifth dorsal collateral digital 
nerves. The posterior carpal nerve, branch of the ulnar 
nerve, appears, posteriorly, at the inner side of the carpus 
and gives off the following branches: the sixth dorsal digital 
nerve, which is continued along the inner border of the meta- 
carpus to become the tenth dorsal collateral digital nerve; 
the communicating nerve, which bifurcates, its branches cross- 
ing the metacarpus to anastomose with the third dorsal digital 
and the fifth dorsal collateral digital nerves ; the fifth dorsad 
digital nerve, which is projected to the cleft between the 
fourth and fifth digits, where it bifurcates into the ninth and 
eighth dorsal collateral digital nerves ; and the fourth dorsal 
digital nerve, which advances to the cleft between the third 
and fourth digits, where it bifurcates into the sixth and seventh 
dorsal collateral digital nerves. 297 
POSTERIOR OF ELBOW, FOREARM, HAND, AND DIGITS. 
4. Fascia.—The fascia of the posterior of the forearm is con- 
tinuous with that of the arm and the anterior of the forearm ; 
that of the dorsal surface of the hand and digits is continuous 
with that of the posterior of the forearm and that of the 
palmar surfaces of the hand and the digits. 
Dissection.—Section tlie subcutaneous veins and nerves (Plate 164) and 
clear them from the fascia. Incise the fascia, in the line of skin incision 1 of 
Figure 13 (page 295), and dissect it from the muscles of the forearm and 
the tendons upon the metacarpus; preserve the posterior annular ligament 
(Plate 165). 
5. Posterior Annular Ligament, Plates 163 to 166, inclu- 
sive.—This is a thickened, oblique, portion of the fascia of 
the forearm, that crosses the distal ends of the radius and 
ulna, and the carpus. It is attached to the bony promi- 
nences at the sides of the wrist, and septa pass from it to 
the deep fascia of the carpus (Plates 167 and 168), forming 
compartments for the run of the tendons of the long ex- 
tensors, that cross from the forearm to the metacarpus. 
6. Compound Extensor Attachment, Plates 163, 165, 167, 
168, and 169.—This is formed by the fusion of the proximal 
ends of the extensor communis digitorum, extensor minimi 
cligiti, extensor carpi ulnaris, extensor carpi radialis brevior, 
and the supinator brevis muscles, to a common attachment to 
the outer condyle of the humerus. 
7. Extensor Communis Digitoruin Muscle, Plates 163, 165, 
and 166.—This muscle has its proximal attachment to the 
outer condyle of the humerus, by the compound extensor at- 
tachment thereto ; it has a distal course through the middle of 
the forearm to the carpus, where it forms two initial tendons, 
which cross the carpus in a special compartment of the posterior 
annular ligament ; distal to the ligament four terminal tendons 
appear, which are projected across the metacarpus to the 
dorsal surfaces of the second, third, fourth, and fifth digits, re- 
spectively ; the one to the fifth digit becomes an accessory 
tendon to the extensor minimi digit! tendon. At the distal 
portion of the metacarpus transverse communicating slips 
pass between the second and third terminal tendons, and 
between the third terminal and the accessory tendons. The 
accessory tendon passes to the fifth digit to fuse with the 298 
UPPER EXTREMITY. 
tendon of the extensor minimi digiti muscle. The continua- 
tions of the terminal tendons of this muscle to the dorsal sur- 
faces of the digits second to fifth, inclusive, will be described 
hereafter. 
8. Extensor Minimi I>igiti Muscle, Plates 163 and 165.— 
This muscle has the same proximal attachment as the last-de- 
scribed muscle ; its course through the forearm is parallel with, 
and to the inner side of it. Its tendon diverges to the inner 
side ; passes through a special compartment of the posterior 
annular ligament; crosses the metacarpus to the dorsum of the 
fifth digit; and receives the fusion of the accessory tendon from 
the extensor communis digitorum muscle. The tendon of this 
muscle, as it presents upon the dorsal surface of the digit, will 
be described hereafter. 
9. Extensor Carpi Clnaris Muscle, Plates 163, 165, 167, 168 
and 169.—This muscle has its proximal attachment to the 
humerus, by the compound extensor attachment thereto ; it 
is continued through the forearm, between the last-described 
muscle to the outer side, and the shaft of the ulna to the inner 
side ; it crosses the carpus in a special compartment of the 
posterior annular ligament; and its distal attachment is to the 
dorsal surface of the proximal end of the fifth metacarpal bone. 
10. Anconeus Muscle.—This triangular muscle has its prox- 
imal attachment by a special tendon to the outer condyle of 
the humerus, at a point internally to the compound extensor 
attachment; it expands and passes to its distal attachment 
at the outer side of the olecranon process of, and the proximal 
end of the shaft of, the ulna. Its proximal border is parallel 
with the outer portion of the distal end of the triceps muscle ; 
its outer border is parallel with the proximal portion of the 
extensor carpi ulnaris muscle. 
Dissection.—Turn the forearm and liand, so that its outer side is upper- 
most, and let the hand hang semi-pronated. Display the muscles, tendons 
and artery along the outer side of the forearm, hand and first digit. 
11. Supinator Longue Muscle, Plates 163. and 165 to 169, 
inclusive.—This muscle was described (page 211) and illustrated 
(Plates 121 and 125) as it appears at the anterior of the fore- POSTERIOR OF ELBOW, FOREARM, HAXD, AND DIGITS. 
299 
arm. At the outer side of the forearm (Plate 166) it lies 
anteriorly to, and parallel with, the extensor carpi radialis 
longior muscle. 
12. Extensor Carpi Radialis Longior Muscle, Plates 121, 
163 and 165 to 169, inclusive.—This muscle was before referred 
to* (page 211), and illustrated (Plate 125) ; it has its proximal 
attachment to the outer condyloid ridge of the humerus (Plates 
121 and 163), immediately proximal to the outer condyle of 
that bone; the belly of the muscle lies to the outer side, and 
parallel with, the extensor communis digitorum muscle, to 
about the middle of the forearm, where the latter diverges 
toward the inner side of the limb. Its tendon passes anteriorly 
to the tendons of the extensor ossis metacarpi pollicis and ex- 
tensor primi internodii pollicis muscles; it then crosses the 
carpus in a compartment of the posterior annular ligament, 
and passes to its distal attachment, at the dorsal surface of the 
proximal end of the second metacarpal bone. 
13. Extensor Ossis Metacarpi Pollicis and Extensor Primi 
Internodii Pollicis Muscles, Plates 165 and 166.—Portions of 
these two muscles cross obliquely the outer side of the distal 
half of the forearm, emerging from between the extensor com- 
munis digitorum and the extensor carpi radial is longior mus- 
cles. 
14. Radial Artery, Plates 165 to 169, inclusive.—This ar- 
tery (vense comites) presents in the outer third of the posterior 
surface of the carpus. It appears, posteriorly, from the an- 
terior of the tendons of the extensor primi internodii pollicis 
and the extensor ossis metacarpi pollicis muscles (Plate 166); 
thence, it is continued to the proximal portion of the first inter- 
metacarpal sjiace, where it passes to the palmar region, between 
the attachments of the dorsal portion of the first dorsal in- 
terosseous muscle. In this portion of its course it gives off 
branches, which "will be described hereafter. 
Dissection.—Section (Plates 165 and 166) the snpinator longns, extensor 
carpi radialis longior, extensor communis digitorum, and extensor minimi 
digiti muscles ; reflect the proximal and distal portions of the muscles. In 
reflecting the proximal portions of the two latter muscles, find and cut the 
branch to them of the posterior interosseous nerve, which enters their an- 300 
UPPER EXTREMITY. 
terior surfaces ; in reflecting their distal portions, cut tlieir tendons out of the 
compartments of the posterior annular ligament. Slit open the compartment 
in the posterior annular ligament for the tendon of the extensor carpi ulnaris 
muscle. Find the trunk of the posterior interosseous nerve, and trace the 
branches of the same to the several muscles they supply. Find the posterior 
interosseous artery and follow its branches to contiguous muscles. Clear the 
surface of the extensor carpi radialis brevior muscle, following it to its distal 
attachment. 
15. Posterior Interosseous Nerve, Plate 167.—This nerve 
emerges, posteriorly, from its perforation of the supinator 
brevis muscle. It gives off branches to the following muscles : 
to the extensor carpi ulnaris ; to the extensor communis digi- 
torum and extensor minimi digiti, which was found and cut in 
the reflection of the proximal portions of the muscles ; to 
the extensor ossis metacarpi pollicis; to the extensor indicis; 
to the extensor primi internodii pollicis ; and to the extensor 
secundi internodii pollicis. The trunk of the nerve has a 
distal course, successively, upon the supinator brevis, the 
extensor ossis metacarpi pollicis, and the extensor primi 
internodii pollicis muscles ; it then disappears anteriorly to 
the extensor secundi internodii pollicis muscle. 
16. Posterior Interosseous Artery, Plates 167 and 168.— 
This artery (venae comites) appears, posteriorly, from between 
the supinator brevis and the extensor ossis metacarpi pollicis 
muscles. It gives off branches to contiguous muscles. 
17. Extensor Carpi Radialis Brevior muscle, Plates 163, 
and 165 to 169, inclusive.—This muscle lies parallel with, and 
anteriorly to, the extensor carpi radialis longior muscle (page 
299 ; Plate 167); its proximal attachment is, to the humerus, 
by the compound extensor attachment (page 297) ; it runs 
through the forearm upon the outer and posterior surfaces of 
the shaft of the radius ; in the distal half of the forearm its 
tendon appears at the inner side of, and in a plane anteriorly 
to, that of the extensor carpi radialis longior; it crosses the 
posterior surface of the carpus, with the latter tendon, in a 
compartment of the posterior annular ligament; its distal at- 
tachment is to the dorsal surface of the proximal end of the 
third metacarpal bone. 
Dissection.—Section (Plate 167) and cut away tlie several branches of the 
posterior interosseous nerve, also, the distal branches of the posterior interos- POSTERIOR OF ELBOW, FOREARM, HAND, AJiD DIGITS. 
301 
seous artery. Clear the surfaces of the extensor indicis and the extensor secundi 
internodii pollicis muscles ; cut open the posterior annular ligament compart- 
ment of the latter. 
18. Extensor Indicis Muscle, Plates 163, 165, 167, and 168. 
—This muscle has its proximal attachment to the outer side 
of the distal third of the shaft of the ulna ; it is projected 
across the carpus in the same compartment of the posterior 
annular ligament as the tendons of the extensor communis 
digitorum muscle, anteriorly to the latter ; it crosses the meta- 
carpus obliquely, to reach the second or index digit, passing 
along the inner side of the terminal tendon, to that digit, of the 
extensor communis digitorum muscle. Its course upon the 
dorsum of the second digit will be described hereafter. 
19. Extensor Secundi Internodii Pollicis Muscle, Plates 
163, and 165 to 169, inclusive.—This muscle is attached, at its 
proximal end, to the outer side of the distal portion of the 
middle third of the shaft of the ulna, proximal to the attach- 
ment of the last-described muscle. It has a distal and oblique 
course to the outer third of the posterior surface of the car- 
pus, where it runs through a compartment of the posterior an- 
nular ligament, common to it and the tendons of the extensor 
carpi radial is longior and brevior muscles ; it lies posteriorly 
to the latter muscles. Its tendon passes upon the dorsal sur- 
face of the first metacarpal bone and phalanx of the first digit, 
to reach the distal attachment of the muscle, at the dorsal 
surface of the base of the phalangette of the first digit. 
Dissection.—Section (Plate 167) the extensor carpi radialis hrevior, the 
extensor carpi nlnaris, the extensor indicis and the extensor secundi internodii 
pollicis muscles ; reflect the proximal and distal portions of the same. Follow 
the trunk of the posterior interosseous nerve, to where it passes anteriorly to 
the deep fascia upon the posterior surface of the carpus. Find and trace the 
perforating branches of the anterior interosseous artery. Clear the surfaces 
of the extensor primi internodii pollicis, the ossis metacarpi pollicis (slit open 
the compartment of the posterior annular ligament lodging the tendons of 
these two muscles), and the supinator brevis muscles. Clear the deep fascia 
upon the dorsum of the carpus and metacarpus. 
20. Posterior Interosseous Nerve, Plate 168.—The proxi- 
mal portion of this nerve was before described (page 800). 
From the point where it passed anteriorly to the extensor 302 
UPPER EXTREMITY. 
secundi internodii pollicis muscle it has a distal course, to 
where it passes anteriorly to the deejD fascia upon the posterior 
surface of the carpus. 
21. Perforating Branches of the Anterior Interosseous 
Artery, Plates 168 and 169.—The anterior portion of this 
artery was described (page 235) and illustrated (Plate 130 and 
Fig. 1, Plate 134). It projects three perforating branches 
through the radio-ulnar interosseous ligament, which appear, 
posteriorly, between the ligament and the deep muscles of the 
posterior of the forearm, suppling the latter. The distal and 
largest branch has a distal course, accompanying the posterior 
interosseous nerve, to where it passes anteriorly to the deep 
fascia upon the posterior of the carpus. 
22. Extensor Primi Intcrnodii Pollicis Muscle, Plates 163, 
and 165 to 169, inclusive.—This muscle is attached, at its proxi- 
mal end, to the outer side of the proximal portion of the distal 
third of the shaft of the radius ; it has an oblique course pos- 
teriorly to the tendons of the extensor carpi radialis longior 
and brevior muscles. Its tendon runs in a compartment of the 
posterior annular ligament, with the tendon of the extensor 
ossis metacarpi pollicis muscle; and is continued, upon the 
dorsal surface of the first metacarpal bone, to reach the distal 
attachment of the muscle, at the dorsal surface of the base of 
the phalanx of the first digit. 
23. Extensor Ossis Metacarpi Pollicis Muscle, Plates 121, 
163, and 165 to 169, inclusive.—The distal and anterior portion 
of this muscle was described (page 212) and illustrated 
(Plates 125, 127, and 129 to 133, inclusive). Its proximal at- 
tachments are : to the outer side of the posterior surface of the 
middle third of the shaft of the ulna, proximal to that of the 
last-described muscle ; to the inner side of the posterior surface 
of the middle third of the shaft of the radius ; and to the pos- 
terior surface of the intervening portion of the radio-ulnar 
interosseous ligament. The muscle has a distal and oblique 
course to the outer side of, and posteriorly to, the tendons of 
the extensor carpi radialis brevior and longior muscles. Its 
tendon passes through a compartment of the posterior annular 
ligament, it then winds to the outer side of the anterior surface POSTERIOR OF ELBOW, FOREARM, HAND, AND DIGITS. 
303 
of the carpus, and is attached to the anterior and outer surfaces 
of the proximal end of the first metacarpal bone (Plate 121). 
24. Supinator Brevis Muscle, Plates 121, 163, 167, 168, and 
169.—The anterior portion of this muscle was described (page 
236), and illustrated (Plates 126, 128, 129, 130, and Fig. 1, 
Plgte 134). The muscle, posteriorly, covers the proximal por- 
tion of the shaft and neck of the radius, bridging therefrom to 
the outer condyle of the humerus and the outer side of the 
proximal end of the shaft of the ulna. It is attached as fol- 
lows : anteriorly (Plate 121), to the outer side of the coronoid 
process and proximal end of the shaft of the ulna, and to the 
outer side of the neck and the proximal end of the shaft of 
the radius ; posteriorly (Plate 163), to the outer condyle of the 
humerus by the compound extensor attachment, to the outer 
side of the proximal end of the shaft of the ulna, and to the 
posterior surface and outer side of the neck and the proximal 
end of the shaft of the radius. 
25. Deep Fascia of Hie Posterior Surface of the Wrist and 
Metacarpus, Plates 165, 167, and 168.—A layer of deep fascia 
invests tlie posterior surfaces of the distal radio-ulnar artic- 
ulation, the carpus, and the metacarpus. The partitions of 
the compartments of the posterior annular ligament bridge 
between the latter ligament and this deep fascia. 
Dissection.—Section (Plate 168) tlie posterior interosseous nerve and re- 
move the portion between the cuts. Cut the middle perforating branch of the 
anterior interosseous artery. Section (Plate 167) the distal ends of the exten- 
sor primi internodii pollicis, and the extensor ossis metacarpi pollicis muscles ; 
reflect their proximal portions and cut them from their attachments, as in 
Plate 169. Dissect away the ulnar attachments of the extensor secundi inter- 
nodii pollicis and the extensor indicis muscles. Cut the tendons of the exten- 
sor carpi radialis longior, extensor carpi radialis brevior, and extensor carpi 
ulnaris at their distal ends (Plate 168). Clear the radial attachment of the 
pronator radii teres muscle. Cut away the ulnar portion of the supinator bre- 
vis muscle and trace, in a proximal direction, the posterior interosseous recur- 
rent branch of the posterior interosseous artery. Clear away the deep fascia 
from the distal ends of the radius and ulna, and from the carpus and meta- 
carpus. Display the distal end of the posterior interosseous nerve and its 
terminal ganglion ; the distal end of the third perforating branch of the an- 
terior interosseous artery, following it to its anastomosis ; the posterior carpal 
branches of the ulnar and radial arteries; the dorsal digital arteries ; the per- 
forating arteries ; the dorsal collateral digital arteries; and the dorsal inter- 
osseous muscles. 304 
UPPER EXTREMITY. 
26. Pronator Radii Teres Muscle, Plates 163, 168 and 169. 
—The anterior portion of this muscle was before described 
(pages 212 and 224), and illustrated (Plates 121, 125, 126, 128, 
129, 130, and Fig. 1, Plate 134). Its distal attachment presents 
at the outer side and posterior surface, of the shaft of the ra- 
dius, distal to the attachment of the supinator brevis muscle, 
and to the outer side of the radial attachment of the extensor 
ossis metacarpi pollicis muscle. 
27. Posterior Interosseous Recurrent Artery, Plate 169.—• 
This artery (venae comites) has a proximal course from its 
giving off from the posterior interosseous artery, along the 
outer side of the ulna, and anteriorly to the posterior portion 
of the supinator brevis muscle. It distributes to the outer 
side of the elbow, contributing to its peri-articular plexus. 
28. Posterior Interosseous Nerve.—The distal end of this 
nerve may be traced between the deep fascia and the posterior 
surface of the wrist, to its termination in a ganglion-like en- 
largement, from which branches are given off to the wrist-joint. 
29. Third Perforating Branch of Anterior Interosse- 
ous Artery, Plates 168 and 169.—This artery (venae comites) 
may be traced, between the deep fascia and the posterior sur- 
face of the wrist, to where it anastomoses with the posterior 
carpal branch of the ulnar artery. 
30. Posterior Carpal Branch of Ulnar Artery, Plate 169. 
—This branch appears, posteriorly, at the inner side of the car- 
pus ; it gives off two carpal branches and the sixth dorsal 
digital artery. 
31. Posterior Carpal Branches of the Radial and Ulnar 
Arteries, and the Posterior Carpal Arches.—There are two 
(sometimes only one) posterior carpal arterial arches (venae 
comites), a proximal and a distal, across the posterior of the 
carpus; the}7 are formed b}7 the anastomoses of the posterior 
carpal branches of the radial and the ulnar arteries. The 
proximal arch receives anastomosing branches from the third 
perforating branch of the anterior interosseous artery. The 
distal arch gives off recurrent branches to the carpus ; its distal 
branches are the third, fourth, and fifth dorsal digital arteries. POSTEEIOE OF ELBOW, FOEEAEM, HAND, AND DIGITS. 
305 
32. Dorsal Digital Arteries.—These arteries (venae comites) 
are six in number : the first and second, from the radial artery ; 
the third, fourth, and fifth from the distal posterior carpal 
arch ; the sixth is the continuation of the posterior carpal 
branch of the ulnar artery. The first has a distal course along 
the outer side of the first metacarpal bone; the second to the 
fifth, inclusive, have a distal course upon the posterior sur- 
faces of the dorsal interosseous muscles ; the sixth has a dis- 
tal course along the inner side of the fifth metacarpal bone. 
33. Perforating Arteries.—These arteries (vena) comites) 
are three in number ; they are branches of the deep palmar 
arch (page 233 ; Plates 132 and 133), which emerge, posteriorly, 
between the proximal portions of the metacarpal attachments 
of the second, third, and fourth dorsal interosseous muscles ; 
they anastomose with the third, fourth, and fifth dorsal digital 
arteries. 
Dissection.—Make the skin incisions 8, 8, 8, 8, 8 of Fig. i 2 (page 295), and 
reflect the flaps of skin from the dorsal surfaces of the digits. Display the 
distributions of the dorsal collateral digital arteries and nerves, also those of the 
dorsal branches of the palmar collateral digital arteries and nerves. 
34. Dorsal Collateral Digital Arteries, Plate 169 ; Fig. 1, 
Plate 170.—These arteries (venae comites) are ten in number, 
two to each digit; they distribute, respectively, to the dorsal 
halves of the lateral surfaces of the phalangeal segments of the 
digits. Thq first, at the outer side of the first digit, is the con- 
tinuation of the first dorsal digital artery ; the second to ninth, 
inclusive, result from the bifurcation of the dorsal digital ar- 
teries, second to fifth, inclusive ; the tenth is the continuation 
of the sixth digital artery. 
35. Dorsal Collateral Digital Nerves, Plate 164 ; Fig. 1, 
Plate 170.—These nerves, described (page 296), distribute to 
the digits as do the last-described arteries. 
36. Dorsal Branches of the Palmar Collateral Digital 
Arteries, Fig. 1, Plate 170.—These arteries, of a digit, appear 
posteriorly at the sides of the plialangine segment; they have 
a distal course along the dorsal halves of the lateral surfaces 
of the plialangine and phalangette segments, and distribute to 
the dorsal surface of tlie digit and to the matrix of the nail. 306 
UPPER EXTREMITY. 
37. Dorsal Branches of the Palmar Collateral Digital 
Werves.—These nerves, of a digit, appear posteriorly with, 
and distribute to the same areas as, the last-described arteries. 
Dissection.—Clear tlie surfaces of the digital portions of the tendons of the 
extensor communis digitorum, the extensor minimi digiti, and the extensor 
indicis muscles. Follow to their distal attachments the lumbricales, the pal- 
mar interosseous, and the dorsal interosseous muscles. Demonstrate the com- 
pound digital extensor aponeuroses of the digits, second to fifth, inclusive. 
38. Extensor Communis Digitorum Muscle, Plates 163 and 
170.—The terminal tendons of this muscle pass to the dorsal 
surfaces of the second, third, fourth, and fifth digits. A given 
tendon is projected upon the dorsal surface of a metacarpo- 
phalangeal articulation, where it has lateral expansions upon 
the sides of the joint, which blend with the palmar ligament 
of the joint ; it advances upon the phalanx of the digit, where 
it contributes to the compound digital extensor aponeurosis. 
39. Extensor Iiulieis Muscle, Plates 165, 167, and Fig. 2, 
Plate 170.—The tendon of this muscle is projected to the dorsal 
surface of the second or index digit, where it contributes to its 
compound digital extensor aponeurosis. 
40. Extensor Minimi Digiti Muscle, Plate 165.—The ten- 
don of this muscle and the accessory terminal tendon of the 
extensor communis digitorum muscle are projected to the dor- 
sal surface of the fifth or minim digit, where they contribute 
to the compound digital extensor aponeurosis of the digit. 
41. Eumbricalcs Muscles, Figs. 1, 2, and 3, Plate 170.— 
The anterior or palmar portions of these four muscles have 
been described (pages 221, 222, 223, and 230) and illustrated 
(Plates 127, 129, 131, 132, and 133). Their distal ends wind 
over the outer sides of the metacarpo-phalangeal articulations 
and bases of the phalanges of the digits, second to fifth, in- 
clusive, to where they end in a fibrous expansion (Fig. 3, 
Plate 170), which contributes to the compound digital extensor 
aponeurosis of the digits, second to fifth, inclusive. 
42. Palmar Interosseous Muselcs, Figs. 1 and 4, Plate 170. 
—The anterior or palmar surfaces of these three muscles have 
been described (page 234) and illustrated (Plates 122, 132, and POSTERIOR OF ELBOW, FOREARM, HAND, AND DIGITS. 
307 
133). Their distal ends are projected along the inner side of 
the second, and the outer sides of the fourth and fifth meta- 
car po-ph ala ngeal articulations, respectively, to where they end 
in fibrous expansions, which fuse with, and contribute to, the 
compound digital extensor aponeuroses of the second, fourth, 
and fifth digits, respectively. As a tendon of one of these mus- 
cles passes a metacarpo-phalangeal joint, it sends a slip to the 
palmar ligament of the joint (Fig. 4, Plate 170). 
43. Dorsal Interosseous Huseles, Plates 122, 163, and 169 ; 
Figs. 1, 2, and 3, Plate 170.—The palmar surfaces of these four 
muscles have been described (page 234) and illustrated (Plates 
122, 132, and 133). In demonstrating their distal ends (Fig. 3, 
Plate 170), each muscle will be found to have a palmar and a 
dorsal portion. The 'palmar portion has its proximal attach- 
ment to the palmar half of the lateral surface of a metacarpal 
bone (Plate 122), and its distal attachment to the same side of 
the base of the phalanx of the corresponding digit (Fig. 3, 
Plate 170). The dorsal portion has proximal attachments to 
the dorsal halves of the lateral surfaces of the two metacarpal 
bones bounding the intermetacarpal space in which the muscle 
is lodged (Plate 163); the two proximal attachments blend 
into a plane of muscle, which bridges the intermetacarpal space 
(Plate 169); the portion narrows to a tendon, which crosses the 
side of the metacarpo-plialangeal articulation of the digit, then 
expands and fuses into the compound digital extensor aponeu- 
rosis of the digit. 
44. Compound Digital Extensor Aponeuroses, Plates 163 
and 170.—Upon the dorsum of each digit, second to fifth, in- 
clusive, is an aponeurotic expansion, formed by the fusion of 
the tendons of the digital extensors, the lumbricales, the palmar 
interosseous, and the dorsal interosseous muscles. The tendons 
of the three latter muscles are, respectively, received at the lat- 
eral borders of the extensor tendons, in the phalanx segments of 
the digits. That of the second digit is formed by (Pig. 2, Plate 
170): a terminal tendon of the extensor communis digitorum 
muscle ; the tendon of the extensor indicis muscle ; the tendon 
of the dorsal portion of the first dorsal interosseous muscle 
and that of the first lumbricalis muscle, at the outer side; 
the tendon of the first palmar interosseous muscle, at the 308 
UPPER EXTREMITY. 
inner side. The aponeurosis of tlie third digit results from 
the fusion of : a terminal tendon of the extensor communis 
digitorum muscle ; the tendon of the dorsal portion of the 
second dorsal interosseous muscle, and that of the second lum- 
bricalis muscle, at the oipter side ; the tendon of the dorsal 
portion of the dorsal interosseous muscle—at the inner side. 
That of the fourth digit is contributed to (Fig. 1, Plate 170) 
by : a terminal tendon of the extensor communis digitorum 
muscle; the tendon of the second palmar interosseous mus- 
cle, and that of the third lumbricalis muscle, at the outer 
side ; the tendon of the dorsal portion of the fourth dorsal 
interosseous muscle, at the inner side. The aponeurosis of 
the fifth digit is formed by: the tendon of the extensor 
minimi digiti muscle with the accessoiy tendon of the extensor 
communis digitorum muscle ; the tendon of the third palmar 
interosseous muscle, and that of the fourth lumbricalis mus- 
cle, at the outer side. The aponeurosis of a digit is broadest 
in its phalanx portion, and opposite the distal portion of that 
bone it trifurcates; the middle slip of the trifurcation is at- 
tached to the base of the phalangine; the lateral slips are 
projected upon the phalangine of the digit, where they blend 
into one slip, which is continued to its attachment to the base 
of the phalangette of the digit. As the aponeuroses cross the 
digital joints they lie upon the posterior ligaments of the 
latter. PLATE 163 
TP/C E PS 
jTnnTcojePYPE "" 
process 
/Compound ex ten sorccttacdment of 
I EXTENSOR COMMUNIS DIGITORUM 
" MINIMI OIG-/TI 
" CARPI U L N A R/S 
\ " C A HP! ' R A DIALIS BR EVJOR 
\ SUPINATOR BREVIS 
EXTSSECUNO ! /NTERNODU 
ROC C /CIS 
EX TENSOR nva/c/s 
EX T ?RR/M/ J A/TERA/Oa// ROUE /C/S 
EX T?CA PP. RAO/A £ /S C OMG/OP 
~ " " ERE V/OP 
SERUM /A/TERPOD.POLL 
■SSC UAID/ » " 
ex 7-0/vr/zv/Af/ p/g/t/ 
(compound dig? ex if 
aponeurosis) 
'~i?f2n.,f,3V‘f£: OOPSAL INTEROSSEOUS, 
(palmar portions) 
- ex tensop nvo/c/s (compound 
cliffl extT aponeurosis) 
ff comacc/ac/s d/g/topum 
{compound die// excTaponeurosisJ 
AT. Cohn,-at2 nar/urarn deZ. PLATE 164 
’S’igjTexZZcut. Zjranciz olptitscuZd~spirl/t 
-J~72/r /t a « a <c rs 
PoslZuZnar a. 
Post r radial v$ 
Dorsal branches of' 
inti cutaneous n. 
PostT annular Ziy”}* 
PostlcarpaZ n 
,lif.2 rado rsldiqitaZ 
•'n* 
Communicating bran ch 
£ f‘SV’&ti efaorsl rtzyital rr? 
6*h-toZOt7* 
Dorsal collateral 
digital nf ~ 
2n.atoSt?* 
KDorsal collateral 
digital rtf 
JkZ.C'ehn.adnacunzfn.aeZU PLATE 165 
— Outer CONDYLE 
Co/npound extensor attachment 
OL E C RA2TON 
process 
Znitidl tendons 
• £X INTERNOD/I POL L /C/S 
— „ S £CU MR/ n " 
RAD/AUS LONG/OR 
„ ~ " BRRV/OR 
Terminal tendons 
It adial art. 
Accessory tendon 
Communicat ing 
slips —==; 
M. Cohn.adnaturam del PLATE 166 
HctcZiczZ 77. 
~EX T?PR/Ml INTERNOD/I RML/CSS 
EXr?CARR/ f?A DM l /S BREV/OR 
/' H V LOUD/OR — 
EXTFSECOND/ /NTE~f?NOD// POLE. 
JkZ7C&?i?z> cZrzcz.£z£7~a?7z PLATE 167 
Inner com/YEE. 
Or.ECMA.AtOE 
process 
Outer coeeyee 
Compound extensor attachment 
— Pos t.rinterosseous n. 
-P.tOEXT'tCOMMUNfS D/G/PORUM& 
£/r? MINIM/ DrGfT/ 
- P.toEXT?OSS/S METACARP/ POLL/CIS 
-AT.to EX T*SECUND/ INTERNODII POLL. 
... // PR/ML // " 
Postrinterosseous n • 
Mto ex tZcarp/ ulnar/s _ 
Postrinterosseous art. 
JZ.tOEXT? /ND/C/S 
EX T?CA RP/ PA D/AL/S Z OA/G/OP 
Piadial ctrh. 
Jltf. Cohn,<zdrzacts*. rvzTTZ czcZ. PLATE 168 
OEPCPA ATO/V 
process 
Outer COATJDYLE 
Compound ex tenfattacTzmeni 
Postfinterosseous n~ 
Postfinterosseous art. 
PRO A)'A TOR PA D/f TENDS 
eXT?SECUNDI INTERNOOH 
POE L. JC/S 
£-XT ? /NO! C/S 
Perforating dranetzes of 
an tTinteross? art. 
At.Co?z>!.admit itram del. PLATE 169 
ORE CEA.EOAT 
process 
Compound extenValtachment 
Oixter CONDYJ.E 
Postfinterosseous n, 
Dosltinterosseous recurrent 
art. 
Post?interosseous art. 
PR ON A TOR RA D/J TERES. 
Perforating hrandzes of £ 
arrtf interosseous art. 
Post.rinterosseous n. 
SUP/NA TOR L ONGUS 
Carpal gangtZzon 
DostTcarpa/ 6 ranch of ztlnar 
art. 
PostTcarpal arches -< 
£Xr?CARPS ULNAR/S 4 
Perforatingr art? 
Dor sat ctiaitaz art?, • 
4*\Si/lgt &•*> 
Dors? cotZateral ct/a?art ?- 
6?ft to ZOthinci. 
Pars? collateral 
digital art?, 
i StApncl. 
M.Coh.n.adnczturam tteL. PLATE 170 
FiG.-& 
FXG. 3 
Fig. 2 
naticrczm deZ. 
Fig. 2 TWENTY-SECOND DISSECTION. 
ARTICULATIONS OF THE HAND, ELBOW, FORE- 
ARM, AND SHOULDER. 
ARTICULATIONS OF THE HAND. 
Dissection.—Dissect away tlie compound digital extensor aponeuroses 
from the digital region (Fig. 1, Plate 170) ; also the muscles from the meta- 
carpal region (Plates 133 and 1G9). 
Terms of Relation.—The following special terms are used 
in describing the articulations of the hand, viz. : proximal and 
distal; palmar and dorsal; inner and older. The regions of 
the hand are : the digital, the metacarpal and the carpal. 
Bones of the Hand, Plates 122 and 163.—Twenty-seven 
bones form the framework of the hand : in the digital region 
are the five phalangettes, the four phalangines, and the five 
phalanges (page 123) ; in the metacarpal region are the five 
metacarpals / in the carpal region—from the outer to the inner 
side—the trapezium, the trapezoid, the os magnum, and the 
unciform construct the distal row, while—in the same direction 
—the scaphoid, the semilunar, the cuneiform, and the pisi- 
form make up the distal row. All of these bones afford attach- 
ments to ligaments. 
Dissection.—Expose the ligaments of the palmar, the inner, the outer, and 
the dorsal surfaces of the digital articulations. Open one or more of the digi- 
tal-joints so as to demonstrate the several ligaments (Eig. 2, Plate 173). 
1. Articulations of the Digits, Plates 171, 172, and Fig. 2, 
Plate 173.—The fourteen bones of the digits form nine articu- 
lations. Each articulation has four ligaments: two lateral, a 
palmar, and a dorsal. The lateral ligaments pass between the 
contiguous ends of the digital bones, in the dorsal halves of 310 
UPPER EXTREMITY. 
the inner and outer sides of the joint area (Fig. 2, Plate 173). 
A palmar ligament fills the space between the palmar borders 
of the lateral ligaments, bridging between points of the palmar 
surfaces of the digital bones contiguous to the joint; it con- 
tains a fibrous plate, whose palmar surface is covered by the 
sheath of the flexor tendons of the digit. A dorsal ligament 
bridges between the dorsal borders of the lateral ligaments. 
Dissection.—Clear the surfaces of the metacarpo-plialangeal articulations, 
displaying the ligaments of the same. Open the joints of the middle and 
pollex digits, at their dorsal surfaces (Figs. 3 and 4, Plate 173) ; also that of 
the fourth digit, at its palmar surface (Fig. 5, Plate 173). 
2. Mctaearpo-phalangeal Articulations, Plates 171 and 
172 ; Figs. 3, 4, and 5, Plate 173.—These articulations, five in 
number, are formed by the proximal ends (bases) of the phalan- 
ges and the distal ends (heads) of the metacarpal bones. They 
have the same ligaments as the digital articulations. The fibrous 
plates of the palmar ligaments of the digits, second to fifth, in- 
clusive, are thicker than those of the digits, while that of the 
pollex articulation includes two sesamoid bones (Fig. 4, Plate 
173). 
Dissection.—Expose tlie palmar and dorsal intermetacarpal ligaments, the 
surfaces of the trapezio-metacarpal, the carpo-metacarpal, and the intercarpal 
articulations. 
3. Inlcrinctacarpal Ligaments, Plates 171 and 172.—These 
six ligaments—three palmar and three dorsal—bridge, at the 
respective surfaces, between the proximal ends (bases) of the 
metacarpal bones, second to fifth, inclusive. 
4. Trapezio-metacarpal Articulation.—This articulation is 
formed by the proximal end (base) of the first metacarpal bone 
and the trapezium of the carpus. It has a capsular ligament, 
which passes from the circumference of one articular surface 
to that of the other. 
5. Carpo - metacarpal Articulation.—This articulation is 
formed by the apposition of the proximal ends (bases) of the 
metacarpal bones, second to fifth, inclusive, and the distal sur- 
faces of the trapezoid, os magnum, and unciform bones of the 
carpus. Ligaments pass, upon the respective palmar and dor- 
sal surfaces, between these two lines of bones. ARTICULATIOXS OF HAND. 
311 
«. Intercarpal Articulations.—These are formed by the ap- 
position of the distal row of carpal bones, of the proximal row 
of carpal bones, and of the two articulated rows with each 
other—medio-carpal articulation. The distal row—trapezium, 
trapezoid, os magnum, and unciform—are bound to each other 
by three palmar and three dorsal transverse ligaments. The 
proximal row—scaphoid, semilunar, and cuneiform—are held 
in apposition by two palmar and two dorsal transverse lig- 
aments. The medio-carpal articulation has palmar and dorsal 
ligaments passing between the distal and proximal rows of 
bones. 
Dissection.—Clear the surfaces of the articulation of the carpus with the 
distal ends of the radius and ulna. Section the inner lateral, the inner por- 
tions of the anterior and posterior radio-carpal ligaments (being careful to 
leave the interarticular fibro-cartilage of the joint in situ), and abduct the 
hand. 
7. Articulation of the Carpus with the Radius and Ulna, 
Plates 121, 122, 163, 171, 172, and Fig. 1, Plate 173.—The ele- 
ments of this articulation are : bones, ligaments, an interartic- 
ular fibro-cartilage, and synovial membrane. The bones are : 
the scaphoid and semilunar, opposed to the radius—radio-carpal 
articulation ; the cuneiform opposite to, but separated by 
the interarticular fibro-cartilage from, the ulna (Fig. 1, Plate 
173). The radius projects, in a distal direction, further than 
the ulna ; this projection, with the separation of the ulna 
from the carpus by the interarticular fibro-cartilage, render the 
motions of the hand independent of the ulna. 
The ligaments are four in number. The anterior radio- 
carpal (Plate 171), which has its proximal attachment to the 
anterior surface of the styloid process, and the anterior bor- 
der of the distal end, of the radius ; its fibres run obliquely, 
toward the inner side, to their distal attachments, to the ante- 
rior surfaces of the semilunar, the cuneiform, and the os mag- 
num bones of the carpus. The outer lateral (Plates 171, 172, 
and Fig. 1, Plate 173) passes from the styloid process of the 
radius to the scaphoid bone of the carpus. The inner lateral 
(Plates 171 and 172) bridges from the styloid process of the 
ulna to the cuneiform and pisiform bones of the carpus ; its 
distal end has an anterior, a posterior, and a middle slip, which 
are attached, respectively, to the anterior and posterior sur- 312 
UPPER EXTREMITY. 
faces of the cuneiform and pisiform bones. The posterior 
radio-carpal (Plate 172) lias its proximal attachment to the 
styloid process, and the posterior border of the distal end, 
of the radius ; its fibres cross obliquely to the inner side, 
to their distal attachments at the posterior surfaces of the 
scaphoid, the semilunar, and the cuneiform bones of the carpus. 
The inter articular fibro-cartilage (Pig. 1, Plate 173) is at- 
tached to the inner border of the carpal articular surface of the 
distal end of the radius, and to the styloid process of the ulna. 
It is thus lodged between the cuneiform bone of the carpus and 
the distal end of the ulna. Its distal surface with that of the 
radius forms the proximal articular surface, which is opposed 
to the proximal row of the carpal bones. 
Dissection.—Cut the remaining ligaments of the outer half of the radio- 
carpal articulation, thus severing the hand from the bones of the forearm. Sec- 
tion the dorsal intermetaearpal, the dorsal carpo-metacarpal, and the dorsal 
carpal ligaments ; separate the bases of the metacarpal bones, also the carpal 
bones from each other, and demonstrate the interosseous ligaments between 
them. 
§. Interosseous Ligaments of the Metacarpal and Carpal 
Regions.—Interosseous ligaments will be found, between : the 
opposed surfaces of the bases of the metacarpal bones, second 
to fifth, inclusive ; the base of the second metacarpal and the 
trapezium ; the fourth metacarpal and the unciform ; the os 
magnum and the unciform ; the scaphoid and the semilunar; 
the semilunar and the cuneiform. 
Dissection.—Clear the surfaces of the elbow-joint so as to display the liga- 
ments of the same. 
ARTICULATION OF ELBOW. 
Terms of Relation.—The same general and special terms 
used in describing the wrist-joint (page 309), will apply to the 
description of these joints. 
Bones of the Elbow-joint, Plates 121 and 163.—The bones 
of this joint are : the ulna—its olecranon process, coronoid 
process, great sigmoid notch, and small sigmoid notch ; the 
radius—its button-shaped head ; and the humerus—its troch- 
lea, capitellum, olecranon fossa, and coronoid fossa. ARTICULATION OF ELBOW. 
1. Outer Lateral Ligament, Plate 174 ; Fig. 2, Plate 175. 
—This ligament is attached as follows: at its proximal end, 
to the outer surface of the outer condyle of the humerus ; at 
its distal end, to the orbicular ligament of the proximal radio- 
ulnar articulation. 
2. Inner Lateral Ligament, Plate 174 ; Fig. 1, Plate 175. 
—This ligament is attached : at its proximal end, to the inner 
condyle of the humerus ; at its distal end, to the inner surfaces 
of the proximal end of the shaft, and the coronoid process, 
of the ulna. 
3. Anterior Ligament, Fig. 1, Plate 174 ; Fig. 1, Plate 
175.—This ligament closes in the anterior of the elbow-joint, 
between the borders of the lateral ligaments. It is attached: 
at its proximal end, to the borders of the coronoid fossa and 
the radial depression of the humerus ; at its distal end, to the 
border of the coronoid process of the ulna, and to the orbicu- 
lar ligament of the proximal radio-ulnar articulation. 
4. Posterior Ligament, Fig. 2, Plate 174 ; Fig. 2, Plate 175. 
—This ligament extends from the borders of the olecranon fossa 
of the humerus to the borders of the olecranon process, and the 
great sigmoid notch, of the ulna. Some of its outer hbres fuse 
with the posterior portion of the orbicular ligament of the 
proximal radio-ulnar articulation. 
ARTICULATIONS OF RADIUS AND ULNA. 
Dissection.—This articulation is included in, and forms a part of, the elbow- 
joint. Open the elbow-joint by cutting transversely its anterior and posterior 
ligaments, and preserving its outer and inner lateral ligaments, and the orbic- 
ular ligament of the proximal radio-ulnar articulation (Figs. 1 and 2, Plate 175). 
1. Orbicular Ligament, Plate 174; Pigs. 1 and 2, Plate 
175.—This ligament consists of circular fibres, which wind 
around the head of radius ; its attachments are to the anterior 
and posterior borders of the small sigmoid cavity of ulna, and 
to the anterior, outer, and posterior surfaces of the neck of the 
radius. The proximal border of the ligament receives the fu- 
sion of fibres of the anterior, the outer lateral, and the pos- 
terior ligaments of the elbow-joint. 314 
UPPER EXTREMITY. 
Dissection. —Section the outer and the inner lateral ligaments of the elbow- 
joint (Figs. 1 and 2, Plate 175). Clear the surfaces of the radio-ulnar interos- 
seous and the oblique ligaments of the middle radio-ulnar articulation. 
2. Radio-ulnar Interosseous Ligament, Plates 134 and 169. 
—This ligament bridges the distal three-quarters of the interos- 
seous space between the ulna and the radius, from the inner 
border of the shaft of the radius to the outer border of the 
shaft of the ulna. The fibres of the ligament have a distal and 
oblique course, from the radius to the ulna. 
3. Oblique Ligament, Fig. 1, Plate 174; Fig. 1, Plate 175. 
—This ligament bridges from the ulna to the radius at the 
proximal limit of the last-described ligament. It passes ob- 
liquely from the outer side of the coronoid process of the ulna 
to the inner side of the radius, distal to its tubercle. 
4. Distal Radio-ulnar Articulation, Plates 171 and 172 ; 
Fig. 1, Plate 173.—The distal ends of the radius and ulna are 
bound to each other by a posterior and an anterior ligament, 
which allow and limit the partial rotation of the radius about 
the immovable ulna. When the radius rolls to the anterior of 
the ulna it is called pronation / when it returns to the outer 
side of, and parallel with, the ulna, it is called supination. 
These motions are participated in by the hand, because of the 
independence of the radio-carpal articulation of the ulna. 
The bones of this articulation present as follows : the radius, 
a groove upon the inner surface of its distal end ; the ulna, a 
rounded border at the outer and anterior surfaces of its dis- 
tal end. 
The posterior radio-ulnar ligament (Plate 172) which limits 
pronation, is attached : at its outer end, to the posterior border 
of the articulating groove of the radius ; at its inner end, to the 
posterior surfaces of the distal end, and the styloid process, 
of the ulna. It is also attached to the posterior border of the 
interarticular fibro-cartilage of the wrist-joint (page 312). The 
anterior radio-ulnar ligament (Plate 171, and Fig. 1, Plate 173), 
which limits supination, is attached : at its outer end, to the 
anterior border of the articulating groove of the radius ; at its 
inner end, to the anterior surface of the inner portion of the 
distal end of the ulna, and to the anterior border of the inter- 
articular fibro-cartilage of the wrist-joint. ARTICULATION OF SHOULDER. 
315 
ARTICULATION OF SHOULDER. 
Dissection.—Clear the proximal end of the humerus, cutting the muscles 
short, that are attached thereto. Display the surfaces of the capsular and coraco- 
clavicular ligaments of the joint. 
Terms of Relation.—The general terms anterior and poste- 
rior, external and internal, superior and inferior, will be used. 
Bones, Plates 113 and 158 ; Fig. 3, Plate 175.—The humerus 
—its head and anatomical neck—and the scapula—its glenoid 
cavity, neck, and coracoid process—contribute to the construc- 
tion of the shoulder-joint or scapulo-liumeral joint. 
1. Muscles Crossing tlie Exterior of the Capsular Liga- 
ment, Plate 176.—Anteriorly, the sub scapular is, from the sub- 
scapular fossa of the scapula to the small tuberosity of the 
humerus ; superiorly, the supraspinatus, from the supraspi- 
natus fossa of the scapula to the superior facet of the great 
tuberosity of the humerus ; posteriorly, the infraspinatus and 
the teres minor, from the infraspinatus fossa of the scapula to 
the middle and inferior facets respectively of the great tuber- 
osity of the humerus. 
2. Capsular Ligament, Plate 176.—This loose, circumfe- 
rential ligament extends from the anatomical neck of the lm 
merus and the circumference of that bone inferiorly thereto, to 
the circumference of the neck of the scapula. 
3. Coraco-lmmeral Ligament, Plate 113; Fig- 1, Plate 176. 
—This ligament extends from the superior portion of the prox- 
imal end of the humerus, between its great tuberosity and 
the anatomical neck, to the external border of the root of the 
coracoid process of the scapula. It serves to strengthen the 
superior portion of the capsular ligament. 
Dissection.—Section the anterior, inferior, and posterior portions of the 
capsular ligament; raise the humerus, superiorly, so as to expose the interior 
of the shoulder-joint. > 
4. Glenoid Ligament, Fig. 3, Plate 175.—This is circum- 
ferential fibro-cartilage, that rims the glenoid cavity of the 
scapula, for the purpose of deepening the same. 316 
UPPER EXTREMITY. 
5. Tendon of Biceps within the Shoulder-joint.—The ten- 
don of the long head of the biceps enters, by the bicipital groove 
of the humerus, the interior surface of the superior portion 
of the capsular ligament of the shoulder-joint; it passes to be 
attached to the superior part of the glenoid ligament. 
SCAPULO-CLAVICULAR ARTICULATION AND SCAPULAR 
LIGAMENTS. 
Dissection;—Clear tlie acromio-clavicular, the coraco-clavicular, coraco- 
acromial, and suprascapular ligaments. 
Terms of Relation.—The same as for the description of the 
shoulder-joint. 
Bones, Plates 113, 158, and 176.—These are the clavicle— 
its external half ; and the scapula—its acromkm and coracoid 
processes, and its superior border. 
1. Acromio-clavicular Articulation.—The external end of 
the clavicle is received at a facet on the internal border of 
the acromion process of the scapula, where it is held by the 
superior acromio-clavicular and the inferior acromio-clavic- 
ular ligaments. 
2. Coraco-clavicular Ligament.—This extends from the 
inferior surface of the external half of the clavicle to the su- 
perior surface and posterior border of the angle of the coracoid 
process of the scapula. It is sometimes described as the cono- 
trapezoid ligament, having two portions : anteriorly and ex- 
ternally, the trapezoid portion ; posteriorly and internally, the 
conoid portion. 
3. Coraeo-acromial Ligament, Plate 113, and Fig. 1, Plate 
176.—This is a stretch of fibrous tissue from the anterior bor- 
der of the acromion process of the scapula to the superior 
border of the external portion of its coracoid process. 
4. Suprascapular Ligament, Fig. 2, Plate 176.—This is a 
band of fibrous tissue, that bridges the suprascapular notch, 
converting tlie same into a foramen. PLATE 171 
Radio-ulnar 
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_A-nterior radio- 
ulnar Ziyi? * 
Inn evict ter? l£a™t - 
ant tportion 
■ inner /> 
-CddJElFOMAT 
UNO IE OR AI 
FL FXOR CARPI UL N. 
OF MA GNUM 
JPaZmar inter- 
■ metacarpai Zigr'nts 
fefaatoi.o bones 
L ateral Zip7?*— 
Palmar lip771* 
' EL EX OR SUBL /MIS DIG/TO RUM 
Coh 72 , Tzacu ram rfeZ. PLATE 172 
jRactio -ulnar interosseous tig7?*1 
Posterior radio 
ulnar Zigr77lt _ 
J’nnriatexaZ Zip' *»<• 
inner portion — 
post P 
extZca rp/ ulma p/s 
extPossis- metacapp/ poll /c/e 
Ca'p&ztZap Zip'77?* 
if* EXE7? CAPE/ PAO/ALIS LONG/OR 
| " BPEV/O/t 
Z/orsaZ ZnlermetacarpaZ Zi<f772fs 
El7 PEAL AEG E TTE 
JkL Cohn, act not zc ram PLATE 173 
Pig. i' 
P adio-ulnar inteross.Zigr*?* 
SUP/GA TOR L ONGUS 
sm otd process 
'A-/zt rra clio-uln ar lig ™ c 
OutriateraZ Zz^^f 
Fig. 3 
.Fig. 2 
FiG.S 
Fig. 4 
sesamoid bones' 
Palmar Zzgr7?2* 
tA.Cohn.cutncLturam del. PLATE 174 
Fig. 2 
* 
M.Cahrz-,a<£rzdzfu7-<zm <£eZ. 
FlG.I PLATE 175 
Fzg .2 
FlG.l 
jF’ZG. 3 
Acromion process 
M.Coh-noLdnatizram del. PLATE 176 
-Fsg.1 
Fig. 2 
-M. Co?z?z,a.cZ?zczti£ra77i del. TWENTY-THIRD DISSECTION. 
SCALP; VERTEX PORTION OF THE MEMBRANES OF 
THE BRAIN ; INTERIOR OF THE BASE OF THE 
CRANIUM. 
Dissection.—The subject is placed as for dissection of the thorax, and 
upper extremities (page 193); the head is so steadied upon a block as to present 
one of its lateral surfaces uppermost (Plate 177). 
Terms of Relation.—These are : the general terms (page 2); 
and the special terms frontal, lateral, occipital, and vertex 
surfaces or areas applied to the exterior of the cranium ; 
exterior and interior, used relatively to the cranial cavity. 
Bones, and Bone Areas of Muscle Attachments, Plates 
181 and 189.—Parts of tile frontal, parietal, sphenoid, temporal, 
and occipital bones form the vault of the cranium. At the 
lateral and occipital surfaces of the cranium the bones present 
areas for the attachments of muscles. Parts of the frontal, eth- 
moid, sphenoid, temporal, and occipital bones contribute to 
form the base of the cranium. 
SCALP. 
Dissection.—Make the skin incisions 1 and 2, of Figure 14 (page 318), and 
reflect a flap as indicated. Care must be taken to reflect the skin only, that 
the vessels and nerves of the subcutaneous plane may be left in situ. As a 
guide for the hairy portion of the scalp, the roots of the hairs should be ex- 
posed projecting from the interior of the flap. 
1. Subcutaneous Tissue.—This plane of the scalp differs 
from the same tissue of other regions: in being very dense ; 
and in its intimate blending with the skin, exteriorly, and the 
musculo-aponeurotic layer, interiorly. 
Dissection*.—Trace through the frontal area of the subcutaneous tissue the 
frontal artery, the supratrochlear nerve, and the anterior branch of the super- 
ficial temporal artery. Expose the surface of the frontal portion of the occipito- 
frontalis muscle. 318 
HEAD AND NECK. 
2. Frontal Artery, Plate 177.—This artery presents superi- 
orly to the internal portion of the supra-orbital region, where 
it has a superior course exteriorly to the occipito frontalis 
muscle. 
Fig. 14. 
3. Supratrochlear Nerve.—This small nerve appears inter- 
nally to, and parallel with, the last-described artery ; it per- 
forates the muscle to the same plane as the artery. 
4. Superficial Temporal Artery.—The anterior branch of 
this artery (vena comes) is projected into the superior portion 
of the frontal area of the scalp. 
Dissection.—Cut out the supra-orbital artery and nerve from the interior 
of the frontal portion of the occipito-frontalis muscle (Plate 177). Trace the 
nerve branches to where they perforate the muscle to reach the subcutaneous- 
tissue plane, and follow them, superiorly and posteriorly, into the anterior por- 
tion of the vertex area of the scalp. SCALP. 
319 
5. Supra-orbital Artery.—This small artery emerges from 
the orbital cavity, at the supra-orbital notch or foramen, into 
the plane interiorly to the occipito-frontalis muscle j its 
branches perforate the muscle, to anastomose with the frontal 
and the anterior branch of the superficial temporal artery. 
