Atlas of Human Anatomy Edited by R. Putz and R. Pabst
In collaboration with Renate Putz
Translation by S. Bedoui
Volume 2 Trunk, Viscera, Lower Limb 14th edition, newly edited 704 colour plates with 914 figures
ELSEVIER UREIi\N.l
URBAN &. FISCHER MOnchen . Jena
Sobotta
Atlas of Human Anatomy
Volume 2 Trunk. Viscera; Lower Limb
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Elsevier GmbH, Urban & Fischer Verlag, Department for Medical Student I nformation, Alexander Gattnarzik, Karlstralle 45, 80333 Munich, Germany e-mail:
[email protected]
Addresses of the editors:
Professor Dr. med. Reinhard Putz Vorstand des Anatomischen Instituts der Ludwig-Maximilians-U niversitiH Pettenkoferstralle 11 80336 Munchen Germany e-mail: reinhard.
[email protected] de Professor Dr. med Reinhard Pabst Leiter der Abteilung Funktionelle und Angewandte Anatomie Medizinische Hochschule Hannover Carl-Neuberg-Stralle 1 30625 Hannover Germany e-mail: pabst.rei
[email protected]
This atlas was founded by Johannes Sobottat, former Professor of Anatomy and Director of the Anatomical Institute of the University of Bonn, Germany. German Editions:
1st Edition: 1904- 1 907 J. F. Lehmanns Verlag. Munich 2nd_11th Edition: 1 9 1 3-1944 J. F. Lehmanns Verlag, Munich 1 2th_20th Edition: 1948- 1 993 U rban & Schwarzenberg, Munich 1 3th Edition: 1 953, editor H. Becher 1 4th Edition: 1 956, editor H. Becher 1 5th Edition: 1 957, editor H. Becher 1 6th Edition: 1 967, editor H. Becher 1 7th Edition: 1972, editors H . Ferner a nd J. Staubesand 181h Edition: 1982. editors H Ferner and J. Staubesand 19th Edition: 1 988, editor J. Staubesand 20th Edition : 1 993, editors R. Putz and R. Pabst 2 1 '1 Edition: 2000, editors R. Putz and R. Pabst, Urban & Fischer Verlag , Munich 22nd Edition: 2006. editors R. Putz and R. Pabst, Elsevier G m b H , Munich Foreign Editions:
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14'h edition 2006 ©2006 Elsevier GmbH, Munich Urban & Fischer Verlag is a n i mprint of Elsevier G m bH. 05 06 07 08 09
5 4 3 2 1
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The 1 4th edition of the Sobotta Atlas consists of two volumes and a booklet containing tables lenclosed in Volume 1 1 : Volume 1 : Hea d , N e c k , U pper Limb Volume 2 : Trunk, Viscera, Lower Limb
Tra nslation: Dr. med. Sammy Bedoui, Hannover Editorial staff at Elsevier: Dr. med. Dorothea Hennessen Alexander Gattnarzik Dr. rer. nat. Andrea Richarz Illustrators: Ulrike Brugger, Munich; Rudiger Himmelhan, Heidelberg; Horst Rull, Munich; Henriette Rintelen, Velbern Book production: Renate Hausdorf, Munich Composed by: Typodata, Munich Printed and bound by: Appl, Wemding Cover desig n : Carsten Tsch i rner, Munich Printed on Nopacoat 1 15 g Printed in Germany ISBN - 1 3: 978-0-443-10349-0 ISBN-1 0: 0-443 - 1 0349-6 Current information by www.elsevier.com and www.elsevier.de
Ara bic Edition Modern Technical Center, Damascus C h i nese Edition Icomplex charactersl Ho-Chi Book Publishing Co, Taiwan C h i nese Edition Isimplified Chinese editionl Elsevier, Health Sciences Asia, Singapore Croatian Edition Naklada Slap, Jastrebarsko Dutch Edition Bohn Stafleu van Loghum, Houten English Edition Iwith nomenclature i n Englishl Atlas of Human Anatomy Lippincott Williams & Wilkins English Edition \with nomenclature in Latini Atlas of H u man Anatomy Elsevier G m b H , U rban & Fischer French Edition Atlas d 'A natomie Humaine Tee & Doc Lavoisier, Paris Greek Edition Iwith nomenclature in Greekl Maria G. Parissianos, Athens Greek Edition \with nomenclature i n Latini Maria G. Parissianos, Athens Hungarian Edition az ember anatomiajilnak atlasza Alliter Kiadai, Budapest Indonesian Edition Atlas Anatomi Manusia Penerbit Buku Kedokteran EGC, Jakarta Italian Edition Atlante d i Anatomia U mana UTET, Torino Japanese Edition Igaku Shoin Ltd. , Tokyo Korean Edition ShingHeung MedScience, Seoul Polish Edition Atlas anatomii cztowieka U rban & Partner, Wroclaw Portuguese Edition \with nomenclature in Englishl Atlas de Anatomia Humana Ed itora Guanabara Koogan, Rio de Janeiro Portuguese Edition \with nomenclature in Latini Atlas de Anatomia H umana Editora Guanabara Koogan, Rio de Janeiro Spanish Edition Atlas de Anatomia Humana Editorial Medica Panamericana, Buenos Aires/Madrid Turkish Edition Insan Anatomisi Atlasi Beta Basim Yayim Dagitim, Istanbul
Contents Preface .... . .....
. .
. . . . ," " .. ," " " , .. ,',.. .
VI Abdominal viscera ... . . ...... ,
Back ...................... , .... . . .....
1 -45
S u rface a natomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . Verte bral colu m n , Colu m na vertebralis . . . . . . . . . . . . . Muscles of the back, M usculi dorsi, su bocci p ital mu scles, M u sculi s u boccipitales, and muscles of the neck, M usculi colli . . . . . . . . . . . . . . . . . . . . . . . Computed tomographic secti o n s t h rough the vertebral colu m n . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Vessels and nerves of the back and the occipital reg i o n . . . . . . . . . . . . . . ., . . . . . . . . . ............ Vessels and nerves of the vertebral canal ., . . ... . ..
1 2-25
,
35
,
36-40 41-45
Thoracic and abdominal wall ...........
46-73
S u rface a natomy . . . . . . . . . . . . . . . .. . . . . . . , . . . . Ribs, Costae, t horac i c cavity, Cavea thoracis . . . . . . . . Ste r n u m , Stern u m . . . . . . . . . . . . . . . . . . . . . . . . ..... Muscles of the thorax, M usculi thoracis, and abdominal muscles, Musculi abdo m i n i s . . . . . .... I n g u i n a l canal . , ..... . .... . ............. . . . . . . .. Diaphra g m , D i a p h ra g ma . . . . . . . . . . . . . . . . . . . . . . . . , B reast, M a m m a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Vessels and nerves of the thoracic and abdominal wa ll Segmental sensory i nn e rvation . . . . . . . . . . . . . . . . . . . Lum bosacral plexus, Plexus lumbosa c ralis . . . . . . . . . Anterior abdominal wall . . . . . . . . . . . . . . . . . . . . . . . . . Sections t h ro u g h the abdominal wall . . . . . . . . . . . . . . .
46 47-49 50-51
,
,
,
,
,
,
Thorax .
26-34
52-59 60-61 62-63 64-65 66 67 68 69-71 72-73
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74- 1 27
Heart , Cor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Trachea, Trachea . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lungs, Pulmones . . . . . . . . . . . . . . . . . . . . . . . . . . . . Shape of the heart . . . . . . . . . . . . . . . . . . . . . . . . . . . B ronchoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . P roj ection of t rachea, lu ngs and pleural borders . . Oesophagus, Oesophagus . . . . . . . . . . . . . . . . . . . . . Thym us, Thymus . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pleural cavity, Cavitas pleura lis, and mediast i n u m , Mediast i n u m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Aorta, Aorta . . . . . . . . . . . .. . . . . . . . . . . . . . . . .. . . . Posterior mediast i n u m . . . . . . . . . . . . . . . . . . . .. . Autonomous nervous system, Pars a utonom ica . . . Phrenic nerve, N e rvus phrenicus . . . . . . . . . . . . . . . Sections thro u g h the thorax . . . . . . . . . . . . . . . . . . . ,
, .. 74-89 . . . 90-91 . . . 92-100 . .. 101 . .. 102 . .. 103 . . . 104-109 . . . 110-111 . . . . . .
. . 112-113 114 .. . 115-116 .. 117 .. 118 . . 119-127 .
. . . . . . . . . 1 28-181
Stomach, Gaster . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Small i ntest i n e , I ntest i n u m tenue . . . . . . . . . . . . . . . . . Larg e i ntestine, I ntesti n u m c ra ss u m . . . . . . . . . . . . . . . Liver, Hepar, gall bladder, Vesica biliaris, and bile duct system . . . . . . . . . . . . . . . . . . . . . . . . . . Pa n c reas, Pancreas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Spleen , Splen [Lien] . . . . . . . .. . . . . . . . . . . . . . . . . . . . . Peritoneal cavity, Cavitas peritonealis, development Location of the abdominal viscera, Situs viscerum . . . . Abdominal arteries, overview . . . . . . . . . . . . . . . . . . . . . Abdominal veins, overview . . . . . . . . . . . . . . . . . . . . . . . Coeliac trunc and s u pe rior as well as i nferior mesenteric a rteries and veins, Tru ncus coeliacus, Arteriae et Venae mesentericae s u perior et i nferior Vessels and nerves of the retroperitoneal space . . . . . vein, Vena ortae h e patis . . . . . . . . . . . H
Pelvic viscera and retroperitoneal space
Kidney, Ren [Nephro s ] . . . . . . . . . . . . . . . . . . . . . . . . . . . Supra renal gland, G land u la supra renalis . . . . . . . . . . . Urinary bladder, Vesica urinaria . . . . . . . . . . . . . . . . . . . M a le u r i n a ry and g e n ital o rg a n s . . . . . . . . . . . . . . . . . . . Female urinary and g e n ital o rgans . . . . . . . . . . . . . . . . . Rect u m , Rectum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Renal a rtery, Arteria renalis ., . . ....... . . . .. , . . .. . O rg a n s of the retroperitoneal space . . . . . . . . . . . . . . . . Vessels and nerves of the retroperitoneal space . . . . . I n nervation of male ge nitalia . . . . . . . . . . . . . . . . . . . . . I n nervation of female g e n italia . . . . . . . , . . . . ........ I nternal pelvic a rteries . . . . . . . . . . . . . . . . . . . . . . . . . . Pelvic viscera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pelvic diaph ra g m a n d peri n e u m , m a le and female external genitalia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sections t h ro u g h abdomen and pelvis . . . . . . . . . . . , . .
Lower limb ..... . .. . . . . . . ..... .
128-133 134-137 138-141 142-151 152-155 156 157 158-167 168 169
170-178 179 180-181
1 82-26 1 182-188 189 190-191 192-199 200-209 210-215 216 217 218-221 222 223 224-225 226-229 230-241 242-261
, . . . . . . . 262-384
262 S u rface a natomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bones, joints, ligaments . . . . . , .. . . ..... . .... . . . . . 263-305 M uscles of the lower l i m b . . . . . . . . . . . . . . . . . . . . . . . . 306-343 Vessels and nerves .. . .. . ... . . . .... . ... . . . . .... 344-379 Sections th ro u gh the lower l i mb , , , , ............... 380-384 .
Appendix ....... .
.
. . . .. . ..... . . ... . .... 385-399 .
I ndex . . . . ... . ... . ...... . , ..................... 385-399
Preface It was just over a h u n d red years ago that Johannes S obotta set out to pubLish the fi rst edition of h i s Atlas of H u m a n Anatomy. Since then, t h i s piece of work has evoLved step by step as a re s u Lt of the constant i nteraction between students, Lectu re rs and edito rs. It has not o n Ly been the most modern basis for the com pLex subject of macroscopic a natomy t h roug hout m a ny g enera t i o n s o f d octors, b u t has a Lso deveLoped i nto a Last i n g work o f reference f o r both clinica L tra i ni ng and advanced medicaL educa tion. ALL in aLL, it has become a book for a medicaL doctor's Life. O nce a g a i n , i n this new edition the additionaL f i g u res have been d rawn strictly on the basis of originaL speci mens. The 14th edition h a s been particuLa rLy designed to meet the de mands of a reformed medicaL c u rricuLum, e m phasizing the i nte g ration of clinical medicine into the p rec linical curriculum. For t h i s pu rpose, the new edition has been extended to include the following features: - S u rface anatomy including p rojection of i nternal o rgans (45 colo u r photos! - Anatomical d i a g rams next to i maging figures - I ntegration of i m a g i n g techniq ues to a g reater extent (u ltrasound, X-ray, CT, M R I ; 119 fig u res! - Endoscopic, intraoperative colo u r images and f i g u res exemp lifyi ng tec h n i q ues of p u ncture and exa m i nation (54 f i g u res! - I mages of patients prese nting with typicaL palsies - Dia g ra m s of the most i m porta nt a rteriaL variations (93 figures! - Frequent variations i n the location of internal organs (24 figu res! - I nteg ration of hi stology at Low magn ification of i m porta nt in ternal o rg a n s (intestine, liver, kidney, etc . ! I n o rder t o i m p rove the presentation of the knowLedge, the foL lowing featu res have been i ntroduced: - C lear-cut arrangement of the chapters according to the d iffer ent reg ions of the body - Thematica lly corresponding figures presented on double pages - A concise, se parate bookLet ( i ncluded i n VoLume 1 ! contains tabLes of m uscles, joi nts a n d nerves, enabling the reader to place it next to any figure i n the atlas One part i c u La r aim of the new edition i s to facilitate fi nding of specific structures. The SOBOTTA depicts anatomical structures preciseLy without the reader loosi n g the g reater picture . There fore, specific didactic tools have been i m p roved and new aspects included: - Each chapter has been allocated to a part i c u la r colour - A "menu bar" o n each doubLe page ensures p recise orie ntation with i n a given chapter - The n u m be r of outlines depicting spatia L o rientation has been significantly increased (270 f i g u res! - Overviews of totaL body reg i o ns ensure g en era L orientation - New d i a g ra m s of particuLar muscles c larify their location and cou rse (24 figures!
- Confusion i s kept to a m i n i m u m by o n ly depicting Limbs of the right side of t h e body - "Compass roses" point to adjacent figures, thus faci litating following a given structure over severa L pages - Continuous leader lines faci litate finding of structures - Coloured dots at the end of Leader Lines i n topogra p h i c diagrams m a rk a rteries, veins, nerves, a n d m uscles - The f i g u res i n the boo kLet relate d i rectly to the figures i n the atlas - The larger d i mensions of the book i m p rove cla rity With the exceptio n of d iscussions a bout the generaL concept of the atlas a n d m ut u a L correction, t h e editors have worked sepa rately o n i n d ivid ual c ha pters , with the work d ivided a s follows: R. Putz: Genera l anatomy, upper Limb, bra i n , eye, ear, back, Lower L i m b ; R . Pabst: H e a d , n e c k , thoracic and a b d o m i n a L walls, t ho racic, abdominaL and pelvic viscera. The inclusion of a larg e n u m be r of new figures is the result of the extraord i na ry capa bility of the following medical i l lustrators: U lrike B rug ger, Rud iger H i m melhan and Horst Rurl. I t i s to their cred it that the classic "SOB OTTA styLe" has been retained. Several of the d i a g rams have been generated o n the computer by H e n riette R intele n . We also g ratefully acknowledge o u r clini cal colLeagues for making cli nical i llustrations available to u s (see picture credits! ' W e owe a d e b t of g ratitude to o u r col leagues fro m t h e i n stitutes for their u n d e rsta nding and heLpful suggestions. D r. N . Sokolov and A. Buch horn have put meticu Lous efforts into g enerating the specimen preparations. S. Fryk and G. Hoppma n n have s u p ported us in text processing . The staff of the ed itorial office of Elsevier p u b lishers , i n particu lar Dr. D. H e n nessen and A. Gattnarzik, has our sincere thanks. Some of t h e creative deve lopment of the work i s a result of very fruitfuL d iscussions. We would aLso like to thank R. Hausdorf for t remendous efforts in the production of the atlas. R . Putz to gether with G. M eier were responsible for the proofreading and s i m plification of page design a n d legends. O u r speciaL thanks g o to Dr. U . Osterkamp- Baust for gene ra t i ng the i ndex, and aLL others i nvoLved i n the corrections. With o u r joint efforts, the SOBOTTA has been once more modernized both i n contents and design. We have included many of the helpful suggestions made over the years by students and colleagues, and wou ld therefore ask aLL readers of this edition to pass o n to u s any c riticism or sug gestions on the new format of this atlas.
M u n i c h and H a n nover, September 2005 R. Putz and R. Pa bst
Univ.-Prof. Dr. med. Reinhard Putz Born in I n nsbruck/Austria Studied medicine at the Leopo ld-Franzens-Un iversity of I n nsbruck Received a doctorate U n iversity assista nt at the I nstitute of Anatomy at the U n iversity of I n nsbruck Lectu re r in a natomy Consultant for a natomy C h a i r of the Anato m i ca l I nstitute at the Albert - Ludwig s - U n iversity of Freiburg C h a i r of the Anatom ical I nstitute at the Ludwi g - M a x i m i lia ns-Un iversity of M u nich President of the E u ropean Association of C l i n i ca l Anatomists Regist ration to practise medicine C h a i rm a n of the Anato mical Society M e m ber of the Akademie der Naturforscher und A rzte [ Leo pold i n a ! D r. h . c . of the U niversity of Constanta, Romania Prorector I of the Ludwig-M a x i m i lians-Un iversity of M un i c h
1962-1968 1968 1968-1982 1978 1979 1982-1989 since 1989 1992-1994 1993 1998-1999 1999 2002 2003
Research a n d fields o f i nterest
-
Functional a natomy of the passive locomotor system Evolution and functiona l a natomy of the verte bral colu m n Form-function-re lations o f joints Applied a natomy [anato m i ca l basics of o rthopaed ics, surgery, radiology! Questions about the co ntents and o rganisation of the medical cu rriculum Development of d idactic t ra i n i n g prog rammes at u niversities
Univ.-Prof. Dr. med. Reinhard Pabst Born in Posen , g rown up in LUneburg Studied medicine at the Hannover Medical School, and in G lasgow/Scotla n d U niversity d e g ree a n d doctorate Reg istration to p ractise medicine Scientific associate in the Department of Clin ical Physio logy, U n iversity of Ulm Lectu rer for Clin ical Physiology, U n iversity of U l m , and new lectu reship at the H a nnover Medical School Senior assistant in the Department of Functional a n d Applied Anatomy, 1976-80 H a n n over Medical School 1978 Extension of the Ven i a legendi to include a natomy Head of the Department of Topograp h i c Anatomy a nd Biomechanics 1980-1992 H ead of the Depa rtment of Funct ional and Applied Anatomy, H a n nover Medical School since 1992 Prorector for studies and education, H a n nover Medical School 1986-1990 1993-1997 Dean of the H a n n ove r Medical School 1997-1998 Chairman of the Anato m i ca l Society 1999-2003 Pro rector of Research of the H a n n ove r Medical School 2001 M e m ber of the Akademie der Naturforscher und A rzte [ Leopold i n a !
1965-1970 1970 1971 1971-76 1976
Research a n d fields o f interest
-
Functional a natomy of lymphatic o rgans Proliferation a n d m ig ration of lymphocytes Deve lopment of the i ntesti n a l i m mune system Function of the pulmonary i m mu n e system Questions of a clinica lly orientated a natomy i n the medical curriculum Evaluation of tea c h i n g
Picture credits The ed itors sincerely thank all clin ical colleag u es that made u l t rasound, comp uted tomogra p h i c and magnetic resonance ima ges a s well as endoscopic and i n t raoperative pictures ava i lable: Prof. Altaras, Centre for Radiology, U n iversity of Gieflen [Fig. 1009,1031,1032] D r. Baumeister, Department of Radio logy, U n iversity of Fre i b u rg [Fig. 1157] PO Dr. B u rgkardt. Orthopaedic C l i n ic, Technical U n iversity of M u n ich [Fig. 14311 Prof. B rUckm a n n & Dr. L i n n , N e u ro ra d iology, I nstitute for Diagnostic Radiology, U n iversity of M u n i ch [Fig. 662,726 a , b, 727 a, b] Prof. Daniel, Department of C a rd i ology, U n iversity of Erla ngen [ F i g . 899,900,901, 973] Prof. Degenhardt, Bielefeld [Fig . 1 133,1135] Prof. Galanski & D r. Kirchhoff, Depa rtment of D i a g nostic Radiol ogy, H a n n over Medical School [ Fig. 962,964,1212,1213] Prof. Galanski & Dr. Schafer, Depa rtment of Diagnostic Radiol ogy, H a n n ove r Medical School [Fig. 871 a , b, 927,971,991, 1194, 1204,1207,1209]
Prof. Gebel, Depa rtment of Gastroenterology, Hepatology and Endocrinology, H a n n ove r M ed i ca l School [Fig. 242,1011, 1026,1027,1038,1039,1074,1092]
Dr. Goei, Radiology, H eerlen, The N etherla nds [ Fi g . 1150,1151] [with permission from Rad iology 173; 137-141: 1989] D r. G reeven , St.- Eliza beth-Hospital, Neuwied [Fig. 150,1238] Prof. Hoffmann & PO Dr. Bekta s, Clinic for Abdominal a n d Transplantation S u rgery, H a n nover Medical School [ F i g . 1028, 1040]
Prof. H o h lfeld, C l i n i c for Pneumology, H a n nover Medical School [Fig. 929,930] Prof. Jonas, U rology, H a n n over Medical School [ F i g . 1102 a , b, 1103]
Prof. Ka m p i k & Prof. MUller, Ophtha lmology, U n iversity of M u n ich [Fig. 657] Dr. Kirc h h off & D r. Weide m a n n , D e partment of Diagnostic Radiology, H a n n over Medica l School [Fig. 1041,1093,1102, 1196,1198,1200, 1202,1205]
Prof. Kre mers , Department for Restorative Dentistry and Periodontology, U niversity of M u nich [Fig. 169] Prof. Kunze, von H a u nersches C h i ld ren ' s H ospital, U n iversity of M u n ich [Fig. 327-330] D r. M eyer, Depa rtment of Gastroentero logy, H epatology a n d Endocrino logy, H a n n over M e d i c a l S c h o o l [ F i g . 944,987 a , b , 992,1145,1146]
Prof. MUller-Va h l, N e u rology, Han nove r Medical School [Fig. 128 a , b ] Prof. Pfeifer, Radiology, I n stitute for Diagnostic Radiology, U n iversity of M u nich [Fig. 293,294,310,312,449,451, 769-772,807-810,1255,1286,1287,1317,1318]
PO D r. Rau, Department of Radiology, U n iversity of Fre i b u rg [Fig. 912,925,926]
Prof. Ravelli t, formerly I n stitute of Anato my, U n iversity of I n nsbruck [Fig. 767] PO D r. Rieger, Rad iology, I nstitute for Diagnostic Rad iology, U n iversity of M unich [Fig. 1395] Prof. Reich, Orofacial S u rgery, U n iversity of B o n n [ F i g . 113 a, b] Prof. Reiser & D r. Wag n e r, I nstitute for Diag nostic Radiology, U n iversity of M u n i c h [ F i g . 436,449,451, 453,571,572,573, 576,577, 792]
Prof. Rudzki-Janson, Department of O rthodontics, U n iversity of M u n i c h [ Fi g . 72,73] Dr. Scheibe, Department of S u rg e ry, Rosman H ospital, B reisach [Fi g . 1289 a-cJ Prof. Scheu m a n n , C l i n i c for Abdominal and Tra nsplantation S u rgery, H a n n over Medica l School [Fig. 243,244,245] Prof. Schillinger, Department of Gynaecology, U n iversity of Freiburg [Fig. 1134] Prof. Schliephake, O rofacial S u rgery, Gottingen [Fig. 152,196,197] Prof. Schlosser, Centre for Gynaecology, Hannove r Medical School [Fig. 1 132a, b, 1140,1 14 1,1178] Prof. Schu macher, N e u roradiology, Depa rtment of Radiology, U n iversity of Fre i b u rg [ F i g . 461 a, b] Dr. Sommer & PO Dr. Bauer, Radiolog ists, M u n ich [ Fi g . 662,1290-1292] Prof. Stotz, Paediatrics, U niversity of M u n i ch [ F i g . 1239,1240] PO Dr. Vog l, Radiology, U n iversity of M u n i c h [ F i g . 436,453, 644,645]
Prof. Vollrath, Ear-Nose-T h roat Depart ment, Monchengladbach [Fig. 229,230,231] Prof. Wag n e r t. Diag nostic Radiology I I , H a n n over Medical School [Fig. 952,1064,1065,1069,1072,1152] Prof. Wenz, forme rly Department of Radio logy, U niversity of Fre i b u rg [ F i g . 768] Prof. Witt, Department of N e u rosurg e ry, U n iversity of M u n ich [Fig. 405] Dr. Wi llfUhr, fo rmerly C l i n i c fo r Abd o m i na l and Tra n s p lantation S u rgery, H a n nover Medical School [Fig. 1051] PO D r. Wimmer, Department of Radio logy, U n iversity of Fre i b u rg [Fig . 799] Additional i llust rations were obtai n ed from the following text books: B e n n i n g hoff-Drenckhah n : Anatomie, Band 1 [ D renckhahn D., H rsg .1 . 16.Aufl., Urban & Fischer, MUnchen 2003 [ F i g . 823, 824.848,849,850]
Welsch, U.: Lehrbuch H istolog ie, U rban & Fischer, MUnchen 2003 [ Fi g . 922,1020,1097, 1122,1123] We lsch , U . [ H rsg.]: S obotta, Atlas H istolog ie, 6. Aufl., Urban & Fischer, MUnchen 2002 [ Fi g . 1037,1085,1125 a , b] Wicke, L.: Atlas der Rontgenanatomie, 3.Aufl., Urban & Schwa rzen berg, MUnchen-Wien-Baltimore 1985 [Fig. 943 a]
Surface
1 Skeleton ···1
... Back
Regions
M . ir9pi;lzius Acromion
Spina scapulae ----:---
M. dekoideus
ri---- M. trapezius Scapula, Angulus inferior
...---. M. terGS major
---"--I
,....... . !I---.
M. erector spinae
M. latissimus dorsi
-----11-... Crista Ihaca
Articulatio sacroiliaca ---- M. gluleus maximus
Vertebra lumbalis V, Proc. spinosus
Fig. 728 Back, Dors u m ; s u rface a natomy.
1-1--+---- Linea mediana posterior
I----C"""=:--- Linea paravertebralis Regia Scapularls
1----.--",,- Linea scapularis
Regia deltmdea
Regia venebralls
--I'----'r-"-;:---;--
---t----I-":--
Regio infrascapularis
Raglo l umballs
1----+-- Linea axillaris posterior
--\----'t--+-
Regia sacralls
--\---+--+----+
Regro glu le alls ---\--+-t--
Fig.729 Regions a n d o rientation lines of the back.
�
Back
Surface
Skeleton
Skeleton of the trunk
Columna vertebralis (Pars cervicalis)
Vertebra promlnens Costa I
Acromion _--"iE=._ Spina
scapulaa
_L-t:.�",-f-���::�
Scapula Margo m edialis
Columna vertebralis (Pars thoracica)
A�gulus Infe rior
Cosla XII Columna vertebralis (Pars lumbalis) Crista
Itlaca
Spina ltiaca
Os
coxae
posterior
superior
Os sacrum [Vertebrae sacrales I-V] Spina iliaca posterior inferior
����.�.�---------
Fig. 730 S keleta l system, S ystema s keletale, of the trunk.
Os coccygis [Vertebrae coccygeae I-IV]
Muscles
To p o g ra p hy
003
Sect i o n s p p. 29, 35
Skeleton of the trunk
Vertebra cervlcahs VII [promlnefls)
�-Humerus
-.---- Vertebra thoracica I
----:T7' ------:-tl.-- Scapula
.....:�.-- Manubrium sterni
Costa II ---_�1
;,'.f--- Corpus sterni
Arcus costalis
Vertebra lumbalis III
Spina iliaca anterior superior
Os ilium
---J....... ...
�
Os sacrum Os coccygls
Facies symphysialis Tuber ischiadicum
Tuber ischiadicum
Fig. 731 Vertebral colu m n , Columna vertebra lis; pectoral g i rdle , C i n g u l u m pectora le, and pelvic g i rd le , C i ng u l u m pelvi c u m ; m e d i a n section t h ro u g h the vertebral colu m n ; medial view.
Fig. 732 Vertebral colu m n, Columna vertebra lis; pectora l g i rd le, C i n g u lu m pectorale, and pelvic g i rdle, C i n g u lu m pelvi c u m ; m e d i a n section t h ro u g h the vertebral colu m n ; viewed from t h e left.
�
Surface
Back
SkeLeton
Vertebral column
A!lElr------ Atlas
�--- Axis
Vertebrae cervicales I-VII
���
I�."'��"--- Vertebra
promlnens
Vertebrae
Ihorac.cae I-XII
Disci intervertebrales
---{J
Foramina
inter· vertebralia
Vertebrae lumbales I-V
Os sacrum
Os coccygis
Fig. 733 Vertebra l colu m n , Columna verteb ralis; ventral view.
Vertebra l colu m n , Columna vertebralis; dorsa l view. Fig.734
Fig. 735 Vertebral colu m n , Columna vertebralis; viewed from the left.
Muscles
(](]5 . .. .
Topography
Sections pp. 29, 35
Vertebral column, development
a
b
Fig. 736 a-e Regional characteristics o f t h e verteb rae. O n ly i n the thoracic reg i o n of t h e verteb ra l colu m n do t h e lateral parts [la belled i n red ] rem a i n sepa rated and form ribs. a Fi rst cervical vertebra. Atlas
b Fou rt h cervical verteb ra , Vertebra cervicalis IV c First t h o racic vertebra, Vertebra tho racica I, with
corresponding ribs, Costae, and stern u m , Sternum d Third lumbar ve rteb ra , Vertebra lumbalis I I I e Sacru m , O s sacrum c
Proc. articularis [Zygapophysis] superior
....,.+---- Proc.
SplnOSUS
Epiphysis anularis' Proc coslalis Proc. accessorius Fig. 737 Vertebral development. Demonstration of the appeara nce of primary ossification centres i n a lu m ba r vertebra [ pedicle : second foetal month; corpus: t h i rd to sixth foetal month). Synostosis of the ossificati o n centres of the vertebral a rch with those of the corpus occurs between the t h i rd and the sixth year of life.
Fig. 738 Vertebral development. C i rc u la r ossification centres (= ri ms*! appear in the epi physes of the vertebrae during the eighth yea r of life and fuse with the verteb ra l bodies until the eig hteenth yea r of life. The centra l portions of the epi physes rem a i n as hyaline cartilagino u s laminae • • t h roughout life. Secondary ossification centre s (apophyses! develop at the processes.
Back
�
Skeleton
Surface
Atlas and axis
Tuberculum anterius Facies articularis
Proc. transversus
Foramen magnum
(Crista occipitalis external
Sulcus arteriae vertebralis
---il---....;..--�II
Arcus posterior atlantis Tuberculum posterius
Fig. 739 Occipital bone, Os occipitale ; section i llustrati n g t h e fora men m a g n u m a nd the a rticula r surfaces of the atlanto-occipital joint; i nferior view.
F i rst cervical vertebra, Atlas; s u perior view. The superior a rticular surfaces of the atlas a re frequently d ivided . Fig. 740
* Canalis a rteriae vertebralis as a variation Tuberculum anterius
Arcus anterior atlantis Facies articularis inferior
Facies articularis superior Facies articularis anterior Fovea dentis
Massa lateralis atlantis
--t:��
��--���""::=-- superior Proc articularis
Proc. transversus
-�',�r::I-- Proc. spinosus
Corpus vertebrae
Tuberculum posterius
Arcus posterior atlantis
Fi rst cervical vertebra, Atlas ; i nferior view.
Foramen transversarium
articularis inferior
Fig. 742 First and second cervical vertebrae, Atlas et Axis ; m e d i a n secti o n .
Fig.741
Apex dentis Facies articularis posterior
Foramen transversarium
Proc ransversus
Proc. articularis i nferior
Foramen
vertebraJe
Tuberculum posterius
Fig.743 Second cervical vertebra, Axis; ventral view.
Proc. articularis inferior
Fig. 744 Second cervical vertebra, Axis ; dorsosuperior view.
Muscles
Topography
Sections pp. 29, 35
Cervical vertebrae
Corpus vertebrae, Facies intervertebralis Tuberculum anterius Sulcus nervi spinalis
Tuberculum posterius
Proc artlcularis superior Foramen vertebrale
00:7
Corpus vertebrae, Epiphysis anularis
-
Foramen transversarium Proc. transversus
--....� . �....;::;;;;;_ iIII.... I �
--. -
Proc. articularis superior Arcus vertebrae
Proc. spinosus
Fig.745 Fifth cerv i ca l vertebra , Vertebra cervicalis V; superior view. The tips of the spinous p rocesses of the cervical vertebrae I I-VI a re frequently d ivided.
Proc transversus
(
Fig. 746 Seventh cervical vertebra, Vertebra cervicalis VI I ; superior view. I n genera l the seventh cervical vertebra ca n be easily identified by its p rotrud i n g s p i nous p rocess and is referred to as vertebra pro m i n ens. In fact, the spinous process of the fi rst thoracic vertebra often p rotrudes even f u rther.
Tuberculum anterius Tuberculum posterlus
Foramen transversarium
Sulcus nervi spinalis
Unci corporis [Procc. uncinati] Fig.747 Second to seventh cervical ve rte brae , Vertebrae cervicales I I -VI I ; ventral view.
Proe. spinosus
Fig.748 Fi rst to seventh cervical vertebrae, Vertebrae cervicales I-VI I ; dorsolateral view.
.. Back
Skeleton
Surface
Thoracic and lumbar vertebrae
Corpus vertebrae, Facies intervertebralis
Epiphysis anularis *
Caput costae supenor Collum costae
Pediculus arcus vertebrae Foramen vertebrale Proc articularis [Zygapophysis] supenor
Fovea costalis superior
Foramen costotransversarium
---=-"-'::Iil
Costa
Fovea costal is processus transversi
Corpus vertebrae
Fovea costalis processus transversi
Incisura vertebral is inferior Articulatio costotransversaria Proc. spinosus
Fig.749 Vertebra, Vertebra ; typical structural features exe m plified b y the fifth thoracic verte bra ; superior View,
Fig.750 Sixth thoracic vertebra, Vertebra t horacica VI; viewed from the left.
* Also: rim of vertebral body
Proc, articularis superior Arcus vertebrae Proc. mamillaris
Corpus vertebrae
--;;;��...
Proc
Iransversus
"r.-+-- Proc.
spinosus
Proc. articularis inferior Fig. 752 Twelfth thoracic vertebra , Vertebra thoracica XII; viewed from the left.
Tenth t ho racic verteb ra , Verte b ra thoracica X ; ve ntral view. Fig. 751
* Region of the vertebral a rch between the superior a n d inferior a rticular p rocesses ("isthmus" ; intera rticular portionl
Pediculus arcus vertebrae
Corpus vertebrae
----j��'"':! .,.l
Proc. spinosus
Third lumbar vertebra, Vertebra lumbalis I I I ; median sect i o n ; spec i men o f a n o ld e r i n d ividual. Fig.753
* Ossification of the ligamentous insertions
Muscles
To p o g ra p hy
(]09
Sectio n s p p . 29. 35
Thoracic and lumbar vertebrae
P roc. articu laris Fovea costal is superior
Fovea costalis processus transversi
Proc
Proe, accessorius
Proc . articularis superior
Proe.
mamilians
Fig. 755 Fou rth lumbar vertebra, Vertebra lumbalis IV; su perior view.
Co rpus vertebrae ----,j�
Proc. articularis inferior
Facies articularis inferior
Fig. 754 Tenth to twelfth thoracic vertebrae, Verte brae thoracicae X-X I I , and first to second lumbar vertebrae. Verteb ra e lum bales I-II; d orsa l view from the left.
Fig.756 Fourt h lumbar verte bra, Vertebra lumbalis IV; ventral view.
Pediculus arcus vertebrae Epiphysi s anularis
Proc, spinosus Lamina arcus vertebrae Proe, articularis inferior
Fifth lumbar vertebra, Vertebra lumbalis V; median section. Note the characteristic wedge-shape of the body of the fifth lumbar vertebra, Fig. 757
•
Re g i o n of the vertebral arch between t he superior and inferior articular process, Here in the fifth and less frequently in the fourth lumbar verteb ra a cleft, bridged by connective tissue [spondylolysisl ca n be formed, This is proba bly caused by local bending stress, As a consequence. the superior vertebra may s li p [ o listhesis l onto the inferior vertebra [spondylolisthesisl.
�
Back
S u rface
I Skeleton I
Sacrum
%:- Proc articularis superior -----:=__;;;: Canalis sacral is
-F-�"""ir- ".....4L..1!!1
-
"::':"
.--i�-- Tuberositas ossis sacri Facies auricularis
�#--- Crista sacralis lateralis
Crista sacral is mediana --+-¥'-+-T.;...:..::=----"--'''--_l_
Crista sacral is medialis
Foramina sacralia posteriora Hiatus sacral is Fig.758 Sacru m , Os sa cru m ; d o rsa l view.
Proc. articularis superior
Ala
ossis sacrl Pars lateralis
Promontorium
Foramina sacralia anteriora
Fig.759 Sacru m , Os sacru m ; ve ntroi nfe rior view.
Ala ossis sacri Pars lateralis
Basis ossis sacri Proc_ articularis superior Canalis sacralis
Sacru m , Os sacru m ; the bone has been sectioned at the level of the second sacral verte b ra ; superior view. Fig.760
Crista sacral is mediana
M u scles
To p o g ra p hy
Secti o ns p p . 29, 35
Sacrum and coccyx
Pars lateralis
Tuberositas ossls sacrl �----I-�::Z:G4 Basis ossis sacri Crista sacral is --"::::::-'-./C. mediana
Canalis sacralis
e.1JiUi!!r-- Promontorium
Fac,es auricularis Cornu sacrale ---..... . Cornu ----i< w---- Apex o�ls seerl coccygeum
Crista sacralis mediana Facies pelvica
Hiatus sacral is
--....lliiJm .
Apex ossis sacri
Os coccygis
Sacru m , as sacru m ; median section. Fig. 762 Fig. 761 Sacru m , as sacru m ; viewed from t h e right.
• Remnants o f intervertebral disc tissue persist even in the adult.
Fig. 763 Sacru m , as sacru m ; gender d iffere nces.
Fig. 764 Sacru m , O s sacru m ; gender d ifferences.
Vertebra coccygea I
Cornu coccygeum
� .tii��- Vertebra
coccygea 1
Vertebrae '.'.•L.---r coccygeae I I I-V Fig.765 Coccyx, as coccyg is; ventrosu perior view.
_-1-- Vertebrae coccygeae 11-1V
Fig.766 Coccyx, as coccygis; dorsoinferior view.
�
Back
Surface
S keleto n
Cervical part of the vertebral column, radiography
Ramus mandibulae
Proc mastoideus
Atlas, Arcus anterior
Os occipitale
Cavitas nasi, Sinus maxillaris
Atlas, Arcus posterior
Palatum osseum
Atlas, Tuberculum posterius
Axis, Dens
Axis, Proc spinosus
Axis, Corpus vertebrae
Incisura vertebrahs inferior
Angulus mandibulae
Incisura vertebral IS supenor
Lingua Vertebra cervicalis III, Corpus vertebrae Epiglottis
Articulatio zygapophysialis
Os hyoideum Proc, articularis inferior
Proc articularis superior
Discus intervertebralis Cartilago cricoidea, Lamina
Proc spinosus
Facies intervertebrales
Pediculus arcus vertebrae Foramen intervertebrale
Vertebra cervical IS VII, Corpus vertebrae
Fig. 767 Cervica l vertebra e , Ve rte b rae cervicales; lateral radiograph of t h e cervica l part of t h e vertebra l colu m n ; u p ri g ht position; t h e central beam i s d i rected onto the t h i rd cervical vertebra ; shou lders a re pu lled downwa rd s.
To p o g ra p hy
Sections p p . 29, 35
Cervical part of the vertebral column, radiography
Proc. spinosus
--
Proc transversus
--
-- Unci corporum [Procc uncinati]
Vertebra celVicalis VI, Corpus vertebrae
-
Trachea ------;=-.;::;=
Fig.768 Cervical vertebrae, Vertebrae cervicales; AP-radiograph of the cervical part of the vertebral colu m n ; u p right position; t h e central bea m i s d i rected onto the third cervical verteb ra . * I ntervertebral disc spaces
(]O'3 '
I
�
Surface
Back
Skeleton
Thoracic part of the vertebral column, radiography
Corpus vertebrae
Costa
Foramen intervertebrale
Facies intervertebrales **
Proc spinosus
Pediculus arcus vertebrae
Fig.769 Thoracic ve rtebrae. Ve rtebrae thoracica e ; lateral rad i o g ra p h o f t h e thoracic part o f t h e vert e b ra l colu m n ; u pright position with the thora x i n i n s p i ration; t h e central beam i s d i rected onto the si xth thora c i c verte b ra .
* Interverteb ral disc space ** C l i n ical term : e n d - p lates
Pediculus arcus vertebrae Corpus vertebrae Costa Articulatio costotransversaria Proc. transversus
Articulatio capitis costae Caput costae
Facies Intervertebral is
Fig.770 Thoracic ve rtebrae, Vertebrae t ho racicae; AP-radiograph of t h e thora c i c part of t h e vert e b ra l colu m n ; upright position w i t h t h e thora x i n i n s p i ra t i o n ; the central beam is d i rected o n t o the s i xth t ho racic verte bra.
* I ntervertebral disc space
Muscles
Topography
Sections pp. 29, 35
Lumbar part of the vertebral column, radiography
Vertebra lumbalis I, Corpus vertebrae
Foramina intervertebralia
Arcus vertebrae, Pediculus arcus vertebrae Incisura vertebral is inferior Facies intervertebrales Incisura vertebral is superior
Proc. spinosus Proc. articularis superior Proc_ articularis inferior
Os ilium. Crista i liaca
Articulatio zygapophysialis
Basis ossis sacri --:------:--�� Crista sacral is median a Promontorium ------Os sacrum
--------=.....:..-
Lumbar ve rtebrae, Vertebrae lu m ba les; lateral rad i o g ra p h of the lumbar part of the verteb ra l colu m n ; upright position; the central beam is d i rected onto the second lumbar verteb ra . I n t h i s case, the a nterior edges o f t h e lower l u m b a r vertebrae a re oblique d u e to pathological a lterations. Fig. 771
I ntervertebral disc space ., Region of the vertebral arch between the superior a nd inferior articular processes '''isthmus'' interarticula r portioni " ' The marks indicate the position of the twelfth rib. which is poorly visible in this copy of the radiograph. =
�
Back
S u rface
S keleto n
Lumbar part of the vertebral column, radiography
Costa XII
Verteora lumoalis I, Corpus verteorae Proc. articularis superior Articulatio zygapophysialis
Procc. costales
Proc. articularis inferior
Pediculus arcus verteorae
Facies interverteorales
Procc spinosi
Proc. costalis
Os coxae; Os ilium
Articulatio sacroiliaca Foramina sacralia anteriora
Fig.772 Lumbar vertebrae, Vertebra e lumba le s ; AP- radiograph of the lumbar part of the vertebra l colu m n a nd the sacru m ; upright position; t h e centra l beam i s d i rected onto t h e second lumbar vertebra. •
I ntervertebral d isc space
M u scles
To p o g ra p hy
Secti ons p p. 29, 35
Craniocervical junctions
Os occipitale, Pars basilaris Membrana atlantooccipitalis anterior Os occipitale, Pars lateralis Os occipitale, Pars lateralis ----....... 'L��....... . Articulatio atlantooccipitalis -----Atlas -....",-...."". Articulatio atlantoaxialis lateral is -----""�=Axis
Vertebra cervicalis III
'-+ --
i4l-�:....::==_��-- Lig, longitudinale anterius
Discus intervertebralis
----b�----"'\
Vertebra cervicalis III, Corpus vertebrae
Fig.773 C raniocervi cal j u nctions and the upper cervical part of the vertebral 'colu m n ; ventral view.
Membrana atlantooccipitalis posterior
Atlas, Massa lateralis
--,-:;;;;;i'-��I..:'�!I��1j
Sulcus arteriae vertebralis
Lig. atlantooccipitale laterale
Tuberculum posterius
Articulatio atlantoaxialis lateralis
Articulatio atlantoaxialis lateralis, Capsula articularis
Axis, Arcus vertebrae
Fig. 774 C ra n i ocervical j u nctions; dorsal view.
Dil7
�
Back
Surface
Craniocervical junctions
Sulcus SinUS sigmoidei
as occipitale
Articulatio -------ll��:',,�� atlantooccipitalis, Capsula articularis
=.....- Atlas
Articulatio atlantoaxial is lateralis, Capsula articularis
Fig.775 C ra niocervical junctions, deep ligaments; dorsa l view.
Fasciculi longitudinales
Canalis nervi hypoglossi
1l\\I.,...�;..� :�"b"- Sulcus sinus sigmoidei
lIg. cruclforme atlantis
!
Articulatio atlantooccipitalis
Capsula articularis
Lig
Articulatio atlantoaxial is lateralis
Fasciculi longltudlnales
Fig. 776 Cran iocervical j u n ctions, deep ligaments; dorsal view.
Lig. apicis dentis
Capsulae articulares
Axis, Corpus
Fig. 777 Cran iocervical j u nctions, deep ligaments; d o rsal view. The a lar ligaments frequently extend to the latera l masses of the atlas.
Skeleton
Muscles
To pog ra p hy
Sectio n s p p . 29, 35
Craniocervical junctions
Os occipitale, Pars basilaris
Dura mater cranial is Lig. apicis dentis
Membrana atlantooccipitalis anterior Membrana tectoria Atlas, Arcus anterior
�-=:"'--.:l"-
_ _
Fasciculi longitudinales Lig cruciforme atlantis
Articulatio atlantoaxialis median a anterior Fasciculi longitudinales Articulatio atlantoaxial is mediana posterior
Squama occipilalis Dens axis
Discus intervertebralis Atlas, Arcus posterior Vertebra cervicalis III, Corpus vertebrae
Axis, Proc spinosus Nn cervicales, Radices
Fig. 778 Craniocervical j u nctions; median secti on .
Os occipitale
Atlas, Arcus anterior, Fovea dentis
Articulatio atlanto occipitalis Dens axis
Articulatio atlantoaxialis mediana posterior
---.�..:,..- Atlas, Arcus posterior __r-- Atlas, Arcus anterior
Atlas, Massa lateralis Articulatio atlanto axial is lateralis
Llg, transversum atianUs
superior
Axis, Corpus Axis, Proc spinosus
Membrana atlanto· occipitalis posterior
Fig. 779 Cran ioce rvical j u nctions; superior view.
Fig. 780 Craniocervical junctions; AP-rad i o g ra p h .
�
S u rface
Back
Ske leton
Ligaments of the vertebral column
Fovea costalis inferior Fovea costal is superior Pediculus arcus vertebrae
Lig costo· ------"�
transversarium
-..:..:..-- Costa
Discus intervertebral is
1-----
---,-=--""--tc-;-+
Arcus
vertebrae
L1g. ---+---h+'�Wb
longltudlnale poslerius
Ug longitudinale
.-:+-w1I!!-:if--- Vertebra
anteflus
Discus intervertebralis
LJg capi1lS
costae
radiaLurn
thoracica XII, Corpus vertebrae
---l�:-���,
----i���:;.::::lll
Fig. 781 Ligaments of the verte bral colu m n ; exem plified b y t h e lower thoracic part o f the verte bra l colu m n ; ventral view.
lig
Fig. 782 Liga ments of the ve rte bral colu m n ; exemplified b y the lower thoracic a n d the upper lumbar part of the ve rteb ra l colu m n ; dorsal view.
capitis costae radiatum
Articulatio capitis costae Proc. articularis superior
lIg. costotransversarium Collum costae
Lig. costotransversarium
Arbculatlo
costolransversarta
����)Zll���'••••' Fig. 783 Costovertebral joints, Articulationes costove rtebra les; cross-section at the level of the lower part of the joint at a head of a rib ; superior view.
Costa
M u scles
To p o g ra p hy
Sect i o n s pp. 29, 35
Ligaments of the vertebral column
Fovea costal is superior
---;�;;:!���
Corpus vertebrae
�:.!!If-
Fovea costalis processus transversI Foramen costotransversarium
Lig costotransversarium laterale
Costa
Lig, longitudinale anterius
Lig. costotransversarium superius
Discus intervertebralis
-----lJIII
Lig. intertransversarium -= =., � s=;; � --=
...o;::-- Lig, capitis costae radiatum
Fig. 784 Ligaments of the vertebral colu m n and the costoverteb ra l joints, Art iculationes costoverteb ra les; lateral parts of the a nterior longitudinal ligament have been remove d ; viewed from the left.
Lig, oosiotransversarium
ialeraie
Fovea costalis processus transversi
--....:..-:--=-�:::
"'">----- Ligg. !lava
Lig. costotransversarium
.....,.
-
�
.....,:,
'----==--- Capsula articularis
=--_ -
....�"""---- Lamina arcus vertebrae
Costa -----,=---
�---- Pediculus arcus vertebrae
Fig. 785 J u nctions between the vertebral a rches; ventral view.
�
Back
S u rface
Costovertebral joints
Llg. capitis costae Intraarticulare Foramen intervertebrale Lig costotransversarium superrus
f'"t,.----- Lig costotransversarium laterale
Lig. longitudinale anterius
Articulatio capitis costae Tuberculum costae
Discus intervertebralis
--���s�i;;�;��� Caput costae
C o stovertebral joints, Articulationes costove rte bra les ; ventral view from the left. Fig.786
Ligg. intertransversaria
Proc spinosus Costae
Lamina arcus vertebrae ------.,,�1IIiiI
Lig. costotransversarrum superius -----m
Lig costotransversarium laterale
Lig. intertransversarium
-----�i
-----!�����E�l[
Proc transversus _' .'''.11. i"�"
Capsula articularis Lig. supraspinale' Fig.787 L i g a ments of the vertebra l a rches a n d the costovertebral joints, Articulationes costovertebrale s ; dorsal view. •
The median portion of the thoracolu m b a r fascia is referred to as supraspinous ligament.
S keleton
M u scles
To p o g ra p hy
Secti o n s p p . 29. 3 5
Ligaments of the lumbar part of the vertebral column
'!A".¥Mr--- Pediculus arcus vertebrae
Lig. longitudinale posterlus
--1O:--...."r
Disci intervertebrales
Vertebra lumbalis V, Corpus vertebrae
as sacrum
---\'>I\
Fig. 788 Ligaments of the l u m bar part of the vertebra l colu m n .
Proc costal is
Articulatio zygapophysialis; Lig. transversum
Proc. spinosus
Fig. 789 Vertebra l j o i nts of the lumbar part of the verte bral colu m n , Articulationes zygapophysiales l u m ba les; d orsa l view from the right.
Rei nforcement of the i ntera rticular j o i nts by strong a n d tra n sverse fi bres [ L i g g . tra n sversa l is restricted to the lumbar part of the verteb ra l colu m n .
�
S u rfa ce
Back
S keleton
Intervertebral discs
Uncus corporis [Proc uncinatus] Anulus fibrosus Pediculus arcus vertebrae Corpus vertebrae
......:....,..:. ..oIj .
-
--�.....::::::&t:ii
Epiphysis anularis
-�::,.::.j��
Anulus fibrosus ----. Epiphysis anularis N, spinalis, Ganglion sensorium nervi spinalis
Nucleus pulposus
..... ..,J
_ _
Corpus vertebrae b
Fig. 790 a, b I nterverteb ra l discs, D i sc i i nterve rteb ra le s. a C e rvical i ntervertebral discs, D i sc i intervertebra les cervicales; frontal section b Lumbar intervertebral disc, Discus i nterve rtebralis lumbalis; median section
* Hyaline cartilaginous covering of the end-plates o f the
vertebral bod Ies reflecting the non-ossified portion of t h e epi physes .* I n the first decade of life, so-ca lled uncovertebral clefts develop in the lateral zones of the cervical intervertebral discs, which can prog ress further towards the m id d le in the following decades.
Fascia thoracolumbalis Discus Intervertebralis
LJg. longitudinal
amerlus
Vertebra lumbalis I, Corpus vertebrae
Proc spinosus Discus intervertebral is Canalis vertebralis; Cauda equina Spatium epidurale Vertebra lumbalis V, Corpus vertebrae Canalis sacral is
Fig. 791 Lumbar i nterve rte bral disc, Discus i n te rvertebralis lumbalis; s u perior view.
Fig. 792 Lumbar parts of t h e vertebral col u m n ; magnetic reso nance tomog raphic i m a g e i M R I ] ; median section,
M u s c les
To p o g ra p h y
Sect i o n s p p . 29, 35
Motion segments
Proc. articularis superior Uncus corporis [Proc. uncinatusJ Facies intervertebral is Epiphysis anularis
Articulatio zygapophysialis, Capsula articularis
•
Corpus vertebrae Lig. interspinale Lig. longitudinale anterius Facies intervertebralis
D·ISCUS intervertebral is
I
Anulus fibrosus Nucleus pulposus
\-"""'.,-- Lig. nuchae
(Foramen venae basivertebralis) Lamina arcus vertebrae Pediculus arcus vertebrae Epiphysis anularis
•
Lig. longitudinale posterius
Fig. 793 Cervical motion segment; schematic median section.
* Also: rim of vertebral body ** Hyaline cartilaginous covering of the end-plate of the vertebral body
reflecting the non-ossified portion of the epiphysis
Foramen intervertebrale Epiphysis anularis
•
Lig. flavum
Lig. interspinale Lig. longitudinale anterius Lig. supraspinale Facies inter vertebral is
Discus intervertebralis
(
Anulus fibrosus Nucleus pulposus Fascia thoracolumbalis
(Foramen venae basivertebralis)
Proc. spino sus Pediculus arcus vertebrae Lamina arcus vertebrae
Fig. 794 L u m ba r motion segment; schematic median secti o n .
Proc. articularis inferior
* Also: rim of vertebral body ** Hyaline cartila ginous covering of the end-plate of the vertebral body reflecting the non-ossified portion of the epiphysis
�
Back
S u rface
S k e leton
Muscle s
Superficial muscles of the back
Protuberantia occipitalis externa M. sternocleidomastoideus
Pars dascendens Pars transversa
M. trapezius
Pars ascendens
Spina scapulae --""M£;",o::---..;:.::;..., ::.:o. Acromion
Fascia deltoidea Vertebra prominens, Proc. spinosus
M teres
major
Scapula, Angulus inferior
M. infraspinatus, Fascia infraspinata M. rhomboideus major
Vertebra thoracica XII, Proc. spinosus
M. obliquus extern us abdominis
Trigonum lurnbale
Fascia thoracolumbalis M. lalissimus dorsI
Os sacrum, Facies dorsalis
I -7 T 17, T 181
Fig. 795 M u scles of the back, M m . dors i ; su perficial layer o f the trunk-arm and trunk-shoulder g i rdle mu scles.
To p o g ra p hy
S e c t i o n s p p . 29. 3 5
Superficial muscles of the back
M sternocleidomastoideus M splenius capitis
M rhomboideus major M, infraspinatus, Fascia infraspinata Costae
Scapula, Angulus inferior
M latissimus dorsi
M serratus posterior Inferior Fascia thoracolumbalis* M obliquus externus abdominis M. obliquus extern us abdominis M. obliquus internus abdominis
Trigonum lumbale
Fig. 796 Muscles of the back, M m . dors i ; deep layer o f t h e trunk-arm and trunk-shoulder g i rdle m uscles. * The 50-called t h oracolumbar fascia forms a dense
aponeurosis.
I -7 T 17-T 191
027
�
Back
S u rfa ce
S k e leton
Deep muscles of the back
M semispinalis capitis M splenius capitis M. sternocleidomastoideus M. longissimus capitis splenius cervicis M, splenius cervicis
M, semispinalis cervicis M. serratus posterior superior M iliocostalis cervicis M. rhomboideus major M infraspinatus, Fascia infraspinata M. iliocostalis thoracis M spinalis thoracis M, longissimus thoracis
M iliocostalis thoracis
M. longissimus thoracis M serratus posterior inferior
M. iliocostalis lumborum M obliquus externus abdominis
Fascia thoracolumbalis
M, obllquus Internus abdominis
M. erector spinae
Fig. 797 Muscles of the back, M m . dorsi; s u pe rficial layer of the deep [ a utochthonous) muscles,
M uscles
To p o g ra p hy
S e ct i o n s pp. 2 9 . 35
Muscles of the back, sections
Lig longitudinale anterius Ren
--r-----��.�;;-�_;_������ ��
Pediculus arcus vertebrae Lamina arcus vertebrae
M psoas major -�----.4Jj
Plexus lumbalis Proc costalis
_---!.:....J�:...-�
M. latissimus dorsi Proc. spinosus
Arcus vertebrae
Mm. transversospinales **
ji��f:r·o' lr:f!f::"'�<'!i
_ _
M. erector spinae
---;.-----:;,i;;jii';:;;1
*
iiIIi..,...-'::--- (Lamina
M quadratus -----,., lumborum Costa XII
M obliquus externus abdominis
)
Cauda equina
profunda)
----t��SSi���� ���
��r;gllll�����_
Fascia thoracolumbalis
(Lamina superficial is)
Fig. 798 M u scles of the back, M m . dorsi ; c ross-section at the level of the second lumbar vertebra; i nferior view. The deep [autochthonousl muscles of the back lie within an osteofibrous tube formed by dorsal parts of the vertebrae and the surrounding a poneu rot i c thoracolumbar fascia. The muscles a re divided i nto a lateral ' and a medial tract. ••
Corpus vertebrae Nucleus PUIPOSUS
Foramen intervertebrale
Anulus fibrosus
}
Discus intervertebral is
N spinalis
Proc. articularis superior
--
M psoas rnajor
p..:."....:.'-,:.,tl-- Cauda equina
Articulatio zygapophysialis
__ Proc. articularis inferior
Lig. flavum *
....� . --il-- M. erector spinae
h-
Mm. transversospinales
Proc. spinosus
Fascia thoracolumbahs
Fig. 799 M uscles of the back, M m . dors i ; computed tomographic c ross-section ( eT) a t t h e level o f the i nterverteb ra l disc between the third and the fourth lumbar vertebra; i nferior view.