/ 6. Supra-orbital Nerve.—This nerve leaves the orbit with, 
and lies in the same plane as, the last-described artery. Its 
branches (usually two) perforate the muscle exteriorly to them, 
and continue into the subcutaneous plane of the scalp. 
Dissection.—Trace the superficial temporal artery and vein in the subcuta- 
neous plane of the lateral area of the scalp, exteriorly to the superficial tem- 
poral fascia. 
7. Superficial Temporal Artery.—This artery is projected 
as a single trunk, superiorly, from a point anteriorly to the ear 
into the subcutaneous plane of the lateral area of the scalp. 
The trunk bifurcates, at a variable point, into an anterior 
and a posterior branch ; the anterior is projected to the frontal 
region (page 318) ; the posterior, the larger of the two, has a 
superior and posterior course in the posterior half of the lat- 
eral area of the scalp—its branches anastomose with the pos- 
terior auricular and occipital arteries. 
8. Superficial Temporal Vein.—The anterior and posterior 
temporal veins (one for each artery) converge to the anterior 
of the ear, where they form the superficial temporal vein, 
which passes into the neck. 
Dissection.—Cut out, from the interior of the superficial temporal fascia, 
the temporal branches of the facial nerve. Find the auriculo-temporal nerve 
and trace it superiorly, to the ramification of its terminal branch in the subcu- 
taneous plane of the scalp. 
9. Temporal Branches of the Facial Nerve.— These 
nerves run, superiorly, interiorly to the superficial temporal 
fascia. They supply : by the posterior branch, the attrahens 
and attollens aurem muscles ; by the anterior branch, the 
frontal portion of the occipito-frontalis muscle, the superior 
part of the orbicularis palpebrarum muscle, and the corrugator 
supercilii muscle. 320 
HEAD AND NECK. 
10. Auriculo-tcmporal Nerve.—This nerve is projected, su- 
periorly, between the superficial temporal vessels and the pinna 
of the ear. Its terminal branch, the superficial temporal nerve, 
ramifies in the subcutaneous plane of the temporal region. 
Dissection.—Clear the occipital area of the scalp, exposing the occipital and 
posterior auricular arteries ; also the occipitalis major, the occipitalis minor, 
and a branch of the third cervical-spinal nerve. Display the occipito-frontalis 
muscle, also the auricular muscles. 
11. Occipital Artery.—This artery (venae comites) passes 
superiorly, from the region of the neck (page 266 ; Plates 148, 
149, and 150), into the subcutaneous plane of the scalp. 
12. Posterior Auricular Artery.—Terminal branches of 
this vessel have a superior course posteriorly to the ear. 
13. Occipitalis Major Nerve.—This nerve, the internal (cu- 
taneous) branch of the posterior division of the second cervical- 
spinal nerve, runs, superiorly, from the region of the neck 
(page 266 ; Plates 148, 149, and 150), into the subcutaneous 
plane of the scalp. 
14. Occipitalis Minor Nerve.—This nerve has a superior 
course, from the neck into the subcutaneous plane of the 
scalp (page 266; Plates 148, 149, and 150), running parallel 
with, and externally to, the last-described nerve. 
15. Brandi of the Third Cervical-Spinal Nerve.—The in- 
ternal (cutaneous) branch of the posterior division of the third 
cervical-spinal nerve is projected, from the neck, into the subcu- 
taneous plane of the scalp. It runs superiorly, parallel with 
and internally to the occipitalis major nerve (page 266 : Plates 
148, 149, and 150). 
16. Oecfpito-frontalis Muscle.—This musculo-aponeurotic 
plane forms the third and interior layer of the scalp, and has 
three portions. The posterior or occipital (muscle) portion is 
attached: interiorly, to the superior oblique line upon the 
exterior of the occipital bone and to the exterior of the mas- 
toid portion of the temporal bone ; superiorly, to the ex- 
terior of the aponeurosis. The anterior or frontal (muscle) 
portion is attached: superiorly, to the exterior of the apo- 
neurosis ; interiorly, it blends with the superior part of the SCALP. 
321 
orbicularis palpebrarum, the pyramidalis nasi, and the corruga- 
tor supercilii muscles. The middle or aponeurotic (fibrous) 
portion is attached: posteriorly, to the superior curved line 
of the occipital bone, and to the exterior of the mastoid portion 
of the temporal bone ; it spreads anteriorly over the vertex 
area of the head to the frontal portion of the muscle. 
17. Superficial Temporal Fascia.—This is a layer of fascia 
located interiorly to the subcutaneous plane of the lateral area 
of the scalp and the attollens and attrahens aurem muscles. It 
is continued, inferiorly, from the aponeurosis of the occipito- 
frontalis muscle to the superior border of the zygomatic arch 
(zygoma of the temporal bone and the malar bone). 
l§. Auricular Muscles.—These muscles—three in number 
—lie exteriorly to the superficial temporal fascia. The su- 
perior or attollens aurem is attached : superiorly, to the apo- 
neurosis of the occipito-frontalis muscle ; inferiorly, to the in- 
ternal face of the superior portion of the pinna of the ear. The 
anterior or attrahens aurem passes from the superficial tem- 
poral fascia, anteriorly to the ear, to the anterior of the helix 
of the ear. The posterior or retrahens aurem bridges from the 
mastoid portion of the temporal bone to the internal face of 
the pinna of the ear. 
Dissection.—Section the vessels and nerves of the scalp (Plate 177). Cut 
the occipito-frontalis, anteriorly and posteriorly, as in Figs. 1 and 2, Plate 178, 
and dissect away the muscle. Reflect, inferiorly, the superficial temporal fas- 
cia with the auricular muscles (attollens and attrahens), and cut them away. 
Display the deep temporal fascia, and then cut its inferior portion away, as in 
Fig. 1, Plate 178. Note the splitting of its inferior portion, superiorly to its 
zygomatic-arch attachment. Expose the temporal muscle. 
19. I>cep Temporal Fascia, Fig. 1, Plate 178.—This thick 
layer of fascia is attached, circumferentially, to the temporal 
ridge—on the frontal, parietal, and occipital bones—and to the 
superior border of the zygomatic arch. Its inferior portion 
splits into two layers, between which adipose tissue is lodged. 
20. Temporal Muscle.—This muscle is attached to the 
lateral area of the cranium, within the boundaries of the tem- 
poral ridge and the superior border of the zygomatic arch ; con- 
verging to a tendinous portion, it passes internally to the zygo- 322 
HEAD AND NECK. 
matic arch, to its inferior attachment, to the coronoid process 
of the inferior maxillary bone (Fig. 2, Plate 184). Note the 
adipose tissue between the muscle and the arch. 
Dissection.—Cut away the temporal muscle, as in Fig. 2, Plate 178, and 
display the deep temporal vessels and nerves. 
21. Anterior and Posterior Deep Temporal Arteries, Fig. 
2, Plate 178.—These arteries (vena? comites), branches of the 
internal maxillary artery (Plate 187), arc projected, superiorly, 
between the temporal muscle and the squamous portion of the 
temporal bone, to supply the temporal muscle. 
22. Anterior and Posterior Deep Temporal Nerves.— These 
two (sometimes three, a middle one) nerves, branches from the 
trifacial nerve (Plate 187), have a superior course, to supply 
the temporal muscle. 
VERTEX PORTION OF THE MEMBRANES OF THE BRAIN. 
Dissection.—Saw the cranial bones at both sides of the skull, as indicated 
by the antero-posterior section-line across Fig. 2, Plate 178. In sawing be care- 
ful not to perforate and injure the contents of the cranium (nothing is gained 
by pressure of the saw, but the work is expedited by the lightness with which 
the saw is drawn along its track). The thickest points are at the antero- 
lateral and postero-lateral angles of the cranium; complete the bone section 
with the chisel and mallet; and remove the calvarium by dragging upon it, 
antero-posteriorlv, with the hook. Recognize the dura mater ; the meningeal 
arteries exteriorly to it; and the prominences of the Pacchionian bodies. 
23. Dura Mater, Plates 179 and 180.—Lining the interior 
of the cranium is this the exterior of three membranes of invest- 
ment of the brain. It is the .thickest of the three ; during 
foetal and infantile life it is an interior periosteum (from which 
the bones derive nourishment) of the cranial bones ; its re- 
duplications—the falx cerebri, the tentorium cerebelli, and the 
falx cerebelli—determine intracranial compartments for the 
lodgement of the several parts of the brain ; its splittings form 
the intracranial sinuses or blood-canals. 
24. Meningeal Arteries.—Exteriorly to the dura mater, be- 
tween it and the lateral portion of the cranial bones, these ar- 
teries are projected, superiorly, toward the vertex. 
25. Pacchionian Bodies, Plate 179.—These are villi from 
the exterior of the arachnoid or middle membrane of the VERTEX PORTION OF THE MEMBRANES OF THE BRAIN. 
323 
brain ; they are located antero-posteriorly, at either side of the 
median line, where they project the dura mater, and produce 
by their development erosions of the interior of the calvarium. 
They vary in number and development in different subjects. 
Dissection.—Incise, from a posterior point anteriorly, the median line of 
the dura mater, where its two halves will be found united by transverse strands 
of fibrous tissue. This will bring into view an antero-posterior canal. 
26. Superior Longitudinal Sinus.—Tliis is one of tile fifteen 
intracranial venous canals formed by the dura mater. This 
sinus is formed by the dipping, inferiorly, of the dura mater, 
between the hemispheres of the cerebrum—forming the falx 
cerebri. The apposed surfaces of the membrane adhere to form 
the floor of the sinus, while the edges of the reduplications are 
bridged by transverse strands of fibrous tissue, which form its 
roof. It is a triangular canal, which is lined by the continua- 
tion of the internal coat of veins emptying into it ; it is small 
anteriorly, and increases in size antero-posteriorly ; laterally, 
it presents the orifices of veins. 
Dissection.—Cut away one-half of the vertex portion of the dura mater 
(Plate 179), so as to display the subdural space and the arachnoid membrane. 
Dissect away, in turn, the posterior half of the exposed arachnoid membrane 
(Plate 179), thereby discovering the subarachnoidean space and the pia mater. 
Kemove a part of the pia mater from the posterior portion of' the cerebrum 
(Plate 179). 
27. Subdural Space, Plate 179.—This is a space between 
the dura mater and the arachnoid membranes of the brain. 
28. Arachnoid Membrane.—This is the middle one of the 
three membranes of the brain. It bridges the sulci of the ex- 
terior surface of the cerebrum, and also the prominences of 
the brain at its base. 
29. Subaraclinoidean Space.—This is a space between the 
arachnoid and the pia mater membranes of the brain, within 
which ramify the supplying arterial trunks to the brain. The 
space communicates with the ventricular cavities of the brain, 
to be referred to hereafter. It contains, in life, a liquid, the 
cerebrospinal fluid. 
30. Pia Mater.—This, file interior of the three membranes 
of the brain, forms an intimate investiture of the organ ; it 
dips into and lines all the sulci and inequalities of the brain, 
and even, as will be shown hereafter, is projected into its 324 
HEAD AND NECK. 
ventricular cavities. It is extremely vascular, as follows: it 
receives all the arteries destined to supply the brain, which 
break up in its texture into minute vessels ; the venous blood 
of the brain is collected into small veins in its substance, which 
empty into the sinuses of the dura mater. 
INTERIOR OF THE BASE OF THE CRANIUM. 
DissEcnoN.—Remove the brain from tlio cranium with the curved scissors, 
as follows: cut the dura mater, circumferentially, at the level of the cranial sec- 
tion ; raise the anterior lobes of the cerebrum and cut the falx cerebri from 
the crista galli of the ethmoid ; raise the posterior lobes of the cerebrum and 
cut the tentorium cerebelli, circumferentially (be careful not to open the lateral 
sinuses or injure the cerebellum inferiorly to the membrane). Let the head 
hang from the shoulders, by taking out the block. Raise the two anterior 
lobes of the cerebrum, antero-posteriorly, from the anterior fossae of the cra- 
nium ; find the bulbs of the olfactory nerves, upon the interior of the cribri- 
form plate of the ethmoid bene, lift one of them so that it may come away with 
the brain, and cut the other so as to leave it in situ ; expose and cut the optic 
nerves, posteriorly to the commissure of the same ; also the internal carotid 
arteries, the right and the left. Open the coronary sinus around the pitui- 
tary body, which is lodged in the sella turcica, at the superior surface of the body 
of the sphenoid bone ; turn out the pituitary body from its bed. Continue to 
lift the brain out of the cranium, in an antero-posterior direction; find and cut 
the following parts, to the right and left, alternately: the oculomotor, the troch- 
lear, the trifacial and the abducent nerves ; the facial and auditory nerves, and 
the auditory arteries; the vertebral arteries ; the glossopharyngeal, pneumo- 
gastric, and hypoglossal nerves ; the spinal cord at its superior end. The brain 
thus freed, pass the palm of the left hand to its base with two fingers into the 
posterior fossa of the cranium, and the palm of the right hand to the vertex sur- 
face, then withdraw the organ, in an anterior direction, from the cranium. Fol- 
low the spinal accessory nerve from its entrance into the cranium, by the 
foramen magnum, to its exit therefrom, by the posterior lacerated foramen. 
Recognize the superior end of the spinal cord. 
31. Interior of the Base of the Cranium, Plate 180.—Al- 
ter the removal of the brain from the cranium, the interior of 
its base presents the right and left anterior, middle, 
terior fos-sce, which are lined by the dura mater. 
32. Exits of Cranial Nerves at the Base of the Cranium. 
—The twelve pairs of cranial nerves leave the interior of the 
dura mater by foramina in the base of the cranium—olfactory, 
optic, auditory, facial, glossopharyngeal, pneumogastric, spinal 
accessory, and hypoglossal ; or by openings in the dura mater 
—oculomotor, trochlear, trifacial and abducent. The nerves 
of a side pass out, in order antero-posteriorly, as follows: INTERIOR OE THE BASE OF THE CRANIUM. 
325 
the Jirst or olfactory,'by filaments from its bulb, through 
the openings in the cribriform plate of the ethmoid bone; 
the second or optic by the optic foramen, at the apex or 
internal end of the posterior border of the anterior fossa 
of the cranium ; the third or ocidomotor, by an opening in 
the dura mater, externally to the anterior end of the basilar 
process of the occipital bone ; the fourth or trochlear, by an 
opening in the dura mater, at a point a little posteriorly and 
interiorly to the transit of the third ; the fifth or trifacial 
(a large sensory and a small motor root), by an opening in the 
dura mater, posteriorly to the transit of the fourth, and in- 
teriorly to the attachment of the tentorium cerebelli to the 
temporal bone; the sixth or abducent, by an opening in the 
dura mater, internally and interiorly to the transit of the 
fifth ; the seventh or facial and the eighth or auditory pass 
out by the meatus auditorius interims, at the posterior surface 
of the petrous portion of the temporal bone ; the ninth or 
glossopharyngeal, the tenth or pneumogastric, and the eleventh 
or spinal accessory by the anterior portion of the foramen 
lacerum posterius—a deficiency in the occipito-temporal articu- 
lation ; the twelfth or hypoglossal by the anterior condyloid 
foramen. 
33. Spinal Accessory IVerve.—This nerve, having its origin 
from the lateral surface of the cervical portion of the spinal 
cord (page 281, Plate 158), enters the cranium by the foramen 
magnum and leaves the same as described above. 
34. Spinal Cord.—The superior end of the spinal cord is 
seen, through the foramen magnum. 
35. Arteries of tlic Base of the Cranium.—Tile internal 
carotid arteries are projected, superiorly, at either side of the 
body of the sphenoid bone. At the foramen magnum the ver- 
tebral arteries enter the cranial cavity. The auditory arteries, 
leave the cranium by the meatus auditorius interims, right and 
left, with the auditory and facial nerves. 
Dissection.—With the curved scissors slit open the posterior and inferior 
portion of the superior longitudinal; also the lateral, the occipital, the superior 
petrosal, the cavernous, the transverse, the coronary, and the inferior petrosal 
sinuses, of one side, of the interior of the base of the cranium. Loop aside one 
of the stumps of an optic nerve and find the ophthalmic branch of the internal 
carotid artery. 326 
HEAD AND NECK. 
36. Venous Sinuses of tlie Cranium.—Antero-posteriorly, 
the following sinuses, of a side, present: the coronary (one 
half of it), at the superior surface of the body of the sphenoid 
bone, where it is located at one side of the pituitary body ; the 
cavernous, at the side of the body of the sphenoid bone—it re- 
ceives the ophthalmic vein from the orbit by the sphenoidal 
fissure ; the transverse (one-lialf of it), crossing one-half of tlie 
line of articulation of the basilar process of the occipital bone 
with the sphenoid bone; the superior petrosal, in the attach- 
ment of the tentorium cerebelli along the superior border of 
the petrous portion of the temporal bone, unites the cavernous 
with the lateral; the inferior petrosal, lodged in the anterior 
portion of the temporo-occipital articulation, unites the trans- 
verse with the lateral ; the lateral, posteriorly, along the line 
of occipital attachment of the tentorium cerebelli and, an- 
teriorly and interiorly, at the interior of the mastoid portion of 
the temporal bone ; the occipital unites the torcular Herophili 
with the terminus of the lateral. The superior longitudinal, a 
part of which was recognized at its median-line position (page 
319, Plate 179) in the convexity of the falx cerebri, empties, 
posteriorly, into the torcular Herophili; the inferior longitudi- 
nal has an antero-posterior course, and a median-line position 
in the edge of the concavity of the falx cerebri, ending at the 
anterior border of the tentorium cerebelli; tlie straight runs 
antero-posteriorly, in a median-line position, in the junction of 
the base of the falx cerebri with the superior surface of tlie 
tentorium cerebelli—it unites the posterior end of the inferior 
longitudinal sinus with the torcular Herophili. The torcidar 
Herophili is the meeting of the superior longitudinal, the right 
and left lateral, the right and left occipital (and tlie straight) 
sinuses, at the median-line junction of the falx cerebri and 
tentorium cerebelli, at the interior of the occipital bone. Tlie 
internal jugular vein, attached to the circumference of the ex- 
terior of the posterior portion of the foramen lacerum posterius, 
presents its orifice to receive the blood collected by the intra- 
cranial sinuses of a side of the cranium. 
37. Ophthalmic Artery—This artery is given off from the 
intracranial portion of the internal carotid artery ; it runs in- 
teriorly to, and into the orbit by the optic foramen with, the 
optic nerve (page 325). PLATE 177 
Jf ranch? 
of supra-1 
orbitfnf\ 
2(&\Co7MmctcZ 7za£zcr*z.rr? tie*. PLATE i 78 
FlG.l 
Fig. 2 
Antrdeep tcmporalart. J 
I,,, n n, 
T>o. :tr " /' 7i. / 
„ „ /, art. 
Cohn, ad- n aturam cZel. PLATE 179 
of 
Aodies 
23ranches of 
middle men- 
inpeal am. 
Jhr. (7ck aa a/ze 772 d cZ* PLATE 180 
Coronary sinus 
OpZitZtu1777ic art. 
Jnticarotzct art. . \ 
Transverse sinus \ ; 
Cavernous VX" 
'Is?, Otfactoeu 7?. 
'**&, Option. 
Ocitiornotor'71, 
/ -irt.,z,Trochlearn, 
/S*?}7>i/aciat,t. 
\ cff,Atctuceu£ 
\\ . n. 
-fn/Cpr/ro- 
sal sim/s' 
AsucZit off/ 
, art. 
Orifice of' ’ 
mtijufuZarix 
Torcultzr 
-Z-ierop/iiZi— 
-M.Cohn.era?naSirram cfsZ, TWENTY-FOURTH DISSECTION. 
SUPERFICIAL REGION OF THE FACE; ORBITAL CAV- 
ITY ; MIDDLE FOSSA OF THE CRANIUM; DEEP 
REGION OF THE FACE. 
SUPERFICIAL REGION OF THE FACE. 
Dissection.—Prepare the face for dissection as follows: remove all hair 
from the skin ; distend the nostrils with oakum; introduce oakum under the 
eyelids and suture their edges together ; close the teeth, insert oakum between 
them and the cheeks and lips, then suture the lips together. With the subject 
in position for dissection of the thorax and upper extremities (page 193), place 
the lateral surface of the head upon a block, and steady it in the position shown 
in Fig. 2, Plate 182. 
Terms of Relation.—These are the general terms (page 2); 
and the special terms antero-lateral—applied to the face—ex- 
terior and interior—relatively to the mouth and nostrils. 
Bones, and Bone Attachments of Muscles, Plate 181.—The 
osseous framework of the antero-lateral area of the face includes 
the following bones: for the cranial region, tli q frontal; for 
the upper jaw region, the nasal, superior maxillary, and 
malar ; for the lower jaw region, the inferior maxillary. The 
facial surfaces of all of these bones, except the nasal, afford 
attachments to muscles. 
Dissection.—Make tlie skin incisions 2, 3, 3, 3, and 4, 4, of Figure 14, 
(page 318) ; reflect a flaj) as indicated. Where the dissection of the scalp has 
preceded that of the face, skin incision 2 will have been made. Expose a layer 
of subcutaneous tissue. 
1. Subcutaneous Tissue.—A layer of subcutaneous tissue 
containing a variable quantity of fat, spreads over the antero- 
lateral area of. the face. 328 
HEAD AND NECK. 
Dissection.—Remove tlie subcutaneous tissue, with the curved scissors, so as 
to display the facial portion of the platysma myoides muscle and the risorius 
muscle. 
2. Platysma Myoides Muscle, Fig. 1, Plate 182.—The facial 
portion of this plane of muscle is projected, from the neck, 
over the border of the inferior maxillary bone—from the median 
line to a point posteriorly to the angle of the bone. Anteri- 
orly and interiorly to the symphysis of the bone, its internal 
fibres blend with those of its fellow of the opposite side, and 
some even cross the median line. Along the body of the bone 
some of its middle fibres are attached, while others with its 
external fibres continue, superiorly and internally, to the de- 
pressor anguli oris and orbicularis oris muscles, the fascia of 
the parotid region, and the zygomatic arch. 
3. Risorius Muscle.—This muscle consists of stray muscle 
fibres, which have a transverse course, from the surface of the 
facial portion of the platysma myoides muscle to their fusion 
with the orbicularis oris muscle, opposite the angle of the lips. 
Dissection.—Section tlie platysma myoides muscle, as in Fig. 2, Plate 182 ; 
reflect it and the risorius muscle, superiorly and internally, thereby exposing 
a thin fascia anteriorly to the facial muscles, etc. Clear off the fascia cover- 
ing the surfaces of the orbicularis oris (one half), depressor anguli oris, depres- 
sor labii inferioris (submental artery and vein), zygomaticus major, zygomati- 
cus minor, levator labii superioris alseque nasi, and orbicularis palpebrarum 
muscles. Find the nasal and frontal arteries, also the supratrochlear nerve. 
4. Orbicularis Oris Muscle, Fig. 2, Plate 182 ; and Plates 
183, and 184.—This is a median-line, sphincter, muscle of the 
lips—its superior and inferior portions are continuous across 
the median line, and at the angles of the lips with each other. 
It is located between the subcutaneous and submucous tissue 
planes of the lips. Certain facial muscles centre to, and blend 
with, it. 
5. Depressor Angull Oris Muscle, Plate 181 ; Fig. 2, Plate 
182; and Plate 183.—This muscle is attached: interiorly, to 
the anterior surface of the body of the inferior maxillary bone, 
near its inferior border, and within the area of the first molar 
and the bicuspid teeth (Plate 181); superiorly, it blends with 
the inferior portion of the orbicularis oris muscle, at the angle 
of the lips (Fig. 2, Plate 182). SUPERFICIAL REGION OF THE FACE. 
329 
6. Depressor Labii Iaaferioris Muscle.—This muscle is at- 
tached : interiorly, to the anterior surface of the body of the 
inferior maxillary bone—superiorly to the attachment of the 
last-described muscle, and interiorly to the mental foramen 
within the area of the bicuspid teeth (Plate 181) ; superiorly, it 
fuses with the orbicularis oris muscle (Fig. 2, Plate 182). The 
terminal portion of the submental artery is projected, from 
the neck, to its anterior surface (Fig. 2, Plate 182; and Plate 
183) or into its substance. 
7. Zygoinaticus Major Muscle, Plate 181 ; Fig. 2, Plate 
182.—This muscle is attached : superiorly and externally, to 
the external surface of the malar bone (Plate 181); interiorly 
and internally, it fuses with the superior portion of the orbi- 
cularis oris muscle, nearly opposite the angle of the lips (Fig. 
2, Plate 182). 
8. Zygoinaticus Minor Muscle.—This muscle passes from 
the external surface of the malar bone, at a point internally 
to the attachment of the last-described muscle (Plate 181) ; 
it runs parallel with, and internally to, the latter muscle, and 
blends with the superior portion of the orbicularis oris muscle 
(Fig. 2, Plate 182). 
9. Levator Labi! Su peri oris Alaeque Nasi Muscle.—This 
muscle is attached : superiorly, to the external surface of the 
nasal process of the superior maxillary bone (Plate 181); in- 
feriorly, it divides into an external part, which fuses with the 
superior portion of the orbicularis oris muscle, and an internal 
part, which is attached to the ala of the nose (Fig. 2, Plate 182). 
10. Orbicularis Palpebrarum Muscle, Plate 181 ; Pig. 2, 
Plate 182; and Plate 183.—This muscle has its bone attach- 
ment, at the internal border of the rim of the orbital fossa, to 
the nasal process of the superior maxillary bone and the in- 
ternal angular process of the frontal bone (Plate 181). Its 
fibres pass in concentric loops around the palpebral slit: the 
central ones, very thin, anteriorly to the tarsi of the eyelids ; 
the circumferential ones, thicker, encroaching, upon the cheek, 
interiorly, the malar region, externally, and the superciliary 
ridge, superiorly. 330 
HEAD AND NECK. 
Dissection.—Through tlio fascia, externally to the masseter muscle, see tho 
branches of the facial nerve—infra-orbital, buccal, and supramaxillary. Cut 
them out (Fig. 2, Plate 182) from the fascia, and follow them: externally, to 
the point where they disappear internally to, and at the border of, the jiarotid 
gland ; and internally, to their distribution to or passage posteriorly to the de- 
pressor anguli oris, orbicularis oris, and zygomaticus major muscles. Dissect 
out and follow (Fig. 2, Plate 182), superiorly and internally, the facial artery 
and vein (in tracing these vessels do not cut the branches of the facial nerve, 
which lie anteriorly to them). Clear the surfaces (Fig. 2, Plate 182) of por- 
tions of the pyramidalis nasi, compressor naris, levator labii superioris pro- 
prius, levator anguli oris, buccinator, and masseter muscles. Find and trace 
(Fig. 2, Plate 182) the superficial temporal artery, the auriculo-temporal nerve, 
the temporal (two) and malar (one) branches of the facial nerve, and the trans- 
verse facial artery, to the border of the parotid gland, internally to which they 
all pass. Dissect the fascia from the external surface of the parotid gland and 
follow (Fig. 2, Plate 182) its duct (Stenson’s), internally, to the point where it 
perforates the buccinator muscle. 
ll. Parotid Gland, Fig. 2, Plate 182 ; Plate 183 and Fig. 2, 
Plate 184.—The anterior portion of this gland is located exter- 
nally to the masseter muscle, parallel with, and inferiorly to, 
the zygomatic arch (zygoma of the temporal bone and the 
malar bone); its posterior portion is lodged, between the ramus 
of the inferior maxillary bone and the sternocleidomastoid 
muscle, and turns over the posterior border of, to the internal 
surface of, the ramus of the inferior maxillary bone. The 
posterior portion of the gland is in close relation with: the 
facial nerve ; the external carotid, superficial temporal, trans- 
verse facial, internal maxillary, and internal carotid arteries; 
the external jugular vein and its submaxillary anastomos- 
ing branch ; and the internal jugular vein. Its duct (Sten- 
son’s), is projected, internally, across the internal third of the 
masseter muscle, from which it is continued to its perforation 
of the buccinator muscle and buccal mucous membrane; it 
opens into the mouth, opposite the second molar tooth of the 
superior dental arch. 
Dissection.—Section (Fig. 2, Plate 182) Stenson’s duct; reflect the pa- 
rotid gland externally, and cut the gland so as to leave its posterior portion 
in situ. Trace (Plate 183) the branches of the facial nerve to the trunk of the 
nerve and to their distribution. Follow (Plate 183) the transverse facial artery 
to the superficial temporal, and that, in turn, to the bifurcation of the external 
caortid artery. (In exposing the trunk of the facial nerve and the bifurcation 
of the external carotid artery reflect the posterior and deep portions of the 
parotid gland, left in situ, and dissect the parts out of it.) SUPERFICIAL REGION OF THE FACE. 
331 
12. Facial Nerve, Plate 183.—This nerve emerges into the 
superficial region of the face, from between the parotid gland 
and the neck of the condyloid process of the inferior maxillary 
bone, where it winds anteriorly, externally to the superficial 
temporal artery—to reach this point the nerve, having left the 
cranium by tlie stylo-mastoid foramen (Plate 199), makes its 
way between or through portions of the parotid gland. As it 
appears on the face it divides into a eervico-facial and a tem- 
poro-facial division. The cervicofacial division distributes : 
to the neck (page 358) by the inframaxillary branch—to the 
platysma myoides muscle, etc.; to the face by the supramax- 
illary branch—to the depressor anguli oris, depressor labii in- 
ferioris, and levator mend muscles—and buccal branch—to the 
orbicularis oris and buccinator muscles. The temporofacial 
division supplies temporal branches (two) before described 
(page 319) and illustrated (Plate 177) ; a malar branch—to the 
orbicularis palpebrarum muscle ; and infraorbital branches 
(three) — the superior, supplies the zygomaticus major and 
zygomaticus minor muscles, the middle, longer, distributes to 
the levator anguli oris muscle, the inferior, the longest, sup- 
plies the levator labii superioris proprius, levator labii super- 
ioris alseque nasi, pyramidalis nasi, compressor naris, the dila- 
tator naris posterior, dilatator naris anterior, and depressor 
alse nasi muscles. 
13. Transverse Facial and Superficial Temporal Arteries, 
Fig. 2, Plate 182 ; and Plate 183.—The transverse facial artery 
(venae comites), branch of the superficial temporal, runs parallel 
with, and interiorly to, the zygomatic arch, between the parotid 
gland and the masseter muscle ; it projects internally to the 
gland (Fig. 2, Plate 182), parallel with, and superiorly to, Sten- 
son’s duct. The superficial temporal artery (vena comes) has 
a superior course, from the internal surface of the parotid 
gland (Fig. 2, Plate 182). It passes (Plate 183) internally to 
the facial nerve, and posteriorly to the neck of the condyloid 
process of the inferior maxillary bone, to its origin from the 
bifurcation of the external carotid artery. The transverse facial 
artery is given off from it, superiorly to the point where it is 
crossed by the facial nerve. 
14. External Carotid and Internal Maxillary Arteries, 
Plate 183; Fig. 2, Plate 184.—The external carotid presents at 332 
HEAD AND NECK. 
the level of, and posteriorly to, the neck of the condjdoid pro- 
cess of the inferior maxillary bone, where it bifurcates into the 
superficial temporal and internal maxillary arteries. The 
latter disappears, to the deep region of the face (page 348), 
posteriorly to the neck of the condyloid process. 
15. Auriculo-temporal Aerve: Fig- 2, Plate 182 ; Plate 183 ; 
Fig. 2, Plate 184.—This nerve has a superior course, to the 
scalp (page 320 ; Plate 177), between the superficial temporal 
artery and the auricle. It emerges from the deep region of the 
face, posteriorly to the temporo-maxillary articulation. 
Dissection.—Clear (Plate 183) the surfaces of the masseter and levator labii 
superioris proprius muscles. Expose (Plate 183) the facial portion of the facial 
vein ; also the same of the facial artery with its branches—inferior labial, in- 
ferior coronary, superior coronary, lateral nasal artery, and angular—which 
may be cut, where required, from out of their muscle beddings depressor 
anguli oris (orbicularis oris and levator labii superioris alaeque nasi muscles). 
Clear (Fig. 2, Plate 183), completely, the surfaces of the compressor naris and 
pyramidalis nasi muscles. 
16. Masseter Muscle, Plate 181 ; Fig. 2, Plate 182 ; and 
Plate 183.—This muscle is attached superiorly (Plates 181 and 
183), by two portions: an anterior, to the inferior border of the 
anterior part of the zygomatic arch ; and a posterior to the in- 
ferior border of the posterior part, and the internal surface of, 
the zygomatic arch. Inferiorly (Plates 181 and 183), the por- 
tions are attached as follows: the anterior passes, inferiorly 
and posteriorly, to the inferior part of the external surface of 
the ramus of the inferior maxillary bone ; tlic posterior bridges, 
inferiorly to the superior part of the external surface of the ra- 
mus, and the inferior portion of the external surface of the 
coronoid process of, the same bone. 
17. levator Labii Superiorly Propriiis Huscle*—Tllis mus- 
cle is attached : superiorly, interiorly to the inferior rim of 
the orbital fossa (Plate 181); interiorly, it blends with the mid- 
dle (of the half) of the superior portion of the orbicularis oris 
muscle (Plate 183), posteriorly to the zygomaticus minor mus- 
cle (Pig. 2, Plate 182). 
18. Facial Vein, Fig. 2, Plate 182, and Plate 183.—This 
vessel emerges from the posterior of the inferior portion of the SUPERFICIAL REGION OF THE FACE. 
333 
orbicularis palpebrarum muscle, and has an indirectly-oblique 
course, posteriorly to the zygomaticus major and minor mus- 
cles (Fig. 2, Plate 182), to the point where it passes anteriorly 
to the body of the inferior maxillary bone, into the subfascial 
plane of the neck (Plate 192). 
19. Facial Artery.—This artery is projected, from the neck 
(Plate 192), anteriorly to the body of the inferior maxillary 
bone, and internally to the facial vein. It has a superior and 
internal, tortuous, course to a point externally to the angle of 
the lips ; then, it is continued, superiorly to the superior lip, 
posteriorly to the zygomaticus major, zygomaticus minor, leva- 
tor labii superioris proprius, and levator labii superioris alseque 
nasi muscles (Fig. 2, Plate 182); finally, it runs, superiorly, 
upon the exterior of the lateral wall of the nose. 
20. Brandies of the Facial Portion of the Facial Artery. 
—These branches present, in order, as follows : an anastomos- 
ing branch passes, superiorly and posteriorly, to the transverse 
facial artery ; the inferior labial has an internal course to the 
inferior lip, posteriorly to the depressor anguli oris muscle; 
the inferior coronary is projected internally, in the submu- 
cous plane of the lip, and has a median-line anastomosis with 
its fellow of the opposite side ; the superior coronary passes, 
internally, in the same plane of the lip, and anastomoses, as 
does the inferior—it gives off the artery of the septum to the 
septum of the nostrils ; the lateral nasal artery runs, inter- 
nally, exteriorly to the fleshy portion of the nostril, to its me- 
dian line anastomosis with its-fellow of the opposite side ; the 
angular artery, the terminal branch of the facial, is located at 
the exterior of the superior portion of the nose, where it anasto- 
moses with the nasal branch of the ophthalmic artery (Plate 
183). 
21. Pyramitlalis IVasi Muscle.—This muscle is lodged exte- 
riorly to the nasal bone ; superiorly, it ends in the skin of the 
inferior portion of the frontal region ; interiorly, it blends with 
the superior border of the compressor naris muscle. 
22. Compressor Xaris Muscle, Plate 181 ; Fig. 2, Plate 182 ; 
Plate 188 ; Fig. 2, Plate 184 ; and Plates 187 and 188.—This 
muscle is attached : externally, to the anterior surface of the 334 
HEAD AND HECK. 
superior maxillary bone, externally to the osseous anterior 
naris, and superiorly to the eminence formed by the root of 
the lateral incisor tooth (Plate 181) ; its fibres pass over the 
fleshy portion of the nose and meet those of its fellow' of the 
opposite side at a median-line, fibrous, raphe. 
Dissection.—Section (Plate 183) the temporo-facial division of, and the 
buccal branch of the cervico-facial division of, the facial nerve, also the masseter 
muscle ; dissect away the branches of the nerve, and the superior portion of the 
muscle—in removing the latter find (Plate 184) the nerve and artery to the 
masseter muscle. Expose the external lateral ligament of the right temporo- 
maxillary articulation. 
23. Bferve and Artery of tlie Masseter Mu§cle, Fig. 2, Plate 
184.—This nerve and artery—branches, respectively, of the 
motor root of the fifth cranial nerve, and the internal maxillary 
artery—emerge from the deep region of the face, through the 
sigmoid notch of the inferior maxillary bone, to enter the in- 
ternal surface of the muscle. 
Dissection.—Dissect awftv (Plate 183) the stumps of the zygomaticus ma- 
jor, zygomaticus minor, levator labii superioris alaeque nasi muscles, and the 
levator labii superioris proprius muscle. Section (Plate 183) the facial vein, 
also the facial artery and its branches ; dissect away the superior portions of 
the two vessels. Display (Fig. 2, Plate 184), the infra-orbital nerve and artery 
and find the buccal branch of the inferior maxillary division of the sensory 
root of the trifacial nerve externally to the buccinator muscle ; clear the sur- 
faces of the buccinator and levator anguli oris muscles. 
21. Buccinator Muscle, Plate 181 ; Fig. 2, Plate 182 ; Plate 
183 ; Fig. 2, Plate 184.—This muscle of the intermaxillary 
region, forms the muscle plane of the cheek. It is attached, 
posteriorly and externally, to the superior and inferior maxil- 
lary bones, respectively, within the area of the molar teeth 
(Plate 181); also to a fibrous raphe, the pterygo-maxillary liga- 
ment (Plate*201), between it and the superior constrictor mus- 
cle of the pharynx. Its fibres converge anteriorly and in- 
ternally to fuse with the orbicularis oris muscle—opposite, 
superiorly to, and interiorly to the angle of the lips (Fig. 2, 
Plate 184). It is perforated, as before described (page 330), by 
Stenson’s duct of the parotid gland. 
25. Levator Angult Oris Muscle, Plates 181, 182, and 183 ; 
Fig. 2, Plate 184.—This muscle is attached: superiorly, to the SUPERFICIAL REGIOX OF THE FACE. 
335 
superior maxillary bone, externally to the infra-orbital foramen 
(Plate 181); inferiorly, it fuses with the superior portion of the 
orbicularis oris muscle, superiorly to the angle of the lips 
(Fig. 2, Plate 184). 
26. Infra-orbital Nerve, Fig. 2, Plate 184.—This nerve—the 
terminal branch of the superior maxillary division of the sen- 
sory root of the trifacial nerve—emerges to the superficial 
region of the face, at the infra orbital foramen; it presents a 
leash of nerves, which pass between the muscles of the superior 
maxillary region, to distribute to the skin of the cheek, su- 
perior lip, and nose. 
27. Infra-orbital Artery. — This artery (venae comites), 
branch of the internal maxillary artery in the deep region of the 
face, appears in the superficial region of the face, by the infra- 
orbital foramen ; it distributes to the contiguous muscles, etc., 
and anastomoses with the facial and nasal arteries. 
Dissection.—Section (Plate 183), and clear away, the superior portions of 
the depressor anguli oris and depressor labii inferioris muscles ; expose the 
mental nerve and artery, and the levator menti muscle. 
28. Mental Nerve.—This nerve, branch of the inferior den 
tal nerve within the dental canal of the inferior maxillary bone, 
is projected from the mental foramen (Plate 181), to distribute 
to the skin of the chin and inferior lip. 
29. Mental Artery.—This artery (venm comites), branch of 
the inferior dental artery within the dental canal, appears at 
the mental foramen, with the last-described nerve. 
30. Levator Menti Muscle, Plates 181, and Fig. 2, 184.— 
This small muscle is attached : superiorly, to the anterior sur- 
face of the body of the inferior maxillary bone inferiorly to the 
alveolus of the lateral incisor tooth (Plate 181); inferiorly, it 
fuses with the skin of the chin at the side of the median line 
(Fig. 2, Plate 184). 
Dissection.—Dissect away (Fig. 1, Plate 184), the orbicularis palpebrarum 
muscle, and display : the corrugator supercilii muscle ; the j>alpebral ligament; 
the tarsi of the eyelids ; and the internal and external tarsal ligaments. Cut 
cut the sutures from the borders of the eyelids and remove the oakum pos- HEAD AND NECK. 
teriorly to tliem. Demonstrate the conjunctival sacs—superior and inferior ; 
and the puncta lachrymalia—superior and inferior. Slit open the latter and 
expose the lachrymal canals—superior and inferior—and the lachrymal sac ; 
pass a probe into the nasal duct. 
31. Corrugator Supercilil Husclc.—This muscle is attached: 
internally, to the external surface of the internal angular pro- 
cess of the frontal bone ; externally, to the skin of the internal 
half of the eyebrow. 
32.—Palpebral Ligament and tlic Tarsi of tlie Eyelids, 
Plate 184.—The palpebral ligament is a fibrous membrane, 
which is attached to the osseous rim of the orbital aperture, 
and the tarsi of the eyelids ; it closes in the orbital cavity. 
The tarsi (formerly described as tarsal cartilages) are dense 
fibrous tissue plates (a superior and an inferior), which con- 
tinue the palpebral ligament into- the eyelids. They give 
the lids shape and form their framework—the superior one is 
the larger of the two. From the internal and external angles 
of the palpebral slit, special fibres of the palpebral ligament 
form the, so-called, internal and external tarsal ligaments. 
33. Conjunctiva and its Sacs, Fig. 1, Plate 184.—This is 
a layer of mucous membrane, continuous with the skin at the 
border of the eyelids, which lines the posterior surfaces of 
the tarsi of the latter and is reflected, circumferentially, from 
the tarsi to the anterior face of the globe of the This re- 
flection forms a superior and an inferior conjunctival sac. At 
the external part of the superior sac the orifices of the ducts 
from the lachrymal gland open. 
34. Lachrymal Puncla, Lachrymal Canals, Lachrymal 
Sac, and Nasal Duct.—Near the internal angle of the palpe- 
bral aperture, an opening presents at the border of either eye- 
lid—lachrymal puncla; these open into small canals, lach- 
rymal canals, which continue, internally, to the lachrymal 
sac; the latter is lodged in the lachrymal groove at the orbital 
face of the lachrymal bone. From it a canal, the nasal duct, 
passes, interiorly and a little posteriorly, to open into the in- 
ferior meatus of the nostril. 
Dissection.—Open the superior portion of the palpebral ligament and ex- 
pose (Fig. 2, Plate 184): the supra-orbital artery aud nerve; the frontal SUPERFICIAL REGION OF THE FACE. 
artery; the supratrochlear nerve ; the anterior portions of the levator palpe- 
brae superiors and obliquus superior muscles ; and the lachrymal gland. 
Dissect away the inferior portion of the palpebral ligament and display: the 
internal portion and anterior surface of the obliquus inferior muscle. Find 
and trace the nasal artery; and the infratroclilear nerve. 
35. Supra-orbital ATcrve and Artery, Fig. 2, Plate 182 ; 
Plates 183 and 184.—This nerve and artery pass out of the 
orbital cavity, by the supra-orbital notch or foramen (Plate 
181), to reach the frontal area of the scalp (page 319 ; Plate 177). 
36. Frontal and Nasal Arteries. — These arteries (venae 
comites) are the branches of bifurcation of the ophthalmic ar- 
tery at the internal side of the anterior of the orbit, inferiorly 
to the trochlea of the obliquus superior muscle. The frontal 
artery has a superior course to supply the frontal area of the 
scalp (page 318 ; Plate 177). The nasal artery runs, inferiorly 
and internally, to distribute to the exterior of the nose, and 
anastomose with branches of the facial and infra-orbital ar- 
teries, and with its fellow of the opposite side. 
37. Supratrochlear Nerve.—This nerve emerges from the 
orbit superiorly to the trochlea of the obliquus superior mus- 
cle ; has a superior course to the frontal area of the scalp 
(page 318 ; Plate 177) ; in its latter distribution it runs parallel 
with, and internally to, the frontal artery. 
38. Infratroclilear Nerve.—This nerve appears from the 
orbit, interiorly to the trochlea of the obliquus superior mus- 
cle. It distributes to the internal portion of the inferior eyelid 
and the nose. 
ORBITAL CAVITY. 
Dissection.—The anatomical elements in one orbit may be dissected consecu- 
tively, without carrying forward the dissection of the two ; but for the illustration 
of the parts contained in one orbit it is convenient to make counter-references to the 
dissected contents of both orbital cavities. 
Terms of Relation.—The general terms (Page 2) are used 
in the description of the dissection of the contents of this 
cavity. 
Bones, and Bone Areas of Muscle Attachments, Plate 
181.—The bones which form the walls of the orbital cavity 338 
HEAD AND NECK. 
are: the frontal (its horizontal portion); the ethmoid (its os- 
planum); the sphenoid (parts of its great and small wings); 
the malar ; the superior maxillary ; the palate (its orbital pro- 
cess) ; and the lachrymal. Of these the frontal, sphenoid, 
and superior maxillary afford attachments to muscles. The 
superior wall of the orbit, the horizontal portion of the frontal 
bone and the small wing of the sphenoid bone—together with 
the cribriform plate (one-lialf) of the ethmoid bone, form an 
anterior fossa (one side) of the interior of base of the cranium 
(page 324, Plate 180). 
Dissection.—Detach the periosteum of the superior border of the orbital 
cavity; introduce the handle of a scalpel between the periosteum and the bone 
of the superior wall of the orbit, and peel the former from the latter. Saw 
along the section lines (Fig. 2, Plate 184), through the supra-orbital portion of 
the frontal bone; then make, with the chisel and mallet a V-shaped cut 
through the roof of the orbit (Plate 180), and remove it with the supra- 
orbital portion of the frontal bone. Introduce the end of a blowpipe into the 
eyeball and inflate it. Cut open, the superior periosteal lining of the orbit, 
and expose by removing the adipose tissue surrounding them, portions of the 
following parts (Plate 185, right orbit): the frontal nerve and its branches; 
the trochlear nerve; the supra-orbital artery; the lachrymal artery and nerve ; 
the lachrymal gland ; the levator palpebrse superioris, obliquus superior and 
a portion of the rectus superior muscles. 
1. Frontal IVerve, Plate 185 (right orbit).—This nerve lias 
an anterior course through the orbit, at first superiorly to, and 
then internally to, the levator palpebrse superioris muscle. It 
bifurcates into the supra-orbital and supratrochlear nerves, 
which continue, anteriorly, into the superficial region of the 
face to reach the frontal area of the scalp, as described (page 
337) and illustrated (Plate 184). 
2. Trochlear Werve.—This nerve perforates the dura mater 
(page 325 ; Plate 180), runs externally to the cavernous sinus, 
and enters the orbit by the sphenoidal fissure. Its orbital por- 
tion has an anterior and internal course, internally to the pos- 
terior part of the frontal nerve, to the point where it enters the 
posterior half of the postero-anterior portion of the obliquus 
superior muscle. 
3. Supra-orbital Artery. — This artery (vena comes), a 
branch of the ophthalmic, has an anterior course, parallel with, ORBITAL CAVITY. 
339 
and internally to, the frontal and supra-orbital nerves, to leave 
the orbit with the latter nerve (page 837 ; Fig. 2, Plate 184). 
4. Lachrymal Artery and Merve.—The anterior portions of 
this artery (vena comes) and nerve have an anterior course, 
through the superior and external portion of the orbit, to sup- 
ply the lachrymal gland. 
5. Lachrymal Gland, Fig. 2, Plate 184 ; Plate 185.—This 
small glandular body is located at the anterior, and superior- 
external portion, of the orbital cavity. It is lodged between: 
the globe of the eye and its external rectus muscle, interiorly ; 
the frontal bone, superiorly ; and the conjunctiva, anteriorly. 
6. Levator Palpeforae Superioris Muscle, Plate 181 ; Fig. 
2, 184 ; and Plate 185.—This mnsele is attached: posteriorly, 
to the orbital surface of the small wing of the sphenoid bone, 
superiorly to the optic foramen ; anteriorly, to the superior 
border of the tarsus of the superior eyelid. It widens as it 
advances anteriorly. 
7. Obltquus Superior muscle.—This muscle lias four por- 
tions : the postero-anterior, the transverse, the mid-tendon, 
and the trochlea. The jpostero-anterior portion is attached : 
posteriorly, to the orbital surface of the small wing of the 
sphenoid bone, internally and superiorly to the optic foramen ; 
anteriorly, it ends in the mid-tendon. The transverse portion 
extends, almost at a right angle to the postero-anterior portion, 
from the mid-tendon to the anterior, antero-posterior, attach- 
ment of the muscle to the sclerotic coat of the eyeball, interi- 
orly to the rectus superior muscle. The mid-tendon is round 
and is common to the two muscle portions. The trochlea is a 
loop of fibrous tissue, which is attached to the orbital surface 
of the frontal bone—at the trochlear fossa ; within it the mid- 
tendon plays. 
Dissection.—Chisel away (according to the section lines on the right 
side of Plate 185) the internal portion of the left small wing of the sphenoid 
bone (pick out, with the forceps, the pieces of bone). Expose, with the sharp 
pointed curved scissors (Plate 185, left side), the transit into the orbit of the 
optic nerve, ophthalmic artery, trochlear nerve, oculo-motor nerve, and the 
ophthalmic division of the sensory root of the trifacial nerve. Cut (as in 
Plate 185, right side) the frontal nerve and supra-orbital artery, and dissect 340 
HEAD AND NECK. 
away their anterior portions. Section (as in Plate 185, right side) the lach- 
rymal artery and nerve ; remove their anterior portions, carrying away the 
lachrymal gland. Cut (Plate 185, left orbit) the levator palpebrae superioris 
muscle ; dissect away its anterior portion, together with the tarsus of the su- 
perior eyelid. Expose (Plate 185, left side) the trochlear nerve, from its in- 
tracranial portion to the obliquus superior muscle. Demonstrate (Plate 185, 
left side) the intra-orbital fibrous ring, which surrounds the posterior ends of 
the intra-orbital muscles, vessels, and nerves. Clear the superior surfaces of 
the rectus superior muscle and the globe of the eye. Removing more fat from 
the orbit, display anterior portions of: the ophthalmic vein and artery, and 
the nasal nerve. 
8. Intra-orbital Fibrous Ring, Plate 185 (left side).—At 
the circumference of the intra-orbital face of the sphenoidal 
fissure and optic foramen, a ring of fibrous tissue presents, 
from which the intra-orbital muscles diverge, and through 
which vessels and nerves pass. 
9. Ophthalmic Division of the Sensory Root of the Tri- 
facial Nerve, Plates 185 and 186.—This division of the trifacial 
nerve is projected, anteriorly and a little superiorly, from the 
Gasserian ganglion of the sensory root of the nerve, to the 
point where it passes from the cranium into the orbit, by the 
sphenoidal fissure. As it enters the fissure it bifurcates into 
a superior—the frontal nerve—and an inferior—the nasal 
nerve—branch. The frontal nerve (page 388) gives off the 
lachrymal nerve (page 339) ; the two pass into the orbit supe- 
riorly to the intra-orbital fibrous ring. The nasal nerve (page 
342) enters the orbit through the ring. 
10. Rectus Superior Muscle, Plates 181 and 185.—This 
muscle runs postero-anteriorly, and is located inferiorly to the 
levator palpebne superioris muscle. It is attached: posteriorly, 
to the orbital surface of the small wing of the sphenoid bone, 
between the optic foramen and the posterior attachment of the 
levator palpebne superioris muscle ; anteriorly, to the superior 
area of the sclerotic coat of the eyeball, near the circumference 
of the cornea. 
11. Ophthalmic Vein, Plate 185.—This commences at the 
internal part of the anterior of the orbital cavity, the con- 
fluence of the comites veins of the frontal and nasal arteries. 
It runs obliquely, posteriorly to the eyeball, to the exter- 
nal side of the posterior third of the rectus superior raus- ORBITAL CAVITY. 
341 
cle ; then it is projected posteriorly, between the posterior at- 
tachments of the rectus externus muscle, and through the 
inferior portion of the sphenoidal fissure, to empty into the 
cavernous sinus (Plate 180). In its intra-orbital course it re- 
ceives the comites veins of all the branches of the ophthalmic 
artery. 
Dissection.—Section (Plate 185, left side) the ophthalmic division of the 
sensory root of the trifacial nerve and its nasal branch, also, the rectus superior 
and obliquus superior muscles. Dissect away the portions of the nerve and mus- 
cles included between the sections of them. Section (Plate 185, left orbit) the 
intra-orbital fibrous ring : reflect the internal portion of the ring with the pos- 
terior attachments of the levator palpebrse superioris and obliquus superior mus- 
cles ; dissect away the external portion, carrying, externally, the superior attach- 
ment of the rectus externus muscle (Plate 186, left orbit). Remove the 
ophthalmic vein, antero-posteriorly. Trace the abducent nerve from its intra- 
cranial stump to its point of entrance into the rectus externus muscle (Plate 
186, left side). Find the ophthalmic ganglion—by cutting away a portion of 
the branch of the ophthalmic artery to the rectus externus muscle—bedded in 
fat, between the rectus externus muscle and the optic nerve (Plate 186, left 
orbit) ; trace its motor root (to the oculomotor nerve), its sensory root (to the 
nasal nerve), and its anterior branches. Follow (Plate 186, left orbit) the ocu- 
lomotor nerve from the cranium into the orbit; find and trace its superior 
branch; also its inferior branch, to the point where it disappears. Track 
(Plate 186, left orbit) the nasal nerve and its branches, also the ophthalmic 
artery and its branches. Display the optic nerve from the cranium to its en- 
trance into the eyeball (Plate 186, left side). Clear (Plate 186, left orbit), 
partially, the superior surfaces of the rectus externus and rectus internus mus- 
cles. 
19. Abducent IVervc, Plates 185 and 186.—This nerve, the 
sixth cranial, perforates the dura mater (page 325 ; Plate 180), 
to run interiorly to the cavernous sinus, and the ophthalmic 
division of the sensory root of the trifacial nerve (Plate 185, 
left side); it finally passes from the cranium into the orbit, by 
the sphenoidal fissure. Its intra-orbital course is, between the 
posterior attachments of the rectus externus muscle, directly to 
the internal surface of that muscle. 
13. Ophthalmic Ganglion, Plate 186 (left orbit). — This 
ganglion is bedded in adipose tissue, internally to the pos- 
terior portion of the rectus externus muscle. It presents as a 
bead-like, shining, reddish body. From it a short branch can 
be traced to the inferior branch of the oculomotor nerve (motor 
root), and a second, longer one, to the nasal nerve (sensory 342 
HEAD AND NECK. 
root). Anteriorly, from it, a variable number of branches (very 
delicate) are given off—the short ciliary nerves-^-which pass 
to enter the posterior surface of the eyeball (Plate 186, left 
orbit, shows two of the larger of these nerves). 
14. Oculomotor iVerve, Plates 185 and 186.—This nerve, 
the third cranial, leaves the interior of the dura mater (page 
325); it is continued, anteriorly, externally to the cavernous 
sinus, and is projected from the cranium into the orbit by the 
sphenoidal fissure. Its intra-orbital portion passes between the 
posterior attachments of the rectus externus muscle. A supe- 
rior branch supplies the rectus superior and the levator palpe- 
brse superioris muscles. Its inferior branch gives off the motor 
root of the ophthalmic ganglion, and continues to its disap- 
pearance inferiorly to the optic nerve (Plate 186, left orbit). 
15. Xasal Werve and its Branches, Plates 185 and 186 (left 
orbits).—This nerve, a branch of the ophthalmic division of the 
sensory root of the trifacial nerve (Plate 185, left orbit), is pro- 
jected, anteriorly into the orbit, through the sphenoidal fissure. 
Its intra-orbital portion passes between the posterior attach- 
ments of the rectus externus muscle; and crosses, internally, be- 
tween the ophthalmic artery and the optic nerve. Its branches 
are : the sensory root of the ophthalmic ganglion, which runs, 
anteriorly, to the ganglion, externally to the optic nerve. As it 
crosses between the optic nerve and the ophthalmic artery, it 
gives off the long ciliary nerves, which run parallel with, and 
superiorly to, the optic nerve, to enter the posterior of the eye- 
ball. At the internal side of the orbit it gives off the infra- 
trochlear branch, which is projected, anteriorly, to its emer- 
gence, in the superficial region of the face (page 337 ; Plate 184), 
interiorly to the trochlea of the obliquus superior muscle. The 
nasal nerve leaves the orbit by the anterior ethmoidal foramen, 
by which it enters the cranium; its intra-cranial portion runs, 
anteriorly, upon the superior surface of the cribriform plate 
of the ethmoid bone (Plate 186), to the point where it passes 
out of the cranium, at the side of the crista galli of the ethmoid 
bone, into a nasal cavity. 
16. Ophthalmic Artery and its Branches, Plates 180, 185, 
and 186.—This artery, a branch of the internal carotid (page 
326; Plate 180) passes, with the optic nerve, from the cranial ORBITAL CAVITY. 
343 
cavity to tlie orbit, by the optic foramen. The posterior of its 
intra-orbital portion curves internally, to cross superiorly to 
the optic nerve; it then advances, obliquely, to the internal side 
of the anterior portion of the orbit, where it terminates by 
bifurcation, inferiorly to the trochlea of the obliquus superior 
muscle. Its branches are : the superior and inferior muscu- 
lar to the intra-orbital muscles; the supra-orbital before de- 
scribed (page 338) and illustrated (Plate 185, right orbit) ; the 
ciliary, which run anteriorly, superiorly to the optic nerve, to 
enter the posterior of the eyeball; the posterior and the anterior 
ethmoidal, which leave the orbital cavity, at its internal wall, 
by the posterior and the anterior ethmoidal foramen, respec- 
tively ; at its terminus it bifurcates into the frontal and nasal 
arteries (page 337 ; Plate 184). 
17. Optic Nerve, Plate 186 (left side).—This, the second 
cranial nerve, leaves the cranial cavity, with the ophthalmic 
artery, by the optic foramen, and enters the posterior or apex 
of the orbit. Its intra-orbital portion advances anteriorly, and a 
little externally, to its entrance into the eyeball, at its posterior 
surface. As lodged it is surrounded by fat, in which arteries 
and nerves run parallel with it—the ciliary (pages 841 and 342). 
18. Rectus Extermis Muscle, Plates 181 and 185.—This 
muscle is attached : posteriorly, to the orbital surface of the 
small wing of the sphenoid bone, externally to the optic fora- 
men (superior head), and at the inferior border of the sphenoidal 
fissure (inferior head) ; anteriorly, at the external area and to 
the sclerotic coat, of the eyeball, near the cornea. 
Dissection.—Cut tlie following parts, (Plate 186, left orbit): the oph- 
thalmic artery; the motor root of the'ophthalmic ganglion ; the nasal nerve ; 
also tlie ciliary arteries and nerves as they enter the eyeball (as in Plate 186, 
right side). Dissect away tlie ophthalmic ganglion, nasal nerve, and ophthal- 
mic artery. In removing the artery find the arteria centralis retinae, and cut it 
near its entrance into the optic nerve (Plate 186, right orbit). Cut the optic 
nerve (Plate 186, right orbit), and remove the included portion. Section 
the rectus externus muscle (Plate 186, right orbit) and dissect away its 
anterior portion. Tilt the eyeball (by a loop of thread), anteriorly and inte- 
riorly ; trace the inferior branch of the oculomotor nerve; clear the surfaces 
of the rectus internus, rectus inferior, and obliquus inferior muscles. 
19. Arteria Centralis Retinae, Plate 186 (right orbit).—This 
small artery, a branch of the ophthalmic—opposite the anterior 344 
HEAD AND NECK. 
portion of the optic nerve—enters the nerve a short distance 
from the posterior of the eyeball. 
20. Oculomotor Nerve.—This nerve was partly described 
(page 342); its inferior branch is now seen distributing branches 
to the rectus internus, rectus inferior, and obliquus inferior 
muscles. 
21. Rectus Interims Muscle, Plates 181 and 186.—This mus- 
cle, at the internal wall of the orbit, is attached: posteriorly, 
to the orbital face of the small wing of the sphenoid bone, in- 
ternally to the optic foramen ; anteriorly, at the internal area, 
and to the sclerotic coat, of the eyeball, near the cornea. 
22. Rectus Inferior Muscle.—This muscle, at the inferior 
wall of the orbit, is attached: posteriorly, to the orbital face 
of the small wing of the sphenoid bone, interiorly to the optic 
foramen ; anteriorly, at the inferior area, and to the sclerotic 
coat, of tile eyeball, near the cornea. 
23, Obliquus Inferior Muscle, Plate 181 ; Fig. 2, Plate 
184 ; Plates 185 to 188, inclusive.—This muscle is located at 
the inferior of the anterior portion of the orbit (Fig. 2, Plate 
184), its internal attachment is to the internal and anterior 
portion of the orbital surface of the superior maxillary bone 
(Plates 181,187, and 188). It winds around the eyeball, inte- 
riorly to the anterior end of the rectus inferior muscle, and be- 
tween the anterior part of the rectus externus muscle and the 
eyeball. Externally it has an antero-posterior attachment to 
the sclerotic coat of the eyeball, at the external surface of its 
mid-portion. 
MIDDLE FOSSA OF THE CRANIUM. 
Dissection.—Either the right or left middle fossa of the interior of the cra- 
nium may be dissected consecutively, but for purposes of illustration both fossce are 
dissected and utilized for counter-references. 
Terms or Relation—The general terms (page 2) will suffice 
to locate the parts in this dissection. 
Bones of a middle Fossa of the Cranium, Plates 180, 181, 
185, 186, and 199.—Portions of the following bones contribute 
to a middle fossa of the base of the cranium (page 324 ; Plate MIDDLE FOSSAE OF THE CRANIUM. 
345 
180): the sphenoid (superior and lateral surfaces of its body, a 
great wing, and a small wing); the temporal (anterior surface 
and apex of its petrous portion). It communicates with : the 
orbit, by the sphenoidal lissure and optic foramen (Plate 181); 
the deep region of the face (Plate 199) by the foramen rotun- 
dum, foramen ovale, and foramen spinosum; with the aque- 
ductus Fallopii, by the hiatus Fallopii. 
Dissection.—Peel the dura mater from the interior of a middle fossa of 
the cranium, and expose (Plate 185, left side) the following parts : the stumps 
of the motor and sensory roots of the trifacial nerve ; the Gasserian ganglion, 
with the ophthalmic, superior maxillary, and inferior maxillary divisions of the 
sensory root of the same nerve; the middle meningeal artery; the large 
superficial petrosal and external superficial petrosal nerves. 
1. Trifacial IVerve: its Gasserian Ganglion; Divisions of 
its Sensory Root; and its Motor Root, Plates 185 and 186.— 
The motor and sensory roots of the trifacial nerve pass, ante- 
riorly, superiorly to the superior border of the internal end of 
the petrous portion of the temporal bone. The Gasserian gan- 
glion, of the sensory root of the trifacial nerve, is located on 
a depression at the anterior surface of the apex of the petrous 
portion of the temporal bone. From the anterior of the 
ganglion the three divisions of the sensory root of the nerve are 
given off : the ophthalmic, the superior maxillary, and the in- 
ferior maxillary. The ophthalmic division has been described 
(page 840) and illustrated (Plates 185 and 186, left sides); the 
superior maxillary division is projected, anteriorly, to its 
emergence from the cranium, to the spheno-palatine fossa of 
the deep region of the face, by the foramen rotundum in the 
great wing of the sphenoid bone ; the inferior maxillary di- 
vision passes, inferiorly, out of the cranium, to the deep region 
of the face (Plate 188), by the foramen ovale in the great wing 
of the sphenoid bone. 
The motor root of the trifacial nerve runs, inferiorly to the 
Gasserian ganglion, to the foramen ovale, where it leaves the 
interior of the cranium to enter the deep region of the face 
(Plate 188) with the inferior maxillary division of the sensory 
root of the nerve. 
2. Middle Meningeal Artery. — This artery enters the 
cranium, from the deep region of the face (Plate 188), by the 
foramen spinosum in the great wing of the sphenoid bone. Its 346 
HEAD AND NECK. 
intracranial portion has a superior course toward the vertex 
area of the head (Plate 179), between the dura mater and the 
lateral osseous wall of the cranium. 
3. External Superficial Petrosal Nerve. — This nerve, 
branch of the geniculate ganglion of the facial nerve, enters 
the interior of the cranium by a small foramen in the anterior 
wall of the petrous portion of the temporal bone. It lias a 
short intracranial course, between the dura mater and bone, to 
the middle meningeal artery, where it communicates with the 
sympathetic nerve plexus upon that arter}^. 
Dissection.—Section (as on right side of Plate 186) the right superior max- 
illary and inferior maxillary divisions of the sensory root of the trifacial 
nerve ; dissect away the ganglion and portion of the motor root of the nerve. 
Expose the intracranial portions of the internal carotid artery, and the large 
superficial petrosal nerve (Plate 186, right side). 
4. Internal Carotid Artery.—The intracranial portion of 
this artery emerges into the interior of the cranium (Plate 
180, right side) from the internal orifice of the carotid canal, at 
the apex of the petrous portion of the temporal bone ; thence 
it is projected, superiorly, at the lateral surface of the body of 
the sphenoid bone. It gives olf the ophthalmic and posterior 
communicating arteries, and then bifurcates into the middle 
and anterior cerebral arteries. (In the removal of the brain, 
etc., from the interior of the cranium (page 324), the internal 
carotid arteries, the right and the left, are cut between the 
giving off of their ophthalmic and posterior communicating 
branches; therefore, the latter branches and the bifurcations 
of these arteries are removed with, and are described with, the 
brain.) 
5. Earge Superficial Petrosal Nerve.—This nerve, branch 
of the geniculate ganglion of the facial nerve—lodged in the 
aqueductus Fallopii of the petrous portion of the temporal 
bone—emerges into the interior of the cranium by the hiatus 
Fallopii, at the anterior surface of the petrous portion of the 
temporal bone. Its intracranial portion runs, internally and 
anteriorly, between the dura mater and the bony floor of the 
middle fossa of the cranium. It passes interiorly to the Gas- 
serian ganglion of the trifacial nerve, and the internal carotid 
artery to reach the foramen lacerum medium—a triangular de- DEEP REGION OF THE FACE. 
347 
ficiency in the base of the cranium, which is bounded by the 
apex of the petrous portion of the temporal bone, externally, 
the basilar process of the occipital bone, posteriorly and inter- 
nally, and the root of the pterygoid process of the sphenoid 
bone, anteriorly. At this point it is joined by the large deep 
petrosal nerve from the sympathetic nerve upon the internal 
carotid artery ; the two form the Yidian nerve, which passes, 
anteriorly, by the Yidian canal, to the splieno-palatine fossa 
of the deep region of the face. 
DEEP EEGION OF THE FACE. 
Dissection.—The deep region of the right side of the face may he dissected 
consecutively to its superficial region, but in order to illustrate, undisturbed, the 
pharynx with its contiguous vessels and nerves, the right side is resei'ved for the 
same, and the deep region of the face is illustrated on the left side. 
Terms of Relation.—The general terms (page 2), are used 
in locating the parts in this dissection. 
Bones, and Bone Areas of Muscle Attachments, Plates 
190 and 199.—Tlie bones forming the walls of this region are : 
internally, the superior maxillary (the postero-external sur- 
face of the body), and the sphenoid (the plates of one its 
pterygoid processes); superiorly, the sphenoid (one of its great 
wings), and the temporal (inferior face of its petrous portion); 
externally, the inferior maxillary (one of its rami), the tem- 
poral (its zygoma), and the malar; posteriorly, the three 
superior cervical vertebra (the anterior of their transverse pro- 
cesses). All of these bones, except the cervical vertebrae, afford 
attachments to muscles of the region. Internally, the region 
is walled by the superior portion of the pharynx, and the pil- 
lars and tonsil of the soft palate. 
Dissection.—The dissection of the superficial region of the left antero- 
lateral area of the face should be made, according to the steps detailed (pages 
327 to 337, inclusive), and the illustrations (Plates 181 to 184, inclusive), given 
for the right. Saw the left zygomatic arch along lines similar to those shown 
in Fig. 2, Plate 184—through the malar bone and the zygoma of the temporal 
bone—and remove the included portion of bone. Clear the external surface 
of the inferior portion of the left temporal muscle, and follow the same to its 
inferior attachment. 348 
HEAD AND NECK. 
1. Temporal muscle, Plate 181 ; Fig. 2, Plate 184.—The 
superior portion of this muscle was before described (page 321) 
and illustrated (Plate 178). Its inferior portion is lodged inter- 
nally to the zygomatic arch, and is attached to the coronoid 
process of the inferior maxillary bone (Fig. 2, Plate 184). 
Dissection.—Preserving (Fig. 2, Plate 184), tlie stumps of the deep tem- 
poral arteries and nerves, of the masseteric artery and nerve, and of the buccal 
nerve, cut away the inferior portion of the temporal muscle from the coro- 
noid process of the inferior maxillary bone. Saw the inferior maxillary bone 
along lines similar to those shown in Fig. 2, Plate 184—at the neck of the 
condyloid process, and through the ramus inferiorly to the level of Stenson’s 
duct. (Saw partly through the bone with a small saw, and complete the sec- 
tion with bone forceps). Dissect away the included piece of bone ; also, the 
posterior part of the parotid gland. Cut away the skin posteriorly to the ra- 
mus of the inferior maxillary bone (Plate 187), and display: portions of the 
digastric (posterior belly) and stylo-liyoid muscles ; and the superior part of 
the external carotid artery. Trace (Plate 187) the internal maxillary aitery 
from its origin, internally ; find its several branches. Follow (Plate 187) the 
temporal nerves inferiorly, and buccal and masseteric nerves superiorly, to 
the points where they perforate or pass posteriorly to the external pterygoid 
muscle. Expose (Plate 187) the following parts : the external surface of the 
temporo-maxillary articulation ; the anterior surface of the external pterygoid 
muscle ; portions of the gustatory, inferior dental, and mylohyoid nerves ; 
and part of the external surface of the internal pterygoid muscle. 
2. Internal Maxillary Artery, Plates 187 and 188.—This ar- 
tery (venae coinites), one of the branches of bifurcation of the 
external carotid artery, passes between the condyloid process 
of the inferior maxillary bone, anteriorly, and the internal 
lateral ligament, posteriorly, to enter the deep region of the 
face. It has an anterior and internal course, externally to 
the external pterygoid muscle, to the point where it enters 
the splieno-palatine fossa (Plate 188). 
a. Brandies of tlie Internal Maxillary Artery, — Tile 
branches of this artery present in order, from its origin inter- 
nally, as follows : the deep auricular, the tympanic, the mid- 
dle meningeal, and the small meningeal have a superior 
course—the first to the external ear, the second to the middle 
ear, the third and fourth to the interior of the cranium ; the infe- 
rior dental is projected interiorly, to enter the inferior dental 
foramen of the inferior maxillary bone; the anterior deep 
temporal and the posterior deep temporal (page 322 ; Fig. 2, DEEP REGION OF THE FACE. 
349 
Plate 178, and Fig. 2, Plate 184), the masseteric (Fig. 2, Plate 
184), and the pterygoid (two or more), distribute superiorly and 
inferiorly to the corresponding muscles ; the buccal has an 
inferior course to the cheek ; the alveolar runs anteriorly, giv- 
ing off the (two) posterior dental arteries—which enter canals 
in the external wall of the superior maxillary bone, to dis- 
tribute to the molar and bicuspid teeth, of one side, of the 
superior dental arch—and continues to the alveolar process 
and gums of the superior dental arch ; the infraorbital is pro- 
jected anteriorly, and a little superiorly, to enter the posterior 
end of the infraorbital canal (Plate 181) in the floor of the 
orbit, where it gives off the anterior dental, before emerging 
to the superficial region of the face by the infra-orbital fora- 
men—the anterior dental nerve passes through a canal in the 
anterior wall of the superior maxillary bone, to supply the 
canine and incisor teeth, of one side, of the superior dental 
arch. 
4. Buccal tterve, Plate 187.—This nerve, branch of the in- 
ferior maxillary division of the sensory root of the trifacial 
nerve, emerges from between the superior and inferior portions 
of the external pterygoid muscle: it has an inferior course to 
distribute to the cheek. 
Dissection;—Section (Plate 187) the internal maxillary artery and its 
alveolar branch ; remove the portion of the vessel included between the cuts. 
Expose the external pterygoid muscle. Dissect away the left condyloid pro- 
cess of the inferior maxillary bone, demonstrating thereby the following parts : 
the external lateral and capsular ligaments (Plate 187), and the interarticular 
fibro-cartilage (Fig. 2, Plate 188) of the temporo-maxillary articulation ; also 
the posterior attachments of the external pterygoid muscle. Cut away the 
interarticular fibro-cartilage, and expose, completely, the internal lateral liga- 
ment of the temporo-maxillary articulation (Fig. 1, Plate 188). 
5. Temporo-maxillary Articulation, Fig. 2, Plate 184; 
Plates 187, 188, and 190.—The anatomical elements of this 
articulation are : bones, ligaments, interarticular fibro-carti- 
lage, articular cartilage and synovial membrane. 
The bones are : the temporal, by the glenoid cavity (Fig. 1, 
Plate 188) of its squamous portion ; and the inferior maxil- 
lary, by its condyloid process. 
The ligaments are : the external lateral (Fig. 2, Plate 184 ; 
and Plate 187), from the anterior portion of the external sur- 350 
HEAD AND NECK. 
face of the neck of the condyloid process of the inferior max- 
illary bone to the zygoma of the squamous portion of the 
temporal bone; the capsular (Plates 187 and 190), from the 
border of the articular surface of the condyloid process to the 
circumference of the glenoid cavity, and, intermediately, to 
the circumference of the interarticular fibro-cartilage (Fig. 2, 
Plate 188) ; the internal lateral (Plate 187 ; Fig. 1, Plate 188 ; 
Plate 190), which passes from the internal border of the infer- 
ior dental foramen (at the internal surface of the ramus) to the 
spine of the sphenoid bone (Plate 199)—it is located internally 
to : the posterior end of the external pterygoid muscle, the 
auriculo-temporal nerve, the internal maxillary, middle menin- 
geal, and inferior dental arteries, and the inferior dental nerve; 
'the stylo-maxillary (Plate 190), from the posterior border of 
the inferior portion of the ramus of the inferior maxillary bone 
to the styloid process of the petrous portion of the temporal 
bone. 
The interarticular fibro-cartilage (Fig. 2, Plate 188), is 
lodged between the articular surfaces of the articulation and 
determines a superior and an inferior cavity to the joint. 
The articular cartilage and synodal membrane are dis- 
posed as with movable joints in general (page 11). 
6. External Pterygoid Mu§cle, Plate 187; Fig. 2, Plate 
188 ; Plates 190 and 199.—This muscle, having a superior and 
an inferior portion, has an antero-posterior course. Its supe- 
rior portion is attached : anteriorly, to the exterior surface of 
the great wing of the sphenoid bone (Plate 190); posteriorly, 
to the internal border of the interarticular fibro-cartilage of 
the temporo-maxillary articulation (Fig. 2, Plate 188). Its 
inferior portion is attached: anteriorly, to the external sur- 
face of the external plate of the pterygoid process of the 
sphenoid bone ; posteriorly, to the internal surface of the neck 
of the condyloid process of the inferior maxillary bone (Plate 
199). 
Dissection.—Dissect away the external pterygoid muscle from its anterior 
attachments; find and preserve its nerve. Remove a portion of adipose tissue 
from the external surface of, and superiorly to, the internal pterygoid muscle. 
Trace (Fig. 1, Plate 188) the deep temporal (anterior and posterior), buccal, 
masseteric, external pterygoid, auriculo-temporal, inferior dental, and gusta- 
tory nerves to their origin from the inferior maxillary division of the sensory DEEP REGION OF THE FACE. 
351 
root and the motor root of the trifacial nerve, in the deep region of the face. 
Find (Fig. 1, Plate 188) the nerve to the internal pterygoid muscle from the 
trifacial nerve ; also, the chorda tympani nerve (Fig. 1, Plate 188) at its junction 
with the gustatory nerve; follow the latter, superiorly and externally, to the 
Glasserian fissure of the glenoid cavity of the inferior maxillary bone. Expose 
the middle and small meningeal arteries (Fig. 1, Plate 188) from their origins 
to their entrances into the cranium. 
7. Inferior Maxillary Division of the Sensory Root, and 
the Motor Root, of the Trifacial Kerve, Plate 188.—The intra- 
cranial portions of this division of the sensory root, and the 
motor root, of this cranial nerve were before described (page 
345) and illustrated (Plates 180, 185, and 186). They emerge 
from the cranium into the deep region of the face, by the fora- 
men ovale in the great wing of the sphenoid bone ; they 
lie externally to the superior portion of the tensor palati 
muscle. 
8. Buccal, Temporal, masseteric, External Pterygoid 
and Internal Pterygoid Serves, Plates 184, 187, and Fig. 1, 
Plate 188.—These are all motor nerves (except the buccal), and 
are given off from the motor portion of the trifacial nerve, 
to supply the muscles their names imply. The buccal nerve 
has been described (page 349) and illustrated (Plate 187). 
9. Anriculo-tcmporal I¥erve, Plates 182 and 183 ; Fig. 2, 
Plate 184; Plate 187 ; Fig. 1, Plate 188.—This nerve may 
be traced from its external portion anteriorly to the auricle 
(Fig. 2, Plate 184), to the point where it winds posteriorly to 
the glenoid cavity of the temporal bone, into the deep region 
of the face. It passes internally, externally to the internal 
lateral ligament of the temporo-maxillary articulation, to the 
point where it divides to include the middle meningeal artery ; 
it then unites again, forming a single trunk, which may be 
traced to the inferior maxillary division of the sensory root of 
the trifacial nerve. 
10. Inferior Dental IVerve, Plates 187 and 188.—This nerve 
is a branch of the inferior maxillary division of the sensory 
root of the trifacial nerve, after the same has entered the 
deep region of the face (page 345 ; Plate 188). It is projected, 
interiorly, externally to the tensor palati and internal ptery- 
goid muscles, to the internal surface of the ramus of the 
inferior maxillary bone, where it enters, the inferior dental 352 
HEAD AND NECK. 
canal, by the inferior dental foramen. Before entering the 
foramen it gives off the mylo-hyoid branch (a motor nerve, 
that receives its filaments from the motor root of the tri- 
facial through the inferior dental nerve), which passes, infe- 
in the mylo-hyoid groove, at the internal surface of the 
ramus and body of the inferior maxillary bone, to supply the 
mylo-hyoid and digastric (anterior belly) muscles ; it is accom- 
panied by the mylo-hyoid branch of the inferior dental artery. 
The inferior dental nerve is accompanied, in the inferior den- 
tal canal, by the inferior dental artery, branch of the internal 
maxillary artery (page 348, Plate 187); while in the canal, the 
nerve and artery supply the teeth (of one half) of the inferior 
dental arch; opposite the mental foramen (Plate 181), the 
artery and nerve give off, respectively, the mental artery and 
nerve, which emerge to the superficial region of the face, by 
the mental foramen (page 335; Fig. 2, Plate 184; Plate 187; 
and Fig. 1, Plate 188). 
ll. Gustatory Nerve.—This nerve, the largest branch of 
the inferior maxillary division of the sensory root of the trifa- 
cial nerve, has an inferior course parallel with, and anteri- 
orly to, the inferior dental nerve ; it runs externally to the 
tensor palati and internal pterygoid muscles, to the point 
where it passes internally to the anterior portion of the in- 
ferior part of the ramus of the inferior maxillary bone. 
12. Chorda Tympani Nerve, Fig. 1, Plate 188.—This nerve, 
branch of the facial nerve (from its portion in the aqueductus 
Fallopii), enters the deep region of the face, from the tym- 
panic wall of the middle ear, by the Gflasserian fissure of the 
glenoid cavity of the temporal bone. It has an anterior and 
internal course, internally to the internal lateral ligament of 
the temporo-maxillary articulation, to the point where it com- 
municates with the gustatory nerve, at the external surface of 
the internal pterygoid muscle. 
13. middle and Small Meningeal Arteries, Plate 187 and 
Fig. 1, Plate 188.—The middle meningeal artery (venae comb 
tes), branch of the internal maxillary artery, has a superior 
course, to enter the cranium by the foramen spinosum (Plate 
199), in the great wing of the sphenoid bone. As before re- DEEP KEGTON OF THE FACE. 
353 
ferred to (page 351), it is included in a ring of nerve, formed 
by the division and reunion of the auriculo-temporal nerve 
(Fig. 1, Plate 188). Its intracranial portion was before de- 
scribed (pages 322 and 345) and illustrated (Plates 179, 185, 
and 186). The small meningeal artery, usually a branch of 
the middle meningeal, has a superior and internal course to 
enter the cranium, by the foramen ovale (Plate 199) in the great 
wing of the sphenoid bone. 
Dissection.—Loop (Fig. 1, Plate 188) the inferior maxillary division of 
the sensory root, and the motor root, of the trifacial nerve internally, and dis- 
play the otic ganglion. 
14. Otic Ganglion, Fig. 1, Plate 188.—This ganglion, one 
of the cephalic ganglia of the sympathetic nerve, presents ag a 
small (bead-like), reddish, and shining body, at the external 
surface of the superior portion of the tensor palati muscle; 
from it very minute filaments radiate. 
Dissection.—Section (as in Fig. 2, Plate 188) the external carotid and mid- 
dle meningeal arteries ; and the auriculo-temporal and chorda tympani nerves. 
Dissect away the stumps of the superficial temporal, internal maxillary and 
middle meningeal arteries; the auriculo-temporal nerve with the otic gan- 
glion, the chorda tympani nerve, and the internal lateral ligament of the tem- 
poro-maxillary articulation. Expose (Fig. 2, Plate 188) the surfaces of parts 
of the tensor palati, levator palati, and superior constrictor (of pharynx) mus- 
cles, and the internal carotid artery. Posteriorly, and externally, to the latter 
artery, find portions of: the styloid process of the temporal bone; the stylo- 
glossus and stylo-pharyngeus muscles; the glosso-pliaryngeal nerve; and the 
spinal accessory nerve. 
15. Internal Carotid Artery, Fig. 2, Plate 188.—The supe- 
rior end of the extracranial portion of this artery presents ex- 
ternally to the superior constrictor muscle of the pharynx, on 
its way to the orih.ee of the carotid canal (Plate 199), at the in- 
ferior face of the petrous portion of the temporal bone. 
16. Tensor Palati and Levator Palatl Muscles; Superior 
Constrictor Muscle and Fibrous Coat of the Pharynx.—The 
external surfaces of the superior portions of these muscles 
present in the triangular space bounded by : the internal ptery- 
goid muscle, anteriorly ; the internal carotid artery, posteri- 
orly ; and the cranium, superiorly. A portion of the fibrous 
coat of the pharynx appears between the superior constrictor 
and the levator palati muscles. 354 
HEAD AND NECK. 
17. Styloid Process of Temporal Bone; Stylo-hyoid, Stylo* 
glossus, and Stylo-pharyngcus muscles, Fig. 2, Plate 188, and 
Plate 190.—The styloid process, of the petrous portion of 
the temporal bone, has a variable length, and from it the 
stylo-hyoid ligament is continued to the small cornu of the 
hyoid bone (Plate 190). It affords attachments to the superior 
ends of the three stylo muscles, which pass, as their names 
imply, to the hyoid bone, tongue, and pharynx. 
18. Glosso-pharyngcal and 8pinal Accessory Aervcs, Fig. 
2, Plate 188.—The superior ends of the extracranial portions of 
these nerves present as follows: the glosso-pliaryngeal nerve, 
posteriorly to, and between, the internal carotid artery and the 
styloid process ; the spinal accessory nerve, posteriorly to, and 
between, the styloid process and the posterior auricular artery, 
to the point where it passes internally to the posterior belly of 
the digastric muscle. 
19. Posterior Auricular Artery, Plates 187 and 188.—This 
artery (venae comites) is given off from the external carotid 
artery, where the latter is located internally to the inferior end 
of the posterior portion of the parotid gland. It passes, supe- 
riorly and posteriorly, under cover of the gland, supplying it, 
the auricle of the ear, and the scalp (page 320 ; Plate 177). PLATE 181 
ORBICULARIS 
J PALPEBRARUM 
fLEV. LAB. SUP. 
ALAUPUE A/ASI 
{Lachrymal 
\ grooue 
sOBLlQUUS INF* 
Jtf.Cchntao{naturccm del. PLATE 182 
F'icf. 1 
Fzg. 2 
,LE\AAT 
.A/VOUL/ 
-OH/S 
W-Tnfra- 
orbztal 
branches 
Submental 
J/if.'labial a/*/, 
A£.Cohn,a&nuticrczm deZ. PLATE 183 
TEMPORAL \ 
Fran&zrerse 
facial arc. 
Temporal 
bran c/z e-s N 
yl u riculo-temp‘ nfm 
Superficial /% 
temporiart./% 
Fxtl lalera/ lipric sj 
Facialn * 
7femporo-fa clat/irif: 
Cerzrzco- " " / 
Fntlmaxillarp art.' 
JZxtf carol id ari. / 
JW.Cohnj ad natzeram del. PLATE 184 
ExO. 1 
Fig. 2 
fyt.Cotin.ad rza.tura.77z atez. PLATE 185 
Jtf.Coh/i ,adndturam ofel. PLATE 186 
ILf. Cah TJjCuX nadu ram afet. PLATE 187 
J/T. Co?zn,aet"nc*tirrctm. PLATE 188 
Ftg. 1 
STYLO-HYOID 
Fig. 2 
In.fra-ordr.trzZ art. 
JW-Cobn ,a.al natural del. TWENTY-FIFTH DISSECTION. 
ANTERO-LATERAL AREA OF THE NECK. 
Dissection.—With the subject placed as for dissection of the upper ex- 
tremities (page L93), rest the left lateral surface of the head upon a block, and 
steady the same in the position shown in Plate 191. 
Terms of Relation.—The general terms (page 2) are used ; 
and the special terms antero-lateral and lateral—to the neck— 
interior and exterior—to the mouth, thorax, and larynx. 
Bones ; Bone and Cartilage Areas for Muscle Attachments, 
Plates 189 and 190.—The bones, forming the framework of this 
dissection, are: posteriorly, the seven cervical vertebrae and 
the two superior dorsal vertebrae (their anterior surfaces) ; in- 
feriorly, the sternum (its superior end), the clavicle (its supe- 
rior border), the two superior ribs (their exterior surfaces); su- 
periorly, the occipital (its inferior surface), the hyoid and in- 
ferior bones (their inferior borders). All of these 
bones, with the thyroid cartilage of the larynx, afford attach- 
ments to muscles in this dissection. 
Dissection.—Make the skin incisions 3, 4, 4, and 5, of Figure 14 (page 318), 
and reflect a flap as commenced. 
1. Subcutaneous Tissue, Plate 191.—This presents as a 
thin layer anteriorly to the platysma myoides muscle, and a 
thick one externally and internally therefrom. 
Dissection.—Dissect the subcutaneous tissue from the platysma myoides 
muscle. 
2. PI at y sin a Myoides Muscle.—The cervical portion of this 
oblong muscle occupies the antero-lateral area of the neck. It 
is attached, inferiorly, to the fascia of the thorax, parallel with, 
and inferiorly to, the clavicle. Its internal fibres meet those of 356 
HEAD AND HECK. 
its fellow of tlie opposite side at a median-line raphe, interiorly 
to the inferior maxillary bone ; it passes superiorly, anteriorly 
to the inferior maxillary bone, to the lateral area of the face 
(page 328 ; Fig. 1, Plate 182). 
Dissection.—Reverse the head and neck on the block, and dissect the left 
side of the neck to the stage of the dissection in Plate 191 ; restore the head to 
its position in Plate 191. Section (Plate 191) the right platysma myoides mus- 
cle, and reflect it inferiorlv. Be careful not to cut away the external jugular 
vein and its branches. Remove the anterior layer of the sheath (formed by the 
splitting of the deep cervical fascia) of the sterno-cleido-mastoid muscle ; take 
care to dissect out, and leave in situ (Plate 192), the portions of the internal 
jugular vein, the occipitalis minor, auricularis magnus, superficial cervical, and 
sternal branches of the cervical plexus of nerves, anteriorly to the muscle. 
3. Sterno-cleido-mastoid Muscle, Plates 189, 192, and 193. 
—This muscle is located in the antero-lateral area of the neck. 
It is attached: superiorly, to the mastoid portion of the tem- 
poral bone (Plate 189); interiorly, by a sternal, tendinous, por- 
tion, to the exterior surface of the superior part of the sternum, 
and by a cleido, muscular, portion to the superior border of 
part of the internal third or half of the clavicle. 
Dissection.—Trace (Plate 192) the external jugular vein to its superior and 
inferior ends. Find (Plate 192), running interiorly and externally, the follow- 
ing branches of the cervical plexus : the nerve to the trapezius muscle, the 
clavicular, and the acromial nerves. Dissect out (Plate 192) the external and 
inferior portion of the spinal accessory nerve. 
4. External Jugular Vein, Plates 192 and 193.—This vein 
extends, from the internal surface of the parotid gland, infe- 
riorly and externally, across the antero-lateral area of the neck 
—anteriorly to the sterno-cleido-mastoid muscle—to its point 
of emptying into the subclavian vein, posteriorly to the middle 
third of the clavicle. It has a submaxillary, and an inferior, 
anastomosing branch: the former with the facial vein; the 
latter with the anterior jugular vein. 
5. Brandies of the Cervical Plexus of Nerves.—From the 
posterior border, and internal surface, of the sterno-cleido- 
mastoid muscle, superiorly to the external jugular vein, these 
nerves emerge, in the following order: the sternal winds, in- 
teriorly and internally, anteriorly to the external jugular vein ANTERO-LATERAL AREA OF THE NECK. 
357 
and sterno-cleido-mastoid muscle, to the subcutaneous tissue 
of the superior portion of the sternal region of the thorax; the 
clavicular is projected, interiorly, anteriorly to the external 
jugular vein and clavicle, to the subcutaneous tissue of the 
subclavicular region of the thorax ; the acromial runs, exter- 
nally and interiorly, to the subcutaneous tissue of the acromial 
region of the shoulder; the superficial cervical passes inter- 
nally, between the external jugular vein and sterno-cleido- 
mastoid muscle, to the subcutaneous tissue of the anterior area 
of the neck; the auricularis magnus takes an internal and 
superior course, anteriorly to the sterno-cleido-mastoid muscle, 
to the internal surface of the pinna of the ear and the subcu- 
taneous tissue of the parotid region of the face; the nerve to 
the trapezius muscle has an external and inferior course, to its 
passage posteriorly to the antero-external border of the trape- 
zius muscle (it accompanies the spinal accessory nerve); the 
occipitalis minor lies externally to, and parallel with, the 
superior portion of the posterior border of the sterno-cleido- 
mastoid muscle, as it advances, superiorly, to its distribution 
to the scalp (page 320 ; Plate 177). 
Dissection.—Dissect out (Plate 192) the antero-external border of the trape- 
zius muscle ; anteriorly and externally to its superior end, expose the occipitalis 
major nerve, a branch of the third cervical spinal nerve, and the occipital artery. 
6. Trapezius Muscle, Plates 189, and 192 to 198, inclusive. 
—This muscle was before described (page 267) and illustrated 
(Plate 149). Its external and anterior border—external for the 
superior half, and anterior for the inferior half—forms the ex- 
ternal boundary of the antero lateral area of the neck. The 
border extends from the occipital to the clavicular attachments 
of the muscle (Plates 189 and 192). 
7. Occipitalis Major Kerve and a Branch of the Third 
Cervical-Spinal Kerve, Plates 192, 194, and 196.—These nerves, 
the internal (cutaneous) branches of the posterior divisions of 
the second and third cervical-spinal nerves, emerge from the 
anterior surface of the superior end of the trapezius muscle, on 
their way to the scalp (page 320 ; Plate 177). 
8. Occipital Artery.—This artery presents between the su- 
perior ends of the trapezius and sterno-cleido-mastoid muscles; 
it emerges from the anterior surface, and at the superior bor- 358 
HEAD AND NECK. 
der of the splenius capitis muscle ; it has a superior course to 
the scalp (page 320 ; Plate 177). 
Dissection.—Commencing superiorly, clear the surfaces of the portions of 
muscles between the borders of the trapezius and sterno-cleido-mastoid muscles 
(Plate 192) ; do not cut away the nerves and vessels, that lie upon the exposed 
portions of the muscles. 
9. Coinplexus, Spicnius Capitis, Levator Anguli Scapula*, 
Scalenus Posticus, Scalenus medius, and Oino-liyoid (posterior 
belly) muscles, Plate 192.—Commencing superiorly, portions 
of these muscles present, in order, between the trapezius and 
sterno-cleido-mastoid muscles. Posteriorly to the complexus 
are the occipitalis major nerve, the branch of the third cervical- 
spinal nerve, and the occipital artery ; externally to the levator 
anguli scapulae are the nerve to the trapezius muscle, and the 
inferior and external portion of the spinal accessory nerve; an- 
teriorly to the scalenus medius is the acromial nerve; ante- 
riorly to the scalenus medius and omo-hyoid (posterior belly) 
muscles are the clavicular nerve and the external jugular vein. 
Dissection.—Display (Plate 192), in a plane posteriorly to the omo-hyoid 
(posterior belly), portions of the superficial cervical, suprascapular, subclavian, 
and posterior scapular arteries ; also portions of the brachial plexus of nerves, 
scalenus anticus muscle, and subclavian vein. Clear (Plate 192) the inferior 
portion of the parotid gland ; find the cervico-facial division of the facial nerve, 
and follow its inframaxillary branch to the neck. Display (Plate 192), in the 
subfascial plane of the submaxillary region, the submaxillary anastomosing 
branch of the external jugular vein, and the facial vein with its tributary 
branches ; also the confluence of the facial and internal jugular veins. 
10. Parotid Gland, Plates 192 to 197, inclusive.—The pos- 
terior portion of this gland (page 330 ; Fig. 2, Plate 182) is 
lodged between the ramus of the inferior maxillary bone and 
the sterno-cleido-mastoid muscle. 
11. Cervico-facial Division of tlie Faeial Nerve.—This nerve 
emerges from between the parotid gland and the ramus of the 
inferior maxillary bone; it projects its inframaxillary branch 
to tlie neck (platysma myoides muscle). 
12. Sulminxillary Anastomosing Brandi of tlie External 
Jugular Teln, Plates 192 and 193.—This vein (of variable size) 
runs posteriorly to, and parallel with, the ramus of the inferior 
maxillary bone, from the external jugular to the facial vein. AHTERO-LATERAL AREA OF THE HECK. 
359 
13. Facial Vein and its Tributary Branches.—This vein 
appears from the face (page 332), over the inferior border of the 
outer third of the inferior maxillary bone. It has an inferior 
and external course, to its emptying into the internal jugular 
vein. In its course it receives tributary veins : the submental, 
the submaxillary anastomosing branch of the external jugu- 
lar, the lingual, and the superior thyroid. 
Dissection.—Expose (Plate 192) portions of the following parts : digastric 
(posterior belly), stylo-liyoid, and livo-glossus muscles; hyoid bone ; submaxil- 
lary gland ; internal jugular vein ; common, internal, and external carotid ar- 
teries ; superior thyroid, lingual, facial, and occipital branches of the external 
carotid artery; hypoglossal, descendens noni, and superior laryngeal nerves. 
Find and trace (Plate 192), inferiorly, the anterior jugular vein from its anasto- 
mosis with the submental vein. Clear (Plate 192), commencing superiorly, 
portions of the mylo-hyoid, digastric (anterior belly), tliyro-hyoid, omo-liyoid 
(anterior belly), and sterno-hyoid muscles. 
14. Anterior Jugular Vein, Plate 192.—This vein runs, in- 
teriorly, from the submental vein, anteriorly to the digastric 
(anterior belly), mylo-hyoid, and sterno-hyoid muscles, to the 
point where it receives the inferior anastomosing branch of 
the external jugular vein; it then disappears posteriorly to 
the sternal portion of the sterno-cleido-mastoid muscle. 
Dissection.—Reverse the position of the head and neck on the block, so 
as to present its left side uppermost; dissect the left antero-lateral area of the 
neck to the same stage of the dissection, as the right side in Plate 192, follow- 
ing the text, from the close of paragraph 2 to the close of paragraph 14. Then 
remove the block from under the head and neck, and steady the head in the 
position shown in Plate 193. Clear additional, portions of the, right and left, 
internal jugular vein, descendens noni nerve, and common carotid artery (Plate 
193). Section (Plate 192) the right and left anterior jugular veins ; the cervico- 
facial division of the facial nerve, and the sternal, clavicular, and acromial 
nerves. Dissect away the veins and the inferior portions of the nerves. Clear 
(Plate 193) the surfaces of the, right and left, sterno-hyoid muscles and the 
uniting median-line portion of intermuscular fascia between them. 
15. Sterno-hyoid Muscle, Plates 190, 192 and 193.—This 
muscle extends, parallel with the median line, from the hyoid 
bone (Plate 190), superiorly, to the point where it disappears 
interiorly, posteriorly to the sternal portion of the sterno- 
cleido-mastoid muscle. 
16. Median-line Intermuscular Fascia, Plate 193.—This is 
a stretch of fascia—varying in width with age and sex—be- 
tween the internal borders of the right and left sterno-hyoid HEAD AND NECK. 
muscles. In infants anil children it is a mere raplie, while in 
adults, more especially men, the development, and consequent 
projection, of the larynx and trachea widens it. 
Dissection.—Restore the head and neck to the position shown in Plate 192. 
Section (Plate 192) the external jugular and facial veins, the superficial cervical, 
auricularis magnus, and occipitalis minor nerves, also the nerve to the trapezius 
muscle ; dissect away the nerves, and reflect the veins inferiorly. Section (Plate 
192) the sterno-cleido-mastoid muscle and reflect it superiorly. In reflecting 
the latter muscle, trace the inferior and external portion of the spinal accessory 
nerve into the sterno-cleido-mastoid muscle ; cut out the nerve from, and 
find the branch of the nerve to, the muscle (Plate 194). Dissect away the 
internal layer of the sheath (from the splitting of the deep cervical fascia) of 
the sterno-cleido-mastoid muscle, and expose (Plate 194) portions of the fol- 
lowing parts : the mid-tendon and fascial slip of the omo-hyoid muscle ; the 
sterno-hyoid muscle ; the common carotid artery ; the internal jugular vein ; the 
descendens and communicans noni nerves, with the branches of the same ; 
the anterior divisions of the third and fourth cervical-spinal nerves and their 
branches; the phrenic nerve; portions of the ascending cervical, superficial 
cervical, and suprascapular arteries. Clear (Plate 194) the surfaces of portions 
of the scalenus anticus, rectus capitis anticus major, and sterno-thyroid mus- 
cles ; also the superior, and internal, portions of the splenius capitis, levator 
anguli scapuhe, scalenus posticus, and scalenus medius muscles. 
17. Spinal Accessory Aerve, Plates 194 to 197, inclusive.— 
This nerve appears in the neck from the internal surface, and 
inferior border, of the posterior belly of the digastric muscle. 
Inferiorly to the muscle, it gives off a branch to the sterno- 
cleido-mastoid muscle ; it then perforates the latter muscle, 
obliquely, to be continued, inferiorly and externally, to its 
passage anteriorly to the inferior portion of the trapezius 
muscle, which it supplies. 
18. Omo-hyoid Muscle, Fig. 1, Plate 135 ; Plates 157, 190, 
192, 193, 194 and 195.—This muscle has four portions (Plates 
194 and 195): an anterior belly, which has an oblique course, 
from the hyoid bone (Plate 190) to the mid-tendon ; a posterior 
belly, which passes from the mid-tendon to the point where it 
runs posteriorly to the external third of the clavicle, to reach 
the inferior attachment of the muscle (Plate 157); a mid-ten- 
don, which determines the anterior and posterior belly to the 
muscle ; from the mid-tendon a fascial slip passes, inferiorly, 
posteriorly to the inferior end of the sterno-hyoid muscle, to 
be attached to the cartilage of the lirst rib (page 238 ; Fig. 1, 
Plate 135). 361 
ANTERO-LATERAL AREA OF THE NECK. 
19. Sterno-hyoid Muscle, Fig. 2, Plate 135 and Plates 190, 
192, 193, and 194.—This muscle was before referred to (pages 
238 and 359). It is attached: superiorly, to the hyoid bone 
(Plate 190); inferiorly, to the interior surface of the superior 
portion of the sternum, and to the posterior surface of the in- 
ternal end of the clavicle (Fig. 2, Plate 135). It should there- 
fore be named sterno-cleido-hyoid muscle. 
20. Internal Jug-ular Vein, Plates 192 to 195, inclusive.— 
This large venous trunk appears in the neck, from the internal 
surface, and inferior border, of the posterior belly of the digas- 
tric muscle. It passes inferiorly, anteriorly to the rectus capitis 
anticus major muscle, to its confluence with the subclavian vein, 
posteriorly to the internal third of the clavicle. In the superior 
third of its cervical course it receives the facial vein (page 359). 
21. Descendens and Conimunieans Noni Nerves.—The de- 
scendens noni nerve, branch of the hypoglossal nerve (page 
365), passes interiorly, parallel with, and anteriorly and inter- 
nally to, the last-described vein ; it gives off a nerve to the 
omo-hyoid (anterior bell}7). The communicans noni nerve 
(Plates 194 and 195), branch of the anterior division of the third 
cervical-spinal nerve, has an inferior course, anteriorly to the 
rectus capitis anticus major muscle and the internal jugular 
vein. It runs posteriorly to the omo-hyoid muscle (anterior 
belly), to its communication with the descendens noni nerve, 
thereby forming the noni loop. A branch from the loop sup- 
plies the omo-hyoid (posterior belly), sterno- (cleido-) hyoid, 
and sterno-thyroid muscles (Plates 194 and 195). 
22. Anterior Division of the Third Cervical-spinal Nerve, 
Plates 194,196, and 197.—This nerve appears from between the 
rectus capitis anticus major and the scalenus medius muscles. 
It receives a communicating branch from the second cervical- 
spinal nerve (Plate 196). It gives off the above-described com- 
municans noni nerve; the occipitalis minor, auricularis mag- 
nus, and superficial cervical nerves, and the nerve to the trape- 
zius muscle (page 857); also, the nerve to the levator anguli 
scapulae muscle (Plates 194 and 196), which crosses the scalenus 
medius muscle. 
23. Anterior Division of the Fourth Cervtcal-spfnal Nerve. 
—Tliis division of tlie fourth cervical-spinal nerve appears in 362 
HEAD AND NECK. 
the neck, inferiorly to, and in the same manner as, the anterior 
division of the third. The stumps of the acromial, clavicular, 
and sternal nerves (page 356 and 357), may be traced to it. It 
also gives off the nerve to the scalenus medius muscle. 
24.. Phrenic Tferve, Plates 194 to 198, inclusive.—This nerve 
is a branch of the anterior division of the fourth cervical-spinal 
nerve (sometimes it is contributed to by the anterior divisions 
of the third and fifth (Plate 198) cervical-spinal nerves, one or 
both). Its cervical portion is projected, inferiorly, upon the 
anterior surface of the scalenus anticus muscle, to its disap- 
pearance between that muscle, posteriorly, and the subclavian 
vein, anteriorly. Anteriorly, it is crossed by the posterior 
belly of the omo-liyoid muscle, and the ascending cervical, 
superficial cervical, and suprascapular arteries. 
Dissection.—Clear (Plate 194) the surface of the submaxillary gland. Raise 
(Plate 194) the submaxillary and parotid glands (by loops of thread) and display 
the mylo-hyoid and digastric muscles; also portions of the stylo-liyoid and 
stylo glossus muscles. Trace (Plate 194) the internal and external laryngeal 
arteries. 
25. Submaxillary Gland, Plates 192 to 197, inclusive.—This 
gland is lodged (Plate 192) between : the external half of the 
body of the inferior maxillary bone, superiorly ; the facial 
vein, externally ; the facial artery, the mylo-liyoid muscle, and 
the inferior ends of the digastric (posterior belty) and stylo- 
hyoid muscles, internally (Plate 194). It is about the size of 
an English walnut. 
26. Mylo-liyoid Muscle, Plates 190 and 192 to 197, inclusive. 
This muscle bridges from the posterior of the superior border 
of the body of the hyoid bone to the mylo-liyoid ridge at the 
posterior surface of the body of the inferior maxillary bone 
(Plate 190). It is located in the floor of the buccal cavity, in 
a plane interiorly to the anterior belly of the digastric muscle. 
Its fibres pass, superiorly and externally, from the hyoid bone 
and a median-line, fibrous, raphe (from the hyoid bone to the 
inferior maxillary bone) between the right and left muscles. 
27. Digastric Muscle, Plates 189, 190, and 192 to 195, in- 
clusive.—This muscle has four portions—a posterior belly, an 
anterior belly, a mid-tendon, and a fascial loop. The posterior 363 
ANTERO-LATERAL AREA OF THE NECK. 
belly is attached, superiorly and posteriorly, in the digastric 
groove of the mastoid portion of the temporal bone (Plate 189); 
it is projected, interiorly and anteriorly, to its ending in the 
mid-tendon—in its course it perforates the inferior half of the 
stylo-liyoid muscle. The anterior belly is attached, superiorly 
and anteriorly, at the posterior of the inferior border of the 
body of the inferior maxillary bone, near to the median line; 
it is directed, interiorly and posteriorly, to its ending in the 
mid-tendon. The mid-tendon determines the two bellies of the 
muscle. The fascial looj) passes around the mid-tendon of 
the musclfc, and is attached to the superior surface of the body 
and the great cornu of the hyoid bone (Plate 190). 
28. 8tylo-liyoi<l Muscle, Plates 190, and 192 to 195, inclu- 
sive.—This muscle runs parallel with, and internally and su- 
periorly to, the posterior belly of the digastric muscle. It is 
attached, superiorly and posteriorly, to the external surface of 
the styloid process of the temporal bone (Plate 190); its infe- 
rior half presents an opening for the transit of the posterior 
belly of the digastric muscle ; interiorly to the digastric open- 
ing, the muscle passes to its inferior and anterior attachment 
to the superior surface of the great cornu of the hyoid bone 
(Plate 190). 
Dissection.—Reverse the position of the head on the block, so as to pre- 
sent the left antero-lateral area of the neck uppermost. Dissect the left side 
of the neck from the stage of the dissection in Plate 192, to that in Plate 194, 
following the steps given for the latter from the close of paragraph 14 to the 
close of paragraph 28. Section the sterno-liyoid muscles, right and left (Plate 
194) and reflect them interiorly. Withdraw the block from under the head and 
neck, and steady the head in the position shown in Plate 195. Clear the sur- 
faces of the sterno-thyroid muscles, right and left; expose the tracheal fascia, 
anteriorly to the trachea ; display portions of the thyroid body, the larynx, the 
cricoid artery, the tliyro-hyoid membrane, and the hyoid bone. 
29. Sterno-thyroid muscle: Fig. 2, Plate 135 ; and Plates 
190, 194, and 195.—This muscle, located posteriorly to the 
sterno-liyoid muscle, is attached : superiorly, to the exterior 
of the thyroid cartilage of the larynx (Plate 190) ; interiorly, 
to the interior surfaces of the superior portion of the sternum, 
and the first costal cartilage (page 238 ; Fig. 2, Plate 135). 
30. Tracheal Fascia, Plates 194 and 195.—This is the mid- 
dle layer of the anterior portion of the deep cervical fascia. 364 
HEAD AND NECK. 
It is located in a plane posteriorly to the last-described mus- 
cle. It is attached, superiorly, to the cricoid cartilage of the 
larynx and passes anteriorly to the thyroid body, trachea, 
and large vessels at the inferior of the mid-region of the neck ; 
thence, it is continued posteriorly to the superior portion of the 
sternum, into the interior of the thorax. 