• Calcification or ossification frequently occurs at the sites of insertion of the ligamenta flava, even i n younger individuals. ••
Adipose tissue deposits
�
Back
S u rface
S ke leto n
Deep muscles of the back
Tract
Longitudinal system
laleral
M , longissimus -capitis -cervlcis -thoracis
lataral
M. iliocostalis -cervlcls -thoracis -Iumborum
medial
M. spinalis -capitis -cervlcls -thoracis
lateral
Mm. ImerIransversanl
medial
Mm. interspinales
Y
Fascia thoracolumbalis
Tract
M splenius' -cepitis -cervims
lateral
--.,_�------ M. semispinalis"
/k=\\rr�::::-:�':;:��-
_ _
'-<._ -
01+____
'--' -
postBrlores
-cervtcls -thoracis -Iumborum
Oblique system
_2_-:-!C--::�7-t-l.t�lr-'"
--�------,-:::-
Fig. 800 Deep [autochthonousl m uscles of the back; d ia g ra m of the d ifferent g ro u ps of m uscles. The deep [autochthonousl m uscles of the back can be divided i nto a longitudi n a l and an oblique system, as well as i nto a medial and a lateral tract. •
••
Spinotransverse Transversospinal
-capitis -cervlcls
medial
M. multifidus" -cervlcls -thoracis -Iumborum
medlaJ
Mm. rotalores long'" -cervlC!S -thoracls -Iumborum
medial
Mm. rotatores breves" -eervleis -thoraeis -Iumborum
medial
M uscles
To pog ra p hy
S e c t i o n s pp. 2 9 , 35
Oeep muscles of the back
M. semispinalis capitis M rectus capitis posterior minor M. rectus capitis posterior major Atlas, Tuberculum posterius
M obliquus capitis superior M splenius capitis M. longissimus capitis M, digastricus, Venter posterior
Atlas, Proc transversus M obliquus capitis inferior M, semispinalis capitis
Mm, Intertransversarii posteriores cervicis
M Ligg intertransversaria Mm interspinales cervicis
Ligg. interspinalia; Lig. supraspinale Mm rotatores thoracis breves
M, spinalis capitis
Mm. intertransversarii thoracis Mm . levatores costarum breves
Mm. intercostales externi
--fFc,fI.�"='...
Mm. rotatores thoracis longi M. semispinalis thoracis
--1:Ar-+�"'��I'!!l;J�r,rtt f
Lig. costotransversarium superius Lig. intertransversarium
Mm. intercostales externi, Fascia
Mm, levatores costarum breves
_...J1��#1�::11��r.l1J
Membrana intercostal is intern a Mm, intercostales interni
Mm levatores costarum longi
Mm intercostales externi
Mm intertransversarii thoracis Costa XII
M q uadratus lumborum, Fascia
Fascia thoracolumbalis Mm, intertransversarii mediales lumborum
M obliquus internus abdominis
M. transversus abdominis
Mm Intertransversarii laterales lumborum Fascia transversalis
Mm. interspinales lumborum
�i"':IIl!-'''''o-_ Ligg. intertransversaria
M. obliquus externus abdominis
Lig. iliolumbale
Spina iliaca posterior superior Mm multifidi
Lig. sacrotuberale
Fig. 801 Muscles of the back. M m . dorsi, and su boccipital muscles, Mm. suboccipitales.
�
S u rface
Back
S k e leton
Oeep muscles of the back
Lig. intertransversarium Lig. costotransversarium
Costa IX
M. levator costae longus --"""WI��':JII-;,.;JI::M
Mm. multifidi
M. levator costae brevis --.,.;....::...,.�H Mm. rotatores thoracis --b7�-'-:;"";;-:--:::ijjlof!#'"':III.
Lig. intertransversarium
Vertebra lumbalis I , Arcus vertebrae
Ligg. flava
Costa XII
>--�....,....-- Vertebrae lumbales, Procc. costales
r-iH--- Mm. intertransversarii laterales lumborum
Fascia thoracolumbalis (Lamina profunda)
Mm. intertransversarii mediales lumborum
Mm. multifidi
Vertebrae lumbales, Procc. spinosi
Fig. 802 Muscles of the back, M m . dorsi; deepest Layer in the reg ion of the Lower t h oracic and the Lumbar part of the vertebraL coLu m n .
M uscles
Topograp hy
(]33
Sections pp . 2 9 , 3 5
Suboccipital muscles
M. rectus capitis posterior minor M. rectus capitis posterior major M. obliquus capitis superior Atlas, Arcus posterior M . splenius capitis --,"",�
M. splenius cervicis Proc. mastoideus
M. longissimus capitis
M digastricus, Venter posterior
M. splenius cerviCis
M. longissimus capitis
obliquus capitis inferior
M semispinalis capilis
Atlas, Tuberculum posterius M. semispinalis capitis Mm. interspinales cervicis
Mm. multifidi M. semispinalis cervicis
M. longissimus cervicis
M iliocostalis cervicis Lig. supraspinale M semispinalis capitis M. semispinalis thoracis Fig. 803 M uscles of the back, M m . dorsi, and su boccipital m u scles. Mm. subocc i p itales.
1 -7
T 20 b,
C
1
M. obliquus capilis superior
Atlas. Arcus posterior M. obliquus capitis inferior
Fig. 8D4 Suboccipital m u scles. Mm. suboccipitales.
1 -7
T 2D c
I
�
S u rfa ce
Back
S k e leton
Suboccipital muscles
M splenius capitis
M. longissimus capitis
M. semispinalis capitis
---l6I"'.,.,..---'..!-:-:-....-f
Lig nuchae
M. splenius cervicis M. levator scapulae
M. trapezius
..: .J4�,!I -....� Vertebra prominens, Proc. spinosus
M. longissimus cervicis M. scalenus medius
M scalenus posterior
-"k-o"I�...,-t\�...--- M iliocostalis cervicis .1---.JH.li1--- M . semispinalis thoracis +1<'"141+---
Costa I
1 -7
T
20a, b
1
M. semispinalis capitis
Co�ta II
Fig. 805 M u scles of t h e back, M m . d orsi, and m u scles of the neck, Mm. colli.
-------:,....".=:;.:;..��...;�
M. rectus capitis posterior minor
M. rectus capitis posterior major
M. splenius capitis
Membrana atlantooccipitalis posterior
M obliquus capitis superior M longissimus capitis
A vertebralis, Pars atlantica
--L1I�'1i"1
Atlas, Proc. transversus
M. digastricus, Venter posterior
M obliquus capitis inferior M obliquus capitis inferior M longissimus cervicis
r____-- M. splenius cervicis
M, intertransversarius posterior cervicis Axis, Proc. transversus M. splenius cervicis M. semispinalis capitis
I-;) T 20cl
Fig. 806 Subocc i p ital muscles, Mm. s u boccipitales.
I II
= =
Posterior tu bercle of t h e atlas Spinous process of t h e axis
M uscles
035
Secti o ns p p . 29, 3 5
To pog ra p hy
Vertebral column, sections
P(oc.
trans-
versus
(
Larynx Corpus vertebrae
�u
TUb���� � �
Foramen
transversanum
Tuberculum poslerlus
Foramen vertebrale Proc articularis inferior Lamina arcus vertebrae Lig. flavum Proc. spinosus, Tubercula
Fig. B07 C e rvical part of the verte bral colum n ; computed tomographic cross-section [ CTJ at the level of the intervertebral disc between the fourth and the fifth cervical vertebra . •
Cartilago thyroidea
M. sternocleido mastoideus Vertebra cervicalis V, Corpus vertebrae Uncus corporis Proc. transversus, Tuberculum anterius Discus intervertebralis N. spinalis Pediculus arcus vertebrae Vertebra cervical is VI, Corpus vertebrae Proc. articularis Lamina arcus vertebrae Proc. spinosus Fig. BOB Cervical part of the verteb ra l colum n ; computed tomographic cross-section [ CTJ at the level of the fifth and the sixth cervical vertebra .
Endotracheal tube and endoscope
Aorta, Pars abdominalis V. cava inferior Discus intervertebralis M. psoas Ren Foramen intervertebrale Proc. articularis supenor Articulatio zygapophysialis Proc articularis inferior Proc. mamillaris
V . cava inferior Aorta, Pars abdominalis Corpus vertebrae M. psoas major
Mm dorsi
Pediculus arcus vertebrae Lig. flavum Proc costalis Proc. articularis inferior Proc articularis supenor Lig. interspinale
Fascia thoracolumbalis
Fascia thoracolumbalis
Proc spinosus
Fig. B09 Lumbar part of the vertebral colum n ; com puted tomographic c ross-section [ CTI a t the level of the i ntervertebral d isc between the second a n d the t h i rd lum bar vertebra .
Mm, dorsi
Fig. B 1 0 Lumbar pa rt of the verteb ra l colu m n ; computed tomographic c ross-section [CT) a t the level of the pedicles of the third lu mbar vertebra.
�
Back
S u rface
S ke leton
Cutaneous innervation
N . auricularis magnus, R posterior (Plexus cervical is)
\-\-\--- N. occipitalis minor (Plexus cervicalis)
Nn. supraclaviculares laterales (Plexus cervicalis)
C4 -----.�
C5
t-----1I--
N. cutaneus brachii lateral is superior (N. axillaris)
N. cutaneus brachii lateralis inferior (N. radialis)
C6
N. cutaneus brachii posterior (N. radialis)
T2
Rr. cutanei laterales (Nn. spinales, Nn. intercostales)
R. cutaneus lateral is (Plexus lumbalis, N. iliohypogastricus)
L1
L..:..;�-?--t--\-- Nn. clunium superiores (Nn. spinales L1 -L3, Rr. posteriores)
L3 L4 --J---L5
'---_-.l-:���:_--r- Nn. clunium medii (Nn. spinales 51-S3, Rr. posteriores)
rr--:--v��-+-- Nn. clunium inferiores
---",,-
(N. cutaneus femoris posterior)
N. cutaneus femoris lateralis (Plexus lumbalis) N. cutaneus femoris posterior (Plexus lumbalis)
Fig. 8 1 1 Seg menta l cutaneous i n nervation (dermatomes) and cuta neous nerves of the back.
M u scles
To p o g ra p hy
S e c t i o n s pp. 2 9 , 3 5
Vessels and nerves of the back
N. occipitalis tertius (C3)
• • N. occipitalis major (C2); A. ; V. occipitalis
N. auricularis magnus (Plexus cervicalis)
N occipitalis major (C2)
N suboccipitalis (Cl )
R. posterior (C6)
N. occipitalis minor (Plexus cervicalis)
R. posterior (C7)
N auricularis magnus (Plexus cervicalis)
posterior (C8)
supraclavicularis lateralis (Plexus cervical is) • M. deltoideus
N. cutaneus brachii lateralis inferior
M serratus posterior superior . Mm. multifidi •
Nn. thoracici. Rr. posteriores, mediales et laterales
N. cutaneus brachii posterior
-�f1U'tjtE���'�
• M , triceps
brachii, Caput longum
. M. iliocostalis thoracis • ----,�::....,,'il-..I
• • N axillaris; A; V. circumflexa
M longissimus thoracis • --!:I>...:.c---::>r't-'!1
humeri posterior"
• • A ; V. circumflexa scapulae'
M serratus posterior inferior . -��ko�" ·
• M. rhomboideus major
M latissimus dorsi . --+1";:;'
M, obliquus externus abdominis •
..... n
_ -
Trigonum lumbale; N iliohypogastricus
(Bursa subcutanea spinae iliacae posterioris superioris)
R posterior (TI2)
(Bursa subcutanea sacralis)
Nn clunium superiores
M. gluteus maxim us •
R posterior (83)
R. posterior (84)
Fig. 8 1 2
Vessels a n d nerves o f t h e back .
• ••
Vessels and nerves of the tria ngular space Vessels and nerves of the quadra n g u lar space
813 814
�
Back
S u rfa c e
S k e leton
Vessels and nerves of the posterior cervical region
N occipitaliS major
M
• A. occipitalis. Rr. occipitales
occipitalis
N. occipitalis major
N. occipitalis minor
A. occipitalis • • R mastoideus
N occipitalis minor
M. longissimus capitis •
N. auricularis magnus
--;..�t.fJ
-
l��
M
• A auricularis posterior. R. occipitalis
Rr. cutanei posteriores (Nn cervicales et thoracici. Rr. posteriores)
N. dorsalis scapulae
V. transversa . colli M rhomboideus . minor
• M trapezius
Rr. cutanei posteriores (Nn. thoracici. Rr. posteriores)
M
Rr. cutanei laterales pectorales (Nn thoracici. Nn. intercostales)
814
812
Fig. 8 1 3 Vessels a n d n e rves of t h e occip ital reg i o n . Regio occipitalis. t h e poste rior cervical region, Regio cervica lis posterior, and t h e upper back.
M u sc le s
To pogra p hy
Sect i o n s p p . 29, 3 5
Vessels and nerves of the posterior cervical region
Protuberantia occipitalis externa • M. epicranius; M. occipitofrontalis, Venter occipitalis
M . semispinalis capitis . M. rectus capitis posterior major .
N
SubOcc'pitalis
M. obliquus • capitis superior
�U"-�-- • A occipitalis
-"':;"-"i���
""';:�"-:J---
Alias, Arcus posterior
Fascia nuchae
M. longissimus capitis •
• M. muttifldus
M obliquus capitis inferior .
M
R. posterior (e 3)
• M. semispinalis cervicis • N. accessorius [XI]
• N. dorsalis scapulae • Mm. rhomboidei major at minor
R profundus (A. transversa colli) •
81 5
Fig. 8 1 4 Vessels and nerves of the occipital reg ion, Regio occipitalis, and the posterior cervical reg ion, Regio cervicalis posterior.
813
�
S ke le t o n
S u rfa ce
Back
Cervical part of the vertebral canal N occipitalis major L
N. occipitalis tertius
M. semispinalis capitis . M obliquus capitis superior .
• M. rectus capitis posterior minor
M. rectus capitis posterior major .
Os temporale, Proc mastoideus
A. vertebralis, Pars atlantica .
i.:�J�rJ�'\::�- '" N. suboccipitalis
N suboccipitalis
�==---+*..,.,.-+--'--- Atlas, Arcus posterior
M. obliquus capitis inferior • -----''''----'�
• M. obliquus capitis inferior
R posterior (C 2) "
N. occipitalis tertius .
• M. rectus capitis posterior major
Plexus cervical is •
• Mm. interspinales cervicis
Fig. 8 1 5 N e rves o f t h e posterior cervical reg ion, Regio cervicalis posterior, and the vertebral a rtery, A. vertebralis.
814
Sinus sagittalis superior .
Cisterna cerebellomedullaris Arachnoidea mater cranial is; Cerebellum Arachnoidea mater spinalis
:=j������S���f����li
_---...,.<.�
_�2��r!:fir"":"--:iIII! --��i-J�t;;:;;;;:"1;ii
Dura mater spinalis
Arachnoidea mater spinalis
M. scalenus medius • Vertebra cervicalis V. Proc. transversus
N . cervicalis [C7l, Fila radicularia posteriora
.1��£:���;j�I�t.;�F
_ _
N. suboccipitalis
Proc. transversus atlantis • A. vertebralis N. occipitalis major
• N occipitalis tertius
+....:;-;;i-��-:j�Ii;.
N spinalis, R posterior
_ _
_-��;"7T�17�-:7�
Medulla spinalis --....:�,.--I
Fig. 8 1 6 Vessels a n d nerves of the deep posterior cervical region, Regio cervicalis posterior, a n d the content of the verteb ra l canal.
Lig denticulatum N . spinalis, R. anterior
N. spinalis, Ganglion sensorium
M u scles
To pogra p hy
S ec t i o n s p p . 29. 35
Lumbar part of the vertebral canal
vertebrae R. meningeus
Ganglion sensorium nervi spinalis
Radix anterior
�)�;:!.�;;:;;�'1
Truncus nervi sPinalis ---
R. posterior ----,"T'--:--H
Radix posterior
N. intercostalis
Canalis vertebralis Arcus vertebrae Proc. spinosus
R medialis
Mm. dorsi
(R. cutaneus lateral is)
(R. cutaneus medialis) Fig. 8 1 7 Spinal nerve. N . spinalis; i n the thoracic reg i o n. Lamina arcus vertebrae
,
" ,"""
(
Spatium epidurale
...,....:1... -- Vertebra lumbalis II. Proc. costalis
Garl(]llon sensonum
nervi spinalis
• M. quadratus lumborum
• Plexus venosus
R. anferlor
vertebralis internus posterior
R. posterior
Rr. dorsales (A.; V. lumbalis) • • Radices anterior et posterior
Dura mater spinalis
�"1L;>-- • Mm. intertransversarii
mediales lumborum
�����'�f.- Arachnoidea mater spinalis Pia mater spinalis
Lig. intertransversarium
Proc. articularis superior
Cauda equina
• M. intertransversarius
lateralis lumborum
R. anterior
• M. intertransversarius
medialis lumborum
Radix anterior
Radix posterior
Lig. iliolumbale
Dura mater spinalis
as sacrum, Pars lateralis
Arachnoidea mater spinalis
Spatium epldurale; Plexus venosus . vertebralis internus anterior
as coxae. as ilium
as sacrum, Proc. articularis superior Fig. 8 1 8 Vessels and nerves of the lumbar part of the vertebral canal. Reg i a l u m balis.
�
Back
S u rfa ce
Ve ins and nerves
S k e leton
of the lumbar part of the vertebral column Llg longltudinale poster!us Plexus venosus vertebral is externus anterior
(V. basivertebral is) Plexus venosus vertebralis internus anterior
Plexus
venosus vertebralis intern us posterior
Plexus venosus vertebral is extern us posterior
-----''----<..B
V. lumbalis ascendens
-L��--\���y--:
_ _
Fig. 8 1 9 Vei n s of the vertebral canal, Canalis verte bralis; venous plexus.
Discus intervertebralis, Anulus fibrosus
Lig. longitudinale anterius
Lig longitudinale posterius
---.."jj'f--+-'-'
R. meningeus
Ganglion trunci sympathici
Capsula articularis
H�+-- R. communicans albus
;�-�----:-:--m
_ _ _
'\l�;r--_ R. communicans griseus
....�.. --- R anterior
R. posterior (R. medialis) (R . lateralis)
Truncus nervi spinalis
Ganglion sensorium nervi spinalis
Fig. 820 Nerves of the ve rtebral colu m n , Colu m na vertebralis; somatic and a utonomous innervation .
M u scles
To pog ra p h y
S e ct i o n s p p . 2 9 . 35
Vessels and nerves of the vertebral canal
N. spinalis, Radix anterior
Truncus nervi spinalis, R Truncus nervi spinalis, R. anterior Epineurium
��j;;'i�!������.��f-
Truncus nervi spinalis, R posterior
Ganglion sensorium nervi spinalis Spatium subarachnoideum
Ganglion sensorium nervi spinalis Dura mater spinalis
-JFCI.,;;;i1iiiil Dura mater spinalis
Spatium epidurale; Plexus venosus vertebral is internus posterior
N. spinalis, Radix posterior Pia mater spinalis Arachnoidea mater splnans
I � 599ff I
Fig. 821 Content of the verteb ra l canal, Canalis vertebra lis; cross-section at the level of the fifth cervica l vertebra.
Lig. longitudinale posterius
Filum terminale
Plexus venosus vertebral is internus anterior Truncus nervi spinalis, R. meningeus
Cauda equina
Ganglion truncI sympathici
N. spinalis, Radix anterior
Truncus nervi spinalis, R. communicans
�-':::.,--::" - Ganglion sensorium nervi spinalis
Truncus nervi spinalis, R anterior
Truncus nervi spinalis, R.
N. spinalis, Radix posterior
Spatium subarachnoideum
(Spatium subdurale)
Dura mater spinalis
Spatium epidurale
Fig. 822 C o ntent of the vertebral canal, Canalis vertebralis; cross-secti o n at the level of the third lumbar vertebra .
I � 599ft I
�3
S u rfa c e
... Back
Lumbar and sacral puncture
Vertebra lumballs III �- ��
�
�
Fig. 823 Lumbar pu ncture to obta i n cerebrospinal fluid. Liquor cerebrospinalis. o r for lumbal a naesthesia; position of the patient.
Cauda equina Plexus venosus vertebralis internus posterior Vertebra lumbalis III, Proc. spinosus Lig interspinale --....,.rt:7��
Arachnoidea mater spinalis
,.....-"'''0::----;'- Dura mater spinalis ""r:--:'--_ Lig. flavum
Lamina arcus vertebrae IV
1-7 8181
Fig. 824 Lumbar pu ncture ; g u idance of the punct u re needle.
Fig. 825 Sacral pu nctu re ; g u i d a nce o f t h e puncture needle.
S ke le t o n
M u scle s
Sec t i o n s pp. 2 9 , 3 5
To pog raphy
Vessels and nerves of the vertebral canal
N. spinalis, Fila radicularia
Q
D'5
Dura mater spinalis
Arachnoidea mater spinalis
• A. spinalis anterior, R. radicularis anterior
Proc. articularis superior Lig. dentlculatum Ganglion sensorium nervi spinalis
Spatium subarachnoideum
Arachnoidea mater spinalis
Rr. spinales . (A intercostalis posterior)
• Plexus venosus
vertebralis internus anterior
Fovea costalis processus transversi --_u.._ R. interganglionaris
Truncus sympathicus; • Rr. communicantes
------==�?'tlliil g'll
longitudinale ":::!::::l! :: ��;:"";��.J.�:;;---- Lig. posterius
fIL----- Corpus vertebrae
Ganglion trunci sympathici • ---1---+'==--;;--
1!:II"..r---- Lig. longitudinale anterius
I � 599 ff I
Fig. 826 Content of the verte b ra l canal, Canalis verte b ralis; thoracic portion after stepwise exposure; ventral view.
R
menlngeus
Radix posterior
Radix anterior
Spatium subarachnoideum
Truncus nervi sp,nalis (L3)
a
Fig. 827 a, b I ntervertebral foramina, Fora m i na interverteb ralia; lu m ba r part of the ve rtebra l colu m n .
b
Viewed from the left b Sag ittal section
a
Discus intervertebral is, Anulus fibrosus
�
T h o ra c i c a n d a bd o m i na L wa LL
S u rface
Surface anatomy Incisura
Articulatio sternoclavlcularis
Jugularis
Clavicula, Corpus
Angulus sterni ....o\-...
� p
Angulus infrasternalis
Arcus costal is
l--"-�"""�'---___ -- -""'iii---- Anulus umbilicalis Spina iliaca anterior superior
Fig, 828 S u rface a natomy of the thoracic and abdominal wall of a young woman.
M. pectoralis major ---i--........ .. .
-
M. serratus anterior M. obllquus exlemus abdominls Spina illaca anterior superior
...
-; �
-- -\---
+-�
Fig. 829 Su rface a natomy of the thoracic a n d abdominal w a l l of a y o u n g m a n .
Linea alba M. rectus abdominis, Intersectio tendinea
S ke leton
M u sc le s
O rg a n s
To p o g ra p h y
Sect i o n s
I
1 047 I
SkeLeton of the trunk
1
Extremitas sternalis Corpus
Incisura jugularis Extremitas acromralls Acrom
Proc. coracoideus
oot--+---Corpus sterni
\:-
� -
�2-::-�"",-�-",:,:,""'4...
--==.:...!. :-.' -----, -
TuberclJlum maj!JS
Tuberculum minus
Cos!a li
Proc xiphoideus
ClavIcula
------�--'-+_'::_--=-_=_-_,c_-...:...""
Angulus infrasternalis
-----iL-p��==���====----'\
Arcus costalis
..."....l. --- Crista III�ca ..'l----
..,�::.,;..__�_�t.;...�*+
Spina
__
Fig. 830 Proj ection of the skeLeton onto the thora c i c and abdominaL waLL
mata anterior superior
Tuberculum pubicum
�
T h o ra c i c a n d a b d o m i n a l wa ll
Skeleton
S u rface
Skeleton of the trunk
Vertebra cervicalis VI
Cosla l
Vertebra Ihoracica I
Costa II --
Cavilas glenoidal is
....,.+-- Scapula
Coslae verae [I-VII]
Cosla VI
/" �'I--- Cosla VII Costa VIII
Coslae spuriae [VIII-XII]
'","',"-
-
Vertebra lumballs I
Fig. 831 Thoracic cage, Cavea thoracis, a n d Left s h ouLder g i rd Le, C i n g u Lu m pectoraLe.
Costa XI
M u scles
Organs
To p o g r a p h y
Sections
Caput costae
Tuberculum musculi scaleni anterioris
�-ii�f--- Sulcus venae subclaviae
Collum costae ---+�
Collum costae, Crista colli costae
Tutmrculum
costae
Corpus costae
Angulus costae
caput costae
Tuberositas musculi serrati anterioris
---J�
Collum costae
Fames
articulans tuberculi costae
Tutmrculum costae
Angulus costae
Corpus costae
Facies articularis --.,." capitis costae
Crista colli costae
--+!i'!
Facies artlcutaris --Hlh" tutmrculi costae
VIII
Fig. 832 R i bs, Costae ; I . - I I I . rib, superior view; VI I I . rib, i nferior view.
Crista capitis costae Collum costae
Tuberculum costae
�
S u rface
T h o ra c i c a n d a bd o m i n a L wa LL
Sternum
Incisura jugularis
Incisura clavicularis
Inc!sura clavlculans
�j/---- Manubrium sterni -----t-1
Incisura costalis I Incisura costalis II
-�;J;::'�".�--- Symphysis
manubriosternalis
Incisura costalis III
�t:S.I�- Incisura costalls I
Angulus sterni -----ii' ..�
Incisura coslalls II
Incisura costalis III
!'7-:.'RI------ Corpus sterni ----i-'
Incisura costalis IV
Incisura costalis IV
Incisura costa lis V
.�..-t--
Incisura costalis VI
Incisura
U"P.l�--
Incisura costalts VII --........ ...
costalls V
Incisura costalls VI Inolsura costalls VII
,�'4....E.;l!I-- Symphysis
xiphosternalis
';:..:;.a--- Proc. xiphoideus ------+.--:
Fig. 833
Sternum, Stern u m .
Fig. 834
Sternu m , Sternum.
Skeleton
M us c le s
O rg a n s
To p o g ra p h y
Sections
Sternum
Synchondrosis I
ccslae
Cartilago costalis I
---- Manubrium sterni 'U � � � � k ' i � � ���
'1��������:;:J--
Symphysis manubriosternalis
���������---�rJ
_ _
Cartilago costal is III
Lig. sternocostale intraarticulare
Corpus sterni ����'Im�'h�,-----
�.J.l."�I1..� , �----''---f-- Articulationes sternocostales
Cartilago costal is V
Cartilago costal is VII ----IfiJII��., ·
Fig. 835 Sternum, Stern u m , and costa l cart i lages, C a rtila g i nes costales; section.
Lig interclaviculare
Clavicula ------:;--
Lig costoclaviculare
---:l��f.;;:'.
Lig costoclaviculare
Capsula articularis Lig. sternoclaviculare anterius
Symphysis manubriosternalis
Fig. 836 Sternoclavicula r joint, Art i c u latio sternoclavicularis.
�
T h o ra c i c a n d a b d o m i n a L wa LL
S u rfa c e
S ke leton
Muscles of the thoracic and the abdominal wall
Spina scapulae
----,:+'_�"' (
M. infraspinatus --*",",�I M teres minor -��-h'l
;.;.:.;:.r---- M pectoralis major, Pars sternocostalis
M. teres major -����.:w ��.
{
M. deltoideus
Corpus mammae, Lobi glandulae mammariae IMI'--- Papilla mammaria
.."'{5--r,rr.:i��-- M serratus anterior
· s brach"II Caput laterale M . tncep caput longum;
",","--- M pectoralis major, Pars abdominalis
M. biceps brachii
M latissimus dorsi ---;.1r;,:...�:, M. obliquus externus abdominis --�f!Io.:"';;--F���';
Arcus costalis
:.�JL--- Anulus umbilicalis
Fascia thoracolumbalis --...,.....,.. Trigonum lumbale
Spina iliaca posterior superior (Fascia glutea)
----2'---? -n:-
--:
---f-tii:..:...,...-'--:--
'. 11-__ V1101rla
.
musculi recti abdominis, Lamina anterior
""'._-- M obliquus externus abdominis, Aponeurosis
Spina iliaca anterior superior
M. gluteus maximus ---?::'''''�''
I� T
1 5,
T 1 7, T 1 8, T
26 1
M. tensor fasciae latae M. sartorius
Fig. 837 Muscles of the thoracic and the abdominal wa ll, Mm. thoracis et abdominis.
M uscles
O rg a n s
To p o g ra p hy
1 05 3
S e c tio ns
Muscles of the thoracic and the abdominal wall
Mm sternocleidomastoidei
Trigonum clavipectorale
Platysma Fascia clavipectoralls Fascia brachii
Fascia axillaris
M. pectoralis major, Pars clavicularis
M. pectoralis major, Pars sternocostalis
M. serratus anterior M. latissimus dorsi
Ligg. costoxiphoidea
M pectoralis major,
Pars abdominal is
Linea alba
M. obliquus externus abdominis Anulus umbilicalis
--III-"''+����(''''�:i---....!:���R
Vagina musculi recti abdominis, Lamina anterior
Tela subcutanea; Panniculus adiposus
Fibrae intercrurales
Crus medlale
M obliquus externus
abdominis, Aponeurosis Lig. reflexum
Funiculus spermaticus Lig. fundiforme penis
suspensorium penis
Fig. 838 M u scles of the thoracic and the abdominal wa ll; superficial layer.
1 � T 1 5, T 1 7, T 1 8, T 261
�
S u rfa ce
T h o ra c i c a n d a b d o m i n a l wa ll
S k e leto n
Muscles of the thoracic and the abdominal wall M sternocleidomastoideus
M pectoralis major, Pars clavicularis M intercostalis internus
M, pectoralis minor
M deltoideus
Plexus brachialis, Pars infraclavicularis
M, coracobrachialis M biceps brachii, Caput breve
M pectoralis ----,,..----F
A. axillaris
major
M pectoralis minor
M. serratus anterior
Costa II
M latissimus dorsi M serratus anterior
M_ pectoralis major, Pars abdominalis
M, pectoralis major, Pars sternocostalis M. obliquus externus abdominis
1--7 T
1 3,
T 1 5, T
26 1
Fig. 839
M u scles of the thoracic wall, M m , t ho racis,
M serratus anterior ---=--t-'�:'t-infll.l1.:i''1I
\ "j \ 1
I
-
M, intercostalis internus
t-
-
iiHt--- Costa VIII
rr�"J�l.'Jlrt.�f.1iIi!!I---- N. intercostal is (T8)
-:7:-:'r":��� ojjM�
-: �
M intercostalis externus --7-+-"':"='-::-�*lr-r-::7HIII�JI.\ Costa IX
V, intercostal is posterior
�N"-- A. intercostalis posterior
---r--�-:'4IfIHtfM'H"
Pleura visceralis [pulmonalis]
Pleura parietalis, Pars costal is Pleura parietalis, Pars diaphragmatica Pars costal is diaphragmatis
Hepar
Peritoneum viscerale Peritoneum parietale Costa X
---+-....:..'"":'-�fflffr��
Recessus costodiaphragmaticus
Fig. 840 M u scles of the t horacic wall, M m . t h oracis; frontal section, •
Position of the needle for puncture of the pleural cavity [pleurocentesisl
M uscles
O rg a n s
To p o g ra p hy
Sections
Muscles of the thoracic wall
Tuberculum anterius [caroticum] (Vertebra cervical is VI)
M . scalenus posterior M M.
scalenus
medius
scalenus anterior
-���'-�illiI\·
M. scalenus anterior
--�---..
M longus colli
Membrana intercostalis interna
Ih\l��"-"=""""I&''\---
MembrarJa
w.;�m�:""':;':-"'ffl:.r.,jlic---
Mm. Intercostales interni
Infercostalis intern a
Mm. inlercoslales
externl
}:.���r--- Mm mtercustales ,nterm Lig longitudinale anterius
Fig. 841 Thoracic cage, Cavea thoracis; posterior wall.
I-7 T 1 1 -T 131
Cartilago costalis I M. sternothyroideus Manubrium sterni
Mm intercostales interni
Corpus stern!
M. transversus thoracis
I- Diaphragma, tendineum s;.ij��:;������Sl��I Centrum Foramen venae cavae
..
�.,�:::c;......,.�""!:;�_ ;;;o
Mm. intercostales interni Proc. xiphoideus
Fig. 842 Thora c i c cage, Cavea thoracis; anterior wall.
�
T h o ra c i c a n d a b d o m i n a l wa ll
S u rface
S k e le t o n
Abdominal muscles
Ugg. costoxlpholdea
M. pectoralis maj or. Pars sternocostalls
M. serratus anterior
M. pectoralis major, Pars abdominal is
Vagina musculi recti abdominis, Lamina anterior
M. obliquus externus abdominis
M. rectus abdominis, Interseetio tendinea
--P........
Mm. intercostales interni
M. rectus abdominis
M. rectus abdominis
M. obliquus externus --&:: 1\"" abdominis .....
Anulus umbilicalis
-.#,r----.-:-l��m�iil��1ti
Spina Illaca amerlor superior
M . Obllquus internus abdomlnls
Anulus Inguinalls superfioialls
{
M. obliquus externus abdominis, Aponeurosis crus latarals Funiculus spermatieus; M. cremaster
Crus med,ala
M pyramidalis
I -7 T 1 3-T 1 5, T 1 7, T 26 1
Lig. reflexum
Fig. 843 M uscles of the abdominal wall, M m . abdominis; s u perficial and m iddle layer.
M uscles
O rg a n s
To p o g ra p h y
1
Sections
Abdominal muscles
'0 5 7
M. pectoralis major
M, serratus anterior
M, latissimus dorsi
M obliquus externus abdominis Mm intercostales externl
.�.'-- Vagina musculi
Mm intercostales interni
recti abdominis, Lamina anterior
Cartilago costalis X
M. rectus abdominis
M. obliquus externus abdominis
....._'--- Vagina musculi reatl abdomlnls, lamina anterior
M
Anulus inguinalis superficialis
Funiculus spermaticus; M . cremaster
Fig. 844 M uscles of the abdominal wall, M m . abdominis; m iddle layer.
1 -7 T
1 3 -T 1 5 ,
T 17
1
�
S u rface
T h o ra c i c a n d a b d o m i n a l wa ll
I
S k e leto n
I
Abdominal muscles
Mm. intercostales ---f;-IhIIIr"--J"". externi Mm. intercostales interni
M. latissimus dorsi
::: _��'--... -+:...J!;..;: .;j ::::�
M serratus anterior M obliquus externus abdominis
-+'-:'I.�'!r�1 Mm. IntercoSlales externl
CarUiagines costales
Costae
-���«'�1'�
M. obliquus extern us abdominis
IX: X
Vagina musculi recti abdominis, Lamina posterior
M obliquus internus abdominis
Linea semilunaris
M. transversus abdominis
M. Ira nsversu s abdominls
Linea arcuata
Vagina musculi recti abdominis, Lamina anterior
rij"77��=-------:l-- Anulus
inguinalis superficial IS, Crus mediale
Fascia transversalis
Anulus inguinalis superficial IS, Crus laterale
Funiculus spermaticus
I � T 1 3-T 151
pyramidalis
Fig. 845 Muscles of the a b d o m i n a l wall, M m. abdominis; deep layer.
M uscles
O rg a n s
To p o g ra p h y
Secti o n s
Abdominal wall
Lig. falciforme
Diaphragma
Diaphragma
Lig. teres hepatis
Umbilicus Peritoneum parietale
--tlHlfH
Linea arcuata
---\oA�
Fascia transversalis
----'tIi'i�
Fossa inguinalis lateralis
---T
Fossa inguinalis medialis Fossa paravesical is
_ ..:::o.�� _
Fig. 846
I nternal su rface of the anterior abdominal wa ll.
I � T 1 4. T 1 5 . T 2 1 1
�
S u rfa c e
Th o ra c i c a n d a b d o m i n a l wa ll
S k e leto n
Inguinal canal
M. obliquus extern us abdominis M. obliquus externus abdominis, Aponeurosis
---J,��t"l��
'!i�§���:
"
.;;=.�:ff�;T��eS?:7��I-- M
obliquus externus abdominis, Aponeurosis
M. obliquus --1�....-=t: .. = �¥1� internus abdominis
Lig. inguinale
; --'-'=-�..,.;..:> : � M cremaster --I--"';:':':"'::o..; Lig . reflexum
1
r7:-;�7"=----.J,JL_ Fibree Inlercrurales
-It=
'"!i;x����\'.lL _
-
Crus laterale
Anulus Inguinalls superflcialls Crus mediale
Lig. fundiforme penos
Funiculus spermaticus
Fig. 847
S u perfic i a l i n g u i n a l ri ng. Anulus ingu inalis s u perficialis.
M. obliquus externus abdominis, Aponeurosis M. obliquus internus abdominis
M. transversus abdominis N . ilioinguinal is
Fascia transversalis
A ductus deferentis
:====�====���;�li!�I� �����!� . � --:-�-...l.r---
------��,-:-;
���::::;::7'O<::'----'--.:.-- N. ilioinguinalis
�------....:..-- Anulus inguinalis
Plexus pampiniformis
superficialis
N. genitofemoralis,
R genitalis M
A.; Vv. epigastrica(e) inferior(es)
---,.:-----r.-..:.;.--:-- Fascia transversalis
....� ..: ..!..-.:._:_!:
_ _ _ _ _ _
Ductus deferens
Anulus inguinalis profundus
Lig. reflexum Lig
Fig. 848
N genitofemoral is.
Fascia spermatica ex(ema
Walls of the i n g u i n a l canal.
R. genitalis
M uscles
O rg a ns
To p o g ra p h y
S e ct i o n s
Inguinal canal and inguinal hernias
Fascia transversalis M transversus abdominis M obliquus internus abdominis M. obliquus externus abdominis (Fascia superficialis) M obliquus externus abdominis, Aponeurosis
=:j�:::S�a;:��
-
--;;;:.... ::, ...
-
Lig. umbilicale medianum (Chorda urachi) A. epigastrica inferior
"���:;:::;�����i1�;:=���f=:::::;;��
Fascia spermatica externa
Fascia cremasterica; M cremaster
(Proc. vag/nails pentonei parsislens)
Fascia spermatica interna Ductus deferens
Septum scroti
Epididymis Testis Fig. 849 D i a g ra m of the i n g u i na l canal. The i n g u i n a l canal, the spermatic cord and the scrot u m a re i llu strated in the sa m e plane for d idactical reasons.
1 Fossa supravesicalis 2 Fossa inguinalis medialis 3 Fossa inguinalis lateralis
3
Fascia transversalis M. transversus abdominis M obliquus internus abdominis
_j�ii.::���
(Fascia superficialis)
A epigastrica inferior A. epigastrica inferior
M. obliquus externus abdominis
�b-�=:------- Anulus inguinalis superficial is
�"7'T--- Fascia spermatica externa
Fascia transversalis
(Proc. vaginalis peritonei), Peritoneum parietale
Fascia spermatica interna
Fascia cremasterica; M. cremaster
Fascia spermatlca externa
Fig. 850 Diagram of i n g u i nal hernias; left side: lateral. i n d i rect hern i a ; right s i d e : medial. d i rect hern i a .
Fascia spermatica interna Cavitas serosa scroli Hernial sac with an intestinal loop Peritoneal space ••• Newly formed peritoneal hernial sac
�
S ke le t o n
S u rfa ce
T h o ra c i c a n d a b d o m i n a l wa ll
Diaphragm and posterior abdominal wall
Pars sternalis diaphragmatis Pars costalis diaphragmatis Oesophagus. Pars abdominalis Hiatus oesophageus
Centrum tendineum
H iatus aorticus Truncus coeliacus
Pars coslalis doaphragmabs -"-iIP!':-��"
Pars abdominalis aortae
Pars lumbalis ---lII"-:':alS::. diaphragmatis, Crus dextrum
Lig. arcuatum -��:c. mediale
Lig. arcuatum laterale
-i:::.lL--- Fascia transversalis
(M. psoas minor)
10.---- Vertebrae lumbales I I I : IV
(M. psoas minor), Tendo
M
M. psoas major
M. iliacus
Promontorium
Peritoneum
vasorum
parietale
Rectum Lig. inguinale Vesica urinaria
M. rectus abdominis
1-7 T 1 5, T 1 6 , T 2 1 , T 42 1
Fig. 851 Diaphra g m , Dia p h ra g m a , and m uscles of the abdominal wall, Mm. abdom i n is.
M uscles
O rg a n s
To p o g ra p hy
S e ct i o n s
Diaphragm
Pars sternalis diaphragmatis
Vv. phrenicae inferiores
Proc. xiphoideus (Trigonum sternocostale): A.; V. thoracica interna, N. phrenicus sinister, R. phrenicoabdominalis
Centrum tendineum
Hiatus oesophageus: Oesophagus; Trunci vagales anterior et posterior N. phrenicus Sinister,
R. phrenicoabdominalis
Foramen v cavae: V. cava Inferior
A phrenlca inferior
N. phrenlcus dexter, R phrenicoabdominalis
N. splanchnicus major
Pars costal is diaphragmatis
V
Lig. arcuatum medianum
hemiazygos
(Trigonum lumbocostale)
Pars lumbalis diaphragmatis, Crus dextrum, (Pars lateral is)
N, splanchnicus minor
Lig arcuatum laterale
Hiatus aorticus: Aorta abdomi· nalis; Ductus thoracicus
Costa XII
M. quadratus lumborum
M. psoas major
Lig arcuatum mediale
Truncus sympathicus
Fig. 852
Pars lumballs diaphragmatis, Crus dextrum, (Pars medialis)
Dia p h ra g m , Diaphra g ma.
Oesophagus, Pars thoracica
Pleura parietalis, Pars diaphragmatica M latissimus dorsi ,g�;�.... Costa VIII --�«aW" Costa VII ---fiM;\ol'11.� M. serratus anterior ----l-,H !JlWO _ _
Gaster, Pars cardiaca
Pars lumballs diaphragmatis, Crus sinistrum, (Pars lateral is)
Costa VI -- ....�!}ltU
M rectus abdominis -
Hiatus aorticus
-it1:'f,-���:?t,- �-..�� -
-
(Trigonum lumbocostale)* Lig arcuatum laterale**
Costa VIII
Costa XII
M. obliquus extern us abdominis
M. transversus abdominis Pars lumbalis diaphragmatis, Crus sinistrum, (Pars medialis)
M. psoas major
M, quadratus lumborum
Vertebra lumbalis III, Proc costalis
(M psoas minor) Fig. 853 Diaphra g m , Diaphra g m a , with apert u res a n d m uscles of the poste rior abdom inal wall. Cli nical term: BOCHDALEK's t ri a n g le ** Psoas a rcade
•
l-j T 2 1 I
�
S u rfa ce
T h o ra c i c a n d a b d o m i n a L wa LL
Skeleto n
Breast
M. pectoralis malor
Papilla mammana Areola mammae
M pectoralis major
--....::-�
Areola mammae
----=----
Papilla mammaria
Glandulae areolares
M. serratus anterior
Fig. 854
B reast, M a m ma.
Fig. 855
Breast, M a m m a .
Papilla mammana
Ductus laclileri Papilla --_--'��... mammaria Sinus lactilerus
Lobuli glandulae mammariae
Fig. 856
B reast, M a m m a , of a p regnant woman .
Fig. 857
B reast, M a m m a , of a p regnant wom a n .
M u s c le s
O rgans
To p o g ra p hy
Sections
Breast
Fig. 858 Radiogra p h o f t h e breast, mammogra p hy, of a 47-yea r-old woman .
Nodi Iymphoidei cervicales anteriores, Nodi profundi Nodi Iymphoidei supraclaviculares
Nodi Iymphoidei deltopectorales
Nodi lymphOidel --40----.:::?"7I axillares
Nodi Iymphoidei --+---c:;;z:= brachiales
Nodus Iymphoideus --+-----I-\-.QI paramammanus
(Nodl lympholdel submammanl)
Fig. 859 Lymphatic d ra i nage of the breast and location of the regional lym p h nodes,
Nodi Iymphoidei parasternales
�
T h o ra c i c a n d a b d o m i n a l wa ll
S k e Leton
S u rfa c e
Vessels and nerves of the wall of the trunk
Nn. supraclaviculares; A ; V. cervicalis superficial is • •
• V. cephalica
Plexus venosus areolaris • A; V. thoraclca lateralis; • • N thoracicus [T2], N. intercostalis, R. cutaneus lateralis pectoralis V, thoraco- . epigastrica
+--
-
�� -*i""..a5ll1 "
•
-
• • A. ; V. epigastrica supenor
T3
T4
T6
Nn thoracici, Nn intercostales, Rr cutanei laterales pectorales
T7
---iIlltm8�*
T8 --4tII=lI5�
• M. obliquus externus abdominis
T9
Vv subcutaneae abdominis .
thoraclcl. Nn intercostales, Rr, cutanei anteriores abdomlnales
Nil.
-"1tt..u..."'&f1M��;:":-
Anulus umbilicalis
A ; V. circumflexa ilium superficialis • • N,
Chorda arteriae umbilicalis
• • A; V. epigastrica inferior
genitofemoral is, R femoralis
A ; V. epigastrica • • superficial is
Nn. thoraclci, Nn. intercostales, Rr cutanei anteriores pectorales
r-------�N.dl��iIl�l�
A. pudenda externa; . -__ Vv pudendae externae • N. femoral is, R cutaneus anterior
V. saphena magna .
Fig. 860 •
Vessels a n d n e rves of the thora c i c a n d the abdominal wall.
C l i nical term: i nternal m a m m a ry a rtery
" N. iliohypogastric us, R. cutaneus anterior
M u scle s
O rg a n s
Topogra phy
Sections
Segmental innervation
Fig. 861 Seg mental sensory innervation of t h e a nterior thoracic and a b d o m i n a l w a l l [dermatomesJ.
T6
Oesophagus (T4, TS) Cor (TIl, T4)
Intestinum tenue (T10)
Fig. 862 Segmenta l sensory innervation of the anterior thoracic and abdominal wall. Regions to which pain from diseased viscera [zones of H EAD ) is referred to a re i n dicated in g rey.
�
S u rface
Th o ra c i c a n d a b d o m i n a l wa ll
M u scles
S ke leton
Lumbosacral plexus
Pars lumbalis diaphragmatis, Crus dextrum • -
-:"' ,..;.;
-
Lig. arcuatum laterale
M quadratus lumborum .
::;:...
-
,.:;j!P'
--.., -
.. ....""'7 . ==::............
"-'-:o
=
r
"1iIi::��tr::--7,"�--- • N. subcostalis
=,.:J.!o.:.I
-"--,'
.. - • N iliohypogastricus ..:. :�.......-.."..�-;,�.;-;--,:-......
N subcostalis 'I: --�""
" -':::-:--:ilf-"�- • N. ilioinguinalis �...\\r"":"-
N. iliohypogastricus
.. c-:--'-l!'ot't----'-IIH•..,.f-lJ.:.:>.>--....� M, obliquus • externus abdominis
Plexus lumbalis
�l���=::§::,��1t1f}'-- .. Truncus sympathicus
M. obliquus • internus abdominis N. cutaneus femoris lateralis N
It
• Truncus lumbosacralis
femoralis _
N. genitofemoral is,
R femoralis
N genitofemoral is,
R. genitalis
•
• N . cutaneus femoris lateralis R genltalis
N cutaneus femoris lateralis
R. lemoralis
N
N , femoral is, ;; Rr cutanei ante rio res N.
1-7 47,
HO
1
genitofemoralis, Rr. genitales _
Fig. 863
Funiculus spermaticus
Lum bosacral plexus. Plexu s lumbosacralis.
N.
obluratoflus, R. anterIor
1
N.
genoo-
femoralls
O rg a ns
To pog ra phy
Secti ons
I Vessels of the anterior wall of the trunk
Manubrium sterni
j
Costa
• • Rr. intercostales anteriores • • A.; V. musculophrenica
A. thoracica interna, • Rr. intercostales anteriores
• • A. ; V. epigastrica superior • Diaphragma
A eplgastrlca . superior Fascia transversalis M. rectus abdominis Vagina musculi recti abdominis, Lamina posterior
'.u:....----,.y.-- • V. epigastrica inferior
Fig. 864 Vessels of the a nterior t ho racic a n d abdomi nal wall.
��dL..._ . • A iliaca externa
A carotis communis dextra
F�':""-- A. subclavia dextra
f\i:"":'�-- A. thoracica interna
Pars thoracica aortae ---!-----I\---:-...:; [Aorta thoracicaj
Pars abdominalis aortae [Aorta abdominalisj Fig. 865 Diagram of the collatera l c i rculation via the i nternal thoracic a rtery, A. thora cica i nterna, the superior epi gastric artery, A. epigastrica s u perior, and the i nferior epigastric a rtery, A. epigastrica i nferior, in the case of aortic occlu sion ; viewed fro m the right.
�1
A. epigastrica superior
---!. -
M rectus abdominis A. epigastrica inferior
�..f.j�-- A. iliaca externa
...�-/--- Lig. inguinale il--=-+-- A. femoralis
�
S u rface
T h o ra c i c a n d a b d o m i n a l wa ll
S ke le t o n
Abdominal wall of a neonate
• • A. ; V. epigastrica
superior
N. thoracicus [TB], N intercostal is; A. ; V. intercostal is N. thoracicus [T9], • • N. intercostalis; A ; V. intercostalis
Vagina musculi recti abdominis, Lamina posterior Funiculus umbilicalis Cartilago costal is VIII
Va�ina musculi recti abdominis, Lamina anterior
N. thoracicus
••
N. thoraclcus
••
[T10], N. intercostalis; A ; V. intercostal is [T1 1], N intercostalis; A ; V intercostalis
• M obliquus extern us abdominis
• V. umbilicalis • Aa umbilicales
M obliquus . externus abdominis Linea arcuata
Cutis
N thoracic us [T12], N. intercostalis
Anulus
umbilicalis
Vagina musculi recti abdominis, Lamina posterior
• A vesicalis superior
Anulus ---:�====.:::::3i....�eio._-< inguinal is superficial is
Vesica urinaria
M obliquus . internus abdominis
Spatium retropubicum
Fascia spermatica interna
Fascia spermatica externa •
M obliquus externus abdominls, • Aponeurosis A testicularis .
Plexus pampiniformis • Ductus deferens
Tunica vaginalis testis, Lamina parietalis
Fascia spermatica Interna Tunica dartos. M dartos .
Fig. 866
• Fascia spermatica externa (Gubernaculum testis)
Ante rior abdominal wall of a neonate.
M uscles
O rg a n s
To pogra p hy
Sect i o n s
Inner contour of the anterior abdominal wall
M. rectus abdominis
Ug . talciforme
Lig. teres hepatis; V. umbilicalis
Fossa supravesicalis
Linea arcuata
Fossa inguinalis medialis
Plica umbilicalis mediana Plica umbilicalis medialis
Fossa inguinalis lateralis
Plica umbilicalis lateral is
Anulus Ingulnalls profundus
Plica vesical is transversa
A.: V. testicularis
M iliacus
A. ; V iliaca externa A umbilicalis Ampulla ductus deferentis Fig. 867
-i:!iil!!!!l�--_ Os ilium
A ; V. iliaca externa Ureter, Pars pelvica
Anterior a b d o m i n a l wa ll of a neonate.
Lig falciforme (hepatis)
M. obliquus externus abdominis Linea arcuata Plica umbilicalis mediana
Chorda arteriae umbilicalis
:"--..;:.���--Jwt:l"'--- M rectus abdominis
Plica umbilicalis medialis
:ct'��
Plica umbilicalis lateralis
,...,H-.":"'�--- A.; V. epigastrica inferior
M. iliopsoas
A. ; V. femoral is
__
Fossa inguinalis lateralis
�����I./--- N femoral is
+���-..:
Anulus inguinalis profundus
_���r.::-"'"�
Arcus iliopectineus Vasa testicularia
Fossa supraveslcalis
Ureter
Vesica urinaria
Fig. 868 Anterior abdominal wall, i nternal aspect.
N. obturatorius; A ; V. obturatoria
Lig. interioveolare
�
S ke Leton
S u rface
T h o ra c i c a n d a b d o m i n a l wa ll
Abdominal wall, sections
Tela subcutanea, Panniculus adiposus
Vagina musculi recti abdominis
Linea alba
M rectus abdominis A ; Vv epigastrica(e) superior(es) M, obliquus externus abdominis, Aponeurosis Vagina musculi recti abdominis, Lamina anterior M. obliquus internus abdominis
a
M obliquus extern us abdominis
������- M transversus abdominis
b
umbilicale medianum (Chorda urachi) M. pyramidalis
Vagina musculi recti abdominis, Lamina anterior
1SI�"
c
M. rectus abdominls
Chorda arteriae umbilicalis
M obliquus internus abdominis M. transversus abdominis
M transversus abdominis
M. obliquus internus _�_'"'�1I."1I\. abdominis M, obliquus externus abdominis
Vertebra lumbalis; Corpus vertebrae
psoas minor)
Ala ossis ilium Fascia thoracolumbalis
t 1�T
M longissimus thoracis
869a 869b 869c
1 4-T 1 6 , T 2 0 a , b, T 42
1
Fascia thoracolumbalis
Fig. 869a-c Muscles of the abdominal wall. M m . abdominis; horizontal sections.
M uscles
O rg a n s
To pog rap hy
Sect ions
A bdominal wall, sections
Diaphragma, Pars costal is • --+-:--�/!--,,r Costa VII --F-....n
.. . ....::; ---"F.,.-..r..." - • Diaphragma,
Centrum tendineum
Costa VIII --t-;!Jfl Costa IX
II."!:o"",,,L--- • • A; V. intercostalis;
:-:'ll1\1
'" N intercostalis (TB)
----l
Costa X ---+'--1L.
•
-
( )
N. subcostalis
Fascia transversalis
'-l�:-+-- Peritoneum parietale
1l"''i::�--
M obliquus externus abdominis • ---'iB"'t!�\.:'
M. obliquus internus abdominis • --�--...\ M transversus abdomlnis • Crista iliaca
M. tensor fasciae latae •
N iliohypogastricus
�,,*,:s--- . N ilioinguinalis
.t.-ii'-",",...z..;rr-- " N cutaneus femoris lateralis
ll ";-r. ,J;l.;;'+""i+lI\l�
M iliopsoas .
Symphysis pubica
•
..
N femoral is
• A femoralis
• V. femoral is
Fig. 870 Muscles of the abdom i na l wall. M m . a bdom i n i s ; frontal section.
871a :::��::���::: 871b M obliquus externus abdominis, Aponeurosis M. obliquus internus abdominis, Aponeurosis M. transverslJS abdommls. Aponeurosis M rectus abdornlnis
M. obliquus externus abdominis, Aponeurosis M. obhq uus Intemus abdominis. Aponeurosis; M . transversus abdominls. Aponeurosis
M,
M. obliquus internus abdominis obllquus exlarnus abdomlnis
Fig. 871 a, b Muscles of the abdominal wall, M m . abdominis; computed tomogra p h i c c ross-sections l eT].
)n(
t
110
T h o racic viscera
Heart
Tra c h e a
Heart
A. carotis communis sinistra
A subclavia sinistra
Truncus brachiocephalicus
Arcus aortae V. cava superior
Truncus pulmonalis
A. pulmonalis dextra
Pericardium serosum, Lamina parietal is
Pericardium serosum, Lamina parietalis
Auricula sinistra
��IO--- V. cardiaca [cordis] magna
", lo'!I!��-'Auricula dextra --fH-#-',"rY
A. coronaria sinistra, R. circumflexus
. :'. �------=:::.-.. . :;.:.,.=:�:i1'1-:z Conus arteriosus --rl1""'..........*' Atrium cordis dextrum --....,:r-:�
A. coronaria sinistra, R. interventricularis anterior V. interventricularis anterior
V cardiaca [cordis] parva
Ventriculus cordis sinister
A. coronaria dextra Ventriculus cordis dexter Pericardium serosum, Lamina visceralis [Epicardium]
Apex cordis
Pericardium serosum, Lamina parietalis Abb. 872
H e a rt. Cor.