Dissection.—Dissect away (Plate 195) tlie fascial slip of the left omo-liyoid 
muscle, and expose, posteriorly to it, portions of : the internal jugular vein; 
the cervical portion of the thoracic or left lymphatic duct; the pneumogastric 
nerve ; and the first portion of the subclavian artery. Section (Plate 193), and 
reflect inferiorly, the anterior belly of the left digastric muscle ; section (Plate 
193) the fascial loop of the left digastric muscle and the left stylo-hyoid muscle 
from their hyoid attachments ; reflect the latter muscle and the posterior belly 
of the digastric muscle, posteriorly, and cut them away, as shown on the left 
side of Plate 195. Section the left mylo-liyoid muscle (Plate 193) close to the 
median-line raphe and from the hyoid bone ; reflect it superiorly and cut it 
away inferiorly to, and parallel with, the body of the inferior maxillary bone 
(Plate 195). Cut away (Plate 195) a portion of the left submaxillary gland ; 
trace the duct of the gland, internally and anteriorly. Find portions of the 
gustatory nerve and stylo-glossus muscle parallel with, and superiorly to, the 
duct. Follow the left hypoglossal nerve, internally and anteriorly. Clear 
the surfaces of the left genio-hyoid and liyo-glossus muscles. 
31. Duct of the Submaxillary Gland, Plates 1.95 and 197. 
—This dnct (Wharton’s) runs internally between the mylo- 
hyoid muscle, exteriorly, and the muscle interiorly. 
It disappears into the floor of the buccal cavity, at the internal 
border of the anterior portion of the hyo-glossus muscle. 
32. Gustatory tfcrve and Stylo-glossus Muscle.—Portions 
of this nerve and muscle present anteriorly to, and parallel 
with, the last-described duct. 
33. Hypoglossal Nerve, Plates 192 to 196, inclusive.—This 
nerve emerges, superiorly, at the inferior border, and from 
the internal surface, of the posterior belly of the digastric 
muscle (Plates 192 to 195, inclusive) ; thence it runs inferiorly, 
internally to the internal jugular vein, posteriorly to the ex- 
ternal jugular vein (Plate 192), and anteriorly to the internal 
carotid artery (Plates 192, 194, and 196) ; it makes an abrupt 
curve internally, inferiorly to the origin of the occipital artery 
from the external carotid artery (Plates 192 to 196, inclusive). 
Continuing internally, it crosses the external carotid artery, to 
the external surface of the posterior-inferior angle of the liyo- 365 
AXTERO-LATERAL AREA OF THE NECK. 
glossus muscle; thence it passes to the hyoid ends of 
the posterior belly of the digastric and the stylo-hyoid muscles, 
to reach the interior surface of the mylo-hyoid muscle (Plates 
192 to 197, inclusive). Its branches are: the descendens noni 
(page 361), from its curve upon the anterior surface of the in- 
ternal carotid artery (Plates 192 to 195, inclusive) ; and the 
nerve to the thyrodiyoid muscle, given off as the nerve passes 
superiorly to the hyoid bone (Plates 192 to 196, inclusive). The 
anterior and internal portion of the hypoglossal nerve runs be- 
tween the mylo-hyoid and liyo-glossus muscles (Plates 195 and 
197), to its disappearance, anteriorly, between the liyo-glossus 
and genio-liyoid muscles. 
34. Gcnfo-liyoid Muscle, Plates 190, 195, 196, and 197.—• 
This muscle, located in tlie floor of the buccal cavity, interiorly 
to the mylo-hyoid muscle, runs at the side of, and parallel 
with, tlie median-line. It is attached : posteriorly, to the hyoid 
bone (Plate 190); anteriorly, to the inferior genial tubercle, at 
the posterior surface of the body of the inferior maxillary bone 
(Plate 190), near the median line. 
35. liyo-glossus Muscle* Plates 190, 192, and 194 to 197, in- 
clusive.—This occupies a plane interiorly to the raylo-hyoid 
muscle. It is attached : posteriorly, to the hyoid bone (Plate 
190) ; anteriorly and superiorly, its fibres pass into the sub- 
stance of the lateral border of the tongue. 
Dissection.—Section (Plate 195) tlie right omo-hyoid and thyro-livoid mus- 
cles. Restore tlie head and neck to its position on the block in Plate 194 ; sec- 
tion (Plate 194) the descendens and communicans noni nerves, also the exter- 
nal laryngeal artery; reflect the omo-hyoid and thyro-liyoid muscles with the 
noni loop of nerves. Section (Plate 194) the right internal jugular vein and re- 
flect it inferiorly ; then expose the right pneumogastric nerve and its branches. 
36. Riglit Pneumogastrtc Nerve and its Branches, Plate 
196. —The cervical portion of this nerve, lodged within the 
carotid sheath, has an inferior course : anteriorly to the rectus 
capitis anticus major muscle; posteriorly to the internal jugular 
vein ; parallel with, and externally to, the internal and common 
carotid arteries. The superior laryngeal nerve (Plates 192 to 
197, inclusive) is given off from it, where it is in relation with 
the internal carotid artery (Plate 197); it curves internally, 
posteriorly to the internal and external carotid arteries, ap- 366 
HEAD AND NECK. 
pears internally to the latter, and passes anteriorly to the 
tliyro-hyoid membrane, where it disappears, in company with 
the internal laryngeal artery (page 367 ; Plate 194), between 
the tliyro-liyoid membrane and muscle. Interiorly, the right 
pneumogastric nerve gives off the following branches: a cervical 
cardiac, which has an inferior and internal course, anteriorly 
to the first portion of the subclavian artery, to its disappear- 
ance into the interior of the thorax; a recurrent laryngeal 
(Plates 196 and 197), which is given off interiorly to the first 
portion of the subclavian artery (page 242 ; Plate 138), and is 
continued, superiorly and internally, posteriorly to the sub- 
clavian and common carotid arteries. 
Dissection.—Clear (Plate 196) the anterior surfaces of the innominate ar- 
tery, and the trachea, preserving the right inferior thyroid vein, recurrent laryn- 
geal nerve, and branches of the inferior thyroid artery. Expose (Plate 196) : 
the right common carotid artery to its bifurcation ; the first portion of the right 
subclavian artery and portions of its branches—vertebral, thyroid axis (with its 
branches), and internal mammary arteries. 
37. Innominate Artery, Plates 196, 197, and 198.—The cer- 
vical portion of this artery is projected into the neck, supe- 
riorly and to the right, posteriorly to the right sterno-clavicular 
articulation. It bifurcates into the right common carotid and 
the right subclavian arteries. 
38. Right Common Carotid Artery, Plates 192 to 196, in- 
clusive.—This artery extends, superiorly, from the bifurcation 
of the innominate artery, parallel with, and internally to, the 
internal jugular vein (Plates 192 to 195, inclusive) and pneumo- 
gastric nerve (Plate 196). On a line with or a little superiorly 
to the superior border of the thyroid cartilage of the larynx, it 
bifurcates into the internal and external carotid arteries. 
Dissection.—Section (Plate 194) the right digastric and stylo-liyoid mus- 
cles ; reflect the anterior belly of the digastric muscle, anteriorly and superiorly, 
the posterior belly of the digastric muscle and the stylo-hyoid muscle, pos- 
teriorly. Clear (Plate 196) the superior end of the hypoglossal nerve, the 
inferior portion of the internal carotid artery, and the inferior part of the ex- 
ternal carotid artery with its branches—superior thyroid, lingual, facial, occip- 
ital, and posterior auricular. Expose (Plate 196) portions of : the middle con- 
strictor (of the pharynx), superior constrictor (of the pharynx), and stylo-glossus 
muscles; the ascending palatine blanch of the facial artery; and the glosso- 
pharyngeal nerve. AXTERO-LATERAL AREA OF THE XECK. 
367 
39. Internal Carotid Artery, Plates 192 to 196, inclusive.— 
This artery passes, superiorly, from its origin to its disappear- 
ance posteriorly to the hypoglossal nerve and occipital artery. 
40. External Carotid Artery.—This artery is projected, 
superiorly, from its origin to the point where it disappears in- 
ternally to the parotid gland. 
41. Superior Thyroid Artery.—This artery (venm comites), 
the first internal branch of the external carotid, is given off 
close to the origin of the latter; it curves interiorly, to run 
internally to, and parallel with, the common carotid artery. 
Its branches are : the internal laryngeal (Plate 194), which 
joins the superior laryngeal nerve (page 366), anteriorly to 
thyro-hyoid membrane and disappears, with the nerve, between 
the membrane and the thyro-hyoid muscle; the external laryn- 
geal (Plate 194), which distributes to the muscles exteriorly to 
the larynx ; the cricoid (Plates 195,196, and 197), which crosses, 
internally, anteriorly to the crico-thyroid muscle, and the supe- 
rior portion of the crico-thyroid membrane, to its anastomosis 
with its fellow of the opposite side. The superior thyroid ar- 
tery terminates by branches, most of which enter the superior 
of the thyroid body, while others anastomose with branches of 
the inferior thyroid artery (Plates 196 and 197). 
42. Inferior Constrictor Muscle, Plates 190, 196 and 197.— 
The inferior portion of this constrictor muscle of the pharynx 
presents externally to the superior thyroid body, on its way 
to its attachment to the thyroid cartilage of the larynx (Plate 
190). The superior thyroid artery lies externally to it. 
43. Lingual Artery, Plates 192 to 197, inclusive.—This ar- 
tery, the second internal branch of the external carotid, passes, 
superiorly and externally, from its origin to its disappearance 
internally to the posterior border of the hyo-glossus muscle, 
where it runs parallel with, and superiorly to, the hyoid bone. 
44. Facial Artery.—This artery, the third internal branch 
of the external carotid, runs from its origin, internally and su- 
periorly, to pass internally to the submaxillary gland ; it reap- 
pears between the gland and the body of the inferior maxillary 368 
HEAD AND NECK. 
bone, and winds to the anterior surface of the external third of 
the latter, on its way to the antero-lateral area of the face (Fig. 
2, Plate 182; Plate 183). A short distance from its origin it 
gives off the ascending palatine artery (Plate 196), which has 
a superior course, to the point where it disappears internally 
to the stylo-glossus muscle. 
45. Occipital Artery.—This artery (venae comites), the first 
external branch of the external carotid, has a superior course, 
anteriorly to the internal carotid artery, internal jugular vein, 
and hypoglossal nerve ; it disappears internally to the pos- 
terior belly of the digastric muscle, and reappears as before 
described (page 357) and illustrated (Plates 192, 194 and 196). 
46. Posterior Auricular Artery, Plate 196.—This artery 
(venm comites), the second external branch of the external 
carotid, is given off internally to the parotid gland; it has a 
superior and posterior course, and sends branches to the paro- 
tid gland, the auricle of the ear, the scalp, and, by the stylo- 
mastoid foramen, to the internal ear. 
47. Stylo-glossus, Superior Constrictor, and Middle Con- 
strictor Muscles, Plates 194 and 196.—Portions of these three 
muscles present in the space bounded : posteriorly, by the ex- 
ternal carotid artery ; anteriorly, by the hyo-glossus muscle 
and submaxillary gland ; and superiorly, by the inferior max- 
illary bone. 
48. Glosso-plinryngeal Nerve, Plate 196. — A portion of 
this nerve runs externally to the superior constrictor muscle, 
between the stylo-glossus and middle constrictor muscles, to 
the point where it passes internally to the posterior border of 
the hyo-glossus muscle. 
Dissection.—Place the block under the right lateral surface of the head, 
and dissect the left antero-lateral area of the neck, from the stage of the dis- 
section presented in Plate 194 to that in Plate 196, following the steps given 
from the close of paragraph 28 to the close of paragraph 48. 
49. Left Common Carotid Artery, Plates 197 and 198.— 
This artery differs from the right in being projected into the 
neck from the interior of the thorax, at a point posteriorly to ANTEEO-LATEEAL AEEA OF THE NECK. 
369 
the internal portion of the left half of the superior end of the 
sternum. Its origin from the arch of the aorta (page 244; 
Plate 138) determines this difference. 
Dissection.—Withdraw the block from beneath the head and neck and 
steady the head as in Plate 197. Section (Plate 196) the right common carotid 
artery and pneumogastric nerve ; reflect them superiorly as in Plate 197. Clear 
away the posterior layer of the anterior portion of the deep cervical fascia, and 
expose the cervical portion of the right sympathetic nerve (Plate 197). 
50. Cervical Portion of the Right Sympathetic Nerve, 
Plate 197.—This nerve cord lies upon the anterior surface of 
the rectus capitis anticus major muscle, posteriorly to the car- 
otid sheath and the deep layer of the anterior portion of the 
deep cervical fascia. It consists of three ganglia—inferior, 
middle, and superior—united by commissural nerve trunks. 
The inferior ganglion lies internally and posteriorly to the 
vertebral artery ; the middle ganglion is usually located an- 
teriorly to the inferior thyroid artery; the superior ganglion 
is lodged posteriorly to the internal carotid artery. (Special 
dissections will demonstrate communicating branches from the 
anterior branches of the cervical-spinal nerves to the ganglia, 
and distributing branches from the ganglia—superior, middle, 
and inferior cardiac nerves—which pass, interiorly, into the in- 
terior of the thorax.) 
51. Superior Laryngeal Nerve (right), Plates 192 . to 197, 
inclusive.—This nerve lias been described at page 865 ; it may 
now be traced to its origin from the superior part of the cervical 
portion of the pneumogastric nerve. 
Dissection.—Clear (Plate 197) the first and third portions of the right sub- 
clavian artery, and the cervical portion of their branches; the subclavian vein, 
and the brachial plexus. 
52. First and Third Portions of the Right Subclavian Ar- 
tery, Plates 192, 194, 19G, 197, and 198.—The first and a part 
of the third portion of this artery present as follows : the first 
portion, from the bifurcation of the innominate artery to the 
internal border of the inferior end of the scalenus anticus mus- 
cle, where it passes, to become the second portion of the ar- 
ter}r, posteriorly to the muscle ; the third portion (its superior 370 
HEAD AND NECK. 
end) is projected, externally and interiorly, from the posterior 
surface, and at the external border, of the scalenus anticus 
muscle. 
53. Thyroid Axis ami its Branches, Plates 192 to 198, in- 
clusive.—The thyroid axis (Plates 197 and 198), branch of the 
iirst portion of the subclavian, trifurcates into the inferior 
thyroid, superficial cervical, and suprascapular branches. The 
inferior thyroid (Plates 190, 197, and 198) extends, superiorly, 
along the anterior surface of the internal third of the scalenus 
anticus muscle, as far as the rectus capitis anticus major mus- 
cle ; it then curves internally and is continued to the lateral 
lobe of the thyroid body. It is located in a plane posteriorly 
to the internal jugular vein, pneumogastric nerve, common 
carotid artery, and sympathetic nerve. Its vertical portion 
gives off the ascending cervical artery, which runs superiorly, 
anteriorly to the scalenus anticus muscle. The superficial 
cervical (Plates 192 to 198, inclusive) has a transverse course 
to the point where it passes, by several branches, to the an- 
terior surface of the inferior portion of the trapezius muscle. 
The suprascapular (Plate 192; Plates 194 to 198, inclusive) 
makes an abrupt curve, interiorly and externally, to the pos- 
terior of the clavicle. 
54. Posterior Scapular Artery, Plates 192, 194, and 197.— 
This artery (venae comites), branch of the third portion of the 
subclavian, is projected, posteriorly, internally to the scalenus 
medins, scalenus posticus, and levator anguli scapulae muscles, 
to reach its posterior distribution (page 269 ; Plate 149). 
55. Subclavian Vein, Plates 192, 194, 196, 197, and 198.— 
This vessel lies posteriorly, and a little interiorly, to the clav- 
icle ; it runs parallel with the second and third portions of the 
subclavian artery, and is separated from the second portion of 
the artery by the scalenus anticus muscle. 
56. Brachial Plexus, Plates 192 to 198, inclusive.—The su- 
perior trunks of this plexus—the anterior divisions of the fifth, 
sixth, and seventh cervical spinal nerves—are projected, exter- 
nally and interiorly ; they emerge from between (sometimes 
perforate) the scalenus anticus and scalenus medius muscles; AXTERO-LATERAL AREA OF THE XECK. 
371 
they run parallel with, and superiorly to, the third portion of 
the subclavian artery, and enter the axilla (Plate 120). 
Dissection.—Dissect away, on the left side, the common carotid, the infe- 
rior portion of the external carotid with its branches, and the inferior portion 
of the internal carotid, by the following steps : section as in Plate 197 the left 
common carotid artery and reflect it superiorly ; continue its reflection, so as to 
raise the external carotid, cutting (Plate 195), in order, the superior thyroid, 
lingual, facial, ascending pharyngeal, and occipital arteries; and, as in Plate 
197, the external, and internal carotid arteries. Section (Plate 197) the left 
pneumogastric nerve, superiorly and interiorly, and dissect away the included 
part. Display the cervical portion of the left sympathetic nerve ; section the 
nerve, interiorly and superiorly (Plate 197), and dissect away the portion be- 
tween the cuts. Expose (Plate 197) completely, the thyro-hyoid muscle ; also 
the antero-lateral surfaces of the hyoid bone, the larynx, the thyro-hyoid mem- 
brane, the thyroid body, and the inferior thyroid veins. 
57. Thyro-hyoid Muscle, Plates 190 and 192 to 197, inclu- 
sive.—This muscle extends, interiorly, from the inferior border 
of the hyoid bone to the exterior of the thyroid cartilage of 
the larynx. 
58. Hyoid Bone.—This movable, ?,£-slmped, bone is located 
at the anterior and superior of the neck. It is held in position 
by the antagonism of the muscles attached to it: inferiorlv, 
the sterno-hyoid, omo-hyoid (anterior belly),and thyro-hyoid; 
superiorly, the digastric (anterior belly), mylo-hyoid, genio- 
hyoid and genio-hyo-glossus ; posteriorly, the digastric (poste- 
rior belly), stylo-hyoid, and middle constrictor (of the pharynx). 
59. Larynx, Plates 190, 195, 196, and 197.—Of this organ 
portions present of the exterior of its thyroid cartilage, cricoid 
cartilage, crico-thyroid muscles and crico-thyroid membrane 
ligament. 
60. Thyro-hyoid Membrane or Ligament, Plates 190, and 
194 to 197, inclusive.—This is a stretch of fibrous tissue be- 
tween the hyoid bone and the thyroid cartilage of the larynx. 
It lies in a plane posteriorly to the superior ends of the sterno- 
hyoid, omo-hyoid (anterior belly), and thyro-hyoid muscles. 
61. Thyroid Body, Plates 195, 196, and 197.—This organ 
(weight in adult about one ounce and a half) is, comparatively, 
larger in infantile than later life, and in women than in men. 372 
HEAD AND NECK. 
It has a median-line isthmus and two lateral lobes: the isth- 
mus, having a variable vertical breadth, and antero-posterior 
thickness (about half by three-quarters of an inch), crosses the 
anterior of the superior portion of the trachea; the lateral 
lobes, a right and a left, mould themselves to the lateral sur- 
faces of the continuous trachea and larynx (a lobe measures 
vertically one inch and three-quarters, transversely one inch, 
and antero-posteriorly half an inch). 
62. Inferior Thyroid Veins, Plates 196 and 197.—These 
veins emerge, inferiorly, from the lateral lobes of the thyroid 
body ; they lie between the tracheal fascia, anteriorly, and the 
trachea, posteriorly ; the right passes anteriorly to the in- 
nominate artery, to the right innominate vein ; the left runs 
anteriorly to the left common carotid subclavian arteries, to the 
left innominate vein. 
Dissection.-—Clear (Plate 197) the left side of the trachea and expose : the 
left recurrent laryngeal nerve ; the thoracic duct; the first part of left sub- 
clavian artery and its branches—vertebral, thyroid axis and its branches, and 
internal mammary; also portions of the oesophagus, the left longus colli mus- 
cle, and the cervical portion of the left brachial plexus. 
63. Trachea, Plates 196, 197, and 198.—The cervical por- 
tion of this fibro cartilaginous air-passage extends, interiorly, 
from the larynx (cricoid cartilage) to its disappearance into the 
interior of the thorax, posteriorly to the innominate and left 
common carotid arteries. It has an antero-posterior direction, 
its inferior end being further from the skin than its superior. 
64. Recurrent Laryngeal Nerves, Plates 196 and 197.— 
These nerves, as their names imply, take a recurrent course to 
the larynx. The right, a branch of the right pneumogastric 
nerve (page 366), runs superiorly, parallel with, and applied to 
the surface of, the right side of the trachea, to the point where 
it disappears posteriorly to the right lateral lobe of the thyroid 
body. The left differs from the right, as follows: because of 
its origin from the left pneumogastric within the interior of the 
thorax (page 242 ; Plate 138), it is projected into the neck from 
the thorax, posteriorly to the left common carotid artery; its 
cervical portion lies in the cleft between the left side of the 
trachea and the oesophagus. ANTEEO-LATERAL AREA OF THE NECK. 
373 
65. Thoracic (or Left Lymphatic) Duct, Fig. 2, Plate 140 ; 
Plates 195, 197, and 19S.—The cervical portion of this duct, be- 
fore described (page 249), is projected from the interior of the 
thorax into the neck, between the oesophagus and the first 
part of the left subclavian artery, and anteriorly to the left 
longus colli muscle. It follows the curve of, and runs supe- 
riorly to, the artery, crossing anteriorly to the vertebral and 
inferior tigroid arteries ; opposite the internal third of the left 
scalenus anticus muscle, it curves inferiorly, anteriorly to the 
left superficial cervical and suprascapular arteries, to pass to 
its emptying into the left subclavian vein, externally to the 
confluence of the latter with the left internal jugular vein. 
66. First Portion of tile Left Subclavian Artery, Plates 
138, 195, 197, and 198.—This portion of the left artery differs 
from that of the right artery (page 369): first, it arises from 
the left of the transverse portion of the arch of the aorta (page 
244; Plate 138); second, it is longer, and is projected, supe- 
riorly, into the neck, from the interior of the thorax. 
67. (Esopliagus, Plates 197 and 198.—The cervical portion 
of this muscular canal, located posteriorly to the trachea, pre- 
sents its left-lateral border externally to it and the left recur- 
rent laryngeal nerve (page 244 ; Plate 188). 
Dissection.—Reflect (Plate 197), inferiorly, the stump of the left submaxil- 
lary gland with its duct ; expose the left submaxillary ganglion of the sympa- 
thetic, with its branches from the left gustatoiy nerve. 
68. Left Subinaxillarj Ganglion, Plate 197.—This cephalic 
sympathetic ganglion is lodged at the external surface of the 
superior and posterior portion of the hyo-glossus muscle. It 
receives branches from the left gustatory nerve. 
Dissection.—Section (Plate 197) the inferior thyroid veins and arteries, 
the trachea, the right and left recurrent laryngeal nerves, and the oesophagus. 
Raise the trachea and oesophagus, anteriorly and superiorly, dissecting them 
from the anterior surfaces of the bodies of the cervical vertebrae, and the longus 
colli muscles ; continue the reflection superiorly, by dissecting the pharynx 
from the bodies of the cervical vertebrae, and the rectus capitis anticus major 
muscles, as far as the base of the cranium. Reflect, superiorly, the right and 
left internal carotid arteries, internal jugular veins, pneumogastric, sympathetic, 
hypoglossal, glossopharyngeal and spinal accessory nerves, by dissecting them 374 
HEAD AND NECK. 
from the right and left rectus capitis anticus major muscles as far as the base 
of the cranium. Saw, along the section line in Plate 189, the right and left 
lateral walls of the cranium. Drag the mass of reflected parts (trachea and 
larynx, oesophagus and pharynx, right and left arteries, veins and nerves), 
superiorly, over the inferior maxillary bone ; then pass the saw blade in be- 
tween these parts, anteriorly, and the vertebral column and right and left 
rectus capitis anticus major and minor muscles, posteriorly (the saw should 
lodge posteriorly to the styloid processes of the right and left temporal bones). 
Saw, superiorly, through the base of the cranium, so as to enter the previous 
saw cuts of its lateral walls (Plate 189). Remove the anterior portion of the 
head with the appended parts of the neck, and keep the same moist for subse- 
quent dissection. The saw cut through the base of the cranium will have cut 
the superior ends of the rectus capitis anticus major and minor muscles, carry- 
ing away their superior attachments upon the anterior portion, while it will 
section the basilar process of the occipital bone parallel with the anterior sur- 
face of the first cervical (atlas) vertebra. Clear the inferior portions of the 
right and left rectus capitis anticus major muscles. 
69. Rectus Capitis Anticus Major Muscle, Plates 189, 194, 
196, 197, and 199.—This muscle (its superior portion was cut 
away by the vertical section of the cranium) is located ante- 
riorly to the transverse processes and pedicles, of the five supe- 
rior cervical vertebra?, and the longus colli muscle. It is at- 
tached : interiorly, to the anterior tubercles of the transverse 
processes of the six superior cervical vertebra? ; superiorly, to 
the exterior of the basilar process of the occipital bone (Plate 
189). 
Dissection.—Remove (Plate 198) tlie inferior portions of the right and left 
rectus capitis anticus major muscles and clear the anterior surfaces of the right 
longus colli muscle, the inferior portion of the left rectus capitis anticus minor 
muscle, and part of the left rectus capitis lateralis muscle. Dissect away (Plate 
198) the inferior portion of the right rectus capitis anticus minor muscle and 
expose the right rectus capitis lateralis muscle. 
TO. Rectus Capitis Anticus Minor Muscle, Plates 189, 198, 
and 199.—This muscle (its superior end was cut away by the 
vertical section of the base of the cranium) is attached : inte- 
riorly, to the superior surface of the anterior portion of the 
lateral mass of the first cervical vertebra (atlas); superiorly, 
to the exterior surface of the basilar process of the occipital 
bone. 
71. Rectus Capitis Lateralis.—This muscle is attached : 
interiorly, to the superior surface of the transverse process of ANTEEO-LATEEAL AEEA OF THE HECK. 
375 
the first cervical vertebra (atlas) ; superiorly, to the exterior 
surface of the jugular process of the occipital bone. 
72. Longu§ Colli Muscle, Plates 189, 197, and 198.—This 
muscle lias three portions—superior oblique, middle vertical, 
and inferior oblique. The superior oblique portion passes from 
the anterior of the two superior cervical vertebrae, to the an- 
terior tubercles of the transverse processes of the third, fourth, 
fifth, and sixth cervical vertebrae. The middle vertical portion 
bridges from the third and fourth cervical vertebrae, to the first 
dorsal vertebra—the anterior of their bodies. The inferior 
oblique portion stretches from the anterior of the bodies of the 
first and second dorsal vertebrae, to the anterior tubercle of the 
transverse process of the sixth cervical vertebra. 
Dissection.—Dissect away (Plate 198) the left longus colli muscle and dis- 
play : the cervical portion of the left vertebral artery; the anterior divisions of 
the superior cervical-spinal nerves, superiorly to their respective transverse pro- 
cesses ; and the anterior surfaces of the scalenus anticus, medius, and posticus 
muscles. 
73. Vertebral Artery, Plates 196, 197, and 198.—This artery 
(vena comes), branch of the lirst part of the subclavian artery, 
is projected, superiorly, anteriorly to the transverse process of 
the seventh cervical vertebra, to its entrance into the foramen 
between the roots of the transverse process of the sixth cervical 
vertebra ; thence, it passes through similar foramina of the 
transverse processes of the five superior cervical vertebrae. It 
gives off external branches, to contiguous muscles; internal, 
spinal, branches, which enter the vertebral canal, by the cervi- 
cal intervertebral foramina ; and posterior branches of anasto- 
mosis and of muscle distribution (page 276 ; Plate 150). 
74. Anterior Divisions of Cervical-spinal Nerves, Plate 
198.—These nerves are projected laterally, superiorly to the 
transverse processes of the cervical vertebrae, and posteriorly 
to the vertebral artery. 
75. Scalenus Anticus Muscle, Plates 189, 192, and 194 to 
198, inclusive.—Tins muscle is attached; superiorly (Plates 
189 and 198), to the anterior tubercles of the transverse pro- 
cesses of the cervical vertebrae, third to sixth, inclusive ; infe- 376 
HEAD AND HECK. 
riorly (Plate 189), to the tubercle between the subclavian grooves 
(the internal for the subclavian vein, the external for the sub- 
clavian artery) on the exterior surface of the first rib. 
76. Scalenus Medius Muscle, Plates 189, and 192 to 198, 
inclusive.—This muscle is attached (Plates 189 and 198): supe- 
riorly, to the posterior tubercles of the transverse processes of 
the cervical vertebrae, second to seventh, inclusive ; inferiorly, 
to the exterior surface of the first rib, posteriorly to the sub- 
clavian-artery groove, and externally to the first levator costa 
muscle. 
77. Scalenus Posticus Muscle: Fig. 2, Plate 150; Plates 
189, and 192 to 197, inclusive.—This muscle is attached : supe- 
riorly, to the posterior tubercles of the fifth, sixth, and seventh 
cervical vertebrae ; interiorly (Fig. 2, Plate 150 ; Plate 189), to 
the exterior surface of the second rib, externally to the second 
levator costa muscle. It is located in a plane posteriorly to the 
last-described muscle. PLATE 189 
Jltf. Cohn.act natur&m etet. PLATE 190 
M.Co/zn, aa'naf <uram del. PLATE 191 
hC. Cohn, adnaturam del. PLATE 192 
J/l.CoTin,aci natu ram aet. PLATE 193 
JUf. Co/irr, act naturam ctei. PLATE 194 
JhfCoAn.aa naticram del. PLATE 195 
M.Cohn ,ad riGUura7TzUel PLATE 196 
Af. C<3bn.actnatura.m tfez. PLATE 197 
&ZLCoPzsL*aot7z<ziu ram eZel. PLATE 198 
HJPff?27t,cMmxtiiram ctel. TWENTY-SIXTH DISSECTION. 
ARTERIES AND NERVES CONTIGUOUS TO THE PHA- 
RYNX ; PHARYNX; SOFT AND HARD PALATE; 
TONGUE AND CONTIGUOUS PARTS; LARYNX; 
NASAL CAVITIES AND CONTIGUOUS PARTS. 
ARTERIES AND NERVES CONTIGUOUS TO THE PHARYNX. 
Dissection.—The anterior of the head and appended parts, as sawn from 
the posterior portion of the head (page 374), are prepared for dissection as fol- 
lows : saw the right and left ramus of the inferior maxillary bone, accord- 
ing to inferior section line on the same in Pig. 1, Plate 184; stuff the pha- 
rynx with oakum, through the mouth and oesophagus ; suspend the anterior 
half of the head and appended parts in the pharyngeal frame (Figure 15, page 
378), by strings extending, superiorly, from gimlet holes in the skull—near 
its superior sawn edge—and, inferiorly, from the trachea ; the strings are tied, 
taut, into the holes of the frame. 
Terms of Relation.—Tile general terms (page 2) are used 
to locate these arteries and nerves. 
Dissection.—The vertical section of the cranium (page 374) will have sev- 
ered the superior end of the right hypoglossal nerve, and have disturbed the 
superior ends of the pneumogastric, spinal accessory, and glosso-pharyngeal 
nerves at their cranial exit by the foramen lacerum posterius (page 325, Plate 
180). As these nerves are bound to each other, and to the internal carotid ar- 
tery, by connective tissue, they will be found to maintain their normal rela- 
tions. Cut away (Plate 200) the left internal carotid artery inferiorly to its 
entrance into the carotid canal in the petrous portion of the temporal bone 
(Plate 199) ; the superior portions of the left external carotid artery; the left 
hypoglossal, pneumogastric (and its branches), spinal accessory, and glosso- 
pharyngeal (and its branches) nerves ; the left lobe of the thyroid body; the 
left recurrent laryngeal nerve ; and the inferior laryngeal artery. Remove the 
superior end of the right external carotid artery, from a point inferiorly to 
the giving off of the occipital artery (Plate 196) ; also, the right facial artery, 
leaving the superior portion of its branch, the ascending palatine artery (Plate 
201). Display (Plate 200) the superior portions of the following parts : the 
right hypoglossal and spinal accessory nerves; the right pneumogastric 
nerve and its superior branches; the right glossopharyngeal nerve and 378 
HEAD AND XECK. 
its pharyngeal branch; the ascending pharyngeal artery ; and the internal 
carotid artery. 
1. Hypoglossal and Spinal Accessory Nerves, Plate 200.— 
The posterior face of the superior ends, of the extracranial por- 
tions, of these nerves present contiguously to the superior ends 
of the internal carotid artery and pneumogastric nerve. 
Figtjiie 15. 
2. Pneumogaslric Nerve and its Superior Branches.—The 
inferior of the cervical part of this nerve has been described 
(page 366) and illustrated (Plate 196). The superior end of its 
extracranial portion lies posteriorly to the internal carotid ar- 
tery and gives off the following branches: the pharyngeal 
nerve, which contributes to the pharyngeal plexus ; the supe- ARTERIES AND NERVES CONTIGUOUS TO THE PHARYNX. 
379 
rior laryngeal nerve, before described (page 36,~) and illustrated 
(Plates 192 to 197, inclusive) at its inferior end, and where it 
gives off the external laryngeal nerve (page 369 ; Plate 197). 
3. Glossopharyngeal Nerve and its Pharyngeal Branch. 
—The superior end of the extracranial portion of this nerve 
appears between the internal carotid artery and pneumogastric 
nerve. Its 'pharyngeal branch winds internally to the artery, 
passing, interiorly, to the pharyngeal plexus. 
4. Pharyngeal Plexus.—This is a plexus of nerves located 
at the exterior surface of the middle constrictor muscle ; it is 
formed by the pharyngeal branches of the pneumogastric and 
glossopharyngeal nerves, respectively, and branches from the 
superior cervical ganglion of the sympathetic (Plate 197). 
5. Ascending Pharyngeal Artery.—This small artery (venae 
comites) arises from the posterior of the external carotid artery, 
at the level of the origin of the lingual artery from the same 
trunk. It has a superior course, posteriorly to the internal 
carotid artery. Its branches supply the pharynx, soft palate, 
prevertebral muscles, and the membranes of the brain (the latter 
branches enter the base of the cranium, at the foramen lacerum 
posterius, and the anterior condylar foramen of the occipital 
bone). 
6. Internal Carotid Artery: Fig. 2, Plate 188 ; Plate 200.— 
The inferior portion of this artery lias been partly described 
(page 367) and illustrated (Piates 192 to 196, inclusive). The 
superior part of its extracranial portion is projected, externally 
to the superior constrictor muscle, to the orifice of the carotid 
canal, at the inferior surface of the petrous portion of the tem- 
poral bone (Plate 199). It is in immediate relation to the fol- 
lowing nerves and vessels : the pneumogastric nerve (Plates 
196 and 200) and ascending pharyngeal artery (Plate 200), pos- 
teriorly ; the hypoglossal nerve (Plates 196 and 200) and the 
internal jugular vein (Plates 194 and 196), externally ; the 
glossopharyngeal nerve and the pharyngeal plexus (Plate 200), 
internally. 380 
HEAD AND NECK. 
PHARYNX. 
Dissection.—Section the superior laryngeal branch of the pneumogastric 
nerve, and the hypoglossal nerve (as in Plate 201). Cut away (as in Plate 201), 
from their superior ends : the right internal carotid artery; the right ascend- 
ing pharyngeal artery; the portions of the external and common carotid ar- 
teries (Plate 200) ; the right pneumogastric, hypoglossal, and spinal accessory 
nerves. Clear away the pharyngeal plexus from the exterior of the middle 
constrictor muscle. 
Terms of Relation.—The general terms (page 2); and the 
special terms exterior and interior—relatively to the cavities 
of the pharynx and larynx—lateral and postero-lateral—ap- 
plied to the pharynx—will be used in this dissection. 
Bone and Cartilage Areas for tlie Attachment of muscles, 
Plates 190 and 199.—The pharynx is suspended, from the cra- 
nium and face, by the attachments of its muscles, etc., to the fol- 
lowing bones : tliq occipital, at the inferior surface of its basilar 
process ; the right and left temporal, at the inferior surfaces of 
their petrous portions and at their styloid processes ; the sphe- 
noid, at its hamular processes and internal pterygoid plates ; 
the inferior maxillary, at the internal surfaces of the external 
portions of tlie two halves of its body ; the hyoid, at its great 
cornua ; the thyroid cartilage of the larynx, at its exterior 
surface and posterior borders. 
Dissection.—Clear (Plate 200) the posterior surfaces of the following parts : 
the superior ends of the oesophagus, trachea, recurrent laryngeal nerves, and in- 
ferior laryngeal arteries from the inferior thyroid arteries ; the right lobe of the 
thyroid body, with the ends of its right inferior and superior arteries ; .the 
superior portions of the exterior of the right and left halves of the fibrous coat 
of the pharynx ; portions of the left tensor palati muscle; the left liamular 
process ; the superior end of the left stylo-pliaryngeus muscle, to the point 
where it passes between the left middle constrictor and superior constrictor 
muscles ; the vertical portion of the left stylo-glossus muscle. Dissect off the 
fascial coat from the exterior of the right and left inferior constrictor muscles, 
and the superior portions of the right and left, middle and superior constrictor 
muscles. Section (Plate 200) the left inferior constrictor muscle, reflect it off, 
externally, and cut it away from its anterior attachment, to the thyroid car- 
tilage of the larynx (Plate 190) ; repeat the same with the left middle con- 
strictor muscle—cut it away from the great cornu of the hyoid bone (Plate 190). 
Expose (Plate 200) the posterior surface of the left stvlo-pharyngeus and supe- 
rior constrictor muscles ; also, the inferior of the left half of the fibrous coat PIIARYXX. 
381 
of tlie pharynx. Change the position of the half head in the pharyngeal frame 
so as to expose the right postero-lateral face of the pharynx, etc. (Plate 201). 
Dissect the internal pterygoid muscle from its pterygoid-plate attachment; 
and section the inferior dental nerve as in Plate 201. Clear (Plate 201) the 
right external surfaces of the following parts: the inferior, middle, and su- 
perior constrictor muscles; the stylo-pharyngeus and stvlo-glossus muscles. 
Display the pterygo-maxillary ligament, and the relations to it of the superior 
constrictor and buccinator muscles. 
1. Inferior Constrictor Muscle, Plates 190, 19G, 200, and 
201.—This muscle is attached to the median-line raphe at the 
posterior of the pharynx, where it meets its fellow of the oppo- 
site side (PI ates 200 and 201). Its fibres wind externally, an- 
teriorly, and inferiorly, to enclose the postero-lateral wall of 
the pharyngeal cavity, exteriorly to its fibrous coat and the in- 
ferior portion of the middle constrictor muscle. It is attached, 
anteriorly, to the exterior of the lateral wall of the larynx— 
thyroid and cricoid cartilages (Plates 190, 196, and 201). 
2. Middle Constrictor Muscle: Plates 190, 196, 200, 201, and 
204 ; Fig. 1, Plate 205.—This muscle attaches itself, posteriorly, 
to the median-line raphe of the pharyngeal wall, meeting the 
muscle of the opposite side (Plates 200 and 201). Its inferior 
portion lies interiorly to the inferior constrictor muscle, its 
superior portion exteriorly to the inferior part of the superior 
constrictor muscle. Its fibres pass, in the postero-lateral walls 
of the pharynx, to their anterior attachment, to the interior 
of the superior border of the great cornu of the hyoid bone 
(Plates 190, 196, 201, and 204; Fig. 1, Plate 205). 
3. Superior Constrictor Muscle: Fig. 2, Plate 188 ; Plates 
190, 196, 200, 201, 203, and 204; and Fig. 1, Plate 205.—This 
muscle is located in the postero-lateral walls of the superior 
half of the pharynx. It lies exteriorly to the fibrous coat of 
the pharynx ; its inferior half interiorly to the superior part 
of the middle constrictor muscle (Plate 200). Its attachment 
posteriorly is to the superior half of the common median-line 
raphe of the constrictor muscles (Plate 200). Anteriorly, its 
inferior fibres blend into the posterior of the lateral border of 
the tongue (Plates 196, 201, and 204 ; Fig. 1, Plate 205) ; its 
superior fibres pass to the inferior maxillary bone (Plate 190), 
the pterygo-maxillary ligament (Plates 201 and 203), and the 382 
IIEAD AXD XECK. 
liamular process and internal plate of the pterygoid process of 
the sphenoid bone (Plates 190, 200, 201, 203, and 204). 
4. Fibrous Coat of tlie Pharynx: Fig. 2, Plate 188 ; Plates 
199, 200, and 201.—This coat of the pharynx, common to both 
halves, is located interiorly to its muscular coat (the right and 
left superior, middle, and inferior constrictor, and stylo-pharyn- 
geus muscles), and exteriorly to its submucous and mucous 
coats, and the right and left palato-pliaryngeus muscles. It con- 
tributes to the postero-lateral walls of the cavity, and is attach- 
ed, superiorly, to the occipital bone (at the median line of the 
inferior surface of its basilar process, Plate 199), the sphenoid 
bone (its body), and the temporal bone (its petrous portion). 
It forms, posteriorly, the median-line, librous, raphe (Plate 200), 
from which the right and left constrictor muscles (inferior, 
middle, and superior) are projected, externally and anteriorly. 
It also appears, free of muscle investment, superiorly, between 
the superior borders of the right and left superior constrictor 
muscles and the inferior surface of the base of the cranium 
(Plate 200). 
5. Stylo-pharyngcus Muscle, Plates 190, 196, 200, 201, 203, 
and 204.—This muscle is attached: superiorly, to the poste- 
rior surface of the styloid process of the petrous portion of the 
temporal bone (Plate 190) ; inferiorly, to the fibrous coat of 
the pharynx (Plate 200) and the external face of the posterior 
border of the thyroid cartilage of the larynx (Plates 190 and 
200). In its inferior course the muscle enters at first, between 
the planes of the superior and middle constrictor muscles ; 
then it runs between the inferior constrictor muscle, exteriorly, 
and the fibrous coat of the pharynx, interiorly. 
6. Pterygo-maxlllary Ligament, Plates 201 and 203.—This 
is a stretch of fibrous tisues from the liamular process of the 
sphenoid bone to the internal surface of the lateral portion of 
the body of the inferior maxillary bone (at the attachment of 
the superior constrictor muscle, Plate 190). It forms a raphe for 
the common attachment of the posterior ends of the mid-fibres 
of the buccinator muscle and the anterior ends of the su- 
perior fibres of the superior constrictor muscle. .This relation 
of the buccinator and superior constrictor muscles, right and SOFT AND HAED PALATE. 
383 
left, together with the fusion of the inferior fibres of the latter 
muscles with the tongue, determine the mouth and pharynx 
as a continuous muscular sac—bucco-pharyngeal cavity. The 
buccal portion is completed, anteriorly, by the orbicularis oris 
muscle, and, interiorly, by the tongue ; the pharyngeal portion 
is completed by the right and left, middle and inferior con- 
strictor muscles, and the fibrous coat of the pharynx. 
Dissection.—Turn the half bead in the pharyngeal frame, presenting its 
posterior wall. Cut open (Plate 202) the pharynx, along its posterior median- 
line raphe, from the oesophagus to the cranium ; loop back, with threads tied 
to the pharyngeal frame, its postero-lateral walls ; take out the oakum from 
its interior and expose its mucous-membrane lined antero -lateral walls. Bec- 
ognize the parts forming its incomplete anterior wTall; also, its anterior, lateral, 
and inferior openings. 
7. Walls and Openings of the Pharynx, Plate 202.—Tile 
postero-lateral walls, right and left, of the pharynx present 
live coats as follows: mucons membrane lining (Plate 202); a 
submucous plane containing the palato-pharyngeus muscle 
(Plate 203) ; a fibrous coat, before described (page 382) and 
illustrated (Plate 200) ; a muscular layer, consisting of the 
three constrictor, and stylo-pharyngeus muscles, right and 
left (Plates 200, 201, and 203) ; and a fascial coat, exteriorly 
to the muscular. Its anterior wall is incomplete, being 
formed by the postero-superior surface of the soft palate, 
the dorsum of the base of the tongue, and the posterior 
surface of the larynx. Its incomplete portions are: superi- 
orly to the soft palate, where the posterior nares open into 
the right and left nasal cavities • and between the soft pal- 
ate and dorsum of the tongue, where the posterior buccal 
orifice is located, and partially shut off from the pharynx by 
the pillars and uvula of the soft palate. The openings into 
the pharynx are seven in number : the right and left posterior 
narium, and the posterior buccal orifice, anteriorly ; the orifices 
of the right and left Eustachian tubes, laterally ; the superior 
openings of the larynx and oesophagus, inferiorly. 
SOFT AND HAED PALATE. 
Dissection.—The half head and appended organs should be swung in the 
pharyngeal frame, with the pharynx, opened along the median line of its pos- 
terior w'all, as in Plate 202. 384 
IIEAD AND NECK. 
Terms of Relation.—The general terms (page 2), and the 
special terms interior, exterior, and lateral—relatively to the 
buccal and pharyngeal cavities—serve to locate the parts of 
this dissection. 
Bones, and Bone Attachments of Muscles, Plates 190 and 
199 ; Fig. 2, Plate 205.—The bones forming the hard palate 
(Fig. 2, Plate 205) are: the right and left superior mamillary 
(their palatine processes); the right and \eh palate (their hori- 
zontal portions). The bones affording attachments to muscles 
of the soft palate are : the right and left temporal (their petrous 
portions); the sphenoid (its navicular fossa); the right and 
left palate (the posterior borders of their horizontal plates). 
Dissection.—Looking through the stretched pharyngeal wall, the outlines 
of the right and left palato-pharyngeus muscle may be seen, located in the 
submucous plane, interiorly to the fibrous coat. Dissect (Plate 203) the mucous 
membrane from the interior of the right and left of the pharynx, and from the 
postero-superior surface of the soft palate ; display (Plate 203) the right and 
the left palato-pharyngeus, levator palati, and azygos uvulas muscles ; and the 
pharyngeal ends of the right and left Eustachian tubes. 
1. Palato-pharyngreus Muscle, Plate 203.—This muscle is 
located in the submucous plane of the lateral wall of the 
pharynx. It is attached interiorly to the posterior border of 
the thyroid cartilage of the larynx ; thence it has a superior 
course to the soft palate, of which it forms the substance of 
its posterior pillar. It ends in the body of the soft palate, 
a superior-internal and an inferior-external portion : the su- 
perior-internal portion consists of stray fibres to the superior 
surfaces of the palatine ends of the levator palati and the 
azygos uvulae muscles, of a side, as far as the median line 
(Plate 203, right side); the inferior-external portion passes to 
the superior of, the. external part of, the body of the soft 
palate, to blend with the palatine ends of the levator palati 
and tensor palati muscles, of a side (Plate 203, right side). A 
slip, from the palatine end of the inferior-external portion of 
the muscle, extends to the Eustachian tube, the salpingo- 
pharyngeus muscle (Plate 203, right side). 
2. Levator Palati Muscle: Fig. 2, Plate 188; Plates 190, 
199, 201, 203, and 204 ; Fig. 2, Plate 205.—The superior end 
of this muscle is attached to the petrous portion of the SOFT AND HARD PALATE. 
385 
temporal bone (Plates 190 and 199); thence, it passes inferiorly 
and internally (Plates 196, 201, and 204), entering interiorly to 
the lateral wall of the pharynx, superiorly to the superior 
constrictor muscle of the same (Plates 201, 203, and 204). Its 
palatine end enters the postero-superior face of the body of the 
soft palate, blending with the palatine ends of the last-described 
muscle (Plate 203, right side), and continuing to meet its fel- 
low of the opposite side at the median-line raphe of the soft 
palate. 
3. Azygos Uvulae Muscle, Plate 203, and Fig. 2, Plate 205. 
—This muscle is attached to the posterior, median-line angle 
of the horizontal plate of a palate bone; it is projected 
parallel with the median line, posteriorly and interiorly, 
between the superior-internal palatine libres of the palato- 
pliaryngeus muscle (page 384), superiorly, and the horizontal 
portion of the tensor palati muscle, interiorly ; it forms, by its 
free end, one-half of the substance of the uvula. 
Dissection.—Cut away (Plate 203, left side) the superior portion of the 
fibrous coat and superior constrictor muscle of the pharynx, trimming away the 
fibrous coat of the same along the posterior border of the stylo-pharyngeus 
muscle. Dissect (Plate 203, left side) from the postero-superior surfaces of 
the horizontal jiortion of the tensor palati muscle, and the superior face of the 
antero-inferior mucous membrane layer of the soft palate, the palatine ends 
of the palato-pliaryngeus and levator palati muscles. Cut away (Plate 203, left 
side) the levator palati muscle. Display (Plate 203, left side) : the tensor pa- 
lati muscle ; the hamular process of the sphenoid bone ; the distribution of the 
ascending palatine artery ; and more of the pharyngeal end of the Eustachian 
tube. 
4. Tensor Palati Muscle, Plates 188, 190, 199, 200, 201, 208, 
and 204.—This muscle lias a vertical and a horizontal portion : 
the vertical portion is attached, superiorly, to the navicular 
fossa at the external face of the superior end of the internal 
plate of the pterygoid process of the sphenoid bone (Plates 190 
and 199); thence, it has an inferior course parallel with, exter- 
nally to, and extending posteriorly to, the internal plate of the 
pterygoid process (Plates 200, 203, and 204), to wind interiorly 
to the hamular process of the internal pterygoid plate ; the 
horizontal portion has an internal course from the hamular 
process to the median line, spreading, antero-posteriorly, as it 386 
HEAD AND NECK. 
advances into the body of the soft palate (Plate 203). At a me- 
dian-line, fibrous, raphe it meets its fellow of the opposite side. 
5. Ascending Palatine Artery, Plates 196, 200, 201, 203, 
and 204.—This artery (venae comites), branch of the facial ar- 
tery (Plate 196), has a superior course, between the stylo-glossus 
muscle, externally, and the superior constrictor muscle, inter- 
nally. A branch or branches of it penetrate the latter muscle 
to- supply the tonsil (at times a tonsillar artery is given off 
directly from the facial artery). It runs to the superior border 
of the superior constrictor muscle, where it winds superiorly 
to it (Plates 200, 201, 203, and 204), to distribute to the sub- 
stance of the soft palate (Plate 203, left side). 
6. Eustachian Tube, Plates 202 and 203.—The pharyngeal 
end of this canal of communication between the cavity of the 
middle ear and the pharynx, is partly cartilaginous and partly 
fibrous in structure. It is projected, internally and inferiorly ; 
Us pharyngeal half runs along the internal side of the superior 
portion of the tensor palati muscle, to which it affords a par 
tial attachment. Its pharyngeal opening is at the superior 
part of a lateral wall of the pharynx, posteriorly to a posterior 
narium, and a little superiorly to the antero-posterior plane of 
the floor of a nasal cavity. 
Dissection.—Take tlie half head from the pharyngeal frame. Section 
(Plate 201) and cut away the right mylo-hyoid muscle; saw the right side of 
the anterior of the body of the inferior maxillary bone, along the section line 
in Pig. 1, Plate 188. Replace the half head in the pharyngeal frame, as in 
Plate 204; put a loop in the tip of the tongue, and another around the 
body of the inferior maxillary bone and tie them both to the pharyngeal 
frame. Gut away the posterior portions of the right superior, middle, and in- 
ferior constrictor muscles ; then by loops, from their cut borders to the frame, 
bring the parts into position, as in Plate 204. Cut away the right buccinator 
muscle, pterygo maxillary ligament, and the anterior of the superior fibres of 
the superior constrictor muscle, as in Plate 204. Expose (Plate 204) the right 
palato-glossus muscle, and dissect the mucous membrane from the right border 
of the tongue. Recognize the pillars and the tonsils of the soft palate. 
7. Paiato-glossus Muscle, Plate 204.—This muscle lies in 
the submucous plane of the lateral wall of the posterior part 
of the buccal cavity, bridging, interiorly, from the anterior of 
the body of the soft palate to the posterior portion of the 
lateral border of the tongue. TONGUE AND CONTIGUOUS PARTS. 
387 
8. Pillars and Tonsils of the Soft Palate, Plates 203 and 
204.—The pillars of the soft palate are two pairs of half arches 
at the sides of the posterior orifice of the buccal cavity. Those 
of a side diverge, interiorly, from the body of the soft palate 
the posterior pillar, determined by the palato-pharyngeus 
muscle (page 384 ; Plate 203), is directed, interiorly, and a little 
posteriorly, to the lateral wall of the pharynx ; the anterior 
pillar, formed by the palato-glossus muscle (page 386; Plate 
204), is projected, interiorly, to the posterior of the lateral bor- 
der of the tongue. The tonsils are aggregations of follicles, 
which are lodged in the submucous plane of the spaces be- 
tween the pillars of the soft palate, right and left ; the 
follicles are lined by involutions of the buccal mucous mem- 
brane, and open into the buccal cavity. The muscles or pillars 
and the tonsils of the soft palate are lined, interiorly, by 
mucous membrane, and are covered exteriorly by the superior 
constrictor muscle (Plate 204). 
Dissection.—At this point dissect the tongue and contiguous parts, after which 
the dissection of the soft and hard palate may be completed (page 391). 
TONGUE AND CONTIGUOUS PARTS. 
Terms of Relation.—The following will be used in this dis- 
section : the general terms (page 2) ; and the special terms in- 
terior and exterior—relatively to the buccal cavity—dorsum, 
base, apex, and lateral border—to the tongue. 
Bone Attachments of Extrinsic Muscles of the Tongue, 
Plate 190.—The bones affording attachments to these muscles 
are : the sphenoid (at its hamular processes) ; the right and 
left temporal (at the styloid processes of their petrous por- 
tions) ; the inferior maxillary (at the posterior and internal 
surfaces of its body) ; the hyoid (at the superior surfaces of 
its body and great cornu). 
Dissection.—Section (as in Plate 204) tlie right glossopharyngeal nerve 
and dissect away its superior portion. Trace (Plate 204) the inferior and an- 
terior part of the gustatory nerve, along the lateral border of the tongue. Fol- 
low (Plate 204) the duct of the submaxillary gland, anteriorly; and display the 
deep portion of the submaxillary gland, and the sublingual glandular tissue. 
Dissect out (Plate 204) the anterior of the hypoglossal nerve. 
1. Right Submaxillary Ganglion, Plates 201 and 204.— 
This ganglion, one of the cephalic ganglia of the sympathetic 388 
HEAD AHD HECK. 
nerve, is similar to that of the left side, which was described 
at page 373 and illustrated in Plate 197. 
2. The Duet of, and Deep Portion of, the Subniaxillary 
Gland, Plates 197 and 204 ; Fig. 1, Plate 205.—The duct of the 
submaxillary gland continues, anteriorly, from the gland pos- 
teriorly to the border of the mylo-hyoid muscle, between the 
mylo-hyoid muscle externally, and the hyo-glossus muscle, in- 
ternally ; it passes internally to the sublingual glandular tis- 
sue, and opens at the buccal floor, by the side of the frsenum 
of the tongue. A deep portion of the submaxillary gland pre- 
sents between the posterior part of the mylo-hyoid muscle and 
the anterior part of the hyo-glossus muscle. 
3. Hypoglossal Bfcrvc.—The cervical part of this nerve has 
been described (page 364) and illustrated (Plates 192 to 197, in- 
clusive), to the point where it disappears, internally to the 
hyoid ends of the stylo-hyoid and digastric muscles. Its an- 
terior and internal portion was partly described (page 365), 
and illustrated (Plate 197). Its latter portion runs between 
the mylo-hyoid muscle, externally, and the and 
genio-hyo-glossus muscles, internally. It distributes branches 
(Plate 204) to the hyo-glossus, stylo-glossus, genio-hyoid, and 
genio-hyo-glossus muscles ; its trunk then enters the substance 
of the tongue to supply its intrinsic muscle structure. 
4. Tongue: Plates 202, 203, and 204; Fig. 1, Plate 205; 
Fig. 2, Plate 206.—This median-line, conical-shaped, organ 
arches, postero-anteriorly, into the floor of the buccal cavity. 
It results from the fusion of the free ends of (Fig. 1, Plate 205) 
live pairs of extrinsic muscles—genio-hyo-glossus, hyo-glossus, 
superior constrictor, stylo-glossus, and palato-glossus—with 
its intrinsic muscle fibres—longitudinal, transverse, and verti- 
cal. The dorsum, lateral borders, and apex of its complex 
muscle structure is covered by mucous membrane, which is 
closely studded with papillae. Its base (Plate 204 ; Fig. 1, 
Plate 205) is fixed : to the liyoid bone, by the attachments of 
the pairs of genio-liyo-glossns and hyo-glossus muscles, pos- 
teriorly ; to the inferior maxillary bone, by the attachment of 
the pair of genio-hyo-glossus muscles, anteriorly. Its lateral 
borders, which are moulded to the contour of the interior 
surfaces of the body and alveolar process of the inferior rnaxil- TONGUE AND CONTIGUOUS PAKTS. 
389 
lary bone, are swung by three pairs of extrinsic muscles—the 
stylo-glossus, palato-glossus, and superior constrictor. Its 
dorsum arches, postero-anteriorly, presenting a pharyngeal 
(Plates 202 and 203 ; Fig. 1, Plate 206) and a buccal face 
(Plate 204). Its apex (Plate 204) or anterior free end is com- 
pletely invested by mucous membrane. 
Dissection.—Clear (Plate 204) tlie external surfaces of tlie right stylo- 
glossus, liyo glossus, and genio-liyoid muscles ; and portions of tlie genio-hyo- 
glossus muscle. Cut away (Plate 204) a piece of tlie posterior of the liyo- 
glossus muscle, in order to bring into view a part of the dorsal artery of the 
tongue, and the anterior direction of the glossopharyngeal nerve. Feel the 
course of the lingual artery internally to the hyo-glossus muscle. 
5. Stylo-glossus Muscle, Plates 190, 194, 196, 200, 201, 203, 
and 204.—This extrinsic muscle of the tongue is attached, 
posteriorly, to the styloid process of the petrous portion of 
the temporal bone (Plates 190, 200, 201, 203, and 204); thence, 
it has an inferior and anterior course, externally to the supe- 
rior constrictor muscle (Plates 196, 200, 201, 203, and 204); at 
the tongue its fibres blend into the lateral border of that organ 
(Plate 204 ; Fig. 1, Plate 205). 
6. Hyo-glosstis Muscle: Plates 190, 192, 196, 201, 203, and 
204 ; Fig. 1, Plate 205.—This extrinsic muscle of the tongue is 
attached, interiorly, to the exterior of the superior border of 
the great cornu of the hyoid bone (Plate 190) ; superiorly, its 
fibres merge into the lateral border of the tongue (Plate 204 ; 
Fig. 1, Plate 205). 
7. Gcnio-hyoid Mu§cle, Plates 190, 195,196, 197, and 204.— 
This muscle is described at page 365, with the parts exposed at 
the left side of the neck (Plates 195, 196, and 197). The genio- 
hyoid and mylo-hyoid muscles, right and left, form, the mus- 
cular floor of the buccal cavity, and consequently belong to the 
region of the head, and not to the neck region. For the same 
reason the hyoid bone, as supporting the tongue and buccal 
floor, is a bone of the head. 
Dissection.—Take the half head from the pharyngeal frame. Section 
(Plate 204) the pillars and tonsil of the soft palate, right and left, and the 
parts contiguous to them, thus dividing the anterior half of the head and ap- 
pended organs into two portions : the superior, made up of the upper jaw 
region of the face and the anterior of the cranium ; the inferior, consisting of 390 
HEAD AND NECK. 
the tongue and larynx. Clear the right lateral surface of the tongue (Fig. 1, 
Plate 205) so as to display the tongue portions of: the lingual artery ; the 
gustatory, glosso-pharyngeal, and hypoglossal nerves; the sublingual glandular 
tissue ; the perforation of the mucous membrane of the buccal floor by the 
duct of the submaxillary gland; and the, complete, external surface of the 
genio-hyo-glossus muscle. 
8. Ungual Artery and Its Branches: Plates 192 to 197, in- 
clusive ; Plates 200, 201, 203, and 204 ; and Fig. 1, Plate 205. 
—This artery (vena conies), branch of the external carotid 
artery (page 367 ; Plates 192 to 197, inclusive), lias a superior 
course from its origin, to the point where it turns to run in- 
ternally, parallel with and superiorly to, the hyoid bone. Its 
tongue portion (Plate 204 ; and Fig. 1, Plate 205) enters be- 
tween the liyo-glossus and middle constrictor muscles, and is 
continued, anteriorly, between the liyo-glossus and genio-liyo- 
glossus muscles; it appears in the anterior angle formed by 
the stylo-glossus and liyo-glossus muscles, where it bifurcates 
into the sublingual and ranine arteries (Fig. 1, Plate 205). 
Branches of the lingual artery are: the hyoid, given off 
before the entrance of the artery internally to the liyo-glossus 
muscle (Plate 204); the dorsal artery of the tongue, arising 
internally to the liyo-glossus muscle, near its posterior border, 
has a superior course to the posterior of the tongue (Plate 204 ; 
Fig. 1, Plate 205); the sublingual, one of its branches of bifur- 
cation, runs, anteriorly, on the external surface of the anterior 
portion of the genio-liyo-glossus muscle ; the ranine, a branch 
of bifurcation, distributes to the anterior of the organ and ter- 
minates in the superior of the frsenum of the mucous membrane 
of the tongue, where it has a direct anastomosis with its fellow 
of the opposite side. 
9. Glossopharyngeal Nerve: Plate 204 ; Fig. 1, Plate 205.— 
Tlie superior portion of this nerve lias been described (pages 368 
and 379) and illustrated (Plates 200 and 201). It enters be- 
tween the liyo-glossus muscle, externally, and the lingual por- 
tion of the superior constrictor muscle, internally (Plate 204). 
It is continued to the external face of the genio-liyo-glossus 
muscle (Fig. 1, Plate 205), where its branches enter the submu- 
cous plane of the posterior lateral parts of the tongue, for 
ultimate distribution to the papillae of that area of its mucous 
membrane. SOFT AND HARD PALATE. 
391 
10. Gustatory Nerve.—The superior portion of this nerve 
has been described (page 352), and illustrated (Plates 187, 188, 
201, and 203). It runs externally to the stylo-glossus muscle 
(Plate 204), to reach the anterior of the lateral border and dor- 
sum of the tongue, where its branches innervate the papillm of 
that area of its mucous membrane. 
11. Sublingual Glandular Tissue.—This is an aggregation 
of small masses of salivary gland tissue, located in the submu- 
cous plane of the floor of the buccal cavity, at the external 
surface of the anterior portion of genio-hyo-glossus muscle. 
From it numerous ducts (the ducts of Rivini) open, through 
the mucous membrane, into the buccal cavity. 
12. Genio-liyo-glossus Muscle: Plates 190 and 204 ; Fig. 1, 
Plate 205.—This muscle is attached to bone : anteriorly, to tlie 
superior genial tubercle of the posterior surface of the body of 
tlie inferior maxillary bone (Plate 190) ; posteriorly, to the 
body of the hyoid bone (Fig. 1, Plate 205). Its glossal portion 
is formed by the free ends of its fibres, which blend into the 
half of the tongue. 
SOFT AND HAED PALATE (Continued from page 387). 
Dissection.—Place the superior portion of the half head (as sectioned page 
389) with the inferior surfaces of the hard and soft palate uppermost (Fig. 2, 
Plate 205); introduce a wad of oakum under the soft palate ; pass a loop into 
the uvula and make the soft palate taut. Make a median-line incision (Fig. 
2, Plate 205) of the antero-inferior mucous membrane of the soft palate ; reflect 
the left half of the same and display the inferior face of the horizontal portion 
of the left tensor palati muscle, and the posterior portion of the left azygos 
uvulse muscle. Dissect (Fig. 2, Plate 205) the mucous membrane from the 
internal surfaces of the superior portions of the right palato-glossus and 
palato-pliaryngeus muscles, and the right tonsil. 
9. Tensor Palati Muscle, Fig. 2, Plate 205.—The postero- 
superior face of tlie horizontal portion of this muscle was before 
described (page 385) and illustrated (Plate 203). Its anterior- 
inferior or buccal surface stretches, internally, from the curve 
of the muscle around thehamular process of the internal plate 
of the pterygoid process of the sphenoid bone ; it widens as it 
advances to the median-line raphe, between it and its fellow of 
the opposite side. 392 
HEAD AND NECK. 
10. Palato-pliaryngeus and Palato-glossus muscles; and 
the Tonsil.—The two muscles diverge, interiorly, from the soft 
palate (page 387), and have the tonsil of the side lodged be- 
tween them. 
Dissection.—Dissect the mucous membrane from the left half of the hard 
palate (Fig. 2, Plate 205), and display the buccal portions of the descending 
palatine artery and anterior palatine nerve. 
11. Descending Palatine Artery.—The buccal portion cf 
this artery (venae comites) appears at the buccal orifice of the 
posterior palatine canal. It runs anteriorly, in the angle 
formed by the alveolar process with the palatine process of the 
superior maxillary bone, supplying the mucous membrane of 
the hard palate and the contiguous gum ; it anastomoses with 
the terminal branch of the naso-palatine artery, which enters 
the buccal cavity by the buccal orifice of the anterior palatine 
canal. 
12. Anterior Palatine BJerve.—This nerve, branch from the 
spheno-palatine ganglion (page 407; Fig. 1, Plate 210), enters 
the buccal cavity, at the orifice of the posterior palatine 
canal, with the last-described artery. It accompanies the latter 
artery along the roof of the buccal cavity, distributing branches 
to the mucous membrane of the hard palate and the contigu- 
ous gum. The posterior palatine nerve, branch of the spheno- 
palatine ganglion, passes, by the accessory palatine canal 
(Plate 199) in the palate bone, to the soft palate. The external 
palatine nerve (when present), also a branch of the same gan- 
glion, passes, by a special canal in the palate bone, to the soft 
palate. 
Bones of the Hard Palate.—The osseous part of tile hard 
palate is formed by the palatine processes of the right and left 
superior maxillary bones, and the horizontal plates of the 
right and left palate bones ; their area is bordered by the alve- 
olar processes of the, right and left, superior maxillary bones. 
These bone surfaces are covered by periosteum, a dense sub- 
mucous tissue, and mucous membrane. The hamular processes 
of the, right and left, internal plates of the pterygoid pro- 
cesses of the sphenoid bone present posteriorly to, and inde- 
pendently of, the tuberosities of the superior maxillary bones. LARYNX. 
393 
LARYNX. 
Terms of Relation.—The general terms (page 2), and the 
special terms exterior and interior—relatively to the cavity of 
the larynx—will be used in the dissection directions, and the 
descriptions, of the parts of this organ. 
Dissection.—Cut away the lateral walls of the pharynx and the superior 
part of the oesophagus (Fig. 2, Plate 206). Hold the larynx and tongue (Fig. 
2, Plate 206) so as to be able to look into the interior of the larynx, through 
its superior opening. 
1. Antero-lateral Furrow, Fig. 2, Plate 206 (left side).— 
This is a mucous-membrane lined furrow, with an anterior and 
two lateral portions, partially surrounding the superior open- 
ing of the larynx. The anterior portion is between the 
pharyngeal face of the dorsum of the tongue and the antero- 
superior surface of the epiglottis ; the frcerium epiglottidis, at 
the median line, and a right and left frenulum, at either side, 
bridge from the epiglottis to the base of the tongue. The 
lateral portions of the furrow are between the right and left 
aryteno-epiglottidean folds, internally, and the superior bor- 
ders of the right and left alee of the thyroid cartilage of the 
larynx, externally. 
2. Interior of the Larynx.—Looking through the superior 
opening of the larynx into its cavity, it presents a mucous- 
membrane lining, which is continued, inferioriy, from the cavity 
of the pharynx, and passes, in turn, inferioriy into the trachea. 
Three constrictions of the canal present—a superior, a middle, 
and an inferior. The superior constriction—the superior open- 
ing of the larynx—is bounded : anteriorly, by the free border of 
the mucous-membrane covered epiglottis ; by the right 
and left aryteno-epiglottidean fold of mucous membrane ; pos- 
teriorly, are two mucous-membrane covered tips, divided by 
a cleft (the tips are determined by the apices of the arytenoid 
and the cornicula laryngis cartilages). The middle constriction 
is formed by the false vocal cords. The inferior, and greatest 
constriction is produced by the true vocal cords. The antero- 
posterior space between the true vocal cords is the rima 
glottidis. Through the rima glottidis are seen portions of 394 
HEAD AND NECK. 
the mucous-membrane lined interior of the anterior of the 
cricoid cartilage, and of the trachea. 
Dissection.—Cut the tongue from the hyoid bone (Fig. 1, Plate 207), also 
the stumps of muscles from the thyroid cartilage of the larynx, and from the 
hyoid bone. 
3. Extrinsic Muscles of the Earynx, Plates 190, 195, 196, 
197, 200, 203, and 204.—There are five pairs of extrinsic muscles 
of the larynx, which are attached to the exterior of the aim 
and to the superior cornua of the thyroid cartilage, and to 
the cricoid cartilage : two inferior, the pair of sterno-thyroid 
(Plates 190 and 195); two antero-superior, the pair of thyro- 
hyoid (Plates 190, 196, and 197) ; two posterior, the pair of in- 
ferior constrictor (Plates 190, 203, and 204); four superior and 
lateral, the pairs of stylo-pliaryngeus (Plates 190, 200, and 203) 
and palato-pharyngeus (Plate 203). 
Di ssection.—Swing tlie larynx and superior part of the trachea in the frame 
(Figure 15, page 378) so as to present the right postero-lateral face of the larynx. 
Clear (Fig. 1, Plate 207) the exterior surfaces of the thyro-hyoid membrane, 
thyro-hyoid ligament, larynx, and trachea, so as to display the following parts : 
the tlivro-liyoid membrane, with the ends of the superior laryngeal nerve and 
internal laryngeal artery protruding through it; the thyro-hyoid ligaments ; the 
ala of the thyroid cartilage and half of the cricoid cartilage, with the crico- 
thyroid muscle bridging between them ; the crico-tliyroid articulation ; and 
the crico-tliyroid membrane. Dissect the pharyngeal mucous membrane from 
the posterior surface of the larynx, and expose the recurrent laryngeal nerve, 
the inferior laryngeal artery, the posterior crico-arytenoid and the arytenoid 
muscles. 
4. Thyro-hyoid Membrane and Tliyro-liyoid Ligaments: 
Plates 190, 194,195, 196, and 197 ; Fig. 1, Plate 207 ; Plate 208. 
—The thyro-hyoid membrane is a stretch of fibrous tissue from 
the superior border of the thyroid cartilage of the larynx to 
the inferior border of the body and great cornua of the 
hyoid bone ; laterally, it gives transit to the, right and left, 
superior laryngeal nerves and internal laryngeal arteries (Fig. 
1, Plate 207). The thyro-hyoid. ligaments (Fig. 1, Plate 207) 
are the lateral thickened borders of the thyro-hyoid mem- 
brane ; they bridge from the superior cornua of the thyroid 
cartilage of the larynx to the tips of the great cornua of the 
hvoid bone. LARYNX. 
395 
5. Thyroid Cartilage: Plates 190, 195, 196, 197, 203, and 
204 ; Fig. 1, Plate 207 ; Fig. 2, Plate 208.—This movable carti- 
lage is shaped like a horizontal letter V—the apex anteriorly, 
the open base posteriorly. Its halves are called alee (Fig. 1, 
Plate 207): their anterior meeting is the angle of the cartilage ; 
from their posterior borders are projected the, right and left, 
inferior and the superior cornua. 
6. Crico-tliyroid Muscle, Plates 190, 195, 196, 197, and 207. 
—This, one of a pair of intrinsic muscles of the larynx, is at- 
tached : interiorly and anteriorly, to the exterior of the ring- 
portion of the cricoid cartilage ; superiorly and posteriorly, to 
the exterior of the posterior part of the inferior border of the 
ala of the thyroid cartilage. 
7. Crico-thyroid Articulation, Plate 207.—The elements of 
this articulation are: a facet at the internal surface of the free 
end of an inferior cornu of the thyroid cartilage ; a facet on 
the lateral surface of the signet-portion of the cricoid cartilage 
(Fig. 2, Plate 207); and a capsular ligament (Fig. 1, Plate 207) 
lined by Synovial membrane. 
§. Crico-tliyroid Membrane, Plates 190, 197, and 207.— 
This is a sheet of fibrous tissue, that bridges between the supe- 
rior border of the ring-portion of the cricoid cartilage and the 
inferior border of the thyroid cartilage. Interiorly, it is lined 
by mucous membrane (Fig. 1, Plate 208) ; exteriorly, are the, 
right and left, crico-tliyroid and lateral crico-arytenoid muscles. 
9. Posterior Crico-arj tenoid Muscle, Fig. 1, Plate 207.— 
This, one of a pair of intrinsic muscles of the larynx, is at- 
tached : interiorly and internally, to the exterior of the signet- 
portion of the cricoid cartilage ; superiorly and externally, to 
the postero-external angle of the base of the arytenoid cartilage 
(Fig. 2, Plate 207). 
10. Arytenoid Muscle.—This single, median-line, intrinsic 
muscle of the larynx crosses, transversely, between its attach- 
ments to the posterior surfaces of the, right and left, arytenoid 
cartilages. 
Dissection.—Track the superior laryngeal nerve and internal laryngeal ar- 
tery into the submucous tissue between the thyro-hyoid membrane, exteriorly, 396 
HEAD AND NECK. 
and the mucous membrane, interiorly; dissect away the thyro-liyoid ligament 
and the half of the thyro-liyoid membrane, exposing (Fig. 2, Plate 207) the 
submucous tissue exteriorly to the mucous membrane of the pharynx. Trace 
(Fig. 2, Plate 207), inferiorly, the superior laryngeal nerve and the internal 
laryngeal artery ; crowd them, and the muscle tissue, interiorly to the ala of 
the thyroid cartilage (Fig. 2, Plate 207), internally from the cartilage, till the 
anterior attachment of the thyro-arytenoid muscle is seen ; cut the thyroid carti- 
lage vertically (Fig. 2, Plate 207), externally to the attachment of the muscle. 
Dissect (Fig. 2, Plate 207) the crico-thyroid muscle from its thyroid cartilage 
attachment; reflect it to the cricoid cartilage and cut it away, leaving a stump. 
Disarticulate the right crico-thyroid joint, and dissect away the posterior part 
of the right ala of the thyroid cartilage (Fig. 2, Plate 207). Display (Fig. 2, Plate 
207) the branches of the superior laryngeal nerve and internal lai’yngeal artery. 
Trace (Fig. 2, Plate 207j, superiorly, by cutting away the posterior crico-aryte- 
noid muscle, the recurrent laryngeal nerve, and the inferior laryngeal artery; 
find the branches of the nerve to the intrinsic muscles of the larynx, and its 
communicating branch with the superior laryngeal nerve ; expose the distri- 
bution of the artery and its anastomosis with the cricoid artery. Clear, and 
define (Fig. 2, Plate 207), the exterior surfaces of the cricoid cartilage, and 
the following intrinsic muscles of the larynx : the lateral crico-arytenoid, the 
thyro-arytenoid, the thyro-epiglottidean, and the aryteno-epiglottidean. 
11. Superior Laryngeal Nerve, Plate 207.—This nerve has 
been described (page 365) and illustrated (Plates 192 to 197, 
inclusive) to the point where it disappears with the internal 
laryngeal artery (page 367), between the thyro-hyoid mem- 
brane, posteriorly, and the thyro-hyoid muscle, anteriorly. 
The nerve perforates the thyro-hyoid membrane (Fig. 1, Plate 
207) to the submucous plane of tissue interiorly to the mem- 
brane (Fig. 2, Plate 207). Its several branches are: a middle 
(one or more), laryngeal branch (or branches), which is con- 
tinued to the mucous-membrane lining of the larynx ; a supe- 
rior, lingual branch, that passes to the mucous membrane of the 
dorsum of the base of the tongue, and of the pharynx ; an in- 
ferior, communicating branch, which communicates with the 
recurrent laryngeal nerve. 
12. Internal Laryngeal Artery.—This artery (venae comi- 
tes), branch of the superior thyroid, has been described (page 
367) and illustrated (Plate 194). It accompanies the last-de- 
scribed nerve through the thyrohyoid' membrane (Fig. 1, Plate 
207), and distributes to the interior tissues of the larynx, to 
the base of the tongue, etc. 
13. Recurrent Laryngeal Nerve and its Branches.—Tllis 
nerve lias been described (pages 242, 366, 372) and illustrated LAKYNX. 
397 
(Plates 138, 196, and 197) to the point where it is about to 
enter the larynx. It passes, superiorly, into the larynx, be- 
tween the posterior crico-arytenoid muscle and the posterior 
surface of the signet-portion of the cricoid cartilage. It dis- 
tributes branches to intrinsic muscles of the larynx in the 
following order : to the posterior crico-arytenoid, arytenoid, 
lateral crico-arytenoid, thyro-arytenoid, thyro-epiglottidean, 
and aryteno-epiglottidean. 
14. Inferior Laryngeal Artery.—This artery (vena3 comites), 
branch of the inferior thyroid artery, accompanies the last-de- 
scribed nerve. It distributes to the intrinsic muscles, etc., of 
the larynx, and anastomoses with the cricoid artery (page 367). 
15. Cricoid Cartilage, Plates 190, 195, 196, 197, 207, and 
208.—This cartilage forms the fixed base of the larynx ; it is 
signet-ring shaped, with the signet-portion posteriorly and the 
ring-portion anteriorly (Fig. 2, Plate 207) ; from it the trachea 
is continued, interiorly. 
16. Lateral Crico-arytenoid Muscle, Fig. 2, Plate 207.— 
This muscle, one of a pair of intrinsic muscles of the larynx, 
is attached, anteriorly, to the superior border of the ring-por- 
tion of the cricoid cartilage ; thence it runs, under cover of the 
inferior border of the ala of the thyroid cartilage, to its poste- 
rior attachment to the inferior portion of the postero-external 
border of the arytenoid cartilage. 
17. Thyro-arytenoid Muscle.—This muscle has two parts, 
an exterior and an interior; the exterior, lying interiorly to 
the ala of the thyroid cartilage, is attached : anteriorly, to the 
posterior face of the internal portion of the ala of the thyroid 
cartilage; posteriorly, to the mid-portion of the postero-exter- 
nal border of, and to the external surface of, an arytenoid 
cartilage. 
18. Tliyro-eplglottidean Muscle.—Tliis muscle is the su- 
periorly-diverging fibres of the exterior part of the last-de- 
scribed muscle, which pass to the epiglottis. 
19. Arytcno-eplglottidean Muscle.—This consists of muscle 
fibres in the fold of mucous membrane 
(page 393 ; Fig. 2, Plate 206), which bridge from the superior 398 
HEAD AND NECK. 
portion of the external face of the arytenoid cartilage, pos- 
teriorly, to the border of the epiglottis, anteriorly. 
Dissection.—Take the larynx from the frame. Cut (Fig. 1, Plate 208), on 
the median line, the posterior of the trachea and the cricoid cartilage, and then 
between the arytenoid cartilages ; make, anteriorly, a second median-line cut 
of the trachea, cricoid cartilage, crico-thyroid membrane, and thyroid cartilage ; 
then slit the epiglottis, sufficiently, to allow the opening of the halves of the 
larynx. Suspend the larynx in the frame, so as to present its interior, as in 
Fig. 1, Plate 208. Demonstrate the ventricles of the larynx, and cavities of 
the, right and left, laryngeal pouches—insert a probe into the latter. 
20. True Vocal Cords: Fig. 2, Plate 206; Plate 208.— 
These are a right and a left, antero-posterior, mucous-mem- 
brane covered, band, at the interior of the lateral walls of the 
laryngeal cavity ; a cord extends from the posterior surface of 
the angle formed by the alse of the thyroid cartilage (a little 
to one side of the median line), anteriorly, to the anterior angle 
of the base of an arytenoid cartilage, posteriorly. 
21. False Vocal Cords.—These are located superiorly to the 
true vocal cords ; they are a right and left, antero-posterior, 
mucous-membrane covered, ridge—less prominent than, and 
not so sharply defined as, the true vocal cords—along the in- 
terior of the lateral walls of the larynx. 
22. Ventricles and Laryngeal Pouches of the Larynx, 
Plate 208.—The ventricles of the larynx are: a right and a 
left oval depression at the interior of the lateral walls of the 
larynx, between the false and true vocal cords. The laryngeal 
pouches are a right and a left, sac-like, involution of the mucous 
membrane of the larynx, which are projected, superiorly, be- 
tween the interior and the exterior parts of the thyro-aryte- 
noid muscles ; they are located superiorly to, and open into, 
the ventricles. 
Dissection.—Cut the right half of the epiglottis, and remove the right 
half of the larynx (Fig. 2, Plate 208) ; place the left half with its interior sur- 
face uppermost and dissect off its mucous membrane, and the half of the crico- 
thyroid membrane. Display (Fig. 2, Plate 208) the interior surfaces of the 
following parts of the left side of the larynx : the half of the cricoid cartilage; 
the internal surface of the arytenoid cartilage ; portions of the crico-thyroid and 
lateral crico-arytenoid muscles; the inferior thyro-arytenoid ligament; the 
superior thyro arytenoid ligament; the thyro-arytenoid, thyro-epiglottidean, 
and aryteno-epiglottidean muscles ; and the epiglottis. LARYNX. 
399 
23. Arytenoid Cartilages: Fig. 2, Plate 206; Fig. 2, Plate 
207 ; Plate 208.—These two cartilages are located at the supe- 
rior surface of the signet-portion of the cricoid cartilage. An 
arytenoid cartilage is pyramidal in form, having : a triangular 
base, with anterior, postero-external, and postero-internal an- 
gles ; internal, external, and posterior surfaces ; anterior, pos- 
tero-external, and postero-internal borders ; and an apex. Of 
the base: it articulates by the posterior portion of its area (Fig. 
2, Plate 208) with the superior surface of the signet-portiou of 
the cricoid cartilage, to which it is held by a capsular and a pos- 
terior crico-arytenoid ligament ; its anterior angle (Plate 208) is 
freely movable and affords attachment to the inferior thyro- 
arytenoid ligament; its postero-external angle (Fig. 2, Plate 207) 
gives attachment to the posterior crico-arytenoid muscle. Of 
the Surfaces : the posterior affords attachment to the arytenoid 
muscle (Plate 208) ; the internal (Fig. 1, Plate 208) is a free 
surface covered by mucous membrane ; the external affords 
part attachment to the thyro-arytenoid muscle and the su- 
perior thyro-arytenoid ligament. Of the borders : the pos- 
tero-external (Fig. 2, Plate 207) gives attachment to the lateral 
crico-arytenoid, the thyro-arytenoid (exterior part), and the 
aryteno-epiglottidean muscles. 
24. Thyro-arytenoid Muscle, Fig. 2, Plate 208.—The exte- 
rior of the exterior portion of this muscle and its thyro-epiglot- 
tidean fibres (the thyro-epiglottidean muscle) were described 
(page 397) and illustrated (Fig. 2, Plate 207). The interior 'por- 
tion of the muscle bridges from the external surface of the 
arytenoid cartilage—in the internal wall of the ventricle of the 
larynx, superiorly to the superior tliyro-arytenoid ligament— 
to the posterior surface of the thyroid cartilage, to one side of 
its angle, and superiorly to the attachment of the exterior por- 
tion of the muscle. The interior surfaces of the exterior portion 
of the muscle, and of the thyro-epiglottidean muscle, present at 
the interior of the thyroid cartilage. 
25. Superior Thyro-arytenoid Ligament.—This ligament, 
the border of a false vocal cord, bridges from the external 
surface of an arytenoid cartilage, posteriorly, to the posterior 
surface of the thyroid cartilage (to one side of the middle 
of its angle), anteriorly. It is so blended with the inferior 400 
HEAD AND NECK. 
border of the interior portion of the tliyro-arytenoid muscle 
that it is not clearly defined. 
26. Inferior Tliyro-arytenoid Ligament.—This well-defined 
ligament, the essential element of a true vocal cord, extends, 
postero-anteriorly, from the anterior angle of the base of an 
arytenoid cartilage to the posterior surface of the thyroid car- 
tilage (to one side of the middle of its angle), and inferiorly to 
the last-described ligament. 
27. Ventricle and Laryngeal Pouch of tlie Larynx.—A 
ventricle was before described (page 398) and illustrated (Fig. 1, 
Plate 208): a laryngeal pouch may now be demonstrated as 
having the interior portion of the tliyro-arytenoid muscle in its 
internal wall, and the exterior portion of the same muscle in 
its external wall. 
28. Epiglottis or Epiglottic Cartilage.—III structure this is 
dense fibrous tissue with some cartilage tissue. It is pitcher- 
cover shaped, and is hinged—by its attachment—to the poste- 
rior surface of the thyroid cartilage—in, and to the sides of, the 
angle—at a point superiorly to the attachments of the superior 
tliyro-arytenoid ligaments. Its surfaces are invested by mucous 
membrane (Fig. 2, Plate 206 ; Fig. 1, Plate 208), which form its 
fnenum and frenula, anteriorly (page 893 ; Fig. 2, Plate 206), 
and its aryteno-epiglottidean folds, posteriorly (Fig. 2, Plate 
206; Fig. 1, Plate 208). Two pairs of muscles act upon it; the 
aryteno-epiglottidean and tliyro-epiglottidean (page 397 ; Fig. 
2, Plates 207 and 208). 
NASAL CAVITIES AND CONTIGUOUS PARTS. 
Terms of Relation.—The general terms (page 2) ; and the 
special terms interior and exterior—relatively to the nasal 
cavities—will serve to locate parts described. 
\Tasal Cavities: llicir Boundary Walls; Osseous Openings; 
and Lining.—Fourteen bones, five cartilages, and fibrous tis- 
sue uniting tlie cartilages, form tlie walls of the two nasal cav- 
ities. These cavities have the following walls : an inferior, a NASAL CAVITIES AND CONTIGUOUS PARTS. 
401 
riglit and left lateral, a superior, a right and left antero-lateral, 
and a median-line septum between the two cavities. The in- 
ferior wall (the superior surface of the hard palate) is formed 
by the following bones : the right and left superior maxillary 
(their palatine processes) ; the right and left palate (their hori- 
zontal plates). A lateral wall is contributed to by bones as 
follows : a superior maxillary (its nasal process and bod}^); 
a lachrymal ; the ethmoid (its lateral mass and turbinate 
processes of same); a palate (its vertical plate); a turbinate; 
and the sphenoid (the internal plate of its pterygoid process). 
The bones of the superior wall are : the ethmoid (its cribriform 
plate) ; the sphenoid (its body) ; the vomer (its aim) ; the right 
and left palate (their sphenoidal processes). The antero-lateral 
walls are constructed by the frontal bone (its nasal spine); the 
right and left nasal bones ; the cartilages of the aim (the right 
and left superior lateral, inferior lateral, and sesamoid), and 
the fibrous tissue of the aim (connecting the cartilages and 
forming the alar borders of the anterior nares). The median- 
line septum between the two cavities is formed by : the ethmoid 
bone (the nasal portion of its perpendicular plate); the vomer 
bone ; and the cartilage of the septum. 
The osseous openings, covered by mucous membrane, of a 
narium are : at the superior wall, the foramina in a half of the 
cribriform plate of the ethmoid bone (for entering branches 
from the bulb of the olfactory nerve), and the points of entrance 
of the nasal nerve, the anterior ethmoidal artery, and the pos- 
terior ethmoidal artery ; at the external wall, the splieno-pala- 
tine foramen (for the entrance of the nasal branches of the 
spheno-palatine ganglion, and the spheno-palatine branch of 
the internal maxillary artery) ; at the anterior of the inferior 
wall, the incisor foramen of the anterior palatine canal (for the 
exit into the mouth of the naso-palatine nerve and artery). 
Mucous membrane (the Schneiderian membrane) lines the 
interiors of the nasal cavities, covering intimately the perios- 
teum of the osseous, and the perichondrium of the cartilagi- 
nous, areas. 
1. Anterior Nares, Plate 197.—These are the right and left 
facial openings into the nasal cavities, Their borders are 
formed of fibrons tissue, which is covered, exteriorly and in- 
teriorly, by the skin. 402 
IIEAD AND XECK. 
2. Posterior Vares: Plates 199, 202, and 203 ; Fig. 1, Plate 
206.—The, pharyngeal openings of the nasal cavities, the pos- 
terior nares, present at either side of the median line, anteri- 
orly to the superior portion of the pharynx. Their osseous 
boundaries are (Plate 199): superiorly, the body of the sphe- 
noid bone, the sphenoidal processes of the palate bones, and the 
aim of the vomer ; laterally, the Internal plates of the pterygoid 
processes of the sphenoid bone ; inferiorly, the posterior bor- 
ders of the horizontal plates of the right and left palate bones 
—from this border the soft palate is projected, posteriorly ; at 
the median line are divided by the vomer. These osseous 
boundaries are covered by periosteum and mucous membrane 
(Fig. 1, Plate 206). 
It. Posterior View of the Interior of the Vasal Cavities, 
Fig. 1, Plate 200.—Looking into I he nasal cavities, through the 
posterior nares, portions of the following parts, covered by mu- 
cous membrane, may be seen : the right and left, postero-ante- 
rior, inferior walls of the nasal cavities, slightly concave trans- 
versely ; the right and left surfaces of the median-line septum 
between the cavities ; the right and left external walls, present- 
ing the posterior ends of the shelf-like projections of the right 
and left turbinate bones, inferiorly, and the right and left tur- 
binate processes of the ethmoid bone, superiorly. Between 
these osseous shelves are the posterior portions of the right and 
left inferior, middle, and superior meatuses. 
Dissection.—Saw to the left of the median line, through the anterior of 
the base of the cranium into the left nasal cavity ; also through the inferior 
wall of the same cavity, at the side of the septum. So place the halves of the 
upper jaw region of the face as to present the interiors of the internal and 
external walls of the left nasal cavity, as in Plate 209. Becognizo the pro- 
jections from, and the galleries along, the external wall of the nasal cavity. 
4. Mucous-membrane Covered Turbinate Bone, Plate 209. 
—This bone forms a slielf-like internal projection from the ex- 
ternal wall of a nasal cavity. It is articulated to a continuous, 
antero-posterior ridge, on the interior surfaces of the follow- 
ing bones, of a side : a superior maxillary (its body); a lachry- 
mal ; the ethmoid (its lateral mass) ; a palate (its vertical 
plate); and the sphenoid (the internal plate of its pterygoid 
process). From this broad base it turbinates or whirls (like 
the inferior half of a letter S) to its internal free border. NASAL CAVITIES AND CONTIGUOUS PARTS. 
403 
5. Mucous-membrane Covered Turbinate Processes of the 
Ethmoid Bone.—These processes are two turbinate portions, 
inferior and superior, of the ethmoid bone, which are projected, 
internally, from the internal surface of a lateral mass of that 
bone, into the superior half of a nasal cavity. The inferior is 
larger than the superior, and both are smaller than the turbi- 
nate bone. 
6. Mucous-membrane Lined Inferior, Middle, and Supe- 
rior Meatuses.—These are three anteroposterior galleries, along 
the external wall of a nasal cavity ; they are determined by 
the mucous-membrane covered turbinate bone and turbinate 
processes of the ethmoid bone. An inferior meatus has : the 
inferior wall of a nasal cavity interiorly ; the inferior portions 
of the body of a superior maxillary bone and the vertical plate 
of a palate bone externally ; a turbinate bone superiorly. A 
middle meatus is bounded as follows : interiorly, by a tur- 
binate bone ; externally, by portions of a superior maxillary 
bone (its nasal process and body), a lachrymal bone, a lateral 
mass of the ethmoid bone, and a palate bone (its vertical 
plate) ; superiorly, an inferior turbinate process of the ethmoid 
bone. A superior meatus is walled as follows: interiorly, by 
an inferior turbinate process of the ethmoid bone ; externally, 
by a lateral mass of the ethmoid bone; superiorly, by a 
superior turbinated process of the ethmoid bone. Superiorly 
to the superior turbinate process of the ethmoid a small 
antero-posterior space presents, which might almost be re- 
garded as an attempt at a fourth meatus. Between the nasal 
septum and the free borders of a turbinate bone and the tur- 
binate processes of the ethmoid bone, of a nasal cavity, there is 
an unobstructed space, which will admit an instrument from 
the anterior narium to the posterior surface of a nasal bone. 
Dissection.—Dissect awav (Plate 209) the mucous membrane from the ex- 
ternal wall of the nasal cavity, posteriorly to the mucous-membrane covered 
turbinate processes of the ethmoid bone and turbinate bone. Find the spheno- 
palatine foramen, and trace the artery and nerves, entering the cavity by it, 
dissecting them out of the submucous plane of the external and the internal 
wall of the cavity. Find the nerve entering the external wall of the nasal cavity 
iuferiorly to the spheno-palatine foramen. Display the arteries and nerve, 
entering through the superior wall of the cavity ; trace their branches, in- 
teriorly, by dissecting them out of the submucous plane of the external, and 
of the internal, wall of the cavity. 404 
HEAD AND NECK. 
7. Spheno-palatinc Foramen, Plate 209.—This foramen, of 
a nasal cavity, is located in the external wall of a nasal cavity, 
posteriorly to the posterior end of an inferior turbinate process 
of the ethmoid bone. 
8. Splieno-palatine Artery: Plate 209 ; Fig. 1, Plate 210. 
—This artery (venm comites)enters a nasal cavity by the spheno- 
palatine foramen. It gives off an internal and an external 
branch : the internal branch or naso-palatine artery (Plate 209) 
has an anterior and inferior course in the submucous plane of 
the nasal septum, to the incisor foramen of the anterior pala- 
tine canal, through which it passes to the buccal surface of 
the hard palate ; the external branch is projected interiorly, 
sending off anterior branches into the submucous plane upon 
the inferior turbinate process of the ethmoid bone, the turbi- 
nate bone, and the walls of the middle and inferior meatuses. 
9. Naso-palatine Nerve, Plate 209.—This nerve, of a nasal 
cavity, enters by the splieno-palatine foramen. It passes to 
the submucous plane of the nasal septum, where it accom- 
panies the above-described naso-palatine artery. 
10. Superior Nasal Nerves : Plate 209 ; Fig. 1, Plate 210. 
—These nerves, of a nasal cavity, enter with the last-de- 
scribed nerve. They have an anterior and a superior course, 
ramifying in the submucous plane upon the turbinated pro- 
cesses of the ethmoid bone, and in the same plane of a superior 
meatus. 
ll. Inferior Nasal Nerve,—This nerve enters a nasal cavity 
posteriorly to-the turbinate bone; it runs anteriorly, sending 
branches into the submucons plane upon the turbinate bone, 
and into the same plane of a middle and an inferior meatus. 
12. Anterior Ethmoidal Artery.—This artery (venae comi- 
tes), branch of the ophthalmic artery (page 343 ; Plate 186), en- 
ters at the superior wall of a nasal cavity, in company with the 
nasal nerve (page 342 ; Plate 186). It bifurcates into an internal 
and an external branch : the internal branch is projected, an- 
teriorly and interiorly, into the submucous plane of the lateral 
face of the nasal septum ; the external branch runs in the sub- 
mucous plane of the antero-lateral wall of a nasal cavity. NASAL CAVITIES AND CONTIGUOUS PARTS. 
405 
13. Posterior Etlimoulal Artery.—This artery (venae co- 
mites) enters a nasal cavity through its superior wall, posteri- 
orly to the last-described artery. It bifurcates into an external 
and an internal branch : the external branch distributes in the 
submucous plane upon the superior turbinate process of the 
ethmoid bone, and in the superior meatus ; the internal branch 
ramifies in the submucous plane of the mid-portion of the su- 
perior part of the lateral face of the nasal septum. 
14. Nasal Nerve.—This nerve enters through the superior 
wall of the cavity in company with the anterior ethmoidal ar- 
tery (page 342 ; Plate 186). It bifurcates into an external and 
an internal branch, which accompany, respectively, the branches 
of the anterior ethmoidal artery. The external branch perfo- 
rates the antero-lateral wall of the nasal cavity, to appear at 
its exterior surface in the subcutaneous plane (page 342 ; Fig. 2, 
Plate 182 ; Plate 183 ; Fig. 2, Plate 184). 
15. Frontal Sinuses.—These are aright and a left space, di- 
vided by a median-line septum, between the exterior and inte- 
rior tables of the supra-orbital area of the frontal bone. They 
are produced by the absorption ot‘ the diploe of that region of 
the bone. They are lined by mucous membrane, continued into 
them from the nasal cavities through the right and left infun- 
dibulum openings. 
16. Sphenoidal Sinuses.—These are a right and a left space, 
divided by a median-line septum, in the body of the sphenoid 
bone. They are lined by mucous membrane, continued into 
them from the nasal cavities, through the openings of the sphe- 
noidal sinuses. 
Dissection.—Cut away, with the curved scissors, the turbinate bone and the 
turbinate processes of the ethmoid bone. Find and demonstrate the openings 
through the external and superior walls of the nasal cavity, which communi- 
cate with contiguous cavities. 
17. Openings of Communication of a Nasal Cavity with 
Contiguous Cavities.—The openings through the external wall 
are partially or completely concealed by the turbinate bone and 
the turbinate processes of the ethmoid bone (Plate 209). They 
are located as follows (Fig. 1, Plate 210) : the nasal duct open- 
ing, at the anterior of an inferior meatus, is the communication 406 
HEAD AND NECK. 
from a lachrymal sac (Fig. 1, Plate 184) ; the infundibulum 
opening, at the anterior of a middle meatus, is from a fron- 
tal sinus and the anterior cells of a lateral mass of the eth- 
moid bone ; the maxillary sinus opening, at the mid-portion 
of a middle meatus, is into the maxillary sinus of a side ; the 
posterior ethmoidal opening, at the anterior of a superior 
meatus, is into the posterior cells of a lateral mass of the eth- 
moid bone. At the posterior of the superior wall (Plate 209 ; 
Fig. 1, Plate 210) is the sphenoidal sinus opening, into the 
sphenoidal sinus of a side. By the above openings the'mucous 
membrane of a nasal cavity passes out to line the respective 
canals and cavities communicated with. 
Dissection.—Following (Fig. 1, Plate 210) the descending palatine artery 
and the anterior palatine nerve, open, in a superior direction (with the hone 
forceps or the chisel and mallet), the posterior palatine canal as far as the in- 
ferior wall of the sphenoidal sinus (remove the fragments of hone). Trace the 
descending palatine artery and the anterior palatine nerve superiorly; find the 
inferior nasal branch of the nerve ; display the splieno-palatine ganglion and 
its branches, also the internal maxillary artery and its branches. 
18. Splieno-palatine Ganglion ; Its Roots ; and its Rranelics, 
Fig. 1, Plate 210.—This ganglion, one of the cephalic ganglia 
of the sympathetic nervous system, is located in the spheno- 
palatine fossa, inferiorly to the sphenoidal sinus, superiorly to 
the posterior palatine canal, and posteriorly to the spheno-pala- 
tine foramen. Its roots are : two sensory roots, which enter the 
superior part of the ganglion, being derived from the superior 
maxillary division of the sensory root of the trifacial nerve ; 
its motor and sympathetic roots enter the posterior part of the 
ganglion, as the Vidian nerve, viz. : the latter nerve is formed 
(page 347 ; Plates 185 and 18G) by the large superficial petrosal 
nerve (page 346) from the facial nerve—the motor root of the 
ganglion—and the large deep petrosal nerve (page 347) from the 
sympathetic plexus upon the intracranial portion of the inter- 
nal carotid artery—the sympathetic root of the ganglion. 
The branches of the ganglion are the following : the naso- 
palatine nerve, before described (page 404) and illustrated 
(Plate 209); the superior nasal nerve, before described (page 
404) and illustrated (Plate 209); the anterior palatine nerve, 
is projected, inferiorly, into the posterior palatine canal, 
where it gives off the inferior nasal nerve (page 404 ; Plate NASAL CAVITIES AND CONTIGUOUS PAKTS. 
407 
209 ; Fig. 1, Plate 210) and enters the buccal cavity, to dis- 
tribute as before described (page 392) and illustrated (Fig. 
2, Plate 206) ; the posterior palatine nerve (Fig. 1, Plate 
210) has an inferior course, through the accessory palatine 
canal, from which it emerges (Plate 199) to distribute to the 
soft palate ; the external palatine nerve, when present (ab- 
sent in the dissection Fig. 1, Plate 210), runs interiorly through 
the external palatine canal to supply parts of the soft palate. 
Th e ptery go-palatine nerve, when present, is projected, poste- 
riorly, through the pterygo-palatine canal for distribution to 
the pharynx. 
19. Internal Maxillary Artery and its Branches: Plate 
209 ; Fig. 1, Plate 210.—The external portion of this artery 
was before described (page 348) and illustrated (Plate 187). 
Its internal portion is lodged in the spheno-palatine fossa, 
where it gives off the following branches : two, very small, 
branches, the Vidian artery and the pterygo-palatine artery, 
are projected posteriorly into the Vidian and the pterygo- 
palatine canals, respectively—they accompany the nerves of 
the same name, described above—and distribute to the mucous 
membrane of the superior part of the anterior pharyngeal 
wall ; the descending palatine artery runs, interiorly, in the 
posterior palatine canal to enter the buccal cavity, as before de- 
scribed (page 392) and illustrated (Fig. 2, Plate 206); and the 
spheno-palatine, its terminal branch, enters a nasal cavity and 
distributes to the interior of its walls, as before described (page 
404) and illustrated (Plate 209). 
Dissection.—Saw, antero-posteriorly, through the superior maxillary bone, 
or, at the level of the malar process of the superior maxillary bone. Place the 
two pieces, as sectioned, in the position shown in Fig. 2, Plate 210. 
20. Maxillary Sinus (Antrum of Highmore), Fig. 2, Plate 
210.—This is a cavity in the body of the superior maxillary 
bone ; it communicates with a nasal cavity, by an opening in 
the external wall of the middle meatus (page 406 ; Fig. 1, Plate 
210), through which the mucous membrane of nasal cavity 
passes to line the sinus. A maxillary sinus has the following 
walls: an internal, which is the external wall of the nasal 
cavity of the side ; an antero-external, which is the antero- 
external portion of the body of th esuperior maxillary bone; 408 
HEAD AND NECK. 
a superior, which is the floor of the orbit; a posterior, which is 
the portion of the superior maxillary bone that articulates with 
a pterygoid process of the sphenoid bone ; an inferior, which is 
the part of the body of the superior maxillary bone situated 
superiorly to the alveolar process of the bone—the thinnest, and 
most inferior, point of this wall is opposite the alveolus of the 
second molar tooth. 
21. Ethmoidal Cells.—These are small cavities in, and re- 
sult from the honeycombed structure of, the lateral masses of 
the ethmoid bone. In each lateral mass of the bone, these 
cells are divided into two, non-communicating, sets of cells, 
the posterior and the anterior. By their respective openings 
into a nasal cavity—the posterior ethmoidal opening and the 
infundibulum—they receive a lining of mucous membrane ; 
vessels, and nerves, also pass to them from the nasal cavity, 
through the submucous plane. PLATE 199 
JW. C7ohrz, ez<£ ncftzzT'a.m *ZeZ. PLATE 200 
M’Cchn, ad nu'ZtcT’etm. deZ, PLATE 201 
Bt.Cohn.adnaturam eieZ. PLATE 202 
JJi'.Cohn.acenaturam ad. PLATE 203 
JVT. Cohn, cirfnatura/n <2el- PLATE 204 
M. (7o72'rfi a cl rtc&u retvz a<sl. PLATE 205 
JSXG. 1 
-F'TCf. 2 
jrj?e7mt<zaxa£urcvn d&Z* PLATE 206 
Fig. i 
Fj:G.2 
JkZ. Co/iTij czcZjza'ftcrzzm aZeZ- PLATE 207 
FrG.2 
FTG.1 
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F’za.2 
Fia. 1 
M'-CoPm, adnat.ciet. PLATE 209 
JkT.Cohrz. actnatu-rccm. aZe£. PLATE 210 
F'ja. / 
f’jCr. 2 
Af.Cohn,tzcZnatztrcon del. TWENTY-SEVENTH DISSECTION. 
ARTERIES OF THE BRAIN; EXTERIOR OF THE CERE- 
BRUM; PARTS OF THE BRAIN. 
Dissection.—The brain, as removed from the cranium (page 324), may 
now be taken out of the solution of chloride of zinc, in which it has been kept. 
Terms of Relation.—The general terms of relation (page 2), 
and the special terms vertex, base, lateral area—applied to 
the brain in general—interior and exterior—applied to the ven- 
tricular cavities—will be used in describing the arteries of the 
brain, the exterior of the cerebrum, and the parts of the brain. 
Membranes of the Brain, Plates 179 and 180.—The three 
investing membranes—dura muter, arachnoid, and pia mater 
—of the brain are described at pages 322, 323, and 324 ; also 
the subdural and subarachnoidean spaces at page 323. 
Venous Sinuses of the Cranium.—These intracranial venous 
canals are described at pages 323 and 326. 
ARTERIES OF THE BRAIN. 
Dissection.—Place the brain upon a dissecting board, with its base upper- 
most (Plate 211). It is to be remembered, that the brain is turned over, and that its 
inferior surface looks superiorly instead of inferiorly. Trace the arteries of the 
posterior half of the base, viz. : the vertebral, the basilar, and the posterior 
cerebral, with their branches. 
1. Vertebral Arteries and [their Branches, Plate 211.— 
The entrances of these arteries into the cranium by the fora- 
men magnum were before described (page 325) and illustrated 
(Plate 180). Their intracranial portions have an antero-superior 
course upon the antero-inferior surface of the medulla oblon- 
gata ; at the superior limit of the latter they converge to form 
the basilar artery. The branches of this portion of a verte- 410 
HEAD AND NECK. 
bral artery are : the posterior spinal (not illustrated) arises 
from the beginning of the artery, and joins its fellow of the 
opposite side, to form the single posterior spinal artery trunk, 
which passes inferiorly to the posterior surface of the spinal 
cord ; the anterior spinal, from the internal side of the artery, 
joins its fellow of the opposite side to form the single anterior 
spinal artery trunk, which descends to the anterior of the 
spinal cord; the inferior cerebellar, from the external side of 
the artery, distributes to the postero-inferior part of the cere- 
bellum. 
2. Basilar Artery and its Branelies.—This single, median- 
line, artery has an antero-snperior course, at the antero-infe- 
rior surface of the pons Varolii, from its inferior to its superior 
border. Its branches are projected to the right and left, as 
follows: short branches to the pons Varolii; the auditory, 
which pass to, and subsequently accompany, the auditory and 
facial nerves ; the anterior cerebellar, which are projected to 
the inferior surface of the cerebellum ; the superior cerebellar, 
which are continued upon the superior portion of the antero- 
inferior surface of the pons Varolii, to reach the superior sur- 
face of the cerebellum. 
3. Posterior Cerebral Arteries and tlieir Branelies.—These 
arteries arise from the bifurcation of the basilar artery, oppo- 
site the superior border of the antero-inferior surface of the 
pons Varolii. They diverge, laterally, over the crura cerebri, 
to distribute to the inferior surface of the cerebrum—its tem- 
poro-sphenoidal and occipital lobes. Its branches are : the 
posterior perforating, which are small arteries, that enter the 
foramina of the posterior perforated space (Plate 214) ; the 
posterior choroid (not illustrated) to the posterior of the cho- 
roid plexus. 
Dissection.—Insert small pieces of wood into the longitudinal fissure and 
the fissure of Sylvius. Find the stumps of the internal carotid arteries, and 
trace their branches upon the anterior half of the base of the cerebrum. Display 
the anterior and posterior communicating arteries, and demonstrate the circle 
of Willis. 
4. Internal Carotid Arteries and tlieir Brandies.—These 
arteries enter the cranium, at the apices of the petrous por- 
tions of the temporal bones, from the internal orifices of the ARTERIES OF THE BRAIX. 
411 
carotid canals (Plate 186, right side); thence they run inter- 
nally, exteriorly to the dura mater, to the lateral surfaces of 
the body of the sphenoid bone ; at these points they are pro- 
jected, interiorly, through the dura mater, and appear at the 
sides of the sella turcica of the sphenoid bone (Plate 180 ; Plate 
185, right side). 