Pericard i u m f i b ro s u m Pericard i u m s e ro s u m L a m i n a p a ri eta l i s La m i n a viscera l i s
}
P",wd " m
E p i c a rd i u m
Lungs
Oesophagus
Thy m u s
To p o g ra p hy
Sections
V. vertebralis
V. brachiocephalica dextra
Truncus brachiocephalicus
Aa intercostales posteriores
Pars descendens aortae [Aorta descendens]
Lig. arteriosum *** -���"',..." .,, "-"--"f--"'"
V. cava superior
Bifurcatio trunci pulmonalis
A. pulmonalis sinistra ---+.-....... ----''!';---
Pericardium
A. pulmonalis dextra Vv. pulmonales dextrae
V. cardiaca [cordis] magna
Atrium cordis sinistrum
A. coronaria siniSlra. R clrcumflaxus
Pericardium serosum. Lamina parietalis Vv. atriales sinistrae
Vv. ventriculi sinisln posteriores
Atrium cordis dextrum
Pericardium serosum
Sulcus terminalis
Lamma viscerahs [Epicardium!
V. cava inferior
Ventriculus cordis sinister
Sinus coronarius
Sulcus coronarius
V.
cardiaca [cordlsl media.
[V. Inlerventrlcularis posteriorI
Fig. 873 Heart, Cor, a n d g reat vessels; d o rsal view.
A. coronaria dextra. R. interventricularis posterior
Ventriculus cordis dexter
Arrow in the transverse pericardial sinus Dou ble arrows in the oblique pericard i a l sinus • • • Remna nts of the foetal d uctus arteriosus [BOTALLO's ligament]
�
T h o racic visce ra
Heart
Tra c h e a
Myocardium
Truncus pulmonalis
Sinus trunCI pulmonalls AU<1ctlla slnlstra
Atrium cordis dextrum
Ventriculus cordis sinister
Sulcus interventricularis anterior
Fig. 874 Myocard i u m , Myocard i u m ; ventral view.
Apex cordis
Aorta ----J:....: Bifurcatio trunci pulmonalis
Sulcus interventricularis posterior --= .--
A. pulmonalis dextra
V. cava superior
Vv pulmonales dextrae
Vv. pulmonales sinistrae
Atrium cordis sinistrum
Atrium cordis dextrum
V. cava inferior
Sinus coronarius
v
Fig. 876 Myocard i u m , Myocard i u m ; dorsoinferior view.
Sulcus interventricularis posterior
Fig. 875 Myocard i u m , Myocard i u m ; viewed from the apex o f t h e heart.
Lungs
Oesophag u s
Thym u s
To p o g ra p hy
Sectio n s
Valves of the heart
Valvula
Valva trunci pulmonalis
semllunarlS dex1ra
Valvula semllunarls
anterior
Valvula semilunaris sinistra
Valvula semilunaris sinistra
Valvula semilunaris dextra Valvula semilunaris posterior
Valva aortae
Trigonum fibrosum sinistrum
Trigonum fibrosum dextrum
Anulus fibrosus sinister ----'=----,4I�
Anulus fibrosus dexter
Valva atrioventricularis Cuspis posterior sinistra [Valva mitral is] Cuspis anterior
Cuspis commissuralis dex1ra
Valva atrioventricularis dextra [Valva tricuspidalis]
Fig. 877 Valves of the heart, Valvae cord i s ; superior view.
V. cava superior ---1-----1Valva aortae ---i:----j� Valva atrioventricularis dextra
Fig. 878 Contour of the heart, valves of the heart. a n d points of a u scultation p rojected onto the a nterior thoracic wall lcirc lesl.
Aorta valva trunci pulmonails Valva alrioventricularis
slnistra
The heart sounds a n d [where a p plica ble] the heart m u r m u rs a re s p reading in the d i rection of the a rrows.
�
T h o ra c i c viscera
H ea rt
Tra c h e a
Internal spaces of the heart Ostium atrioventriculare dextrum
Pars ascendens aortae
'-;;;'""ir:;1i'i;"f1i"r.-- Mm
pectinati
Auricula dextra
Foramina venarum mlnlmarum
A. coronaria dextra
Limbus fossae ovalis
Atrium cordis dextrum
Crista termlnalis atrli dextri
Valva atrioventricularis dextra. Cuspis anterior
Tuberculum intervenosum
M papiliaris septal is
Fossa ovalis
M papiliaris anterior Valva atrioventricularis dextra, Cuspis septalis
Valvula venae cavae inferioris
Ostium sinus coronarii Septum interventriculare, Pars muscularis
Valva atrioventricularis dextra. Cuspis posterior
Mm papillares posteriores
Trabecula septomarginalis
Ventriculus cordis dexter
Fig. 879 R i g ht atri u m , Atrium cord i s dextrum, a n d right ventricle, Ventriculus cord i s dexter; ve ntral view.
V. cava superior
---j;;6:::;;�
Vv. pulmonales dextrae Septum interatriale
Limbus fossae ovalis
Fig. 880 R i g ht atri u m, Atrium cord i s dextru m , of a neonate; ventral view from the right.
Pericardium serosum. Lamina viscerairs [Epicardium]
Auricula dextra
Valva atrioventricularis dextra [Valva tricuspidalis]
"""::---- Ostium atrioventriculare dextrum
Lungs
O e so p h a g u s
Thymus
To p o g ra p hy
Sections
Internal spaces of the heart V pulmonalis sinistra superior Vv pu Imonales dextrae V cardiaca [cordis] magna
Atrium cordis sinistrum, Septum interatriale
Anulus fibrosus sinister Ostium atrioventriculare sinistrum
V. pulmonalis sinistra inferior
Valvula foraminis ovalis (Falx septi)
M. papillaris anterior -_....-'1M
Anulus fibrosus sinister
Valva atrioventricularis sinistra, Cuspis posterior
Pericardium serosum, Lamina visceralis [Epicardium] Ventriculus cordis sinister
Fig. 881 Left atri u m , Atr i u m cordis s i n istru m , and left ventricle, Ventriculus cord i s s i n i ster; latera l view.
Chordae tendineae
M. papillaris posterior Myocardium
Septum interventriculare, Pars muscularis
Trabeculae carneae
Lunula valvulae semilunaris
Truncus
A. coronaria sinistra, R. interventricularis anterior Septum interventriculare, Pars membranacea Myocardium Chordae tendineae
A coronaria dextra
Nodulus valvulae semilunaris Valvula semilunaris dextra
Valvula semilunaris posterior Valva atrioventricularis sinistra, Cuspis anterior
Fig. 882 Left ventricle, Ventriculus cordis s i n i ster, and ascending aorta, Aorta ascendens; position of the cusps of the aort i c valve [a rrows) in their position at the filling phase of the heart [diastole ) ; lateral view.
M papillaris anterior Ventriculus cordis sinister
�
T h o ra c i c viscera
H e a rt
Tra c h e a
Internal spaces of the heart
Valva aortae, Valvula semilunaris posterior Pars ascendens aortae
Valva aortae, Valvula semilunaris sinistra Atrium cordis sinistrum Cusp is anterior Cuspis posterior
Sinus aortae
} Valva atrioventricularis sinistra
Auricula dextra
A, coronaria dextra -- -"H'T11V
Septum interventriculare, Pars membranacea
���'fIh�""""....;:..., :, .-t-- M. papillaris posterior
Valva atrioventricularis dextra, Cuspis posterior
Valva atrioventricularis dextra, Cuspis septalis
M papillaris anterior
M papillaris anterior
M. papillaris posterior Septum interventriculare, Pars muscularis
....-= ... '---=.; ;./--- Apex cordis
Fig. 883 Left and right ventricle , Ventriculus cord i s s i n i ster et dexter.
V.
interventricularis anterior
A. coronaria sinistra, R, interventricularis anterior axis of the heart
Sulcus interventricularis anterior Pericardium serosum, Lamina visceral is [Epicardium] Ventriculus cordis dexter Trabecula septomarginalis
M papillaris anterior A coronaria sinistra, --..iI.\;. R, marginal is sinister Ventriculus cordis sinister Mm papillares posteriores
...�-- A. coronaria dextra,
R. marginalis dexter
--'II�--n--- Myocardium
M. papillaris posterior
'.ClI�"'"'i'--�r-- Trabeculae carneae Septum interventriculare, Pars muscularis
Valva atrioventricularis dextra [Valva tricuspidalis], Cuspis septalis Sulcus interventricularis posterior A coronaria dextra, R. interventricularis posterior
Fig. 884 Left and right ventricle , Ventriculus cord i s s i n i ster et dexter; superior view.
L u ng s
Oesophagus
I
T h ym u s
I
To p o g ra p hy
Sections
Internal spaces of the heart
Valva atnolientricularos
Sl nlstra. Cuspis posterior Chordae
tendlneaa
M papillaris anterior
M. papillaris posterior
Fig. 885 Left ventricle. Ventriculus cord i s sin ister; ventrosuperior view from the left.
Valva atrloventriculans dextra. Cusp1s anterior
Valva atrioventricularis dextra, Cuspis posterior
Chordae ----'---
tendlneae
M papillaris ---
posterior
Trabecula septomarginal is
Fig. 886 R i g ht ventricle, Ventriculus cordis dexter; dorsal view.
�
T h o racic visce ra
Hea rt
Tra c h ea
Conducting system
A coronaria sinistra
Sinus trunci pulmonalis
Ostium venae cavae superioris
Valva trunci pulmonalis, Valvula semilunaris sinistra
Atrium cordis dextrum
Valva aortae, Valvula semilunaris sinistra
Nodus sinuatrialis
Fasciculus atrioventricularis
".""__- Crus dextrum
Ostium venae cavae inferioris
R.,-.+-�- Nodus atrioventricularis
Valvula sinus coronarii
M. papillaris anterior
Ostium sinus coronarii
Valva atrioventricularis dextra, Cuspis anterior
Fig. 887 R i g ht atriu m . Atri u m cord i s dext r u m , and r i g h t ventricle , Ventricu lus cord i s dexter; conducting syste m , C o m p lexus sti m u lans cord i s [Systema conduce nte cord is] ' h i g h l i g hted i n yellow; ve ntral view.
Pars ascendens aortae A. coronaria dextra
1
Valvula semilunaris posterior Valva aortae Valvula semilunaris dextra
=------.;:+r.::4�;;--- Septum atrioventriculare Truncus pulmonalis
�--- Valva atrioventricularis slnistra,
Cuspis anterior
A coronaria sinistra
Fasciculus atrioventricularis, Crus sinlstrum
M. papillaris anterior
Ventriculus cordis sinister
Fig. 888 Left ve ntricle , Ve ntriculus cordis s i n ister; conducting system . Com plexus sti m ulans cordis [Syste ma conducente cordis]' h i g h lig hted i n yellow; ve ntral view from the left.
Lungs
Oesophagus
I
T h ym u s
I
To p o g ra p h y
S e c ti o n s
Conducting
N vagus [Xl ---#-I
system
-r--- Ganglion cervicale superius
H---- N. cardiacus cervicalis superior
N. laryngeus ----{-H+N .. recurrens R, cardiac us --_-'all-l1l-1 cervicalls Inferior
R cardlacus
thoraClcus Infenor
----Ik-\1P1:�
+--- Ganglion cervicale medium
1H_jlff-IlI--- N. laryngeus recurrens Ganglion cervicothoracicum [Ganglion stellatum]
1I��.a.�=----- Nmedius cardiacus cervical is HJ--- N. cardiacus cervicalis inferior
P-'---- Plexus cardiacus
Fig. 889
I n nervation of the heart, diagra m ; sympat hetic trunk: g reen; vag u s nerve: pu rpLe . •
The branches beyond the cardiac plexus contain sympathetic and vagal fibres.
Aorta
V. cava
inferior
Nodus sinuatrialis
----I-
---!�;:::"��'\1!
��I���tr--
Nodus atrioventricularis
Fig. 890
Conducting system of heart. CompLexus sti m u Lans cord i s [Systema cond ucente cord i s ] ; section at the pLane o f t h e a x i s of the heart .
Crus sinistrum
�
Rr. subendocardiales
Crus dextrum
Septum interventriculare
�
T ho ra c i c viscera
Hea rt
Tra c h e a
Coronary arteries
Lig. arteriosum V. cava superror
A pulmonalis sinlstra
Pericardium serosum, Lamina parietalis
Truncus pulmonalis
A. pulmonalis dextra
Pars ascendens aortae -�rh"'-'-;
Sinus transversus perrcardii ---h"'''
A. coronarra dextra --tl.,.--�� Auricula dextra -'!-'o--.-�.lrd��
A coronaria sinistra
Atrium cordis sinistrum. Auricula sinistra V. cardiaca [cordis] magna A coronarra sinistra, R. circumflexus
Atrrum cordis dextrum Vv. ventriculi dextri anteriores
Fig. 891 Coronary a rteries. Aa . coronariae; ventral view. Arrow in the t ra n sverse perica rd i a l sinus
A. coronaria sinistra, R. interventricularis anterior
-\;��.�
V. interventricularis anterior
R. atrialis
Apex cordis
Valva trunci pulmonalis
Valvula semllunans slnistra Valvula semilunar.s dexlra
R. interventricularis anterior A. coronaria sinistra --,_-..:��'
R circumflexus --�:::::::��".....,
Valva aortae Valvula semllunaris posterior A. coronaria dextra nodi sinuatrialis
Anulus librosus dexter
Trigonum fibrosum SIOistrum
V. cardiaca [cordis]
magna
Fasciculus atrioventricularis
Anulus fibrosus sinister
Fig. 892 Coronary a rteries. Aa. coronariae; superior view.
1
R marginalis dexter
R marginalis sinister Ostium sinus coronaril V. cardiaca [cordis] media [V. interventricularis posterior]
A corona ria dextra, R. interventricularis posterior
Valvula sinus coronarii
A. coronaria -7!!�. sinistra
Fig. 893 Va riabi lity of the coronary a rteries. The conus a rteriosus b ra n c h a rises from the aorta as a n i ndependent a rtery [-37%1.
Lungs
O e so p h a g u s
Thymus
Sections
To p o g r a p h y
Vessels of the heart
Arcus aortae
A. pulmonalis dextra
V. cava superior
Bifurcatio trunci pulmonalis
Pericardium
A pulmonalis sinistra Atrium cordis sinistrum
Vv. pulmonales dextrae Sinus venarum cavarum
Auricula sinistra
V. obliqua atrii sinistra
Sulcus terminalis cordis
A. coronaria sinistra, R circumflexus Sinus coronarius
Atrium cordis dextrum
V ventriculi sinistri posterior
V. cava inferior Sulcus coronarius V. cardiaca [cordis] parva A. coronaria dextra
Ventriculus cordis sinister
Ventriculus cordis dexter V. cardiaca [cordis] media [V. interventricularis posterior]
Sulcus interventricularis posterior
Incisura apicis cordis
Fig. 894
3
Fig. 895 a-c Variations i n the a rterial supply of the posterior aspect of the heart ; d o rsal view.
Vei ns of the heart, Vv. cordis.
3
A. corona ria sinistra, R. circumflexus 2 A coronaria sinistra, R. posterior ventriculi sinistri 3 A. coronaria dextra, R interventricularis posterior 4 A. coronaria dextra
a Balanced coro n a ry a rtery s u p p ly b Dominant left coro n a ry a rtery supply c Dominant right coronary a rtery s u p p ly
�
H e a rt
Tho racic vi scera
Trac h e a
Coronary arteries, variability of supply
A. coronaria sinistra
R. nodi sinuatrialis R. coni arteriosl
R. interventricularis anterior
---J.---;�l..._-C"-)
R. marginalis sinister R lateralis
R atrialis
Fig. 896 Coronary a rteries, Aa. coronariae; poste rior a rterial b ra n c hes a re shown i n a lighter colo u r; the poste rior interventri cular b ra n c h a ri ses from the right coronary a rtery I ba la nced coronary a rtery sup ply) ; ventral view.
--"'�",",,'-'I\._-
R, nodi atrioventncularis (R
Rr. atriales
R marginalis ---=---"1...... dexter
Rr. interventnculares septales
R interventricularis posterior Rr
Interventrtculares septales
R posterior ventriculi sinistri Rr. atrioventriculares
A. coronaria dextra
R nodi sinuatrialis
R. coni arteriosi ---j�---;If&---
R. marginalis sinister
,�p"--,:...- Rr. interventriculares
R. atrialis
Fig. 897 Coronary a rteries. Aa. coronariae; the poste rior i nterve ntricular b ra nc h a rises fro m the left corona ry a rtery I d o m i n a n t left coronary a rtery supply ) ; ventral vi ew.
septales
Rr. posteriores ventriculi sinistri
R marginalis dexter
Rr interventriculares septales
R. interventricularis posterior
R. nodi sinuatrialls R. coni arteriosi
. ... ��-- R. marginalis sinister �....ar:.�.---- Rr interventriculares
Rr. atrioventriculares
R atrialis
Fig. 898 Coro n a ry arteries, Aa. coronariae; the posterior wall of the ve ntricles i s m a i n ly s u p p lied by b ra n ches of the right coronary artery Idominant right corona ry a rtery supply); ventral view.
septales
R nodi atrioventricularis
R. posterior ventriculi sinistri
R marginalis dexter Rr interventriculares septales
Lungs
Oes o p h a g u s
I Thymus I
To p o g ra p hy
Secti o n s
Coronary arteries, radiography
A. coronaria sinistra
A. coronaria sinistra,
R marginalis sinister
A. coronaria sinistra,
Rr. interventriculares septales
A coronaria sinistra,
R. circumflexus
A. coronaria sinistra,
R. interventricularis anterior
A. coronaria sinistra,
R interventricularis posterior, Var Diaphragma
* Catheter in the aorta and in the
opening of the left coronary a rtery
Fig. 899 Left coronary a rtery, A . coronaria s i n i st ra ; coronary a n g i o g raphy;
the beam is d i rected obliq uely fro m right anterior to left posterior ( RAO).
A. coronaria sinistra
A. coronaria sinistra,
R. marginalis sinister
A coronaria sinistra,
R. circumflexus
A. coronaria sinistra,
R. interventricularis anterior
A. coronaria sinistra,
Rr. interventriculares septales
A. coronaria sinistra, R interventricularis posterior, Var * Catheter in the aortic bulb
Diaphragma
---.::...---.....;;
Fig. 900 Left coro n a ry a rtery, A. coronaria s i n i st ra ; coro n a ry a n g iography;
and i n the opening of the left coronary a rtery ** Shadow of the catheter in the descending thoracic aorta
the beam is d i rected obliquely fro m left a nterior to rig ht posterior [ LAO).
A coronaria dextra, R. coni arteriosi A coronaria dextra, R. atrioventricularis A coronaria dextra
A coronaria dextra, R. marginal is dexter Diaphragma
A coronaria dextra,
R interventricularis posterior A corona ria dextra, (R posterolateralis dexter)
Fig. 901 R i g ht coro n a ry a rtery, A. corona ria dextra; coronary angiography;
* Catheter in the aorta and i n the
open i n g of the right coronary artery ** Shadow of the catheter in the descending thoracic aorta
the beam i s d i rected obliquely fro m left a nterior to right posterior [ LAO).
... ...
... Th oracic viscera
Heart
Tra c h e a
Heart situs
A ; V thoracica interna • • N. vagus [Xl
(Nodi Iymphoidei mediastinales anteriores)
N. vagus [Xl N. laryngeus recurrens
Bronchus principalis dexter
�::""'�o!L":':;:aP'i-:-\t- Lig. arteriosum
Nodi Iymphoidei tracheobronchiales superiores
Nodi Iymphoidei tracheobronchiales supenores
A pulmonalis dextra •
• V. pulmonalis
sinistra superior
pulmonalis • dextra
• A. pulmonalis
Nodi Iymphoidei tracheobronchiales Inferiores
• V. pulmonalls
V.
sinistra
sinistra inferior
Nodi Iymphoidei tracheobronchiales inferiores
(Nodus Iymphoideus ligamenti arteriosi)
Nodi Iymphoidei phrenici superiores
Fig. 902
Fig. 903 Position of the heart ; i ns p i ration.
Position of the heart in the thorax, Situs cord i s.
Nodi Iymphoidei phrenici superiores
Fig. 904 Position of the heart ; exp i ration.
Lungs
Oeso p h a g u s
Thymus
Sections
To p o g ra p hy
Pericardium
laryngeus recurrens sinister V. brachiocephalica dextra •
V. thoracica interna •
N. phrenicus
• • A ; V pericardiaco·
phrenica
Truncus . brachiocephalicus V. cava superior •
.iC�'::-'r--
Pulmo sinister (
Pleura parietalis, Pars mediastinalis
Plexus aorticus thoracicus N. vagus [Xl
N. laryngeus recurrens
Pulmo dexter
I���fil;���'-
Sinus transversus pericardii
V, pulmonalis • dextra superior
��f�:O'l
• A. p ulmonails
·
dextra
trunci puimonalis
:��-
Pleura parietal is, Pars mediastinalis
V pulmonalis • dextra inferior
• V. pulmonalis
sinistra superior
• V. pulmonalis
sinistra inferior
Pericardium serosum, Lamina parietal is
Pleura parietalis, Pars diaphragmatica V, cava inferior .
Fig. 905
Pericard i u m , Perica rd i u m .
V jugularis interna dextra
V subclavia dextra ---11__'
,-:::;::; : � ;i �=------ V. brachiocephaiica
V. cava superior -------131111
sinistra
r--- Vv. pulmonales s,nistrae
Vv pulmonales dextrae Vv hepaticae
----"7�C�:"'i V cava inferior
1------ Pericardium Fig. 906 O p e n i n g s of the large vei ns i nto the heart; ventra l view.
�
H e a rt
Th o ra c i c visce ra
Trachea
Trachea and bronchi Right main bronchus, Bronchus principalis dexter Bronchus lobaris superior dexter
1 2 3
Cartilago thyroidea, --\. Lamina dextra
_ _
= = =
Bronchus segmental is apical is [B I] Bronchus segmentalis posterior [B II] Bronchus segmentalis anterior [B III]
Bronchus lobaris medius dexter
4 5
Lig. cricothyroideum -4-\-j�-,\--L " ,"'� medianum
= =
Bronchus segmental is lateralis [B IV] Bronchus segmental is medialis [B V]
Bronchus lobaris inferior dexter
6 7 8 9 10
Arcus cartilaginis cricoideae
= = = = =
Bronchus segmentalis superior [B VI] Bronchus segmentalis basalis medialis [B VII] Bronchus segmentalis basalis anterior [B VIII] ronchus segmentalis basalis lateralis [B IX] ronchus segmentalis basalis posterior [B X]
Left main bronchus, Bronchus principalis sinister
Cartilagines tracheales ---1II&---'=:"!1
Bronchus lobarls superior sinister
1 ,2 3
4
5
= = = =
Bronchus segmentalis apicoposterior [B I + II] Bronchus segmentalis anterior [B III] Bronchus lingularis superior [B IV] Bronchus lingularis inferior [B V]
Bronchus lobaris Inferior sinister
6 7 8 9 10
Ligg anularia -�IW':7lI!it!'''
= = = = =
Bronchus segmental is superior [B VI] Bronchus segmental is basalis medialis [B VII] Bronchus segmentalis basalis anterior [B VIII] Bronchus segmentalis basalis lateralis [B IX] Bronchus segmentalis basalis posterior [B X]
Bronchus lobaris superior sinister
Bronchus lobaris inferior sinister B
Fig. 907 Larynx, Larynx ; trachea, Trachea, a n d b ro n c h i , Bronchi.
10
Bronchus lobaris supenor dexter
Bronchus principal is dexter
Fig. 908 Projection of the trachea and the b ronchi onto the a nterior thoracic wall.
Bronchus lobaris medius dexter Bronchus lobaris inferior dexter
Bronchus principal is sinister Bronchus lobaris supenor sinister Bronchus lobaris inferior sinister
L u n gs
Oesop h a g u s
Thym u s
To p o g ra p hy
Sections
Trachea. structure
Cartilago thyroidea, Lamina dextra Cartilago corniculata
"'�-...."I-- Cartilago arytenoidea �-=��J.- Lamina cartilaginis cricoideae
Cartilagines tracheales
\,f1-f11�-- Paries membranaceus
Ligg anularia ---<(..-IJ:go..m:
It--:il.- Glandulae tracheales
M. trachealis
Bronchus lobaris superior dexter 2
; �����1�����
Bronchus lobaris _--11l-t:'!1.1"11I superior siniste
B
10
Fig. 909 Larynx, Larynx; trachea, Trachea, and bronc hi, B ro n c h i ; dorsal view.
Cartilago trachealis
TUnica mucosa -H-""""'�
Paries membranaceus -�:..;...; ; :::; ; ...�..;;"
l.'I"'+'�++-- Glandulae tracheales
-:��!§'7.i37/f-- M trachealis
Fig. 9 1 0 Trachea, Trachea; c ross-section; m i c roscopic e n la rgement at low m a g n ification .
�
T h o ra c i c vi sce ra
Segmental bronchi
Fig. 9 1 1 B ro n c h i . B ro n c h i ; the l o b a r a n d the segmental b ro n c h i have been projected onto the lungs and a re illustrated with d i fferent colours; ventral view. N u m be rs i n d i cate the segmental b ronchi [see p. 9 0 1 .
H e a rt
Trachea
Lungs
Oesophagus
I
T h ym u s
I
To p o g ra p h y
Sections
Bronchial tree, radiography
____
Bronchus segmentalis apicoposterior [B I + II]
Bronchus principal is sinister Bronchus lobaris superior sinister
--
Bronchus lobaris inferior sinister
Bronchus set/mentalis anterior [B II II
-- Bronchus lingularis superior [B IV]
Bronchus segmentalis superior [B VI]
Bronchus lingularis inferior [B V]
Bronchus segmentalis basalis lateralis [B IX] Bronchus segmentalis basalis posterior [B X]
Bronchus segmentalis basalis anterior [B VIII]
Fig. 9 1 2 B ro n c h i . B ro n c h i ; AP-radiograph; b ronchogra phy of t h e left l u n g . •
B ronchog raphy catheter in the trachea
�
T h o ra c i c viscera
H e a rt
Tra c h e a
Lungs
Apex pulmonis Lobus superior -----,F":&''-:-;;... Flssura obliqua Lobus superior, Facies costal is
Fissura horizontalis pulmonis dextri Lobus medius pulmonis dextri, Facies costalis
Lobus inferior, --+-Ir-=---"� t:..'.» Facies costal is Lobus inferior -----tilt:-�; 'l"
Fissura obliqua
Fig. 9 1 3 Right l u n g , Pulmo dexter; latera l view.
Apex pulmonis Lobus superior, Facies costalis Fissura obliqua Ma{Qo a nterior ---r.,.!';.�: ..'�""n;;.r.' Itl�;;..tl
Lobus superior
--N."'"'.....:;,r:,:..;...:.:.,�
Lobus inferior, Facies costal is
Incisura cardiaca pulmonis sinistri
Lingula pulmonis sinistri Fig. 9 1 4 Left l u n g , Pulmo sin ister; lateral view.
Fissura obliqua
Margo inferior
Lungs
Oesophagus
I
Thym u s
I
To p o g ra p h y
Secti o n s
Lungs kJll!l!!:li!�'".:I:liii::--- Apex pulmonis Lobus superior Fissura obliqua
Lobus superior A pulmonalis dextra
Bronchus lobaris medius dexter et inferior dexter Nodus Iymphoideus tracheobronchialis inferior �,------ Pleura parietal is, Pars mediastinalis
Margo anterior Vv,
pulmonales dextrae -----lr.r......
__=_:_
Impressio cardiaca ---l-�"",,,'--
+--- Lobus inferior
Fissura horizontal is pulmonis dextri
114--- Lig, pulmonale
Lobus medius pulmonis dextri
i'H--- Facies
diaphragmatica; Basis pulmonis
.H:+--- Margo inferior
Fig. 9 1 5 R i g ht Lung, PuLmo dexter; sag ittaL section at the pLa n e of the h i L u m of t h e L u n g ; m e d i a L view.
....� ... "=2�!lr-- Apex pulmon
is
A.
Fissura obliqua
pulmonalis sinistra
Pleura parietalis, Pars mediastinalis
V. pulmonalis sinistra inferior
Margo anterior
Facies costa lis
Nodi Iymphoidei tracheobronchiales
lIg pulmonale
Impressio cardiaca
Lobus _-1!!'I1I;;;;;'
Inferior
Incisura cardiaca pulmonis sinistri Lingula pulmonis sinistri
Margo
Inlenor
Facies diaphragmatica; Basis pulmonis
Fissura abllqua
Fig. 9 1 6 Left Lung, PuLmo s i n i ster; sag ittaL section at the pLa n e of the h i L u m of the Lung; mediaL view.
�
H e a rt
T h o racic viscera
Bronchopulmonary segments
Pulmo
dexter
Pulmo dexter, Lobus superior
.. .. ..
8egmentum apicale [8 I]
8egmentum posterius [8 II] 8egmentum anterius [8 III]
Pulmo dexter, Lobus medius
.. ..
8egmentum laterale [8 IV]
8egmentum mediale [8 V]
Pulmo dexter, Lobus inferior
8egmentum superius [8 VI]
8egmentum basale mediale [cardiacum] [8 VII] '
8egmentum basale anterius [8 VIII]
8egmentum basale laterale [8 IX]
8egmentum basale posterius [8 X]
•
This segment is generally not an independent segment, but rather fused with the anterior basal segment [S VI l IJ.
Fig. 9 1 7 Right lung, Pulmo dexte r; bronchopulmonary segments, Segme nta b ronchopu lmonalia ; lateral view.
Pulmo
sinister
=)
Pulmo sinister, Lobus superior
_ .. ..
"'gm"""m ",ro","'"", [S I . II: 8egmentum anterius [8 III]
8egmentum lingulare superius [8 IV]
8egmentum lingulare inferius [8 V]
Pulmo sinister, Lobus Inferior
8egmentum superius [8 VI]
8egmentum basale mediale [cardiacum] [8 VII]'
8egmentum basale anterius [8 VIII] 8egmentum basale laterale [8 IX]
8egmentum basale posterius [8 X]
•
T h is segment is generally not an independent segment, but rather fused with the a n terior basal segment [S VIlIJ.
Fig. 9 1 8 Left lung, Pulmo s i n ister; bronchopu lmonary segments, Segmenta bronchopulmonalia; lateral view.
Tra c h e a
Lungs
Oes o p h a g u s
[ T hy m u s [
To p o g ra p h y
Sections
Bronchopulmonary segments
Fig. 9 1 9 R i g h t l u n g , Pulmo d exter; b ronchopulmonary seg ments, Segmenta bronchopulmonalia; medial view.
Fig. 920 Left lung, Pulmo sin ister; bronchopulmonary seg ments, Segmenta bronchopulmonalia; medial view.
�
T h o ra c i c viscera
H e a rt
Tra c h e a
Lungs, structure
Truncus brachiocephalicus
Vv. brachiocephalicae dextra et sinistra
A. pulmonalis sinistra
{
V cava superior A pulmonalis dextra, Aa lobares superiores V. aplcalis V pulmonalls V. dextra sUperior V. anterior
Pulmo sinister, Lobus su perior A. pulmonalis sinistra, Aa. lobares superiores
Bronchus lobaris superior sinister V. pulmonalis sinistra superior, V. apicoposterior
Pulmo dexter, --J;':':>L.< Lobus medius A. pulmonalis dextra,
Nodi Iymphoidei tracheo bronchiales
A. lobaris media
V. pulmonalis dextra superior, V. lobi medii
A. pulmonalis dextra, Aa. lobares interiores, Pars basalis, A segmentalis basalis anterior
Auricula dextra A. coronaria dextra A.
Truncu. pulmonalis, pulmonalis
pulmonalis sinistra, Aa. lobares interiores, Pars basalis, A. segmentalis basalis anterior
Sinus trunci
Pulmo sinister, Lobus interior
Ventriculus cordis dexter
V. pulmonalis sinistra interior
A. coronaria sinistra, R, interventricularis anterior
Ventriculus cordis sinister
Fig. 921 Lungs, Pulmones, and heart , Cor; the a rteries, the veins and the b ronchi have been d issected u p to the external surface of the lungs.
.y-:"�"':;�4..IL":'��
_ _
Bronchus
Ductus alveolaris Bronchiolus terminalis
----_
-11a1,..,.;..,,�s-;.""';I--- Bronchiolus Fig. 922 Lung, Pulmo; overview of the lung structure; m i c roscopic e n la rgement at low mag nification.
Lungs
Oesophagus
Thymus
To p o g ra ph y
S e c ti o n s
Vessels of the lungs and bronchi
Apex pulmonis
Pulmo sinister, Lobus superior
•
/
j
A. carotis communis
Trachea, Panes membranaceus
Truncus brachlocephahcus
Pulmo sinister, Lobus inferior
V. cava superior
Lig. arteriosum
Bifurcatio tracheae
Bronchus lobaris superior sinister A. pulmonalis sinistra
Bronchus principalis sinister Bronchi segmentales A.
pulmonalis sinistra, Aa. lobares inferiores, Pars basalis
V
"'-....,,=...,....-- Nodi Iymphoidei tracheobronchiales
A. segmentalis basalis lateralis
a;:�-- V. pulmonalis dextra superior
A segmental is basalis medialis
A. pulmonalis dextra
A segmentalis basalis posterior
V pulmonalis dextra inferior
Atrium cordis sinistrum
smistra superior
pulmonalls
Atrium cordis dextrum
V. pulmo�ahs sinlstr8
inferior
Pulmo Sinister, Lobus inferior
V. cava inferior
V. cardiaca [cordis] media
Apex cordis
Ventriculus cordis dexter
Fig. 923 VesseLs of the Left Lung. PuLmo sin ister; dorsaL view.
Trachea
A carotis communis sinistra
A. subclavia dextra
A. subclavia sinistra
A. IntercostatlS d8Xtra I I I
Bronchus principal is sinister -
....
_ _
_ �
�����_:::--- Bronchus principal Is dexter R. bronchialis dexter
Rr. bronchiales sinistri -..,..,.. <::....
Pars thoracica aortae Fig. 924 Bro n c h i , B ro n c h i ; a rteriaL suppLy.
.. T h o racic viscera
H e a rt
Tra c h e a
Vessels of the lung, radiography
Fig. 925 Arte ries of the right l u n g , A a . pulmonales dextra e ; AP-ra d iograph [pulmonary a n g iogra phyl; after i njection of a contrast med i u m i nto the right ventricle; ventral view. The n u m bers desig nate the segmental a rteries !compare p. 961.
Fig. 926 Vei n s of the right lung, Vv. pulmonales d extra e ; AP-ra diograph [ return v i a pu lmonary veins of t h e contrast m e d i u m i nj ected i nto the right ventricle l ; ventral view. N u mbers i n d i cate the segmental veins !compare p. 961.
Lungs
Oeso p h a g us
I
Thymus
I
To p o g ra p hy
Sections
Thoracic viscera, radiography
Trachea Bronchus principalis dexter
Corpus costae I ; I I I ; IV
Clavicula _--'=---'::..:0..--':'
- Angulus coslae IV
- Truncus pulmonalis
V. cava superior
== - Atrium cordis sinistrum
Atrium cordis de)(\rum
- Ventriculus cordis sinister
A. pulmonalis dextra, As lobares Infeoores
Diaphragma Apex cordis
Recessus costo diaphragmaticus
Fig, 927 Thoracic cage, Cavea thoracis, and thora c i c viscera ; PA- radiograph of a 27-year-old male [thorax radiogra p h ! .
M
1
="Aortic knob"
2 =Arch of the pulmonary artery
3 =Arch of the left atrium 4 =Arch of the left ventricle 5 = Arch of the right vessels 6 =Arch of the right atrium
Arcus aortae ( 1 )
V.
cava superior (5)
Truncus pulmonalis (2) Auricula sinistra (3) Ventriculus cordis sinister (4)
Atrium cordis dextrum (6) V. cava inferior
Fig, 928 O u t l i n e o f the heart shadow i n t h e radiog ra p h ; Dt Transverse diameter, a b + cd 13- 1 4 em L Longitu d i n a l axis of the heart [fro m the superior border of the ri ght atri a l conto u r to the a pex of the heart] 15-16 c m M = M e d i a n plane o f t h e body =
=
Dlaphragma
=
=
M
... Th o ra c i c visce ra
H e a rt
Tra c h e a
Bronchoscopy
(Cartilago bronchial is)
Carina tracheae
Bronchus principalis dexter
Bronchus principalis sinister
Fig. 929 B ronchi, B ro n c h i ; b ronchoscopy of a healthy i n d ividual displaying the tracheal bifurcation a n d the carina of trachea.
Bronchus segmental is apicoposterior [B I + II]; Bronchus segmentalis anterior [B i l l]
..... ---+-- Bronchus lobaris superior sinister
-------...;...-- Bronchi lingulares superior et inferior [B IV-V]
Bronchus segmentalis supenor [B VI]
�------:- Bronchus segmental is basalis anterior [B VIII]
Bronchus segmentalis basalis lateralis [B IX]
Bronchus segmental is basalis posterior [B X]
Fig. 930 B ronchi, B ro nc h i ; b ronchoscopic view of the left segmental b ro n c h i .
Lungs
Oesophagus
I
Thym u s
I
To p o g ra p h y
Sect i o n s
Lungs. surface projections
Vertebra cervical is VII [prominensj
Cupula pleurae Lobus superior
Lobus superior
Lobus medius pulmonis dexlri
Incisura cardiaca pulmonis sinislri
Spina scapulae
Lobus inferior
Lobus inferior -�'--.-I--
Recessus casto· diaphragmallcus
Crisla iliaca
Fig. 931 Projection o f t h e pulmonary a n d t h e pleural borders onto the a nterior t horacic wall.
Fig. 932 Projection of t h e p u lmonary and the pleural borders onto the posterior thoracic wa ll.
B o rders of the lungs - line Borders of the p le u ra - dashed line
Lobus superior
Lobus superior
Lobus medius
pulmonis dex1rl
Fig. 933 Projection of the pulmo nary and the pleura l borders o n t o the lateral t ho racic wa ll.
Fig. 934 Projection of the pulmonary and the pleural borders onto the latera l thoracic wall.
�
H e a rt
T h o ra c i c viscera
Tra c h ea
Oesophagus
M, constrictor ph aryngis Inferior Cartilago thyroidea, Lamina dextra A, carotis communis
Glandula thyroidea, Lobus dexter A carotis communis
A. subclavia
Isthmus glandulae thyroideae Oesophagus, Pars cervicalis
A_ carotis communis dextra
Arcus aortae Lig. arteriosum
Bronchus principalis dexter
Cartilagines tracheales
Truncus brachiocephalicus
Arcus aortae
BHurcatio tracheae
Lig. arteriosum Bronchus lobaris superior dexter
Pars thoracica aortae Oesophagus, Pars thoracica
Aa. intercostales posteriores Pars thoracica aortae
Diaphragma, Centrum tendineum Foramen venae cavae
Bronchus lobaris superior dexter
Oesophagus, Pars abdominal is
Gaster, Pars cardiaca
Pars lumbalis diaphragmatis, Crus dextrum Aa. phrenicae inferiores Hiatus aorticus
-�4��rJi,��1 -"'"""-....'HiliJA
Pars
abdommalis aortas
Pars lumbalis diaphragmatis, Crus sinistrum
Fig. 935 Oesophagus, Oesophagus; trachea, Trachea, and the thoracic aorta, Pa rs thoracica aortae; ventral view.
Fig. 936 Oesophagus, Oesophagus; trachea, Trachea, and the thoracic aorta, Pars thoracica aortae; viewed from the right.
Lungs
Oeso p h a g u s
T hy m u s
To p o g ra p h y
S ecti o n s
Oesophagus, structure
Glandula thyroidea, Lobus sinister Glandula thyroidea, Lobus dexter A, carotis communis V jugularis interna
A. carotis communis
MlM�1
A subclavia ___.....
V. jugularis interna
V. brachiocephalica dextra Truncus brachiocephalicus V. cava superior
....iI!l:;I�:;o;;;;;:-- Bifurcatio tracheae R. bronchialis Bronchus principalis dexter A pulmonalis dextra
A. pulmonalis sinistra Bronchus principalis sinister
Vv. pulmonales dextrae
Vv. pulmonales sinistrae
Ventriculus cordis sinister
Aa i ntercostales posteriores "-=--:---- V. cava inferior
L.>--"--c....,.---- Oesophagus, Pars thoracica �'-it.:.:,.:..: .;;;, ;..:.:�=::-....:... -- Pars thoracica aortae N.'tF-F�- Hiatus oesophageus
Fig. 937 Oesophag u s , Oesop hagus, a n d the thoracic aorta, Pars thoracica aorta e ; dorsal view.
Tunica
{
mucosa
(
Epithelium Lamina propria mucosae Lamina muscularis mucosae
Tela submucosa -------�-� Tunica muscularis
Tunica adventitia
Fig. 938 Oesophagus, Oesophagus; m icroscopic e nlargement at low magn ificati o n .
.
Glandulae oesophageae -----..�
Stratum circulare Stratum longitudinale
�
H ea r t
Thora c i c viscera
Tra c h ea
Vessels of the oesophagus
Oesophagus, Pars cervicalis
A thyroidea inferior
A. thyroidea inferior,
V. brachiocephalica sinistra
Rr. oesophageales
A carotis communiS dextra
.....t-- A. subclavia V. cava ---:::..... superior
Trachea ---..... . Pars thoracica aortae, Rr bronchi ales
Vv intercostales -""i�IIi;;:;i..;;�.l1 1r.; posteriores
Oesophagus ---.. Pars thoracica aortae, Rr. oesophageales
Oesophagus, Pars thoracica V hemiazygos
Diaphragma
_---'S�=:;;;��
Truncus coeliacus
Diaphragma, Foramen venae cavae
-=-
-
Pars lumbalis diaphragmatis, Crus dextrum et Crus sinistrum
Oesophagus, Pars abdominalis
V phrenica inferior
V. gastroomentalis sinistra
V. cava inferior V gastrica sinistra
Fig. 939 Oesophagus, Oesophagus; su pplying a rteries; ventral view.
Fig. 940
1
Ve i n s of the oesophagus, Vv. oesop hageae.
� 1 07 7 . 1 078
1
Vv. oesophageae
V. hemiazygos
V. azygos (Plexus venosus submucosus)
(R oesophageal is)
V. oesophagea
-i-'-----+-- (R. oesophageal is) V. phrenica inferior
rk,...... -----;.--- V. gastrica sinfstra
V. cava inferior
V. portae hepatis
-
.. r---....� Fig. 941 Vei n s of the oesophagus, Vv. oesop hag eae ; magn ification of Fig. 940; demonstration of anastomoses between bra n ches of the hepatic porta l ve i n and the superior vena cava .
Lungs
Oeso p h a g u s
Thym u s
Top o g ra p h y
Sect i o n s
Thoracic lymph nodes
A carotis communis
Oesophagus, Pars cervicalis
A carotis communis
Truncus brachiocephalicus
A. subclavia V. cava superior Nodi Iymphoidei iuxtaoesophageales Trachea. Paries membranaceus Arcus aortae Pars descend ens aortae
Nodi Iymphoidei tracheobronchiales superiores A. pulmonalis sinistra
Bifurcatio tracheae
"��::r- Bronchus principal is dexter
A'!!••�-
Nodi Iymphoidei tracheobronchiales inferiores
Nodi Iymphoidei tracheobronchiales superiores A. pulmonalis dextra
Bronchi lobares
(Nodi Iymphoidei mediastinales posteriores)
V. pulmonalis dextra inferior
Oesophagus, Pars thoracica (Nodi Iymphoidei mediastinales posteriores)
Pericardium fibrosum
V. cava inferior
Diaphragma
Hiatus oesophageus
Fig. 942 Thoracic lym p h nodes; Nodi lym phoidei thora c i s ; dorsal view.
�
T h o ra c i c visce ra
H e a rt
Tra c h ea
Oesophagus, radiography and oesophagoscopy
Scapula
ClavIcula. Extremitas sternalis
Recessus piriformis
Manubrium sterni
Oesophagus , Pars cervlcalis·' · ·
Oesophagus, Pars thoracica *
Oesophagus, Pars thoracica
••
�-IIK;..;=---- Claviculae
___r-�;..;,;:2.
IJ.-,,---- Arcus aortae
-
i-'::iiof,-=::"';;"-=';� Oesophagus,
Pars thoracica
Diaphragma a
Fig. 943 a, b Oesophagus, Oesop hagus; rad i og ra p h after swallow i n g of a contrast med i u m . a R i g ht a nterior oblique position, obli q u e dia meter I [beam d i rected from left a nterior to right posteriori b Left a nterior oblique position, oblique dia meter I I [ bea m d i rected from right a nterior to left posteriori
* Oesophageal constriction caused by the a o rtic arch *. Retrocardial portion of the oesophagus " ' Oesophageal constriction at the ju nction of the pharynx with the oesophagus
Gaster, Pars cardiaca, Tunica mucosa
Oesophagus, Pars abdominalis, --....:... Tunica mucosa Fig. 944 Oesop hagus, Oesophagus; oesophagoscopy [te c h n i cal deta i ls see Fig. 9861 ; supe rior view.
Lungs
Oeso p h a g u s
I
Thym u s
I
To p o g ra p h y
Sect i o n s
Oesophagus
Mm. pharyngis --�,:..... Larynx --�..
Trachea
--Je�[I
Trachea
---"'�IO
Pars descendens aortae [Aorta descendens] Pars ascendens aortae [Aorta ascendens]
Oesophagus, ----1....-1 Pars thoraclca
Bronchus principalis dexter
Pars thoracica aortae, [Aorta thoracica]
Diaphragma
Gaster. Cardia
Fig. 945 Oesophagus, Oesophagus; constrictions. • •• •••
Upper oesophageal sphincter N a r rowing caused by the aortic arch Diaphragmatic constriction
Oesophagus, Pars abdominalis
Fig. 946 Oesophagus, Oesophagus; typical location and freq u ency of d iverticula . Cervical diverticulum IZENKER's diverticuluml. l-70%1 M id-oesop hageal diverticulum 1-22%1 • • • Epiphrenic diverticulum [-8%1 •
••
�
T h o ra c i c viscera
H e a rt
Tra c h e a
Thymus
• M. sternohyoideus (Lobus pyramidalis, Var.) M sternothyroideus .
Glandula thyroidea
{
• M. omohyoideus, Venter superior
• V thyroidea superior
Lobus dexter
Fascia cervicalis, Lamina superficialis
Lobus sinister
• M. sternocleidomastoideus
Vv. thyroideae inferiores • Arcus venosus jugularis •
Plexus caroticus communis
N. phrenicus M.
• Vv, brachiocephalicae Clavicula
• V, thoracica interna
M, subclavius . Apex pulmonis Costa II
----J'mr.-.,;n�<-.,'"
Thymus
-
--------HJ.�
:tI:�---__;_---_:-- • M. pectoralis major
Pleura parietalis, --------1 Pars costal is Pulmo dexter, Margo anterior
Pu Jmo dexter
(su�� � Lobus medius
Lobus inferior
Pulmo sinister, Lobus superior
-------,--H,IM
Margo anterior
Pericardium
�---r.JJI',;
_ _
Incisura cardiaca pulmonis sinistri
---+--����:IO�
Pleura parietal is, Pars diaphragmatica Recessus costodiaphragmaticus
-1[-r�t2Il(��1��d�i����������� ��h.. -....-41fM1llMr
Lingula pulmonis sinistri Pulmo sinister, Lobus inferior Margo inferior • M. obliquus externus abdominis
Recessus costomediastinalis
Fig. 947 Thymus, Thymu s ; pericard i u m , Perica rd i u m , and lungs, Pulmones, of a n adolescent. N ote the size of the adolescent thym us, I n o ld e r i n d ividuals, the t hym i c tissue i s a lmost entirely replaced by ad i pose t i ssue,
Lungs
O e so p h a g u s
Thym u s
To p o g ra phy
Secti o n s
Thymus
Trachea N. laryngeus recurrens • A subclavia .
����¥�_- • V. brachiocephalica sinlstra
Plexus brachialis V. thoracica interna . Vv pericardiacophrenicae •
A. carotis communis
-�A.I������I\
_--1����2::;;-'
N. vagus [Xl
• A. subclavia
V brachiocephalica dextra • N. phrenicus
•
Pleura parietal is, Pars mediastinalis •
V. cava superior .
Lobus sinister
Pulmo dexter, Lobus superior
}
N phrenicus
Lobus dexter
Thymus
Pulmo sinister, Margo anterior
Pericardium fibrosum
Pleura parielalls, Pars diaphragmatica (NOdl lymphoid,1I med,aslinales anleriores)
• Pars sternalis diaphragmatis
Fig. 948
Thym us, Thym us, of an adolescent.
�
H e a rt
T h o racic viscera
Tra c h ea
Pleural cavity
Plexus brachial is, Pars infraclavicularis • Truncus sympathicus, Ganglion thoracicum II • N . vagus [X], N. laryngeus recurrens • N vagus [X], Rr. cardiaci thoracici ..
�jEi�����:.---- • V. subclavia
N. vagus [X], Plexus pulmonalis • V. azygos .
• A. thoracica interna
Bronchus principal is dexter R. bronchialis (Aorta); • V. bronchial is N. vagus [X], Rr cardiaci thoracici
•
• V. brachiocephalica dextra
•
V. intercostalis posterior .
N. thoracicus [T 7] , N. intercostalis Truncus sympathicus, Rr. communicantes
•
N. splanchnic us • major
Aa intercostales . posteriores
Pleura parietal is, Pars costalis
•
---I'c{{1!,jmm
• • • N. phrenicus; A ; V. pericardiacophrenica
----f'li7Hiflf'3:-f.
--�4IIIIIt;;:
"-1......:...u___ • Vv pulmonales
Pericardium fibrosum; Pleura parietalis, Pars mediastinalis
�1tI'-'-"";:;7::;t.:��';-'���.:.!iIA\lI+�l-:.r- Lig. pulmonale
S��I'�����ll2;���i�����I��q�l�l-
,0;
It
N. vagus [X] , Plexus oesophageus
Pleura parietalis, Pars costalis Oesophagus
• Diaphragma; Pleura parietalis, Pars diaphragmatica Diaphragma, Centrum tendineum •
Fig. 949 Pleural cavity, Cavitas pleuralis, and mediasti num, Mediasti n u m , of a n adolescent; latera l thoracic wall and right lung have been re move d ; viewed from the right. The x indicate the a reas at the root of the lung and the pulmona ry ligament, respectively, where the visceral pleura folds back i nto the pa rietal pleura.
Lungs
Oes o p h a g u s
Thym u s
To p o g raphy
Sections
Pleural cavity
Plexus brachialis. Pars i nfraclavlcularis
Truncus sympathicus, R. cardiacus thoraclcus N vagus [X], R. cardiacus thoracic us Oesophagus, Pars thoracica
M. subclavius .
Ductus thoracicus, Pars thoracica
A. axillaris •
N laryngeus recurrens (N. vagus)
V. axillaris . A.
subclavia •
Lig. arteriosum Nodi Iymphoidel tracheobronchiales • V. hemiazygos accessoria
V. brachiocephalica • N. vagus [Xl
Oesophagus, Pars thoracica
N phrenicus Plexus aorticus thoracicus, Plexus cardiacus Plexus pulmonalis A.
pulmonalis sinistra •
-�]�Z��i��1
�1r"--,JflrL.�
-�f;,srs��� Bronchus principalis --iij ��fJ�§�zj�V:����� sinister Thymus
V pulmonalis sinistra •
N, phrenicus
V pulmonalis sinistra • Pericardium fibrosum V. pericardiacophrenica . A.
l. � ---h"ili'fl�u.
---j�U�Il��r.fA";����?�4���H
--f�rfIII�rf'I,.
--jt;1:j;tI1iH:'"<;:"t:f.j'IJI.��(;: Recessus _-J�\ltlllly.,rl costomediastinalis
N. vagus [Xl. Plexus pulmonalis • Pars thoracica aortae Plexus aorticus thoracicus • • A . ; V. intercostalis posterior R. communicans N. splanchnicus major
1Hllfit--- • •
A. ; V. inter· costal is posterior; N. intercostal is
pencardiacophrenica •
Pleura parietalis, Pars medlastinalis
Truncus sympathicus, Ganglion thoracicum IX Pleura parietal is, Pars costalis
(Nodi Iymphoidei mediastinales anteriores) Pleura parietal is, Pars diaphragmatica Centrum tendineum
Fig. 950 Pleura l cavity, Cavitas pleuralis, a n d mediast i n u m , Mediast i n u m , o f a n adolesce nt; vi ewed from the left. In older i n d ividuals, the thym i c tissue is a lmost entirely re placed by a d i pose tissue.
�
H e a rt
T h o ra c i c viscera
Tra c hea
Aortic arch
A. vertebralis dextra
A. vertebralis sinistra
A subclavia sinistra A. subclavta dextra Arcus aortae Lig. arteriosum
V. cava superior
Pars ascendens aortae Atrium cordis --y--� � dextrum Ventriculus cordis sinister
1 Arcus aortae 2 A. thoracica intern a
3 Truncus brachiocephalicus 4 A. subclavia dextra 5 A carotis communis dextra 6 A vertebralis dextra 7 Rima glottidis 8 A vertebralis sinistra
9 Trachea 1 0 A. subclavia sinistra 11 A. carotis communis sinistra 1 2 Pars descendens aortae 1 3 Cor 14 Valva aortae 15 Pars ascendens aortae
Ventriculus cordis dexter
Fig. 951
Heart, C o r, and a o rtic a rc h , Arcus a o rtae,
with the origins of the major a rteries; ventral view.
Fig. 952 Aortic a rc h , Arcus aortae, and b ranches; AP-radiograph after i njection of a contrast medium i nto the a o rtic bulb; ventral view. • C atheter
A carotis extern a sinistra A. carotis interna sinistra
A. carotis interna dextra A vertebralis dextra A carotis communis dextra A subclavia dextra
A. vertebralis sinistra
--t.�"l
A. subclavia sinistra
Pars ascendens aortae
a
70 %
Pars descendens aortae, Pars thoracica aortae
Fig. 953 a-e Va riabi lity of the origin of the major a rteries from the aortic a rc h , Arcus aortae. a "Textbook case" b Common origin of the b rach iocephalic tru n k and the left common carotid a rtery c C o m m o n trunk for the b ra c h iocephalic tru n k and the left common carotid a rtery
d Left vertebraL a rtery bra n c h i n g off the aortic a rc h e
independently Right s u bclavian a rtery as the u ltimate b ranch of the aortic a rch This abnormal a rtery frequently passes b e h i n d t h e oesopha g u s t o the rig ht, w h i c h c a n resuLt i n swa llowing d ifficuLties [ Dysphagia lusoria l .
Lungs
Oesophagus
Thym u s
To pography
Secti o n s
Posterior mediastinum
• N. laryngeus recurrens • N vagus [Xl
N. laryngeus recurrens "
Pars ascend ens aortae . [Aorta ascendensl
• N. laryngeus recurrens
�!l---- • N. vagus [Xl
,
Rr. bronchi ales
Bronchus principalis dexter
Bronchus principalis sinister • Pars thoracica aortae, Rr. oesophageales
• N. laryngeus recurrens,
Mm. intercostales • interni
Rr. oesophageales
Oesophagus, Pars thoracica
Vv. intercostales • posteriores
• Aa. intercostales posteriores
Mm. intercostales • externi Tnmcus syrnpathiclJs. Ganglion
• Pars thoracica aortae
Nn. thoracici, • Nn. intercostales
Ductus Ihorac[cu5, Ihoracica
Pars
N. splanchnicus • minor
• N. splanchnicus major
• V. azygos
Pars lumbalis • diaphragmatis N
Costa XI
• Truncus coeliacus
N. splanchnicus minor .
• A. mesenterica superior • Pars abdorninalis aortae
Fig. 954 Thoracic a n d abdominal aorta, Pars t h o racica aortae et Pars abdomi nalis aortae.
�
H e a rt
T h o ra c i c visce ra
Tra c h e a
Posterior mediastinum
V. thyroidea inferior • V. brachiocephalica dextra • Arcus venae azygos .
• V. brachiocephalica sinistra
Oesophagus, Pars thoracica Ductus thoracicus. Pars thoracica
• Aa. intercostales posteriores • Mm , intercostales interni V. azygos . • V. hemiazygos accessoria • V. hemiazygos
• • Aa.; Vv. intercostales posteriores Truncus sympathicus, Ganglia
• Nn. thoracici, Nn. intercostales
Lig. longitudinale anterius N splanchnicus major
Vv intercostales • postenores • V. hemiazygos
Cisterna chyli Costa XI • Pars lumbalis diaphragmatis, Crus dextrum et Crus sinistrum
N. subcostal IS
V. cava inferior .
Fig. 955
Vessels a n d nerves of the posterior m e d i a st i n u m ,
M e d iast i n u m posteri u 5 .
Lungs
Oesoph a g u s
Thymus
To p o g ra phy
Sect i o n s
Posterior mediastinum
Ganglion cervicothoracicum [stellatum]
Truncus sympathicus, Ganglion cervicale medium
N. laryngeus recurrens
Ansa subclavia N vagus [X] Truncus sympathicus, Ganglion thoracicum II
Plexus aorticus thoracicus; Plexus cardiacus
N vagus [X] N laryngeus recurrens
•
N. laryngeus recurrens
•
N vagus [X], Rr. bronchiales Bronchus principal is sinister
N vagus (X), Rr. bronchiales
Truncus sympathicus
.,..;�-- • Pars thoraclca
Oesophagus, thoraclca
Pars
aortae
__
-.!!I&-- • N. vagus [X],
Truncus sympathicus, Ganglia thoracica
Plexus oesophageus
•
N. splanchnlcus major
Truncus sympathicus, Rr. communicantes
Oesophagus, Pars abdominal is
N. splanchnicus minor
Diaphragma •
.1r--';;"'��l-- Gaster
Pars pylonca
T'lr':-:-''-:-�II-- • N. iliohypo
Duodenum
N. subcostalis
gastricus
Pars abdominalis aortae .
Truncus vagalis anterior, Rr. gastnci antenores
Fig) 956 Autonomous nervous system of the thoracic cavity, Pars thoracica autonomica.
I � 49, 5 0 I
T h o ra c i c viscera
�
H e a rt
Tra c h e a
Phrenic nerve
N laryngeus recurrens
N. laryngeus recurrens
V. subclavia •
N vagus [Xl
v. brachiocephalica sinistra • V.
til
brachiocephalica • dextra Pulmo dexter, Lobus superior
N. vagus [Xl N. vagus [Xl, Rr cardiaci thoracici Pulmo sinister, Lobus superior
Arcus aortae . V. cava . superior
N. phrenicus
[j��:i!�"7"..:.l���ir-'l-- • • A. ; V. pericardiacophrenica
Plexus " cardiacus N phrenicus
N. phrenicus. R pericardiacus Pulmo dexter, Lobus medius
Pericardium
Pulmo dexter, Lobus inferior Recessus costodiaphragmaticus Pleura parietalis, Pars diaphragmatica
• Diaphragma
Fig. 957 Thoracic viscera of an adult; the a nterior thoracic wall has been re moved, a n d the right and the left lung have been sectioned i n the frontal plane; ventral view.
M. scalenus anterior N. phrenicus A. subclavia dextra
V. subclavia dextra
V. cava superior
Pericardium
---IH,..., I
---!IF-
Diaphragma
N phrenicus, Rr. phrenicoabdominales
Fig. 958 C o u rse of the p h renic nerve, N. p h re nicus.
Lungs
O e s op h a g u s
Thymus
To pog ra p hy
Sections
Mediastinum
Mediastinum superius
iIHJ�F'-tII�i.:---A-\--- Mediastinum poS1erius
A'�"""':�-\--- Mediastinum medium
Mediastinum inferius
Fig. 959 Org a n isation of t h e mediast i n u m , M e d iast i n u m .
M arytenoideus transversus . Oesophagus, Pars cervical is
Lig. vocale
Trachea, Paries membranaceus
Cartilago thyroidea
Fascia cervicalis, Lamina superficialis Bronchus principalis sinister Nodi Iymphoidei tracheobronchiales superiores Vertebra cervicalis VII [promlnens], Proc spinosus
Articulatio sternoclavicularis
Ligg i nterspinalia Bifurcatio tracheae, Carina tracheae Vv. baslvertebrales • Bronchus principalis dexter Nodus Iymphoideus tracheobronchialis inferior Plexus venosus . vertebralis internus posterior M. interspinalis . A. pulmonalis dextra • Oesophagus, Pars thoracica V. pulmonalis sinistra . Sinus transversus pericardii V. hemiazygos • Atrium cordis sinistrum
Valva aortae, Valvulae semilunares sinistra, posterior et dextra
�:1�:�1(lri'�('j!�'ill�-jl'!!l��!�1 __�"':'.,.;.:q!���Mr1R1
Valva atrioventricularis dextra [Valva tricuspidalis] Costae VI; VII
Septum i nteratriale A_ coronana dextra; • • V. cardiaca media Medulla spinalis Dura mater spinalis Spatium subarachnoideum
Lamina visceralis [Epicardium] Lamina parietalis
Pars lumbalis diaphragmatis • Nodus Iymphoideus phrenicus superior
Atrium cordis dextrum
Fig. 960 Thoracic cavity, Cavitas thoracis, and mediasti n u m , M e d iasti n u m ; median sag ittal section t h ro u g h t h e neck a n d t h e thorax; lateral view from the right.
)
• Pars sternalis diaphragmatis Pericardium serosum
�
T h o racic visce ra
H ea rt
Tra c h ea
Thorax. frontal sections
Trachea A vertebral is • Nodi Iymphoidei thoracis, Nodi paratracheales
Oesophagus Nodi Iymphoidei cervicales laterales, Nodi profundi inferiores • A thoracica interna
• M. subclavius Costa I • A. axiliaris
A. subclavia • dextra
N. vagus sinister [X] • V. axiliaris V. cava superior .
• Arcus aortae • M. pectoralis minor
V. pulmonalis dextra superior, • V anterior, Pars intrasegmentalis
lW,ti!�t'-- Costa IV f-IW"�������������---- . Pars ascendens aortae
A. intercostalis •
��1I11a,-t-- • M. serratus anterior
Fissura horizontalis pulmonis dextri
,0..1.,,+--- • M. intercostalis internus
!l!f.":;;-'7�-!""�+-_ • A, coronaria sinistra
Atrium cordis dextrum Fissura obliqua Pleura parietal is, Pars costalis Pleura visceralis
----I4��1
----l�II'j'�1
Bronchus intrasegmentalis Ventriculus cordis sinister Lamina visceralis [Epicardium]
Diaphragma •
Lamina parietalis
Recessus costodiaphragmaticus Peritoneum parietale
Valva atrioventricularis dextra
Fig. 961
• A. coronaria dextra, R. interventricularis posterior Fundus gastricus Ventriculus cordis dexter
Thoracic cavity, Cavitas t h o racis.
A. carotis communis Trachea Truncus brachiocephalicus V. cava superior
Pars ascendens aortae
Truncus pulmonalis Pulmo sinister
Pulmo dexter Atrium cordis dextrum Ventriculus cordis sinister Diaphragma
Ventriculus cordis dexter
Hepar
Valva atrioventricularis dextra
Fig. 962 Thoracic cavity, Cavitas thoracis; magnetic resonance tomographic i mage ! M R I ) ; frontal section a t t h e level o f t h e su perior vena cava ; ventral view.
Lungs
Oesophagus
T h ym u s
To p o g ra p h y
Sections
Thorax, frontal sections
Fissura obliqua
Pars thoracica aortae Mediastinum posterius
Pleura visceralis [pulmonalis]
Pulmo sinister Oesophagus, Pars thoracica ·'"". '·Ib "&-- Cavitas pleuralis
Pulmo dexter, Lobus inferior
Diaphragma
Cavitas pleuralis
Pleura parietalis, Pars costalis
Diaphragma
1lI.1�""""ft.I
Hepar V. hepatica dextra
Recessus costo diaphragmaticus
Recessus phrenicomediastinalis
Omentum majus V. cava inferior Pars lumbalis diaphragmatis Gaster, Ostium cardiacum
Flexura coli sinistra Gaster. Pars cardiaca
Fig. 963 Diaphra g m , D i a p h ra g m a , a n d oesophagus, Oesophagus, with its t ra n sition i nto t h e stomach, Gaste r ; fronta l section through the lower part of the thoracic cavity a n d the upper part of the abdominal cavity.
A. caratis c.ommums sln l stra V. )ugularls Interna
Trachea Truncus
V. subclavIi!
brachfocephalicus
Pars ascen de ns aortae
Truncus pulmonalis
Atrium cordis dextrum Ventriculus cordis sinister Ventriculus cordis dexter
Diaphragma
Hepar
Fig. 964 Thora c i c cavity, Cavitas t horacis; magnetic resonance tomogra p h i c image [ M R l i ; fronta l section at t h e level o f t h e a ortic valve; ventral view.
�
H e a rt
Th o ra c i c viscera
Tra c h ea
Thorax, frontal sections
M trapezius . supraspinatus
M. erector . spinae
M. splenius . capitis
�I�lr!I����:;c.§�-_.J. '��i?-�:,;+--..,-,"""rm;:y!'''':!:!!!�
_ _
�
--=��4'
Articulatio acromioclavicularis • M. subscapularis Scapula, Cavitas glenoidal is Caput humeri
Vertebra thoracica II Cupula pleurae N. axillaris Pleura visceralis
M. intercostalis internus
• A, circumflexa humeri posterior
•
f!fu--'\&.....IiH .. Ht--t.- • M. teres major M'-\M-t-''-::'�;.,j�-
Costa I I I
I!"
Plexus brachial is, Fasciculus posterior
m:;-"It'"':h"lfll tJl'l-- • A. axillaris 4!1
Aorta .
•
V anterior, • Pars intrasegmentalis Bronchus segmentalis anterior [B III]
Plexus brachial is, Fasciculus medialis Plexus brachial is, Fasciculus lateralis
• M, coracobrachialis
N. thoracodorsalis M. serratus . anterior
• A. circumflexa scapulae
Fig. 965 Thoracic cavity, Cavitas thoracis; axilla, Axi lla , a n d s h o u lder joint, Art i c u latio h u m e r i ,
M scalenus medius .
• V jugularis interna Proc, coracoideus • M, biceps brachii, Caput longum, Tendo
Plexus brachial is • M, deltoideus Nodi Iymphoidei paratracheales Costa I A carotis communis . ---..... .; ...... sinistra
Nodus Iymphoideus tracheobronchialis
--,�:-;f-'
N. thoracicus longus
Fig. 966 Thoracic cavity, Cavitas thora c i s ; axilla, Axi lla, a n d s h o u l d e r j o i nt , Art i c u latio humeri.
Lungs
Oesophag u s
I
Thymus
I
To p o g ra p hy
Sections
Thorax, transverse section
M scalenus anterior . N vagus dexter [X]
M
• A. carotis communis
Plexus brachialis
..LU""'O<--
:-:�����t-:--
• A. subclavia
Pulmo dexter, Apex
Pleura visceralis
Pleura parietalis
Vertebra thoracica III, Proc. spinosus
a • M, serratus anterior
Clavicula
• M trapezius
• V. subclavia
M stemohyoideus • pectoralis major
Trachea
Oesophagus
Plexus venosus vertebral is intemus •
Spatium subarachnoideum
Medulla spinalis
b
Fig. 967 a, b Thoracic cavity, Cavitas thoracis; axilla, Axilla, and shoulder joint, Articulatio h u meri.
N. suprascapularis
a Right part of the body b Left pa rt of the body
�
H e a rt
T h o ra c i c viscera
Tra c h ea
Thorax, transverse sections
Manubrium sterni
• Truncus brachiocephalicus • A. carotis communis sinistra Trachea
N. phrenicus dexter
N. phrenicus sinister
V cava superior • M pectoralis major .
N. vagus sinister [X]
M. pectoralis . minor
Costa I
Oesophagus
N
Pulmo sinister, Lobus superior
V. pulmonalis • dextra superior
N. thoracicus longus
thoracicus longus V. axillaris • l-l'�� • --"'--'¥.i'-
Humerus A. axillaris
Plexus brachialis -
• Arcus aortae
Nodus Iymphoideus axillaris, Nodus apicalis
• A. subscapularis
M. subscapularis .
Bronchus segmentalis posterior [B II]
M. teres major . Pleura visceralis Truncus sympathicus Lig
Vertebra thoracica II, Proc. spinosus
Fig. 968
Thoracic cavity, Cavitas thora c i s.
Corpus sterni Recessus costomediastinalis N phrenicus dexter Bronchus segmentalis anterior [B III]
Nodi Iymphoidei paratracheales A pulmonalis sinistra, A segmentalis anterior
• Pulmo sinister, Lobus superior
N intercostalis Bronchus intrasegmentalis
---+---'l:InII'--....::�.;:,;�·.��
N thoracicus longus N thoracicus longus
Pulmo dexter, Lobus superior
Oesophagus
M.
• A. thoracodorsalis
N. vagus dexter [X]
• M. teres major M. subscapularis . N. vagus sinister [X]
V. azygos .
Truncus sympathicus M. Vertebra thoracica IV
Fig. 969
Ductus thoracicus
Thoracic cavity, Cavitas thoracis.
Lungs
Oesopha g u s
Thym u s
To p o g ra p hy
Secti ons
Thorax, transverse sections
Corpus sterni
A lobaris superior . Pulmo dexter, Lobus superior Nodi Iymphoidei bronchopulmonales M serratus anterior . Costa III
Cartllago costal is
1,;;��������i i;�;�i,r�� �
M pectoralis major .
--*--41:.1.
n /
Cavitas pericardiaca
N. phrenicus dexter
• Truncus pulmonalls N. phrenicus sinister
•
• V. pulmonalis sinistra superior Bronchus principal is sinister Bronchus lobaris superior
---+-- Glandula mammaria
--+---l1liL11.'
N. thoracIc us longus
N. thoracicus longus
Fissura obliqua • A lobaris superior
Bronchus principalis dexter
• M serratus anterior
Pulmo dexter, Lobus inferior Fissura obliqua
M teres major . N vagus [XJ
Scapula
Truncus sympathicus
M. trapezius . Vertebra thoracica V
Fig. 970
Ductus thoracicus
Thora c i c cavity, Cavitas thoracis.
Bronchus principal is dexter Sternum Pleura parietalis, Pars mediastinalis M. pectoralis major
Bronchus segmentalis anterior [B I I IJ
Pars ascendens aortae
Bronchus segmentalis posterior [B IIJ
�_::....._..l._ V. cava superior
_
_ _ _ _ _
t------ Bronchus principalis sinister
�------ Pars descendens aortae
Bronchus lobaris superior dexter Bifurcatio tracheae Oesophagus Vertebra thoracica IV, Corpus vertebrae Vertebra thoracica IV, Proc. transversus
Fig. 971 Thoracic cavity, Cavitas thoracis; computed tomog ra p h i c cross-section [ CTI .
�
H e a rt
T h o ra c i c visce ra
Tra c hea
Thorax. transverse sections
Corpus sterni V. pulmonalis dextra superior . Sinus transversus pericardii • Truncus pulmonalis Costa III
N phrenicus dexter . M. pectoralis major .. Bronchus lobaris medius
N. phrenicus sinister Auricula atrii sinistri
Pulmo dexter, Lobus medius
Pulmo Sinister, Lobus superior
Bronchus lobaris medius
Glandula mammaria Bronchus lobans inferior
Oesophagus Nodi Iymphoidei �����S_.;llfl'----\-- bronchopulmonales 1IF1��!'!II��i.fI�----L_ Fissura obliqua
N thoracicus longus
;,;
Aa lobares inferiores . --+----
Cavitas pleuralis
Pulmo dexter, Lobus inferior
Bronchus segmental is basalis posterior [B X]
M. serratus anterior •
• V pulmonalis sinistra inferior
M, latissimus dorsi . V, pulmonalis dextra inferior •
• Pars descendens aortae
Ductus thoracicu s
M.
M trapezius .
Fig. 972
Vertebra thoracica VI
Thoracic cavity. Cavitas thoracis.
Atrium cordis sinistrum
}
Ostium atrioventriculare sinistrum CuSpiS anterior Cuspis posterior
Valva atrioventricularis sinistra [Valva mitral is]
Ventriculus cordis sinister
Valva aortae Valvula semilunaris dextra
Septum interventriculare Ventriculus cordis dexter
.,; ::: ....:..:.:
-
.,; "'" ....�
_ _ _ _
Fig. 973 H eart, Cor; u lt rasound i mage viewed fro m the oesop hagus [tra nsoesophageal echoca rd iog ra phyl.
Lungs
Oesophagus
I
Thy m u s
I
To p o g ra p h y
Sect i o n s
Thorax,
transverse sections
Sternum, Proc. xiphoideus Cartilago costalis Valva aortae Ventriculus cordis dexter
N phrenicus dexter Pulmo dexter. Lobus medius
• A. coronaria
sinistra, R. interventri cularis anterior
Papilla mammaria
Ventriculus cordis sinister
Glandula mammaria
Valva atrioventricularis sinistra [Valva mitral is]
�11�����--��k-- Lobus Pulmo sinister, superior
Fissura obliqua
Atrium cordis sinistrum M. serratus anterior .
•
V basalis inferior, • V. pulmonalis dextra inferior
N. phrenicus sinister
• V. cardiaca magna
Nodus Iymphoideus bronchopulmonalis Costa VI
N. vagus dexter [X] M, latissimus dorsi . Pulmo dexter, Lobus inferior
Pulmo sinister, Lobus inferior Vertebra thoracica VII N intercostalis Oesophagus
Fig. 974
Truncus sympathicus Ductus thoracicus
Thoracic cavity, Cavitas thoracis.
M. pectoralis major .
Sternum, Proc xiphoideus Valva atrioventricularis dextra [Valva tricuspidalis]
Pulmo dexter. Lobus medius Ventriculus ccrdis sinister
N. intercostalis Recessus costomediastinalis
'II
Mamma
---.J-.--+.'II
Fissura obliqua
,l";"'�=:;:;'--- • M. serratus anterior
Nodi Iymphoidei tracheobronchiales inferiores
N. phrenicus coronaria dextra
Pulmo dexter, Lobus infenor
• Pars descendens aortae
Bronchus segmentalis basalis lateralis [B IX] Nodus Iymphoideus juxtaoesophagealis N vagus dexter [X]
Ductus thoracicus V. azygos .
Fig. 975
Vertebra thoracica VII, Proc. spinosus
Thoracic cavity, Cavitas t horacis.
�
Abd o m i n a L viscera
��
I Stomach I S m a ll i ntest i n e I La rg e i ntest i n e I
Stomach
Oesophagus, Pars abdominal is
Incisura cardialis
;;:0....-- Fundus gastricus
Curvatura minor
Corpus gastricum
Duodenum, -----F-c -, Pars superior
Curvatura major Duodenum, Pars descendens
--fo---
Fig. 976 Stomach, Gaster; ve ntral view.
Liver
Pa n c reas
I
Sp le e n
I
To p o g ra ph y
Sections
Muscles of the stomach
-----
Fundus gastricus
Tunica muscularis, Stratum longitudinale
Oesophagus, Tunica muscularis
Curvatura major Tunica muscularis, Stratum longitudinale Curvatura minor
Pylorus --#H"''--''':;��
Fig. 977 Stomach, Gaster; externaL m uscle Layers; ventraL view.
Oescphagus, Tunica muscularis
Tunica muscularis. Stratum circulare
Pylorus
Tunica muscularis, Fibrae obliquae
--H-----.�
Duodenum --t...--
Fig. 978 Stomach, Gaster; the perito n e u m has been removed to demonstrate the i nternaL m u scle Layers; ventraL view.
�
Abd o m i na l viscera
��
I Sto m a c h I S m a ll i n t e s t i n e I La rg e i n testi ne I
Stomach, structure
O'S:;Iia:-- Fornl� gaslricus Incisura cardialis
Oesophagus, Pars abdominalis
Fundus gastrlcus
---iIo<>;e.:>or-.
Cardia [Pars cardiacaj, Ostium cardiacum
CurvBtura
---"��
"r;.'l:����A£IAIIW--
minor
Corpus gaslrloum
Curvatura Plicae gaslncae
Duodenum, Pars superior, Ampulla
Plicae circulares Duodenum, Pars descendens
Pars pylorica, Canalis pyloricus, Antrum pyloricum Pylorus
Fig. 979 Stomach, Gaster, a n d d u o d e n u m , Duoden u m ; ventral view.
Areae gastricae Foveolae gaslricae
Tunica mucosa Lamina propria mucosae Nodulus Iymphoideus solitarius
Tela submucosa
�,,��:;;;:••!:::�;:;�::::::::=;.,/�
{ Stratum clfClJ r
-
Tunica muscularis
la e
Stratum long,tudlnale
Tela subserosa Tunica
serosa
--����l�;':"�;;'-
Fig. 980 Diagra m of the stomach wall; the layers of the wall have been removed stepwise; m icrosco pic e n la rgement at low magn ification.
major
Liver
P a n cre a s
I S p le e n I
To pog ra p h y
Sections
Vessels of the stomach
A.; V gastrica sinistra, Rr. oesophageales Cardia [Pars car'o la"al ·.... A.; V. gastrica sinistra A, hepatica propria V. portae hepatis Ductus cysticus Ductus hepaticus communis
Omentum minus, Lig. hepatogastricum
Aa. ; Vv. gastricae breves
Lig. hepatoduodenale
A. hepatica communis A.; V. gastroomentalis sinistra
Pylorus
A.; V. gastrica dextra Omentum majus
Flexura duodeni inferior
A;
v. gastroomentalis dextra, Rr. omentales
Fig. 981 B lood vessels of the stomach, Gaster; ventra l view.
Lobus hepatis sinister
Nodi Iympholdei
hepatlci
Gaster
Lobus --1".-- hepatis dexler
7':;'"':"'.,.,.F--
Nodi Iymphoidei pylorici
Nodi Iymphoidei gastroomentales dextri
Fig. 982 Stomach, Gaster, a n d liver, H e par, with lym p h nodes, Nodi lym phoidei; ventral view.
Nodi Iymphoidei gastrici dextri
.... I
.. Abd o m i na l vi scera
Stomach
I
S m a l l i ntest i n e
I
Large i ntesti n e
Stomach, radiography
Oesophagus with contrast medium. At the transition (1 a) into the fundus of stomach, the grooves between the folds appear as dark striations 2 Fundus of stomach with air bubble 3 Body of stomach 3a Lesser curvature 3b Greater curvature. In the linings of the latter, notches corresponding to the contour of the mucous are visible. 4 Peristaltic constriction at the angular notch 5 Pyloric part prior to the progression of a portion of the stomach's content 6 Ampulla of duodenum 7 Descending part of the duodenum with circular folds 8 Jejunum 9 Left "dome" of diaphragm to Left colic flexure (filled with air) =
=
=
= =
=
=
=
=
=
=
=
Fig. 983 Stomach, Gaster, a n d duodenum, Duode n u m ; AP-radiogra p h after oral a d m i n istration of a contrast medium; u p ri g h t position ; ventral view.
Sternum, Proc. xiphoideus
Gaster, Cardia [Pars cardiaca]
Costa X
Gaster, Cardia [Pars cardiaca]
----"f'1fIQ
Costa X
---:;po,,2!Y
Gaster, Pars pylorica
Gaster, Pars pylorica Spina iliaca anterior superior
Fig. 984 Stomach, Gaster; projection of a " normal" stomach onto t h e a nterior abdominal wall; u pright positi o n .
Spina iliaca anterior superior
Fig. 985 Stomach, Gaster; p rojection of a "lo n g " stomach onto the a nterior abdominal wall; upright position.
I
Liver
Pa n c re a s
I
S p le e n
I
To p o g ra p h y
Sections
Gastroscopy
11 -1----- Oesophagus
Antrum pyloricum
Duodenum
Fig. 986 Tech nical procedure of oesophagoscopy and gastroscopy. " Gastroscope "" The gastroscope's tip located in the body of stomach icompare Fig, 987 a i """The gastroscope's tip located in t h e pylo ric antrum icompare F i g , 987 bi
�
Gaster, Paries anterior
-_--I-- Gaster.
_ _ __ _ _ _
Paries anterior
Plicae gastricae
--�- Pylorus
----- Gaster, Pars pylorica, Antrum pyloricum
��====d-- Gaster,
Gaster, Paries posterior
Paries posterior
a
Fig. 987 a, b Stomach. Gaster; endoscopic i mage of the stomach [gastroscopy) ; s u pe rior View,
b
a View of t h e body of stomach. Corpus gastricum. with d isti nct longitudinal folds of the m ucosa [ Plica gastricael b View of the pyloric antrum. Antrum pyloricum, pred o m i n a ntly covered with s mooth m ucosa
1�3.,"
�
Abd o m i n a L viscera
��
I Sto m a c h I Small i ntestine I La rg e i n test i n e I
Duodenum
-+'+---- Gaster. Pars pylorica
Duodenum. Pars superior
11,.-&--- Jejunum Duodenum. Pars descendens
Duodenum. Pars hOrizontalis
Fig. 988
Duod e n u m . D uoden u m .
Duodenum, Pars superior
�=;�=-+--
Duodenum, Pars descendens Pancreas, Caput Duodenum, Pars horizontal is
Pancreas. Cauda
Pancreas, Corpus
Flexurtl duodenojejunalls Duodenum. Pars asce nd ens
Fig. 989 Duodenum, Duode n u m , and pancreas, Pa n c reas; projected onto the a nterior abdominal wall.
L ive r
Pa n c re a s
I
S p Le e n
I
To p o g ra p h y
Sections
Duodenum
Duodenum, Pars superior, Ampulla [Bulbus]
,..�:--- Pylorus, Ostium pyloricum Canalis pyloric us Antrum pyloricum
Plicae circulares
)
Pars pylorica
IQ---- M. suspensorius duodeni
•
Duodenum, Pars descend ens
a..---
Ampulla hepatopancreatica
Flexura duodenojejunalis
Papilla duodeni major • •
�.....,""'-- Jejunum Tunica muscularis
Duodenum. Pars horizontal is
Fig. 990 Duodenum, Duod e n u m ; ventraL view. * **
Clinical term: m u scle of TREITZ Clinical term: papilla of VATER
Flexura duodenojejunalis Gaster. Curvatura minor
Phcae clrculares
DlJodenum. Pars horlzonlalls Fig. 991 Duodenu m , Duode n u m ; AP-ra d i o g ra p h after oraL a d m i n istration of a contrast m ed i u m ; upright position; ventraL view.
Fig. 992 Duodenum, Duode n u m ; endoscopic image.
•
Abdo m i n a l vi scera
••
I Sto m a c h I Small intestine I Large i nt e st i n e I
Small intestine, structure
Tela submucosa
---;--'--.:f-�-i�')��
�T,'''' .,.-""...""",;;.{itJ
duodanalBs'
Tunica muscularis, Stratum circulare
Fig. 993 Superior part of t h e d u o d e n u m , Pa rs s u perior d u o d e n i ; layers o f the wall. •
Tunica muscularis, Stratum longitudinale
Clinical term: BRUNNER's glands
Pe 'l t
�i�C����
{
}
Lamina muscUlariS mucosae Tunica mucosa Villi intestinales
����[
TUniCa serosa Tela subserosa
Nodulus Iymphoideus --3Ilf-ftI"< solitarius
Tunica muscularis
{
Stratum longitudinale
Stratum circulare
Fig. 994 Small i ntestine, I ntest i n u m tenue; c ross-section t h ro u g h t h e upper small i ntestine.
Villus intestinalis
Tunica mucosa
(
Tela submurosa Tunica muscularis
Glandulae intestinales
__��-----��:;���������� Lamina muscularis mucosae
Stratum circulare
Stratum longitudinale
�:�=====;� �
Tela sUbse"rosa Tunica serosa -
Lamina propria mucosae
Vas Iymphaticum centrale
����
��
Fig. 995 Small i ntest i n e , I ntest i n u m tenue; layers of the wall; m i c roscopic e n la rgement at low m a g n ification.
���������
Liver
I
Pa n c re a s
S p le e n
I
To p o g ra p h y
Sections
Mucosa of the small intestine
Tela ---1....,.:�--1,'
subserosa
41', Tunica muscularis
Plicae circulares
..- .---""
� � �
""..-.- Plicae circulares Noduli Iymphoidei solitarii
Fig. 996
Jej u n u m , Jej u n u m .
Fig. 997
I le u m , I le u m .
Plicae circulares
Noduli Iymphoidei solitarii
� ������Mi�t�['t�r�����
---i--<..
Noduli Iymphoidei aggregati*
Fig. 998 Terminal i le u m , Pars terminalis i lei . •
Clinical term: PEYER's patches
Fig. 999 M ECKEL ' s d iverticulum ( D iverticulum ileiJ. This vestige of the yolk stalk (Ductus omphaloentericusJ occurs i n 1-3% of cases. It is located 30� 70 cm oral to the i leocaeca l j u n ction opposite to the attach ment of the m esentery.
�
Abd o m i na l viscera
��
I
Sto m a c h
I
S m a l l i ntest i n e
Large intestine
Flexura coli sinistra
--7JS��
Flexura coli dextra
Colon ascendens
Ileum
Colon transversum
)110../(,1"".--+- Haustra coli
___-- Colon descend ens
--IIt-:".MlI . ..
Caecum
Appendix vermiformis Colon sigmoideum
Fig. 1 000 Large i ntestine, I ntesti n u m crassu m ; ventral view.
Flexura coli
dexlra
Colon ascend ens Ileum Caecum App endi x verm l forml s
-- ---,t<:-...,. ---,f-i
--r--+�'iiL)
'----- Flexura coli sinistra ---- Colon transversum Colon descendens Colon sigmoideum Rectum
Fig. 1 001 Larg e i ntesti n e , I ntest i n u m crassu m ; projected o n t o t h e a nterior a b d o m i n a l wa ll. The positions of the t ransverse colon and of the sig moid colon a re h i g h ly va ria ble [compare Fig. 1010).
I
Larg e i ntestine
I
Liver
Pa n c re a s
I
S p le e n
I
To p o g ra p hy
Sec t i o n s
Large intestine, structure
Taenia libera
----,��..,.�
Colon ascend ens
Taenia omentalis
Plicae semilunares coli
Colon ascendens
Papilla ilealis
Plicae semilunares coli
11I':.=_- lIeum
�!5_-
Appendix verml formis
Caecum
Ileum
Noduli Iymphoidei aggregati '
Frenulum ostii ilealis Caecum Appendix vermiformis Ostium appendicis vermiformis
Fig. 1 003 Asce n d i ng colon, Colon ascendens; caec u m , Caecum, a n d vermifo rm appendix, Appe n d ix vermiform is; ventra l view.
Fig. 1 002 Caecum, Caec u m ; ve rmiform appendix, Appendix vermiformis, a n d terminal i le u m , Pars terminalis ilei; dorsal view.
•
Clinical term: PEYER's patches
Plicae semilunares coli
Omentum majus
Taenia omentalis
Haustra coli
Mesocolon transversum
Fig. 1 004 Tra nsverse colon, Colon t ra n sve rs u m ; ventroi nferior view.
Appendices omentales [epiploicae]
Glandulae intestinales
Tunica mucosa
:�;;�lon�gltU;din;a�le�:;��!!t!I! II�iI!!iI���!i��I!�ii !II !l� Lamina muscularis mucosae
Tela submucosa
Tunica muscularis
Fig. 1 005 Colon, Colo n ; layers o f the wall; microscopic e n la rgement at low m a g n ification.
Tela subserosa Tunica serosa
{ StraStturamtuclmrculare
-------".-_
�
Abdo m i naL viscera
��
I
Sto m a c h
I
S m a ll i ntest i n e
I
La rge i ntestine
Vermiform appendix
Splen [lien] Lobus hepatis dexter
Gaster
Vesica biliaris
Omentum majus
----it-tl1At
�."..,.-:._....-l;. . �!-- Colon transversum
Duodenum, Pars descendens
r'"::-;tflt-t--
Caput pancreatis
Duodenum, Pars ascendens
r--�iifiil�--\!ml4-- Radix mesenterii �ttilH�- Colon descendens
Colon ascendens
Ileum Caecum Colon sigmoideum Ampulla tubae uterinae
Fig. 1 006 Vermiform appendix, Appendix vermiformis; va riations i n its posit i o n ; ventraL view.
:-:--�-- Tunica musculans, Taenia llbera
Colon ascendens
---
Ileum
Colon ascendens Spina iliaca anterior superior
Appendix vemniformis
a
Spina iliaca anterior superior
- 30 %
_ _
Appendix vermiformis Caecum
b
- 65 %
c
-2%
d
<1%
Fig. 1 007 a-d Vermiform appendix, Appendix vermiformi s ; va riations i n i t s position. a Descending i nto the Lesser peLvis b B e h i n d the caecum c I n front of the iLeum d B e h i n d the i Le u m
Fig. 1 008 Caecum, Caecum, a n d vermiform appendix, Appendix verm iform is; projection onto the a nterior abdominaL waLL. •
••
Clinical term: v. LANZ's point, at the right third of a line connecting the anterior superior iliac spines, locates the tip of the vermiform a ppendix Clinical term: McBURNEY's point, at the outer third o f a line connecting the right anterior superior i liac spine a n d the u m b i licus. locates the base of the vermiform appendix
I
Liver
')1.<"
,I
To p o g r a p h y
Large intestine, imaging
Flexura coli dextra
-
....
;;; -",i;
-
Flexura coli sinistra
Caecum Appendix vermiformis
Colon lransversum Haustra coil
Colon sigmoideum Colon descendens
Rectum
Fig. 1 009 Colo n , Colo n , a n d rect u m , Rect u m ; AP-radiograph after filling w i t h a contrast m e d i u m a n d a i r [double contra st method ! '
Fig. 1 0 1 0 a-d Transverse colon. Colon tra n svers u m ; common va riat i o n s i n i t s position; ventral view.
a Normal position b Twisted
Fig. 1 0 1 1 Asce n d i n g colon , Colon ascendens; e ndoscopic image after passage of the rectu m , the sigmoid colon , t h e d escending colon and t h e transverse colon [colonoscopyl.
c U-shaped d V-shaped
�
Abd o m i na l viscera
��
I Sto m a c h I S m a ll i ntest i n e I La rg e i ntest i n e I
Liver
Lig. triangulare dextrum
Lig. coronarium
Diaphragma
-----
Lig. triangulare sinistrum
Lobus hepatis sinister, Facies diaphragmatica
Lobus hepatis dexter, Facies diaphragmatica
Lig. falciforme
Lig, teres hepatis
Fig. 1 0 1 2 Liver, Hepar; ventral view.
Impressio oesophagea
. . FaCies dlaphragmatica
Appendix fibrosa hepatis
{
pars superior'' A rea nuda
Impressio suprarenalis
coronarium Lobus caudatus V.
Impressio gastrica
portae hepatis
Impressio renalis Tuber omentale Ductus choledochus [biliarisj
Proc. papiliaris
A. lobi caudati Impressio duodenalis
Lobus hepatis sinister
A. cystica A Lobus hepatis dexter
Fig. 1 0 1 3 Liver, H epar, a n d porta hepatis, Porta hepatis; dorsal view. * Borders of the su p eri o r recess of the omental bu rsa
Live r
Pan creas
I
S p leen
I
To p o g ra p hy
Sect i o n s
Liver
Lobus hepatis dexter, Tunica serosa
Lobus hepatis sinister, Tunica serosa
Lig. coronarium
Appendix fibrosa hepatis
Peritoneum V. cava inferior
Fig. 1 0 1 4 Liver, Hepar; superior view.
V.
portae hepalls
Fig. 1 01 5 Liver, H epar, of a foetus; oxyge n content of the blood is shown by d i fferent colours and the d i rection of flow by a rrows; d o rsal view. • Also: Ductus ARANTII
1 44, .�
�
Abd o m i n a l viscera
��
I S t o m a c h I S m a l l i nt e st i n e I Large i nt e st i n e I
Liver puncture
Costa V
Diaphragma
---i--Hepar, Lobus sinister
Hepar, Lobus dexter
Lig teres hepatis
Fig. 1 0 1 6 Liver, Hepar; projection onto t h e anterior abdominal wall; i ntermediate positi o n between inspiration a n d exp i ration.
Vesica biliaris
* Position of the needle f o r liver puncture Pulmo
M intercostalis externus M. intercostal is internus
Fig. 1 0 1 7 Layers of the a b d o m i n a l w a l l a n d the liver, Hepar; f rontal section. * Position o f the needle for liver puncture
c a
b
Fig. 1 0 1 8 a-d Liver, Hepar; va riations i n shape . a Small left lobe of liver, Lobus hepatis sin ister b Ton g u e - s haped process of the right lobe of liver, Lobus h epatis d exter c Bridged flat shape d D i a p h ragmatic fu rrows
d
Liver
Pa n c re a s
I
Spleen
I
To p o g ra p h y
Sect i o n s
Liver, structure
coronanum
Lig coronarium
Facies visceralis
Fig. 1 0 1 9 Liver. Hepar; sagittal section t h ro u g h t h e right lo be of liver to demo nstrate the branches of the hepatic vei ns and the hepatic portal vein.
•
••
Intrahepatic branches of the hepatic veins Intrahepatic branches of the hepatic portal vein a nd the hepatic a rtery
��..-'.lr--
Laminae
hepatocytjcae
.... ,......--- Ductus bilifer interlobularis
V interlobularis
",.,r-_ A interlobularis
Fig. 1 020 Liver. Hepar; m icroscopic structu re [ m i croscopic enla rgement at low mag n ification i ;
t rias of GLISSON [consists of a b ra n c h of the hepatic portal ve i n . a bra n c h o f the hepatic artery proper a n d a small b i le duct!. a n d a small live r lobule s u rro u n d i n g a central vei n .
1 46
I
�
Abd o m i n a l viscera
��
I S t o m a c h I S m a l l i ntest i n e I Large i ntest i n e I
Blood vessels of the liver
! 1-- v. cava inferior 1.I!II1I!!!. --f�IC----:"�<-
Vv hepaticae dextrae
������'-:�- Vv. hepaticae sinistrae
Vv. hepaticae intermediae
.....'!--- A. hepsllca proplJa V. portae hepalis
Vesica biliaris
Fig. 1 02 1 Liver, Hepar, a n d hepatic vei ns, Vv. h e patica e ; ventral view.
Ductus hepaticus sinister
V. portae hepatis, R. sinister
A hepatica propria, R. dexter
V. portae hepatis, R. dexter
--1-=�::::I1I!!!
A hepatica propria, R. sinister
Ductus hepaticus dexter
Ductus choledochus [biliaris]
v. portae hepalis
Fig. 1 022 Liver, Hepar, a n d the hepati c portal ve i n , V. portae hepatis; ventral view.
Liver
Pa n c re a s
[ S p le e n [
To p o g ra p h y
Sect i o n s
Segments of the liver
Fissura portalis prineipalis SegmenlUm posterius medlale dextrum [VIII)
Fissura portal is dextra
--!'
Segmentum posterius laterale dextrum [VII]
---+-- Segmentum posterius laterale sinistrum [II]
�"�-------T---�--
Lig. laleiforme
Segmentum anterius laterale sinistrum [III]
Segmentum anterius laterale dextrum [VI]
Segmentum anterius mediale dextrum [V]
Fig. 1 023 Liver, Hepar; the segments of the lobes a re shown in d ifferent colours ; ventral view.
Lig. triangulare sinistrum (Lig. venae cavae) Segmentum [I] Segmentum posterius laterale sinistrum [II]
--j�-
---.-- Segmenlum poslerlus laterale dexlrum [VII]
Lig. venosum -�:------'
Segmentum anterius laterale sinistrum [III]
---\:--
___
-
Segmentum anterius laterale dextrum [VI]
�IMI--- Segmentum anterius mediale dextrum [V]
Segmenlum medlale s-inistrum [IV] Lig. teres hepatis
Fig. 1 024 Liver, H epar; the segments of the lobes a re shown in different colours; dorsal view.
�
Abdo m i n a l viscera
��
I Sto m a c h I S m a ll i ntest i n e I L a rg e i ntest i n e I
Liver, ultrasound
\ ) V. hepatica sinistra
V hepatica intermedia
V hepatica dextra
V. cava inferior
Diaphragma Pulmo dexter, Lobus inferior
1 -7
1 02 1
I
Fig. 1 02 5 Hepatic vein s , Vv. h e paticae ; u lt rasound image showing the opening of the hepatic veins i nto the i nferior vena cava ; i nferior view . • Abdominal wall
V portae hepatis, R. dexter
(
R. anteCior
---.::�� Pars abcominalis aortae
R postetlot
Pars costal is diaphragmatis
Fig. 1 026 Hepatic portal vei n , V. portae hepatis; ultrasou n d image showing the d ivision of the hepatic porta l ve i n i nt o the m a i n branches; i nfe rior view. •
Abdominal wall
Liver
Pa n c re a s
I
S p le e n
I
To p o g ra ph y
Sections
Liver, laparoscopy
Diaphragma
Fundus vesicae biliaris
Colon transversum
Hepar, Lobus dexter
Omentum majus
Fig. 1 027 Live r, Hepar, a n d ga llbladder, Vesica biliaris [fe llea]; laparoscopy; oblique i nferior view fro m the left.
Fundus vesicae biliaris Lobus hepatis sinister
Corpus vesicae blliaris
.. ... ...."'--1'1 . --11'"........
A.; V. cystica
Peritoneum parietale -��-Collum vesicae biliaris Lobus hepatls dexter Duodenum. Pars superior
Fundus gastricus
Flexura
0011 dextra
Omentum maills
Fig. 1 028 Gallbladder, Vesica b i liaris [felleal, a n d liver, Hepar; laparoscopy; ve ntral vi ew.
�
Abd o m i na l viscera
��
I Sto m a c h I S ma l l i n t e s t i n e I L a rg e i n test i n e I
Gallbladder and bile duct system
Lig falciforme
Lobus hepatls
sinister
Lobus hepatls dexter
Ductus hepaticus dexter
Ductus hepaticus sinister
Collum vesicae biliaris
a Ductus hepaticus communis
Plicae mucosae
',"*-"--
Plica spiralis*
Ductus choledochus [biliaris]
Tunica serosa
:: ___ : ::::-. Plicae circulares '-:::::::::
Noduli Iymphoidei solitarii
Plica longitudinalis duodeni
--:;ooOOO,;r�� "l't'-::.�r---'�-
(Oriticium ductus pancreatici)
Papilla duodeni major **
Fig. 1 029 Ga llbladder, Vesica b i liaris [felleal. a n d bile d u ct system ; ventral view, * *.
Clinical term: HEISTER's valve Clinical term: tubercle of VATER
Fig. 1 030 a-c Va riations i n the b i le duct system: common hepatic d u ct, Ductus hepaticus co m m u nis, a n d bile duct, Ductus c holedochus, a H i g h u n i o n of t h e common hepatic duct, Ductus hepaticus communis, a n d the cysti c d uct, Ductus cystic u s b Low u n i o n o f the c o m m o n hepatic d u ct, D u c t u s hepaticus c o m m u n i s, a n d t h e cystic duct, Ductus cyst i c u s c Low u n i o n after the cysti c d uct, D u c t u s cysticus, crosses over the common hepatic duct, Ductus hepaticus c o m m u n i s
Live r
Pa n c re a s
I
S p lee n
I
To p o g r a p h y
Sec t i o n s
Bile duct system, radiography
Ductus hepaticus dexter
Ductus hepaticus communis
Ductus cysticus
Vesica biliaris
Ductus choledochus [biliaris]
Duodenum
Fig. 1 03 1 B i le duct system; AP-radiogra p h after a d m i n istration of a contrast m ed i u m ; upright posi t i o n ; ventral view.
Ductus cysticus, Plica spiralis
.:.-.-..,;,...,-- Ductus hepaticus communis
Collum vesicae biliaris
Duodenum
�-t--
Corpus vesicae biliaris
Fig. 1 032 Gallbladder, Vesica biliari s [felleal, and b i le d uct system; AP-ra d i o g raph after a d m i n istration of a contrast mediu m ; upright positi o n ; ventral view.
Ductus choledochus [biliaris]
Abd o m i n a l viscera
�
��
I
Stomach
I
I
S m a ll i n test i n e
La rg e intest i n e
Pancreas
Pars thoracica aortae A
gastrica sinistra
Diaphragma A.; V. splenica [Iienalis]
Glandula suprarenalls
Ren
Ductus cysticus Cauda pancreatis
A. gastro· duodenalis Ren A ; V. mesenterica
superior
( V. gastro· duodenal is)
�J�7'1f--J�'������ �JZJt===lb=����' �����j !����r
Truncus coeliacus A hepatica communis A renalis
Caput pancreatis Duodenum. Pars descend ens
V. renalis
--�--�----����---
A.; V colica media A. ; V. colica dextra Jejunum M M,
V, mesenterica inferior A. mesenterica inferior Aa,; Vv. jejunales et ileales
Fig. 1 033 Retroperitoneal o rgans a n d vessels of the u pper abdomen; ventral view.
Canalis pyloricus M sphincter pyloricus Corpus pancreatis
lriII1il1 ,'�--- Cauda pancreatis
Ductus choledochus [biliaris] Ductus pancreaticus accessorius** Papilla duodeni minor
M. suspensorius duodeni****
Ductus choledochus [biliaris]
Incisura pancreatis
Duodenum, Pars descendens
....-I'W�...�- Flexura duodenojejunalis
Plica longitudinalis duodeni
....::.....-I-=�--- Duodenum, Pars ascendens
Papilla duodeni major'*'
Caput pancreatis Duodenum. Pars horizontalis Proc. uncinatus
Fig. 1 034 Duodenum, Duodenum, a n d pancreas, Pa n c reas; ve ntral view. Clinical term: d uct of WIRSUNG Clinical term: SANTO R I N I 's duct *** Clinical term: tubercle of VATER **** Clinical term : muscle of TREITZ
I
Liver
I
Pancreas
S p le e n
I
To p o g ra p h y
Sect i o n s
Pancreas
,..----- Ductus hepaticus communis
fi4iij;S\f�r7---==:':O;;;:- Ductus cysticus
Flexura duodeni superior
(SulcuS arteriae splenicae)
:A----'----'r--
Corpus pancreatis
Ductus choledochus [biliaris]
Ductus pancreaticus Duodenum, Pars descend ens Caput pancreatis
A. mesenterica superior
Flexura duodeni inferior
Fig. 1 035 Duoden u m , Duodenum, a n d pancreas, Pancreas; dorsal view.
Duodenum, Pars horizontalis
Ductus choledochus [biliaris] .--.:;;.--- Ductus pancreaticus
IIi< · H _"._
-----
Pancreas
Papilla duodeni mal or
c
b
Papilla ----" duodenl minor
e
d
Fig. 1 036 a-f Va riations i n the opening of t h e bile d u ct, Ductus c holedochus, a n d the pancreatic duct, Ductus pancreaticus. a Long common part b Ampulla ry e n la rgement at the term i n a l part
c Short common part d Separate opening e S i n g le opening with a septu m divi d i n g the common d u ct
f Accessory duct, Ductus pa n c reaticus accessori u s
W-'::-"",--- Pancreatocyticus exocnnus
Insula pancreatica
Fig. 1 037 Pancreas, Pa n c reas; microscopic enlargement at low magnification.
-:-t!a.� ., .--in....r....
-
.-..P.II!oJ--- Acini pancreatici -..,...".,,1-- Ductus excretorius
�
Abd o m i n a l viscera
��
I
Stomach
I
S m a l l i ntesti n e
I
Large i n test i n e
Pancreas, imaging
Ductus pancreatic us; Cauda pancreatis
Ductus hepaticus -I-_��"':"-'-"':"" commUniS
Ductus cysticus ----T--;:'-----�.il Jejunum
Vesica biliaris --+'-,-----
Ductus choledochus [biliaris]
--1=::;;;;",:","'"
Ampulla hepatopancreatica Ductus pancreatic us
Fig. 1 038 Pancreatic duct. Du ctus pancreaticus; bile d uct, Ductus c holedochus, a n d g a llbladder, Vesica b i liaris [fellea l ; AP-ra d i o g ra p h ; s u p i n e position; after endoscopic intu bation of the common excretory duct of the liver
"\
j
a n d the pancreas, as well as i nj ection of a contrast m e d i u m ; ventral view. C l i n ical term : ERCP [ endoscopic retrograde chola n g i o pancreaticog ra phyj.
V. portae hepatis, R. sinister Hepar, Lobus sinister A mesenterica superior A. splenica
Lig teres hepatis Corpus pancreatis V. portae hepatis
V. renalis sinistra
Cauda pancreatis
Pars abdominalis aortae Vertebra lumbalis I
Fig. 1 039 Pa n c reas, Pancreas ; u ltrasou n d image showing t h e pancreas a n d adjacent large vessels i n deep inspira t i o n ;
oblique i nferior view. • Abdominal wall
I
L iver
Pancreas
I
S p lee n
I
To p o g ra p hy
S ections
Pancreas. imaging
Gaster, -�-------,""","--- (Paries posterior)
Cauda pancreatis
Corpus pancreatis
Colon transversum
Flexura coli dextra
Fig. 1 040 Pa n creas , Pa n c reas; the gastrocolic ligament of the g reater omentum has been d issected to expose the omental b u rsa; p hotogra p h ta ken d u ri n g s u rgery. * D issection line at the greater omentum
M, rectus abdominis
Gaster
Cavitas pleuralis A splenica caput Corpus Cauda
A. gastrica sinistra
A hepatica propria V cava i nferior
-11--,..,----_-'-_
}
pancreatis
V. splenica
Hepar Splen [Lien] Pars lumbalis diaphragmatis, Crus dextrum Truncus coeliacus
Ren
Corpus vertebrae Pars abdominalis aortae [Aorta abdominalis]
Fig. 1 041 Panc reas, Pancreas; computed tomographic horizontal section l eT] ;
i nferior view. I n t h i s s u bject, the coeliac trunk is located re marka bly low. * Air bubble in the sto m a c h
�
Abdo m i n a l visce ra
��
I
Stomach
I
S m a l l i ntest i n e
I Large i ntest i n e I
Spleen
Margo superior
V.
splenica [Iienalis] Facies visceralis. Facies colica
A. splenica [Iienalis]
Hilum splenicum
Facies visceralis. Facies gastrica
Lig. splenorenale
Lig gastrosplenicum
Extremitas anterior
Extremltas posterior
Facies visceralis. Facies renalis
Fig. 1 042 Splee n . Splen [Lien]; ventromedial vi ew.
FaCies diaphragmatica
Extremitas anterior Extremitas posterior
Fig. 1 043 Spleen. Splen [Lien) ; 5u perolatera l view.
Facies diaphragmatica Tunica serosa; Tunica fibrosa Facies renalis Trabeculae splenicae
Pulpa splenica
V
splenica [lienal is]
Fig. 1 044 Spleen. Splen [Lien); c ross-section t h ro u g h the splenic h i l u m ; 5 u pe romedial view.
A. splenica [lienalisJ
Hilum splenicum
Facies gastrica
Liver
I
P a n c reas
S p Leen
I
Sections
To pogra p hy
Development of the intestines
.---':--Hepar
Pars thoraclca aortae
Hepar
Cavitas
Gaster
per�onealls
Pancreas
Gaster Duodenum Bursa omental is
---6,"""I--i"';,d�
Colon transversum Omentum majus
Bursa omental is
-----"i2l-f �,....
--�-t'�iItI_...1I""':
Splen [Lien!
-r.f1*I-__hl-
-
Pancreas
Jejunum
V. cava inferior
Pars abdomlnalls
aortae
Fig. 1 045 Development of the peritoneal cavity, Cavitas perito nealis, and the visceral relationships; schematic m e d i a n sect i o n ; latera l view.
Fig. 1 046 Development of the peritoneal cavity, Cavitas peritonealis; schematic horizontal sect i o n ; superior view.
Hepar
JIII-J;;;� ; !:----!-:---r-- Pars thoracica aortae
Diaphragma
Oesophagus
Lig. hepatogastricum Pancreas Bursa omentalis
Cavitas peritoneal is Gaster
---'-�I-<
Mesocolon transversum ---L--l&I-'--.,.4ii;C;,,,, Lig gastrocolicum
Colon transversum Duodenum
Cavitas peritonealis
Colon sigmoideum
Excavatio rectouterina
Excavatio vesicouterina
Fig. 1 047 Development of the peritoneal cavity, Cavitas peritonealis, and the visceral relationships of the female; final state of the peritoneal cavity with adhesion of the g reater omentum to t h e t ra n sverse colo n ;
*
schematic median sect i o n ; latera l view. The omental b u rsa correspo n d s with the peritonea l cavity via the omental fora me n . •
Clinical ter m : pouch of DOUGLAS
�
Abd o m i n a L viscera
��
I S t o m a c h I S m a l l intest i n e I Large i nt e st i n e I
Greater omentum
Pars pylorica Lobus hepatis dexter
Fundus vesicae biliaris
Lig. gastrocolicum
��t-:.��Fi1ii11�;';;.,!1!�";:;"'.y...- Colon transversum
M. transversus abdominis
Taenia omental is
M. transversus abdominis
'ill�-:'�r-- M. obliquus internus abdominis
M. obliquus externus abdominis
Colon ascend ens, Taenia libera
Colon sigmoideum
Peritoneum parietale
Plica umbilicalis lateralis (A.; V. epigastrica inferior) Ileum
Linea arcuata Plica umbilicalis medialis (Chorda arteriae umbilicalis) Plica umbilicalis mediana (Lig. umbilicale medianum)
Fig. 1 048 Position of the a b d o m i n a l viscera , Situs visceru m , a n d g reater omentum, O m e n t u m majus.
Live r
Pa n c reas
I
S p le e n
I
Top o g ra p hy
S e ct i o n s
Abdominal viscera of the neonate
Pericardium fibrosum
Pleura parietalis, Pars costal is
Pulmo sinister, Lobus superior
Pulmo dexter, Lobus superior
Pulmo dexter, Lobus medius Pleura parietalis, Pars mediastinalis
Pulmo dexter, Lobus inferior
Pleura parietal is
{
Pars mediastinalis
Pulmo sinister, Lobus inferior
Pars diaphragmatica
�Hf4I1"---
Diaphragma
"'�1I4y.:�--
Lig falciforme
Splen [Lien], Extremitas anterior Lobus hepatis sinister
Gaster, Curvatura major Colon descend ens
Lobus hepatls dexter
V, umbilicalis
Intestinum tenue
Plica umbilicalis lateralis (A,; V, epigastrica inferior)
Plica umbilicalis medialis (A umbilical is)
Vesica urinaria
Anulus umbilicalis Lig_ falciforme
Fig. 1 049
V, umbilicalis
Position of t h e abdominal vi scera of the neonate,
�
Abd o m i n a L viscera
��
I Sto m a c h I S m a ll i n test i n e I La rg e I ntest i n e I
Abdominal viscera in the upper abdomen
Ug.
teres hepaUs
Lobus hepatis Sinister, Facies visceralis
Lobus hepatis dexter, Facies diaphragmatica
Fundus
gastricus Lobus quadratus
����H!t-I- Appendix
Omentum minUS, Lig. hepatogastricum
fibrosa hepatls
�t\---ui<WiHr-- Cardia IW\-It:..II+rl-- Recessus
Vesica biliaris
costodiaphrag maticus
Omentum minus, -�lJ:!,JJI Lig. hepatoduodenale Foramen omentale [epiploicum]
•
.:1rr't"IIl-H- Corpus gastricum, Paries anterior
-'-Hl�tII!i�
Splen [Lien] Gaster, Curvatura
Lobus hepatis
minor
dexter, Facies
visceralis
Lig. gastrosptenicum
Duodenum, Pars superior
����:.Ali'ir:-7- Lig, phrenicocolicum Incisura angularis
Ren, Extremitas supenor
Gaster, Curvatura major
Pylorus
Omentum majus A.; V. gastro omentalis sinistra
Flexura coli dextra
Mesocolon transversum
Taenia omentalis
Omentum majus, Lig. gastrocolicum
Fig, 1 050 Position of t h e abdominal viscera i n t h e upper a b d o m e n ; ventral view. •
Also : fora m e n of WI NSLOW
Hepar, Lobus sinister
Gaster, Pars pylorica
Gaster, Curvatura major
Hepar, Lobus dexter
Vesica biliaris
'�---....,�---t- V. gastroomentalis sinistra, R. omentalis V. gastroomentalis dextra, Rr gastrici
Fig_ 1 05 1 Stomach, Gaster, a n d g reater o m e nt u m , Omentum maj u s ; photograph taken d u ri n g s u rg e ry; ve ntral view. • ••
Surg ical d ra p e S u rg i c a l retractor
Liver
I
Pa n c reas
S p le e n
I
To pog ra p hy
S ec t i o n s
Abdominal viscera in the upper abdomen
Lobus hepatis sinister, Facies diaphragmatica Lig. teres hepatis Recessus superior bursae omentalis Splen [Lien], Margo superior Plica gastropancreatica
Lobus caudatus
Recessus splenicus Vesica biliaris
--Rlfr4IM1!4 Corpus gastricum, Paries anterior Omentum minus, Lig. hepatogastri cum
Omentum minus, Lig. hepato duodenale
Corpus pancreatis
Mesocolon transversum
Tuber --",-",'1,""' omentale Facies antero superior
Gaster, Curvatura major Recessus inferior bursae omentalis
Fig. 1 052 Abd o m i n a l viscera i n the upper abdomen ; part s of t h e lesser omentum have been removed to expose the omental b u rsa a n d the pa n c reas; oblique view from superior.
Plica gastropancreatica
Lig. gastrocolicum
Glandula suprarenalis Lig. gastrosplenicum
Splen [Lien], Margo superior Lig. hepato duodenale
A. ; V. splenica
Pylorus Hilum splenicum
Duodenum, Pars superior
Cauda pancreatis Corpus pancreatis, Facies anterosuperior Taenia omentalis
Colon transversum
Colon ascendens Taenia libera
Mesocolon transversum
�lI��H.1I Fig. 1 053 O m e ntal b u rsa, B u rsa omentalis; after d issectio n of the gast rocolic liga ment; oblique view from i nferior.
�
Abd o m i n a L viscera
��
I Sto m a c h I S m a ll i ntest i n e I Large i ntesti n e I
Abdominal viscera in the lower abdomen
Omentum majus
Taenia libera
Flexura coli dextra
Appendices omentales [epiploicae1
--i�;;'�
Flexura coli sinistra
,....:..:o<-..,i"";i--Colon ascendens
Jejunum
--'l't�::=-:.;
Taenia libera
rlf----:l:II-- Colon sigmoideum Sulci paracolici
Appendices omentales [epiplolcaej
Ileum Plica ileocaecalis
Fig. 1 054
Position of the abdominal viscera, Situs viscerum.