The branches of the intracranial portion of an internal ca- 
rotid artery are: the ophthalmic, before described (page 326) 
and illustrated (Plate 180); the anterior choroid, which en- 
ters the middle horn of a lateral ventricle (Pig. 2, Plate 218) 
to contribute to the choroid plexus ; the terminal end of the 
artery bifurcates. The middle cerebral artery, one of the 
branches of bifurcation, passes, from its origin, into the fissure 
of Sylvius ; its branches enter the pia mater upon the frontal, 
central, parietal, and temporo-sphenoidal lobes of the cerebrum, 
to supply these several lobes. The anterior cerebral artery, 
one of the branches of bifurcation, bends internally, and ante- 
riorly, to enter the longitudinal fissure, upon the inferior sur- 
face of the rostrum of the corpus callosum ; it then curves, 
superiorly, over the anterior reflection of the corpus callosum, 
to run, antero-posteriorly, upon the superior surface of the 
latter or the floor of the longitudinal fissure ; its branches enter 
the pia mater upon the internal and the inferior surfaces of the 
frontal lobe to distribute to these portions of the lobe. 
5. Anterior and Posterior Communicating Arteries.—The 
anterior communicating artery is a short, transverse trunk, by 
which the anterior cerebral arteries anastomose ; it is located at 
the posterior of the anterior portion of the longitudinal fissure 
upon the inferior surface of the rostrum of the corpus callosum. 
The posterior communicating arteries are two, short, ob- 
lique, vessels, that unite the internal carotid and the posterior 
cerebral arteries. 
6. Circle of Willis.—This is an arterial circuit at the centre 
of the inferior surface of the brain, which is formed by the fol- 
lowing arteries : anteriorly, the anterior communicating ; pos- 
teriorly, the bifurcation of the basilar ; a side of the circle 
presents, in order, antero-posteriorly, the anterior cerebral, the 
internal carotid, the posterior communicating, and the poste- 
rior cerebral ; this half circuit, repeated on the opposite side, 
completes the circle of Willis. 412 
HEAD AND NECK. 
EXTERIOR OF THE CEREBRUM. 
Dissection.—Cut the arteries (with the scissors) between the nerve origins 
at the base of the brain (Plates 211 and 214) ; pick away (with the forceps) the 
pieces of arteries from between the nerves ; then (with the forceps) peel off the 
jiia mater, and included vessels, from the exterior of the brain (this is best 
done by short twitches of portions of the membrane). Holding the brain so 
as to be able to see its vertex (Plate 212) and a lateral (Plate 213) area of one 
of its hemispheres, alternately, determine the fissures, the furrows, the lobes, 
the sulci, the lobules, and the convolutions of the exterior of the cerebrum. 
Open the fissure of Sylvius by everting, inferiorly, the temporo-splienoidal lobe 
of the cerebrum. 
1. Fissures and Furrows of tlic Vertex and Lateral Area 
of a Hemisphere of the Cerebrum, Plates 212 and 213.—These 
areas of the exterior of the cerebrum present three fissures and 
two furrows—three antero-posterior and two transverse. The 
longitudinal fissure is a complete, antero-posterior, median- 
line fissure, located between the hemispheres (Plate 212) of the 
cerebrum ; it lodges the falx cerebri of the dura mater, and has 
the superior surface of the corpus callosum for its floor. The 
fissure of Sylvius is an incomplete, antero-posterior, fissure, 
which is located at a lateral area of the exterior of the cere- 
brum ; it has a long posterior and a short anterior division. 
Thq furrow of Rolando is a well-marked, transverse furrow, 
which has an oblique course, inferiorly and anteriorly, from a 
poiqt externally to the junction of the posterior and middle 
third of the longitudinal fissure (Plate 212) to a point superiorly 
to the middle of the fissure of Sylvius (Plate 213). The occipito- 
parietal fissure is a transverse fissure, which has a slightly 
oblique course, externally and posteriorly, from the posterior 
third of the longitudinal fissure to the inferior bolder of the 
posterior part of the cerebrum. The intraparietal furrow 
(Plate 213) is a short, antero-posterior, furrow, which runs, 
anteriorly, from about the middle of the occipito-parietal fis- 
sure to the ascending parietal convolution of the parietal lobe. 
2. Lobes of the Cerebrum, Plates 211 to 215, inclusive.— 
A hemisphere of the cerebrum presents live lobes. The frontal 
lobe is bounded : at the median line, by the longitudinal fis- 
sure (Plates 211 to 215, inclusive); posteriorly, by the fur- 
row of Rolando (Plates 212, 213, and 215) and the central 
lobe (Plates 213 and 214) ; inferiorly, by the fissure of Syl- EXTERIOR OF THE CEREBRUM. 
413 
vius and the central lobe (Plate 213). The parietal lobe is 
bounded: at the median line, by the longitudinal fissure (Plates 
212 and 215) ; anteriorly, by the furrow of Rolando (Plates 212, 
213, and 215) ; posteriorly, by the occipito-parietal fissure ; in- 
feriorly, by the fissure of Sylvius and the temporo-sphenoidal 
lobe (Plate 213). The occipital lobe (Plates 212, 213, and 214) 
is bounded: at the median line, by the posterior part of the 
longitudinal fissure ; anteriorly, by the occipito-parietal fis- 
sure ; inferiorly, by the cerebellum. The temporo-sphenoidal 
lobe (Plate 213) is bounded : superiorly, by the fissure of 
Sylvius and the parietal lobe ; as a free portion of the cere- 
brum, it is lodged posteriorly to the frontal lobe, and exter- 
nally to the central lobe. The central lobe is located at the 
floor of the fissure of Sylvius, where it is bounded : superiorly, 
by the operculum of the frontal and parietal lobes (Plates 213 
and 214); anteriorly, by the frontal lobe (Plates 213 and 214); 
internally, at the base of the cerebrum, by the anterior per- 
forated space (Plate 214). 
Dissections.—Section the right hemisphere of the cerebrum so as to slice 
off its vertex portion, as in Plate 215. Cut away the anterior border of the left 
temporo-sphenoidal lobe, as in Plate 214. Demonstrate the convolutions and 
lobules of the five lobes of the cerebrum as determined by sulci, which present 
with variable degrees of uniformity and definition in different brains. 
3. Convolutions and Sulci of a Frontal Lobe, Plates 212 
to 215, inclusive.—The convolutions of this lobe maybe demon- 
strated as follows : at its vertex and external-lateral surfaces, 
the ascending frontal (Plates 212, 213, and 215) lies parallel 
with, and between the furrow of Rolando, posteriorly, and the 
transverse frontal sulcus, anteriorly ; the superior frontal, 
the middle frontal, and the inferior frontal divided by the 
superior frontal sulcus and the inferior frontal sulcus, are 
anteriorly to the ascending frontal sulcus, and run postero-an- 
teriorly, therefrom; at its inferior surface, x\\v posterior orbi- 
tal, the anterior orbital, and the internal orbital (Plate 214) 
are determined by the orbital sulcus; at its internal-lateral 
surface, or the wall of the longitudinal fissure, the marginal 
convolution, and the convolution of the corpus callosum, are 
defined by the calloso marginal sulcus. 
4. Lobules, Convolutions, and Sulci of a Parietal Lobe, 
Plates 212, 213, and 215.—Tlie vertex and external-lateral area 414 
HEAD AND NECK. 
of this lobe present the following : the ascending parietal 
convolution posteriorly to, and parallel with, the furrow of 
Rolando ; posteriorly to the ascending parietal convolution, 
the intraparietal furrow (page 412 ; Plates 212 and 213) divides 
the posterior part of this lobe into a superior parietal lobule 
(Plates 212 and 215) and an inferior parietal lobule (Plates 
212 and 213)—in the latter sulci determine the supra-marginal 
convolution, anteriorly, and the angular convolution, poste- 
riorly. The internal-lateral surface or wall of the longitudinal 
fissure of this lobe presents the quadrate lobule (Plate 215), 
which is bounded: anteriorly, by the calloso-marginal sulcus ; 
inferiorly, by the convolution of the corpus callosum ; posteri- 
orly, by the occipito-parietal fissure. 
5. Convolutions, Sulci, and Lobule of an Occipital Lobe. 
—Of this lobe sulci, at its postero-external surface, map out, 
more or less definitely, the superior occipital, the middle occip- 
ital, and the inferior occipital convolutions (Plate 212). At its 
internal-lateral surface or its portion of the wall of the longi- 
tudinal fissure, is the calcarine sulcus, and the area called the 
cuneate lobule. 
6. Convolutions and Sulci of tlie Temporo-splienoidal 
Lobe, Plates 213 and 214.—At the external-lateral face of this 
lobe are the following : the superior temporo-splienoidal con- 
volution and the middle temp or o-sphenoidal convolution, sepa- 
rated by the superior temporo-sphenoidal sulcus (Plate 213). 
Its inferior surface (Plate 214) presents : the continuations of 
the superior and middle convolutions divided by the last- 
named sulcus ; the inferior temporo-sphenoidal convolution 
lias the middle temporo-sphenoidal sulcus separating it from 
the middle convolution ; the collateral sulcus marks off the 
uncinate convolution from the last-named convolution. 
7. Convolutions and Suit*! of tlie Central Lobe, Plate 213. 
—The short vertical convolutions of the exterior of this lobe are 
determined by from four to six shallow, parallel, and vertical 
sulci. 
PARTS OF THE BRAIN. 
Brain, Plates 212, 213, and 214.—This intracranial organ is 
amass of grey and white neural tissue, which is variously dis- 
tributed in its parts. It is divided : primarily, into four parts— PARTS OF THE BRAIH. 
415 
the cerebrum, tbs pons Varolii, the cerebellum, and themedidla 
oblongata ; secondarily, each of these parts is made up of dis- 
tinguishable portions. The organ has a mean weight, in the 
adult (taking both sexes) of from two and a half to three and 
a quarter pounds, with the extremes at two and four pounds 
—the male brain ranges a little over one-quarter of a pound 
heavier than the female. 
Dissection.—Place the brain with its inferior surface uppermost, 
1. Basal Surface of tlie Brain, Plate 214.—This surface 
of the brain presents the following : parts of the cerebrum—in- 
ferior surfaces of frontal and temporo-splienoidal lobes, ante- 
rior perforated spaces, lamina cinerea, optic commissure and 
optic tracts, pituitary body, tuber cinereum, corpora mam- 
millaria, crura cerebri, and posterior perforated space ; the 
antero-inferior surfaces of the pons Varolii, medulla oblongata, 
and cerebellum ; and the origins from the exterior of the brain 
—cerebrum, pons Varolii, and medulla oblongata—of the 
twelve pairs of cranial nerves. 
2. Longitudinal Fissure.—The anterior of this cerebral 
fissure divides, antero-posteriorly, the frontal lobes, at their 
basal surfaces ; it is limited posteriorly by the inferior portion 
of the anterior reflection—the rostrum—of the corpus callosum, 
and the lamina cinerea. 
3. Anterior Perforated Spaces.—These areas are bounded : 
anteriorly, by the posterior orbital convolution of the frontal 
lobe and the olfactory nerve ; externally, by the central lobe; 
posteriorly and internally, by the optic tract and the optic 
commissure. Its openings give transit to branches of the mid- 
dle cerebral artery (Plate 211), which pass, superiorly, to the 
corpus striatum of the cerebrum. 
4. Lamina Cinerea.—This is a stretch of neural tissue 
(grey), from the posterior of the rostrum of the corpus callo- 
sum to the optic commissure, and posteriorly to the latter to 
the tuber cinereum. It is between the right and left anterior 
perforated spaces, and closes in the anterior recess of the infe- 
rior wall of the third ventricle of the cerebrum. 
5. Optic Tracts and Optic Commissure.—The optic tracts 
or peduncles are a right and a left band, which wind, inferiorly, 416 
HEAD AND NECK. 
around the external sides of the crura cerebri (Plate 214, left 
side), to the anterior of the inferior surface of the crura, whence 
they have an anterior, and internal, course to their anterior 
convergence. The optic commissure is the point of junction of 
the right and left optic tracts or peduncles ; it is located be- 
tween the anterior perforated spaces, posteriorly to the lamina 
cinerea, and to the tuber cinereum. 
6. Crura Cerebri or Cerebral Peduncles.—These are two 
columns of neural tissue, which are projected, right and left, 
from the anterior of the pons Varolii; they pass to, and cross 
superiorly to, the optic tracts into the right and the left hem- 
isphere, respectively, of the cerebrum. 
7. interpeduncular Space.—This is an area—sometimes 
spoken of as lozenge-shaped or like the diamond figure on a 
playing-card—located at the centre of the basal surface of the 
brain, and bounded as follows : antero-laterally, by the optic 
commissure and its converging peduncles or the optic tracts ; 
postero-laterally, by the pons Varolii and the diverging cerebral 
peduncles or crura cerebri. It encloses the tuber cinereum, the 
pituitary body suspended by the infundibulum, the corpora 
mammillaria, and the posterior perforated space. These parts 
form the floor of the third ventricle of the cerebrum. 
§. Tuber Cinereum.—This is a stretch of nerve tissue from 
the posterior of the optic commissure to the corpora mammil- 
laria, and crura cerebri. From its anterior portion the infun- 
dibulum is projected inferiorly. 
9. Pituitary Body.—This is a flattened, transversely ovoid 
body, about the size of a pea, which is held, by the infundi- 
bulum, to the tuber cinereum. It is lodged, in situ, in the 
sella turcica—superior surface of the body of the sphenoid 
bone—where it is covered by the dura mater ; in taking the 
brain from the cranium (page 324), the infundibulum was seen 
emerging from the centre of this portion of the dura mater. 
As removed from the sella turcica, the pituitary body hangs 
from the tuber cinereum, by the infundibulum, as a cherry on 
its fruit-stalk. 
10. Corpora Mammillaria.—These are two symmetrical, 
small, mamma-like prominences located between : the tuber PARTS OF THE BRAIN. 
417 
cinereum, anteriorly; the crura cerebri, right and left, later- 
ally ; and the posterior perforated space, posteriorly. They 
are the terminal ends of the anterior pillars of the fornix (Fig. 
2, Plate 217). 
11. Posterior Perforated Space.—This triangular space is 
located between : the corpora mammillaria, anteriorly ; the 
crura cerebri, laterally ; and the pons Varolii, posteriorly. Its 
perforations give transit to small arterial twigs, from the bifur- 
cation of the basilar artery into the posterior cerebral arte- 
ries (Plate 211), which pass, superiorly, into the cerebrum, to 
supply the thalami optici, corpora quadrigemina, etc. 
12. Pons Varolli.—The antero-inferior surface of this part 
of the brain presents a somewhat quadrangular area. Ante- 
riorly from it, the crura cerebri are projected superiorly ; pos- 
teriorly and interiorly, it is continuous with the medulla ob- 
longata ; laterally, the right and left middle or pons Yarolii 
peduncles of the cerebellum pass to the right and left hemi- 
sphere of that part of the brain. 
13. Medulla Oblongata.—This part of the brain is contin- 
ued superiorly from the spinal cord—in fact, it is the cranial 
portion of the cord ; it passes, anteriorly and superiorly, into 
the pons Yarolii and cerebellum. 
14. Cerei»elliun.—The basal surface of this part of the 
brain shows it lodged between the medulla oblongata, interi- 
orly, and the occipital iobes of the cerebrum, superiorly. Its 
antero-inferior surface extends, laterally and posteriorly, from 
the medulla oblongata and pons Yarolii; its mid-portion being 
superposed upon the postero-superior surfaces of the two latter 
parts of the brain. 
15. Exterior Origins of tlie Twelve Pairs of Cranial Nerves, 
Plates 211 and 214 ; Fig. 1, Plate 222.—The twelve pairs of 
cranial nerves present their exterior origins from the brain, at 
the basal surfaces of the cerebrum, pons Varolii, and medulla 
oblongata. 
The first or olfactory nerves are projected, anteriorly, from 
the cerebrum, from points anteriorly to the anterior perforated 
spaces (Plate 214); they are lodged in the olfactory sulci 418 
HEAD AND NECK. 
(Plate 214) at the inferior surfaces of the frontal lobes of the 
cerebrum ; at their anterior ends are enlargements, the olfac- 
tory bulbs (Plate 214), from which the distributing filaments of 
the nerves are given off. 
The second or optic nerves are given off, anteriorly, right 
and left, from the optic commissure. 
The third or oculomotor nerves emerge from the internal 
surfaces of the posterior thirds of the crura cerebri, and wind 
out of the posterior part of the interpeduncular space. 
The fourth or trochlear nerves arise from the valve of Yieus- 
sens (Fig. 2, Plate 221) and appear winding interiorly and an- 
teriorly, externally to the posterior ends of the crura cerebri. 
The fifth or trifacial nerves come out from the lateral sur- 
faces of the pons Yarolii—a large sensory and a small motor 
root. 
The sixth or abducent nerves appear, at either side, from 
the groove between the antero-inferior surfaces of the pons 
Yarolii and medulla oblongata. 
The seventh or facial nerves present, from the sides of the 
postero-superior surface of the medulla oblongata, over the 
posterior borders of the middle or pons Yarolii peduncles of 
the cerebellum. 
The eighth or auditory nerves have their exterior origins in 
the same'way as, but posteriorly to, the seventh. A small 
nerve, the nerve of Wrisberg, appears between the origins of 
the seventh and eighth nerves. 
The ninth or glossopharyngeal nerves emerge from the 
medulla oblongata, from the superior part of the grooves pos- 
teriorly to its olivary bodies. 
The tenth or pneumogastric nerves spring, by a number of 
filaments, from the same grooves of the medulla oblongata as 
the ninth, but inferiorly to them. 
The eleventh or spinal accessory nerves arise from the lat- 
eral column of the medulla oblongata, and—as its name im- 
plies—from the spinal cord—the cervical portion of its lateral 
column (Plate 158); the accessory spinal portions of the nerves 
enter the cranium by the foramen magnum (page 325 ; Plate 
180). 
The twelfth or hypoglossal nerves are projected, by a num- 
ber of filaments, from the grooves, of the medulla oblongata 
anteriorly to its olivary bodies. PARTS OF TIIE BRAIN. 
419 
Dissection.—Remove, by an antero-posterior section, the vertex portion of 
the right cerebral hemisphere, to correspond with the sectioned left hemi- 
sphere in Plate 215. 
16. Centrum Ovale of Vieussens, Plate 215.—This is the 
sectioned plane of the hemispheres of the cerebrum, at the 
level of the corpus callosum (of which one-half is shown in 
Plate 215). It presents: the circumferential grey neural tis- 
sue, in the walls of the sulci between the convolutions ; the 
central mass of white neural tissue; and the commissural 
character of the corpus callosum. 
17. Corpus Callosum, Plates 214 to 218, inclusive.—This is 
a transverse commissure of neural tissue (white) between the 
hemispheres of the cerebrum. It is located at the level of the 
floor of the longitudinal fissure, and extends, right and left, 
from a median-line raplie (Plates 215 and 216). At about the 
centre of the mid-line surfaces of the cerebral hemispheres, it 
occupies nearly one-half of their antero-posterior diameter. 
Its portions receiving special names are: its anterior point of 
reflection, interiorly, the genu (Plates 215 and 216); its inferior 
portion, from the anterior reflection, the rostrum (Plate 214) ; 
its posterior portion, the splenium (Plates 215 and 216 ; Fig. 
1, Plate 217 ; Fig. 2, Plate 218). 
Dissection.—Section through the corpus callosum, antero-posteriorly, on 
either side of the median-line, as in Plate 216, thereby opening the roofs of the 
cavities of the right and left lateral ventricles; introduce the handle of the 
scalpel into the openings made, and turn off the roofs of the cavities, and of 
the right and left anterior and posterior cornua, externally; trim away the 
displaced portions of the corpus callosum, circumferentially, as in Plate 216. 
Slice off an additional part of the occipital lobe of the right hemisphere of the 
cerebrum (Plate 216). 
18. Right and Left Lateral, or First and Second Ventricles 
of the Brain, Plates 216, 217, and 218.—These intracerebral 
cavities are located, antero-posteriorly, at either side of the 
median line. The parts of a lateral ventricle are: the cavil// 
at the mid-portion of a hemisphere of the cerebrum ; an ante- 
rior cornu or projection of the ventricle into the frontal lobe ; 
a 'posterior cornu, or extension of the ventricle into the occipital 
lobe; and a middle cornu (Fig. 2, Plate 218) or continuation 
of the ventricle into the temporo-sphenoidal lobe. The cavity 420 
HEAD AND NECK. 
of a lateral ventricle is bounded as follows : superiorly, by the 
half of the corpus callosum (Plate 215); internally, by the sep- 
tum lucidum, anteriorly, and by the attachment, along the 
median line, of the inferior surface of the corpus callosum to 
the superior surface of the fornix, posteriorly ; externally, by a 
part of the corpus striatum; interiorly, and in order antero- 
posteriorly, by portions of the corpus striatum, the lamia semi- 
circularis, the anterior tubercle of the thalamus opticus, the 
choroid plexus, and the fornix. 
19. Septum Lucidum.—This is a median-line, vertical parti- 
tion, between the anterior portions of the cavities of the right 
and left lateral or first and second ventricles ; it passes from 
the inferior surface of the anterior of the superior portion of 
the corpus callosum, superiorly, to the superior surface of the 
rostrum of the corpus callosum, interiorly ; and from the pos- 
terior surface or concavity of the genu of the corpus callosum, 
anteriorly, to the anterior surface or convexity of the anterior 
pillars of the fornix, posteriorly. 
20. Foramen of Monro, Plate 216; Fig. 1, Plate 217.—- 
This is located posteriorly to the anterior pillars of the fornix, 
as a curved deficiency or slit in the partition between the cavi- 
ties of the lateral ventricles (a bristle is passed through it) ; by 
it the two lateral ventricles and the third ventricle communicate. 
21. Corpus Striatum, Plates 210 and 217; Fig. 1, Plate 
218.—This is one of the two anterior, basal, ganglia of the cere- 
brum. It has two portions : an intraventricular, which pro- 
jects into the cavity of the lateral ventricle at its external and 
inferior wall ; and an extraventricular, which is lodged in the 
Cerebral mass, externally to the cavity of the lateral ventricle. 
22. Taenia Semieireularis.—This is a narrow band of neu- 
ral tissue (white), which may be traced, antero-posteriorly, 
in the cavity of a lateral ventricle, where it is bedded in the 
groove between a corpus striatum and a thalamus opticus. It 
extends posteriorly and externally from the pillars of the for- 
nix, anteriorly. 
23. Anterior Cornu of a Lateral Ventricle, Plates 216, 217, 
and 218.—This is the anterior ventricular recess, into the fron- 
tal lobe of a cerebral hemisphere. PARTS OF THE BRAIX. 
421 
24. Posterior Cornu of a Lateral Ventricle.—This is tile 
posterior ventricular extension into the occipital lobe of a cere- 
bral hemisphere. Its internal wall presents the intra-ven- 
tricular projection of a cerebral convolution, which is called the 
hippocampus minor. At the floor or inferior wall of its ante- 
rior portion, a prominence appears, the eminentia collateralis. 
Dissection.—Section tlie corpus callosum (Plate 216) ; reflect its anterior 
portion, thereby exposing the cavity of the fifth ventricle of the brain (Fig. 1, 
Plate 217) ; reflect its posterior portion, by cutting it from the superior surface 
of the fornix, as in Fig. 1, Plate 217. 
25. Septum Luciduin and Fifth Ventricle of the Brain, 
Plates 217 and 218.—The septum lucidum as sectioned demon- 
strates its right and left, antero-posterior, lamina, of white neu- 
ral tissue, which enclose a median-line space, the fifth ven- 
tricle. 
26. Fornix, Plates 216, 217, and 218.—This is an antero- 
posterior sheet of white neural tissue, which bridges the median 
line. Its parts are : a body, two anterior pillars and the cor- 
pora mammillaria, two posterior pillars and the corpora fim- 
briata. The body and posterior pillars, are in the cavities of 
the lateral ventricles (Fig. 1, Plate 217) where they form a tri- 
angular-shaped plane ; its apex is directed anteriorly, and it 
is reflected interiorly, as its anterior pillars ; its borders are 
free and are internally to, and parallel with, the right and left 
choroid plexus; its base, for its central portion, fuses with the 
splenium of the corpus callosum, while its lateral portions are 
its posterior pillars, a right and a left ; the latter curve in- 
teriorly, and externally, to enter the middle cornua of the lat- 
eral ventricles. 
27. Choroid Plexus of a Lateral Ventricle of tlie Brain, 
Plate 216 ; Fig. 1, Plate 217.—This is a plexus of vessels, 
which is located in the floor of the cavity, and in the middle 
cornu, of a lateral ventricle of the brain. In the cavity it is 
externally to, and parallel with, a free border of the body of 
the fornix. Anteriorly it converges to, and disappears interi- 
orly and posteriorly to, an anterior pillar of the fornix; poste- 
riorly, it curves interiorly and externally, along the external 
border of a posterior pillar of the fornix, to entea’ the middle 
cornu of a lateral ventricle. 422 
HEAD AND NECK. 
28. Thalamus Opticus.—A portion of the superior surface 
—the anterior tubercle—of this body—one of the posterior, 
basal, cerebral ganglia—presents, at the floor of the cavity of 
a lateral ventricle, between a taenia semicircularis, externally, 
and a choroid plexus, internally. 
Dissection.—Section tlie fornix at the anterior section line in Fig. 1, Plate 
217 ; reflect the anterior and posterior portions as in Fig. 2, Plate 217. (This 
is done with the handle of the scalpel, which slides it off from the superior sur- 
face of the velum interpositum). 
29. Anterior Pillars of tlie Fornix, Plates 214, 216, and 217 ; 
Fig. 1, Plate 218.—These are the anterior reflections of the for- 
nix—a right and a left pillar—which pass, interiorly, to the base 
of the brain, where they terminate as the corpora mammillaria, 
before described (page 416) and illustrated (Plate 214). 
30. Velum Interpositum, Fig. 2, Plate 217 ; Fig. 1, Plate 
218.—This is a triangular, intraventricular, portion of the pia 
mater of the brain, which is projected, anteriorly, from the 
inferior surfaces of the occipital lobes of the cerebral hemi- 
spheres ; it enters the lateral ventricle, inferiorly to the sple- 
nium of the corpus callosum and the body of the fornix. Its 
borders support the choroid plexuses. 
31. Intraventricular Veins, Plates 216 and 217.—These are 
small veins, which ramify in the interior walls of the lateral 
ventricles. They converge to a right and a left vessel, which 
curve, internally, to enter posteriorly to the anterior pillars of 
the fornix (Plate 217); they pass inferiorly to the velum inter- 
positum, where they become the venon Galeni. 
Dissection.—Cut (Fig. 2, Plate 217) the veins emptying into the venae 
Galeni ; dissect away the intraventricular veins. Turn off, as in Fig. 1, Plate 
218, the velum interpositum, and the right and left choroid plexus, posteriorly, 
upon the reflected posterior portion of the fornix (Fig. 2, Plate 217). 
32. Venae Galeni, Fig. 2, Plate 217 ; Fig. 1, Plate 218.— 
These are two antero-posterior veins, which run parallel with, 
and at either side of, the median line, at the inferior surface 
of the velum interpositum. 
33. Clioroid Plexus of (lie Third Ventricle of Hie Brain, 
Fig. 1, Plate 218.—Tlie anterior ends of the clioroid plexuses of PARTS OF THE BRAIH. 
423 
the lateral ventricles curve interiorly to the venae Galeni, to 
where they meet at the median line, anteriorly ; along the me- 
dian line, and between the venae Galeni, they are continued, an- 
tero-posteriorly, as the choroid plexus of the third ventricle. 
Posteriorly, it broadens to surround the pineal body. 
34. Pineal Body and its Crura, Fig. 1, Plate 218 ; Figs. 2 
and 3, Plate 222.—This (misnamed a gland) is a small, reddish, 
cone-shaped body, which is lodged between the velum interpo- 
situm, superiorly, and the nates of the corpora quadrigemina 
(Fig. 2 , Plate 222), interiorly. It projects a right and a left 
crus, anteriorly, along the superior-internal borders of the 
thalami optici; they are continued to the anterior pillars of 
the fornix. 
35. Tlialamu§ Opticus, Plates 216, 217, and 218.—This 
body—one of the two posterior, basal ganglia of the cerebrum 
-—was referred to at pages 419 and 421. It is oval in shape 
and located as follows : internally, and partly interiorly, to a 
taenia semicircularis, and a corpus striatum (its posterior por- 
tion) ; externally to, and forming the lateral wall of, the third 
ventricle of the brain (Fig. 1, Plate 218); interiorly to the half 
of the velum interpositum and a choroid plexus—except where 
the anterior tubercle of a thalamus opticus appears at the floor 
of the cavity of a lateral ventricle (Plates 216 and 217). Its 
superior surface presents an anterior and a posterior tubercle 
(Fig. 1, Plate 218). 
36. Third Ventricle of the Brain, Fig. 1, Plate 218.—This 
intracerebral cavity is bounded : superiorly, by the velum in- 
terpositum (Fig. 2, Plate 217); laterally, by the right and left 
thalamus opticus, respectively; anteriorly, by the anterior 
pillars of the fornix; posteriorly, by the corpora quadri- 
gemina ; inferiorly by the lamina cinerea, and the parts con- 
tained in the interpeduncular space (page 415 ; Plate 214)—the 
tuber cinereum, the corpora mammillaria, and the posterior 
perforated space. The ventricular cavity is crossed by three 
transverse commissures: an anterior commissure, of white 
neural tissue, lies anteriorly to the anterior pillars of the fornix 
(Fig. 2, Plate 217; Fig. 1, Plate 218), and unites the anterior 
portions of the thalami optici; a posterior commissure (Fig. 1, 
Plate 218 ; Fig. 3, Plate 222), of white neural tissue, located 424 
HEAD AND NECK. 
anteriorly to the corpora quadrigemina, bridges between the 
posterior portions of the thalami optici ; a middle commissure 
presents as a broad band of grey neural tissue, which spans 
the ventricular cavity between the internal surfaces of the 
thalami optici. By the foramen of Monro, before described 
(page 420) arid illustrated (Plate 216 ; Fig. 1, Plate 217) the 
third ventricle communicates with the right and left lateral or 
first and second ventricles. At the posterior wall of the third 
ventricle, and inferiorly to the posterior commissure of the 
same, a small opening presents, the anterior orifice of the aque- 
duct of Sylvius (a bristle protrudes from it). 
Dissection.—Replace the velum interpositum (Fig. 2, Plate 217) and the 
fornix (Fig. 1, Plate 217) ; cut the fornix, the right and the left choroid plexus, 
and the velum interpositum, along the section line transversely across the 
fornix and choroid plexuses (Fig. 1, Plate 217) ; remove the anterior portions 
of the sectioned parts, as in Fig. 2, Plate 218. Cut, transversely, through the 
external wall of the left lateral ventricle—along the posterior transverse sec- 
tion line shown at the left side of Fig. 1, Plate 218—down to the floor of the 
middle cornu of the ventricle ; continue, by a curved incision, anteriorly, at 
the level of the floor of the cornu (Fig. 2, Plate 218) ; make a transverse cut 
through the cerebral mass—along the anterior transverse section line at the 
left side of Fig. 1, Plate 218—as far as the middle of the left thalamus opti- 
cus ; then remove the lateral wedge of the included part of cerebrum, by an 
oblique cut through the posterior portion of the left thalamus opticus. 
37. Middle Cornu of a Lateral Ventricle of tlie Brain, and 
its Contained Parts, Fig. 2, Plate 218.—This is tlie recess of a 
cavity of a lateral ventricle, into the temporo-sphenoidal lobe of 
a hemisphere of the cerebrum. Its direction is tortuous, viz.: 
posteriorly, externally, inferiorly, anteriorly, and internally. 
Its internal wall is formed by the hippocampus major, which 
is the intraventricular projection of a cerebral convolution. 
A posterior pillar of the fornix, and a choroid plexus are re- 
flected into this cornu, from the cavity of a lateral ventricle— 
the fornix here presents its corpus jimbriatum portion. The 
latter and the choroid plexus are applied to the internal wall 
of a middle cornu, upon the hippocampus major. The choroid 
plexus here receives the anterior choroid artery. 
Dissection.—Cut the right hemisphere of the cerebrum along the anterior, 
transverse section line shown at the right side of Fig. 1, Plate 218 ; cut along 
the section line directed anteriorly from the last named line out into the an- 
terior portion of the longitudinal fissure (Fig. 1, Plate 218). PARTS OF THE BRAIN. 
425 
38. Anterior Transverse Section of the Basal Ganglia of 
the Cerebrum, Fig. 1, Plate 219.—This section of a hemisphere 
of the cerebrum presents the following: the lissure of Sylvius 
between the anterior portion of the temporo-sphenoidal lobe, 
interiorly, and the central lobe, and the operculum of the frontal 
lobe, superiorly. Internally to, and running parallel with, the 
central lobe, is a line of grey neural tissue, the claustrum ; in- 
ternally to the claustrum is the external capsule—white neural 
tissue—of the basal ganglia; internally to the external capsule 
is the nucleus lenticularis—grey neural tissue—of the extra- 
ventricular portion of the corpus striatum ; the internal cap- 
sule of the basal ganglia is internally to the nucleus lenticu- 
laris ; the anterior portion of the thalamus opticus is between 
the internal capsule and the cavity of the third ventricle of the 
brain; superiorly to the external portion of the thalamus op- 
ticus is the anterior portion of the nucleus caudatus or intra- 
ventricular projection of the corpus striatum. 
Dissection.—Cut the right hemisphere of the cerebrum, along the poste- 
rior, transverse, section line, sliow'n at the right half of Fig. 1, Plate 218. Re- 
move the slice of the cerebrum anteriorly to the cut. 
39. Posterior Transverse Section of the Basal Ganglia of 
the Cerebrum, Fig. 2, Plate 219.—This section, of a hemisphere 
of the cerebrum, presents the same parts of the basal ganglia of 
the cerebrum as the anterior section, described above, with this 
difference : the thalamus opticus occupies a much larger area ; 
the nucleus lenticularis lias a smaller area; the nucleus cau- 
datus is very much smaller, and is located externally to the 
superior portion of the thalamus opticus. 
Dissection.—Remove the temporo-sphenoidal and occipital lobes of the 
left hemisphere of the cerebrum, by cutting through the left posterior pillar 
of the fornix and the splenium of the corpus callosum, out into the posterior 
part of the longitudinal fissure (Fig. 2, Plate 218). Cut away the frontal lobe 
of the left hemisphere of the cerebrum, by the anterior section line from the 
thalamus opticus out into the anterior portion of the longitudinal fissure 
(shown on the left side of Fig. 1, Plate 218). Remove the temporo-sphenoidal 
and occipital lobes of the right hemisphere of the cerebrum, by the oblique 
cut through the posterior portion of the right thalamus opticus (as on the left 
side of Fig. 1, Plate 218), and the cut through the right posterior pillar of the 
fornix and the splenium of the corpus callosum (as shown, on the left side, in 
Fig. 2, Plate 218). Hold the cerebellum and medulla oblongata so as to ex- 
pose the interior of the fourth ventricle of the brain (as in Fig. 1, Plate 220). 426 
HEAD AND NECK. 
40. Postero-inferior Opening Into the Fourth Ventricle of 
the Brain, Fig. 1, Plate 220.—The postero-inferior portion of 
this ventricle is located between the postero-superior surface of 
the medulla oblongata and the inferior surface of the cere- 
bellum. The sides of its floor present the diverging restiform 
bodies of the medulla oblongata or inferior peduncles of the 
cerebellum entering the latter part of the brain. 
41. Cerebellum, Plate 211 ; Plates 213 to 218, inclusive; 
Plates 220 and 221 ; Fig. 2, Plate 222.—This portion of the 
brain is located interiorly to the occipital lobes of the hemi- 
spheres of the cerebrum, and postero-superiorly to the medulla 
oblongata and pons Varolii. It is in continuity with the other 
three parts of the brain, as follows : with the medulla oblon- 
gata by the restiform bodies of the latter, which are its, right 
and left, inferior or medulla oblongata peduncles (Plate 220 ; 
Fig. 2, Plate 222); with the pons Varolii by the inferior, trans- 
verse, fibres of the same, which form its, right and left, middle 
or pons Varolii peduncles (Plate 214 ; Fig. 1, Plate 220 ; Fig. 
2, Plate 222) ; with the cerebrum by the processi e cerebello 
ad testes, which are its, right and left, superior or cerebrum 
peduncles (Fig. 2, Plate 220 ; Fig. 2, Plate 222). It is divided 
into a right and a left hemisphere by a postero-inferior notch 
(Fig. 2, Plate 220 ; Fig. 1, Plate 221). Its median-line portion 
is commissural between the hemispheres, forming the inferior 
and the superior vermiform processes (Plate 220 ; Fig. 1, Plate 
221). Its surface differs from that of the cerebrum, in that it 
presents laminae separated by linear furrows, instead of convo- 
lutions divided by sulci. 
Dissection.—Section the peduncles of the cerebellum, as follows : the 
right and left inferior peduncles, and the right and left middle peduncles (Fig. 
1, Plate 220 ; Fig. 2, Plate 222) ; the right and left superior peduncles, as in 
Fig. 2, Plate 222. Place the cerebellum so as to present its antero-inferior sur- 
face (Fig. 2, Plate 220) ; cut away the right amygdala. 
42. Antero-inferior Surface of llie Cerebellum, Plate 220. 
—Anteriorly, tlie cerebellum presents a broad notch (Fig. 2, 
Plate 220) for its adaptation to tlie postero-snperior surfaces of 
the medulla oblongata and the processi e cerebello ad testes 
—this surface contributes to the roof of tlie fourth ventricle ; it 
is within this area that the right and left superior, middle, and 
inferior peduncles of tlie cerebellum enter its substance (Fig. PARTS OF THE BRAIN. 
427 
2. Plate 220). Anteriorly, at its median-line portion, between 
its superior peduncles is the lingula (Fig. 2, Plate 220 ; Fig. 
1, Plate 221), which in situ, rests upon the superior surface of 
the valve of Vieussens, between the processi e cerebello ad 
testes (Fig. 2, Plate 222). Along the median line of its inferior 
surface is a depressed area, the vallecula, within which is lo- 
cated the inferior portion of the transverse commissure between 
the hemispheres, the inferior vermiform process (Fig. 2, Plate 
220). The latter process presents, in order antero-posteriorly, 
several distant prominences : the nodule, the uvula, the pyra- 
mid, and the tuber uvulae. Laterally, there pass from the 
nodule to the right and left flocculus of the hemispheres, re- 
spectively, a thin band of white neural tissue, the right and 
left inferior medullary velum (Fig. 2, Plate 220). The inferior 
surface of a hemisphere of the cerebellum presents, near its 
external lateral border, a horizontal fissure. Minor fissures 
(not named) divide this surface of a hemisphere into areas, 
named as follows : externally to the horizontal fissure is the 
inferior face of the poster o-superior lobe; internally and 
anteriorly to the horizontal fissure are the postero-inferior 
lobe, the slender lobe, the biventral lobe, the flocculus, and 
the amygdala. 
Dissection.—Turn the cerebellum so as to present its superior surface 
(Fig. 1, Plate 221). 
43. Superior Surface of the Cerebellum, Fig. 1, Plate 221. 
—At this area of the cerebellum is seen the posterior notch, 
which divides the organ into a right and a left hemisphere. 
The superior part of its median-line, commissural, portion pre- 
sents the superior vermiform process, which is surmounted by 
a part of the lingula. At this surface of a cerebellar hemi- 
sphere are found the following defined areas : the partial su- 
perior face of the postero-inferior lobe, is at its postero-inter- 
nal border; a part of the horizontal fissure divides the latter 
lobe from tlia postero-superior lobe ; and anteriorly to the lat- 
ter lobe is the antero-superior lobe. 
Dissection.—Place the cerebellum upon its superior surface, with its pos- 
terior border toward you, and section its hemispheres (Fig. 2, Plate 221) as 
follows : the right, by a transverse antero-posterior cut, near the middle of its 
vertical diameter ; the left, by a transverse vertical cut at about the middle of 
its antero-posterior diameter. 428 
HEAD AND NECK. 
44. Structural Appearances of the Cerebellum, Fig. 2, 
Plate 221.—The interior of the cerebellum presents circumfer- 
ential grey and central white neural tissue. The lamination of 
its exterior determines a peculiar foliated appearance at the 
circumference of its vertical section called arbor rites—this re- 
sults from the grey neural tissue borders to the minor fissures 
of its exterior, in contrast with the central white neural tissue. 
At the side of the median line the central, white, neural tissue 
of a cerebellar hemisphere presents a small area bordered by a 
dentated line of grey neural tissue, with a lighter-colored cen- 
tre, the corpus dentatum. 
Dissection.—Cut away the stump of the cerebrum anteriorly to the pons 
Yarolii, as in Fig. 1, Plate 222; place the same, with the pons Varolii and 
medulla oblongata portions of the brain, in the position shown in Fig. 1, Plate 
222. Follow the left optic tract to the geniculate bodies of the left thalamus 
opticus. 
45. Optic Tract, and tlie External and Internal Genicu- 
late Bodies of a Thalamus Optieus, Fig. 1, Plate 222.—The 
optic tracts were partly described (page 410) and illustrated 
(Plate 214). An optic tract may be followed, externally and 
posteriorly, to the inferior surface of the posterior portion of 
a thalamus opticus, where it enters the two prominences of the 
external and internal geniculate body there located. 
Dissection.—Turn the part of the brain, Fig. 1, Plate 222, upon its antero- 
inferior surface, so as to display its postero-superior area, as in Fig. 2, Plate 222. 
46. Corpora Quadrlgemina, Fig. 1, Plate 218 ; Figs. 2 and 
3, Plate 222.—These present as four prominences, two anterior 
—nates—and two posterior—testes; they are divided by a 
median line and a transverse furrow (Fig. 2, Plate 222), and 
are located posteriorly to the cavity of the third ventricle, and 
the internal portions of the right and left thalamus opticus. 
The pineal body is lodged superiorly to the anterior portions 
of the nates (page 422; Figs. 2 and 3, Plate 222). From the 
external and the internal geniculate bodies, respectively, an 
optic tract branches to the natis and testis, of a side, by well- 
marked lateral welts, the superior and inferior brachium of 
the latter bodies, respectively. 
47. Process! e Ccrcbcllo ad Testes, Fig. 2, Plate 222.— 
These are a right and a left band of white neural tissue, which PARTS OF THE BRAIX. 
429 
are projected postero-inferiorly from the right and left testis, 
respectively, of the corpora quadrigemina, to the cerebellum ; 
they are the superior or cerebrum peduncles of the cerebellum 
(page 426 ; Fig. 2, Plate 220). 
48. Valve of Vieussens and llie Fourth Pair of Cranial 
or tlie Trochlear Serves.—This valve is a sheet of grey neural 
tissue, that bridges between the internal borders of the processi 
e cerebello ad testes ; upon the superior surface of its posterior 
portion the lingula (Fig. 2, Plate 220) of the cerebellum is 
lodged. From the superior surface of its anterior portion the 
fourth pair of cranial or the trochlear nerves take their exte- 
rior origins. 
Dissection.—Return the portion of brain to its former position, as in Fig. 
1, Plate 222. 
49. Crura Cerebri or Cerebral Peduncles, Plate 214 ; Fig. 
1, Plate 222.—These were partly described (page 415) and illus- 
trated (Plate 214). They diverge, right and left, from the an- 
terior of the pons Yarolii; they are projected from the latter to 
the basal ganglia of the cerebrum—the tlialami optici and the 
corpora striata. The third pair of cranial or the trochlear nerves 
wind over their external, to their inferior, surfaces ; and the 
third pair of cranial or oculomotor nerves have their exterior 
origins from their internal surfaces. 
50. Pons Varolii, Plates 211 and 214 ; Fig. 1, Plate 220 ; 
Fig. 1, Plate 222.—This part of the brain, before referred to 
(page 216 ; Plate 214), is the commissure between the other 
three parts of the organ. Its inferior, and exterior, fibres are 
transversely commisural between the hemispheres of the cere- 
bellum, forming its right and left middle or pons Varolii pe- 
duncles (page 422 ; Plates 214 and 220 ; Fig. 1, Plates 221). Its 
interior and superior, substance is longitudinally commissural 
between the medulla oblongata and the cerebrum. Its postero- 
superior surface contributes to the floor of the fourth ventricle 
(Fig. 3, Plate 222). The fifth pair of cranial or trifacial nerves 
(a sensory and a motor root) emerge from the anterior of its 
lateral portion. 
51. medulla Oblongata, Plates 211 and 214 ; Fig. 1, Plate 
220 ; Plate 222.—This portion of the brain was before referred 430 
HEAD AXD XECK. 
to (page 417 ; Plate 214). Besides being the most vital nerve 
centre, its parts are longitudinally commissural: between the 
spinal cord and the cerebellum ; and between the spinal cord 
and the pons Yarolii. Its grey neural tissue is central, but by 
the divergence, at its postero-superior surface of its posterior— 
longitudinal portions, its central grey neural tissue is exposed, 
at the medulla oblongata portion of the floor of the fourth ven- 
tricle of the brain (Fig. 2, Plate 222). 
52. Antero-Iateral Surface of tlie Medulla Oblongata, 
Plate 214 ; Fig. 1, Plate 222.—This area of the medulla oblon- 
gata presents the following : an anterior median fissure con- 
tinued from the spinal cord ; externally to, and parallel with, 
the lissure is an anterior, longitudinal, column, continued from 
the lateral column of the spinal cord, tlie pyramid—its fibres 
decussate at the bottom of the fissure, with those of its fellow 
of the opposite side ; externally to a pyramid is a lateral col- 
umn continued from the same column of the spinal cord— 
which has an olivary body lodged in its superior end—the 
spinal accessory nerve has a partial exterior origin from this 
column of the medulla oblongata ; a slight antero-lateral 
groove presents between an olivary body and a pyramid, from 
which the exterior origin of the hypoglossal nerve is projected 
(page 418 ; Plates 211 and 214)—inferiorly the groove is trace- 
able to the spinal cord ; posteriorly to a lateral column is a 
funiculus of Rolando, inferiorly, which is continued into a 
restiform body, superiorly ; between an olivary and a restiform 
body a postero-lateral groove exists, from which a glossopha- 
ryngeal and a pneumogastric nerve are given off—the groove is 
not well defined, inferiorly. A transverse groove divides the 
medulla oblongata from the pons Varolii—the abducent, fa- 
cial nerve of Wrisberg, and auditory nerves are projected from 
this fissure, contiguously to the olivary bodies. 
Dissection.—Turn the portion of brain (Fig. 1, Plate 222) upon its antero- 
inferior surface, thereby presenting its postero-superior face (Fig. 2, Plate 222). 
53. Postero-superior Surface of tlie Medulla Oblongata, 
Fig. 1, Plate 220 ; Figs. 2 and 3, Plate 222.—This area presents 
the following : a poster tor-median fissure ; for its inferior half, 
and at either side of the fissure, are the right and left funicu- 
lus gracilis, which broaden superiorly into a right and left PARTS OF THE BRAIN. 
431 
clava, and diverge externally; externally to the latter, and sep- 
arated from them by longitudinal grooves are the right and 
left funiculus cuneatus ; externally to, parallel with, and sep- 
arated by slight grooves from, the last-described funiculi, are 
the right and left funiculus of Rolando. The two last named 
funiculi diverge, superiorly, and fuse to form the right and left 
restiform body, respectively, or the inferior or medulla oblon- 
gata peduncles of the cerebellum. The right and left diver- 
gence of the posterior longitudinal portions of the medulla ob- 
longata determines the inferior apex of the floor of the fourth 
ventricle. 
Dissection.—Make two longitudinal cuts along the lines of fusion of the 
valve of Vieussens with the right and left processi e cerebello ad testes; re- 
flect the former anteriorly upon the corpora quadrigeniina, as in Fig. 3, Plate 
222. 
5 4. Interior of tlie Fourth Ventricle of the Brain, Fig. 1, 
Plate 220 ; Figs. 2 and 3, Plate 222.—The postero-inferior open- 
ing of this ventricular cavity was described (page 425) and illus- 
trated (Fig. 1, Plate 220). Superiorly its roof is formed, antero- 
posteriorly by : the valve of Vieussens (Fig. 2, Plate 222); the 
right and \eit processus e cerebello ad testes (Fig. 2, Plate 222); 
and the ventricular area of the antero-inferior surface of the 
cerebellum (Plate 220). Laterally, it is bounded by (Figs. 2 and 
3, Plate 222): the fusion of the right and left processus e cere- 
bello ad testes with the pons Varolii; the internal surfaces of 
the right and left restiform bodies of the medulla oblongata ; 
and the divergence of the funiculi at the posterior of the me- 
dulla oblongata. Interiorly, is its floor, which is divided into 
two portions : for its inferior third, the medulla oblongata por- 
tion, which is formed by the superior part of the postero- 
superior face of the medulla oblongata ; for its superior two- 
thirds, the pons Varolii portion, which is the postero-superior 
area of the pons Varolii. 
The medulla oblongata portion of the floor of the fourth 
ventricle (Fig. 2, Plate 222) is shaped like a pen-point, hence 
it is named the calamus scriptorius—at the bottom of the 
cavity of the tip is the opening into the central canal of the 
spinal cord. At the median line of the portion is a longitudi- 
nal groove, the median sulcus ; from the lateral portions of 
the floor, superficial linear markings of fibres present, the 432 
HEAD AND NECK. 
strice acusticce, which pass externally, out of the ventricle, and 
join the auditory nerve, right and left, respectively. 
The pons Varolii portion of the floor of the fourth ventri- 
cle (Fig. 3, Plate 222) presents the superior continuance of the 
median sulcus. At its superior end is the posterior opening of 
the aqueduct of Sylvius (a bristle emerges from it); the ante- 
rior opening of this aqueduct was described (page 423) and 
illustrated (Fig. 1, Plate 218 ; the aqueduct or canal runs be- 
tween these two openings, inferiorly to the corpora quadri- 
gemina, from the third (page 423; Fig. 1, Plate 219) to the 
fourth ventricle of the brain. At the external ends of the 
transverse line of junction of the two portions of the fourth 
ventricle are the lateral recesses of the cavity. 
Dissection.—Section, as in Fig. 3, Plate 210, longitudinally, at the left of 
the median line, through the medulla oblongata, pons Varolii, corpora quad- 
rigemina, crus cerebri, and thalamus opticus. 
55. Structural Appearances of tlie medulla Oblongata, 
Pons Varolii, Corpora Quadrigcinina, Crus Cerebri, and 
Thalamus Opticus, Fig. 3, Plate 219.—This section of these 
parts is made to afford an approximate appreciation of the dis- 
tribution of the grey and white neural tissues through them. 
FINIS. PLATE 211 
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Co?erz, <7cZ nce^uram c£e?. PLATE 213 
ct<£ <£&Zm PLATE 214 
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Fig. 2 
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CaPirz, a&£rzatztram d&Z. PLATE 219, 
It's <7.2 
Fif?.2 
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JHT.C'cr7zn,acZrta£itra?7i del- INDEX. 
This index has been compiled with two styles of figures: the first, which come 
before the semicofo/is—1--2-3-4-5-6-7-8-9-0—refer to the pages of the text; the second, 
which come after the semicolons—1, 2, 3, 4, 5, 6, 7, 8, 9, 0—refer to the Plates. To 
avoid complication, references to the Figures of the Plates are omitted, the Plate ref er- 
ence being considered sufficient. A Plate reference, like this—192 to 197—means that 
the part referred to is illustrated in the plates from 192 to 197, inclusive. 
Abnormalities, 2 
Abdominal interior, 73 
bone areas of, 80 ; 42 
cartilage areas of, 80 ; 21 
Anatomical elements, 5 
Aorta, 257 ; 144 
abdominal. 70; 38 
arch of, 252 ; 141 
ascending portion of arch, 252 ; 141 
descending portion of arch, 252, 260 ; 
144 
transverse portion of arch, 243 ; 138 
thoracic, 247 ; 139, 140 
Aponeurosis or aponeuroses, 7 
anterior intercostal, 204 ; 113 
compound digital extensor (foot), 150; 
67, 68,82 
compound digital extensor (hand), 
307 ; 163, 170 
of obliquus externus muscle, 48, 52 
of obliquus internus muscle, 49, 52 
of transversalis abdominis muscle (an- 
terior), 51, 52 
of transversalis abdominis muscle 
(posterior), 274 ; 151, 152 
of sartorius, semitendinosus, and gra- 
cilis muscles (compound), 187 
posterior intercostal, 248 ; 139, 140 
Appendix vermiformis, 61, 86; 35, 37, 
47 
Arbor vitae uterinus, 105 
Arch or arches: 
aortic, 252 ; 141 
deep palmar, 232 ; 132, 133 
deep palmar (branches of), 232; 132, 
133 
plantar, 147; 82 
posterior carpal, 304 ; 169 
saphenous, 124; 69, 70, 71 
superficial palmar, 219 ; 127 
Arlerrn centralis retina,, 843 ; 186 
Artery or arteries, 9 : 
acromio-thoracic, 117 
acromio-thoracic (humeral branch), 
197 ; 116, 117 
alveolar, 349 ; 187 
anastomotic branch of first digital 
(foot), 135; 76, 77 
anastomotica magna (arm), 205, 214 ; 
118, 119, 125, 126 
anastomotica magna (thigh), 118, 172 ; 
64, 65, 98 
angular, 333 ; 182, 183 
anterior branch (superficial temporal), 
318, 319 ; 177 
anterior carpal, 236 ; 134 
anterior cerebellar, 410 ; 211 
anterior cerebral, 411; 211 
anterior choroid, 411, 424 ; 211, 218 
anterior circumflex, 201 ; 117, 119, 
120 
anterior communicating, 411 ; 211 
anterior deep temporal, 322, 348; 
178, 187 
anterior dental, 349 
anterior ethmoidal, 343, 404; 186, 
209, 210 
anterior intercostal, 239 ; 135 
anterior interosseous (forearm perfor- 
ating branch), 304 ; 168, 169 
anterior interosseous (forearm), 235 ; 
130, 134 
anterior perforating (cerebrum), 411 
anterior peroneal, 132, 162; 74, 90 
anterior radial carpal, 225; 134 
anterior spinal, 410 ; 211 
anterior tibial, 129, 132, 160 ; 73, 74 
88, 90 
anterior tibial recurrent, 132 ; 74 
anterior ulnar recurrent, 226 ; 134 434 
INDEX. 