Live r
Pa n c reas
I
S p Le e n
I
To pography
Sect i o ns
Abdominal viscera in the lower abdomen
Omentum majus
Haustra coil
Fundus vesicae biliaris
A.; V. colica media
Flexura coli dextra
Lobus hepatis dexter, Margo inferior Duodenum, Pars horizontal is
Mesocolon transversum
-----'im---"'=-"
Pancreas
------'�b�--I.
Taenia libera
Jejunum
---"!,!'Iii!'''';''
Recessus ileocaecales superior et inferior
--f--d.P.f,
Radix mesenterii
Plicae semilunares coli
SulcI paracolici
Ileum, Pars terminalis
_.J:,;......J,.-1"i"'11�
Ileum
Plica ileocaecalis
Caecum Ureter, Pars abdominalis
Appendix vermiform is
Fig. 1 055 Small i ntest i n e , I ntest i n u m tenue, a n d large i ntestine, I ntest i n u m crass u m .
�
Abd o m i n a l viscera
��
I Sto m a c h I S m a L L i ntest i n e I La rge i n test i n e I
Abdominal viscera in the lower abdomen
Taenia libera
A.;
V.
colica media Pancreas, Facies anteroinferior
Mesenterium
.rW""'";j�:-'ij,*"-
Intestinum tenue
Recessus duodenales superior et inferior
---,�""_. Sulci paracolici
Colon
sigmoideum
Mesocolon sigmoideum
Recessus lleocaecalls
Inferior
Mesoappendix
Fig. 1 056 Small i ntestine, I ntest i n u m tenue, a n d large i ntestine, I ntest i n u m crassu m .
Live r
Pa n c re a s
I
S p le e n
I
To pogra p hy
S ec t i o n s
Mesenteric root
Omentum majus
Mesocolon transversum
Flexura coli slnislra Flexura coli dextra
Taenoa IIbera
Colon ascendens
i=-'i=:-':!31"';-- Jejunum
Mesenterium Recessus ileocaecalis supenor
--iIii!�'iI:l': Colon descend ens
Appendices omentales [epiploicaej
Recessus ileocaecalis inferior Mesoappendix
Colon sigmoideum
Fig. 1 057 Mese ntery, M esenteriu m , a n d large i ntest i n e , I ntest i n u m c rassu m .
�
Abd o m i n a l visce ra
��
I Sto m a c h I S m a l l i n t e st i n e I La rg e i n t e st i n e I
Mesenteric root and retroperitoneal space
Plica gaslropancreatica Lig. A
; V
gaslrica brevis
Lig
Appendix
fibrosa hepatls
I
Margo superior Splen Facies
Omenlum mllnu!; --+..iCOiJ1f!tll
gaslriea
[Lien]
Cauda pancrealis
--h.,-\l;HOILig hepaloduodenale ---I!,.IoIj�� Corpus pancreatis --=idi�� Duodenum, Pars superior --"tp."'�H Fundus vesicae biliaris
Flexura coli sinislra Mesocolon transversum
.1tiI1Hif-i1-- Lig. gastrocolicum -:::�iHt-- Lig. phrenicocolicum
Ren, Extremitas superior Flexura coli dextra
Omentum majus
Gaster, Pars pylorica Colon transversum Flexura duodenojejunalis; Recessus duodenales superior et inferior
Omentum majus, Lig gastrocolicum Omentum majus
Colon descend ens
Colon ascendens Colon transversum Recessus ileocaecalis superior Ileum Recessus ileocaecalis inferior
Colon sigmoideum
Caecum Recessus relrocaecalis
Mesocolon sigmoideum
Appendix vermiformis
Ureter, Pars pelvica Ductus deferens
Mesoappendix
Excavatio reclovesicalis
Fig. 1 058 Posit i o n of the abdom i na l viscera, Situs visceru m , a n d t h e omental b u rsa, B u rsa omentalis. An a rrow i n d icates the omental [epi ploic] foramen.
L iver
I S p leen I
Pa n creas
To p o g ra phy
Sections
Retroperitoneal space
Ostium cardiacum coronarium, Lig. triangulare sinistrum gastrophrenicum Glandula suprarenalis; Bursa omental is
)
Margo superior Splen
Glandula suprarenalis
Facies gastnca
[Lien)
Lig coronarium Bursa omentalis. Recessus splenicus
V portae hepatis;
A hepatica propria Ductus hepaticus communis Ductus cysticus
Cauda pancreatis
Lig hepatoduodenale
111I'�!lJ.-- Mesocolon transversum
Duodenum, Pars superior
V. mesenterica inferior
Peritoneum parietale Duodenum, Flexura duodenojejunalis
Mesocolon transversum
A;V
gastroomentalis dextra --I1"oHiU.
����i44i�lI-- Ren, Extremitas inferior
Duodenum, Pars descend ens
Recessus duodenales superior et inferior
Ren, Extremitas inferior
�ii�fI1.'-4l:=+i.1�L_ Plica duodenalis inferior
Caput pancreatis
Duodenum, Pars ascendens
A : V. colica sinistra A. mesenterica i nferior
Radix mesenterii
Aa. sigmoideae Plica ileocaecalis A rectalis superior Recessus ileocaecalis superior
Recessus intersigmoldeus
Recessus ileocaecalis inferior
Ureter, Pars pelvica
Mesoappendix
Mesocolon sigmoideum A. ; V. ovarica; Lig suspensorium ovar"
A.; V Illaca communiS Linea terminalis
Ampulla tubae uterinae Ovarium Tuba uterina [Salpinx) teres uteri"
Fig. 1 059 Poste rior wall of the peritoneal cavity, Cavitas peritonealis, and splee n , Splen [Lien], of the female. Sites of attachment of the ascend i n g and desce n d i n g colon a re i n d i cated [+1. Cli nical term : pouch o f DOUGLAS •• Clinical term : round ligament •
�
... ... I S t o m a c h I S m a ll i n test i n e I Large i n t est i n e I
Abd o m i n a l viscera
Abdominal arteries, overview
Pars abdominalis aortae [Aorta abdominal is]
A. splenica [lienal is]
A. hepatica communis
A, gastrica sinistra Aa. gastncae
breves
A. splenica
[Ilenalis]
--45"�ii;III�� ----------:;if--�..... A. gastrica dextra �I� A. cystica
-
A, gastroduode nal is (A. supraduodenalis) A, pancreaticoduodenal is superior posterior
� 'ii;:11t_iII"_Ip...
_ _ ..
A hepatica propria
-
--
------ttaf---------..... . �(I . ---
--'
_ _ _ __ _ _ _
qtt
--;;r�:f!':.;j
-
_1�����·
-
...,--;;!��--]r-___:::�:::; l�--;-=���==
�'i:=�!..,.Ji! .:... �::::=----
_ _ _ _ _ _ _
A pancreaticoduodenal is inferior
�
: ------,---� -:r��� ::::::;..
-
A, pancreatica magna A, caudae pancreatis A. gastroomentalis dextra A. pancreatica dorsalis
A. prepancreatica
mesenterica ------=7-���A'i�:__=:-:-___!JtIII,.ij�-- A.superior
J�-----t- T��:"""'.;J.;I--- A. marginalis coli
--k--;1f.:J�..._;;;;:=-.:3!",;::".. ., A. colica dextra --�::���fl�-��'III;;;;: Iii ;:;;:>�'" A colica media
A ileocolica
r-----------::o!,..--I�:=;f.!L:;L+-- A, mesenterica Inferior
--f--ll'1J�5�;;�:;fitD
..a. , �--- A. coliea slnislra
Aa. sigmoideae
A, rectalis superior
A, appendicularis
Fig. 1 060 Arteries of the abdominal viscera; semi-schematic; possi b le anastomoses a re i n d icated [OJ.
A, rectalis inferior
live r
Pa n c reas
I
S p le e n
I
To p o g ra p hy
Secti ons
Abdominal veins, overview
V. gastrica dextra
W. oesophageae
Vv hepaticae
V. gastrica sinistra Vv. gastricae breves
V portae hepatis, R dexter
V. splenica [lienalis]
--'�,...� . _d�lII=. V. portae hepatis -�'I.---�-/----"��!'( V. cystica
V. splenica [Iienalis] V. mesenterica superior
V. gastroomentalis [gastroepiploica] sinistra
-----J.�I-----�����-��=:::�Ii ---.l�
W. pancreallcae V. ga.troomentalis [gaslroepiploica] daxtra
u,_------==_-- V. mesenterica interior iiIIJ.-rIo-- (V. marginalis coli)
(Vv duodenales) V. pancreatico duodenal is superior posterior
.. �....".JI..-4"�I Ir.i'J!lll�-
V. colica media
V. colica sinislra
V. colica dextra
�--..lltr-*--l�+rr--::a-- V rectalis superior
V. ileocolica
VV. sigmoideae
Vv. rectales mediae
Vv. rectales interiores
V. appendicularis
Vv. lleales
Vv. jejunales
Fig. 1 06 1 H epatic porta l vein, V. portae hepatis, with tributaries; semi-schematic.
�
Abd o m i n a L viscera
to to
I Sto m a c h I S m a ll i n testi ne I La rge i n testi n e I
Coeliac trunk
Lig. teres hepatis
Ductus hepaticus communis A. hepatica propria Truncus coeliacus A. gastrica sinistra
Vesica biliaris A. cystica Ductus cysticus
A hepatica propria A. gastroduodenalis
-....,._ . �..
A gastrica dextra
-..\.-----
--=::"'-�"""...J.'1J
A. hepatica communis
V portae hepatis
A. splenica A. gastroomentalis sinistra
- 50 %
A. pancreaticoduodenal is superior posterior A. gastroomentalis dextra
A mesenterica superior
a
A gastroomentalis dextra
A. mesenterica superior
A hepatica propria. R dexter
A hepatica communis
-3% c
-3%
- 12%
d
e
7%
Fig. 1 062 a-f Va riabi lity of the a rterial b lood supply of the live r. a "Textbook case " b The superior mesenteric a rtery. A. mesenterica superior. p.a rticipates i n the s u pply of the right lobe of the liver. c The common hepatic a rtery. A. hepatica com m u n is . a rises from the superior mesenteric a rtery. A. mesenterica superior. d The left lobe of the liver is s u pplied by the left gastric a rtery. A. gastrica sin istra. e A branch of the left gastric a rtery. A. gastrica s i nistra. supplies the left lobe of the live r a long with the left b ranch of the hepatic a rtery p roper, A. h epati ca p ropria. An accessory b ranch of the hepatic a rtery proper, A. hepatica p ropria. su pplies the lesser c u rvat u re of the stomach.
Fig. 1 063 a-e Va riabi lity of the arterial b lood supply of the stomach. a "Textbook case " . closed a rterial arcade supplying both the lesse r and the g reater c u rvat u re b The left gastric a rtery, A. gastrica sin istra, partici pates i n the s u pply of the left lob e of the liver. c Anastomosis between the right and left gastro-omental a rteries. Aa. gastroomenta les dextra et s i n istra, at the g reater c u rvat u re d Absence of an a nastomosis between the right a n d left gastro-omental arteries, Aa . gastroo mentales d extra e t s i nistra , a t the greater curvat u re e An accessory posterio r gastric a rtery. A. gast ri ca posterior. arising from the splenic a rtery. A. splenica, su pplies the posterior wall of t h e stomach.
L i ve r
Pa n c reas
I
S p le e n
I
To pogra p hy
Sect i o n s
Arteries of the upper abdomen, radiography
A. hepatica propria
A. gastrica sinistra
A. hepatica communis Truncus coeliacus
A gastroduodenalis
A. splenica A
gastroomentahs dexlra
A. gastroomentalis sinistra Pelvis renalis
Ureter sinister
PelVIS r"n�""--
Fig. 1 064 Arte ries of the stomach, Gaster; t h e spleen, Splen [Lie n ] , a n d the liver, Hepar; AP-rad iograph after selective i njection of a contrast medium i nto the coeliac tru n k lcoeliacogra phyJ with concom itant visualization
of the renal pelvis due to the renal excretion of the m e d i u m ; ventral view. * **
Catheter loop in the aorta Catheter i n the aorta
A. hepatica propria, Aa. segmenti anterioris et posterioris
......::=--��:..!.II4--
A hepatica propria, R dexter
A. hepatica communis
A. gastroduodenal is
A, pancreaticoduodenalis superior posterior
A. gastroomentalis dextra
A. pancreaticoduodenalis superior anterior
A. pancreatica dorsalis A. pancreatica inferior
Fig. 1 06 5 Common hepatic a rtery, A. hepatica com munis; AP-ra d i o g raph after selective i nj ection of a contrast medium into the common hepatic a rtery; ventral view.
Branches to the left lobe of the liver replacing a single left branch of the hepatic artery proper *. An accessory branch of the hepatic artery to the lesser c u rvature of t h e stomach Catheter in t h e aorta
.**
�
Abd o m i n a L viscera
��
I S t o m a c h I S m a ll i ntest i n e I La rg e i n testi ne I
Vessels of the upper abdomen
LobuS hepatis sinister •
Llg teres hepatis
V. cava inferior .
Pars lumbalis diaphragmatis
• Truncus
coeliacus
•A
phrenica inferior
Vesica biliaris
• Pars abdominalis
Lobus hepatis dexter; Lobus quadratus A ; V. cystica
aortae
• A. splenica
• • ---+--1
A hepatica . propria
"-..:.� .! ...._ .. - Splen [Lien]
• • A. ; V.
gastroomentalis sinistra
Omentum majus
A ; V. gastroomentalis dextra
• •
Fig. 1 066
Vessels of t h e upper abdomen.
Liver
I
Pa n c re a s
S p Leen
I
To pography
Sect i o n s
Vessels of the upper abdomen
A. hepatica communis . V
gastrica sinistra
cava inferior •
• • A . ; V. gastroomentalis sinistra
• A. phrenica inferior
• A. gastrica brevis
• • A.; V
splenica
• • Rr. splenici A ; V. gastro· • • omentalis dextra
--=-�..
'-
A. gastro· . duodenalis V.
Corpus pancreatis
portae hepatis •
A. pancreatico- • duodenalis superior anterior
• A. pancreatico' duodenalis inferior
Caput pancreatis V.
mesenterica • superior
Proc uncinatus
Mesocolon
transversum
Lig. gastrocolicum
Fig. 1 067
Vessels of the u p pe r abdomen .
�
Abd o m i n a l viscera
��
I
Sto m a c h
I S m a l l i n t e st i n e I La rg e i nt e st i n e I
Superior mesenteric artery
A mesenteriea superior
A. marglnar.s coli
A, colica dema
A. ileoeoliea
-"t""'"':"t-�ii:;.....-1�'-=:=:---7:'i:-+-+- - Aa jejunales 1�;=-�-=---'Ii1-.....;._1-
--+--7-+1-----:;,
Aa ileales
A mesenteriea inferior
A. caecal,s posterior
A . appendieulans
a
- 20 %
Fig. 1 068 a-d Va riability of t h e b ranches of the superior mesenteric a rtery. A. mesenterica superior, su pplying t h e large i ntesti n e . a "Textbook c a s e " . t h e asce n d i n g and t h e t ra n sverse colo n , C o l o n ascendens et tra n sve rsu m , a re s u pplied b y t h ree branches.
- 10%
b The i leocolic a rtery, A. i leocolica, a n d the right colic a rtery, A. colica dextra , form a common trunk. c O n ly two b ra nches a rise from the mesenteric a rtery while the right colic a rtery, A. colica dextra, is absent. d Duplication of the right colic a rtery, A. colica dextra
A. mesenteriea superior A. coHea media
Aorta, Pars abdomlnalls Aa. jejunales A colica dextra
Aa. ileales
Fig. 1 069 Superior mesenteric a rtery, A. mesenterica superior; AP-radiogra p h after i njection of a contrast m e d i u m i nto the origin of t h e superior mesenteri c a rtery; ventra l view.
* **
Catheter in the aorta Catheter i n the common iliac a rtery
Liver
Pa n c rea s
I
S p lee n
I
To pogra p h y
Sect i o n s
Vessels of the lower abdomen
A. colica media .
Colon
lransversum
V collea • media
• Aa. jejunales
--tai!l!i����
Flexura coll sinlslra
Flexura call ---'1'' dexlra
P--+- Jejunum i-""-...'I-- • Vv. jejunales
A ; V colica • • dextra Aa. ileales •
Vv Ileales .
A ; V epigaslrica inferior • •
Caecum
Appendix vermiform is
Ileum
Fig. 1 070 Superior mesenteric a rtery a n d ve i n , A. et V. mesenterica s u perior. The a rteries supplying t h e small i ntestine fo rm a series of arcades.
Colon sigmoideum
�
Abd o m i na l viscera
��
I Sto m a c h I S m a l l i n te st i n e I La rg e i n test i n e I
Inferior mesenteric artery
A colica media
A mesenterica superior
A. mesenterica inferior
iii ���T_f--- A. marginalis coli 7'f��,__i!!f;:;;:;;ijOiii
---f---iir------I:3:d-�J --I-.".- -rf-f-
-
-
-#''+-�lIo...
-
-"-..... �i--- A. colica slnistra
I-�""'rl--"*-- Aa. sigmoideae
I:::-JI----t-,IL.--+--- A. rectal is superior
Fig. 1 07 1 a-c Va riations in t h e b ra n c hes of the i nferior mesenteric a rtery. A. mesenteri ca i nferior. a The i nferior mesenteric a rtery. A. mesenterica i nferior. d ivides i nto t h ree parts s u p plying the desce n d i n g a n d sigmoid colo n . a s w e l l as the rect u m.
b An accessory m i d d le colic a rtery. A. colica media. a rises fro m t h e i nferior mesenteric a rtery. A. mesenterica i nferior. c An accessory m id d le colic a rtery. A. colica media. a rises from the left colic a rtery. A. colica s i n i stra. •
Clinical term: 5UOECK's point
V.
mesenterica inferior
A. ascendens A mesentenca Inlanor
A. colica s I niSi na V
colica sinistra
A . marglnalis coli Aa slgmoideae
Crista iliaca
Articulatio sacroiliaca A rectal is superior
Fig. 1 072 I nferior m esenteric a rtery. A. mesenterica i nferior; AP-ra diograph after selective i njection of a con t rast m ed i u m i nto the orig i n of t h e i nferior mesenteric a rtery; ventral view. •
Catheter in the aorta
Liver
I
Pa n c re a s
S p lee n
I
To p o g ra p hy
Sections
Vessels of the lower abdomen
A pancreaticoduodenalis inferior .
•
Pars abdomlnalls aortae
Flexura duodenol ejunalis
Pancreas
Mesocolon transversum
A.; V. collea
media
••
••A
. • V. collca slnfstra
-----=---=-04 -; 1-"-----=-"'- ..'""" ... '1-'<
BiftJrcatio . aonae
• A. mesenterica inferior • A. colica sinlstra Aa. ; Vv. • • jejunales
Radix mesenterii
ReclUm
Fig. 1 073 I nferior mesenteric artery a n d vei n . A. et V. mesenterica i nferi or.
�
Abd o m i n a L viscera
��
I Sto m a c h I S m a l l i ntesti ne I Large i nt e st i n e I
Coeliac trunk
Pars thoracica aortae
A. mesenterica superior
Pars abdominalis aortae
Discus intervertebralis Vertebra lumbalis I
Fig. 1 074 Abdominal aorta, Pars a b d o m i nalis aortae, with the coeliac t ru n k, Tru ncus coeliacus, a n d the superior mesenteric a rtery, A. mesenterica superior; ultrasound image; a lmost i n the sagitta l plane . • Abdominal wall
Truncus coeliacus
A hepatica communis _-'01_'"
A. gastrica sinistra A. splenica A. pancreaticoduodenalis superior posterior
A. mesenterica superior
- 25 %
Fig. 1 075 a-e Va riabi lity of the coeliac tru n k. Tru ncus coeliac us. a "Textbook case", division of the trunk into t h ree branches b Division of the t ru n k i nto four b ranches c Deve lopment of a hepatosple n i c t ru n k, Truncus hepatosplenicus
d Development of a g a strosplenic trunk, Truncus e
gast rosple n i c u s Development of a gast rosple n i c t r u n k , Truncus gast rosple n icus, a n d a h epatomesenteric tru n k, Tru ncus hepato mesentericus
LIver
Pa n c re a s
I
S p leen
I
To p o g ra p hy
Sections
Vessels of the retroperitoneal space
A V portae hepatis • Pars costal is • diaphragmatis
Gaster, Pars cardiaca • Truncus coeliacus Glandula suprarenalis
Glandula suprarenal is
• • A,; V. splenica
Ductus hepaticus communiS
Cauda pancreatis
Ductus cystlcus
• V. mesenterica inferior
Ductus choledochus [biliaris]
• • A ; V. mesenterica superior Duodenum, Pars superior, Ampulla
Jejunum
Duodenum, Pars descendens Caput pancreatis, Proc. uncinatus
Ren sinister
---ib11ll
Ureter
Duodenum, --II-
• Pars abdominalis aortae
N, iliohypogastricus
N iliolnguinalls
V cava Inferior .
A ; V testicularis • •
• A. colica sinistra
t=:�"-"....��BIft;ft-- • Bifurcatio aortae I'D.dl5o'�MtB!'�t-- • • A.; V. lumbalis IV
.;,j -- • • A. ; v. mesenterlca ��"'!II";�:e-M!.H inferior
N. cutaneus femoris
iiIf-.w--"!I-- • • A ; V. sacralis
lateralis
(M psoas minor), Tendo
•
��'tfi.,*��-.:�
_ _
A, ; V, iliaca • • communis
mediana
• A. rectalis superior
Mesocolon sigmoideum
N femoralis
Fascia iliaca
A. ; V circumflexa • • ilium profunda
Colon sigmoideum
Fig. 1 076 Vessels of the retroperitoneal space, Situs ret roperitonealis, of the male.
�
Abd o m i n a l viscera
��
I
Sto m a c h
I S m a ll i n test i n e I Large i n t e st i n e I
Hepatic portal vein, overview
Oesophagus
Vv oesophageae
V. cava inferior Vv. hepaticae Gaster
Hepar
V. splenica [Iienalis]
V. gastrica sinistra
V. portae hepatis Vv gastricae breves V. gastrica dextra -...--- Splen [Lien] V. cystica
Vesica biliaris [feliea]
----fl�'Hi,...
V. mesenterica superior
_-+IIt:rt7ii.
V. gastroomentalis sinistra
V. mesenterica inferior
V. gastroomentalis dextra V colica media
Vv pancreaticoduodenales
V. colica sinistra Colon ascendens
V. colica dextra Vv. jejunales; Vv. ileales V. ileocolica Colon descendens
Vv slgmoldeae V. appendicularis
Rectum
V. recLalis 5 uperlor
Fig. 1 077 H e patic portal vei n . V. portae hepatis; ventral view.
Liver
Pa n c reas
I S p lee n I
To p o g ra p h y
S e cti o ns p p .242 f f
Portocaval anastomoses
V. hemiazygos
V. azygos
(Plexus venosus submucosus) V. phrenica inferior V. hepatica
_ _
-- (R. �r�-------��,-
oesophagealis)
11----------....;.�I__-- V. gastnca sinistra
V. portae hepatis V. splenica [lienalis]
V. renalis sinlstra V. mesenterica superior
V. lumbalis ascendens
V. mesenterica inferior V. paraumbilicalis
V. cava inferior
---to�---'I--..lI:
---I---;j�--Jllllt7Il!ii"ilk-�tf-
V. colica sinistra
_---l�t....-----l"
V. epigastrica superficialis
V. iliaca communis
----jt----jr---��" V. sigmoidea
V. epigastrica inferior
--�'hdll'"
V. iliaca interna
....-#.t. --:j:\
_ _
Vv. rectales infenores
------�
Fig. 1 078 Hepatic portal vei n , V. portae hepatis, a n d i nferio r vena cava, V. cava i nferior; semi -schematic; tri butaries of t h e inferior vena cava i n blue; tributa ries of the hepatic portal vein i n p u rple; potential portocaval a nastomoses a re i n dicated by circles.
V. rectalis superior
1 8 2' ·�
�
Pelvic viscera a n d ret roperitoneal space
Kid ney
S u p ra r e n a l g la n d
U r i n a ry b La d d e r
Kidney
Margo superior
Capsula adiposa
Margo medialis Aa. suprarenales mediae Glandula suprarenalis
---'c--1P'-
A. suprarenalis inferior A renal is, R. posterior
---,j�li:'iiii_;;
V. testicularis/ovarica sinistra
Ureter
Fig. 1 079 Kidney, Ren [ N e p h rosl, a n d s u prarenal gland. Glandula su prarenalis; ventral view [ left ! .
Aa suprarenales superiores
Margo superior
Glandula suprarenalis
Glandula suprarenalis, Hilum
--:::;iIII_II .il����
Capsula adiposa Capsula fibrosa
Aa suprarenales mediae Vv. suprarenales ,-...- - Margo medialis -
'�""'r--- A. suprarenal is inferior
A. renalis
V renalis
Ureter
Fig. 1 080 Kidney, Ren [ N e p h rosl, and s u prarenal g la n d , Gla n d u la s u p ra renalis; ventral view [right!.
Margo lateralis
G e n it a l i a
Rectum
To p o g ra p hy
0 83
Sections
Kidney
Cortex renalis Papillae renales Medulla renalis, Pyramides renales
Calyx renalis major
-,'t"�i1��1.!!
Sinus renalis
�1Iiifl""'t-- Cortex renalis
-H--
Fig. 1 081 Kidney, Ren [Nephrosl ; oblique a n d vertical h e misection displaying the renal cortex, the medu lla and the pelvis; ventral view ( left!. Arrows point fro m the pyra mi d s to the calyces.
Columnae renales
Pelvis renalis Calyx renalis major Medulla renalis
Calices renales minores
Ureler
Crista iliaca Spina iliaca posterior superior Cortex renalis
Fig. 1 082 Proj ection of the kid neys o nto the back.
Capsula fibrosa
Cortex renalis
Columna renalis
Aa. interlobares
--11'"""':_
Sinus renalis; Corpus adiposum
Columnae renales
A arcuata
Fig. 1 083 Kidney. Ren [ N e p h rosl; oblique and vertical h e m isect i o n ; ventral view [left).
�
Pelvi c viscera a n d ret ro p e ritoneal space
S u p ra re n a l g La n d
Kid ney
Kidney, structure
Cortex renalis
Capsula fibrosa
Medulla renalis
V. rsnalls Aa. interlobares Pelvis renalis
S,nus renalis
---=...".,.,..;�� ,;,;;'""'....,-'....1--- Pyramides renales
Papilla renalis
Calyx renalis minor
Fig. 1 084 Kid ney, Ren [Nephros); tra n sverse section t hrou g h the renal s i n u s ; i nferior view [ left ) .
. .. '"
Corpusculum renale
Tubulus distal is
•
,
;-�,
'&
. . ..... . .
•
t---""!'-"-"":"':"":_-- Polus urinarius
----1..-.... - .;,; .. ;;.. ...:.; :.....
....:.,�.:....2... .. _...:.L..:..._
_ _
. ;...:-';--?---'lIo:.!-....r-' . '---....:...,...i..... -�...:� : -- Tubulus proximal is
Fig. 1 085 Kid ney, Ren [Nephros) ; m i c roscopic section of the cortex [ 1 00 x l .
U ri n a ry b L a d d e r
Genitalia
Rectum
To p o g ra p hy
Sections
Kidney, development
Glandula suprarenalis Glandula suprarenalis V.
cava inferior V.
renalis
Ren M.
Pars abdominalis aortae
A. umbilicalis
Fig. 1 086 Kid n ey, Ren [ N e p h rosl, and the su prarenal gland, Glandula su p ra renalis, of a - 5-month-old foetus.
Fig. 1 087 Kidney, Ren [ N e ph rosl; dorsal view. The lower poles of both kidneys a re fused (= horseshoe kidney) .
psoas major
II
1 8 6 ':�
,. Pelvic viscera a n d ret roperitoneal space
... ...
K i d ney
S u p ra re n a L g la n d
U ri n a ry b la d d e r
Renal pelvis and calyces
Calyx renalls malor
Calices renales minores
Ureler --t�.
a
b
Fig. 1 088 a, b Renal pelvis, Pelvis rena lis; corrosion casts; ventra l view [ left], a Dendritic type b Ampullar type
Vertebra thoracica XII Papilla renalls
Papilla renalis
Colon ascendens
Pelvis renalis
Calyx renalis major
Calyx renalis minor
Papilla renalis
Ren sinister, Extremitas inferior Colon descendens
M. psoas major Ureter
Ureler
Fig. 1 089 Kid ney, Ren [ N e p h ros] ; ren a l pelvis, Pelvis renalis, a n d u reter, U reter; AP-rad iogra p h after retrograde i njection of a contrast medium via both u reters.
;�' 187 ..
G e n it a l i a
Rectum
To pography
Secti o n s
Areas of contact and renal segments
...l..�oM,--- Segmentum SUperius
Segmentum anterius superlus
l&-__ _ __ Segmentum anterius inferius
----/--
A. renalis
--'1---- V. renalis
--+---!t'"
,
Ureter Segmentum inferius
Segmenlum poste'ius
------4
a Ventral view I rig ht)
Fig. 1 090 a, b Renal segments. Segmenta renalia.
b Dorsa l view I ri g ht)
Truncus coeliacus
V. cava inferior
---t--
A
renalis sinistra
V. renalis sinistra
V. renalis dextra
V. testicularis/ovarica sinistra V. testicularis/ovarica dextra
Fig. 1 09 1 Kidney. R e n ; a reas of contact with adjacent o rgans; ventral view.
Areas of contact of the kid neys
.. .. ..
Glandulae suprarenales
Colon. Flexura dexlra
Splen [Lien]
Hepar
Jejunum
Pancreas
Gaster
Colon descendens
Duodenum. Pars descendens
_
1 88·
� I
;
K i d n ey
Pelvic viscera a n d ret roperitoneal space
Suprare n a l g la n d
Kidney, imaging
I
Ren. Facies anterior
Hepar
Medulla renal is. Pyramis renalis
Pelvis renalis
Extremitas superior Diaphragma
Extremitas inferior
M. psoas major
Ren, Facies posterior
Fig. 1 092 Kidney, Ren [Ne phrosl ; u ltrasound i m a g e ; the t ransducer i s d i rected from ventro i nferior to d orsosu p e rior; latera l view !rightJ. * A b d o m i n a L waLL
Colon
Hepar, Lobus dexter
V. cava inferior
Cutis
Pars abdominal is aortae
Ren Mm.
V. renalis dextra abdominales
Corpus vertebrae
Ren, Capsula adiposa Fascia renal is
Proc. spinosus Costa XII
M
erector spinae
Fig. 1 093 Kidney, Ren [ N e p h rosl ; p u ncture of the right kid ney; comp uted tomogra p h i c c ross-secti o n [ eTI ; i nferior view. * GU idance of a needle for kidney biopsy
U ri n a ry b la d d e r
Gen italia
Rectum
To p o g ra p hy
Sections
Suprarenal gland A a.
suprarenaJes suponores
A. phrenica inferior Aa. suprarenales mediae
Margo superior
A. suprarenalis inferior A. renalis Aorta abdominalis
Facies anterior
a
-
34 %
b
-
26 %
Margo mediafis
Medulla
----'..:..I,W
c
Fig. 1 094 Supra renal gland, G la ndula s uprare na lis; ventra l view [right).
-
33%
d
v. renBhs dexlra
V. renalls slnlst,a
V. cava inferior
Fig. 1 095 a-d Variability of the supra renal a rteries, Aa. s uprarenales, and course of the s uprarenal veins, Vv. s uprarena les. a Arterial s u pply by t h ree a rteries [ "textbook case"] b Arterial sup ply without a b ra n c h fro m the ren a l a rtery, A. ren a lis c Arterial supply without a d i rect branch fro m the aorta, Aorta d C o u rse of the supra renal veins, Vv. su prarenales
Cortex
Zona fasclculata
�--::�--- Zona retlcularls Medulla
1Et:�=t-- Medulla jL-oF-�+--- V. cenVlllis
Fig. 1 096 Supra renal gland, G landula supra renalis; sagittal sect i o n ; latera l view [right).
Fig. 1 097 Supra renal gland, Gla n d u la supra renalis; m i c roscopic enla rgement at low magn ification.
1
Cortex
1 90 : 1
�
K i d ney
Pelvic viscera a n d ret ro p e r i t o n e a l space
S u pra re n a l g la n d
U r i n a ry bLadder
Urinary bladder
umbilicale medianum Apex vesicae
Tunica muscularis
(Plicae mucosae)
Oslium urelerls Plica .nterurelsrica
Urethra masculina, Pars prostatica
(
Trigonum vesicae
'I.-:-b-Crista urethral is
Prostata
H��-- Ductuli prostatici
Sinus prostaticus Colliculus seminalis Utriculus prostaticus Ductus de/erentes, Ductus ejaculatorii
Fig. 1 098 Urinary bLadder, Vesica urinaria; p rostate, Prostata. and u rethra, U reth ra ; ve ntraL view.
Peritoneum parietale
Vesica urinaria
--�r--'�"""",,"� ..'1o...l....e.�.."
Symphysis pubica
-""H-J+--_ Rectum
�-.tJ--tOHH--- Excavatio
---+-"'<
rectovesical is Excavatio rectovesicalis
Rectum
Fig. 1 099 U ri n a ry bLadder, Vesica u ri n a ria, aLmost compLeteLy void ed.
Fig. 1 1 00 Urinary bLadder, Vesica u ri n a ri a , fiLLed. In this situation, the bLadder can be punctured from j ust above the p u b i c bone without passing t h ro u g h the peritoneaL cavity.
* Puncture needle
Gen italia
R e ct u m
To p o g ra p hy
Sections
Urinary bladder, ductus deferens and seminal vesicle
Lig. umbilicale medianum
Corpus vesicae, Tunica muscularis
Ureter
Ductus deferens
Ampulla ductus deferentis Ampulla ductus deferentis, Diverticula ampullae Glandula vesiculosa
Glandula vesiculosa
Prostata, Facies posterior
Fig. 1 1 01 Urinary blad der, Ves i ca u r i na r i a ; ductus deferentes, D u ctus deferente s ; seminal vesicles, Glandula e vesiculosae, and p rostate, Prostat a ; dorsa l view.
Corpus vesicae Plica Interureterica
Corpus vesicae Plica interureterica _-----.:.- Ostium ureteris
_..... . ...,.---+- Ostium ureteris
a ....___
--.l
_ _ _ � _ _ _ _
Trigonum vesicae
---
b
Trigonum vesicae
Fig. 1 1 02 a, b Urinary bladder, Vesica urinaria; e ndoscopic view of the opening of the u reter !cystoscopy] , a Open osti u m of the u reter with a peristaltic wave t ra nsporting urine i nto the bladder b C losed ost i u m of the u reter
Fig. 1 1 03 Urinary bladder, Vesica urinaria; endoscopic view of the mucosa i n the body of the b ladd e r !cystoscopy) ; i nferior view.
1 92 ij
�
Pe Lvic viscera a n d ret roperitoneaL space
K i d ney
S u p ra re n a l g t a n d
���
Male urinary and genital organs, overview
Pelvis renalis
(Infundibulum ductus paramesonephncl)*'
Epididymis
�
Ureter
�
(Paradidymis)
Ductus mesonephricus*
--�
� Gubernaculum testis Ductus paramesonephricus"
Ureter Urachus Ductus deferens
Vesica urinaria
Glandula vesiculosa
Ductus ejaculatorius
Utriculus prostaticus
---I+--!'t.
Corpora cavernosa penis
Glandula bulbourethralis Ductus glandulae bulbourethralis
Corpus spongiosum penis
Caput epididymidis Glans penis (Ductulus aberrans inferior)
Appendix testis
Cauda epididymidis
Fig. 1 1 04 M a le urinary and g e n ital o rg a n s ; O rgana u rogen italia masculina; diagra m of the develop ment: the parts that dege nerate a re displayed i n pale p i nk, and the position of the testis prior to its descent i s ind icated by the dashed line; viewed from the right.
U ri n a ry b l a d d e r
Epid idymis Paradidymi s
= =
g e n ital part of the mesoneph ro s ; re mnants of t u b u les of the meso n e p h ros
* WOLFF,an duct ** M O LLERian duct *** Junction of the M O LLERian ducts, Ductus paramesonephrici
Male gen italia
Gen italia
Rectum
Sections
To p o g ra p hy
Fe m a le g e n i t a l i a
Testis and epididymis
Fascia cremasterica; M cremaster
Fascia spermatica intern a
Tunica vaginalis testis, Lamina parietalis Funiculus spermaticus (Appendix epididymidis) Extremitas supenor
Sinus epididymidis
-]���\���
Mediastinum testis -....-;,',
Facies lateralis
Lobuli testis
�....<&... -
Margo posterior Margo anterior
Cauda epldidymidis
Cauda epididymidis
--�� .'\.
Extremitas inferior
Fig. 1 1 06 Testis, Testis [Orchis]. and epididymis, Epididymis; viewed from the right.
Fig. 1 1 05 Testis, Testis [Orc h i s] . and e p i d idym is, Epididymis; viewed from the right.
A . cremasterica
A. du ctus delerentis
---Ifl-HI
A ; V. testicularis Plexus pampiniformis
Caput epididymidis
Cauda epldidymldis
Fig. 1 1 07 B lood vessels of the test i s, Testis, the epid idymis, Epididymis, a n d the spermatic cord , Fu niculus spermaticus; vi ewed from the right.
Septula
testis
�
PeLvic viscera a n d retro p e ritoneaL space
K i d ney
S u p ra re n a l g la n d
���
Testis and epididymis •
Plexus pampiniformis
---,.��rJl
A. testicularis
Ductuli efferentes testis
Caput epididymidis
--';':'=::;"1'P:b\M��*,!I"
Tunica albuginea
Lobuli testis
Corpus epididymidis
-----,;.-+---0,-1':'. I.".::"""�- Septula testis
(Ductulus aberrans inferior)
----,:-:-;""-+_�
Cauda epididymidis
--':'!'::�;.:J"';;�
Fig. 1 1 08 Testis, Testi s ; epididymis, Epidi dym is, and d u ctus deferens [vas deferens)' Ductus deferens; lateral view.
Tunica vaginalis testis
[
Septum scroti Lamina visceralis'
��iIi.!I��S;=
Lamina parietalis"
Fascia spermatica interna M. cremaster
Septula testis
Fascia cremasterica Fascia spermatica externa (Cavum serosum scroti)
Tunica dartos Mediastinum testis
Tunica dartos
Sinus epididymidis Corpus epididymidis A testicularis
Plexus pampiniformis Ductus deferens
Fig. 1 1 09 Testis, Testi s ; e p i d i dymis, Epididymis, and scrotu m , Scrotu m ; superior view. •
Also: Epiorc h i u m
• • Also: Periorchium
U r i n a ry blad d e r M a le g enitalia
Gen italia
R ec t u m
To pography
Sections
Fem a le g e n it a l i a
Ductus deferens and seminal vesicle
Ductus deferens
Glandula vesiculosa
Glandula vesiculosa Ampulla ductus deferentis
Lobus prostatae medius Lobus prostatae dexter Lobus prostatae sinister Urethra masculina
Fig. 1 1 1 0 Ductus deferentes, Ductus deferentes, seminaL vesicles, GLand uLae vesicuLosae, and prostate, Prostat a ; su perior view,
Ductus deferens
Glandula vesiculosa
Ampulla ductus deferentis
Fig. 1 1 1 1 Ductus deferentes, Ductus deferentes, and seminaL vesi c les, G La n d u La e vesicuLosae ; AP-ra d i o g ra p h after i njection of a contrast medium v i a the ejacuLatory d u c t s ; ventra L view,
Ostium ureteris
Though t h i s tech n i q u e demonst rates size and position of the seminaL vesicles, it i s no m o re a pplied under clinicaL c i rc u m stances,
Glandula vesiculosa
Trigonum vesicae
��L-_ Ampulla ductus deferentis
Ostium urethrae internum
Urethra masculina, Pars prostatica
Urethra masculina, Pars intermedia [membranacea]
-,.,.'"-......
-
Cervix vesicae
Ductus ejaculatorius
Fig. 1 1 1 2 Uri nary bLadder, Vesica urinaria; prostate, Prostat a ; d uctus deferens Ivas deferens), D u c t u s deferens, and s e m i n a L vesicle, GLa n d u La vesicuLosa ; viewed from the right.
�
Kidney
Pe Lvic viscera and ret roperitoneaL space
S u pra re n a l g l a n d
���
Urinary bladder and male genitalia
Lig. umbilicale medianum
A iliaca externa
V. iliaca externa --!,ltI.
---..,..."'IIi . �_
Lig. inguinale
Ductus deferens Ureter
Plica umbilicalis medialis
--JtT;,., -J.,�"Ml"
Os pubis, Ramus superior
Excavatio rectovesicalis
Ampulla ductus deferentis
Glandula vesiculosa Glandula vesiculosa
Ductus ejaculatorius
Urethra. Pars intermedia [membranacea]
U ri n a ry b l a d d e r
Glandula bulbourethralis
Crus penis
Corpora cavernosa penis
Corpus spongiosum penis
Corona glandis
Fig. 1 1 1 3 U rinary bladder, Vesica urinaria; ductus deferentes. Ductus deferentes; seminal vesicles, Glandulae vesiculosae; prostate, Prostata, and male u rethra , U rethra masculi n a ; dorsa l view.
M a le genitalia
I
Gen italia
Rect u m
To p o g ra p hy
Sections
Fe m a le g e n i t a l i a
Spermatic cord
0,9 7
_-'i---- Umbilicus
Spina iliaca anterior superior
•. , _ -"'
Ii:..---...�--- Lig. Inguinale Pubes
Penis, Corpus
Penis, Dorsum
Scrotum
Preputium penis
Glans penis
Fig. 1 1 1 4 M ale external genitalia, O rgana genitalia mascu lina externa.
/ • Plexus deferentialis Ductus deferens
- . N . genitofemoralis, . ������������:w;tt- R. genitalis
�
Corpus cavernosum penis
Tunica albuginea ----I-" corporum cavernosorum Plexus pampiniformis •
:=-ti"lrrn l �iJ.���rJ!�
----:
����"""rr�:T-- .
A.
testicularis
r "�,*��"-7-:t.Iif---. Plexus testicularis
l't'.'�-:4II�---:""':: : :""";��I--- Fascia spermatica interna
Fascia penis (profunda)
Vv. pudendae externae •
lJ>-::.iEl-t-.:.Jl :. ....'-i .. '-?;;:;.. - Vasa Iymphatica
---i���:""LfI.
;,..:-T.,...... .::. ...�.,.:--- • Fascia cremasterica; M. cremaster • Fascia spermatica externa • Tunica dartos
Corpus spongiosum penis
Fig. 1 1 1 5 Spermatic cord , Fu n i culus spermaticus; fronta l secti o n ; ventral view [left , 250%).
�
PeLvic viscera a n d ret ro p e ritoneaL space
K i d n ey
S u prare n a l g la n d
���
Male urethra
Plica interureterica Trigonum vesicae
--.-""::'=&itr--- Ostium ureteris
Uvula vesicae
lJ.a;;:,;:;:=:.- Ostium urethrae internum
Pars intramuralis
Colliculus seminalis; Utriculus prostaticus
Pars prostatica
Pars intermedia [membranacea]
Ductuli prostatici
Glandula bulbourethralis, Ductus glandulae bulbourethralis
-fT-�J�ltll'a� '.�---l--+--
Bulbus penis Crus penis
.rui----,U---,�- Ductus glandulae bulbourethralis
....�,>-- Tunica albuginea corporum cavernosorum
Urethra masculina
Corpus spongiosum penis Trabeculae corporum cavernosorum A. profunda penis Pars spongiosa
Aa helicinae
Cavernae corporum cavernosorum Lacunae urethrales
Corona glandis Glans penis
-..l,\l�":'_(
Preputium penis
U r i n a ry b l a d d e r
(Valvula fossae navicularis) Fossa navicularis urethrae Ostium urethrae externum
Fig. 1 1 1 6 Urinary bladder, Vesica urinaria; p rostate, Prostata, and male u rethra , U rethra masculina; ventra l view.
Male genitalia
G e n i t a lia
Rect u m
Sections
To po g ra p hy
Fem a le g e n i t a l i a
Penis
V. dorsalis profunda penis A.
dorsalis penis Preputium penis
-----j'-,L-,'(;io'l�
Glans penis, Corona gland is
{"i!!� ! ;,u,.!l;· !fI;" i�l\�'�&��- Tunica
albuginea corporis spongiosi
Cutis
f.:J!'lt-I;"!l'7f+-- Corpus
Tunica albuginea corporum cavernosorum
cavernosum penis Tunica albuginea corporum cavernosorum
Septum penis Urethra masculina, Pars spongiosa
Fascia penis (profunda) Corpus spongiosum penis
Urelhra
Septum penis
masculine
b
a Glans penis; Corpus spongiosum penis, Cavernae corporis spongiosi
Preputium penis Urethra masculina, Fossa navicularis urethrae
dorsalis ��Jii!::�j������\-- A.penis
-h'..f"F-L*l�-- Corpus
cavernosum penis, Cavernae corporis cavernosl
:J:,J�����'hI-- Septum glandis
Corpus spongiosum penis
d
c
Fig. 1 1 1 7 a-d Penis, Pen i s ; cross-sections; p lanes ind icated i n Fig. 1 1 18; ventral view.
a C ross-section t h rough the middle of the shaft b C ross-section at the level of the p roxi mal part of the
glans penis c C ross-section t h rough the m i d d le of the g lans penis d C ross-sectio n at the level of the d i sta l part of the glans penis
Ostium urethrae externum
Fascia penis (profunda)
Fascia penis (superficial is) Preputium penis
Frenulum preputii
Fig. 1 1 1 8 Pe nis, Pe n i s , with glans penis, Glans penis, and prepuce, Preputium penis.
Level of section Level of section Level of section .**. Leve l of section
••
• ••
of Fig. of F i g . of F i g . of Fig
1 1 1 7a 1 1 1 7b 1 1 1 7c 1 1 1 7d
Kid n ey
... Pelvi c viscera and ret ro p e ritoneal space
S u p ra re n a l g la n d
U r i n a ry b l a d d e r ... ... �
Female urinary and genital organs, overview
Ren
_ _ _ _
Pelvis renalis
.--- Ureter
Epoophoron, Ductus longitudinalis, Ductuli transversi
ltitr--:----
Paroophoron
�---o-'--- DuClus paramesonephricus"
Ductus mesonephric us'
M---- Lig_ ovarii proprium
Epoophoron
Infundibulum tubae uterinae Urachus
Ug ovaril propnum
Ductus mesonephricus'
Ostium urethrae externum Crus clitoridis
Ostium vaginae
Bulbus vestibuli
Fig. 1 1 1 9 Female u rinary and genital o rgans, O rgana u rogenitalia fem i n i n a ; d i a g ra m of the development: the pa rts that degenerate a re displayed in pale p i n k , a n d the position of the ovary prior to its descent i s ind icated by the dashed line; ventral view.
Glandulae vestibulares majores'"
Epoophoron Pa roophoro n
g e n ital part of the mesonephros; re mnants of the tubules of the mesonephros
*
WOLFFian duct
••
MOLLERlan d uct
• ••
BARTHOLIN's glands
M a le g e n i t a l i a
Genitalia
Rectum
Sections
To p o g ra p h y
Female genitalia
Uterus and ovaries
Fimbria ovarica Ampulla tubae uterinae
Ovarium. Extremitas tubaria
Ostium abcominale tubae uterinae; Infundibulum tubae uterinae
A ; Vv. ovarica(e)
Fimbriae tubae uterinae
Tuba uterina [Salpinx]
Lig. suspensorium ovarii A.; Vv. ovarica(e)
Extremitas uterina
Ovanum. Margo hber
Portio supravaginalis cervicis M. rectouterinus**
Excavatio rectouterina; Tunica serosa [Perimetrium]
Plica rectouterina
Fig. 1 1 20 Uterus. Uterus; ovary, Ova r, and uterine tube, Tuba uteri n a ; dorsal view.
• Clinical term: cardinal ligament
•• Clinical term: sacrouterine ligament
ovarii proprium Isthmus tubae uterinae
Tuba uterina [Salpinx] Lig. teres _�� "'T.' uteri*** Lig. ovarii propnum
Portio vaginalis cervicis
Fig. 1 1 2 1 Uterus, Uterus; ovary, Ovar. a n d uterine tube, Tu ba uterina; dorsal view.
Infundibulum tubae uterinae; Fimbriae tubae uterinae
Folliculi ovarici vesiculosi' Corpus luteum Lig. latum uteri . Pars uterina; Ostium uterinum Tuba utenna Corpus uteri
}
•• •••
Cli nical term: GRAAFian follicle Stalked hydatid Clinical term : round ligament
�
Pelvic vi sce ra a n d ret ro p e ritoneal space
K i d n ey
S u p ra re n a l g la n d
���
Ovaries and uterus Folliculi ovarici prlmarii
Corpus luteum
FolliCUlUS ovaricus malurus
Cumulus oophorus
Corpus luteum menstruaMnis Corpus luteum
Fig. 1 1 22 Ovary, Ova r ; m i c roscop i c enlargement at low magn ification.
I
Cavltas uteri
Facies intestinalis Isthmus uteri Canalis cervicis uteri
Fundus uteri Tunica mucosa [Endometrium]
Fornix vaginae, Pars posterior
Tunica muscularis [Myometrium] Tunica serosa [Perimetrium]
Peritoneum urogenitale Facies vesical is
Excavatio rectouterina
Peritoneum urogenitale, Excavatio vesicouterina Portio supravaginalis cervicis Fornix vaginae, Pars anterior
Fig. 1 1 23 Uterus, Uterus, a n d vag i na, Vag i na ; viewed from the right.
Stratum functionale endometriale
Stratum basale endometriale Tunica muscularis
Fig. 1 1 24 M u cosa of the uterus, Uterus; ea rly phase of proliferation .
U ri n a ry b la d d e r
Fig. 1 1 25 M ucosa of the uterus, Uterus; late phase of p roliferation with exc retory glands.
M a le g e n i t a l i a
Genitalia
R e ct u m
To p o g ra p h y
f203
Sections
Female genitalia
Uterus
•
Fig. 1 1 26 Uterus. Uterus. a n d vag i na . Vag i n a ; normaL a n g Les between the vag i n a , the cervix. and t h e body of uterus; viewed from the right.
Fundus uteri
•
••
•••
Longitudinal axis of the va g i n a Lon g itudinal a x i s o f the cervix of uterus Longitudinal axis of the body o f uterus
AngLe between vag i n a and cervix of uterus version AngLe between cervix and body of uterus flexion N o rmaL topog ra phicaL situation of the uterus: anteversi o n . a nteflexion ReLatio n to the median pLane position =
=
=
Fig. 1 1 27 a-c Uterus, Uterus, and vag i n a . Vag ina . a Anteversi on, a nteflexion normaL position b Anteversi on. but n o a nteflexion c Retrovers i o n . retroflexion =
f----- Ostium uterinum tubae uterinae
�---- Tuba uterina
[Salpinx]
"7-----_ Cavitas uteri
'-A..ti"'rjr-..:...:.---- Ampulla tubae uterinae r----__ Canalis cervicis
uteri
Fig. 1 1 28 Uterus. Uterus, and uterine tube, Tu ba uteri n a ; AP-radiogra p h after i njection of to contrast medium into t h e cervix of uterus i hysterosalpingographyi; uterus i n dextroposition; ventra l view.
This formerly clin ically a pplied tec h n i q u e a llows to determine the position of the o rgans and the patency of the tubes. K tube adaptor for i njection of the contrast medium =
�
Pelvic viscera a n d ret ro p e ritoneal space
K i d n ey
S u p r a re n a l g la n d
���
Arteries of the female internal genitalia
Lig. teres uteri '
Lig. ovar" proprium
Lig. sus pensorium ovam Appendix vesiculosa
Lig teres uteri '
Ostium abdominale tubae uterinae; Infundibulum tubae uterinae Cervix uteri A. vaginalis VagIna
Fig. 1 1 29 Arteries of the female i nternal g e n italia, O rgana g e n italia fem i n i n a i nterna ; dorsal view.
* Clinical term : rou n d ligament
Fundus uteri (R. fundi uteri)
A ovarlca
----=::.;a,_6t'--"
b
a
d
e
- 10%
U r i n a ry b la d d e r
Fig. 1 1 30 a-f Va ribi lity of the a rterial supply of the female i nternal g e n ita lia; dorsal view. a Supply of t h e uterus, Uterus I "textbook case" ] b, c, d Supply o f the ova ries, Ova r i a I b , "textbook case"] e, f Supply of the fundus of uterus, Fu ndus uteri Ie. "textbook case"]
M a le g en i t a l i a
Rect u m
Geni t a l i a
To p o g ra p hy
Sect i o n s
Female genitalia
Uterus
Articulatio sacroiliaca
(Spatium retrorectale)
(Spatium pararectale)* Ug .
Rectum
rectouterinum
1;-.i�����---:-'�=----.;...--:iJ . &;"":-;;;:- ---- Excavatio rectouterina
Ug. cardinale lUg. transversum cervicisj**
Excavatio vesicouterina Vesica urinaria
��
Ureter
..,-
Spatium retropubicum
-=-..��:... ..:: J.����a� .:
Symphysis pubica
Fig. 1 1 31 Uterus, Uterus; uterine ligaments and connective tissue spaces; semi-schematic t ra n sverse section at the level of the cervix of uterus ; superior view.
Ostium ureteris
Ostium urethrae internum Clinica l term: Paraproctium
** Clinical term: Parametrium
[existence of this structure I S controversial)
*** Clinical term: Paracyst i u m
Fornix vaginae, Pars anterior
Portio vaginalis cervicls
Portio vaginalis cervlclS Ostium uteri
Labium anterius
Labium posterius Rugae vaginales
Fig. 1 1 32 a, b Vag i na l portion of the cervix of uterus, Portio vaginalis cervicis. a Photograph of the cervix of a you n g n u lliparous woman b Photog raph of the cervix of a you n g woman who has g iven b i rth to two c h i ldren
Ostium uteri
Labium anterius
Labium posterius
VagIna
For the i nspection of the vag i n a l portion of the cervix the normally slit-like vag i n a i s spreaded by means of a bivalve speculum ( * 1 ; i nferior view.
2 0\6 -
�
I
Pelvic visce ra a n d ret ro p e ri t o n e a L s pace
K i d n ey
S u p ra re n a l g la n d
U r i n a ry b la d d e r ���
Pregnancy, ultrasound
Truncus Caput
Fig. 1 1 33 Uterus, Uterus, with an embryo ; u lt rasound image taken i n the e i g hth week of pregnancy; lateral view (right!.
Membrum inferius ---c:;== Truncus
Fig. 1 1 34 Uterus, Uterus, with a foet u s ; u lt rasound i mage taken i n the 28th w e e k of pregnancy ; lateral view [ left! '
Funiculus umbilicalis
Membrum inferius
The e m b ryo is i m mersed in the a m n iotic fluid of the chorionic cavity,
Caput, Frons Nasus
Labium superius
Regio mentalis
U ltrasou n d exa m i nation a llows the visualization of move ments of the extremities and the opening of the mouth.
Digiti II -V Antebrachium
Palma Pollex [Digitus I]
Humerus
Fig. 1 1 35 H a n d , M a nus, of a foetu s ; u ltrasound i mage taken i n t h e 1 8t h week of pregna ncy; lateral view,
Details s u c h as fi ngers can be observed .
M a le g e n i t a l i a
G e n italia
Rectum
To p o g ra p hy
Sect i o n s
Female gen italia
Pregnancy V umbilicalis
Aa. umbilicales
Fundus uteri
Colon sigmoideum Fornix vaginae. Pars posterior Portio vagmalls cervicis.
Ostium
uteri
EXGavatio rectouterine"
Placenta
Os coccygis Fascia rectovaginalis [Septum rectovaginale] Excavatio vesicouterina
Spatium rellopubicum"
Corpus ano coccygeum [Lig. anococcygeum]
_.
Symphysis pubica, Discus interpubicus Clitons, Corpus cavernosum clitoridis
M. sphincter ani externus
Glans clitoridis Labium minus pudendi
Urethra feminina
M. sphincter urethrae
Fig_ 1 1 36 Uterus, Uterus, with a foetu s ; the pelvis h a s b e e n sectioned i n the median plane. Mucous plug [ of KRISTELLERi i n the cervical canal of the uterus Clinical term: pouch of D O U G LAS
.** Clinical term: vesicovaginal septum
••••
Clinical term: cave of
RETZIUS
... ...._""+-- Sternum, Proc. •iphoideus .I\,,.--' Arcus
oostalls
Spina iliaca anterior superior Fig. 1 1 37 Uterus, Uterus; position of the fundus of uterus d u ri n g p regnancy. N u mbers refer to the end of the respective month of p regnancy [= 28 days ) .
'2 ;0'-"S"
I
",I-,-- -
I �
:1
Pelvic viscera a n d ret ro p e ritoneal space
��
K i d n ey
Placenta
a
b
Fig. 1 1 38 a, b Placenta, Placenta, a n d u m b i lical cord , Fu nicu lus u m b i lica l i s . a View of the foetal s u rface b View of the maternal s u rface of a part u rient placenta
S u p ra re n a l g la n d
U ri n a ry b la d d e r ���
M a Le g e n i t a l i a
Rectum
Genitalia
Secti o n s
To p o g r a p h y
Female genitalia
Ovaries and uterine tubes
Fimbriae tubae uterinae A.; V. ovariea
Caecum
Lig. suspensorium ovarii*
Infundibulum tubae uterinae
Ampulla tubae uterinae
Ampulla tubae uterinae
Ovarium, ---2'Ir--: Facies medialis
Mesosalpinx Isthmus tubae uterinae
Margo mesovaricus
Lig. latum uteri
Lig ovarii proprium Lig. teres uteri Plica umbilicalis medialis
Uterus, Facies vesicalis
209
Plica umbilicalis mediana
Vesica unnana
Excavatio vesicouterina
Fig. 1 1 39 Fe male i nternal g e n italia, O rgana genitalia fe m i n i n a i nterna ; ventral view. Clinical term : i nfundlbu lo p e lvi c l i g a m e n t *
Colon sigmoideum
Tuba uterina
Uterus
Fimbriae
Ampulla
Ampulla
tubae uterlnaa
Ovanum
ls1hmus
Facies intestinalis Fundus Facies vesical is
Fig. 1 1 40 Fe m a le i nternal g e n ita lia, Organa gen italia fe m i n i n a i nterna ; surg i ca l exposure i n a young wo man; ova ries d i splaced both media lly and superi orly by compresses 1 * ) in the pouch of D O U G LAS; ventrosu perior view. *' Swab
Lig. ovarii propnum
Fimbriae tubae uterinae
Lig. teres uteri Ovarium
Ostium abdomina Ie tubae ulerlnae
Fig. 1 1 41 Abd o m i n a l ost i u m of the uteri ne tube, Ost i u m abdomi nale tu bae uterinae; s u rgical exposure i n a young wom a n ; t h e pelvic cavity is fi lled w i t h saline t o demo nstrate the f i m bria ; dorsosu perior view.
* Plastic tray to support the uterine tube
20 D
�
Kid ney
Pelvic viscera a n d ret ro p e ritoneal space
S u p ra re n a l g la n d
U r i n a ry b la d d e r
Rectum
'.\\ "'h--- Flexura
sacralis
Pentoneum u(ogenltale.
Excavatto rectoveslcalis
Tunica muscularis, Stratum longitudinale
Flexura anorectal is [perinealis]
Tela subcutanea, Panniculus adiposus
Fig. 1 1 42 Rectu m , Rect u m ; viewed from t h e left.
A
V. cava inferior
_ _ _
rectal is superior
V. iliaca communis V. sigmoidea
V. sacralis mediana ----'11 V. rectalis superior
-It-'I.I �
_ _ _
V, Illaca
extema
Phca transversa
Plica transversa recti"
recti
.M"'.--__ V. itiaca Intern a
Ampulla recti ----'-'::.JIUU (Spatium pararectale) Plexus venosus rectalis M. levator ani
Columnae an ales
M sphincter ani internus
M. sphincter ani externus
Fig. 1 1 43 Rectu m , Rect u m ; blood supply ; t h e m u cosa a n d t h e para rectal a d i pose tissues have been pa rtly remove d ; o p e n i n g s i nto the hepatic porta l ve i n i n p u rple.
Ampulla recti ---;:::-tI�t-'lIK!td
.��":'!--- Vv. rectales mediae
A pudenda interna
Junctio anorectalis Sinus anales Columnae anales Pecten anal is Cutis
Valvulae anales M. sphincter ani extern us Linea anocutanea
Fig. 1 1 44 Rect u m , Rect u m , a n d anus, Anus; ventral view. • H a emorrhoidal node •• KOHLRAUSCH's fold
G e n it a l i a
Top o g ra p hy
Rectum
Sections
Rectum
Columna analis
...
---1 ;-
Canalis analis
Sinus analis -
-----..... .
-' '-
Fig. 1 1 45 Rectu m , Rect u m ; e ndoscopic i mage of the a n a l c a n a l w i t h s i x e n la rged n odes of the cavernous rectal body, haemorrhoids; superior view. • ••
Colonoscope Three haemorrhoidal nodes
Plica transversa recti
Fig. 1 1 46 Rect u m , Rectu m ; e ndoscopic i mage of t h e rectal a m p u lla I rectoscopy ) ; i nferior view.
21 2 �I
�
Pelvic viscera a nd ret ro p e ritoneal space
K i d n ey
S u p ra re n a l g la n d
U ri n a ry b la d d e r
Arteries of the rectum
A.
mesenterica inferior
Pars abdominal is aortae
A rectalis superior'
A. sacralis mediana
Aa. sigmoideae ----.�iii::'''t-.....::� Colon slgmoideum ----'�-----_
A. glutea superior A. iliaca interna
Canalis obturatorius
A. iliaca externa
Spina ischiadica
A. glutea inferior A. pudenda interna
A. rectalis media A. rectalis inferior
Anus
Tuber ischiadicum M. sphincter ani externus
Fig. 1 1 47 Recta l a rteries, Aa. rectales; d o rsal view.
* Clinical term: SUDECK's point Ifrom this point on there are no further anastomoses with the sigmoid arteries]
I
G e n it a l i a
Rectu m
To p o g ra p hy
,3 i 1 2
Sect i o n s
" ,
Veins of the rectum
V. iliaca communis
V. cava inferior
Vv. sigmoideae V. rectalis superior
Colon sigmoideum
V. glutea superior V. iliaca interna --.j:......----�
Spina ischiadica V. obturatoria
V. rectalis media Plexus venosus rectalis
M. sphincter ani externus
Fig. 1 1 48 Rectal veins, Vv. rectale s ; d iagram w i t h pa rts of the pelvis a n d the pelvic d ia p h rag m ; dorsal view. There a re numero u s connections between the veins d ra i n i n g i nto the hepatic portal vein (superior rectal vei n ) and t hose d ra i n i n g i nto the i nferior vena cava ( m i dd le a n d i nferio r rectal veins). They form the portocaval a n a stomoses, which a re of pa rticular clinical i mportance.
Tuber ischiadicum
1 -7 1077, 1 078 1
�
Pelvic viscera a n d ret roperitoneal space
K i d n ey
S u p ra re n a l gla n d
Innervation of the rectum
Plexus coeliacus; Ganglia
Truncus coeliacus
Pars abdominalis aortae
Ganglia trunci sympathici Ganglion mesenterlcum Inferius
A
Nn. spianchnlci lumbales
mesenterica inferior
Plexus hypogastricus superior A.
iliaca communis
Radices anteriores (S 2-S 5)
N hypogastricus dexter
Plexus hypogastricus inferior
Plexus rectalis superior --<JI'fit...\.'Ii
Ganglia pelvlca,
Plexus rectalis medius ---I��'"
Radix parasympaltm:a [Nn. splanchnlcl pel vlcij
Plexus rectalis inferior
Plexus sacralls
M levator ani
M. sphincter ani externus
Fig. 1 1 49 Rectum, Rectum ; schematic overview of the i n n e rvat i o n ; ve ntral view. Green sym pathetic nervous system Pu rple parasympathetic n e rvous system =
U r i n a ry b la d d e r
I
Genitalia
Rectu m
To p o g ra p h y
Sectio n s
Rectum, radiography
2'1 5
Femur, Caput femons
as sacrum
Ileum -----Fsmur, Corpus
lemons
Colon sigmoideum
----
as pubis, Ramus inferior --�--
Ampulla recti as coccygis M. gluteus maximus
Tuber ischiadicum
Canalis analis
Fig. 1 1 50 Rect u m , Rectu m ; latera l radiograph i n volu ntary closure of t h e a n u s after filling with a contrast medium [defaecogra p hy).
Femur,
Femur, Corpus femoris
--_
as PUbiS, Ramus Inferior ----=---
The t ransitional zone betwee n t h e a n u s a n d t h e rectum [a rrow) is located at the level of the t i p of t h e coccyx [tria n g le ) . The a n g le betwee n the axes of t h e a n u s a n d t h e rectum [ 4 1 i s approxi mately 900 a n d depends u po n the c u rvat u re of t h e levator a n i muscle [ pu borectal muscle). Scale i n c m.
Caput femoris
as sacrum Colon sigmoideum
as coccygis Ampulla recti
Tuber ischiadicum -- l--'-i,.,r;�
Fig. 1 1 5 1 Rect u m , Rect u m ; lateral rad i og ra p h o f t h e defaecation after filling with a contrast m e d i u m [defaecography).
M. gluteus maximus
I n compa rison to Fig . 1 1 5 0 , t h e anorectal transitional zone has descended a n d t h e a n g le [2\-1 i n c reased to 1 370 d u e to the relaxation of t h e c u rvature of t h e levator a n i m uscle. As the bending acts like a valve, the elongation results i n a n u n i m peded pressure of the faeces on the anal ca n a l lea d i n g to d efa ecation.
I
•
PeLvic viscera a n d ret ro p e ritoneaL space
K i d n ey
S u p r a re n a l g la n d
Arterial supply of the kidney
Costa X I
A. renalis
[
A. arcuata A. interlobaris A. segmenti
Ren, Extremitas superior Vertebra lumbalis I, Proc. costalis Ren, Margo medialis A. renalis
Calyx renalis
Ren, Margo lateralis
Ren, Extremitas inferior
��....-. Pelvis renalis
�"'.....:I�-,.ij"- Ureter, Pars abdominalis
Crista iliaca
Fig. 1 1 52 Kid ney, R e n ; AP-radiogra p h after i ntrave nous i njection o f a cont rast medium which i s excreted via the kid neys to demonstrate the renal pelvis and the u reters [ i ntravenous pyelo g ra p hy) ;
conco m itant visua lization of the a rteries by i njection of a contrast m e d i u m i nto the ren a l a rtery t h ro u g h a catheter" i nt roduced into t h e aorta [ a rteriogra phy] .
(A. renalis polaris inferior)
Fig. 1 1 53 a-d Va riations in the a rterial supply of the kidney. a One re nal a rtery, A. renalis, with a bra n c h to t h e s u perior pole b Two renal a rteries to the renal hilum c Two renal a rteries, o n e of which supplies the s u perior pole d Two ren a l a rteries, one of which supplies the i nferior pole
U r i n a ry b la d d e r
Genitalia
Rectu m
To pography
Sections
Retroperitoneal space, overview
phrenica . inferior
(Facies contacta hepatis)
Glandula suprarenalis Peritoneum parietale
Glandula suprarenalis
Truncus coeliacus • A. mesenterica • superior
A. suprarenalis inferior; • V. suprarenalis dextra • (A renalis . accessorial
V
cava inferior •
A.; V. renalis • •
Costa XI
Ren, Capsula adiposa
.. N subcostalis
Ureter
• • A.; V. lumbalis I
M. obliquus externus • abdominis
N. iliohypogastricus
M obliquus internus • --HiHrl abdominis M transversus . abdominis
---jrmitlMl'IJA�C1j
V.; A testicularis • • M psoas major .
Aa sigmoideae .
(M . psoas minor) •
.
{
_J.t£.�fl!!It1I�fif:�'t7f1.'fI:2
" N. ilioinguinalis • M. quadratus
lumborum
Lig. iliolumbale N. cutaneus femoris lateralis
Aa ; Vv iliacae • • communes
N . genltofemoralis
mesenterica ���:lthitf1fnit-- • A.inferior
R. femoralis
• • A.; V. iliolumbalis, Rr iliaci
R. genitalis
A.; V iliaca interna • •
}
R. femoralis N. genito ., R. genitalis femoralis
Mesocolon sigmoideum
• A. iliaca interna
Excavatio rectovesicalis
Plica umbilicalis mediana
Fig_ 1 1 54 Position of the retroperitoneal structures, Situs retroperitonealis, of the m a le . Whereas the left test i c u la r ve i n opens i nto the left renal vei n , the r i g h t test i c u la r vein d ra i n s d i rectly i n t o the i nferior vena cava. The sa me a p plies to the ovarian veins. a
A.
testicularis sinistra
b
Fig. 1 1 55 a, b Va riabi lity of the course of the testicular a rteries, Aa. testicu lares. a "Textbook case" b Both testicular a rteries, Aa . testi c u la res, b ranch off cra n ially to the renal ve ins, Vv. renales; the right a rtery passes posterior to the i nferior vena cava, V. cava i nferior, and the left a rtery passes a nterior to the left renal vei n , V. renalis s i n i st ra.
�
PeLvic viscera a n d ret roperitoneaL space
K i d n ey
U r i n a ry b la d d e r
S u p ra re n a l g la n d
Lymphatics of the retroperitoneal space
A. phrenica • inferior
•
Nodi Iymphoidei phrenici inferiores
•
gastrlca sinlstra A.
A.
hepatica
communis
• A. splenlca
}
Truncus
coellacu6
• A. renalis
Truncus intestinalis
:-�t-'��--=-:-"7tIr.�f-- • A mesenterica superior
Cisterna chyli
.----�.rl...- • Pars abdominalis
Truncus lumbalis dexter
aortae
Nodi Iymphoidei lumbales intermedii
Nodi Iymphoidei lumbales dextri V. cava inferior . -----FE"'
r>--"r--i--Ij..,,,.-.- • A iliaca
communis
Ureter
• V. iliaca
communis
���I-
Nodl -��-----��-��� lymphOldei iliaci externl
A. temoralis •
Nodi Iymphoidei iliaci interni Mesocolon sigmoideum
Colon sigmoideum
Nodi Iymphoidei inguinales superticiales, Nodi superolaterales '
Fascia cribrosa Nodl lymphoidel m9ulnales supertlclales. Nodi supero medial as et IIlfenores
N. femoralis
Nodi Iymphoidei inguinales. (Nodi profundi)
Fig. 1 1 56 Lymph nodes, Nodi lymphoidei, and lym phati cs, Vasa lym phatica, of the posterior a bdominal wall a n d the i n g u i n a l reg i o n ; ve ntral view.
N. ilioinguinalis
The n u m bers X a nd X I I ind icate the respective ribs. •
Clinica l term: " h orizontal chain", d ra i n i n g the lower abdominal wall. the gluteal region. the perineum and the external gen ital
Gen italia
R e ctu m
To p o g ra p h y
Sections
Lymphatics of the retroperitoneal space, radiography
Truncus lumbalis sinister
Vas Iymphaticum --'--�"":..:,II'" efferens
...... - Nodus Iymphoideus
inguinalis superiicialis
Vasa Iymphatica --;----E� afferentia
Fig. 1 1 57 Lymphatics, Vasa lym p hatica, a n d lym p h nodes, Nodi lym phoidei, of the i n g u inal, the pelvic a n d the lumbar reg i o n ; AP-radiogra p h after bi latera l i nj ection o f a contrast m e d i u m i nto lymphatics of the foot [ lymphography). This forme rly applied tec h n i q u e visualizes t h e position a n d s i z e of lymphatics a n d lym p h nodes.
�
Pelvic viscera a n d ret roperitoneal space
K i d n ey
S u p ra re n a l g la nd
U r i n a ry b l a d d e r
Nerves of the retroperitoneal space
N. splanchnicus major . N
N. vagus [Xl. Plexus oesophageus Oesophagus
Ihoracicus (Tll I, N.
InlerCOSlalis
N. subcostalis
• M . quadratus lumborum
N iliohypogaslricus
Truncus sympathicus N. ilioinguinalis
Plexus mesentericus inferior
N. cutaneus femoris laleralls
Crista iliaca
N. genitofemoralis
N femoralis
• M. iliacus
N. obturalorius
Truncus lumbosacralis
, Plexus sacralis
Rectum
1 � 47. 49, 501
Fig. 1 1 58 Nerves of the posterior a b d o m i n a l wa ll, the lum bosacral plexus. Plexus lum bosacralis. a n d the abdominal part o f the autonomous nervo us system, Pars abdominalis autono m i c a ; ventral view.
I
Gen italia
Rectum
To p o g ra p hy
221
Secti o n s
Vessels and nerves of the retroperitoneal space
N.
splanchnicus major
Hiatus oesophageus
A ; V. renalis' • •
N. subcostalis
A ; V. testicularis • •
Truncus sympathicus
N. subcostalls
• A. mesenterica
inferior
• • k; V. iliaca
communis
N. iliohypogastricus
• A. lumbalis IV •
N genitofemoralis
Truncus lumbosacralis
N ihoinguinalis
Rr. musculares N. ilioinguinalis
N. femoralis
• M transversus •
N. genitofemoralis, R, femoralis
•
N. cutaneus femoris lateralis N. genitofemoralis, R. genitalis
• • A.; V. circumflexa
ilium profunda
Ureter, Pars pelvica
Ductus deferens
abdominis
A ; V sacralis mediana • •
Rectum
Fig. 1 1 59 Vessels a n d nerves of t h e posterior abdominal wall of the m a le. * I n - 1 0% the left re nal vein passes posterior to the aorta .
• • A.; V. epigastrrca
inferior
�
K i d n ey
PeLvic viscera a n d ret roperitoneaL space
S u prare n a l g la n d
U ri n a ry b la d d e r
Innervation of the male genitalia
Fig. 1 1 60 M a le genitalia, O rgana g e n italia masculina; d i a g ra m demonst rating the autonomous i n nervation of the left s i d e ; ve ntral a n d lateral view, respectively. Green sympathetic n e rvous system Pu rple parasympathetic nervou s system
� Medulla spinalis
=
Rr communicantes
=
Truncus sympathicus
•
ALso; engen! nerves
S u rg i ca l removal o f p a raaortic lym p h nodes o r operations a t t h e abdominal a orta a n d t h e large a rteries o f t h e pelvis can cause damage to the sympathetic nerves with the consequence of eja c u latory i m potency l i m potentia genera n d i l . Prostate operations, in t u rn, may damage the para sympathetic fibres i n n e rvating the penis, thus leading to erectile i m potency I l mpotentia coe u n d i l .
Glandula vesiculosa
Vesica urinaria
;:;��:=-:t:)�\.1ir��s;;;;;:�==-: Corpus spongiosum penis
Corpus cavernosum penis Urethra masculina
Ganglia pelvica, Radix parasympathica [Nn splanchnici pelvici]-
Glans penis
Plexus testicularis
I n n ervat i o n of t h e m a le g e n italia Parasympathetic
Sympathetic
Origin
Course
O rgan
Function
Sacra l part of the s i n a l cord S2 - 54! Thora c i c part of the spinal cord [T1 0 - T 1 2!
Ganglia pelvlca, Radix a rasympath ica N n . sp la nch n i c i pelviciJ Plexus m esenterici s u perior et i nferior
Penis Corpus cavernosum
Vasodilatation Erection
Testis
Reg u lation of blood flow
Gland u la bulbou reth ralis Ductus [vas! deferens
Expulsion of its fluid
�
�
-l-
Truncus sym path icus -l-
Plexus testicularis Lumbar part of the s p i n a l cord [ L 1 - L2!
-l-
Plexus hypogastricus s u pe rior -l-
N . hypogastricus -l-
Plexus hypogastricus i nferior
Somatomotor, somatosensory
Sacral part of N pudendus the spinal cord 152 - 54)
N n . scrotales posteriores N . dorsalis penis
Contract i o n , t ransport of the sperms into the u rethra
Glandula vesi c u losa Prostata
Expulsion of its content i nto the u rethra
[M sph incter vesicae!
C losure of the u ri n a ry bladder to prevent retrog rade ejacula·ion Expulsion of the eja c u late out of the u reth ra
M isch i ocavernosus M b u lbospongiosus Scrotal s k i n Penile s k i n
G e n ita l i a
Rectu m
S e ct i o n s
To p o g ra p hy
Innervation of the female genitalia
Fig. 1 1 6 1 Fem a le g e n italia, O rgana genitalia femi n i n a ; d i a g ra m demonstrating the autonomous i nnervation ; ventral view. Green sym pathetic nervous system Purple parasym pathetic nervous system =
=
• Clinical term: FRANKENHAuSER's ganglion A ls o erigent nerves ••
:
The autonomic plexus a re i n terspersed with ganglia. The hypogastric a n d uterovaginal plexus conta i n both sympathetic and parasym pathetic fi bres.
Radices anterio res (S2-S5)
1-7 49, 50 1 OVarium
Plexus hypogastricus inferior Plexus uterovaginalis·
N. sacralis [S1 ]
\::S;::;::\:�:----':- Ganglia pelvica,
Radix parasympathica
Ganglia pelvica, Radix parasympathica [Nn. spianchnici pelvicit·
[Nn. splanchnici pelvici]
Cilloris
---
Labium minus pudendi
Plexus sacralis
N pudendus Nn. labiales posteriores
(Introitus vaginae)
I n n e rvat i o n of t h e f e m a le g e nitalia Parasympathetic
Sympathetic
Origin Sacral part
t
o f the s n a l cord I 2 - 54]
T h o ra c i c p a rt of t h e s p i n a l c o rd IT1 0 - T 1 2 ]
Course Ga n g l i a pelvica, Radix a rasym p a t h i ca N n . s p la n c h n i c i p e lvi c i J
fr
J,
N n . cave rn o s i clito r i d i S Plex u s m e s e n t e r i c u s ." su perior Plex u s ova r l c u s 71
Organ Tuba uterina U t e ru s
Function Vasodilatation Vas o d i latat i o n
Va g i n a C litoris
Tra n s s u d a t i o n Erection
Ova r
Va s o c o n st r i c t i o n
T u b a uterina Uterus Va g i n a
C o n t ra c t i o n
Plex u s re n a l i s
Tru n c u s sympa t h i c u s Lu m b a r pa rt o f t h e spinal cord I L1 - L2]
J,
Plexus hyp o g a st r i c u s superior J, N hypogastri c u s Plex u s hypogastri c u s i nfe r i o r
J,
8
Plexus uterol(a i na l i s I F RAN K E N HA S E R ' s ganglion]
Somatomotor, somatosensory
Sacral p a rt of t h e s p i n a l cord 1 5 2 - 54]
N. p u d e n d u s
71 ."
N d o rsalis c litori d i s N n l a b i a les p osteri ores
C li t o ri s L a b i a maj o ra M. i s c h i ocave rn o s u s
M b u lbospongiosus
Co n t racti o n
�
K i d n ey
Pelvic viscera a n d ret ro p e ritoneal space
S u p ra re n a l g la n d
Pelvic arteries
A. iliaca communis A. sacralis lateralis A iliaca interna
A glutea superior M piriformis
A iliaca externa A. obturatoria
A. umbilicalis
A. glutea inferior
--:::;-L---...,.�JI
-r-ooc;;;::::--,���
-++- Lig. sacrospinale
__._:1I'm!r--I-J
A pudenda interna
A vesica lis superior
-10 %
Fig. 1 1 62 a-d Va riabi lity of the branching pattern of the i nternal iliac a rtery, A. i liaca i nterna ; viewed from the left. a All b ranches a rise fro m the same stem . b T h e i nternal iliac a rtery. A. i liaca i nterna. d ivides i nto two major branches [ " textbook case" ) . c T h e i nternal i liac a rtery, A. i liaca i nterna. d ivides i nto t h ree maj o r branches. d The i nternal i liac artery, A. i liaca i nterna, d ivides i nto more than t h ree major b ranches.
U ri n a ry b la d d e r
G e n italia
Rectum
To p o g ra phy
S e ct i o n s
Vessels and nerves of the pelvic wall
Pars abdominalis aortae .
A. mesenterica inferior .
Plexus sacralis, Truncus lumbosacral is
N, sacralis [S1], R, anterior
A
• A. glutea superior A
Truncus sympathicus, Ganglia sacralia
N obturatorius
N. genitofemoralis, R genitalis
Anulus inguinalis profundus
N sacralis [S2], R anterior
--:;�l\o�....Ir'" ..
�\'�::-';�_- • A glutea inferior
N sacral is [S3], R. anterior Nn anales [rectales] inferiores
A cremasterica . A. epigastrica • inferior
Nn. sacrales [S4: S5]. Rr. anterlores M Ischloooccygeus lM. coccygeus] PlexUs coccygeus; N . coccygeus
•
Nn. anococcygel
sacrospinale
A obturatoria, R
M obturatorius internus
N. pudendus
•
Plexus sacral is
Fig. 1 1 63 I nternal i liac a rtery, A. i liaca interna, a n d sacra l plexus, Plexus sacralis; viewed from the left.
1
�
Pelvic viscera a n d ret roperitoneal space
K i d ney
S u p ra re n a l g la n d
U ri n a ry b la d d e r
Organs of the male pelvis
A.; V. sacral is lateral is. Rr spinales • • N. sacralis [81], R. anterior
N. lumbalis [L5], R anterior V. iliaca externa •
Mesocolon sigmoideum
Vesica unnana
[
N. sacralis [82]. R. anterior Peritoneum parietale
• M. gluteus maxim us
Colon sigmoideum
Rectum. Flexura sacralis
Appendices omentales [epiploicae]
Excavatio rectovesicalis
Tunica serosa
Tunica muscularis
Articulatio sacrococcygea
M. rectus abdominis •
Ureter
as pubis
..j ""'t---:'--.IfI�....I-Glandu la vesiculosa
Ug. puboprostaticum
Corpus anococcygeum lUg. anococcygeum]
Funiculus spermaticus
• M. levator ani
Ductus deferens --....,�....:.\���\�
Corpus anococcygeum lUg . anococcygeum]
M cremaster . _�f!,.:.-'''":-+'I�I :''!l!
Tunica dartos. M. dartos .
Rectum. Flexura anorectal is [perinealis]
A profunda penis . M
Glandula bulbourethralis'
Fig. 1 1 64
O rgans of the male pelvis.
* Clinical term: COWPER's gland
• M. transversus perinei profundus
Gen italia
Rectum
To pogra p hy
S e ct i o n s
Vessels of the male pelvis
• A. umbilical is. Pars patens
A
Canalis sacralis
A
."
....".u.� • • A.; V. vesicalis inferior • A ductus deferentis
A.; V. circumflexa • • ilium profunda
1ULl.!;J..:.;If-- • M. piriformis
Plica umbilicalis lateralis; A ; V epigastrica • • inferior
����I-- • M. Ischiococcygeus lM. coccygeus!
Plica umbilical is medialis -;::;-�ML,--�'
ffiE��I-- • • A.; V. rectailS medIa
Vesica urinana ...:t;���.--
Ductus deferens sinister
Ureter sinister
Glandula vesiculosa
Funiculus spermaticus
Corpus cavernosum penis
Fig. 1 1 65
• • A ; V. pudenda interna, Rr. scrotales posteriores
B lood sup ply of the male pelvis.
2 2 8·
�
Pelvic viscera a n d ret roperitoneal space
K i d n ey
S u p ra re n a l g la n d
U ri n a ry b la d d e r
Vessels of the female pelvis
Rectum, Tunica muscularis, Stratum longitudinale
• • A; V. rectalis media Ovanum dextrum
Plica rectouterina Ureter sinister
Tuba uterina
Lig teres uteri
• • A.; V. uterina
A; V iliaca externa • •
Vagina Uterus
• • A.; V. rectalis media
Vesica urinaria
"�----:if-"';"'- • A. vaginalis
• A. vesicalis inferior
• Plexus venosus vaginalis
Bulbus vestibuli • Lig. teres uteri
Fig. 1 1 66
Blood supply of t h e fem a le pelvis.
G e n italia
Rectum
To pogra p hy
S e ct i o n s
Vessels of the female pelvis Nodi Iymphoidei preaortici, aortici laterales et retroaortici Nodus Iymphoideus precavalis
• A. iliolumbalis • • A ; V. rectalis superior
Nodi Iymphoidei iliaci interni
Rectum
Nodus Iymphoideus iliacus externus
• • A.; V uterina
N genitofemoralis N. obturatorius
Nodus Iymphoideus rectalis superior
A.; V iliaca externa • • A ; V obturatoria • •
• A. vaginalis
Nodi Iymphoidei iliaci externi mediales et laterales
• A. pudenda interna
• A. rectalis media
A ; V epigastrica • • inferior
Lig. sacrospinale
Chorda arteriae ....� .. �;-'O'�.....; umbilicalis
Nodi Iymphoidei pararectales
Excavatio rectouterina'. Plica rectouterina
Lig teres uteri ..
Anulus femoralis
• • A.; V. rectalis media
Nodi Iymphoidei iliaci externi obturatorii
Lig teres uteri
Fig. 1 1 67 Lym p hatics, Vasa lym phatica, and lymph nodes, Nodi lym phoidei, of t h e pelvic wall of t h e fem a le.
umbilicale medianum
The lymph nodes are freq uently much smalle r than i llustrated but they a re a lways present. Tu m o u r cells fro m the uteru s can reach the superficial i n g u i nal lym p h nodes via lym phatics of t h e round l i g a m e n t of uterus.
* Clinical term: pouch of DOUGLAS *. Clinical term: round ligamen t
A. lllaca --l� commu�ls A. iliaca --1----#' interna A. obturatoria --t'--v·....... Foramen obturatum
Fig. 1 1 68 a-c Va riabi lity of the origin of the obturator a rtery, A. obturatoria; medial view. a Orig i n fro m the a nterior branch of t h e internal iliac artery, A. i liaca i nterna [ "textbook case"]
A epigastrica Inferior
b Origin as an independent b ranch fro m t h e internal iliac a rtery, A. i liaca i nterna c Origin from t h e external iliac a rtery, A. i liaca exte rna O n ly i n 75% of the cases, the obturator a rtery originates fro m t h e trunk of the i n t e r n a l i l i a c a rt e ry.
2 3 0,
�
Pelvic visce ra a n d ret ro p e ritoneal s pace
K i d n ey
S u p ra re n a l g l a n d
U ri n a ry b la d d e r
Female pelvic diaphragm
Tuberculum pubicum
pubicum inferius
Urethra feminina, Tunica muscularis
transversus perinei profundus
Spina iliaca anterior superior
Fossa acetabuli
Crista iliaca
Lig. transversum acetabuli
Os Ilium Fascia perinei [Fascia investiens perinei superficialis] M. transversus perinei superficial is Fascia inferior diaphragmatis pelvis Fascia obturatoria Lig. sacrotuberale puborectalis Spina ischiadica
Facies lunata M obturatorius internus _-ro...,..... Tuber ischiadicum Fascia obturatoria
M levator ani, M. iliococcygeus M. ischiococcygeus [M coccygeus] M. sphincter ani extern us
lIg
Lig. sacrotuberale Spina iliaca posterior superior Corpus anococcygeum [Lig. anococcygeum]
M sphincter ani externus
Fig. 1 1 69 Peri neal muscles, M m . peri n e i , and t h e pelvic dia p h ra g m , D i a p h ra g ma pelvis, of t h e female; i nferior vi ew. Tuberculum pubicum
Linea terminalis
Eminentia iliopubica
Corpus ossis pubis ---+-�"-"'�
•
Probe in the pudendal canal [ALCOCK's canal]
Symphysis pubica Canalis obturatorius
M. levator ani, M. pubococcygeus
M. rectococcygeus
Os sacrum
Ligg , sacroiliaca anteriora _-\-..n-.,.-:.. ....,,� .
Os ilium -...liilW\9;,\'If.i
Proc articularis superior
Fig. 1 1 70 Pelvic d i a p h ra g m , D i a p hragma pelvis, of the fe m a le ; superior vi ew.
Foramen ischiadicum Lig sacrotuberale ug sacrococcygeum anterlus: 1M. sacrococcygeus) * Clinical term: levator hiatus [ H iatus u rogen italis et a n i )
G e n italia
Rectum
To p o g ra p h y
Sections
Female pelvic diaphragm
A.; V, iliaca interna • • N
obturatorius
M. transversus . abdominis
M obliquus . --," " 1 internus abdominis
• M. Ischiococcygeus
[M. coccygeus]
M obliquus . ----l\,1i;I\1 externus abdominis M iliacus .
A,; v, iliaca externa • • A ; V, circumflexa • • ilium profunda
Rectum
A ; V, epigastrica inferior • • N obturatorius Pecten ossis pubis A ; V. obturatoria • •
Corpus anocoooygeum lUg, anococcygeum]
M. obturatorius • Internus (Arcus tendineus musculi levatoris ani) Clitoris, Corpus clitoridis
• M, sphincter ani externus
V, dorsalis profunda . clitoridis
• M. sphincter ani internus
Ostium urethrae externum Labium majus pudendi
Centrum perinei
Fig. 1 1 71 M uscles of the pelvic diaph ra g m , Diaphragma pelvis, of the fe m a le .
• M. sphincter ani externus
23'2'
I �
K i d n ey
PeLvic vi scera a n d ret ro p e ri t o n e a L space
S u p ra re n a l g la n d
U r i n a ry b la d d e r
Male pelvic diaphragm
Corpus spongiosum penis
bulbospongiosus
Glandula bulbourethralis
M. ischiocavernosus
•
M. gracilis
M transversus perinei superficial is
perine. [Fascia mvestlens
Fascia
perlnei supert.clallsj
Tuber
Ischiadlcum
Tela subcutanea, Panniculus adiposus
----��'1i'jl1W1...,1:
Lig sacrotuberale
Fossa Ischloanalis
M
M_ gluteus maximus
M, levator ani
Os coccygis
Corpus anococcygeum [Lig anococcygeum]
Fig. 1 1 72 Peri n e u m , Peri n e u m , and pelvic diaphra g m . Diaphra g m a pelvis. of the m a le ; i nferior view. •
Clinical term: COWPER's gland
sphincter ani externus
Gen italia
R ec t u m
To pogra p hy
Sections
Female pelvic diaphragm
M gracilis
Ostium urethrae externum
Rugae vaginales Glandula vestibularis major. (Ostium) '
M. ischiocavernosus M. bulbo spongiosus
M. bulbo spongiosus
Raphe pennel
Fascia perinei [Fascia investiens perinei superficial is]
Tuber
perinel superficial is
ischiadlcum
Ug . ---"":;':=;"-.,.-4"';
saorolubemle
Fascia obturatoria
FascIa obturatorla
Fossa ischioanalis
M. sphincter ani externus M.
gluteus maximus
Mm. transversi perinei superficialis et profundus
Fig. 1 1 73 Peri neum. Peri n e u m ; peLvic diaph ra g m . Diaphragma peLvis. and femaLe externaL g e n itaLia. Organa g e n itaLia fe m i n i n a externa; i nferior view.
* C li nical term:
BARTHOLlN's g la n d
O s coccygis
Corpus anococcygeum lUg. anococcygeum]
The va g i n a L and the anaL orifices a re Located i n close prox i mity. D u ri n g deLivery the skin and m uscles of the peri neum can rupture u p to the sphincter m uscles of the a n u s [ I . I I I . degree peri neaL Lacerations). These can be prevented by s u rgicaL i n c isions d i rected either Laterally o r i n the median pLane [perineaL incision Latera L or mediaL episiotomy). -
=
Pe lvic vi sce ra a n d ret ro pe r i t o n e a l space
K i d n ey
Su prare n a l g la n d
U ri n a ry b La d d e r
Urogenital diaphragm
Lig. inguinale Symphysis publca
Glandula bulbourethralis'
M. transversus perinei profundus .
Ductus glandulae bulbourethralis
A ; V bulbi penis • •
• M. transversus perinei profundus
A ; V perinealis • • N. perinealis A.; V. pudenda interna • • N.
Fascia perinei [Fascia investiens perinei superficial is] Ramus ossis ischii
pudendus
• M. transversus
perinel superficialis
Fig. 1 1 74 U rogenital diap h ra g m , Diaph ragma u rogenitale, of the male; i nferior view. * C l i n i cal term: COWPER's gland
Tuberculum pubicum
Lig. inguinale
Os pubis, Ramus superior
Symphysis pubica
• V. dorsalis profunda clitoridis
Lig pubicum inferius
�..JI..--'r - - Urethra feminina
Os pubis, Ramus inferior
__....- • M transversus perinei profundus _ -;--_
Tuber ischiadicum
perlnel superficial is Fig. 1 1 75 U rogen ital diaph ra g m , Diaph ragma u rogenita le, o f t h e female ; i nferior view.
Fascia perinei [Fascia investiens perinei superficialis]
G e n it a l i a
R e c u rn
To p o g ra p hy
Sections
Female external genitalia
Tuberculum pubicum
::��;...:::f;;:��)
Ug. suspensorium clitoridis
�����iii;::'::::� Lig. inguinale
Labium minus pudendi -...,��..
Ostium vaginae; Columna rugarum anterior -7,i....�rJI�t..IJLl Glandula vestibularis major', (Ostium)
M. transversus
Fascia perinei [Fascia investiens perinei superficialis]
perinei profundus
Tuber ischiadicum M.
sphincter ani externus, Pars subcutanea Corpus anococcygeum lUg. anococcygeum] Fig. 1 1 76 Female external genitalia, Organa genitalia fem i n i na extern a ; ventroi nferior view. Clinical term : BARTHOLlN's g land •
Preputium clitoridis Frenulum clitoridis
(Ductus paraurethralis) Ostium urethrae externum
Glandula vestibularis malor, (Ostium)
Fossa vestibuli vaginae
Commissura labiorum posterior Fig. 1 1 77 Fe male external genitalia, O rgana genitalia fem i n i na externa ; i nferior view.
Commissura labiorum r1���""""--;-:�]Iil;��- anterior Commissura labiorum anterior
Glans clitoridis
Labium majus pudendi
Labium minus pudendi
lIL'-:''::'--::''::r-
Preputium clitoridis
Labium majus pudendi
- Rima pudendi 1l� !lLj�":!':'-f;�"-r
. 1IH::.I��.z.--l--
Ostium vaginae
Labium minus pudendi
Hymen
Frenulum labiorum pudendi
Perineum, Raphe perinel
_t:-�...,....;...-- Perineum
i::::=�::::=- Anus Fig. 1 1 78 Fem a le external genitalia, O rg a n a genitalia fem i n i n a externa; i nferior view.
�
Pelvic visce ra a n d retro p e ritoneal space
K i d ney
S u p ra re n a l g la n d
U r i n a ry b la d d e r
Male pelvic organs and retroperitoneal space
-
Fossa supravesicalis
Plica umbilicalis median a (Lig, umbilicale medianum, Chorda urachi)
Plica umbilicalis medialis (Chorda arteriae umbilicalis) • • Plica umbilicalis lateralis (A,; V. epigastrica inferior)
Plica vesical is transversa
Vesica urinarla
M,
psoas major .
A ; V iliaca externa • • -------!1...,:>I!l
'-='+l�;!-- Fossa inguinalis medialis
Ductus deferens ----11i'flli,�'Wii&'lH.:7 Nodi Iymphoidei iliaci externi
��o;r��!.n.,,"
-
N. obturatorius •
A.; V. obturatoria • •
Nodi Iymphoidei iliaci externi
� ����i�ii�ij
Ductus deferens
M.
obturatorius internus •
M
obturatorius externus • Excavatio rectovesicalis
Ampulla ductus deferentis
• Plexus venosus vesicalis; Plexus venosus prostaticus
�r1��7Ir- Fossa ischioanalis
A ; V, pudenda interna; N, pudendus • • • M,
transversus perinei profundus .
Fig. 1 1 79 Pelvic d i a p h ra g m , Diaphragma pelvis; pelvic o rg a n s and a nterior abdominal wall, O rgana abdominis et pelvis , of the male; frontal section t h rough the head of the femur and the urinary b ladder o n the left ; dorsal view.
Genitalia
R e ct u m
To p o g ra p hy
S e ct i o n s
Female pelvic organs and retroperitoneal space
J"J' _.::---- Fascia pelvis visceralis Excavatio v8sicouterina
M.
obturatorius internus •
N.
-����-f,f.jl\���� Vesica urinaria
pudendus internus '
• Plexus venosus
vesical is
Diaphragma urogenitale
Crus clitoridis
Glandula vestibularis major
Urethra feminina
Labium minus pudendi
Ostium urethrae externum
Fig. 1 1 80 Pelvic diaphra g m , Diaphragma pelvis . a n d pelvic o rgans, Organa pelvis. o f the female; frontal section Ion the rightl combined with a median sect i o n ; ventra l view.
�
Pelvic viscera a n d ret roperitoneal space
Ki d n ey
S u p ra re n a l g la n d
Male external genitalia
A dorsalis penis .
Lig fundiforme penis
Lig. sl)SpenSOMum pems
• V. dorsalis profunda penis
Anulus inguinalis superficialis
FunlcLlius sperm"t'�us
N.
V. testicularls •
ilioinguinalis
Funiculus spermaticus
N. genitofemoral is, R. genitalis
• A. cremasterica; • (V. cremasterica)
N. dorsalis penis Plexus pampiniformis •
• Rr scrotales anteriores • V. dorsalis profunda penis • V. dorsalis superficialis penis
Fascia penis (profunda)
Fig. 1 1 81 M a le external g e n italia, Organa g e n italia masculina externa.
U r i n a ry blad d e r
Gen italia
Rectum
To p o g ra phy
Sect i o n s
Male external genitalia
Anulus inguinalis superficialis, Crus mediale Tela subcutanea, Panniculus adiposus
obliquus externus abdominis, Aponeurosis
• N. ilioinguinalis
Canalis
Ingulnalls
Ug. suspensoriurn
Anulus inguinalis --�dr:;-...,.c:= superficiaiis, Crus lalerale
penIs
Fascia spermatica externa • --""'�""''''':r'� Fascia cremasterica; • M cremaster
• V. dorsalis profunda
penIs;
• • A.; N. dorsalis penis
�::'-���\l�1I1r:n��'1
Plexus pampiniformis •
--i��������iI��
�--- • A. profunda penis
Corpus cavernosum penis
Ductus deferens ----:--7'";'1
l
Urethra masculina
A. testicularis • Epididymis
Corpus spongiosum penis
Caput
(Appendix)
Appendix testis
• Fascia cremasterica; M
Tunica vaginal is testis, Lamina visceralis
cremaster
• Fascia spermatica externa
Tunica vaginalis testis, LamIna parietalis
Fascia spermatica interna Fascia spermatica externa •
Fig. 1 1 82 M a le g e n italia, O rgana gen italia masculina.
I � 1 1 05. 1 1 1 7 1
�
Pelvic visce ra a n d ret ro p e ritoneal space
K i d n ey
S u p ra re n a l g la n d
U r i n a ry b la d d e r
Male perineal region
Nn. scrotales posterrores
• A. perineal is, Rr scrotales posteriores
A. dorsalis penis .
• M. bulbospongiosus
A. bulbi penis .
N dorsalis penis
• M sphincter ani extemus • A. perinealis
Rr perineales (N. cutaneus femoris posterior)
• M. transversus
perinel superfieialis
Nn. clunium inferiores (N. cutaneus femoris posterior)
N.
N. dorsalis
pennealis
penis
N. dorsalis penis
Nn. anales [rectales] Inferiores
• • A.: V. pudenda
interna
N. perinealis
Lig. saerospinale
• A. reetalis inferior
N pudendus
Nn. elunium inferiores (N. cutaneus femoris posterior)
Corpus anococcygeum [Lig anococcygeum]
Nn. anococcygei
Fig. 1 1 83 Vessels a n d nerves of the peri n e u m , R e g i a perinealis, a n d the m a le external g e n italia, O rgana gen italia masculina externa.
Gen italia
Rectum
To p o g ra p hy
Sections
Female perineal region
M.
V. bulbi . vestibuli
bulbospongiosus •
•
A. pudenda interna, Rr. labiales posteriores •
Bulbus vestibuli
M,
ischiocavernosus
A dorsalis .
clitoridis
A. perineal is •
Nn. labiales posteriores
N dorsalis clitoridis
A pudenda .
interna
•
Rr perineales (N cutaneus femoris posterior)
(D;aphragma urogenlialeJ
• M transversus
penne; superficialis
N. dorsalis clitoridis
Nn clunlum inferiores (N. cutaneus femoris posterior)
•
Nn. perineales
N pudendus
A
M
sphincter ani extern us • Corpus anococcygeum (Lig, anococcygeum]
Nn anococcygei
M. gluteus
maxlmus
N n. anales (rectales] inferiores Nn. clunium inferiores (N. cutaneus femoris posterior)
Fig. 1 1 84 Vessels and nerves of the peri neum, Reg i o perinealis, a n d the female exte rnal g e n italia . Organa g e n italia fem i n i na externa.
�
Kid ney
Pelvic viscera a n d retro p e ritoneal space
S u p ra re n a l g la n d
U r i n a ry b la d d e r
Abdomen, median section
-
Oesophagus
Plexus venosus . vertebralis intern us anterior, V. basivertebralis
Hepar, Area nuda Sternum, Corpus Sternum, Proc. xiphoideus
���-+-- Gaster, Cardia
'I'!!-r-"";H-- Fornix gastric us
A. gastroduodenalis •
��rlIf----Ir+-- Pancreas,
Ductus pancreaticus
A. mesenterica superior .
"lfr----:ff-rt-- Colon transversum ... ctft.-....-"I
Pars lumbalis . ---;i-"'-;rb:rfitlWllIol diaphragmatis
Linea alba
V. renalis dextra •
,.__--��.. ���r_-- Jl eILnUm
Filum termlnale '
-'1,:-�-- Omentum majus "'�"T"."�-1-_- Peritoneum viscerale
V. mesenterica superior .
A il,aca communis • ----E--f1h'r=-4!.' -iF==-='9:..-t�• • dextra V iliaca communis • ---I"--f-,H';c,(,I�� dextra Cauda equina Promontorium --+��'"
Colon sigmoideum
Glandula vesiculosa ---r.-'-'-�:l!t..JJl
Ampulla recti ---H"':'--�JIr.I Os coccygis
M sphincter ani . extern us M levator ani, • M, pubococcygeus M transversus perinel • profundus
-f-"--- Anulus umbilicalis rf.�".:.t'--ii-'-':'F--- Cavltas per�onealis
;."'--7filrilfo=o.....l-q--- • A. jejunalis
--'�,..�n:::::'t-g--
Plica transversa recti Os sacrum
Prostata
tll"'.,..-';'/--- Peritoneum parietale
Ileum
�-:r.t--- • M rectus abdominis
=r--- Vesica urinaria ,�,;O-'":tb-:l---- . M pyramidalis
"':;�r-fI�r-z..:.�--- Os pubis
I. f��i--- Lig fundiforme penis
t;Jli*'liiI.fJ�-- Corpus spongiosum penis
Corpus cavernosum penis
Tunica albuginea corporum cavernasarum
.,---- Septum scroti Preputium penis
Tunica vaginalis testis, Lamina visceralis cremaster • Tunica dartos
Fig. 1 1 85 Abdomen, Abdo m e n , a n d pelvis , Pelvis, of the m a le ; median sect i o n .
Genitalia
R ectum
To p o g ra p hy
Sections
Abdomen, sagittal section
Pulmo dexter. Lobus inferior Lig falciforme
Recessus phrenicomediastinalis
Hepar. Lobus sinister
M. rectus abdominis
•
•
Pars sternalis . diaphragmatis Gaster
•
A hepatica propria . ---r-Ii--,wL Caput pancreatis; Ductus pancreaticus
-I"it--..lj��::!!!!
;,:5o"i",...= ., -1,
_-1L\!-�}f-���--1,-�!
Ductus choledochus [biliarls) V. portae hepatis • Ornentum majus, _--:''-'I---:r-:Lig. gastrocolicum \ Colon transversum
1�����
Omentum majus
Caput pancreatis, Proc uncinatus V mesenterica . superior A
V. cava inferior
Nodi Iyrnphoidei retrocavales • •
V. renalis dextra
A. renalis dextra
Ouodenl.1m
•
Linea alba
--�lQ�\I��·
Nodi Iymphoidei ileocolici ---t:-:::*� lIel.1m M
Pars lumbalis diaphragmatis
• •
M.
A. iliaca communis
V. iliaca comml.1nis
Os sacrum
N. sacralis [81 )
Rectum
--.3r��
•
rectus abdominis • ---''tr..�,. Cavitas peritonealis
erector spinae
_..J\f!�����Oii!!I�i!i!l�
Vesica urinaria --��� ii'lt"-;-o:--:-,�III:!III
Corpus ossis pubis --l��"':':'�"&,!1
Lig fl.1ndiforme penis ----.:y.:.�.
Corpl.1S cavernosum penis
Fig. 1 1 86 Abd omen, Abdomen, and pelvis, Pelvis, of the male; sag i tta l section to the right of the median pla n e .
piriformis
Excavatio rectovesicalis Dl.1ctl.1s deferens
Glandula vesicl.1losa Rectum • (M sacrococcygel.1s) � ---<__ • M. gll.1tel.1s maximus
�--I-- Prostata •
•
8eptl.1m penis
M.
•
M
M.
levator ani. M. iliococcygel.1s
levator ani,
M.
pl.1bococcygeus
(Diaphragma l.Irogenitale)
2 4a :
�
Pelvic viscera a n d ret ro p e ritoneal space
Kid n ey
S u p ra re n a l g La n d
U ri n a ry b La d d e r
Abdomen. frontal section
•
Hepar, Lobus caudatus
V. portae hepatis, R dexter
v. cava inferior
•
Gaster, Ostium cardiacum
A hepatica propria .
• •
Duodenum, Pars superior
A.; V. gastrica sinistra
Colon transversum
1-1--- Cauda pancreatis
Hepar, Lobus dexter
•
Colon transversum --.;.:.,iWl..".
•
�JJ8�J��&+-�ffll���
Caput pancreatis __
A. gastroduodenal is V. splenica
Duodenum, Flexura duodenojejunalis
Colon ascendens
•
A.; V. mesenterica • • superior
•
Ileum
A mesenterica superior
Aa jejunales
Cavitas peritonealis
Os ilium
Colon descendens
M sartorius .
M. tensor fasciae latae • M.
iliacus .
N. femoral is
Colon sigmoideum
M.
Symphysis pubica
Lig. fundiforme penis
M. M
Urethra mascullna
Fig. 1 1 87 Abdomen, Abdomen; frontal secti o n t h ro u g h the most a nterior part of the abdominal cavity.
G e n italia
Rect u m
To p o g ra p h y
Sect i ons
Upper abdomen, frontal section
(
Ostium cardiacum
Lobus Pulmo superior sinister Lobus inferior
Pulmo dexter, Lobus medius
Lobus hepatis sinister Lig. triangulare sinistrum
Pleura parietalis, Pars diaphragmatica Lobus hepatis dexter
Diaphragma • Lig , gastrosplenicum Corpus gastricum
Ductus thoracicus
(Nodus Iymphoideus mediastinalis posterior) • A. subcostalis
Splen [Lien]
Glandula suprarenalis Lig splenorenale Nodi Iymphoidei splenici A,; V, splenica • •
Pancreas Omentum majus Pyramis renalis Colon descendens Papilla renalis Costa XI Ren A.: V renalis •
• •
Pars abdominalis aortae
Nn. splanchnici major et minor
Glandula suprarenalis
• •
A.; V. lumbalis I
• Truncus
sympathicus
•
M
Pars lumbalis • diaphragmatis
Fig. 1 1 88 Abdomen, Abd o m e n ; frontal section demonstrati n g the d i a phra g m , the o rgans of the u p p e r a b d o m e n a n d the kid neys ; d orsa l view.
�
Pelvic vi scera a nd ret roperitoneal space
K i d n ey
S u p ra re n a l g l a n d
Upper abdomen, sagittal section
-
Diaphragma, • Centrum tendineum
Pulrnc dexter. Lobus inferior
Pleura visceral is [pulmonalis)
"'�I\---,r---- Pleura parietalis, Pars costal is
Costa XI
Pars costalis • diaphragmatis Recessus costo diaphragmaticus
r-;--:\--- • Pars costalis
diaphragmatis
��....�"==*-- • V. hepatica dextra
M. erector . spinae <'!IIt,....�iI--- • V. portae
Columna renalis
hepatis, R_ dexter, R. anterior
V. renalis • --+'-'-'--4H1t+i
A. renalis .
Pelvis renalis
/11+-'-,"*--- • M. rectus
abdominis
Medulla renalis
���-- Peritoneum viscerale
Calyx renalls minor
M. quadratus . lumborum
Cortex renalis
Gaster
Ren, Capsula adiposa
Ren, Capsula fibrosa
Fig. 1 1 89 Abdomen, Abd o m e n ; sa g i ttal section t h ro u g h the u pper abdomen at the level of the right kid ney; viewed from the right.
U r i n a ry b l a d d e r
G e n it a l i a
Rectum
To p o g ra p hy
Sections
Upper abdomen, sagittal section
h� i
'.-
J
(
�-
I
I
Gaster, Cardia, Ostium cardlacum Omentum minus, Lig. hepatogastricum
Gaster, Fornix gastricus
lIg. phrMlcosplamcum Pulmo Sinister.
Lobus Inferior
Costa VI
Pleura visceral is [pulmonalis]
'w........ .. .. - Pleura parietal is,
Pars costalis • diaphragmatis
Pars costalis
Hepar, Lobus sinister ---;_,/11l1li
A gastrica sinistra . --j:-flI'I-'
"" JI' R intercostal is anterior; . --f-,-fIrf'"l" V intercostalis anterior; • N intercostalis Costa IX
--t--ttI�
Mf-+-- Splen [Lien]
-.-+-- Lig. gastrosplenicum
ffillllmf�T- Bursa omentalis III--i-- Recessus
Ifi--+--
costodiaphragmaticus M. erector spinae
•
11-...-+- Costa XII
""--4-- Medulla renalls
--��I.:-IIIiIiIll�Ji,--""';'+-Pars n m
Ges1e<.
pylorica, A tru
--+-'':;·4,110 '-I0'0I+
pylorlcurn
ranalis
"i..,.-.Iti NH--....:;'-i·-- Capsula librasa
C<\psula adlposa
A. gastroomentalis . --'l""'�. sinistra
M
Cortex
Omentum majus, Lig. gastrocolicum
Fig. 1 1 90 Abd o m e n , Abdome n ; sag ittal section thro u g h t h e upper abdomen at t h e level of the spleen ; viewed fro m the left.
•
Ren
M. quadratus lumborum
Fascia renalis
24 8: '
�
Pelvic viscera a n d ret ro peritoneal space
K i d n ey
S u pra re n a l g la nd
U r i n a ry b la d d e r
Upper abdomen, transverse sections
Lig falciforme Linea alba
Pleura parietal is, Pars diaphragmatica
Pars costalis diaphragmatis • Peritoneum parieta Ie
•
Peritoneum visceraIe
Costa VII --F:-:�....rJI
Mm
M. obliquus externus abdominis
.JIC::.j.-.,.'::';-- Splen [Lien]
intercostales . --t--4'.,rI' Costa VIII
Cavitas peritonealis
M N
V. portae hepatis, R. dexter, • R. posterior
/'
I I
Vertebra thoracica XI, Proc. articularis superior Vertebra thoracica XI
t-J
�
intercostalis (T 9)
Bursa omentalis • Pars lumbalis diaphragmatis, Crus sinistrum Truncus sympathicus
Spatium epidurale
,_.\ ---.S.'j ) I' t- "\ ) I-
Fig. 1 1 9 1 Abdomen, Abdomen; transverse sect ion through the upper abdomen at t h e level of the e leventh thoracic verte b ra .
\
'11
Proc x,phoideus ----
---- M.
Hepar, Lobus sinister ----
---- Pars costalis diaphragmatis
Costa VII ----
---- Gaster
---- Splen [Lien]
Hepar, Lobus dexter ----
Vertebra thoracica X ---M.
rectus abdominis
Pars thoracica aortae
erector spinae
Pars lumbalis diaphragmatis
Abdomen, Abdomen ; computed tomographic cross-section leT) at the level of the tenth thoracic vertebra ; i nfe rior vi ew. Fig. 1 1 92
G e n it a l i a
Rectum
To p o g ra p hy
Sect i ons
Upper abdomen, transverse sections
Lig. falciforme M rectus abdominis, Vagina musculi recti abdominis •
Lig. teres hepatis; Lobus hepatis sinister Omentum minus, Lig. hepatogastricum • •
A Lobus caudatus, Proc papillaris; Recessus superior bursae omentalis
A ; V. gastrica sinistra; Ganglion coeliacum; Nodi Iymphoidei gastroomentales Omentum majus
{
V. portae hepatis, • -->�1.flJ R. dexter Pars costal is; Diaphragma . Pars lumbalis, Crus dextrum
Recessus splenicus Hilum splenicum; Nodi Iymphoidei splenici
HeJ'HIfrlf-- Splen [Lien]
Lobus hepatis dexter
V. cava inferior .
Cauda pancreatis
Ductus thoracicus
Pleura parietalis, Pars costal is V. hemiazygos; N. splanchnicus major Aorta; Diaphragma; N. splanchnicus minor N. thoracicus [T12]
M serratus posterior inferior . N. splanchnicus minor � M, longissimus thoracis •
•
Vertebra thoracica XII, Proc. spinosus Mm multifidi
Fig. 1 1 9 3 Abd o m e n , Abd o m e n ; transverse secti o n t h ro u g h the upper abdomen at the level of the i nterve rtebral disc between the eleven t h thoracic and fi rst lumbar vertebra; with the exce ption of the omental bursa hig hlighted i n yellow g reen the perito n e u m is coloured in blue.
Colon transversum
Lig falciforme
Lig. teres ne�)atls -
Jejunum
� _ _
Pancreas
Hepar, Lobus caudatus
Colon descendens
Hepar, Lobus dexter ---V. portae hepatis ---
- Aorta
_ _ _
V. cava inferior ----
Pars lumbalis diiaphrclgnlatlis -----
____
Costa X ------'
---- Splen [Lien] ---- Ren sinister
M. latissimus dorsi ---Costa XI
---- M. erector spinae
Ren dexter Costa XII
Vertebra lumbalis, Corpus vertebrae
Fig. 1 1 94 Abdomen, Abd o m e n ; computed tomog raphic sectio n l eT) at the level of the fi rst lumbar vertebra. The i ntestine is partia lly fi lled with a cont rast m ed i u m .