Artery or Arteries—Continued. 
ascending cervical, 370 ; 196, 197, I 
198 
ascending palatine, 368, 386 ; 196, 
200, 201, 203, 204 
ascending pharyngeal, 379 ; 200 
auditory, 325, 410; 180, 211 
axillary, 203 ; 117, 118, 119 
azygos articular, 172; 98 
basilar, 410 ; 211 
buccal, 349 ; 187 
brachial, 198, 203, 214, 292 ; 116,117, 
118, 125, 126, 161 
bronchial, 253 ; 142 
cervicalis princeps, 276 ; 150 
ciliary, 343 ; 186 
circle of Willis, 411; 211 
coeliac axis, 62, 70 ; 35, 36, 38 
common carotid (left), 244, 368 ; 138, 
197, 198 
common carotid (right), 366; 192 to 
196 
common iliac, 73 ; 38, 39 
common interosseous (forearm), 235 ; 
130, 134 
common pulmonary, 252, 259, 262 ; 
141, 144, 145 
comes nervi iscliiadici, 168; 96, 97 
comes nervi phrenici, 239 ; 137, 138 
colica dextra, 60 ; 34 
colica media, 60 ; 34 
colica sinistra, 62 ; 35 
coronary (left), 259, 261; 144 
coronary (right), 259 ; 144 
cricoid, 367 ; 195, 196, 197 
cystic, 63; 35, 36 
deep auricular, 348 
deep cervical. 276 ; 150 
deep circumflex iliac, 50 ; 27 
deep dorsalis clitoridis, 36 ; 15, 16 
deep dorsalis penis, 20, 45 ; 8, 22 
deep epigastric, 54, 74; 28, 38, 39 
deep perineal, 21, 36, 38, 39 ; 8, 15, 
16, 17 
descending palatine, 392, 407; 205, 
210 
digital (foot), 139, 145, 148 ; 77, 79, 
81, 82 
dorsal (tongue), 390 ; 204, 205 
dorsal collateral digital (foot), 131 ; 
71, 74 
dorsal collateral digital (hand), 305 ; 
169, 170 
dorsal digital (hand), 305 ; 169 
dorsal digital (foot), 130 ; 71, 74 
dorsalis pedis, 130 ; 74 
dorsalis pedis (branches of), 130; 74 
dorsal scapular, 201, 294 ; 116, 117, 
119, 120, 161, 162 
external carotid, 331, 367; 183, 184, 
192 to 196 
external circumflex, 115 ; 63 
external circumflex (articular branch), 
122 ; 66 
Artery or Arteries—Continued. 
external iliac, 73 ; 38, 39 
external Laryngeal, 367 ; 194 
external malleolar, 130; 74 
external plantar, 140, 144 ; 79, 81 
facial, 333, 367; 182, 183,192 to 197 
femoral, 112, 113 ; 63 
fifth digital (hand), 222 ; 127 
first digital (hand), 232 ; 133 
first digital (foot), 135, 138 ; 76, 77 
fourth digital (hand), 222, 127 
frontal, 318, 337; 177, 182, 183, 
184 
gastric or coronary, 62; 35, 36 
gastro-duodenal, 65 ; 35, 36 
gastro-epiploica dextra, 65 ; 35, 36 
gastro epiploica sinistra, 66 ; 36 
gluteal, 76 ; 40, 46 
gluteal (deep branches), 173 ; 99 
gluteal (superficial branch), 168; 95, 
99 ' 
hepatic, 63, 91 ; 35, 36, 48, 52 
hyoid, 390 ; 204 
ileo colic, 61 ; 34 
ilio lumbar, 76; 38, 39, 40, 41 
inferior cerebellar, 410 ; 211 
inferior coronary, 333 ; 183 
inferior dental. 348 ; 187, 188 
inferior external articular, 160, 172 ; 
88, 90, 98 
inferior external pudic, 108 ; 60 
inferior hemorrhoidal, 17, 33; 7, 13, 
14 
inferior internal articular, 160, 172 ; 
88, 90, 98 
inferior labial, 333; 182, 183 
inferior laryngeal, 397 ; 207 
inferior mesenteric, 62, 72 ; 35, 38 
inferior pancreatico-duodenal, 66, 88; 
36, 49 
inferior profunda, 205, 215; 118,119, 
126 
inferior thyroid. 370; 196, 197, 198 
inferior vesical, 75 ; 39 
infra-orbital, 335, 349 ; 184, 187, 188 
innominate, 243, 366; 138, 196, 197, 
198 
innominate (bifurcation of), 244 ; 138 
intercostal (abdominal parietes\ 50 ; 
26, 27 
intercostal, 139, 247 ; 140 
intercostal (posterior branches), 275; 
152 
intercostal (left', 248; 140 
intercostal (lateral cutaneous branch- 
es), 196; 116 
internal carotid, 325, 346, 353, 367, 
410; 188, 185, 186, 192 to 196, 
200, 211 
internal circumflex, 117, 119, 173, 
175 ; 63, 64, 98, 99, 100 
internal circumflex (articular branch), 
192 ; 110 
internal iliac, 74 ; 38, 39 INDEX. 
435 
Artery or arteries—Continued.. 
internal laryngeal, 367, 394, 396 ; 
194, 207 
internal malleolar, 130; 74 
internal mammary, 239 ; 135 
internal mammary (branches), 241 ; 
136 
internal mammary (perforating 
branches), 194 ; 114, 115 
internal maxillary, 331, 332, 348, 407 ; 
183, 184, 187, 188, 209, 210 
internal plantar, 135, 137, 139; 7 6, 
77, 79 
internal plantar (anastomotic branch), 
135, 137; 76, 77 
interosseous (hand), 233 ; 132, 133 
lachrymal, 339; 185 
lateral nasal, 333 ; 182, 183 
lateral sacral, 76 ; 39, 40 
lingual, 367, 390; 192 to 197,200, 
201, 203, 204, 205 
long thoracic, 200; 116, 117, 119, 
120 
lumbar, 77; 33, 38, 41 
lumbar (posterior branches), 275; 152 
masseteric, 349; 184 
mediastinal, 240 ; 135, 136 
meningeal, 322; 179,180 
mental, 352 ; 184, 187, 188 
metatarsal, 130; 74 
midd'e cerebral, 411; 211 
middle hemorrhoidal, 27 ; 12 
middle meningeal, 345, 348, 352; 
185, 186, 187, 188 
nasal, 337; 182, 183, 184 
naso palatine, 404 ; 209 
obliterated hypogastric, 55 ; 29 
obturator, 74, 118 ; 39, 46, 64, 65 
obturator (articular branch of), 192 ; 
110 
occipital, 266, 320, 357, 368 ; 148, 
177, 192 to 197 
oesophageal, 247 
of the base of the cranium, 325 ; 180 
of the bulb (female), 36, 38 ; 15, 16 
of the bulb (male), 21 ; 8 
of corpus cavernosum (female), 36 ; 
15 
of corpus cavernosum (male), 20; 8 
of septum, 333 ; 183 
of vas deferens, 100 ; 56 
ophthalmic, 326, 342, 411 ; 180, 185, 
186, 211 
ovarian, 72, 103 ; 38, 57 
palmar collateral digital, 223 ; 127, 
131, 132, 133 
palmar collateral digital (dorsal 
branches), 305 ; 170 
palmar digital, 210 ; 124 
pancreatic, 66 
perforating (hand), 233. 305 ; 132, 
133, 169 
perforating (profunda femoris), 114, 
117, 171; 63, 64, 98 
Artery or arteries— Continued. 
perforating (thorax), 239 ; 135 
perforating branches of anterior in- 
terosseous, 302 ; 168,169 
perforating branches of digital (foot), 
131, 148 ; 68, 74, 
pericardial, 240 ; 135, 136 
peroneal, 160, 161; 88, 90 
phrenic, 80 ; 38, 41 
plantar (cutaneous), 134 ; 76 
plantar (arch of) external, 147 ; 82 
plantar collateral digital, 135; 76, 
77 
popliteal, 150, 161, 171, 172; 86, 87, 
88, 90, 94, 96, 97, 98 
popliteal (muscle branches), 156, 160 ; 
86, 87, 88, 90 
posterior auricular, 320, 354, 368; 
177, 187, 188, 196 
posterior branch (superficial temporal), 
319; 177 
posterior cerebral, 410 ; 211 
posterior choroid, 410 
posterior circumflex, 206, 293 ; 120, 
161, 162 
posterior communicating, 411 ; 211 
posterior deep temporal, 322, 348 ; 
178, 187, 188 
posterior dental, 349 ; 187 
posterior ethmoidal, 343, 405; 186, 
209, 210 
posterior interosseous, 300 ; 167, 168 
posterior interosseous (forearm), 235 ; 
130, 134 
posterior interosseous recurrent, 304 ; 
169 
posterior perforating, 410; 211 
posterior peroneal, 162 ; 90 
posterior scapular, 269, 370; 149,192, 
194, 197 
posterior spinal, 410 
posterior ulnar recurrent, 226 ; 128, 
130 
posterior tibial, 157, 160 ; 85, 87, 88 
profunda femoris, 114, 116; 63, 64, 
65 
pterygo-palatine, 407 
pterygoid, 349 ; 187 
pulmonary (common), 257 ; 144 
pulmonary (left), 252, 254 ; 141,142 
pulmonary (right), 254; 142 
pudic 18, 33, 75, 174 ; 7, 13, 14, 39, 
95 to 100 
pyloric. 65 ; 35, 36 
radial, 212, 214, 225, 299; 125, 126, 
127, 128, 130, 134, 165 to 169 
radial (posterior carpal branch), 304; 
169 
radial recurrent, 216 ; 126 
ranine, 390; 205 
recurrent carpal, 233 ; 132, 133 
renal, 71, 94; 38, 54 
sacra-media, 76 ; 38, 39, 40, 41 
1 sciatic, 75, 167 ; 39, 95 to 100 436 
INDEX. 
Artery or Arteries—Continued. 
second dorsal digital (foot), 128; 71 
to 74 
second digital (hand), 221, 232; 127, 
132, 133 
sigmoid, 62 ; 35 
sixth digital (hand), 218 ; 127 
sixth digital (foot), 135 ; 76, 77 
small meningeal, 348, 353 ; 188 
spermatic, 72, 100; 38, 56 
spheno-palatine, 404, 407; 209,210 
splenic, 62, 66 ; 35, 36 
sternal, 240 ; 135 
subclavian (left), 244 ; 138 
subclavian (first portion, right), 369 ; 
192, 194,196, 197, 198 
subclavian (second portion, right), 
369 
subclavian (third portion, right), 369 ; 
192, 194, 196, 197, 198 
subclavian (first portion, left), 373 ; 
138, 195, 197, 198 
subcutaneous (anterior of thigh), 108 ; 
60 
subcutaneous (back), 266 ; 148 
sublingual, 390; 205 
submental, 329 ; 182, 183, 192, 193 
subscapular, 200 ; 116, 117, 119, 120 
superficial cervical, 149, 268, 370; 
192 to 198 
superficial circumflex iliac, 44, 108; 
22, 60 
superficial dorsalis clitoridis, 36; 16 
superficial dorsalis penis, 44 ; 22 
superficial epigastric, 44, 108 ; 22, 60 
superficial perineal, 18, 32 ; 7, 13 
superficial temporal, 318, 319, 331, 
332 ; 177, 182, 183 
superficialis volae, 217; 127 
superior cerebellar, 410 ; 211 
Superior coronary, 333 ; 183 
superior epigastric, 54 ; 28 
superior external articular, 156, 172 ; 
86, 87, 88, 90, 98 
superior external pudic, 44, 108 ; 22, 
60 
superior hemorrhoidal, 62; 35 
superior internal articular, 156, 172 ; 
. 86, 87, 88, 90, 98 
superior mesenteric, 60, 71 ; 34, 38 
superior pancreatico-duodenal, 66 ; 
36 
superior profunda, 204, 216, 292; 
118, 119, 126 
superior thyroid, 367 ; 192 to 196 
superior vesical, 75 ; 39 
supra-orbital, 319, 337, 338 ; 177, 
182, 183, 184, 185 
suprarenal, 70 ; 38 
suprascapular, 293, 294, 370 ; 162, 
192, 194 to 198 
tarsal, 130 ; 74 
third digital (hand), 221 ; 127 
thyroid axis, 370 ; 192 to 198 
Artery or Artei'ies— Continued. 
to corpus cavernosum (male), 20; 8 
to Cowper s gland, 21; 8 
tonsillar, 38(3 
to pons Varolii, 410 
to vulvo-vaginal gland, 38 ; 16 
transverse facial, 331 ; 182, 183 
transverse perineal, 18, 32 ; 7 
tympanic, 348 ; 188 
ulnar, 214, 218, 226, 228 ; 125, 126, 
128, 130, 131, 132, 134 
ulnar (posterior carpal brancli) 304; 
169 
uterine, 75, 103 ; 39, 57 
vaginal, 75 
vesical (inferior), 75; 39 
vesicle (superior), 75; 39 
vertebral, 325, 375, 409 ; 180, 196, 
197, 198, 211 
vertebral (posterior branches), 276 ; 
150 
Vidian, 407 
Articulation or articulations: 
acromio-clavicular, 316; 113, 158, 
176 
ankle, 177 
carpo-metacarpal, 310; 171, 172 
carpus with radius and ulna, 311; 
121, 122, 163, 171, 172. 173 
costo vertebral (anterior), 284; 156 
crico-tliyroid, 395 ; 207 
cu bo-metatarsal, 179 
cuneo-metatarsal, 179 
elbow, 312 
foot, 179 
inferior tibio-fibular, 185 ; 101, 102, 
103 
intercarpal. 311 ; 171, 172 
intermetatarsal, 180, 182, 185 ; 101, 
103 to 106 
metacarpo-plialangeal, 310 ; 171,172, 
173 
metatarso-plialangeal, 179, 180 ; 101, 
102, 104 
occipito atlantal and occipito-axoid, 
283. 284; 155, 156 
of digits (hand), 309; 171, 172, 173 
of dibits (foot), 179 ; 101, 102, 104 
of hand. 309 ; 171, 172, 173 
of hip, 190; 59, 91 
of knee, 187 
of radius and ulna, 313 
of vertebra 84, 277, 283; 42, 155, 
156, 198 
pubic, 84; 42, 45 
radio-ulnar (distal), 314; 171, 172, 
173 
of shoulder, 315 
of tibia and fibula, 185 
sacro coccygeal 84, 286 ; 42, 45 
sacro-iliac, 84, 286; 42, 45, 147 
sacro-vertebral, 84, 285 ; 42, 147 
scapulo-clavicular, 316; 113, 158, 
176 INDEX. 
437 
Articulation or Articulations—Continued. 
sterno chondral, 239 ; 135 
sterno-clavicular, 237; 113, 136 
superior tibio-fibular, 186; 107, 
108, 109 
temporo-maxillary, 349; 184, 187, 
188, 190 
trapezio metacarpal, 310; 171, 172, 
Axilla and its boundanes, 197 
Back, region of, 265 
Bis-ischiatic fascial junction (male), 18 
33; 7, 8, 14, 16, 17 
fascial junction (female), 39 ; 17 
l.ne, 14 ; 5 
Bladder, male, 68 ; 37 
female, 40, 69, 102 ; 20, 37 
exterior trigone, 26 ; 12 
interior of, 96 ; 55 
peritoneal investment of, 95 ; 12, 31, 
37 
Bone or bones: 11 
hyoid, 371. 380, 387 ; 190, 192 to 197 
sesamoid (hand), 310; 173 
sesamoid (foot, 149 ; 82 
of abdominal parietes. 43 ; 21, 42 
of abdominal and pelvic interiors, 80 ; 
42 
of ankle-joint, 177 ; 68, 83 
of anterior of elbow, forearm, and 
hand. 207 ; 121, 122 
of anterior of leg and dorsum of foot, 
123; 67, 68 
of anterior of thigh, 107 ; 59 
of anterior of thoracic parietes, 237 ; 
113, 115 
of anterior scapular region, 287 
of antero-laterul area of neck, 355 ; 
189, 190 
of articulation of carpus with radius 
and ulna, 311 
of deep region of face, 347 ; 190,199 
of elbow joint, 312 ; 121, 163 
of foot, 179 ; 68, 75 
of gluteal region and posterior region 
of thigh, 163 ; 91 
of hand 309 ; 122, 163 
of hard palate, 392 ; 205 
of hip-joint, 190 ; 59, 91 
of inferior meatus. 403 
of interior of base of cranium, 317 
of knee-joint, 187 ; 59, 83, 91 
of middle fossa of cranium, 344 ; 180, 
181, 185, 186, 199 
of middle meatus, 403 
of nasal cavities 400, 401 
of orbital cavity, 337 
of perineal region, 14 ; 5 
of plantar region, 133; 75 
of posterior nares, 402 ; 199 
of posterior of elbow, forearm, hand, 
and digits, 295 
of posterior of leg and popliteal space, 
151 ; 83 
Bone or bones—Continued. 
of posterior of shoulder and arm, 288 ; 
158 
of radio-ulnar articulation, 314 
of region of back 265 ; 147 
of scapulo-clavicular articulation, 316; 
113, 158, 176 
of shoulder-joint, 315 ; 113,158,175 
of superficial region of face, 327 ; 181 
of superior meatus, 403 
turbinate (mucous membrane cov- 
ered). 402 ; 209 
of vault of cranium, 317 ; 181 
of vertebral column, 277,281, 282, 347; 
42, 147, 155, 156, 189, 190, 199 
phalangette, 123 
phalangine. 123 
phalanx, 123 
Bone areas for muscle attachments: 
of abdominal parietes, 43 
of abdominal and pelvic interiors, 80 ; 
43, 45 
of anterior of elbow, forearm, and 
hand, 207 ; 121, 122 
of anterior of leg and dorsum of foot, 
123 ; 67, 68 
of anterior of thigh, 107 ; 59, 91 
of anterior of thoracic parietes, 237; 
113, 115 
of anterior of thorax, arm, and axilla, 
193; 113 
of anterior scapular muscles, 287 ; 113 
of antero-lateral area of neck, 355; 
189, 190 
of compound proximal end of super- 
ficial flexors (forearm), 224 ; 121, 
128, 129, 130, 134 
of compound proximal end of exten- 
sors (forearm), 297 ; 163,165, 167, 
168, 169 
of deep region of face, 347 ; 190,199 
of exterior of cranium, 317 ; 181,189 
of gluteal region and posterior region 
of thigh, 163;’91 
of orbital cavity, 337; 181 
of muscles of pharynx, 380; 190,199 
of muscles of soft palate, 384; 190, 
199, 205 
of pelvic cavity, 82 ; 42, 45 
of perineum, 14, 29 ; 5 
of pharynx, 380; 190, 199 
of plantar region, 133 ; 75 
of posterior of elbow, forearm, hand, 
and digits, 295 
of posterior of shoulder and arm, 288 ; 
158 
of posterior region of leg and popliteal 
space, 157 ; 83 
of region of back, 265 ; 147 
of superficial region of face, 327 ; 181 
of the surfaces of the knee, 187; 59, 
67, 83, 107, 108, 109, 110 
of tongue (extrinsic muscles), 387 ; 
190 438 
INDEX. 
'Brain, 414 
anterior cornu of lateral ventricle, 
424; 216, 217, 218 
aqueduct of Sylvius at third ventricle, 
424 ; 218, 222 
arteries, 409 
basal surface of, 414 ; 214 
calamus scriptorius of fourth ventri- 
cle, 431 ; 222 
cavity of a lateral ventricle, 419 ; 
216, 217, 218 
choroid plexus of a lateral ventricle, 
421; 216,217 
choroid plexus of middle cornu of a 
lateral ventricle, 424; 218 
choroid plexus of third ventricle, 422 ; 
218 
fifth ventricle. 421 ; 217, 218 
foramen of Monro, 420; 216, 217 
fourth ventr cle 425 ; 220, 222 
interior of fourth ventricle, 430 ; 220, 
222 
lateral recesses of fourth ventricle, 
431; 222 
lateral walls of fourth ventricle, 431 ; 
222 
left lateral or second ventricle, 419 ; 
216, 217, 218 
median sulcus of fourth ventricle, 
431 ; 222 
medulla oblongata portion of fourth 
ventricle floor. 431 ; 222 
middle cornu of a lateral ventricle, 
424 ; 218 
orifice of canal of spinal cord at fourth 
ventricle, 431 
parts of, 414 
pons Varolii portion of fourth ven- 
tricle floor, 431 ; 222 
postero-inferior opening of fourth 
ventricle, 425; 220 
right lateral or first ventricle, 419 ; 
216, 217, 218 
roof of fourth ventricle, 431 ; 220, 
222 
striae acusticae of fourth ventricle, 
431 ; 222 
taking from cranium of, 324 
third ventricle, 423 ; 218 
vertex portion of membranes of, 322, 
323; 179 
Bronchi, 253; 142, 143 
Bursa or Burses : 5 
of gluteus maximus muscle, 166 ; 96, 
4 
of biceps muscle, 236 ; 121 
of elbow, 295; 164 
of obturator intern us muscle, 176 ; 4 
of patella, 108 ; 60 
of psoas and iliacus muscles, 120; 66 
subcutaneous, 8 ; 60 
submuscular, 8 ; 4 
Cadaver, division of a, A: 
CcBcum, 61, 86; 34, 35, 37, 47 
Canal or Canals: 
carotid, 346, 353; 186, 199 
dental (anterior), 349 
dental (inferior), 351 
dental (superior), 349 
femoral, 112 
for tendon of peroneus longus muscle 
(fibro-osseous), 183 ; 105, 106 
Hunter s, 112; 62 
Hunter's, contents of, 113 ; 63 
of Nuck, 99 
palatine (accessory), 392, 407; 199 
palatine (anterior), 392 ; 205 
palatine (posterior), 392, 407; 199. 
205 
palatine f'pterygo-), 407; 199 
spinal, 278 ; 153, 154 
uro seminal. 97 
vertebral, 282 
Cartilage or cartilages: 
arytenoid, 399 ; 206, 207, 208 
cricoid, 397; 190,195, 196,197, 207 
cornicula larvngis, 208 
epiglottic, 393, 400 ; 206, 208 ♦ 
of nasal cavity walls, 400 
of anterior of thoracic parietes, 237 ; 
113. 115 
thyroid, 380, 395; 190, 195, 196, 
197, 203, 204, 207, 208 
Cartilage areas for muscle attachments: 
of abdominal interior, 80 ; 21 
of anterior of thoracic parietes, 237; 
113, 135 
of anterior of thorax, axilla and arm, 
193 ; 113 
of antero lateral parietes of abdomen, 
43 ; 21 
of antero-lateral area of neck, 355 ; 
189, 190 
of larvnx (intrinsic muscles), 395, 397, 
399 
of pharynx muscles, 380 ; 190 
Carunculee myrtiformes, 30 
Cauda equina, 279 ; 154 
Cavity or cavities: 
nasal, and contiguous parts, 400 
orbital, 337 
pelvic, 82; 42. 45, 46 
Cerebellum: 417, 425, 431; 211, 213 to 
218, 219 220, 221, 222 
antero inferior surface. 426 ; 220 
antero superior lobe, 427; 221 
amygdala, 427; 220 
arbor vitae, 427 ; 221 
biventral lobe, 427; 220 
corpus dentatum, 427; 221 
flocculus. 427; 220 
hemispheres (right and left), 426 ; 
220, 221 
horizontal fissure, 427 ; 220, 221 
inferior medullary velum, 426; 220 
inferior vermiform process, 426 ; 220 
lingula, 426, 427 ; 220, 221 
nodule, 426; 220 INDEX. 
439 
Cerebellum— Continued. 
notch, 426 ; 220. 221 
peduncles (inferior), 426 ; 220, 222 
peduncles 426; 214, 220, 
222 
peduncles (superior), 426 ; 220, 222 
postero inferior lobe, 427 ; 220, 221 
postero superior lobe, 427 ; 220, 221 
pyramid, 426 ; 220 
slender lobe, 427 ; 220 
superior surface, 427 ; 221 
superior vermiform process, 426, 427 ; 
221 
structural appearances, 427 ; 221 
tuber uvulae, 426 ; 220 
uvula, 426 ; 220 
vallecula, 426 ; 220 
Cerebrum: 
aqueduct of Sylvius, 423 ; 218 
bracliium 428 
brachium (superior), 428 
capsule (external), 424, 425 ; 219 
capsule (internal), 424 ; 219 
central lobe, 413 ; 213, 214, 219 
central lobe (convolutions and sulci), 
414 ; 213 
centrum ovale of Vieussens, 418 ; 215 
claustrum, 424 ; 219 
commissure (anterior), 423 ; 217, 218 
commissure (middle), 423 ; 218 
commissure (posterior), 423 ; 218, 222 
corpora mammillaria, 416, 422 ; 214 
corpora quadrigemina, 428 ; 218,222 
corpora quadrigemina (structural ap- 
pearances , 431; 219 
corpus callosum. 418 ; 214 to 218 
corpus fimbriatum, 424 ; 218 
corpus striatum 420 ; 216, 217, 218 
crura cerebri, 415, 429 ; 214, 222 
crus cerebri (structural appearances), 
431; 219 
cuneate lobule, 414 ; 215 
eminentia collaterals, 420 ; 216, 217, 
218 
exterior of, 412 
fissure of Sylvius, 412 ; 212, 213 
fissures and furrows of vertex and lat- 
eral areas, 412 ; 212, 213 
fornix, 421 ; 216, 217, 218 
fornix (anterior pillars), 421 ; 216, 
217 
frontal lobe, 412 ; 211 to 215 
frontal lobe (convolutions and sulci), 
413 ; 212 to 215 
furrow of Rolando, 412; 212, 213 
ganglia (basal), 424, 425 ; 219 
geniculate body (external), 428 ; 222 
geniculate body (internal), 428 ; 222 
genu, 419 ; 215, 216 
hippocampus major, 424 ; 218 
hippocampus minor, 420; 216, 217, 
218 
infundibulum opening, 406 ; 210 
interpeduncular space, 415 
Cerebrum— Continued. 
intraparietal furrow, 412; 212, 213 
lamina cinerea, 415 ; 214 
lobes, 412; 211 to 215 
longitudinal fissure, 412, 415 ; 212, 
213, 214 
nates, 428 ; 218, 222 
nucleus caudatus, 425 ; 219 
nucleus lenticularis 424, 425 ; 219 
occipital lobe, 413 ; 212 to 215 
occipital lobe (convolutions, sulci, and 
lobule), 414; 212, 213, 215 
occipito parietal fissure, 412; 212, 
213 
optic commissure, 415; 211, 214, 
222 
optic tracts, 415, 428 ; 214, 222 
parietal lobe, 412; 212, 213, 215 
parietal lobe (lobules, convolutions, 
and sulci), 413 ; 212, 213, 215 
parietal lobule (inferior), 414; 212, 
213 
parietal lobule (superior), 414; 212, 
215 
peduncles, 428 
pineal body, 422, 428; 218, 222 
pineal body (crura of), 422; 218, 
222 
pituitary body, 415; 214 
perforated spaces (anterior), 415 ; 214 
perforated space (posterior), 415; 
214 
processi cerebello ad testes, 426, 428, 
431; 220,222 
quadrate lobule, 414 ; 215 
raphe, 419 ; 215, 216 
rostrum. 415, 419 ;• 214 
septum lucidum, 419, 421; 216, 217, 
218 
splenium, 419 ; 215 to 218 
taenia semicircularis, 420; 216, 217, 
218 
temporo-splienoidal lobe, 413 ; 213, 
214 
temporo-splienoidal lobe (convolu- 
tions and sulci), 414; 213, 214 
testes, 428 ; 222 
tlialamus opticus, 421, 423, 424, 425, 
431 ; 216 to 219 
thalamus opticus (anterior tubercle), 
423 ; 216, 217, 218 
thalamus opticus (posterior tubercle), 
423 ; 218 
tuber cinereum, 416 ; 214, 222 
valve of Vieussens, 428, 431; 222 
veins (intraventricular), 422; 216, 
217 
velum interpositum, 422 ; 217, 218 
venae Galeni, 422 ; 217, 218 
Clitoris, 30 
elastic sheath, 37; 16 
structure, 37 
suspensory ligament of, 37 ; 16 
vessels and nerves, 36, 37; 16 440 
INDEX. 
Colon, 61 ; 34, 35 37 
ascending, 61 ; 35 
descending, 61 ; 35 
transverse. 61; 34, 35 
Conjunctiva, 336 ; 184 
Cord or cords: 
inner brachial plexus, 204 ; 119 
outer, brachial plexus, 204 ; 119 
posterior brachial plexus, 205 ; 120 
Coipus or corpora: 
cavernosa, 99 ; 55, 56 
spongiosum, 19, 99 ; 8 to 12, 55, 56 
Cotyloid: 
cavity, 192 ; 110, 111 
notch, 192; 59, 110 
Cranium: 
interior of base, 324; 180 
middle fossa, 344 
Crus or crura: 
clitoridis, 15, 34, 37; 5, 14, 15, 16 
penis, 15, 19, 20 ; 5, 7, 8, 10, 55, 56 
Cul-de-sac: 
recto-vaginal or Douglas’, 69, 102 
recto-vesical, 67 ; 37 
vesico-uterine, 69 
Dissection : 
how to keep a, 5 
object of, 4 
review of a, 5 
general rules for, 4 
special rules of, 5 to 12 
Dissectors' use of this work, 1 
Duct or ducts: 10, 11 
cystic, 63, 92 ; 35, 36, 48, 52 
ejaculatory, 96 ; 55 
hepatic. 91 ; 48, 52 
nasal, 336 ; 184-~1 
of submaxillary gland, 364, 388 ; 195, 
197, 204, 205 
pancreatic, 67, 89 ; 36, 49 
thoracic or left lymphatic, 246, 249, 
373 ; 139, 140,“ 195, 197, 198 
Rivini (of sublingual), 391 
Stenson s, 330 ; 1.82 
Wharton s, 364 
Ductus: 
arteriosus, 254 ; 142 
communis choledochus, 63, 67, 87, 
92 ; 35, 36, 48,49 
venosus, 90 ; 52 
Duodenum, 59, 64, 87; 35, 36, 48 
interior of, 89 ; 50 
Eminence, minim, 209 ; 124 
pollex, 209 ; 124 
Epidermis, 5 
Epididymis, 56 
Epiglottis, 393, 400 ; 206, 208 
Eustachian tube, 386 ; 202, 203 
Eyelids, 336 ; 184 
Face, deep region of, 347 
superficial region of, 327 
Fallopian tubes, 69, 102 ; 37, 57 
Fascia or fasciae : 
anal, 17, 23 ; 7, 8 
axillary, 195; 115 
bicipital, 212; 125, 126 
cribriform (saphenous opening), 110 
external spermatic (intercolumnar), 
48; 24 
deep, 8 
dissection of deep, 8 
deep temporal, 48, 321; 24, 178 
dissection of superficial 7; 2 
internal spermatic (infundibuliform), 
54, 99 ; 28, 56 
intermuscular (leg', 159 ; 88 
intermuscular (median-line of neck), 
359; 193 
lata, 109, 164 ; 60, 92 
levator (female), 33, 39; 13, 14, 17 
levator (male), 15, 17, 22, 23; 5, 7, 8 
obturator (female), 33 ; 13, 14 
obturator (male), 17 ; 7 
of anterior of arm, 195 ; 115 
of anterior of forearm, 209 ; 123, 115 
of leg and foot. 125 ; 3, 69, 70 
of pectoralis minor muscle, 200 ; 117 
of posterior of forearm, 297 ; 164 
of posterior of shoulder and arm, 289; 
159 
of posterior surface of the wrist and 
metacarpus (deep), 303; 165, 167, 
168 
palmar, 210 ; 124 
pelvic, 23 
perineal, 15, 16, 32 ; 5, 6, 13 
plantar, 134; 76 
recto-vesical, 25, 40; 10, 19, 46 
scapular, 268 ; 149 
superficial, 7 ; 3 
superficial (abdominal parietes), 47; 
23 
superficial (back), 266 ; 148 
superficial (leg), 152 ; 84 
temporal, 321 ; 177 
tracheal, 363 ; 194, 195 
transversalis, 53; 28 
upon erector spinae muscle, 149 
Fibro-cartilaf/es : 189; 109, 110 
interarticular (wrist), 312; 173-1 
interarticular, (temporo-maxillary ar- 
ticulation) 350; 188-2 
interarticular (thorax), 238 ; 136 
knee, 189; 109, 110 
of plantar digital ligaments, 179 ; 104 
Forceps, 3 ; 1 
Fossa or fossae: 
ischio-rectal, 16, 33 ; 7, 13, 14 
palmar, 209 ; 124 
Foramen or foramina: 
great sacrosciatic, (parts passing 
through) 176; 100 
intervertebral, 282 ; 156 
mental, 352; 181 
of Winslow (demonstration of), 57 INDEX. 
441 
Foramen or Foramina—Continued. 
ovale, 261 
sacral, 282 ; 42, 1,47, 154 
small sacrosciatic (parts passing 
through), 176 ; 100 
spheno-palatine, 404 ; 209 
vertebral, 282 
Gall-bladder, 58, 92 ; 30, 48, 52 
Ganglion or ganglia : 
Gasserian, 345; 185, 186 
on posterior roots of spinal nerves, 
281 ; 153 
Genitalia, external female: 
carunculse myrtiformes, 30 
clitoris, 30 
fossa navicularis, 31 
fourchette, 31 
hymen, 30 
labia majora, 30 
labia minora, 30 
meatus urinarius, 30 
mons Veneris, 30 
orifices of ducts of vulvo-vaginal 
glands, 29, 31 ; 16 
pudendum, 29 
uro genital furrow, 29, 30 
vaginal orifice, 30 
vestibule. 30 
Gland or glands: 
Cowper’s, 22 ; 8 
Brunner s, 89; 50 
lachrymal, 339 ; 184, 185 
lymphatic, 10 
parotid, 330, 358; 182, 183, 184, 
192 to 197 
saphenous lymphatic, 108 
solitary, 87 ; 47 
sublingual 391; 204, 205 
submaxillary, 362; 192 to 197 
submaxillary (deep portion), 388 ; 
204 
vulvo-vaginal, 31, 38 ; 16-3 
Groove (tarsal) for flexor longus tendons, 
145 ; 75, 81 
Heart. 257; 144 
apex, 257 
aortic orifice, 263 ; 146 
aortic semilunar valves, 263 ; 146 
anterior surface, 251 ; 141 
auricular opening of vena cava infe- 
rior, 261 ; 145 
auricular opening of coronary vein, 
261; 145 
base, 257 
chord* tendin*, 262, 263 ; 145, 146 
column* carnese 262, 263 ; 145,146 
coronary valve, 261 ; 145 
endocardium, 262, 263; 145, 146 
Eustachian valve, 261 ; 145 
exterior of (left), 259 ; 144 
exterior of (right), 258 ; 144 
foramina Thebesii, 261 ; 145 
Heart— Continued. 
fossa ovalis, 261, 263 ; 145, 146 
interauricular septum, 257, 261; 145 
interior of left auricle, 260 ; 144 
interior of right auricle, 262 ; 144 
interior of left ventricle, 263 ; 146 
interior of right ventricle, 262; 145 
interventricular furrow (right and 
left), 258; 144 
interventricular septum, 257, 262, 
263 ; 145, 146 
left auricle, 260; 144 
left auriculo-ventricular furrow, 259 ; 
144 
left auriculo-ventricular orifice, 263 ; 
146 
left side of auriculo-ventricular sep- 
tum, 257 
left interauricular furrow, 260; 144 
left ventricle, 144 
mitral valves, 263 ; 146 
musculi papillares, 262, 263; 145, 
146 
musculi pectinati, 261. 262 ; 145, 146 
openings (left auricle) of pulmonary 
veins, 262 ; 146 
orifice of common pulmonary artery, 
262; 145 
orifices of coronary arteries, 264; 146 
posterior surface, 253 ; 142 
pulmonary semilunar valves, 262; 
145 
right auricle, 258 ; 144 
riadit auriculo-ventricular furrow, 
258; 144 
right auriculo-ventricular orifice, 261; 
145 
right side of auriculo-ventricular sep- 
tum, 257 
right ventricle, 258 ; 144 
section lines for opening left auricle, 
262; 144 
section lines for opening left ventricle, 
263; 144 
section lines for opening right auri- 
cle, 262 ; 144 
section lines for opening right ven- 
tricle. 261 ; 144 
tricuspid valves, 262 ; 145 
weight, 257 
Hooks, chain, 3 ; 1 
Instruments, dissecting, 3 ; 4 
Ileum, 59 ; 32 
Intervertebral discs, 283 ; 156, 198 
Intestine: 
coats of small, 85 ; 47 
mucous membrane of large, 87; 47 
Peyer s patches, 85; 47 
structure of ileum, 85; 47 
structure of jejunum, 85 ; 47 
structure of large, 86, 87 ; 34, 35, 
47 
valvulas conniventes, 85 ; 47 442 
INDEX. 
Jejunum, 59; 32 
Joints, 11, 12 
Kidney, 71, 93, 94 ; 38, 54 
calices, 94; 54 
capsule, 94 
columns of Bertini, 94; 54 
cortical substance, 94; 54 
liilus, 94; 54 
infundibula. 94; 54 
medullary portion, 94 ; 54 
papillae, 94; 54 
pelvis portion, 94; 54 
pelvis proper, 94 ; 54 
pyramids of Malpighi, 94 ; 54 
weight, 93 
Lachrymal puncta, 336; 184 
canals, 336 ; 184 
sac, 336 ; 184 
Large intestine, 61 ; 34, 35 
Laryngeal pouches, 398, 400 
Larynx, 361, 393; 190, 195, 196, 197 
antero-lateral furrow, 393 ; 206 
extrinsic muscles, 394; 190, 195, 
196, 197, 200, 203, 204 
false vocal cords, 393, 398 ; 206 
Fraenum epiglottidis, 393; 206-2 
interior, 393 ; 206 
true vocal cords, 393, 398; 206, 208 
rima glottidis, 393 ; 206 
ventricle, 398, 400 ; 268 
Ligament or ligaments: 
annular, 7 
anterior (ankle), 178 ; 101, 102, 103 
anterior i elbow-joint), 313 ; 174, 175 
anterior (knee), 116,188 ; 64, 65,107 
anterior annular (ankle), 126 ; 71, 72 
anterior annular (wrist), 219 ; 127 
anterio* common, 283 ; 42, 156, 198 
anterior costo transverse, 284 ; 156 
anterior costo-vertebral, 284 ; 156 
anterior crucial, 189 ; 109, 110 
anterior inferior tibio-fibular, 185; 
101, 103 
anterior layer of broad (uterus), 102 ; 
57 
anterior portion of capsular (hip), 190; 
66, 112 
anterior radio-carpal, 311 ; 171 
anterior radio-ulnar, 314 ; 171, 173 
anterior sacro coccygeal, 84, 286 ; 42, 
45 
anterior sacro iliac, 84, 286 ; 42, 45 
anterior sterno-chondral. 239 ; 135-1 
anterior sterno clavicular. 238; 113 
anterior superior tibio-fibular, 186, 
187 ; 107 
broad (liver), 57, 90; 30, 51, 52 
broad (uterus), 102 ; 57 
capsular (hip), 121 ; 64, 65, 66 
capsular (shoulder-joint), 315; 176 
capsular < temporo-maxillary articula- 
tion), 350; 187,188,190 
Ligament or Ligaments—Continued. 
capsular (vertebral), 277, 278 ; 155 
coraco-acromial, 816 ; 113, 176 
coraco-clavicular, 316 ; 113, 158, 
176 
coraco-humeral, 315 ; 113, 176 
coronary (knee), 190 ; 110 
coronary (liver , 56, 90; 51, 52 
costo clavicular, 238 ; 113 
costo-transverse, 284; 155, 156 
costo-vertebral, 284; 155,156 
crucial (atlas), 283; 156 
crucial (knee), 189 ; 109, 110 
distal intermetatarsal, 180 ; 104 
dorsal astragalo scaphoid, 182 ; 101, 
102, 103 
dorsal calcaneo-cuboid, 181 ; 101, 103 
dorsal calcaneo-scaplioid, 181 ; 101, 
103 
dorsal cubo metatarsal, 180 ; 101, 
103 
dorsal cuneo-cuboid. 181 ; 101, 103 
dorsal cuneo-metatarsal, 180 ; 101, 
102, 103 
dorsal intercuneiform, 181 ; 101, 103 
dorsal intermetacarpal, 310 ; 171,172 
dorsal intermetatarsal, 180; 101,103 
dorsal scaplio-cuboid, 181 ; 101, 103 
dorsal scapho-euneiform, 181 ; 101, 
102, 103 
dorsal of digits (hand), 310; 172 
dorsal of digits (foot), 179 ; 101,102, 
103 
dorsal metacarpophalangeal, 310; 
171, 172, 173 
dorsal metatarso phalangeal, 180 ; 
101, 102 
external astragalo-calcaneal, 181; 101, 
103, 106 
external lateral (ankle), 177,178; 101, 
102, 103 
external lateral (knee), 187, 188 ; 107 
external lateral (temporo-maxillary ar- 
ticulation), 349 : 184, 187 
external tarsal, 336 ; 184 
Gimbernat s, 48 
glenoid, 315 ; 175 
great sacro-sciatic, 22, 38, 167, 286 ; 
8, 9, 17 to 20, 95, 99, 100 
ilio-femoral, 121, 191; 66, 112 
ilio-lumbar, 84, 286; 42, 147 
inferior acromio-clavicular, 316 
inferior interosseous (tibio fibular), 
186 
inferior sterno-chondral, 135 
inferior tliyro-arytenoid, 400 ; 208 
inner lateral (elbow-joint), 174 ; 175 
inner lateral (wrist), 311; 171, 172 
interarticular (vertebral), 284; 156 
interclavicular, 238 ; 113 
intermetacarpal, 310 ; 171, 172 
internal lateral (ankle), 177, 178 ; 
102, 103 
internal lateral (.knee), 188 ; 107 INDEX 
443 
Ligament or Ligaments—Continued. 
internal lateral (temporo-maxillary ar- 
ticulation), 350 ; 187, 188, 190 
internal tarsal, 336; 184 
interosseous (calcaneo-astragaloidb 
185; 106 
interspinous, 277, 278 ; 155 
lateral (digits of foot , 179 ; 101, 102, 
104 
lateral (digits of hand), 309; 171, 
172, 173 
lateral (liver), 56, 90; 51, 52 
lateral occipito-odontoid, 283 ; 156 
long calcaneo cuboid, 182 ; 105, 106 
metacarpal and carpal (interosseous), 
312 
metatarsal and tarsal (interosseous), 
185; 104 
middle costo-transverse, 278, 284; 
155 
oblique, 314; 174, 175 
occipito atlantal capsular, 284; 156 
of abdominal interior, 84 ; 42, 45 
of cervical vertebrae (posterior), 277; 
155 
of capsular of shoulder-joint (muscles 
crossing its exterior), 315 ; 176 
of dorsal vertebrae (posterior), 277; 
155 
of lumbar vertebrae (posterior), 277; 
155 
of ovary, 103 ; 57 
of pelvic interior, 84 ; 42, 45 
of vertebral column, 277,283; 155, 
156 
orbicular, 313 ; 174, 175 
outer lateral (elbow-joint), 313 ; 174, 
175 
outer lateral (wrist), 311; 171, 172, 
173 
palmar (digits), 310 ; 171, 173 
palmar carpo-metacarpal, 310; 171, 
172 
palpebral, 336 ; 184 
plantar (digits), 179 ; 104 
plantar calcaneo-scaphoid, 184; 105, 
106 
plantar cubo-metatarsal, 184 ; 106 
plantar cuneo-cuboid, 184; 106 
plantar cuneo metatarsal, 184 ; 106 
plantar intercuneiform, 184; 106 
plantar intermetatarsal, 182; 105, 
106 
plantar metatarso-phalangeal, 180 ; 
104 
plantar scapho-cuboid, 183 ; 106 
plantar scapho cuneiform, 184; 106 
posterior (ankle), 178 ; 102 
posterior (elbow-joint), 313 ; 174, 175 
posterior (knee) 188 ; 108 
posterior annular (wrist), 297; 163 
to 166 
posterior astraealo calcaneal, 185; 102 
posterior atlanto-axial, 277 ; 155 1 
Ligament or Ligaments—Continued 
posterior cervical, 277, 282; 158 
posterior common (vertebral), 283; 
156 
posterior costo transverse, 278, 284; 
152, 155 
posterior crico arytenoid, 399 
posterior crucial, 189 ; 109, 110 
posterior dorsal (vertebral), 277, 282 ; 
155 
posterior inferior (tibio-fibular), 186 ; 
102 
posterior layer of broad (uterus), 102 ; 
57 
posterior lumbar (vertebral), 277, 282 ; 
155 
posterior oecipito-atlantal, 277 ; 155 
posterior portion of capsular (hip- 
joint), 109 ; 110, 111 
posterior radio-carpal, 312 ; 172 
posterior radio-ulnar, 314; 172 
posterior sacro-coccygeal, 286 
posterior sacro-iliac, 286 ; 147 
posterior sterno chondral. 239 ; 135 
posterior sterno-clavicular, 238 ; 136 
posterior superior tibio-fibular, 187; 
107, 108, 109 
pterygo-maxillary, 382 ; 201, 203 
Poupart’s, 48 ; 24 
pubic (anterior), 84; 42 
pubic (inferior), 84 ; 45 
pubic (posterior), 84 ; 45 
pubic (superior), 84 ; 45 
radio-ulnar interosseous, 314; 134, 
169 
radio-ulnar (oblique), 314 ; 174, 175 
round (liver), 57, 90 ; 30, 51, 52 
round (uterus), 48, 69, 103 ; 37, 57 
short calcaneo cuboid, 184; 105, 106 
small sacro-sciatic, 286 
stylo hyoid, 354; 188, 190 
stylo-maxillary, 350; 190 
superficial transverse (plantar), 134 ; 
76 
superficial transverse (palmar), 210; 
124 
superior acromio-clavicular, 316 ; 113, 
158, 176 
superior costo-transverse, 278, 284; 
155 
superior occipito-odontoid, 283 ; 156 
superior sterno-cliondral, 239 ; 135 
superior tliyro arytenoid, 399 ; 208 
suprascapular, 316; 176 
supraspinous, 277; 155 
suspensory (clitoris), 37 ; 16 
suspensory (penis), 45 ; 22 
thyro-hyoid, 394 ; 207 
tibio-fibular interosseous, 186 ; 67, 83 
transverse (hip), 191 ; 110, 111 
transverse (knee), 190 ; 110 
transverse metacarpal, 234; 132, 133 
triangular, 20, 35 ; 8, 15 
triangular (anterior layer), 15 ; 5 444 
INDEX. 
Ligament or ligaments—Continued. 
triangular (posterior layer), 15, 22, 23 ; 
5, 8 
lAgamentum or ligamenta: 
of, 121 ; 66-2 
ligamenta denticulata. 280 
ligamenta subtlava, 277, 278 ; 155 
ligamentum arcuatum externum, 81 ; 
43 
ligamentum arcuatum internum, 81; 
43 
ligamentum nucliael, 267; 150, 151 
ligamentum patellae, 115, 187; 61, 
107 to 110 
ligamentum teres, 191; 110, 111 
Line, pelvic fascia, 83 ; 46 
Linea or linece: 
alba, 47, 53 ; 24, 28 
semilunares, 47, 53 ; 24, 28 
transversae, 47; 24 
Liver, 58, 90 ; 30, 51, 52 
Lungs, 241, 255, 256; 137, 138, 143 
Lungs and heart together, 251 to 255 ; 141, 
142 
section lines for separating heart from 
lungs, 255; 142 
Lymphatic vessels, 10 
Mamma, 194 ; 114 
Markings (abdominal parietes) fibrous tis- 
sue, 47 ; 24 
Meatuses of a nasal cavity: 
inferior (mucous membrane lined), 
403; 209 
middle (mucous membrane lined', 
403; 209 
superior (mucous membrane lined', 
403 ; 209 
Mediastinum, 249; 140 
Medulla oblongata, 417, 429 ; 211, 214, 
219, 220, 222 
anterior-median fissure, 429; 214, 222 
antero-lateral furrow, 430 ; 222 
antero-lateral surface, 429; 214, 
222 
clava, 430; 222 
decussation of fibres, 429 ; 222 
funiculus cuneatus. 430 ; 222 
funiculus gracilis, 430 ; 222 
funiculus of Rolando, 430; 222 
lateral column, 430 ; 222 
olivary body, 430 ; 222 
posterior median fissure, 430; 222 
postero-lateral furrow, 430 ; 222 
postero-superior surface of, 430 ; 220, 
222 
pyramid, 429 ; 214, 222 
restiform body, 425, 430 ; 220, 222 
structural appearances, 431 ; 219 
Membrane or membranes: 
arachnoid, 279, 280, 323 ; 153, 154, 
179 
costo-coracoid, 199; 117 
crico-tliyroid, 395 ; 190, 197, 207 
Membrane or membranes—Continued. 
dura mater, 279, 322 ; 153,154, 179, 
180 
mucous, 11 
pia mater, 279, 280, 323; 153, 154, 
179 
thyro-liyoid, 371, 394 ; 190, 194 to 
197, 207, 208 
serous, 11 
Mesentery, 56, 59; 34 
Meso-caecum, 56 ; 31 
Meso-colon: 
ascending, 56 ; 34 
descending, 56 ; 35 
transverse, 59 ; 32 
Mew-rectum, 56, 68 
Meso-sigmoid, 56 ; 35 
Muscle or muscles, 7 : 
abductor minimi digiti (foot), 138; 
75, 77, 78 
abductor minimi digiti (hand), 218; 
122, 127, 129 
abductor pollicis (foot), 137 ; 77, 78 
abductor pollicis (hand), 217 ; 122, 
127, 129 
accelerator urinaa, 19 ; 7 
musculus accessorius, 272 ; 1D1 
adductor brevis, 118 ; 59, 64, 93 
adductor longus, 111 ; 59, 61, 62, 63 
adductor magnus, 111, 119, 166, 171; 
59, 61, 64, 65, 66, 91, 93 to 100 
adductor pollicis (foot), 143, 146 ; 75, 
77 to 82 
adductor pollicis (hand), 220, 231; 
122, 127, 129, 131, 132 
anconeus, 298 ; 163, 165, 167, 168, 
169 
anterior scapular, 287 
arytenoid, 395 ; 207 
aryteno-epiglottidean, 397; 207 
atollens aurem, 321 ; 177 
attraliens aurem, 321; 177 
auricular, 321 ; 177 
azygus uvulae, 385 ; 203, 205 
biceps (arm), 197, 199,212, 235; 113, 
116,117, 119, 120, 121, 125, 126, 
128, 129, 130, 134 
biceps (thigh), 153, 165, 187; 67, 85, 
86, 87, 88, 89, 94 
biventer cervicis, 273 
brachialis anticus, 198, 203, 214, 236 ; 
113, 116, 118, 121, 125, 126, 128, 
129, 130, 134 
buccinator, 334 ; 181, 182, 183, 184 
cervicalis ascendens, 272 ; 151 
coccygeus, 15, 25, 40 ; 5, 8, 9, 10, 39, 
40, 45, 46 
complexus, 272, 358 ; 147, 149, 150, 
151, 192 
compressor naris, 333 ; 181, 182,183, 
184, 187, 188 
constrictor urethrae (female), 38 ; 16 
constrictor urethrae (male), 15, 22; 5, INDEX. 