�
Pelvic visce ra a n d ret ro p e ritoneal space
K i d n ey
S u p ra re n a l g la n d
U r i n a ry b la d d e r
Upper abdomen, transverse sections Vesica blliBns
Hepar, Lobus sinister V, portae hepatis • Lig, teres hepatis
Gaster
Nodus Iymphoideus pancreaticus Jejunum
Pleura parietalis, Pars costalis
Costa IX Hepar, Lobus dexter Cosis X
"�ff!ic'�--I- Colon
descen dens
-I--�
A, 'li ��r:pr-:t"JjMf--t-- . renalis � C<:lsia XI
_---'i,,--.....,A;i • M. latissimus dorsi
V, cava inferior .
Pelvis renalis
Pars lumbalis diaphragmatis .. Truncus sympathicus M
1
erector spinae ..
Vertebra lumbalis I
Cauda equina
R en »
A. mesenterica inferior .
Fig. 1 1 95 Abdomen. Abdomen; transverse sect i o n t h rough the u pper abdomen at the level of the f i rst lumbar vertebra, A. mesenterica superior
Hepar, Lobus sinister
Jejunum
Vesica biliaris A , renalis
Pars
V, cava inferior
V,
Corpus vertebrae lumbalis I
abdominalls aortae
renalls
Sinus renallS
Hepar, Lobus dexter Ren
Fig. 1 1 96 Abdomen, Abdomen; computed tomograp h i c section l eT] at the level of the first lumba r vertebra ; i nferior view, * I n testinal gas
Ren
Rectum
G e n it a l i a
To p o g ra p hy
Secti o n s
Lower abdomen, transverse sections
A.;
V mesenterica superior, Aa.; Vv ileales • •
Linea alba
rectus abdominis
Peritoneum parietale
• M. obliquus
Colon sigmoideum
internus abdominis •
V. cava . Inferior Pars • abdominalis aortae
�>-�����J.2�\---
�"-'----'"!!O� Of -c:'I
_ _
Colon ascendens
M. obliquus externus abdominis
• •
A.; V. mesenterica superior, Aa.; Vv. ileales Colon descendens
q uadratus lumborum M.
Truncus SYmpathlcus
Cauda equina Vertebra lumbalis IV. Proc SplnOSUS
Fig. 1 1 97 Abdomen, Abd o m e n ; transverse section thro u g h t h e Lower a b d o m e n at the level of the t h i rd lumbar vertebra . M. rectus abdorninis
Linea alba
Jejunum'
Colon descendens
lie urn
M. obliquus externus abdominis M.
Caecum
obliquus internus abdominis
M. transversus abdominis
Appendix vermiformis
Pars abdominalis aortae
Corpus vertebrae lumbalis III Fig. 1 1 98 Abdom e n , Abdomen; computed tomographic section leT) at the LeveL of the t h i rd lumbar vertebra; i nferior view. Jej u n u m filled with a contrast m e d i u m +
�
Pelvic viscera a n d ret ro p e ritoneal space
K i d n ey
S u p ra re n a l g l a n d
U ri n a ry b l a d d e r
Male pelvis, median sections
Colon sigmoideum
Ostium urethrae internum
Filum terminale
Apex vesicae
Plica transversa recti'
Plica umbilicalis mediana (Lig umbilicale medianum) Spatium retropubicum**
Llg sacrococcygeum posterius superficiale
Excavatio rectovesical is
Linea alba
:!:.! -+-- Articulatio 1I1U�1Jl;:!\t!
sacrococcygea
Symphysis pubica
Ampulla recti
Lig fundiforme penis
l«�t;�"�2i�'f/:"-1."-- Prostata
Fascia rectoprostatica
V dorsalis profunda penis .
Fascia pelvis visceral is
V. dorsalis superficialls penis .
Corpus anococcygeum [Lig. anococcygeum]
Urethra, Pars spongiosa
• M. sphincter ani externus
Ductus deferens
• M. sphincter ani intern us
Caput epididymidis
Tunica albuginea corporum cavernosorum
Columnae anales; Sinus anales
Corpus cavernosum penis Corpus spongiosum penis --lil,n;�!.·l . tJ!,,-l-!i....� Septula testis --+....�
• M. sphincter ani extern us
• M. transversus perinei profundus
Corona glandis
Ductuli efferentes testis •
M, cremaster; Fascia cremasterica • Lobuli testis
Ductus deferens; Cauda epidldymidls
Scrotum. Tunica dartos. M dartos
Fig. 1 1 99 Pelvis, Pelvis, of the male; median sect i o n ; viewed fro m t h e left. * Clinical term: KOH LRAUSCH's fold
Lig. puboprostaticum
Bulbus penis, Corpus spongiosum penis
Vertebra lumbalis V
** Clinical term: cave of RETZIUS
Canalis sacralis Os sacrum
M. rectus abdominis
Ampulla recti
Colon slgmoideum
Os coccygis
Vesica urinaria Symphysis pubica
Fig. 1 200 Pelvis, Pelvis, of the male ; magnetic resonance tomogra p h i c image ! M R I ] ; para m ed i a n sect i o n ; viewed fro m t h e left.
Urethra, Pars intermedia [membranacea]
Bulbus penis Testis
--
Prostata Canalis analis
R e ct u m
G e n italia
To p o g ra p hy
Sect i o ns
Female pelvis, median sections
Infundibulum tubae uterinae A. sacralis mediana •
Cavitas uteri; Canalis cervicis uteri, Plicae palmatae
Lig suspensorium ovarii; A.; V. ovarica • •
Colon sigmoideum •
Ovarium, Folliculus ovaricus vesiculosus
A. sacralis mediana
Plica rectoutenna"" DilI!lo-f.,-- Ampulia recti; Plicae transversae recti
...lJ1iIo.1.ff"- Excavatio rectouterina***
Plica umbilicalis mediana ----I��1\r: (Lig. umbilicale medianum) Fascia pelvis parietalis
Fornix vaginae, Pars posterior
Isthmus uteri
Portio vaginalis cervieis
Ostium uteri
Uterus, Facies vesicalis
Excavatio vesicouterina
Glomus coccygeum Fascia rectovaginalis [Septum rectovaginale]
Ostium urethrae internum
Corpus clitoridis, Corpus cavernosum clitoridis Labium minus pudendi
Labium majus pudendi
Ostium urethrae externum
Os sacrum
Promontorium --·s--�
Fig. 1 20 1 Pelvis, Pelvis, of t h e female ; med ian sect i o n ; t h e i ntest i n e has b e e n a lmost com pletely removed with some rem n a nts of the sigmoid a n d rectu m ; viewed from the left. Clinical term: vesicova g i nal septum Clinical term: sacrouterine ligament ... Clinical term: pouch of DOUGLAS ••
M. erector spinae
lntestinum tenue
M rectus abdominis
Corpus uteri
Vesica unnana
Symphysis pubica
Portio vaginal is cervicis
Vagina Spatium rectovaglnale Urethra
Fig. 1 202 Pelvis, Pelvis, of the female; mag netic resonance tomographic image I M R l i ; paramedian section; viewed f ro m the left.
�
PeLvic vi sce ra a n d ret ro p e ritoneaL space
K i d n ey
S u p ra re n a l g la n d
U r i n a ry b la d d e r
Lower abdomen, transverse sections Omentum maJus
\.'" \
:
!
f1
I,
I
---..1.5'
• A. rectalis superior
\
Ileum
.. M. obliquus internus abdominis • M. transversus
Ileum
abdominis
obliquus externus abdorninis
,. M .
Colon ascendens
�'f.U.!lr."�--.j..,-,;_- Crista iliaca
M. psoas '" mal or
Colon descendens
Plexus lumbalis
Ala ossis ilium
Vertebra lumbalis V
.. M. gluteus medius
A ; V. glutea superior • • Ligg. sacroiliaca interossea
Cauda equina
1>
Llg. flavum
Fig. 1 203 Pelvis, Pelvi s ; tra nsverse section at the level of the fifth lumbar vertebra. This male speci men i s d ifferent from Fig. 1 1 9 1 , 1 1 93, 1 1 9 5 a n d 1 1 97.
Os sacrum, Proc. articularis superior
M gluteus maximus
Vertebra lumbalis V. Proc articularis inferior
As the sigmoid reaches far i nto the upper abdomen the f i g u re a lso displays the dome of co lon i c flexure. The t h i c kness of the ad i pose tissue layer on the gluteus medius muscle m ust be taken i nto consideration when i nj ecti n g i ntra m uscula rly.
transversus abdominis Colon sigmoideum Caecum A. iliaca communis V. iliaca interna M. psoas major
Fig. 1 204 Pelvis, Pelvi s ; com puted tomogra p h i c c ross-sectio n (eTI at the level of the f i rst sacra l vertebra after a d m i n ist ration
M. obliquus intern us abdominis
M. obliquus externus abdominis Crista iliaca M. iliacus M gluteus medius M gluteus maximus
of a contra st medium i nto the colo n ; supine position ; i nferior view. * Calcification in t h e wa ll of the i liac artery.
Rect u m
Genitalia
To p o g ra p hy
Sections
Lower abdomen, imaging
255
Atrium cordis dextrum
Ventriculus cordis sinister
Diaphragma
Gaster
Hepar, Lobus sinister
-rl"-- Splen [Lien]
Ug teres hepatis _
Hepar, Lobus dexter
A mesenterica supenor
Gaster, Pars pylorica Jejunum
Duodenum Ren dexter
Colon descendens
Colon ascendens
Spina ,lIaca anterior superior
A. lIeocolica
Fig. 1 20 5 Abdomen, Abdomen; voLume-guided reconstruction i n the frontaL pLa n e based on horizontaL computed tomographic sections l eT). The section planes of o rg a n s such a s the heart. the stomach. the liver and parts of the small i ntestine. a ppear granulated.
1-7
1 070.
1 187 1
256 ' �
�
Pelvic visce ra a n d ret ro p e ritoneal space
K i d n ey
S u p ra r e n a L g La n d
U r i n a ry b la d d e r
Male pelvis, transverse sections Funiculus spermaticus • M pectineus Nodus Iymphoideus inguinalis superficialis, Nodus superomedialis
N
N. femoralis
M
Lig. capitis --H� ��Z femoris ����l� -w-. Femur, --f-ti.A%'¥Caput femoris Zona ---orbicularis M. tensor . fasciae latae
Bursa subtendinea iliaca •
Femur, Trochanter major
•
M. obturatorius internus
Plexus venosus vesical is • M gluteus maxlmus N. ischiadicus
Bursa trochanterica musculi glutei medii M gluteus . medius
A. circumflexa • femoris medialis V. circumflexa femoris medialis .
Rectum
Bursa subtendinea musculi obturatorii interni
• • A. ; V pudenda interna
Glandula vesiculosa
Fig. 1 206 Pelvis , Pelvis, of t h e male; tra n sverse section t h ro u g h the lesser pelvis.
t
M rectus abdominis
Os pubis
Funiculus spermaticus V. femoral is M.
M. obturatorius internus
rectus femoris
M. tensor fasciae latae
Fossa acetabuli
::::'=..---:;!: -- \Iesica urinarla
Caput femoris
Mm glutei medius et minimus
Glandula vesiculosa
Femur, Trochanter major
M obturatorius externus
M gluteus maximus
N ischiadicus
M
ischiococcygeus [M coccygeus]
Fig. 1 207 Pelvis, Pelvis, of the male; computed tomographic c ross-sect ion [eTI t h ro u g h the lesser pelvis w i t h the s u bj ect i n supine position. • Calcification i n the medial part of the femoral artery
R e ctu m
Genitalia
To p o g ra p hy
Sections
Female pelvis, transverse sections
M
M
M
Lig pubicum superius Spatium retropubicum pectineus .
Symphysis pubica
obturatorius
M tensor
fasciae latae
M vastus . lateralis Articulatio coxae
M
Femur, Collum femons
N ischiadicus cutaneus femoris posterior • A. glutea inferior N. gluteus inferior N.
Bursa subtendinea musculi obturatorii interni: Tuber Ischiadicum
Fossa ischioanalis M levator ani Vagina •
Excavatio rectouterina
Fig. 1 208 Pelvis. Pelvis, of the female ; t ra n sverse secti o n t h rough t h e lesser pelvis at the level of the symphys is.
M
M. sartorius M iliopsoas
M tensor fasciae latae M vastus lateralis
V femoralis
Vesica urinaria
--"::::Ijr1��,,-...,flli' .
Vagina
.
Rectum, Ampulla recti
Femur. Collum femoris M. obturatonus extern us
Fossa ischioanalis
Ramus ossis ischii; Tuber ischiadicum N.
ischiadicus M obturatorius intern us Fig. 1 209 Pelvis. Pelvis. of the female ; comp uted tomogra p h i c cross-section leT) through the lesser pelvis with the s u bj ect i n supine position •
Remnants of contrast i n g intestinal contents
.
�
Pelvic viscera a n d ret ro p e ri t o n e a l space
Ki d n ey
S u p ra re n a L gla n d
Male pelvis, oblique frontal section
�
�J �
I ,
I
, , � .
lc) )
Peritoneum parietale
• Aa sigmoideae • V. iliaca interna
.:'�Iifj!lf--- Os Ilium
Appendices omentales -���IWI\ [epiploicae]
Colon sigmoideum
Ductus deferens
Glandula vesiculosa M obturatorius intern us
Ampulla reell
Mi'\lt�-- . M. levator ani
Fossa Ischloanalis ----1�lfifrj
!iIP/i'\-- • • V. ; A pudenda interna'
Columnae anales -�Ii-----f-\Bl
OJI5�'r-- Tuber ischiadicum �1-+-4-- . M. biceps femoris;
M. semitendinosus; M. semimembranosus
levator ani, M , puborectalis
Fig. 1 2 1 0 Pelvis, Pelvis, of the male; oblique frontal section t h rough the lesser pelvis. •
Clin ical term: ALCOC K's canal
U r i n a ry b la d d e r
G e n ita l i a
R ec t u m
To p o g ra p hy
Sect i o n s
Pelvis, imaging
Discus intervertebralis
Vesica urinaria
M. gluteus maximus
Corpus ossis ilium
M gluteus medius
Caput femoris
M obturatorius internus
Prostata
M. obturatorius externus
Urethra masculina
M vastus lateralis
Corpus cavernosum penis
(Mm. adductores)
Corpus spongiosum penis
Fig. 1 2 1 1 PeLvis, PeLvis, of t h e m a Le ; magnetic resona nce tomographic i mage I M RI J ; frontaL section at the LeveL o f t h e h i p joints; ve ntraL view.
,
_ M. psoas major
Cavitas uteri Corpus uteri Corpus ossis ilium
M. iliacus M. gluteus maximus M. gluteus medius
Caput femoris Collum femoris
M. obturatorius internus
M. obturatorius externus Vesica urinaria
Fig. 1 2 1 2 PeLvis , PeLvis, of the femaLe ; magnetic resonance tomogra p h i c image I M RI I ; frontaL section at t h e LeveL o f t h e h i p j o i nts; ventraL view.
(Mm. adductores)
When the u ri n a ry bLadder is e m pty, t h e uterus Lies on the apex of the b Ladder due to its a n teflexion.
�
Pelvic viscera a n d retro peritoneal space
K i d n ey
S u p ra re n a l g la n d
U ri n a ry b la d d e r
Male pelvic diaphragm, angled-frontal section
Vesica urinaria, Plica interureterica Ostium urethrae internum
Membrana obturatona
Fossa acetabufi Caput femoris
Crus penIS
• M. obturatorius externus
C*--- • • A.; V.
M. iliopsoas, • Tendo
circumflexa femoris medialis
M. quadratus • --�,f--�Hifi!ir;c:�_.. femoris
Ramus inferior ossis pubis
M adductor . ---!
M. adductor • _--li(JjW�1II magnus
Mm . ischiocrurales
• M. transversus
perinei profundus
• N. perinealis
• M transversus perinei superficialis Penis, Corpus spongiosum
Fascia perinei (superficial is)
Fig. 1 2 1 3 Pelvis, Pelvis, of the male ; a n g led-frontal section thro u g h t h e urinary bladder. • Clinica l term : paracystium • • C li n ical term: prostatic ve nous plexus
• • A ; V. pudenda interna
G e n it a l i a
Rectum
To p o g r a p h y
Sections
Female pelvic diaphragm, angled-frontal section
N obturatorius; A.; V. obturatoria
M obturatorius internus •
Peritoneum urogenitale, Fossa paravesicalis
Acetabulum
caput femoris
Membrana obturatoria
• • V.; A.
M. obturatorius • externus
pudenda intema; • N. pudendus
• (Diaphragma
N perinealis
urogenitale)
M. iliopsoas .
M adductor . brevis
l!llt m l � � � � � ������I�
A. profunda . femoris, Aa. circumflexae femoris medialis et lateralis V. profunda . femoris, Vv. circumflexae femoris medialis et lateralis
M adductor . longus
Labium majus pudendi
Fig. 1 2 1 4 Pelvis, Pelvis, of the female; a n g led -frontal section t h rough the u ri n a ry bladder. •
Paracystium with ve nous plexus
Ramus ossis ischii
Crus cI�oridis
. M. ischiocavernosus
Bulbus vestibuli
• M. bulbo
sponglosus
Urethra feminina, Ostium urethrae extemum
�
Lower l i m b
Su rface
I
Skeleton
���
Overview
Surface anatomy
Spina iliaca anterior superior ---+_ M. tensor fasciae latae ---::_ Regio inguinal is, Lig. inguinale
--,----_
Trochanter major (Femur)
-------+---- 05 sacrum
1------=-- (Sulcus analis) -
--....-l. - Regio glutealis,
-..- .....
r--- Trochanter major (Femur)
� -
Regio lemorls ----:--- anterior
M. sartorius ---i-----
---j---
M. quadriceps ---'-. femoris
Reglo lemons poslerlor
Fossa poplitea
.t---- Caput fibulae
Tuberositas tibiae---;FofI
Regio cruris ----.. anterior
Sulcus glutealis
--4---- Regio genus posterior,
Regio genus anterior, ---t.... Patella Caput fibulae----i
-A.-..... -- M. gastrocnemius ... ....:. -1' --
Margo anterior (Tibia) ----'!,01
Regio cruris posterior, Sura
Malleolus medialis (Tibia)
Malleolus medialis (Ti
Malleolus lateralis (Fibula)
Malleolus lateralis
+-i8!:--- Dorsum pedis
Digitus minimus [quintus] Digitus quartus
Fig. 1 2 1 5
M. gluteus maxim us
Lower l i m b , M e m brum i nferi us.
Fig. 1 2 1 6
Lower limb, Membrum i nferi u s .
I
Mu scles
Pelvis
Hip
To p o g ra p h y Thigh
Knee
Sections Leg
Foot
Skeleton of the lower limb, overvIew
Cingulum pelvicum
� , -:-----=="'-----:-;'--- Articulatio sacroiliaca
Os �oxae Coxa
�--'<:--'-:oo---+'---- Articulatio coxae
Femur
.-.
Patella -++-'1
. _�-- Articulatio genus ....O'?II
Pars libera membri inferioris
{
(Articulatio femoropatellaris) (Articulatio meniscofemoralis) (Articulatio meniscotibialis)
Articulatio tibiofibularis
Fibula
Crus
Trbla --+rr- :
"' "arsus, Ossa tarsr' Pes
Metatarsus, Ossa metatarsi
g��� �:
�T �'rum: - Phalanx proximalis - Phalanx media - Phalanx distalis
(-
{-
Syndesmosis tibiofibularis Articulatio talocruralis
__
(
}
Articulatio calcaneocuboidea Articulatio subtalaris (Articulatio talotarsalis) Articulatio talocalcaneonavicularis - - - - -J,q,�':"";I--- Articulatio cuneonavicularis (Articulatio cuneocuboidea) Articulationes intercuneiformes Articulationes tarsometatarsales -- - -
Articulationes metatarsophalangeae ..4od-'---Articulationes interphalangeae pedis
Fig. 1 2 1 7 Lower limb, Membrum i nferi u s ; skeleton a n d j oi nts,
�
Lowe r l i m b
S u rface
I
S keleton
���
Overview
Pelvis
L
Os sacrum, Pars lateralis
Articulatio sacroiliaca
Spina IJiaca posterior superior
Linea terminalis
/\
Ala ossis ilium, Fossa iliaca Labium internum
1
Crista Linea intermedia iliaca Labium externum
Tuberculum iliacum
Linea arcuata Os ilium
Spina iliaca anterior superior Spina iliaca anterior inferior Spina ischiadica
Eminentia iliopubica Pecten ossis pubis Ramus superior ossis pubis
Articulatio sacrococcygea Apertura pelvis inferior
Tuberculum pubicum
Symphysis pubica
Fig. 1 2 1 8 Sacru m , Os sacrum, and pelvic g i rdle , C i n g u lu m pelvic u m. The reg i o n cra n i a l to t h e linea terminalis is referred to as the g reater pelvis, Pelvis major, and the reg ion caudal to it i s known a s lesser pelvis, Pelvis minor.
Diameter
transversa Diameter --�-Yl:,.,.. obliqua II
--\-+--=1-'--- Diameter obtlqua I
Conj ugata vera
Fig. 1 2 1 9 Pelvis, Pelv i s ; shape and d i mensions of t h e pelvic i n let of the female.
Fig. 1 220 Pelvis, Pelv i s ; s h a p e of t h e pelvic i n let of t h e male,
I
M u sc le s Pelvis
Hip
To p o g ra p h y Thigh
Secti o n s
Knee
Leg
Foot
Pelvis
k-k
a-b a -e a-c
= = =
=
Pelvic axis Anatomical conjugate Diagonal conjugate 1 2 5-13 cm True conjugate 1 0 4-1 1 cm
h-d Sagittal diameter of the pelvic brim 1 2-12.5 cm e-g = Sagittal diameter of the pelvic constriction 1 1-1 1 .5 cm e-f Sagittal diameter of the pelvic outlet (= Distantia pubococcygeal 9-1 0 cm =
=
Spina iliaca anterior superior Spina iliaca anterior inferior
.';!,{O".! :'W1l..... ..L - Foramen ischiadicum majus
Linea termil l aills ---;:'IIIF-��
Apertura pelvIs superior ---_----.�
Lig. saerosp,nale Ug. sacrotuberale
Foramen ischiadicum minus
Foramen obturatum
Apertura pelvis inferior Tuber ischiadicum
Fig. 1 22 1 Pelvis. Pelvis; d i mensions in the female; median section.
b
a-a
b-b
c-c
=
=
=
•
Crestal distance 28-29 cm' Anterior spinal distance 25-26 cm' Posterior spinal distance (width of the sacrum) 10 cm In this perspective. the crestal distance appears shorter than the anterior spinal distance
d-d
Transverse diameter of the pelvic brim ( interacetabular line) 1 2-1 2.5 em e-e Transverse diameter of the pelvic constriction ( interspinal line) 1 0.5 cm f-f = Transverse diameter of the pelvic outlet ( tuberal diameter) 1 1-1 2 cm) =
=
=
=
Fig. 1 222 Pelvis, Pelvis, d i mensions i n the fema le.
=
�
Lower l i m b
Su rface
Skeleton ���
Overview
Hip bone
Linea intermedia --..,.<'"
Labium internum
Facies sacropelvica
Fossa iliaca --....,.'-'=
Tuberositas Iliaca
Spina iliaca anterior superior
Facies auricularis
Spina iliaca posterior superior
y".J---- Spina iliaca posterior inferior Incisura ischiadica major
Eminentia iliopubica
Sulcus obturatorius ---+�
Ramus superior ----,'-#; ossis pubis, Pecten ossis pubis
Incisura ischiadica minor
Foramen -----=" obturatum
(Tuberculum obturatorium posterius)
Ramus ossis ischii
Crista Illaca
(
Fig. 1 223 H i p bone, Os coxae ; medial view. The t h i n reg i o n in t h e centre of the a la of i l i u m i s characteristic fo r its frame-like structu re .
labium Intornum ----"co
Linea Intermedia
----'-:�
Tuberositas iliaca
Labium externum
Spina Illaca ani
Fossa iiiaca ---l:--� riar supenor ---":-�1l
Sulcus supraacetabularis ----i
Spina iliaca anterior inferior
( Limbus Acetabulum
acetabuh
FaCias lunata
Fossa acetabuil Incisura acelabull
Corpus assis Isahll
(Tuberculum obturatorium posterius) Fig. 1 224 H i p bone. Os coxae; ventral view.
Foramen obturatum
Tuber ischiadicum
Facies symphysialis
(Angulus ossis pubis)
M u s c le s PeLvis
Hip
To p o g ra p h y Thigh
Knee
S e ct i o n s Leg
Foot
Hip bone
Facies glutea
[
Labium Internum
ot-::::=....,--- Linea intermedla -....-.0. --- Labium externum
Linea glutea anterior
-"'r"..,... .:Io ... -- Tuberculum ,I,acum
Lin ea glutea I
linea
glutea postenor
(Tuberositas muSculi ---j� glutei maxlmi)
)
Crista Illaca
Spina iliaca anterior superior
Spina iliaca posterior superior -----'t-. Spina iliaca posterior inferior ---"....i:.,
Crista obturatoria
Tuberculum pubicum
Ramus inferior ossis pubis
Corpus ossis ischii
Tuberculum obturatorium anterius
Tuber ischiadicum
(Tuberculum obturatorium posterius)
Fig. 1 22S H i p bone, Os coxa e ; d o rsolateral view.
.��-- Crlsla thaca
(camlaglnea)
Ala ossis ilium ---i::---,":--
....,--.. --�<-- lntarJs
•
"'..--- Corpus ossis ilium ..,1---- Eminentia iliopubica
Corpus ossis ischii ----i""'-lf-Tuber ischiadicum -- --.:,. (cartilagineum) Ramus ossis ischii
Fig. 1 226 H i p bone, Os coxae ; development •
Approximately sixlh yea r of life
Ramus superior ossis pubis Ramus inferior ossis pubis
Fig. 1 227 H i p bone, Os coxae; sta ge of deve lopment in a 6-year-old child. I n the acetabulum, the three pa rts of t h e h i p bone a re fused to a Y -shaped cartilaginous j u nction. This j u nction ossifies at t h e age of 1 3- 1 8 years.
�
Lowe r L i m b
Skeleton
Surfa ce ���
Overview
Joints of the pelvic girdle
Vertebra lumbalis IV Ligg. sacroiliaca anteriora
Lig longitudinale anterius
D,scus intervertebralis Lig. iliolumbale
Spina iliaca anterior superior
}
Articulatio lumbosacralis
Llg. Inguinale
-.....;."""lo:i#-.�r-.f-Lig pubicum superius
Articulatlo
sacroiliaca
,.,..--- Lig. iliolemorale
Canalis obturatorius
Articulatio coxae. Capsula articularis
Trochanter major
Membrana obturatoria
Symphysis publca,
D,scus Interpubicus
Fig. 1 228 J o i nts of the pelvic g i rd le, J u nc t u ra e c i n g u li pelvic i , a n d the l u m bosacral j o i nt, Articulatio lumbosacralis, of the male.
Vertebra lumbalis IV
}
Discus intervertebral is Articulatio lumbosacralis Lig. iliolumbale
Lig inguinale
--...:i!�,,";-:""--- Articulatio sacroiliaca Canalis obturatorius
!"---:rI�- Lig. iliolemorale
Trochanter major
Articula�o COKae. articularis
Capsula
Fig. 1 229 J o i nts of the pelvic g i rd le, J u nct u rae c i n g u li pelvic i , a n d the lum bosacral j o i nt, Art i c u latio lum bosacralis, of the female.
Muscles Pelvis
Hip
To p o g ra p hy Thigh
Knee
Sect i o n s Leg
Foot
Joints of the pelvic girdle
Vertebra lumbalis IV, Corpus Vertebra lumbalis V, Proc. costalis
Articulatio sacroiliaca, Lig sacroiliacum anterius Foramen ischiadicum majus
Spina iliaca antenor superior Lig. inguinale
Lig sacrotuberale
--\'....
-
Lacuna musculorum ----��� Arcus iliopectineus
Lig. sacrospinale
M. rectus femoris, Tendo
;";",,&'""4'-¥.1I1M�-- Foramen ischiadicum minus Articulatio coxae, Lig. iliofemorale
Fig. 1 230 Joints of the pelvic g i rd le , J u ncturae c i n g u li pelvici, a n d the lu m bosacra l joint, Art i c u latio lum bosacralis, of the male.
Vertebra lumbalis IV, Corpus
Vertebra lumbalis V, Proc. costalis
Lig. iliolumbale Articulatio sacroiliaca, Lig, sacroiliacum anterius
Foramen ischiadicum majus
Lig . sacrospinale � _JL---::;;"�"--
Spina iliaca anterior superior
Lig. inguinale ---....;.....
Lacuna musculorum
...,.Hl-'lliiI!I'
\.�L..J,.--=i��'lI--- Lig. sacrotuberale
_ _ _
Foramen ischiadicum minus M. rectus femoris. Tendo
:':'-8._
Arcus iliopectineus
Articulatio coxae, Lig. iliofemorale
Fig. 1 231 Joi nts of the pelvic g i rd le. J u ncturae c i n g u li pelvic i , and the lum bosacral j o i nt, Articulatio lumbosacralis, of the female.
�
Lower l i m b
S u rfa ce
S keleto n ���
Overview
Joints of the pelvic girdle
iliolumbale
Ligg sacroillaca posteriora
Ligg sacroiliaca interossea
Lig sacrotuberale
Lig. sacrococcygeum posterius superficiale
-
Lig. sacrospinale Lig. pubicum inferius
Fig. 1 232 J o i nts of the pelvic g i rd le , J u ncturae c i n g u li pelvici, a n d the lumbosacral joint, Articulatio lumbosacralis. of t h e female .
Lig. sacrococcyg eum poslerius superficiale
Spina iliaca poslerior superior Ug. sacroluberale
Foramen ischiadicum majus
Lig sacrosplnale
Foramen ischiadicum minus
Articulatio coxae, Capsula articularis Lig inguinale -
Lig pubicum inferius
Fig. 1 233 J o i nts of the pelvi c g i rd le, J u n ct u ra e c i ng u li pelvici, of the female.
M u sc le s Pelvis
Hip
To p o g ra p hy Thigh
Knee
Sect i o n s Leg
Foot
Joints of the pelvic girdle
Canalis sacral is
Ligg. sacroiliaca posleriora
sacroiliaca interossea
Ligg sacroillaca anteriora
Lig sacrospinale
Foramen ischiadicum
Lig capitis femoris
Lig sacrotuberale
Lig capitis femoris
Cavitas articularis
Zona orbicularis
Membrana obturatoria
Lig. pubicum inferius
Symphysis pubica, Discus interpubicus
Articulatio coxae, Capsula articularis
Fig. 1 234 J o i nts of the peLvic g i rd Le , J u ncturae c i n g u Li peLvic i , of the femaLe.
Vertebra lumbalis V, Corpus
Foramen intervertebrale
Articulatio lumbosacral is, Discus intervertebralis Crista iliaca
Fossa iliaca ---i-;.nil!--
Spina iliaca anterior superior --..,.,_,
(
�..... - Articulatio sacroillaca, Lig. sacroillacum
antenus
Spina iliaca anterior inferior -- -i1. Ltnea termtnalis
Foramen ischiadicum majus
Ltnea arcuata Pecten OSSIS pubis
Tuberculum pubicum _-�Jr....l..:o
Facies symphysialis ---,,'
Fig. 1 235 Joi nts of the peLvic g i rdLe, J u nctu rae c i ng u Li peLvici, a n d the Lum bosacraL j o i nt, Art i cuLatio Lum bosacraLis, of the femaLe; median sect i o n .
Lig sacrospinale ....r--_ Os coccygis
Llg, sacrotuberale
N orma LLy, t h e a nterior border of the Lowest i ntervertebraL disc forms the furthest projecting point of the posterior circumference of the peLvic i n Let. Radiogra p h icaLLy, the most a nterior part of the sacrum i s referred to a s p romontory.
Lowe r l i m b
�
Skeleton
Su rfa ce ���
Overview
Joints of the pelvic girdle
Articulatio zygapophysialis
Vertebra lumballs V.
Proc (!ostalls
Ligg sacroiliaca interossea
Arti(!ulatlo sacroillaca Ligg. sacroiliaca anteriora
Fig. 1 236 Sacroiliac joint, Articu latio sacroiliaca; frontal section.
� �
----
���
t
----
1 237
Ramus superior ossis pubis
Lig. pubicum inferius
Fig. 1 237 Pubic sym physis, Sym physis pu bica ; oblique section in the d i rection of the longitudinal axis of the symphysis. The interpubic d isc consi sts of fi brous cart i lage, with the exception of the a rticular sym p hysial s u rfaces of both pubic bones that a re covered with hyaline cartilage. A longitudinal flat cleft occurs after the first decade of life 1 * 1 .
M u scles Pelvis
Hip
To p o g ra p hy Th i g h
Knee
S e ct i o n s Leg
Foot
Pelvis, radiography
%
1
Proc spinosus Proc. articularis superior Vertebra lumbalis IV Pediculus arcus vertebrae Proc costalis
Spina iliaca posterior supenor
Os sacrum, Pars lateralis
Spina iliaca posterior inferior
Articulatio sacroiliaca
Ala ossis ilium
Spina iliaca anterior supenor Linea arcuata Spina iliaca anterior inferior
Os sacrum Articulatio coxae, Cavitas articularis Fossa acetabuli
Spina ischiadica
Fovea capitis femoris
Caput femons
Eminentia iliopubica
Trochanter major Collum femoris Crista inter trochanterica
Tuber ischiadicum
Trochanter minor
Foramen obturatum
Ramus superior ossis pubis
Fig. 1 238 Pelvis, Pelvis, of the male; AP-radiogra p h with the centra l beam d i rected onto the t h i rd sacral segment; upright position .
�
Lowe r L i m b
S keleton
S u rface ���
Ove rvi ew
Pelvis, development
Os ilium
Vertebrae sacrales
Trochanter major '
Symphysis pubica
Os pubis Trochanter mi no r
+
Os ischii
Fig. 1 239 Pelvis, Pelvis, a n d femur, Fem u r; AP-ra d iogra p h of a female, premature baby [ e i g hth month of pregnancy] .
Osseous roof o f the acetabuLum V-shaped j u nction i n the a cetabuLar fossa "*The ossification centre in the head of the femur does not appear before t h e third to fifth month of Life. + At this age, both g reater trochanters onLy become a p p a rent as small p rotubera nces of the bone of the d iaphysis.
Os ilium Vertebrae sacrales
Trochanter major
Cartllago epipnysiahs
+
Symphysis pubica
Os pubis
Fo ra me n obturatu m
Os ischii
Trochanter minor
+
Femur, Diaphysis -.-..,-' --- -
Fig. 1 240 Pelvis, Pelvis, a n d femur, Fem u r ; AP-radiogra p h of a 1 2- month-o ld boy.
Osseous roof of t h e acetabuLum V-shaped j unction i n the a cetabuLar fossa *** Ossification centre in the epi physis of t h e head of the femu r A t t h i s a g e , both g reater trochanters onLy become apparent as small p rotu berances of the bone of the d i a p hysis. •
M u s c le s Pelvis
Hip
Top o g ra p hy Thigh
Knee
S e ct i o n "
Leg
Foot Femur
Collum femons Trochanter major
Fovea capitis femoris
Caput femoris
Collum femoris
Linea intertrochanterica
Trochanter minor
Caput femoris
Trochanter major
Fovea capitis femoris
Tuberculum quadratum
Collum femoris Trochanter minor Linea pectinea
Tuberositas glutea
Corpus femoris
Linea supracondylaris lateralis
Tuberculum adduclorlum Epicondylus lateralis
Eplcondylus medialis
Facies poplitea
Tuberculum
adductorlum
Condylus medialis
Condylus laleralis Fossa
Fig. 1 241 Fem u r. Fem u r ; ventral view.
Intercondylaris
Fig. 1 242 Fem u r, Fem u r ; dorsal view.
�
Lowe r l i m b
S ke leton
S u rfa ce ���
Overview
Femur
" "
Fovea capitis femoris
Collum femoris
"
Trochanter major
Tuberculum quadratum
Crista intertrochanterica
Fig. 1 243 Fem u r. Fe m u r ; prox i m a l extre m ity; dorsal view.
Fig. 1 245 Fem u r, Fem u r ; trabecula r structure of the femoral bone with a large neck-shaft a n g le [coxa valg a ) ; section in the pla n e of the a n g le of anterior torsio n '60%1. The lateral plates of the t rabecular bone' ' ''tensile system " ) a re o n ly poorly d eveloped, whereas the medial plates" ( "' com pressive syste m " ) a re m u c h stronger.
Fig. 1 244 Fe m u r, Fem u r ; va riabi lity o f t h e a n g le o f t h e neck of the fem u r; dorsal view. The a n g le between the neck a n d the shaft of the fem u r i s referred t o as nec k-shaft a n g le . It is 1 500 i n i nfants a n d a b o u t 1 260 i n the a d u lt.
Fig. 1 246 Fem u r, Fem u r ; trabecula r structure of the femora l b o n e with a s m a l l neck-shaft a n g le [coxa vara ) ; section i n t h e p l a n e of t h e a n g le of anterior torsion '60%1. The latera l plates of the t rabecular bone • ' ''tensile system" ) are well d eveloped, while the medial plates • • ' ''com pressive syste m " ) a re deve loped less stro n g . A s a result of the h i g h demand of flexio n , the cortex on the i n ner side of the femora l neck i s particula rly thick.
M u s c le s
Pelvis
Hip
To p o g ra p h y Thigh
Knee
Sect i o n s
Leg
Foot Fem u r
Fovea capitis femoris
Trochanter major
Collum femoris ---"'III.
Fossa trochanterica
Trochanter minor
Linea aspera
Fig. 1 248 Fe m u r, Fem u r; varia b i lity of the a n g le of a nterior torsio n ; the p roximal end of the fem u r has been projected over the d ista l end; proximal view. The a n g le of a nterior torsion i s about 30° in i nfants and about 1 4° in a d u lts.
Corpus femoris
Substantia compacta
Tuberculum adductorium
ol-:>--t--- Substantia spongiosa
Fossa intercondylaris
Epicondylus medialis
Condylus lateralis
Labium meciale
Labium laterale
Fig. 1 247 Femur, Fem u r ; m e d i a l view.
}
Cavitas medullaris Linea aspera
Fig. 1 249 Fem u r, Fe mur; c ross-section t h rough the m i d d le of the shaft; d istal view.
�
Lowe r L i m b
S k e leton
S u rface � ��
Overview Pelvis
Hip joint
M rectus femoris. Tendo ---�,.. '>.c _�_
Llg lliofemorale
{
Pars descendens Pars
fransversal':;:::"2�l
Membrana obturatoria
Trochanter major --��
Trochanter minor
Fig. 1 250 H i p j o i nt. Artic u Latio coxae; ventrod istaL view.
Lig sacrospinale ----........
}
Caput reflexum
-\----- Caput rectum
Lig iliofemorale
Lig sacrotuberale ---..;:...
Collum femoris
Trochanter major
Trochanter minor
Tuberositas glutea
Fig. 1 25 1 H i p joint. ArticuLatio coxae ; d o rsaL view.
M u scles
M. rectus femoris. Tendo
Hip
To p o g ra p h y Thigh
Knee
S e ct i o n s Leg
Foot
Hip joint
Caput rectum
M. rectus femoris, Tendo
iliofemorale
Caput reflexum ----�
Canalis obturatorius Os pubis, Facies symphysialis
Caput femoris ---ff:?-':5IH.-
Lig pubofemorale
Lig, capitis femoris
Membrana obturatoria
)
caput rectum M. reClus
Fig. 1 252 H i p joint. Articulatio coxa e ; t h e articular capsule has b e e n opened a n d the h ead of the fe m u r has been pa rtly exart i c u late d ; laterod istal view.
Caput rellexum
femoris, Tendo
Lig, lIiofemorale;
capsula articularls Facies lunata
Fossa acetabuli
"1,J"'k�r--�r--- Lig. capitis femoris
=:!:::::;;;;;,1��_ ::>�:'-'-- Canalis obturatorius
Fig. 1 253 H i p joint, Articulatio coxa e ; aspect o f the a cetabulum after removal o f t h e a rti c u la r capsule a n d exarticu lation o f t h e head of t h e fem u r ; laterodistal view.
M tensor fasciae latae
M. gluteus medius
transversum acetabuli Lig ischiofemorale; Capsula articularis
Facies lunata Cavitas articularis Caput femoris .....;"':"..\11":"",1..--- Fossa acetabuli l�";';�Mlr--- Lig, capitis femoris
--...�mrJ .:;IT'�f-E\"11ti� Jj�J , .fl "''''•.·'J
M. gluteus mlnimus
--��:::lW:�frfl�'-If.�H'¥�;'I,' �a-:-::HfGI�f.lfTJ,�I1f.-l..,J-:;'"
II
-
Zona orbicularis ---1�J.1a:lJ.jrH�t"7�7-�;:,jr.J.'" Fossa trochanterica --1�1Lt� Trochanter maior --........ ..j ��I!f.-1li�H\���:I••,{
.. ���i-'-* M gluteus maximus, Tendo' --....h Bursa trochanterica musculi ---ti":1i+.tI-�H glutei maximi Bursa trochanterica musculi glutei medii
-1��f.lHr;-n
_ _
Tractus iliotibialis _--1I7"p'!k\T'T" ti
,�*-+r"""&�..... -- Fovea capitis femoris \',.,;"llr�--- M. obturatorius
�;;����E�g�����--
internus
-+T...-'!in:;:;,.�I\!01�+-- Collurn femoris ;. #�:..:..:....:;;:;...;.--r �
I
Labrum acetabuli
!!!__!P'"---- M. obturatorius extern us
M, Iliopsoas, Tendo (j�1Jiut..::,o;�:i;����;---
�i;?;n;,H.1-JoI-":"��1!Iy.��---- Trochanter minor
M. vastus lateralis
Fig. 1 254 H i p joint, Articulatio coxae; vertical section at the plane of the a n g le of a ntetorsion Radiations into the iliotibial t ract •
.
�
Lowe r L i m b
S ke Leton
S u rface ���
O v e rview
Hip joint, radiography
Articulatio sacroir.aca
Corpus ossis ilium
Unea terminalis
Fossa acetabuli
Caput femoris
Fovea capitis femoris
Collum femoris
Trochanter major
Foramen obturatum
Tuber ischiadicum
Femur, Corpus
Fig. 1 255 H i p joint, Art i c u latio coxae ; AP-ra d iogra p h ; upright position o n both legs.
Trochanter minor
Clin ical term: acetabular roof � tangenlial p rojection of the lu nate surface .. Clinical term : edge of the acetabular roof the most lateral projection of the acetabulum **. Clinical term: KOHLER's t eard rop � projection of the acetabular fossa �
E:--:.;....!�- Os ilium Incisura ischiadica major
Caput femoris
. -I-- Cavitas articularis' -......:J .. �-=::--:-;;��-!:��-----p..._-t!-_ Spina ischiadica
_ _ ...:. ...
Trochanter major
...�--
-+--_ Incisura ischiadlca
__ _
-�--'---.lI-- Foramen obturatum
Trochanter minor -4';-=�,:.o;-.i!'
Fig. 1 256 H i p joint, Art i c u latio coxa e ; AP-ra d iogra p h ; supine position with the t h i g h abd ucted and flexed Iso-ca lled LAUENSTEIN projection!.
minor
-= -"-o_____�_
_ _ _
•
Tuber ischiadicum
Due to m i nimal absorption o f X-rays b y cartilage, the a rticular cleft a ppears a bnorma lly broad
M us c l e s Pelvis
Hip
To p o g ra p h y Thigh
Knee
S e ct i o n s Leg
Fo ot
Femur
Epicondylus lateralis Condylus laleralis Sulcus popliteus --it::'-'':''''
Fig. 1 257 Fem u r, Fem u r ; d i stal extrem ity; lateral view.
Epicondylus medialis
Epicondylus lateralis
Condylus medialis
Condylus lateralis
Fig. 1 258 Fem u r, Fem u r ; d istal extre m i ty; d istal view.
Cavitas meduliaris
Substantia spongiosa Linea epiphysialis
Epicondylus lateralis
Sulcus popliteus --���"\
Condylus lateralis - _____ -
Epicondylus medialis - Condylus medialis ........ .. iiII . ..."----
Fig. 1 259 Fem ur, Femur; frontal sect i o n thro u g h the d ista l part ; ve ntral view.
�
Lowe r l i m b
S u rface
I S keleton I
���
Overview Pelvis
Tibia
Condylus lateralis
Facies artlcularls
Condylus medialis
fibularis
Corpus tibiae
Margo anterior
Foramen nutricium
Facies lateralis Margo
n Ulrlclum Foramen
Facies lateralls
Facies posterior
Facies medialis
inlerosseus
Facies articularis fibularis
Eminentia intercondylaris Area intercondylaris posterior Linea musculi solei
Facies posterior
Ma;.ll0
Margo
Margo
anlerior
Inlerosseus
Margo interosseus
madi is
Facias laleralls
Corpus tibiae
Incisura fibularis
Facies articularis malleoli
medialis
--I.�'.���
Facies articularis
inferior
Fig. 1 260 T i b i a , T i b i a ; ventral view.
Facies articulans inferior
Facies articularis malleoli medialis
Facies articularos malleoli medialis
Fig. 1 262 Tibia, Tibia; d o rsal view.
Fig. 1 26 1 Tibia, T i b i a ; lateral view.
Area intercondylans anterior
Tuberositas tibiae
Tuberculum intercondylare laterale
Condylus medialis' ----l:--
Condylus lateralis'
Tuberculum intercondylare mediale
Fig. 1 263 Tibia, Tibia, a n d fibula, Fibula; prox i m a l view. * The a rticular surfaces of the condyles together are referred to as superior a rticula r s u rface
Caput fibulae
Articulatio tibiofibularis
M u s c le s
Hip
To p o g ra p hy Thigh
Knee
Sec t i o n s Leg
Foot Tibia and fibula
Apex capitis fibulae
Facies articularls capitis fibulae
Apex capitis fibulae
Caput fibulae
Caput fibulae
Collum fibulae Crista medialis
Margo interosseus
Facies medialis Margo � anterior
Linea
musculi
solei
Margo posterior
Foramen nutricium Corpus fibulae
Margo anterior Facies lateralis
Co;eus
Corpus libiae
fibu ae
Facies posterior
Facies articularis malleoli lateral is
Sulcus malleolaris
Fossa malleoli
lateralls
Fig. 1 264 Fibula, Fibula; med ial view.
Malleolus lateralis
- -..-- Sulcus malleolaris
Fig. 1 266 Tibia, Tibia, a n d f i b u l a , Fibula; d o rsal view.
Fig. 1 265 F i b u la , F i b u la ; latera l view.
Facies lateral is Membrana Interossea cruris
Facies medialis
Margo anterior Corpus fibulae Facies posterior Crista medialis
Fig. 1 267 T i bia, Tibia, a n d f i b u la , F i b u l a ; c ross-section with the i n terosseous membrane of leg ; d istal view. • Opening for the a nterior tibial artery
Corpus tibiae
�
S keleto n
S u rface
Lowe r l i m b
���
Overview Pelvis
PateLLa and knee joint
Basis patellae
-------..,.A'l- Facies articularis
Facies anterior
Apex patellae
Apex patellae
Fig. 1 268 Patella, Patella ; ve ntral view.
Bursa subcutanea prep,,(ellarts
Fig. 1 269 Patella, Patella ; dorsal view.
Facies articularis, Cartilago articularis Retinaculum patellae mediale
Articulatio genus (Articulatio femoropatellaris)
��IIII �����r--
Retinaculum patellae laterale
(Plica synovial is mediopatellaris)
��:>..,l�lLI,'l,-- Facies patellaris, Cartilago articularis ���'rt-':':'--li:-,,"---
Epicondylus lateralis ---IJ""'ffff
M biceps femoris
M
{
collaterale
tiblale
----!Mt-?t.I.!\_ M . sartorius, Tendo
gastrocnemius, -----'�IUII�fi Caput laterale A poplitea
N. ischiadicus
Eplcondylus medialis
Ug
V. saphena magna
V poplitea
semimembranosus, Tendo
N fibularis communis N. tibialis
M. semitendinosus, Tendo
M . gastrocnemius, Caput mediale
Fig. 1 270 Knee j o i nt, Art i c u latio genus; c ross-secti o n . * M e d i a l border facet
M u s c le s
Hip
To p o g r a p h y Thigh
Knee
Sections Leg
Foot
Knee joint
Fe mur
M. articularis genus
Plica synovial is infrapatellaris
Condylus lateral is
Patella, --,t:�...:.... Facies
anterior
Lig collaterale fibulare
Retinaculum --IH-... patellae laterale Corpus adiposum infrapatellare
---l�-l-r-x�!;if;fiirim·�
Retinaculum patellae mediale
Facies
artlcularis
Capsula --'''--1articularis
Lig.
collaterale
fibulare
Bursa Infrapalellarls profunda
r:--:-Hi....- Patella.
lig, patellae
Fig. 1 27 1 Knee j o i nt, Articulatio genus; i ntact a rticular capsule ; ventral view,
Fig. 1 272 Knee j o i nt. Art i cu latio g e n u s ; the a nterior part o f the a rticular ca psule h a s b e e n reflected downwards after d issection of the q u a d riceps m u scle; the s u p rapatellar b u rsa has been o pened ; ve ntral view,
�
Lowe r L i m b
S u rfa ce
S keleton ���
Overview Pelvis
Knee joint
Facies patellaris
Lig. cruciatum posterius ** Condylus medialis
Condylus lateralis
Meniscus medialis
Meniscus lateralis Lig. capitis fibulae anterius ---iHH'l
Lig. cruciatum anterius *
Lig. transversum genus
Caput fibulae
Tuberositas tibiae
Fig. 1 273 Knee j o i nt. ArticuLatio genus; i n 90° flexio n ; the a rticuLa r capsuLe a n d t h e LateraL Ligaments have been removed ; ve ntraL view.
* Clinical term: ACl [= anterior cruciate ligamentl ** Clinical term : PCl [= po steri o r cruciate liga mentl
M. adductor magnus, Tendo M. gastrocnemius. Caput laterale
M. gastrocnemius, Caput mediale
Lig. collaterale fibulare
Lig popliteum obliquum
Lig. popliteum arcuatum
Lig. collaterale tibiale
M biceps femoris, Tendo
M. semimembranosus, Tendo
M. popliteus
Tibia
Fig. 1 274 Knee j o i nt, Art i c u Latio genus; i ntact a rt i c u La r ca psuLe with muscuLar origins; dorsaL view.
Membrana Interossea
cruris
M u s c le s
Hip
To p o g ra p h y Thigh
Knee
Sections Leg
Foot
Knee joint
M. adductor magnus, Tendo
M. gastrocnemius, -----;l..rjj��� Caput mediale, Tendo
Femur, Condylus medialis ----+tf---
Lig meniscofemorale posterius - -....,,,......
-t-fiA�<'....� \�
--
-
M. gastrocnemius, Caput laterale, Tendo
Lig collaterale tibiale ----\""
M semimembranosus, Tendo -----;!,.,...
-...a.=----'lkA'til-- Lig, cruciatum antenus -...,...1+1. ---- Femur, Condylus lateral is ...H----- M. popliteus, Tendo
...�tH.'I,......
Meniscus lateralis
Lig collaterale fibulare
Llg popliteum obliquum
Tibia. Condylus lateralis
Lig. cruciatum posterius
Lig. capitis fibulae posterius
Caput fibulae
M. popliteus, "U'Jllt'UIIJ�";M. popliteus
Fig. 1 275 Knee j o i nt. Art i c u latio genus; exposu re of the cruciate ligaments a n d the menisci; dorsal view.
M quadriceps femoris. Tendo Femur
Patella --...._ .. l:.':
Eplcondylus ---t!:r-*l:':-'l*"-r. medialis
Lig. patellae ---'.......:.
Meniscus medialis
��:r-:;:'!:;;';'..iI .,;
_ -
.-:�:t��-""t1iir
Lig collaterale tibiale __
Tuberositas tibiae __-!r>lW
Tlbla _--I,MIIrFibula
Fig. 1 276 Tibial collateral ligament. Lig. collaterale tibiale ; k n e e I n extended position; medial view. O n ly the poste rior fibres of the tibial collateral ligament a re attached to the medial men iscus.
Fig. 1 277 Tibial collateral ligament. Lig. collatera le tibiale; knee i n flexed position [90°); medial view. In the course of flexi o n . the posterior a n d p roxi m a l fi bres of the tibial collateral ligament become twisted. t h e reby sta bilizing the medial meniscus.
�
Lowe r li m b
S u r fa ce
S keleton ���
Overview
Knee joint
Bursa suprapatellaris
M. Quadriceps femoris, Tendo
Bursa subfascialis prepatellaris Lig , collaterale fibulare M. popliteus, Tendo
I'I.�>--- Lig. patellae
-,\:\t
-
.Il-----j.".,--- Meniscus lateralis
....+.--- Bursa infrapatellaris profunda
Lig. popliteum arcuatum M biceps femoris, Tendo
Fig. 1 278 Knee joint, Articulatio g e n u s ; synovial mem bra n e tightly fi lled after i njection of plastic materia l ; lateral view. Su bpopliteal recess n ot shown [compare Fig. 1 2791.
M, adductor magnus, Tendo
Lig. collaterale tibiale*
M, semimembranosus, Tendo -- ""'o:Ir..�. Meniscus medialis
Lig popliteum obliquum
Fig. 1 279 Knee j o i nt, Art i c u latio genus; synovial mem brane thig htly fi lled after i njection of plastic material; dorsal view. * Clinical term: M C l 1= medial collateral ligamentl ** C linical term: lCl 1= lateral collateral ligamentl
Lig. cruciatum posterius
Lig. meniscofemorale posterius M. gastrocnemius, Caput laterale Lig. collaterale fibulare** Meniscus lateralis
ofiIllilr.'it-- M. popliteus, Tendo
M. biceps femoris, Tendo Lig, popliteum arcuatum
M u s c le s
Pelvis
Hip
To p o g ra p hy Thigh
Knee
Sections Leg
Foot
Knee joint
Bursa infrapatellaris
Lig. cruciatum anterius
Meniscus medialis
A. media genus, (R. posterior)
Ug.
collate raja tiblale
Lig. cruciatum anterius
M. popliteus, Tendo
poplitea Ug. cruciatum posterius A.
Fig. 1 280 Menisci of the knee j oint, Articulatio genus, and cruciate ligaments, Ligg. cruciata ; proximal view.
Ug. collaterale fibulare A. inferior lateraJis genus
Fig. 1 28 1 Menisci of the knee joint, Articulatio genus; a rterial supply; proxi m a l view.
a Fig. 1 282 a, b lateral view.
D isplacement of the menisci d u ring flexio n ;
a Extended position
b Flexed position
Fig. 1 283 D i splacement of the menisci during flexio n ; proximal view. I n flexion, both menisci a re displaced posteriorly over the edges of the tibial condyles. The g reater mobility of the lateral men iscus accounts for its lesser risk of damage.
�
S u r face
Lower li m b
I
Skeleton
���
Overview
Knee joint, sections
�1!i-'�+-+-li!r----"'-2""I----- M. vastus medialis
M. vastus lateralis -----t-n-'-\\\rfHII
·""'t-'�ttt---'--'\l�J----- M. adductor mag�us. Tendo
Epicondylus lateralis -----'A-'-'o14!1foI
Lig. cruciatum anterius ----�-:tW���7"ilf.r:�ti". M. popliteus, Tendo ------ItHPr+;
Femur, Condylus lateralis
------\lr.-'It;\"it���
�\�·�.n�;[tfl,,1t---- Epicondylus medialis ""=-+11---- Lig. collaterale tibiale
����!i�����W��===
" �r..:--'-in,I-'n"---- Lig. cruciatum posterius ��.,.x;""�
Capsula articularis
Femur, Condylus medialis
Meniscus medialis
Tibia, Condylus medialis
Meniscus lateralls
Tibia, Condylus lateralis
Eminentia Intercondylaris M. soleus
M tibialis anterior
Fig. 1 284 Knee joint, Art i c u latio g e n u s ; frontal section .
Bursa suprapatellaris
[ FBaaCsIeispatelae FacAiepsex
M. quadriceps femoris, Tendo Femur, Facies patellaris
Patella
anteroor - --,...-'lw,;� -
artocularis ----i1If'-�#*_�.,�.
patellae ---' *I""�'iIr-�
Corpus adiposum infrapatellare ---- -\'t;....-t[
Meniscus lateralis, (Cornu anterius)
----1�1tr:1 :_�::::;;. ; - .:::
lig patellae Tibia, Condylus lateralis
M. tibialis anterior
Femur, Condylus lateral is Capsula articularis, Lig. popliteum arcuatum _-L�+--- Meniscus lateral is, (Cornu posterius)
-'1'----- M popliteus, Tendo I�+----- Recessus subpopliteus
Lig. capitis fibulae posterius Articulatio tibiofibularis M soleus
Fig. 1 285 Knee joint, Art i c u latio genus; sagittal section t h ro u g h the lateral part of the j o i nt.