445 
Muscle or muscles—Continued. 
coraco-brachialis, 199; 113, 116 to 
120 
corrugator supercilii, 336; 181, 184 
cremaster, 50 ; 25 
crico thyroid, 395; 190, 195, 196, 
197, 207 
crureus, 114 ; 59, 63 
deeptransversus perinaei (female), 38 ; 
16 
deep transversus perinaei (male), 15, 
21 ; 5, 8 
deltoid, 197, 289; 113, 116 to 120, 
158, 160 
depressor alae nasi. 321 
depressor anguli oris, 328 ; 181, 1£2, 
183 
depressor labii inferioris, 329; 181, 
182, 183 
diaphragm, 80, 241, 250; 21, 38, 41, 
42, 43, 44, 137, 138, 139, 140 
diaphragm (tendinous centre), 81; 
44 
digastric, 362 ; 189, 190, 192 to 195 
dilatator naris (anterior), 331 
dilatator naris (posterior), 331 
dissection of, 8 ; 2 
dorsal interosseous (foot), 131, 148, 
149 ; 68, 74, 82 
dorsal interosseous (hand), 234, 307 ; 
122, 132, 133, 163, 169, 170 
erector spinae, 271 ; 147, 151 
external pteryeoid, 350; 187, 188, 
190, 199 
extensor brevis digitorum, 129 ; 68, 
71, 72, 73 
extensor carpi radialis brevior, 300 ; 
163, 165 to 169 
extensor carpi radialis longior, 198, 
211, 299 ; 116, 121, 125, 163, 165 
to 169 
extensor carpi ulnaris, 298 ; 163, 165, 
167, 168, 169 
extensor communis digitorum, 297, 
306 ; 163, 165, 166, 170 
external intercostal, 204, 239, 247; 
113, 120, 135, 139, 140 
extensor indicis, 301, 306 ; 163, 165, 
167, 168, 170 
extensor longus digitorum, 127; 67, 
68, 71, 72 
extensor minimi digiti, 298, 306; 
163, 165 
extensor ossis metacarpi pollicis, 212, 
299, 302 ; 121, 125, 127, 163, 165 
to 169 
extensor proprius pollicis, 127; 67, 
68, 71, 72 
extensor primi internodii pollicis, 
299, 302: 163, 165 to 169 
extensor secundi internodii pollicis, 
301; 163, 165 to 169 
first lumbricalis (hand), 221 ; 127 
flexor accessorius, 142 ; 75, 79, 80 
Muscle or muscles— Continued. 
flexor brevis digitorum, 137; 75, 77, 
78 
flexor brevis minimi digiti (hand), 
219; 122, 127, 129 
flexor brevis minimi digiti (foot), 143, 
219 ; 75, 77 to 81, 122, 127, 129 
flexor brevis pollicis (hand), 217, 231 ; 
122, 127, 129, 131, 132 
flexor brevis pollicis (foot), 146 ; 77 
to 81 
flexor carpi radialis, 211, 234; 121, 
125, 127 to 133 
flexor carpi ulnaris, 211, 229 ; 121, 
124, 125, 127 to 134 
flexor longus digitorum, 159 ; 75, 83, 
88, 89 
flexor longus pollicis (band), 230 ; 121, 
127 to 131 
flexor longus pollicis (foot), 157, 159 ; 
75, 83, 85, 88, 89 
flexor profundus digitorum, 229 ; 121, 
130, 131 
flexor sublimis digitorum, 226 ; 121, 
128 129 
fourth lumbricalis (hand), 223 ; 127 
gastrocnemius, 87, 153 ; 83, 85 
gemellus inferior. 175 ; 91, 95 to 100 
gemellus superior, 174 ; 91, 95 to 100 
genio-liyo-glossus, 391; 190, 204, 
205 
genio-hyoid, 365, 389 ; 190, 195, 
196, 197, 204 
gluteus maximus, 15, 16, 164, 166; 
5, 7, 91, 93, 94, 95 
gluteus medius, 113, 168 ; 62 to 65, 
91, 95 to 100 
gluteus minimus, 113, 173; 59, 62, 
63, 64, 65, 91, 99, 100 
gracilis, 111, 154, 165 ; 59, 61 to 65, 
67, 85 to 88, 90 
hyo-glossus, 365, 389 ; 190, 192, 194 
'to 197. 201 to 205 
iliacus interims, 82, 120 ; 38 to 42, 
44, 45. 46, 59, 61 to 65, 93 
inferior constrictor, 367, 381; 190, 
196, 197, 200, 201 
infraspinatus, 290 ; 158. 160, 161 
internal intercostal, 239, 247; 135, 
139, 140 
internal ptervgoid, 350; 187, 188, 
190, 199 
interosseous (foot). 143; 79, 80 
interosseous (hand), 234 ; 122, 132, 
133 
interspinales, 274 ; 152 
intertransversales, 274; 152 
ischio-cavernosus (erector penis), 15, 
19; 5, 7 
ischio-cavernosus (erector clitoridis), 
34; 14 
lateral crico-arytenoid, 397 ; 207 
latissimus dorsi, 196, 267, 291; 113, 
116 to 120, 149, 160, 161, 162 INDEX. 
Muscle or muscles—Continued. 
levator anguli oris, 334 ; 181, 182, 
183, 184 
levator anguli scapulae, 269, 358; 
149, 192 
levator ani et prostatae, 15, 24, 83 ; 5, 
9, 45, 46 
levator ani et vaginae, 15, 39, 83 ; 5, 
18, 45, 46 
levatores costarum. 274 ; 152 
levator labii superioris alaeque nasi, 
329 ; 181, 182 
levator labii superioris proprius, 332 ; 
181, 182, 183 
levator menti, 335 ; 181, 184 
levator palati, 353, 384; 188, 190, 
199, 201, 203, 204, 205 
levator palpebrae superioris, 339 ; 181, 
184, 185 
lingual intrinsic muscle fibres, 388 
longissimus dorsi, 271; 151 
longus colli, 375; 189, 197, 198 
lumbricales (foot), 142, 149; 77 to 
80, 82 
lumbricales (hand), 230, 306; 127, 
129, 131, 132, 133, 170 
masseter, 332 ; 181, 182, 183 
middle constrictor, 381 ; 190, 196, 
200, 201, 204, 205 
multifidus spinae, 273 ; 152 
mylo hyoid, 362; 190, 192 to 197 
obliquus externus, 47, 269 ; 21, 24, 
149 
obliquus inferior (back), 275 ; 147, 
150 
obliquus inferior (orbit), 344; 181, 
184, 185 to 188 
obliquus internus, 49, 269 ; 21, 24, 
149 
obliquus superior (back), 147, 275; 
150 
obliquus superior (orbit), 339 ; 181, 
184, 185 
obturator externus, 121, 175 ; 59, 64, 
65, 66, 91, 95 to 100 
obturator internus, 84, 174 ; 39, 40, 
45, 46, 91, 95 to 100 
occipito-frontalis, 320 ; 177 
omo-hyoid, 358, 360 ; 135, 157, 190, 
192 to 195 
opponens minimi digiti, 228; 122, 
131, 132, 133 
opponens pollicis, 227,231; 122,131, 
132 
orbicularis oris, 328 ; 182, 183, 184 
orbicularis palpebrarum, 329 ; 181, 
182, 183 
palmaris brevis, 209 ; 124 
palmar interosseous, 234; 122, 132, 
133, 170 
palmaris longus, 211 ; 124 
palato-glossus, 386, 392 ; 204, 205 
palato-pharyngeus, 384, 392 ; 203, 
204, 206 
Muscle or muscles—Continued. 
pectineus, 117 ; 59, 61 to 64 
pectoralis major, 11)0 ; 113, 116 
pectoralis minor, 200; 113, 117 
peroneus brevis, 129, 156, 161; 67, 
68, 71 to 75, 80, 85, 87 to 90 
peroneus longus, 128, 156, 161; 67, 
71 to 75, 85, 87 to 90 
peroneus tertius, 127 ; 67, 68, 71, 72 
plantaris, 157, 187 ; 83, 85, 86, 87 
plantar interosseous, 148, 149 ; 82 
platysma myoides, 194, 328, 355 ; 
li5, 182, 191 
popliteus, 158, 187; 83, 87, 88, 90 
posterior crico-arytenoid, £95; 207 
pronator quadratus, 235; 121, 128, 
129, 130, 134 
pronator radii teres, 201, 212, 224, 
304; 113,116,118,121, 125,126, 
128, 129, 130,134, 163,168, 169 
psoas magnus, 82, 120 ; 38 to 44, 59, 
65, 66, 93 
psoas parvus, 81 ; 44, 39 to 43 
pyramidalis abdominis, 51 ; 28, 42 
pyramidalis nasi, 323; 182, 183 
pyriformis, 82, 167; 39, 40, 42, 45, 
‘46, 95 to 100 
quadratus femoris, 120, 172 ; 59, 65, 
66, 91, 95 to 100 
quadratus lumborum, 82 ; 38, 41 to 
44 
quadriceps extensor femoris, 115, 187; 
59, 61 to 65 
quadriceps extensor femoris (com- 
pound aponeurosis), 115 ; 59, 61 to 
65 
rectus abdominis, 52 ; 28, 42 
rectus capitis anticus major, 374; 
189, 194. 196, 197, 199 
rectus capitis anticus minor, 374; 
189, 198, 199 
rectus capitis lateralis, 374; 189,198, 
199 
rectus capitis posticus major, 275; 
147, 150 
rectus capitis posticus minor, 275 ; 
147, 150 
rectus externus, 343 ; 181, 185 
rectus femoris, 110, 113 , 59, 61, 62 
rectus inferior, 344; 181, 186 
rectus internus, 344 ; 181, 186 
rectus superior, 340 ; 181, 185 
retrabens aurem. 321 ; 177 
rliomboideus major, 268 ; 149 
rhomboideus minor, 268 ; 149 
risorius, 328 ; 182 
sacro-lumbalis, 271; 151 
salpingo-pharyngeus, 384; 203 
sartorius, 110, 154; 59, 61, 67, 85 to 
88, 90 
scalenus anticus, 375 ; 189, 192, 194 
to 198 
scalenus medius, 358, 376; 189, 192 
to 198 INDEX. 
447 
Muscle or muscles—Continued. 
scalenus posticus, 358, 376 ; 150, 189, 
192 to 198 
second lumbricalis (hand), 222; 
127 
semimembranosus, 120, 154,165,187; 
64, 65, 83, 85 to 88, 90, 94 
semispinalis colli, 273 ; 150, 152 
semispinalis dorsi, 273 ; 150, 152 
semitendinosus, 154, 165, 169 ; 67, 
85 to 88, 90 91. 93 to 98 
serratus magnus, 196, 287; 113, 116, 
157 
serratus posticus inferior, 269 ; 149, 
151 
serratus posticus superior, 269 ; 149, 
150, 151 
soleus, 156, 157, 187; 83, 85, 87 
sphincter ani (female), 32 ; 13 
sphincter ani (male), 15 ; 5, 6 
sphincter vaginae, 34, 37 ; 14 
spinalis dorsi. 273 ; 151 
splenius capitis, 270, 358; 149, 150, 
192 
splenius colli, 270 ; 149, 150 
sterno-cleido-liyoid, 361 
sterno-cleido mastoid, 356 ; 189, 192, 
193 
sterno-hyoid, 359, 361 ; 135, 190, 
192, 193, 194 
sterno-thyroid, 363 ; 135, 190, 194, 
195 
stylo-glossus, 354, 364, 389; 188, 
190, 194,196, 197,200,201,203, 
204 
stylo-hyoid, 354, 363 ; 188, 190, 192 
to 195 
stylo-pliaryngeus, 354, 382; 188, 
190, 196, 200, 201, 203, 204 
subclavius, 200 ; 119, 120 
subcrureus, 116 ; 59, 64, 65 
subscapularis, 287 ; 113, 157 
superior constrictor, 353, 381; 188, 
190, 196, 200, 201, 203, 204, 205 
superficial transversus perinaei (fe- 
male). 33; 14 
superficial transversus perinaei (male), 
15, 19; 5, 7 
supinator brevis, 236, 303 ; 121, 126, 
128, 129, 130, 134, 163, 167,168, 
169 
supinator longus, 198, 211, 298 ; 116, 
121, 125, 163, 165 to 169 
supraspinatus, 290; 158, 160, 161 
temporal, 321, 348 ; 178, 181, 184 
tensor-palati, 353, 385, 391 ; 188, 
190, 199, 200, 201, 203, 204, 205 
tensor vaginae femoris, 110 ; 61 
teres major, 196, 291; 113, 116 to 
120, 158, 160, 161, 162 
teres minor, 291; 158, 160, 161 
third lumbricalis (hand), 222 ; 127 
thyro-arytenoid (exterior portion), 
397; 207 
Muscle or muscles —Continued. 
thvro-arytenoid (.interior portion), 
399 ; 208 
thyro-epiglottidean, 397; 207 
thyro-hyoid, 371; 190, 192 to 197 
tibialis anticus, 126 ; 67, 71, 72 
tibialis posticus, 162; 75, 79 to 82, 
83, 87 to 90 
trachelo mastoid, 272 ; 151 
transversalis abdominis, 51; 27, 42 
transversalis cervicis, 272; 151 
transversus pedis, 143, 145; 75,79, 
80, 81 
trapezius, 267, 357 ; 147, 149, 189, 
192 to 198 
triangularis sterni, 239 ; 135 
triceps, 199, 201, 215, 289, 291; 113, 
116 to 120, 126,158, 160,161,162 
vastus externus, 110, 114, 154, 165 ; 
59, 61 to 65, 85 to 88, 90, 91, 93, 
94 
vastus internus, 110, 115 ; 59, 61, 
62, 63, 93 
zygomaticus major, 181, 182 
zygomaticus minor, 329 ; 181, 182 
Naves : 
anterior, 401 ; 197 
posterior, 402 ; 199, 202, 203, 206 
Nasal cavities, 400 
antero-lateral walls, 401 
inferior wall, 401 
lateral walls, 401 
median-line septum, 401 
mucous membrane, 401 
openings of communication with con- 
tiguous cavities, 405 ; 210 
osseous openings (submucous), 401 
posterior view of interiors, 402 ; 206 
superior wall, 401 
Nerve or nerves, 9, 10; 2 
abducent, 325, 341, 418, 430; 180, 
185, 186, 211, 214, 222 
acromial, 194, 357; 115, 192, 193 
accessory obturator, 78 ; 39, 40, 41 
46 
anterior crural, 78, 112 ; 38, 39, 40, 
41, 61 
anterior crural (muscle branches), 
115 ; 61, 62, 63 
anterior deep temporal, 322 ; 178 
anterior interosseous, 225, 229, 235 ; 
128, 130, 134 
anterior interosseous (terminal 
branch), 236 ; 134 
anterior palatine, 392, 406 ; 205, 210 
anterior superficial perineal, 18, 32 ; 
7 13 
anterior tibial, 125, 128, 130, 132; 69, 
71 to 74 
articular (knee), 118, 131; 64, 74 
articular (shoulder), 262. 293 
auditory, 325, 418, 430; 180, 211, 
214, 222 448 
INDEX. 
Nerve or rterves—Continued. 
auricularis magnus, 357; 192, 193 
auriculo-temporal, 320, 332, 351; 
177, 182, 183, 184, 187, 188 
buccal (facial), 331 ; 183 
buccal (inferior maxillary division of 
trifacial), 349, 351 ; 184, 187, 188 
cervical cardiac (pueumogastric), 243, 
366; 138, 196 
cervical cardiac (sympathetic', 243 ; 
138 
cervical spinal (anterior divisions), 
375; 196, 197, 198 
cervical spinal (posterior divisions), 
276; 150 
chorda tympani, 352 ; 188 
circumflex, 205, 292 ; 120, 161, 162 
circumflex (cutaneous branch of), 289 ; 
159 
clavicular, 194, 357; 115, 192, 193 
coccygeal (anterior divisions', 79, 281 ; 
33, 39, 40, 41, 153 
coccygeal (posterior divisions), 281 ; 
153 
communicans noni, 361 ; 194, 195 
communicating (hand), 296 ; 164 
cranial (exits at the base of the cra- 
nium), 324 ; 180 
cranial (exterior origins), 417 ; 211, 
214 
cutaneous (abdominal parietes), 47 ; 
23 
cutaneous (back), 266, 275 ; 148 
cutaneous (thorax). 124, 266 ; 23, 148 
deep dorsalis elitoridis, 37 ; 16 
deep dorsalis penis, 20, 45 ; 8, 22 
deep palmar, 218, 233 ; 127, 132, 
133 
deep perineal, 21, 36, 38 ; 8, 16, 17, 
39 
descendens noni, 361, 365; 192 to 
195 
dorsal collateral digital (foot), 124 ; 
69, 71 
dorsal collateral digital (hand), 296, 
305; 164, 170 
dorsal digital (foot), 124, 125, 128; 
69, 70, 71 
dorsal digital (hand), 296 ; 164 
dorsal spinal (anterior divisions), 284; 
139, 140, 156 
dorsal spinal (posterior divisions), 
274 ; 152 
external cutaneous, 77, 109, 163; 38 
to 41, 60, 92 
external laryngeal, 365; 196 
external palatine, 392, 407 
external plantar, 141 ; 79, 81 
external plantar (deep branch), 141 ; 
79, 81 
external plantar (superficial branch), 
141 ; 79, 81 
external popliteal, 131, 155 ; 72, 74, 
85 to 88, 90 
Nerve or nerves—Continued. 
external popliteal (cutaneous branch- 
es;, 125, 153 ; 69, 85, 86 
external saphenous, 124, 152; 69,84 
external saphenous (inner root), 153; 
85, 86 
external saphenous (outer root), 153 ; 
85, 86 
external superficial petrosal, 346 ; 
185, 186 
facial, 325, 331, 418, 430 ; 180, 183, 
211, 214, 222 
facial (cervico-facial division!, 358; 
192 to 197 
facial (temporo-facial division), 331; 
183 
facial (temporal branches', 319 ; 177 
fifth sacral (anterior branch), 79 ; 33, 
39,40, 41 
fourth cervical spinal (anterior divi- 
sion), 361 ; 194. 196, 197 
fourth sacral, 22, 38 ; 8, 9 
frontal, 340 ; 185 
geuito-crural, 78, 110 ; 38, 41, 60 
glossopharyngeal, 325, 354, 379, 390, 
418, 430 ; 180, 188, 200, 204, 205, 
211, 214, 222 
glossopharyngeal (pharyngeal branch), 
379 ; 200 
great sciatic, 169 ; 95, 97 
great splanchnic, 246 ; 33, 139 
gustatory, 352, 364, 391; 187, 188, 
195, i97, 204, 205 
hypoglossal, 325, 364, 378, 388, 418, 
‘430; 180, 192, 197, 200, 204, 205, 
211 214 222 
ilio-liypogastric, 49, 50, 77, 164, 266 ; 
25, 26,, 27, 33, 38, 41. 92, 148 
ilio-hypogastric (superficial dorsalis 
penis or elitoridis), 45 ; 22 
ilio-inguinal, 49, 50, 77, 266 ; 25, 26, 
27, 33, 38, 41, 148 
inferior dental, 351 ; 187, 188 
inferior gluteal, 167; 95 to 100 
inferior hemorrhoidal. 17 ; 7 
inferior nasal, 209, 4< 6 ; 210 
inferior pudendal, 16, 32; 6, 13 
infra orbital, 335 ; 184 
infra orbital branches (temporo-facial 
division of facial), 331; 183 
inframaxillary (cervico-facial division 
of facial), 358 ; 183, 192 
infratroclxlear, 337, 342; 182, 183, 
184, 186 
intercostals, 247, 248 ; 139, 140 
intercostals (anterior cutaneous 
branches), 47, 194 ; 23, 114, 115 
intercostals (lateral cutaneous branch- 
es), 47, 196 ; 23, 116 
intercostal (twelfth dorsal), 77, 266; 
33, 41, 148 
in ter costo-humeral, 195, 202, 289 ; 
115, 117, 118, 159 
internal calcaneal, 125 ; 70 INDEX. 
449 
Nerve or nerves—Continued. 
internal cutaneous (arm), 195, 198, 
202; 115, 116, 117, 118 
internal cutaneous (anterior of thigh), 
109; 60 
internal cutaneous (forearm), 208 ; 
115,123 
internal cutaneous (posterior of fore- 
arm), 296; 164 
internal plantar, 140 ; 79 
internal plantar (digital branches), 
136; 77 
internal popliteal, 155 ; 85, 86 
internal saphenous, 113,114,125, 152, 
154, 172 ; 61, 62, 63, 70, 84, 86 
lachrymal, 339, 340 ; 185 
large deep petrosal, 347 
large superficial petrosal, 346 ; 185, 
186 
long ciliary, 342 ; 186 
lumbar-spinal (anterior divisions), 77 ; 
33, 41 
lumbar-spinal (posterior divisions), 
274; 152 
malar, 331; 183 
masseteric, 351; 184 
median, 198, 202, 213, 225,227; 116, 
117, 118, 125, 126, 128, 130, 131 
median (palmar cutaneous branch), 
209; 124 
mental, 335, 352; 184, 187, 188 
middle cutaneous, 109 ; 60 
musculo-cutaneous (arm), 203, 208 ; 
115 to 119, 123 
musculo-cutaneous (palmar branch), 
209 ; 124 
musculo-cutaneous (leg), 124, 125, 
132 ; 69, 70, 71, 74 
musculo-spiral, 206, 215, 292; 119, 
120, 126, 161 
musculo-spiral (inferior external cu- 
taneous branch), 196, 208, 289 ; 
115, 123, 159 
musculo-spiral (superior external cu- 
taneous branch), 289 ; 159, 164 
mylo hyoid, 352 ; 187, 188 
nasal, 340, 342, 405; 185, 186, 209, 
210 
naso palatine, 404, 406 ; 209, 210 
obturator, 78, 117, 121 ; 39, 40, 41, 
46, 64, 65, 66 
obturator (anterior portion), 118 ; 64 
obturator (articular branch), 192 ; 110 
obturator (posterior portion), 119 ; 65, 
66 
occipitalis major, 266, 320, 357 ; 148, 
177, 192, 194, 196 
occipitalis minor, 266, 320, 357 ; 148, 
177, 192, 193 
oculomotor, 325, 342, 344, 417, 429; 
180, 185, 186, 211, 214, 222 
of Wrisberg (cranial), 418, 430 ; 214, 
222 
olfactory, 325, 417; 180, 211, 214 
Nerve or nerves—Continued. 
optic, 325, 343, 417; 180, 186, 211, 
214, 222 
palmar collateral digital, 210, 223; 
124, 127 
palmar collateral digital (dorsal 
branches), 306 ; 170 
palmar cutaneous (median), 209 ; 124 
palmar cutaneous (inusculo-cutane- 
ous), 209 ; 124 
palmar cutaneous (ulnar), 209 ; 124 
palmar digital (fifth and sixth), 218, 
222; 127 
palmar digital (first, second, third, 
and fourth), 227 ; 127, 131 
pharyngeal (pneumogastric), 378; 
200 
phrenic, 80, 241, 362; 38,41, 137, 
194 to 198 
plantar (cutaneous), 134 ; 76 
plantar collateral digital, 134, 135, 
136, 138 ; 76, 77 
plantar digital, 134, 135, 136, 138; 
76, 77 
pneumogastric, 242, 245, 325, 365, 
378, 418, 430 ; 138, 139,180, 196, 
200, 211, 214, 222 
pneumogastric (right), 365 ; 196 
posterior carpal, 296 ; 164 
posterior deep temporal, 322 ; 178 
posterior interosseous, 215, 300, 304 ; 
126, 167, 169 
posterior palatine, 392, 407 ; 210 
posterior perineal (muscle branches), 
34; 14 
posterior superficial perineal, 18, 32 ; 
7, 13 
posterior thoracic, 201 ; 116, 117, 
119, 120 
posterior tibial, 157, 159 ; 85, 87, 88 
pterygo-palatine, 407 
pudic, 18, 174 ; 7, 95 to 100 
pulmonary, 253 
radial, 211, 215, 225, 296 ; 125, 126, 
128, 130, 164 
recurrent laryngeal, 242, 366, 372, 
396; 138, 196, 197, 207 
renal, 94 ; 33 
sacral-spinal (anterior divisions), 79 ; 
33, 39, 40, 41 
sacral-spinal (posterior divisions), 164; 
92 
short ciliary, 342; 186 
small internal cutaneous, 195, 198, 
202; 115 to 118 
small sciatic, 152, 164, 167 ; 84, 85, 
92, 94 to 100 
spinal (internal branches of posterior 
divisions), 266 ; 148 
spinal (roots), 280 ; 153, 154 
spinal accessory, 268, 281, 325, 354, 
378, 418, 430 ; 149, 153, 180,188, 
200, 211, 214, 222 
sternal, 194, 356; 115, 192, 193 450 
INDEX. 
Nerve or nerves—Continued. 
subcutaneous, 6 ; 2 
subcutaneous of gluteal and posterior 
thigh regions, 163 ; 92 
superficial cervical, 357 ; 192, 193 
superficial dorsalis clitoridis, 36; 16 
superficial dorsalis penis, 45 ; 22 
superficial palmar (ulnar), 218 ; 127 
superior gluteal, 173 ; 99 
superior laryngeal, 365, 369, 379, 394, 
396 ; 192 to 197, 200, 207 
superior nasal, 404, 406 ; 209, 210 
supra-orbital, 319, 337 ; 177, 182, 
183,184 
supratrochlear, 318, 377; 177, 182, 
183, 184 
suprascapular, 293 ; 162 
temporal, 351; 187, 188 
third cervical spinal (internal branch 
of posterior division), 266, 320, 357; 
148, 177, 192, 194 
third cervical spinal (anterior divi- 
sion), 361; 194, 196, 197 
thoracic cardiac, 243; 138 
to abductor minimi digiti muscle 
(foot), 140; 79 
to abdhctor minimi digiti muscle 
(hand), 228 ; 127, 131 
to abductor pollicis muscle (hand), 
232; 133 
to abductor pollicis muscle (foot), 146 ; 
82 
to adductor brevis muscle, 118 ; 64, 
65 
to adductor longus muscle, 118; 64, 
65 
to adductor magnus muscle, 118 ; 65 
to adductor pollicis muscle (hand), 
232; 133 
to adductor pollicis muscle (foot), 
146; 82 
to anconeus muscle, 292 ; 161 
to aryteno-epiglottidean muscle, 397 ; 
207 
to arytenoid muscle, 397 ; 207 
to attollens aurem muscle, 319 ; 177 
to attrahens aurem muscle, 319 ; 177 
to biceps muscle (arm), 203 ; 118 
to biceps muscle (thigh), 169 ; 96, 
97 
to brachialis anticus muscle, 203; 
118 
to buccinator muscle, 331; 183 
to cervicalis ascendens muscle, 276 ; 
150 
to coccygeus muscle, 79 ; 39, 40 
to complexus muscle, 276 ; 150 
to compressor naris muscle, 331; 183 
to constrictor urethrae muscle. 34 
to coraco-brachialis muscle, 203; 117 
to 120 
to corrugator supercilii muscle, 319 
to crico thyroid muscle, 196 
to crureus muscle, 115 ; 63 
Nerve or nerves—Continued. 
to deep transversus perinaei muscle, 34 
to deltoid muscle, 293 ; 161, 162 
to depressor alae nasi muscle, 331 
to depressor anguli oris muscle, 331 ; 
182, 183 
to depressor labii inferioris oris mus- 
cle, 331 ; 182, 183 
to diaphragm, 80 ; 38, 41 
to digastric muscle (facial and mylo- 
hyoid nerves), 352 
to dilatator naris (anterior), 331 
to dilatator naris (posterior), 331 
to erector spinae muscle and its divis- 
ions (muscular branches of spinal 
nerves), 275, 276 
to extensor brevis digitorum muscle, 
128; 78 
to extensor carpi radialis brevior mus- 
cle, 216; 126 
to extensor carpi radialis longior mus- 
cle, 215 ; 126 
to extensor carpi ulnaris muscle, 300 ; 
167 
to extensor communis digitorum mus- 
cle, 300 ; 167 
to extensor indicis muscle, 300; 167 
to extensor longus digitorum muscle, 
130; 73 
to extensor minimi digiti muscle, 300 ; 
167 
to extensor ossis metacarpi pollicis 
muscle, 300 ; 167 
to extensor primi internodii pollicis 
muscle, 300 ; 167 
to extensor proprius pollicis muscle, 
130; 73 
to extensor secundi internodii pollicis 
muscle, 300; 167 
to external intercostal muscles, 247 ; 
to external pterygoid muscle, 351; 
188 
to first dorsal interosseous muscle 
(foot), 147 ; 82 
to first dorsal interosseous muscle 
(hand),, 233; 133 
to first and second lumbricales mus- 
cles (foot), 137; 77 
to first and second lumbricales mus- 
cles (hand), 227; 131 
to first palmar interosseous muscle, 
233; 133 
to first plantar interosseous muscle, 
144 ; 81, 82 
to flexor accessorius muscle, 141 ; 79, 
81 
to flexor brevis digitorum muscle, 
140 ; 79 
to flexor brevis minimi digiti muscle 
(foot), 141 ; 79 
to flexor brevis minimi digiti muscle 
(hand). 228; 131 
to flexor brevis pollicis muscle (foot), 
136; 77 INDEX. 
451 
Nerve or nerves— Continued. 
to levator ani et prostatse muscle, 79 
to levator ani et vaginas muscle, 79 
to levatories costorum muscles, 247 
to levator labii superioris alaeque nasi 
muscle, 331 ; 183 
to levator labii superioris proprius, 
331; 183 
to levator menti muscle, 331; 183 
to levator palati muscle, 392, 407; 
210 
to levator palpebrae superioris mus- 
cle, 342 ; 185, 186 
to lingual (intrinsic muscle fibres), 
388 
to longissimus dorsi muscle, 274, 275 
to longus colli muscle, 375 ; 198 
to masseter muscle, 334 ; 184 
to middle constrictor muscle, 379 
to multifidus spinas muscles, 275, 276 
to mylo-hyoid muscle, 352 
to obliquus externus muscle, 50 ; 26, 
27 
to obliquus inferior muscle (back), 
276; 150 
to obliquus inferior muscle (orbit), 
344; 186 
to obliquus internus muscle, 50; 26, 
27 
to obliquus superior muscle (back), 
276 ; 150 
to obliquus superior muscle (orbit), 
338; 185 
to obturator externus muscle, 119; 
65, 66 
to obturator internus muscle, 79,174 ; 
95 to 100 
to occipito-frontalis muscle, 319; 
177 
to omo-hyoid muscle (anterior belly), 
361; 193, 194, 195 
to omo-hyoid muscle (posterior belly), 
361 
to opponens minimi digiti muscle, 
228; 131 
to opponens pollicis muscle, 227; 131 
to orbicularis oris muscle, 331 ; 183 
to orbicularis palpebrarum muscle, 
319; 177 
to palmaris brevis muscle (ulnar 
nerve), 218 
to palmaris longus muscle, 214; 126 
to palato-glossus muscle, 392, 407 
to palato-pharyngeus muscle, 392, 407 
to pectineus muscle, 112, 115, 121; 
61, 66 
to pectoralis major muscle, 204; 117 
to pectoralis minor muscle, 204 ; 117 
to peroneus brevis muscle, 132; 74 
to peroneus longus muscle, 132 ; 74 
to peroneus tertius muscle, 130; 73 
to plantaris muscle, 155; 85, 86 
to platysma myoides muscle, 358; 192 
to popliteus muscle, 158 ; 88, 90 
Nerve or nerves—Continued. 
to flexor brevis pollicis muscle (hand), 
227,232; 131,133 
to flexor carpi radialis muscle, 214 ; 
126 
to flexor carpi ulnaris muscle, 228 ; 
130 
to flexor longus digitorum muscle, 
158, 166; 88 
to flexor longus pollicis muscle (fore- 
arm), 226, 229 ; 128, 130 
to flexor longus pollicis muscle (leg), 
158, 159, 160 ; 88 
to flexor profundus digitorum muscle, 
225, 229 ; 128, 130 
to flexor sublimis digitorum muscle, 
214, 226 ; 126, 128,130 
to fourth dorsal interosseous muscle 
(foot), 141 ; 79 
to fourth dorsal interosseous muscle 
(hand), 233 ; 132, 133 
to fourth lumbricalis muscle (foot), 
144; 81, 82 
to fourth lumbricalis muscle (hand), 
233;132 
to gastrocnemius muscle, 155 ; 86, 87 
to gemellus inferior muscle, 176 ; 99, 
100 
to gemellus superior muscle, 174 ; 99, 
100 
to genio-hyo-glossus muscle, 388; 
204, 205 
to genio-hyoid muscle, 388 ; 204, 205 
to gluteus maximus muscle, 167 ; 95 
to 99 
to gluteus medius muscle, 173 ; 99 
to gluteus minimus muscle, 173 ; 99 
to gracilis muscle, 118 ; 64 
to hyo-glossus muscle, 388; 204, 
205 
to iliacus internus muscle ; 39, 40, 
41 
to inferior constrictor muscle (pharyn- 
geal plexus and external laryngeal); 
196, 200 
to infraspinatus muscle, 294 ; 162 
to inner head of flexor brevis pollicis 
muscle (hand), 233 ; 162 
to internal intercostal muscles, 247 
to internal pterygoid muscle, 351 ; 
188 
to interspinales muscles, 274, 275, 
276 
to intertransversales muscles, 274, 
275, 276 
to ischio-cavernosus muscle, 34 
to lateral crico-arytenoid muscle, 397; 
207 
to latissimus dorsi muscle, 201 ; 116, 
117, 119, 120 
to levator anguli oris muscle, 331; 
183 
to levator anguli scapulae muscle, 361; 
194, 196 
to 99 452 
INDEX. 
Nerve or nerves—Continued. 
to posterior crico-arytenoid muscle, 
397; 207 
to pronator quadratus muscle, 236 ; 
134 
to pronator radii teres muscle, 214; 
126 
to psoas magnus muscle, 77 
to psoas parvus muscle, 77 
to pyramidalis abdominis muscle, 50; 
26, 27 
to pyramidalis nasi muscle, 331 ; 183 
to pyriformis muscle, 79 
to quadratus femoris muscle, 79, 176 ; 
99, 100 
to quadratus lumborum muscle, 50 ; 
41 
to rectus abdominis muscle, 50 ; 26, 
27 
to rectus capitis anticus major muscle, 
375 
to rectus capitis anticus minor muscle, 
357 
to rectus capitis lateralis muscle, 357 
to rectus capitis posticus major muscle, 
276; 150 
to rectus capitis posticus minor mus- 
cle, 276 ; 150 
to rectus externus muscle, 341 ; 186 
to rectus femoris muscle, 115 ; 63 
to rectus inferior muscle, 344 ; 186 
to rectus internus muscle, 344; 186 
to rectus superior muscle, 342 ; 186 
to retrahens aurem muscle (facial) 
to rliomboideus major muscle, 276 
to rhomboideus minor muscle, 276 
to risorius muscle (facial) 
to sacro-lumbalis muscle, 274, 275 
to salpingo-pliaryngeus muscle, 392, 
407 
to sartorius muscle, 115; 63 
to scalenus anticus muscle (anterior 
divisions of cervical-spinal nerves), 
375; 198 
to scalenus medius muscle, 362; 194, 
196 
to scalenus posticus muscle (anterior 
divisions of cervical-spinal nerves), 
375; 198 
to second dorsal interosseous muscles 
(foot), 147; 82 
to second dorsal interosseous muscle 
(hand). 233; 133 
to second palmar interosseous muscle, 
233 ; 132, 133 
to second plantar interosseous muscle, 
144 ; 79, 81, 82 
to semimembranosus muscle, 170; 96, 
97 
to semispinalis colli muscle, 276; 150 
to semispinalis dorsi muscle, 274, 275 
to semitendinosus muscle, 170; 96, 97 
to serratus magnus muscle, 201; 117, 
119, 120 
Nerve or nerves—Continued. 
to serratus posticus inferior muscle, 
274, 275 
to serratus posticus superior muscle, 
276; 150 
to soleus muscle, 158; 87 
to sphincter ani muscle, 17 ; 7 
to sphincter vaginae muscle, 34 
to spinalis dorsi muscle. 274, 275 
to splenius capitis muscle, 276 ; 150 
to splenius colli muscle, 276 ; 150 
to sterno-cleido-mastoid muscle, 360 ; 
194, 196 
to sterno-liyoid muscle, 361; 194,195 
to sterno-thyroid muscle, 361 ; 194, 
195 
to stylo-glossus muscle, 388 ; 204 
to stylo-hyoid muscle (facial) 
to stylo-pliaryngeus muscle. 390; 201 
to subclavius muscle (brachial plexus), 
370 
to subcrureus muscle, 115 ; 63 
to subscapularis muscle, 201 ; 116, 
117, 119, 120 
to superior constrictor muscle, 379 
to superficial transversus perinaei 
muscle, 34 
to supinator brevis muscle, 216 ; 126 
to supinator longus muscle, 215 ; 126 
to supraspinatus muscle, 293 ; 162 
to temporal muscle, 322 ; 178 
to tensor palati muscle (otic ganglion), 
353; 188 
to tensor vaginae femoris muscle, 173; 
99 
to teres major muscle, 206 ; 119, 120 
to teres minor muscle, 293 ; 161, 162 
to third dorsal interosseous muscle 
(foot), 144 ; 81, 82 
to third dorsal interosseous muscle 
(hand), 233; 132,133 
to third lumbricalis muscle (foot), 
144; 81,82 
to third lumbricalis muscle (hand), 
233; 132,133 
to third palmar interosseous muscle, 
233 ; 132 
to third plantar interosseous muscle, 
141; 79 
to thyro-arytenoid muscle, 397 ; 207 
to thyro-epiglottidean muscle, 397; 
207 
to thyro-hyoid muscle, 365 
to tibialis anticus muscle, 130 ; 73 
to tibialis posticus muscle, 158 ; 88 
to trachelo-mastoid muscle, 276; 150 
to transversalis abdominis muscle, 50; 
26, 27 
to transversalis cervicis muscle, 276 ; 
150 
to transversus pedis muscle, 144 ; 81, 
82 
to trapezius muscle, 357; 192,193 
to triangularis sterni muscle, 247 INDEX. 
453 
Nerve or nerves—Continued. 
to triceps muscle, 206, 292 ; 119, 120, 
161 
to vastus externus muscle, 115; 61, 
62, 63 
to vastus internus muscle, 115 ; 61, 
62, 63 
to zygomaticus major muscle, 331 ; 
183 
to zygomaticus minor muscle, 331 ; 
183 
trifacial, 325, 345, 418, 429; 185, 
186, 211, 214, 222 
trifacial (divisions of sensory root), 
345 ; 185, 186 
trifacial (inferior maxillary division 
of the sensory root, and the motor 
root), 351 ; 188 
trifacial (motor root), 345 ; 185, 186 
trifacial (ophthalmic division of sen- 
sory root), 340; 185, 186 
trifacial (superior maxillary division 
of sensory root), 345, 406; 185, 
186 
trochlear, 325, 338, 417, 428; 180, 
185, 211, 214, 222 
ulnar, 202, 215, 218, 228 ; 117, 118, 
125 to 128, 130 to 134 
Vidian, 347, 406 ; 210 
(Esophagus, 244, 245, 248, 373 ; 138, 
139, 140, 197, 198 
Omentum, great. 56, 58 ; 30, 31 
gastro-liepatic, 56, 58 ; 31 
Opening or openings: 
aortic (diaphragm', 81 ; 44 
caval (diaphragm), 81, 250; 44, 140 
for anterior peroneal artery, 162, 186 ; 
90 
for anterior tibial artery, 132,186 ; 74 
for branches of anterior tibial artery, 
186 
for femoral artery (in adductor mag- 
nus muscle), 118, 119, 171 ; 64, 65, 
96, 97, 98 
for perforating arteries from profunda 
femoris (in adductor magnus mus- 
cle), 119, 171 ; 63, 64, 65, 98 
maxillary sinus, 406; 210 
nasal duct, 405; 210 
oesophageal (diaphragm), 81, 250; 44, 
140 
saphenous (facia lata), 109 ; 60 
Ovary, 104; 57 
Pacchionian bodies, 322; 179 
Palate: 
soft, 347 
soft and hard, 383, 391 
bones of the hard, 392 ; 205 
pillars of the soft, 387 ; 203, 204 
Palm, 209; 124 
Pancreas, 88 ; 48, 49 
Parts, right and left, 2 
Pelvis, 73 
bone areas of interior, 80; 42, 45 
outlet (male and female), 27 ; 5, 9 to 
12, 17, 18, 19 
Pelvic organs: 
male, in situ, 67 ; 37 
female, in situ, 68 ; 37 
female, out of body (lateral surface), 
101 
Penis, 19, 20, 98; 7, 8, 55, 56 
Pericardium, 240, 251, 253 ; 136, 137, 
138, 141, 142 
Perineal body, 40 ; 13 to 19 
Perineum, boundaries of, 13, 20 ; 5 
position of body for dissecting (male), 
13, 14; Figure 1 (page 14) 
position of body for dissecting (fe- 
male), 29, 31; Figure 2 (page 31) 
rectal region (male and female), 14, 
29 ; 5 
surface appearances (male), 13 
surface appearances (female), 29 
tendinous centre (female), 34 ; 14 
tendinous centre (male), 19 ; 7, 8 
urethral region (male and female), 14, 
29; 5 
urethro-vaginal region, 14, 29 ; 5 
Peritoneum: 
greater, 55, 56 ; 20, 30, 31, 32, 34, 
35, 37 
lesser, 55, 58 ; 20, 30, 31 
cavity of greater, 56 ; 30, 31, 32, 34, 
35, 37 
cavity of lesser, 58 ; 31 
diaphragmatic, 56 ; 31 
of antero-lateral parietes of abdomen, 
51; 31 
of female pelvis, 69 ; 37 
of pelvic viscera, 56 ; 35, 37 
peritoneal investment of uterus, 103; 
57 
plicae semilunares, 67 
pelvic reflections of greater (female), 
101 
pelvic reflections of greater (male), 
67; 29, 37 
recto-vaginal cul-de-sac, 41 ; 20 
recto-vesical cul-de-sac, 26, 67; 12, 
37 
Pharynx, 347, 380 
arteries and nerves contiguous to, 377 
fibrous coat, 353, 382; 188,199,200, 
201 
openings of the, 383 ; 202 
position of anterior half of bead for 
dissection of, 377 ; Figure 15 (page 
378) 
walls, 383 
Plate references, 1 
Plates, reproduction of, 2 
Pleura, 240 ; 136 
Plexus or plexuses: 
brachial, 370 ; 192 to 198 
cardiac, 243 454 
INDEX. 
Plexus or plexuses—Continued. 
cervical (branches), 356 ; 192, 193 
lumbar, 77; 33, 41 
pharyngeal, 379 
pulmonary, 253; 142 
sacral, 79 ; 33, 39, 40, 41 
Pons Varolii, 416, 429 ; 211, 214, 219, 
220, 221, 222 
structural appearances, 431 ; 219 
Probes, 4 ; 1 
Process or processes : 
liamular (sphenoid), 392 ; 205 
styloid (temporal), 354 ; 188, 190 
Pronation, 314 
Prostate, 26, 97, 98 ; 12, 55, 56 
Receptacultjm Ciiyli, 80 ; 41 
Rectum, 27, 41, 68; 11, 12, 20, 37 
female, 70, 105 ; 37, 58 
peritoneal investment, 95 ; 31, 37 
Relation, terms of: 
abdominal parietes, 43 
anterior of elbow, forearm, and hand, 
207 
anterior of leg and dorsum of foot, 
123 
anterior scapular muscles, 287 
anterior of thoracic parietes, 237 
anterior of thorax, arm, and axilla, 
193 
antero-lateral area of neck, 355 
arteries and nerves contiguous to 
pharynx, 377 
articulation of ankle, 177 
articulations of foot, 178 
articulations of hand, 309 
articulation of hip, 190 
articulation of tibia and fibula, 185 
brain, 409 
deep region of face, 347 
elbow-joint, 312 
female perineum, 29 
general, 2 
gluteal region and posterior region of 
thigh, 163 
hard and soft palate, 384 
knee-joint, 187 
larynx, 393 
middle fossa of the cranium, 344 
nasal cavities, 400 
orbital cavity, 337 
perineum. 13 
pharynx, 380 
plantar region, 133 
posterior of elbow, forearm, hand, and 
digits, 295 
posterior of leg and popliteal space, 
151 
posterior of the shoulder and arm, 288 
region of back, 265 
scalp, interior of the base of the cra- 
nium, etc., 317 
scapulo-clavicular articulation, etc., 
316 
Relation, terms of—Continued. 
shoulder-joint, 315 
superficial region of face, 327 
tongue and contiguous parts, 387 
Ring or rings: 
femoral, 112 
iliac abdominal (internal), 53 ; 28 
intra-orbital fibrous, 340 ; 185 
pubic abdominal (external), 48 ; 24, 
25 
Scalp, 317 
Scalpels, 3 ; 1 
Scalpel strop, 4-, 1 
Scarpa’s triangle, 111; 61 
Scissors, 3 ; 1 
Scrotum, 45, 48, 50. 54, 99 ; 22, 24, 25, 
28, 56 
Section, post-pharyngeal transverse (of cra- 
nium), 373, 374 ; 189, 197 
Section lines on parts, 2 
Septum or septa: 
intermuscular, 7; 3 
inner intermuscular, 205, 214; 119, 
126 
intermuscular (abdominal parietes), 
49, 50 
recto-vesical fascial, 25 ; 11 
Sheath or sheaths: 
dartos of scrotum and penis, 45 ; 22 
digital, of flexor tendons (foot), 136; 
76 
digital, of flexor tendons (hand), 223 ; 
4, 127 
elastic, of penis, 45 ; 22 
of rectus abdominis muscle, 52; 28 
Shoulder and arm, posterior of, 288 
Shoulder-joint, tendon of biceps within, 
316 ; 175 
Sigmoid flexure (large intestine), 61; 35 
Sinus or sinuses, 9 : 
frontal, 405 ; 209, 210 
maxillary, 407 ; 210 
of the cranium (venous), 326, 409; 
179, 180 
sphenoidal, 405 ; 209, 210 
sphenoidal (opening of), 406; 209, 
210 
superior longitudinal, 323 ; 179, 180 
Skin, 5 ; 2 
Skin incisions: 
abdominal parietes, 43 ; Figure 3 
anterior of elbow, forearm, and hand, 
207; Figure 10 
anterior of leg and dorsum of foot, 
123 ; Figure 5 
anterior of thigh, 107 ; Figure 4 
anterior of thorax, axilla, and arm, 
193 ; Figure 9 
antero-lateral area of neck, 318, 355 ; 
Figure 14 
back, 265 ; Figure 11 
female perineum. 31 ; Figure 2 
male perineum, 14 ; Figure 1 INDEX. 
455 
Skin incisions—Continued. 
gluteal region and posterior region of 
thigh, 163 ; Figure 8 
plantar region, 133 ; Figure 6 
posterior of elbow, forearm, hand, and 
digits, 295 ; Figure 13 
posterior of leg and popliteal space, 
151; Figure 7 
posterior of shoulder and arm, 288; 
Figure 12 
scalp, 317, 318 ; Figure 14 
superficial region of face, 318, 327; 
Figure 14 
Small intestine, 58, 59; 30, 32 
Space or spaces: 
anconeal, 213 ; 125, 126 
anconeal (inner portion), 213; 126 
anconeal (outer portion), 215 ; 126 
anconeal (floor of outer portion), 216 ; 
126 
forearm intertendinous, 216, 217; 
125, 127 
palmar intertendinous, 220; 127 
popliteal, 154, 166; 86, 94 
RetziusN 68 ; 31 
subarachnoidean, 280, 323 ; 153, 179 
subdural, 279, 323; 153, 154, 179 
Spermatic cord, 48, 54; 28 
Spinal cord, 325; 180 
arachnoid, 279, 280; 153,154 
conus medullaris, 179 ; 154 
dura mater, 279; 153, 154 
Slum terminale, 279 ; 154 
in situ, 278 
pia mater, 279, 280 ; 153, 154 
Spleen, 92; 53 
Stomach, 58, 63; 30, 35, 36 
interior, 89 ; 50 
Subcutaneous tissue, 6: 
abdominal parietes, 44, 46 ; 22, 29 
anterior of elbow and forearm, 208; 
123, 115 
anterior of thorax, axilla, and arm, 
193; 114 
anterior of thigh, 107 ; 60 
antero-lateral area of neck, 355 ; 191 
deep layer, 6 
dorsum of foot and digits, 124; 69, 
70, 71 
female perineum, 32 
gluteal and posterior of thigh regions, 
163; 91 
inguinal region, 46 ; 22 
male perineum, 15 ; 6 
plantar region, 133; 75 
posterior of elbow, forearm, hand, and 
digits, 295 ; 164 
posterior of leg and popliteal space, 
151; 84 
posterior of shoulder and arm, 288; 
159 
superficial region of the face, 327 
superficial layer, 6 
Sublingual glandular tissue, 391; 204,205 
Subserous areolar tissue of abdominal pa- 
rities, 54 
Supination, 314 
Suprarenal capsules, 71, 93 ; 38, 54 
Sympathetic nervous system: 
abdominal plexuses, 60; 33 
cervical portion, 369 ; 197 
coccygeal ganglion, 79; 33, 39, 40, 
41 
dorsal portion (left), 249 ; 140 
dorsal portion (right), 246 ; 139 
dorsal portion (branches of right), 
246; 139 
lumbar portion, 76 ; 33, 38, 41 
ophthalmic ganglion, 341; 186 
otic ganglion, 353 ; 188 
sacral portion, 79 ; 33, 39, 40, 41 
splieno-palatine ganglion, 406 ; 210 
submaxillary ganglion, 373, 387; 197, 
201, 204 
Symphisis pubis, 84; 42, 45 
Tarsi, 336; 184 
Tendinous slip between flexor longus pollicis 
and flexor longus digitorum tendons 
(plantar region), 144; 79, 80 
Tendinum, vincula accessoria, 230 ; 131 
Tendo Achillis, 153, 158; 83, 85, 86, 87 
Tendon or tendons, 7 
compound of flexor brevis pollicis 
(foot), 147 ; 75, 82 
compound of flexor brevis pollicis 
(hand), 231 ; 131, 132 
compound of obturator internus, ge- 
mellus superior, and gemellus infe- 
rior muscles, 175 ; 91, 95 to 100 
conjoined, 51; 27, 42 
dissection of sheaths of, 8 
dorsum of foot, 126 ; 71, 72 
extensor brevis digitorum muscle, 
128; 71, 72 
flexor longus digitorum muscle, 157; 
85, 87 
flexor longus digitorum muscle (initial 
and terminal), 139, 142; 77, 78, 
79, 80 
flexor longus pollicis (hand), 218 ; 127 
flexor longus pollicis muscle (leg), 138, 
142 ; 75, 77 to 81 
flexor sublimis digitorum muscle 
(sheathed), 220; 4, 127 
flexor sublimis and flexor profundus 
digitorum muscles (relations of), 
229 ; 121, 129, 131, 132 
peroneus brevis muscle, 143,181; 79, 
80, 101, 103 
peroneus longus muscle, 143,181; 79, 
80, 101, 103 
plantaris muscle, 156 ; 85 
popliteus muscle, 188 ; 107,108,109, 
110 
tibialis anticus muscle, 141, 183; 75, 
79, 80, 81, 102, 103, 105, 106 
tibialis posticus muscle, 141,157,182; 456 
INDEX. 
Tendon or tendons—Continued. 
75, 79, 80, 81, 85, 87, 102, 103, 
105,106 
tibialis posticus muscle (plantar ex- 
pansions), 145, 183 ; 82, 105, 106 
sheaths of, 8 ; 4 
Testes, 9!); 56 
tunica albuginea, 100 
tunica vaginalis, 99; 56 
Thoracic: 
cavity (interior of), 245 
parietes (anterior of), 237 
viscera in situ, 240 
viscera, taking out of, 244 
Thread, 3 
Thymus, 241; 137 
Thyroid body, 371; 195, 196, 197 
Tongue, 388 ; 202, 203, 204, 205, 206 
Tongue and contiguous parts, 387 
Tonsils, 387, 392; 203, 204, 205 
Torcular Herophili, 326 ; 180 
Trachea, 244, 253, 372; 138, 142, 196, 
197, 198 
Tuberosities, superior maxillary, 392 ; 205 
Turbinate processes of ethmoid bone (mu- 
cous membrane covered), 403 ; 209 
Urachus, obliterated, 55; 29 
Ureters (male and female), 41, 72, 94, 96 ; 
20, 38, 54, 55 
Urethra, female, 40, 41, 102 ; 20 
male, 97 ; 55, 56 
membranous portion, 23, 97 ; 10, 11, 
12, 55, 56 
prostatic portion, 97 ; 55, 56 
spongy portion, 97 ; 55, 56 
Uterus, 104 ; 57 
external os, 105 ; 57 
internal os, 105 ; 57 
interior, 105 ; 57 
Utricle or sinus pocularis, 97; 55 
Uvula, 383, 385 ; 202, 203, 205, 206 
Vagina, 104; 57 
bulb of, 35; 15 
inferior wall, 41 ; 20 
superior wall, 41; 20 
Vas aberrans, 100 ; 56 
Vds deferens, 26, 100; 12, 29, 38, 56 
Vasa brevia, 66 ; 36 
Vein or veins : 
anastomotic branch (arm), 208 ; 123 
anterior jugular, 359 ; 192 
anterior ulnar, 208 ; 115, 123 
axillary, 202; 117, 118 
basilic* 195, 198, 208 ; 115, 116, 123 
cephalic, 195,197,208 ; 115,116,123 
common iliac, 74 ; 38, 89 
common ulnar, 208; 115, 123 
coronary, 260 ; 144 
deep dorsalis clitoridis, 37 ; 16 
deep dorsalis penis, 20, 46 ; 8, 22 
external iliac, 74 ; 38, 39 
Vein or veins—Continued. 
external jugular, 356 ; 192, 193 
external jugular (inferior anastomos- 
ing branch), 356; 192, 193 
external jugular (submaxillary anas- 
tomosing branch), 356, 358, 359; 
192,193 
external saphenous, 151, 152; 84, 
85, 86 
facial, 332. 359; 182, 183, 192, 193 
femoral, 112, 113 ; 63 
inferior thyroid, 372 ; 196, 197 
innominate (left), 242 ; 137 
innominate (right), 242 ; 137 
intercostal (left superior), 248 ; 140 
intercostal (right superior), 245 ; 139, 
140 
internal iliac, 74 ; 38, 39 
internal jugular, 326, 361; 180, 192 
to 195 
internal saphenous, 44, 108, 125,152, 
154 ; 22, 60, 70, 84, 86 
median, 195, 208; 115, 123 
median-basilic, 208 ; 123 
median-cephalic, 208; 123 
ophthalmic, 340 ; 185 
popliteal, 155 ; 86 
posterior radial, 296 ; 164 
posterior ulnar, 208, 296 ; 123, 115, 
164 
pulmonary (common), 253, 257, 260 ; 
142, 144 
pulmonary (left), 252 ; 141 
pulmonary (right), 252 ; 141 
radial, 208 ; 123, 115 
subclavian, 370 ; 192, 194, 196, 197, 
198 
subcutaneous, 6, 9 
subcutaneous (arm), 208 ; 115, 123 
Venn or venm: 
azygos major, 245, 254; 139,140,142 
azygos minor, 248 ; 140 
cava inferior, 71, 92, 253, 257, 258; 
38, 48, 52, 142, 144 
cava superior, 242, 252, 254, 257, 
258 ; 137, 141, 142, 144 
comites, 9 
Galeni; 217, 218 
porta, 88, 91 ; 35, 36, 48, 52 
Vertebra or vertebrae: 
arch of, 281; 
articular processes of, 282 ; 155, 156 
body of, 281 ; 155, 156 
laminae of, 282 ; 155 
notches of, 282; 154 
pedicles of, 281 ; 155, 156 
spinous process of, 282 ; 155 
Vertebral column, 281, 282 ; 42,147,155, 
156, 189, 198 
Vesiculae seminales, 26, 98; 12, 55 
Viscera, 10 
Zygomatic arch, 330