I
M u s c le s
Pelvis
Hip
To p o g ra p hy Thigh
Knee
S e ct i o n s Leg
Foot
Knee joint, radiography
Corpus femoris
Basis patellae
Eplcondylus lateralis
Epicondylus medialis
Fossa intercondylaris Sulcus popliteus
Apex patellae
Femur, Condylus lateralis
Femur, Condylus medialis
Tibia, Condylus lateralis
)
Tibia, Condylus medialis Tuberculum intercondylare mediale
Apex capitis fibulae
Tuberculum intercondylare laterale
Articulatio tibiofibularis
Caput fibulae
Linea epiphysialis
Corpus fibulae
Corpus tibiae
Fig. 1 286 Knee joint, Articulatio g e n u s ; AP-ra d i o g ra p h w i t h the central b e a m d i rected onto the middle of the joint; subj ect rec lined.
Corpus femoris
Patella, Facies artlcularis
Facies poplitea
Apex patellae
Fossa intercondylaris
Femur, Condylus medialis Femur, Condylus lateralis
Eminentia intercondylaris
Linea epiphysialis
Apex capitis fibulae Articulatio tibiofibularis
Tuberositas tibiae
Caput fibulae
Corpus tibiae
Corpus fibulae
Fig. 1 287 Knee j o i n t , Art i c u latio genus; lateral rad i ograph with the centra l beam d i rected onto the m i d d le of the j o i n t ; s u bject reclined.
Eminentia intercondylaris
�
Lowe r li m b
Skeleton
S u rface ���
Overview
Knee joint, arthroscopy
Patella, Facies articularis '
Bursa
1 2 3 4 5 6 7
Arthroscope Inlet or outlet for the rinsing fluid Cold light source Ocular or connector for the video system Anterolateral access Anteromedial access Additional instrument
Fig. 1 288
suprapatellaris ••
Fig. 1 289 a-c Knee j o i nt, Art i c u latio genus; arthroscopy. a D i stal view i nto the femoro patellar j o i nt * Patellar roof ridge: ridge between the medial and lateral a rticular su rfaces ** CLinical term : suprapatellar recess
Accesses for a rt h roscopy.
Femur, Condylus lateralis
Femur.
Condylus lateralls
\ Femur
Condyius medialis
b
Medial view of the free inner edge of the lateral m e n iscus; retra ctor 1 * 1 slightly depressing the anterior part of the m e n iscus
c
Antero lateral view of the d istal part of the a nterior c ruc iate ligament. Lig. cruciatum anteri u s. The ligament is covered by a richly vascu larized synovia l mem b rane. I t i s d rawn media lly b y a retractor 1*1.
M u s c le s P e lv i s
Hip
To p o g ra p h y Thigh
Knee
Sections Leg
Foot
Knee joint, imaging
M
Femur.
Condylus lateraUs
Condylus lateralis
Fossa intercondylaris
Capsula articularis; M gastrocnemius, Tendo
Meniscus lateralis, (Cornu posterius)
Femur. Condylus medialis Lig. coliaterale tibiale
M popliteus, Tendo
Meniscus medialis
Tibia, Condylus medialis
Facies a mcul arl s
superior.
Caput fibulae Articulatio tibiofibularis Tibia
Condylus lateralls
Memscus lateralis, (Comu anterlus) Corpus adiposum infrapatellare Llg. patellae
Llg cO llate rsl s fibulare
Fig. 1 290 Knee joint, Articulatio g e n u s ; m a g n e t i c resonance tomogra p h i c i mage [ M R l i ; frontal section; knee i n the extended position. I n this imaging technique. compact bone a p pears b lack.
Fig. 1 29 1 Knee joint, Articulatio genus; magnetic resona nce tomogra p h i c i mage [ M R l i ; sagittal section t h ro u g h t h e lateral part o f t h e j o i n t ; k n e e i n the exte nded position. 1 291 1 292a 1 292b
Fossa intercondylaris
Capsula articularis, Lig popliteum obliquum Lig cruciatum anterius
Capsula articularis, Lig. popliteum obliquum
Lig. cruciatum posterius '
Lig cruciatum posterius Area intercondylaris anterior
a
Area intercondylaris posterior
b
Corpus adiposum Inlrap a lellare
Fig. 1 292 a, b Knee j o i nt, Articulatio g e n u s ; m a g n e t i c resonance tomogra p h i c i mage [ M R l i ; sagittal sections t o demonstrate t h e cruciate ligaments; knee i n the extended position.
a Anterior cruciate ligament, Lig. cruciatum anterius, b •
[ACLi
Posterior c ruc iate ligament, Lig. cruciatum posteri us, i P C Li The i n homogeneity is d u e to oblique sectioning of the fibre bundles.
�
Lower L i m b
Surface
Skeleton ���
Joints of the bones of the leg
Articulatio tibiofibularis, Lig. capitis fibulae anterius Caput fibulae Tuberositas tibiae
��.-- Membrana interossea cruris
Malleolus lateralis
Malleolus medialis
Syndesmosis tibiofibularis, Lig. tibiofibulare anterius
Fig. 1 293 J o i nts of the bones of t h e leg ; ventral view.
Facies articularis inferior Facies articularis malleoli medialis
Malleolus lateralis Facies articularis malleoli lateralis
Malleolus medialis
Fig. 1 294 Tibia, Ti bia. a nd f i b u la , Fibula; d ista l view.
Overview
M u sc le s Pelvis
Hip
To p o g ra p hy Thigh
Knee
Sections Leg
Foot
Skeleton of the foot
Phalanx distalis
Fig. 1 295 Skeleton of the foot, Ossa pedis; p roximal view.
Phalan� media Phalanx proximal is Caput phalangis
Corpus phalangis
Caput ossis metatarsI
Basis phalangis
Corpus ossis metatarsi BasIs ossis metatarsi __Ik-- Os cuneiforme
laterale
Hallux [Digitus primus] Digitus secundus III Digitus tertius IV Digitus quartus V Digitus minimus [quintus]
Tuberositas ossis metatarsi quinti Caput tali Talus
Proc. lateralis tali Trochlea tali
Caput phalangis 1-111
Calcaneus
Phalanx distalis Phalanx media Phalanx proximalis
BaSIS phalangis 1-111
Ossa dlgilarum
[Phalanges)
Ossa metatarsi I-V
Ossa sesamoidea
"' o.l!F-'--'''' - Tuberositas ossis metatarsi primi
Basis ossis -1--4-....., metatarsi III-V
Os cuneiforme medlale
Os cuneiforme intermedium
Tuberositas ossis metatarsi quinti
Os cuneiforme laterale
Sulcus tendinis musculi fibularis longi
Proc lateralis tuberls calcanei
Tuberositas ossis navicularis
ProC.
Sustentaculum tali medialis
tuberis calcanei
Fig. 1 296 Skeleton of the foot, Ossa ped i s ; plantar view.
�
Lowe r L i m b
I
Su rface
���
S keleto n Overview
I
Skeleton of the foot
Caput tali
Collum tali
O s cuneiforme Inlermedlum
Talus
·�f�I:::ij!�
..
J/ ...._.'.r
_
-... .. _ ..... . _
Proc. posterior
Tuberculum -\-�mtali,:ediale
_ _
Sustentaculum tali
•'---1--- Calcaneus, Proc. medi alis luberls calcanei
SulCUs lendlms musculi llexoris hallucis
Basis ossis metatarsi hallucis
longi
Os cuboideum, Tuberositas ossis cuboidei
Fig. 1 297 Skeleton of the foot, Ossa pedis; medial view.
Ossa tarsi Articulatio tarsi transversa'
Talus
Collum
Os cuneiforme intermedium
, _ lall ---:---- � -T =_
Trochlea lall-_
_ _ _ _ _ _
Faoles malleolarls ---t'-----�:.. laleralis
r-
Proc. poslenor lall,-, TuberCUlum laterale
.
_ _
�
- � � -i
Ossa digitorum [Phalanges]
Calcaneus ---+-�::. Trochlea l�bIJlans'--+-\---';'':-'�=Tuber calcanei ---+--'....�.
Tuberositas essis metatarsi V
Articulationes tarsometatarsales"
Fig. 1 298 Skeleton of the foot, Ossa pedis; lateral view. * s o C H O PART's joint ** s o LlSFRANC's oint
Al : Al :
j
Caput ossis metatarsi V
M u s c le s P e lv i s
Hip
To p o g ra p hy Thigh
Knee
Sect ions Foot
Leg
Talus and calcaneus
Caput tali
Facies articularis navicularis Caput tali --....,.l1li
Corpus tali Proc. posterior tali. Tuberculum medials
Sulcus tendinis muscutl flsxorls hallucis longi
!
-
ealcanea anterior
Proc lateralis tali
Facies malleolaris medialis
Facies artlcularis
calcanea media
Facies artlculans - -,.;;......
��-+-- Collum tali
, l l " ---E-''--- Facies malleolaris lateralis Trochlea tali, Facies superior Proc posterior tali . Tuberculum laterale
Collum tali
-
-.. t--�
_ _
Corpus tali
Proc lateralis tali
Sulcus tendinis musculi flexoris hallucis longi
Facies articularis calcanea posterior
Proc posterior tali
Fig. 1 300 Ta lus, Ta lus ; plantar view.
Fig. 1 299 Ta lus, Talus; proximal view.
Facies articularis talaris posterior
Facies articularis talaris anterJor-----t�
Sulcus tendinis musculi flexoris hallucis longi
Facies articularis cuboidea -----J�
Proc. medialis tuberis calcanei
Fig. 1 30 1 Calcaneus, Calcaneus; medial view.
Facies articularis talaris
Facies articularis talaris media Facies articularis talaris anterior Sulcus calcanei Facies articularis cuboidea Sulcus tendinis musculi fibularis longi
Tuber calcanei ---"'It:-=
Fig. 1 302 Ca lca neus, Ca lca neus; latera l vi ew.
�
Lowe r L i m b
Skeleton
Surface ���
Overview Pelvis
Tarsal bones
as metatarsi II
as metatarsi III
as metatarsi I ----t-�
as metatarsi IV
II
Caput ossis metatarsi Tubero�ltas ossi$ metatarsi prim I
V
as cuneiforme mediale ----:-...;..:..:;y � as cunelforme intermedium ---P�IIi!I"'--.H�-.I� as cuneiforme laterale
Basis OSSIS metatarsi
Tuberositas 05sls metatarsi qulnti
---'"-c,.-"='-'----�--'..:-"'!!:.... .!!..:;:;, . ..
-
as naviculare ----'::c;;,
Tuberositas ossis navicularis --�k'
Caput tali --�-"I� ' Collum tali --E"'-::II
Facies malleolaris medialis Talus
as metatarsi V
Corpus os sis metatarsi
(Facies articularis calcanea)
---
Trochlea tali ----'r----�
Facies malleolans lateralis
1
Os cuboideum*
Facies artlcularis cuboidea
__��
Facies articularis talaris anterior
Facies artlcularis talaris media
��...;� ;. -""-�-- Sulcus calcanei
Tuberculum mediale . . musculi. Proc, tendlnls posterior Sulcus flexons hallucls long I tali Tuberculum laterale
Facies articularis talaris posterior
Sulcus tendinis musculi flexoris hallucis longi L _ _ _ _ _ _ _ _ _ _
Fig. 1 303 Ta rsa l bones, Ossa tarsi, a n d metatarsal bones, Ossa metatars i ; proximal view, * The cuboid bone is shown In a medial view.
)
Proc. lateralis tuberis calcanei Tuber . Proc. medialis calcanei tuberis calcanei
M u s c le s
Calcaneus
Hip
To p o g ra p hy Thigh
Knee
Sections Foot
Leg
Skeleton of the foot
Ossa cuneiformia --�1"-7
.-\.._�""'-- Ossa cuneiformla
Os naviculare ---#--
Os cuboideum ---+-
--\-- 05 naviculare
Talus
Calcaneus ------.J--
Calcaneus
The heads of aLL metatarsaL bones Lie i n the pLantar pLane. The cuneiform bones, the navicuLar bone a n d the taLus rest upon the LateraL pa rts of t h e skeLeton, especiaLLy i n the posterior p a rt of the foot. The taLus i s therefore situated a bove the caLcaneus and the LongitudinaL a rch i s formed. The wedg e-shaped cross-section of the c u neiform bones and the bases of t h e metatarsaL bones contribute t o the format i o n of the t ra n sverse vauLt.
Fig. 1 304 a, b SkeLeton of the foot, Ossa ped is; struct u ra L o rg a n isation. a Proxi m a L view b PLantar view
Ta l us
Hallux
{
Phalan� proximalls
--rr-t-- Calcaneus
Phalanx dislalis
Aponeurosis plantaris
Fig. 1 30 5 S upporting structures of t h e mediaL a rch of the LongitudinaL vau Lt of the foot; mediaL view.
abductor hallucis, Fascia M.
Lig. calcaneonaviculare plantare
The Ligaments s h own i n t h i s i llustration are mostly directed i n t h e LongitudinaL axis o f t h e foot a n d s u p po rt passiveLy the LongitudinaL va u Lt of the foot. The short m u scles of t h e foot prima riLy support t h is construct i o n .
�
Lowe r l i m b
Ske Leton
S u r face ���
Overview Pelvis
Joints of the foot
Lig.
coliateraJe mediaI e [deIIOldeum]
M. tibialis anterior, Tendo
M. tibialis posterior, Tendo
(
Fibula
Pars tibiotalaris posterior Pars tlblocalcanea Pars tlbiatalans antenor Pars tibionavicularis
""':-"'011'--- Tibls
Lig. tibiofibulare posterius Sustentaculum tall
Ligg. tarsometatarsalia plantaria
Lig calcaneo naviculare plantare
Sulcus tendlnis musculi fibularis longi
Lig plantare longum
Fig. 1 306 J o i nts of the foot, Art i c u lationes pedis; ligaments a n d tendons; medial view.
Lig. tibiofibulare anterius Lig. talofibulare anterius
talocalcaneum interosseum
Malleolus lateralis
Lig. cuboideonaviculare dorsale
Ligg_ cuneonavicularia dorsalia
Tendo calcaneus*
Lig calcaneo naviculare
Lig . bifurcatum
fibularis [peroneus] brevis, Tendo
Fig. 1 307 J o i nts of the foot, Articulationes pedis; ligaments a n d tendons; lateral view. * ALso: Achilles tendon
M u s c le s
Ligg metatarsalia transversa profunda
Hip
To p o g r a p h y Thigh
Knee
S e ct i o n s Leg
Foot
AnkLe joint
Lig tibiofibulare posterius
Lig , talofibulare posterius
Malleolus medialis
Lig. collaterale mediale, Pars tibiotalaris posterior
Malleolus lateralis
Lig. collaterale mediale, Pars tibiocalcanea ---H'D\ Lig. talocalcaneum posterius Talus Lig calcaneofibulare
Lig. talocalcaneum mediale
Tendo calcaneus'
Tuber calcanei
Fig. 1 308 J o i nts of the foot, Art i c u lationes ped i s ; ligaments a n d tendons o f t h e posterior part o f t h e foot. * Also: Achilles tendon
Membrana interossea cruris ---I""","""....
Lig, tibiofibulare anterius
Facies articularis inferior
---,""''::''''fo-y''"'/
Facies articularis malleoli medialis Facies articularis malleoli lateralis
--+--4"-
Malleolus lateralis -.-..,..- ..
Malleolus medialis
.: '�ii..L_- Sulcus malleolaris Lig tibiofibulare posterius
Fig. 1 309 An kle j o i nt, Art i c u latio talocrura l i s ; proximal a rticular surfaces; d i stal vi ew.
Lowe r li m b
�
Skeleton
S u rfa ce ���
Overview
Joints o f the foot Fig. 1310
J o i nts of the foot, Articulationes ped i s ; plantar view. •
With t h e long plantar ligament t h e g roove for the tend on of the fi bularis lon g u s muscle is enclosed i n a c a n a l.
Ligg coliateralia
ligg. plantaria lig. metatarsale transversum profundum
---'I�_--lHllf>¥ Basis OSSIS metatarsi
I
Ligg tarsometatarsalia plantaria Os cunelforme mediale Tuberositas ossis metatarsi quinti
Ligg cuneonavicularia plantana lig. cuboideonaviculare plantare Tuberositas ossis navicularis
Lig. calcaneo· cuboideum plantare
Lig calcaneonaviculare plantare
Sustentaculum tali Llg coliaterale mediale, Pars tibiocalcanea Articulationes metatarsophalangeae Proc. medialis tuberis calcanei
Os sesamoideum
Lig. metatarsale transversum profundum
--tl.::t"I!:+ .....,,'"
ligg. metatarsalia plantana
M
-- "'4't"-:;,?
fibularis [peroneus] brevis, Tendo Tuberositas ossis cuboidei
"tMoL__ Llgg tarsometa· tarsalia plantaria
i1llit--- ligg. tarsi plantana
lig. cuboideo· naviculare plantare
lig calcaneonavlculare plantare
Fig. 131 1
J o i nts of the foot, Art i c u lationes pedis; ligaments a n d tendons of the tarsus a nd metata rsu s ; plantar view.
Ltg. calcaneocuboideum plantare
M u sc l e s
Pelvis
Hip
To p o g ra p h y Thigh
Knee
S e ct i o n s Leg
Foot
Talotorsal joint
Ligg. tarsometatarsalia dorsalia Os metatarsi I I
O s metatarsi
O s metatarsi I
Ligg intercuneiformia dorsalia
IV
Os metatarsi
"'�f76�nt1�
_ _
V
Tuberositas ossis metatarsi quinti Lig. cuneocuboideum dorsale
Ligg . cuneonavicularia dorsalia
Os cuboideum Lig calcaneonaviculare Lig. calcaneocuboideum
Os naviculare
} Lig. bifurcatum
M. flbularis [peroneus] brevis, Tendo Lig , calcaneonavlculare plantare
Facies articularis talaris anterior
Ug. talocalcaneum interosseum Lig talofibulare anterius
Facies articularis talaris media Lig. talocalcaneum interosseum Facies articularis talaris posterior
�"",",1!-- Lig. deltoideum
Lig. calcaneofibulare Calcaneus
Fig. 1313
Fig. 1312
Ta lotarsa l jo i nt, Art i c u latio talotarsa lis; p rox i m a l a rt i c u la r s u rfaces; d istal vi ew.
Ta lotarsal j o i nt , Arti culatio talotarsa lis; d i stal a rticular surfaces; p roxi m a l view.
Os naviculare (Facies articularis talaris) Lig cuboideonaviculare dorsale
Facies articularis talaris media Facies articularis talaris posterior
Lig. talocalcaneum Tnterosseum
Fig. 1314
Ta lotarsa l j o i nt, Art i c u latio talotarsa lis; the talus a n d the lateral liga ments have been removed; latera l vi ew. The two a rrows point out the helical d istorsion of the ta loca lca neal i nterosseous ligament.
Lig calcaneonavTculare Lig, calcaneocuboideum
•
. I Lig. bifurcatum
Tight connective tissue layer between the plantar calcaneonavicula r ligament a n d t h e tibionavicular part o f t h e deltoid ligament l i m i t i n g a medially directed g l i d i n g o f the head o f the t a l u s ; slacke n i n g o f this layer results i n flattening of the long itudinal vault [flat-foot, pes valgusl
�
S keleton
S u rfa ce
Lowe r li m b
� ��
Ove rview
Ankle and talotarsal joint, sections
Metaphysis, Linea epiphysial is Articulatio talocruralis
Syndesmosis
Ubiofibularis
Tibia, Malleolus medialis
Metaphysis, Linea epiphysial is
Lig collaterale mediale, Pars tibiocalcanea
Corpus tali
M tibialis posterior, Tendo
Fibula, Malleolus lateralis
Vagina tendinis musculi tibialis posterioris
Lig, talofibulare posterius
M. flexor digitorum longus, Tendo Va\l ina tendinis musculi flexoris digltorum longi Retinaculum musculorum flexorum
Lig. calcaneofibulare
Articulatio subtalaris
Retinaculum musculorum fibularium [peroneorum) superius M. fibularis [peroneus) brevis, Tendo
Articulatio subtalaris
Lig, talocalcaneum interosseum
--'\rt�r.;
_ _
Vagina communis tendinum _--m'(\] musculorum fibularium [peroneorum)
N.
M, fibularis [peroneus) longus, Tendo
plantaris medialis
(V plantaris medialis)
A plantaris medialis
Retinaculum musculorum fibularium [peroneorum) inferius
M abductor hallucis
Calcaneus
M. quadratus plantae A.; N, plantaris lateralis; (V. plantariS lateralis)
M abductor digiti minimi Aponeurosis plantaris
flexor digitorum brevis
Fig. 1315
Ankle a n d talotarsal joint, Articulationes talocruralis et ta lotarsa lis; fronta l section,
M. flexor hallucis longus extensor hallucis longus M. triceps surae, --4/04Tendo calcaneus
Lig. talocalcaneum interosseum
Articulatio talocruralis
Articulatio subtalaris Articulatio talocalcaneonavicularis
}
.....",.. .. ",......,. . -'.i'I . hi,...= . ...:....,. . .... .
(Articulatio talotarsalis)
M, fibularis [peroneus) longus, Tendo
-
-r.'':'_ ''' �IA
�;lfI�i.1
Calcaneus --�4�"'-"':,:-J:.!'"
Tuber calcanei
Aponeurosis plantaris M, flexor digitorum brevis
Lig plantare longum M quadratus plantae
Fig. 1316
M adductor hallucis, Caput obliquum
An kle a n d talotarsa l joint, Articulationes talocruralis et talotarsalis ; sagittal sect ion. • Fat pad of the heel
Articulatio metalarsophalangea (Digitus II)
M u sc les P e lv i s
Hip
To p o g r iJ p h y Thigh
Sec t i o n s
L eg
Foot
Ankle and talotarsal joint, radiography
Fibula 1lbia
Linea epiphysialis
Syndesmosis tibiofibularis Trochlea tali
Articulatio talocruralis
Malleolus medialis
Talus
Malleolus lateralis
Fig. 1317
Ankle j o i nt, Art i c u latio talocru ralis; AP-radiogra p h with the s u bj ect recli ned a n d the central beam d i rected tangentia lly onto the troch lea of talus.
•
Clinically, the posterior border of the fibular notch is a lso referred to as the third ma lleolus.
Fibula
TIbia
Linea epiphysial is"
Articulatio talocruralis Trochlea tali Malleolus medialis Proc. posterior tali Malleolus lateralis Articulatio subtalaris
•
Collum tali Sinus tarsi
Caput tali Articulatio talocalcaneonavicularis
Sustentaculum tali
•
==. �-- Os naviculare
Tuber calcanei
Fig. 1318
Ankle and talota rsa l j o i nt, Art i c u lationes talocruralis et ta lotarsa lis; AP-ra d i o g ra p h with the s u bject rec li ned a n d the central beam d i rected tangentia lly onto the apex of the troch lea of talus.
•
**
Due to their helical d l storsio n , the joint clefts are not displayed orthogonally. Overlapping epi physeal lines of the t i b i a and fibula
1 -7 1428, 1429 1
�
Lower li m b
S ke le t o n
S u rface ���
Fasciae of the lower limb
Spina iliaca anterior superior
,
/
M tensor fasciae latae
r Margo falciformis l
Cornu superius Cornu inferius
Lig. inguinale
Funiculus spermaticus
---1H:-----;:----\;K
V saphena magna
Tractus iliotibialis
Retinaculum ---r- patellae laterale Caput fibulae
�"""I""'-_ Hiatus saphenus, Fascia cribrosa
--;:--;:,If--- Patella I..I��"""-- Bursa subcutanea prepatellaris
-�"I--- Lig, patellae �"'.,,1Jf--- Bursa subcutanea infrapatellaris
Fascia cruris nbia, Margo anterior
_.-- nbia. Facies medialis .;r.."':::II--- M tibialis anterior, Tendo
Retinaculum musculorum extensorum superius M. extensor digitorum longus, Tendines
----1;...,.,::-
"7Mf--- Retinaculum musculorum
extensorum inferius M. extensor hallucis brevis
M, extensor hallucis longus, Tendo Fascia dorsalis pedis
Fig. 1319
Fascia lata, Fascia lata , a n d deep fascia of leg, Fascia cruris. The transition zone between the a po neurosis of the external oblique abdomina l muscle a nd the fascia lata is known a s i n g u i n a l liga ment. T h i s l i g a m e n t extends latera lly from the a nterior superior iliac spine to its atta c h ment on the pubic tubercle media lly. •
Ope n i n g s in the fascia for the perforator v e i ns [DODD's veinsl
Overview
M uscles
Pelvis
Hip
To p o g ra p h y Th i g h
Leg
S e ct i o ns Foot
Fasciae of the Lower Limb
Crista
lIIaca
---:::-�r.iit[!:;'lI .-t--- (Fascia glutea)
M tensor fasciae latae ;:"-:=-�I-- Sulcus glutealis Tractus
IlIotiblalis
_�-- Fascia lata
Fossa poplitea
(Fascia poplitea)
M gastrocnemius
-,!II'-- M. gastrocnemius, Tendo
Malleolus medialis
Fig. 1320
Fascia lata , Fascia lata, and deep fascia of leg , Fascia c ru ris.
�
S ke leton
S u rfa ce
Lower li m b
���
Muscles of the lower limb, overview
M. Iliopsoas
(
M I liacus M psoas major ---'-'-�"'"
M. tensor fasciae latae
...��"...-- M pectineus M. sartorius
;.,HI-:--;.,.-!p....
-
fr::,+tI1....--- M. adductor longus M vastus lateralis
_J"_�
-
M. gracilis M.
quadriceps femoris
M. rectus femoris
--"'�
M vastus medialis ---'-Il�..tK4
M fibularis [peroneus] longus
---f-'
M tibialis anterior --�H M . soleus
M. extensor digitorum longus ---l,\t...
M. extensor haliucis longus ---'".-1-1
-7 T 42, T 44, T 47, T 48
T 45,
Fig. 1321
overview.
M uscles of the lower l i m b , M m. extrem itatis i nferiori s ;
Overview
Muscles Pelvis
Hip
To p o g ra p hy Thigh
Leg
Sect i o n s Foot
Muscles of the lower limb, overview
M. gluteus medius
M gluteus maximus
M
M.
semitendinosus
---tl1IIi
...'!'if----
M.
biceps femoris
semimembranosus
M
soleus
H---- Tendo calcaneus
Fig. 1322 overview.
M uscles of the lower limb, M m . extre m itati s i nferi oris;
1-7 T
43,
T 46, T 49
1
�
Lowe r L i m b
S u rfa ce
S k e le t o n ���
Origins and insertions of the muscles of the hip, the thigh and the leg
M obliquus internus abdominis
':!��;J��- M. psoas major
M. transversus abdominis M. iliacus
....,........;..;..
-
M. sartorius
M. obturatorius internus M. piriformis
(Bursa iliopectinea)
Ltg, sacrospinale; M. anococcygeus
-----7---7'-4,,-':--
M. pectineus
M. gluteus minimus
M. obturatorius externus
M . vastus laterahs
M. adductor longus
M. gracilis M. vastus intermedius
M , adductor magnus quadratus femoris biceps femoris M. semimembranosus
M, articularis genus M. quadriceps femoris M. vastus medialis M. biceps femoris Lig. collaterale fibulare Retinaculum patellae 'Iaterale
-�WlI-+·:i
M. sartorius
Tractus iliotibialis M extensor digitorum longus
Lig patellae
M. fibularis [peroneusj longus
1-7 T 42 -T4SI
Fig. 1 323
Ori g i n s a n d i nsertions of the m uscles at the lower lumbar vertebrae , the pelvic bones, the femur and the prox i m a l extremities of t h e bones of t h e leg ; ve ntra l view.
Overview
M uscles Pelvis
Hip
To p o g ra p hy Thigh
Leg
S e ct i o n s Foot
Origins and insertions of the muscles of the hip, the thigh and the leg M. obliquus extern us abdominis M. gluteus minim us M. piriformis
M tensor fasciae latae
M gluteus maximus M. rectus femoris --if:��
-t---t'----.i!��,
M. obturatorius extern us
-
M . gluteus medius
M. gemellus superior --J!L'Y�r-....;r.. .J
M. gluteus minimus
M. obturatorius internus ---""�"""'1-."\"' �
Bursa trochanterica musculi glutei medii
M. levator ani
M. quadratus femoris
M. transversus perinei profundus
Bursa subcutanea trochanterica
Bursa ischiadica musculi obturatorii interni
M gemellus inferior M.
M. vastus intermedius
M adductor magnus
M. vastus lateralis
Bursa subtendinea musculi gastrocnemii medialis M. semimembranosus M. sartorius M graciliS
M. semitendinosus
M. semimembranosus
Foramen nutricium M. flexor digitorum longus
Fig. 1 324
"[111'-1'-- M. popliteus
M. soleus
Arcus tendineus musculi solei M tibialis posterior
Origins a n d i nsertions of the muscles at the pelvic bones, t h e femur a n d the proximal extremities of the bones of the leg ; d orsal view.
1 -7 43- 46, 49, T
T
T
T 50
I
�
Lower l i m b
S u rfa ce
S k e lE:� t o n ���
Overview
M uscles P e lv i s
Hip
Muscles of the thigh
M . vastus medialis
...._ ... - M. vastus intermedius
. ....--'W-l..-- M vastus laterans '
Lig. patellae
Fig. 1 325
Fig. 1326
Te nsor fasciae latae m uscle, M . tensor fasciae latae. a n d sarto rius muscle. M . sa rtori us.
Quadriceps femoris muscle , M . q u a d ri ceps femoris.
M pectineus .. ...-- M. adductor longus M. adductor brevis
M. adductor mag nus
M. gracilis
M.
Fig. 1327
Adductor muscles, Mm. a d d uctores.
Iliacus
Fig. 1 328
I lio psoas muscle, M i l i opsoas.
To p o g ra p h y Thigh
Leg
S e ct i o n s Foot
Muscles of the thigh
M, Iliopsoas
(
M, psoas major M Iliacus ------,U/,--'
Lig inguinale ---j':?fli!-+-��U M, iliopsoas ---All
M. tensor fasciae latae ---.H."
-;.-:+-- (M, psoas minor)
.,......;.",---- Arcus iliopectineus
1<:......30 . ....,..
_ _
Lig. pectineum
l�iII:,-d,�.-- M. pectineus
M rectus femoris ---+t;:'I-
M. vastus lateralis -----'l�i.ti��...
Fascia lata, Tractus iliotibialis ---....
Bursa subtendinea prepatellaris ---¥:"r.;.:"";':i-:-:+. Caput fibulae ---I!iIf..'l'
M. vastus medialis
Femur, Condylus medialis Lig. patellae
Bursa subcutanea infrapatellaris
Fig. 1 329
M uscles of t h e t h i g h a n d the h i p ; after removal of the fascia lata except f o r t h e iliotibial tract. * Common i n sertion of the sartorius, g racilis and semitendinosus m uscles just below the medial condyle of the tibia [formerly known as the superficial pes anserinus, Pes a nserinus su perficialisJ
1 -7 T 42, 44, T 45 1 T
�
Lowe r L i m b
S ke le t o n
S u rface �� �
Muscles of the thigh
M.
iliacus
M
psoas major
..... -- Promontorium M . sartorius tensor fasciae latae
M
gluteus medius
M
......,.---
--�.'
---r..;,o. ,
-
.0.,.-----
"1-
-'_ _ _
_ _
_-=---
M. iliopsoas ---;-,-:'-+-:----:-�
.1Bt---
M.
reclus femoris ----+t.�.;;.;.,IF�
M.
pirilormis
lig. sacrospinale Pecten ossis pubis
lig pubicum superius M.
pectineus
M.
adductor longus
M
gracilis
Canalis adductorius; A.; V. femoralis Septum intermusculare vastoadductorium
M
quadriceps femoris' M. vaslus lalerahs
M
vastus
----t\io\"�.\"
medialis
--.l����
_ _ _
M.
sartorius
Fascia lata ---.::. M.
Patella ---�rr---
-..."'1---- Femur. Condylus medialis lig. patellae
1-7 T
42.
T 44. T 45
1
----:--t=�-
Fig. 1330
M u scles of the t h i g h a n d the h i p ; after removal of t h e fascia lata. t h e tensor fasciae latae m uscle and the sartori u s muscle. * The fourth head of the quadriceps muscle. the vastus I ntermedius m u scle. is covered by the rectus femoris muscle.
Overview
M uscles Pelv i s
Hip
To p o g ra p hy Thigh
Leg
S e ct i o n s Foot
Muscles of the thigh
Spina iliaca anterior supenor
M. rectus femoris"
{
M, pinformis M , sartorius Bursa subtendinea iliaca
-====-'� caput rectum Caput reflexum ----'willi_ -
Pecten ossis pubis M , gluteus medius Lig iliofemorale M iliopsoas
----t:ll
��__-- M. adductor longus' '''
---flM'tf-:..L::""r'""i
��.�7tJf:t---
---lit".
M. pectineus
�"",I,--- M. adductor brevis
M vastus lateralis
--�....\
..1+--- M. gracilis ;.,.,.+__�-- M. adductor longus
��-- M. adductor magnus
Fascia lata
iJlI.IIII+-- Hiatus adductorius
--...;,;;t\
-11,,+--- M, vastus medialis M. vastus intermedius
--:;
-
:-\l....:..., .. ;,.;,'!1 ,;; �..,,'
M. rectus femoris, Tendo
----'--l,\.y.lr-'!
M sartorius, Tendo
..,."..- - Femur, Epicondylus medialis -
Patella ---;:,l�-
Lig. patellae
Fig. 1331
---:..:...�.;..;,.'-"
M usc les of the t h i g h and the h i p ; deep laye r after removal o f t h e sartorius, t h e rectus femoris a n d the adductor longus musc les as well a s parts of the i liopsoas muscle i n t h e j o i nt region.
C o m m o n inse rtion of the sartorius, g racilis a n d semitendi nosus muscles just below the medial condyle of the tibia The o r i g i n of the rectus femoris muscle has been flapped laterally u pwards. part of the adductor longus muscle has been flapped upwards,
*** A
1-7 T
42,
T 44, T 45
1
�
Lower li m b
S u rfa ce
S k e le t o n ���
Muscles of the thigh
M. sartorius
M piriformis
M. rectus femoris
Canalis obturatorius
M, pectineus
Bursa subtendinea iliaca
M. adductor longus
M gluteus medius
M. obturatorius externus
Trochanter minor
M pectineus
M adductor brevis ----L"
t;�!;.:..:���"I---- - M. adductor minimus M adductor magnus
M. vastus lateralis M adductor longus M. gracilis M, vastus medialis ---�"""',...<+ ..: ----!�\"
"",.J.!.l.--
Hiatus adductorius
M. vastus i ntermedius --....,;,.....� M, adductor magnus, Tendo
M. gracilis, Tendo
Bursa subtendinea musculi sartorii
M semitendinosus, Tendo
I� T
42,
T 44, T 45
1
Fig. 1 332
M uscles of t h e thigh a n d the h i p ; after a lmost com plete removal of superfi c i a l a n d several d e e p e r m uscles; ventral view.
Overview
M uscles Pelv i s
Hip
Sect i o n s
To p o g ra p hy Thigh
Leg
Foot
Muscles of the thigh
Vertebra lumbaUs V
Canalis vertebralis
Crisla UiaCll
M. Iliacus
M. psoas major
(M. psoas minor),
Tendo Spina iliaca anterior superior N. cutaneus femoris lateralis Lig. inguinale
Peclen ossis pubis
Canalis sacralis
(Foramen suprapiriforme)
-""..
_ _
N. genitofemoralis, R. femoralis N. femoralis
Arcus iliopectineus
(Foramen infrapiriforme)
A.; V. iliaca externa Ramus superior ossis pubis N . obturatorius; A.; V. obturatoria Ug. lacunare
M. ischiococcygeus [coccygeus]
Fascia obturatoria
Foramen ischiadicum minus Lig. sacrotuberale M obturatorius internus
Canalis obturatorius M.
sartorius
Symphysis pubica
(Arcus tendineus musculi levatoris ani) A. femoralis
M.
Ramus ossis ischii
Ramus inferior ossis pubis
adductor longus M.
M.
gracilis
M. rectus femoris M.
adductor magnus
M.
Fig. 1 333
M uscles of the thigh a n d the h i p ; medial view.
biceps femoris, Caput longum
semimembranosus
1" -7 22a, 42-T 46 1 T
T
�
Lower l i m b
S u rface
S k e le t o n ���
Overv i ew
Muscles of the thigh and the hip
M. gluteus maxlmus
M. semitendinosus
--
-----''<-'
'""'"
Caput longum
..-- Capul breve M. semimembranosus
Fig. 1334
D o rsa l muscles of t h e t h i g h .
)
Tractlls iliojibialis
--+----,r-__r_
M biceps
femoris
Fig. 1 335
Gluteus maximus m uscle,
M. g luteus maxim us.
M. gluteus medius
M. obturatorius internus
Fig. 1 336
Gluteus medius m uscle,
M . g luteus medius.
Fig. 1 337
Deep dorsal muscles of t h e h i p .
M uscles P e lv i s
Hip
To p o g ra p hy Thigh
Leg
S e ct i o n s Foot
Muscles of the thigh and the hip
Crista iliaca M erector spinae, ----"-I� Fascia thoracolumbalis
M gluteus medius, Fascia
----- M. gluteus maximus
..._--- Trochanter major
-------.li�
Sulcus glutealis
iliotibialis
Fascia lata ---<
M. gluteus maximus, Tendo
Fig. 1338
M. latissimus dorsI, Aponeurosis M . erector spinae, Fascia thoracolumbalis
(
M gluteus maximus
Foramen ischiadicum majus
M u scles of the t h i g h and the h i p .
""';;:ii���::;:;t'::�_-
� �;:::::-
':"' ....;:
Crista iliaca
-----'----
Fascia lata, (Fascia glutea)
----r�M _ _ _ _
- M. gluteus medius
��r���)
supra
(Foramen ----1.0+...-41 infrapiriforme)
,___,--_ M piriformis
Spina ischiadica Foramen ischiadicum minus Lig sacrotuberale
---'::;i'JHoiMI --i:.:t;,iiI
Ramus inferior ossis pubis
M. gemellus Inferior
-,;;;...----;.
Tuber ischiadicum
--------='---:lI
Ramus ossis Ischii
---�",-."
M. gracilis M adductor magnus M. semitendinosus M biceps femoris, Caput longum
Fig. 1 339
M. obturatorius internus'
Bursa trochanterica musculi glutei maximi
7---_ M. quadratus femoris
---�
M . gluteus maximus
�,.."'"';,;.
-
M. adductor minimus
---.;,;. ---�
M u scles of the t h i g h a n d the h i p ; the g luteus m a x i m u s m u scle has b e e n sectioned ; dorsal vi ew.
Tuberositas glutea
•
The part of the obturator intern us muscle between the c u rved edge of the lesser sciatic notch and the insertion in the trochanteric fossa frequently consists of tendinous bands.
1 -7 T
43, T 45, T 46
1
�
Lowe r L i m b
S u rface
S keleton ���
Muscles of the thigh and the hip
M. gluteus minimus (Foramen suprapiriforme) M. gluteus maximus M. pinformis M gemellus superior
(Foramen infrapiriforme)
M. tensor fasciae latae
M obturatorius internus
M gemellus inferior
Ug. sacrotuberale M. obturatorius internus
M. quadratus femoris
---t:;:---1i!5j1fi1
M. gluteus medius
Tuber ischiadicum
Trochanter major Bursa trochanterica musculi glutei maximi
M. adductor mag nus
-+-t-'rr,"'/.
_ _
M. gluteus maximus
M. gracilis M. semitendinosus M. biceps femoris, Caput longum M. biceps femoris, Caput breve
M semimembranosus
M. biceps femoris, Caput longum
M semitendinosus, Tendo M. semimembranosus, Tendo M. gastrocnemius, Caput mediale
1� T
43.
T 45. T
46 1
Fig. 1 340
M. gastrocnemius, Caput laterale
M uscles of the t h i g h and the h i p ; t h e g luteus max i m u s a n d medius m uscles have been partia lly remove d ; dorsa l vi ew.
Overview
M uscles P e lv i s
Hip
To p o g ra p hy Thigh
Leg
S e ct i o n s Foot
Muscles of the thigh and the hip
M gemellus inferior
M. gluteus maxim us M DlnTOnllIS,
M. obturatorius internus, Tendo __
Bursa trochanterica musculi glutei medii
(Foramen infrapiriforme) --������
Trochanter major
M. gemellus superior ---II/I�
M. obturatorius internus
----'tIN
M. obturatorius externus
Bursa ischiadica musculi obturatorii interni
M. Quadratus femoris
Lig sacrotuberale
glutei maximi '" �I!��r-.,.'---- M. iliopsoas, Tendo
Bursa trochanterica musculi
M. biceps femoris, Caput longum
M. semitendinosus
Trochanter minor
Foramen ischiadicum minus M sernirr,errlb"'no,su.;� M. adductor minimus
M
M adductor magnus
M. vastus lateralis M. semimembranosus
M. biceps femoris, Caput longum M. biceps femoris, Caput breve
M semitendinosus, Tendo
M semimembranosus, Tendo
M. gastrocnemius, Caput mediale
Fig. 1341
M. gastrocnemius, Caput laterale
M u scles of the t h i g h a n d the h i p ; d e e p layer after almost com plete removal o f the superficial g luteal a n d the ischiocrural m uscles; dorsal view.
1 -7
T 43,
T 4 5 , T 46
1
�
Lowe r l i m b
S u rface
S k e leto n ���
Overview
Muscles of the thigh and the hip
M obliquus externus abdominis
"'H-�'-- Spina iliaca anterior superior
M. gluteus maxirnus
--R,...� ..: r-,-.:>",�..".N lensor
�..-- M.
fasciae lalae
M. vast us lateralis
M biceps femoris, Caput longum
Tractus iliotibial is
M semimembranosus
M biceps femoris, Caput breve
-;!I--- Pat(!lIa M gastrocnemius, Caput laterale
Ug. patellae
1 -7 T
43,
T 44, T 46
1
Fig. 1342
M uscles of the thigh a n d the h i p ; after remova l of t h e fascia lata except f o r t h e iliotibial tract.
M uscles P e lv i s
H ip
To p o g ra p hy Thigh
Leg
Sections Foot
Muscles of the thigh
M. vastus medialis ----->�---4
M.
M sartorius
"=f-_�""
-
serrumembranosus
M. gracilis, Tendo M semimembranosus, Tendo
Patella
---3d. M. semitendinosus, Tendo
Retinaculum patellae mediale Corpus adiposum infrapatellare Lig. patellae M. gastrocnemius, Caput mediale
1 -7 T
Fig. 1343
M uscles in the region of t h e knee joint; medial view. * Common i nsertion just below the medial condyle of the tibia
44- T 46,
T 49
1
T 49
1
Iformerly known as superficial pes a nserinus, Pes anserinus superficialisJ
M vastus lateralis M adductor magnus
----;H-I::1'ITt, UR
-
M. biceps femoris, Caput breve M. gracilis
---\%1 -l���
Hiatus adductorius
-
M . vastus medialis
_
. ...____
M. biceps femoris, Caput longum
M , adductor magnus, Tendo --+11'-;'l1-li
M semimembranosus -----� -, �H
Articulatio genus, Capsula articularis M , sartorius
M semimembranosus, Tendo
-t---- M. biceps femoris, Tendo
-tl�f'tf.-lt'l
-
M. graciliS, Tendo
-1*1
_ _
M. semitendinosus. Tendo ----'l""',\.�
M. gastrocnemius, Caput mediale M. gastrocnemius, Caput laterale
Fig. 1344
M uscles in t h e region of the knee joint; after a lmost com plete removal of the isch ioc ru ra l m uscles; d orsal view,
1 -7 T
44- T 46,
�
Lower li m b
S keleton
S u rface ���
Origins and insertions of the muscles of the thigh and the ventral part of the leg
Tractus iliotibialis
M. extensor dlgitorum
M. gracilis
longus
M quadriceps femoris M. biceps femoris -----..j
__..--- M. semitendinosus
00-1---- M. sartorius
M fibularis [peroneus] longus
M. extensor digitorum longus
M. fibularis [peroneus] brevis
M
1-7 T 44-T 47 1
-----1;,;1
----
F-!--+4
----
extensor halluc,s
longus
...".-,---f---- M. tibialis anterior
-fool',
---i�""'.
Fig. 1 345
Origins a n d i nsertions of the m u scles at the bones of the leg ; ventral view.
Overview
M uscles Pelv i s
Hip
To p o g ra p h y Thigh
Leg
Sect i o n s Foot
Origins and insertions of the muscles of the thigh and the dorsal part of the leg
M. semImembranosus
-t-:<:��..:
-
M. popliteus
�_�:L._
_ _ _
M soleus
-l-V
-
..-....--- M tibialis posterior
M, flexor digitorum longus
----jl---,
a...-- M. fibularis [peroneus] longus
....1. -- M. flexor hallucis longus
....--- M. fibularis [peroneus] brevis
M. flexor hallucis longus, Tendo
M. tibialis posterior, Tendo M. flexor digitorum longus, Tendo
Fig. 1346
M. fibularis [peroneus] brevis, Tendo
M. fibularis {peroneus] longus, Tendo
Origins and i nsertions of the muscles at the bones of the leg ; dorsa l view.
1 -7 T
46,
T 48-T 50
1
�
Lowe r li m b
S u rface
S ke le t o n ���
Overview
Muscles of the leg Fig. 1347
Extensor muscles of the leg.
M tibialis anterior
--- +.........
1----/-- M fibularis [peroneus] longus
M e><1ensor dlgllorum longus
---\.-. 1 .
M. extensor
hallucls long us
--
C"-+-- M. fibulans [peroneus] brevis
-\+to"
Fig. 1348
Caput laterale Caput mediale
)
Lateral [fibular] muscles.
"+Hf-i-- M. flexor digitorum longus
M. gastrocnemius
.'-+1+- M. tibialis posterior M flexor haliucis longus
ff1i7!''"-;;-l;t--- (Chiasma cru rale) M. soleus
I....
r-
-
-
(Chiasma tarsale)
---r--++--- Tendo calcaneus
Fig. 1349
Tri ceps surae m uscle,
M. t riceps s u rae.
Fig. 1 350
Deep flexor m u scles of t h e leg.
M u scles Pelv i s
Hip
To p o g ra p h y Thigh
Leg
Sections Foot
Muscles of the leg
Patella
Tractus iliolibialls
.. _ ::.. ---\-,-.:�.......:
-----..!I-I',...
F.-IR_---- Tibia,
Condylus medialis
Ug. pateOae
Tuberositas tibiae
Uo----- M. gastrocnemius M. 'ibula�s (peroneus] longus
---+III
M. ubialis anterior -----4��
M. extensor digitorum longus
;;J----- M. soleus
-44---11......
-
M. fibularis [peroneus] brevis
�---- Tibia. Facies medialis
---....l,-�Iio
Septum intermusculare cruris anterius
-----l,�....
M. extensor ----....:,;H""·H digitorum longus M . extensor hallucis longus
011----- M. tibialis anterior. Tendo
--\+....�..,.
-
Malleolus lateralis
-----1i\o
M. extensor dlgitorum longus, Tendines
.....--- Malleolus medialis
�":rl""'+
Retinaculum musculorum extensorum inferius
-
M. extensor hallucis longus, Tendo
M extensor hallucis brevis
Fig. 1 35 1
M usc les of the leg a n d the foot.
l-t T 47. T 481
�
Lower l i m b
S ke le t o n
S u rface ���
Muscles of the leg
--/-4.fol-. mr l,'J
M. semitendinosus M semimembranosus M gracilis
---+--F.'-j.--#"I#-> ---!-�
Femur, Facies poplitea M semitendinosus. Tendo
M semimembranosus, Tendo
femoris
M . plantaris
--+-I�'II
---+-Hf-. ---l,..4�H::"';"
M. gastrocnemius, Caput mediale
M. soleus
M. biceps
-
M gastrocnemius, Caput laterale
---+1M _'1--- M. sole\IS
M. gastrocnemius. Tendo
M. plantaris. Tendo
Fascia cruris
---H��--,' ---.-lI.\I\
.....
_
Malleolus medialis ----'_
Tendo calcaneus • Tuber calcanei
---�I.j.!..,.;..j�
141;:"""";':'--;--- Malleolus lateral is
---��,...
Fig. 1 352
Muscles of the leg ; superficial layer.
* Also : Achilles tendon
Overview
M uscles P e lv i s
Hip
To p o g ra p hy Thigh
Leg
Secti o n s Foot
Muscles of the leg
M gastrocnemius, Caput mediale
M. biceps femoris M semimembranosus Bursa subtendinea musculi gastrocnemii medialis
----0-4-.....)
M gastrocnemius, Caput laterale
Bursa musculi semimembranosi Lig. popliteum arcuatum
Lig popliteum obliquum Tibia, Condylus medialis
A.; V poplitea; Arcus tendineus musculi solei
M. soleus
---1.J�Iit-::-
M plantaris, Tendo
M. gastrocnemius
M. fibularis [peroneus] longus
M gastrocnemius, Tendo
----l�""--
M flexor digitorum longus
---I....w. j
M tibialis posterior, Tendo
M. flexor haliucis longus
Septum intermusculare cruris posterius
Tendo calcaneus'
Retinaculum musculorum flexorum
Fig. 1353
M u scles of the leg ; superficial layer after partial removal of the ga stroc n e m i u s m uscle . • Also: Achilles tendon
Retinaculum musculorum fibularium [peroneorumJ superius
�
Lowe r L i m b
Skeleton
S u rfa ce ���
Muscles of the leg
M gastrocnemius, Caput mediale
Bursa subtendinea musculi gastrocnemii medialis
M. gastrocnemius, Caput laterale
Bursa musculi semimembranosi M. semimembranosus, Tendo Lig. popliteum obliquum
';;"!IIJ--- M. plantaris
-r--'--
--+--t-�":::::7
M tibialis posterior
--+-� M soleus Fibula, Margo interosseus
M flexor digitorum longus
M tibialis posterior
---J!.oo=H,-;!'-;--:M fibularis [peroneus] longus
M. flexor hallucis longus
M. flexor digitorum longus. Tendo
Malleolus medialis M tibialis posterior, Tendo M. flexor hallucis longus, Tendo Retinaculum musculorum flexorum
Retinaculum musculorum fibularium [peroneorum] superius Tendo calcaneus'
Fig. 1 354 M uscles of t h e leg ; deep layer. •
Also: Achilles tendon
Overview
M uscles
Pelvis
Hip
To p o g ra p h y Thigh
Leg
Secti o n s Foot
Muscles of the leg
M. gastrocnemius, Caput mediale Bursa subtendinea musculi gastrocnemii medialis M. plantaris Bursa musculi semimembranosi
------'Ir--�,..'''?
M. popliteus "'.--- M. biceps femoris, Tendo
Tibia, Condylus medialis --�i--
Recessus subpopliteus
M popliteus ------''I!fI-i-''-+1f.1'
Fibula, Margo Interosseus
nbla ----r M. soleus
M flexor digitorum longus
----:fI'-::-
M. tibialis posterior
----fl 'H*f--- M. flexor hallucis longus
M tibialis posterior, Tendo ---....f.1J .
M. flexor hallucis longus, Tendo M. flexor digitorum longus, Tendo ---l:+:,""
Retinaculum musculorum flexorum
M. fibularis [peroneus] brevis
---
Tendo calcaneus
Fig. 1 355 M uscles deepest layer.
of
the leg ;
�
Lowe r l i m b
S keleton
S u rfa ce ���
Overview Pelvis
Muscles of the leg
M. biceps ---\,.-&'+I-I femoris
Tractus iliotibialis
M quadriceps femoris, M , vastus lateralis
---I--llJIl+.�+l1
-
caput --����- fibulae
�11;_f�
Patella.
iM,j�---- Ug. patellae ----- Tuberositas IIbiae
M , gastrocnemius
--�....-'" .
M Sole�5
---- M. fibularis [peroneus] longus
---- M tibialis anterior
---H--If,. j
Septum intermusculare cruris anterius
----\-IHMO-..HI-.....
M. fibularis [peroneus] brevis
f------ M extensor digitorum longus ---+1-.1.1--lIl-+--•• M tibialis anterior, Tendo
Tendo calcaneus
Malleolus lateralis
M extensor hallucis longus
-----j..1-
Retinaculum musculorum extensorum inferius
f-!L1J!II= IE= :..;..
-
-
Retinaculum musculorum fibularium [peroneorum] superius M. extensor hallucis brevis
Tuber calcanei M, fibularis [peroneus] longus, Tendo
M, extensor digitorum longus, Tendines
Retinaculum musculorum fibularium [peroneorum] inferius M flbularis [peroneus] brevis, Tendo
J
M. fibUJa.ns peroneus] tertius, Ten 0 M extensor digitorum brevis
1 -7 T
4 7 - T 49, T 5 1
1
Fig. 1 356
M u scles of the leg a n d the foot.
M u scles
Hip
To pog ra p hy Thigh
Leg
Sect i o n s Foot Origins and insertions of the muscles of the th e foot and the leg
""""..----
M. triceps surae, Tendo calcaneus
M. extensor digitorum brevis; M. extensor hallucis brevis
M. fibularis [peroneus] brevis --...... M. fibularis [peroneus] tertius
M. abductor digiti minimi
Mm. interossei plantares
lL[)���.---t--
---<{::�r-+4���L i��'_
Mm. interossei dorsales pedis
M. abductor hallucis
Mm. extensores hallucis longus et brevis
Mm. exten50res digitorum longus et brevis
Fig. 1 357 Origins and insertions of the m u scles at the bones of the foot; dorsal view.
�
T 47, T 48, T 5 1 , T 53, T 54
�
Lowe r li m b
S ke le t o n
S u rface ���
Overv i ew
Tendon sheaths of the foot
M extensor digitorum longus
Lig. tibiofibulare anterius
M. tibialis anterior, Tendo
M. extensor hallucis longus
Retinaculum musculorum extensorum inferius Vagina tendinis musculi tibialis anterioris
Malleolus lateral is
Vagina tendinis musculi extensoris hallucis longi Retinaculum musculorum fibularium [peroneorum] inferius Vagina communis tendinum musculorum fibularium [peroneorum]
Va9'na tend,num muscuh elCtensons dlg,torum pediS long;
M fibularis [peroneus] brevis, Tendo
�I\�l--- M. tibialis anterior, Tendo
M. extensor digitorum brevis Tuberositas ossis metatarsi quinti
;-'1,..!.:.:..:.J.allk-- M extensor hallucis brevis
M abductor digiti minimi
WI'I'!i�-- Ligg. tarsometatarsalia dorsalia
M. fibularis [peroneus] tertius, Tendo (M opponens digiti minimi) Corpus ossis metatarsi I M extensor digitorum longus, Tendines
M. extensor hallucis brevis. Tendo
Mm. interossei dorsales pedis M. extensor hallucis longus, Tendo
Fig. 1358
o f the foot.
Te ndon sheaths, Vaginae ten d i n u m .
M u scles Pelv i s
Hip
To p o g r a p h y Thigh
Leg
Sections Foot
Tendon sheaths of the foot
M. extensor hallucis longus. Tendo M extensor digitorum longus
Vagina tendinum musculi extensoris digitorum longi
M fibularis [peroneus] brevis
Fibula
Retinaculum musculorum extensorum inferius
-.l,..l:�--+!A._
Vagina tendinis musculi extensoris halluc is longi M. extensor hallucis brevis
Retinaculum musculorum --l-----''..../J fibularium [peroneorum] superius Retinaculum musculorum fibularium [peroneorum] lnferius
M extensor digitorum longus, Tendines
_�_..:.._---=.;r; . '7:;';:;".T;"-:;
Vagina communis tendinum musculorum fibularium [peroneorum]
M. fibularis [peroneus] tertius, Tendo M. fibularis [peroneus] brevis, Tendo
Fig. 1359
Tendon sheaths, Vaginae ten d i n u m , of the foot.
Vagina tendinis musculi tibialis anterioris
Vagina tendinis musculi tibialis posterioris Vagina tendinis musculi flexoris digitorum longi
Retinaculum musculorum extensorum inferius
Vagina tendinis musculi extensoris hallucis longi
Vagina tendinis musculi flexoris hallucis longi
�
Vagina tendinis musculi flexoris hallucis longi
Vagina tendinis musculi tibialis posterioris
M. abductor hallucis,
Tendo
M. abductor hallucis
Vaginae tendinum dlgltorum pedis Vagina tendinis musculi flexoris digitorum longi
Fig. 1 360
Te ndon sheaths, Vag i na e te n d i n u m , of the foot.
�
Lowe r l i m b
S ke le t o n
S u rface ���
Overview
Muscles of the foot
M tibialis anterior. Tendo M. extensor hallucis longus
M. extensor digitorum longus
Malleolus lateralis
---¥if--NHoII:l:-irllt1
---f,,.;j....:::-1I1t:'::-Jr -H'Wo
-
Retinaculum musculorum extensorum inferius -----'I-'-' M. fibularis [peroneus] brevis, Tendo Retinaculum musculorum fibularium [peroneorum] inferius
M. extensor dig ito rum brevis
M fibularis [peroneus] tertius, Tendo
M extensor digitorum longus, Tendines
M. abductor digiti minlmi
---tJd� l'lr' -----+_+_
---+-11111-
-----jH....1tf"-
----;h�t�fi���If_.
---- M tibialis anterior, Tendo
---- M extensor hallucis longus, Tendo
M. extensor hallucis brevis
---fl�
Articulatio metatarsophalangea hallucis, Capsula articularis
Mm. interossei dorsales pedis
1
� T 47, T 5 1 , T 53
1
Fig. 1 361
Muscles of the foot ; after removal of the tendon sheaths.
M u sc les P e lv i s
Hip
To p o g ra p h y Th i g h
Leg
Sec t i o n s Foot
Muscles of the foot
M fibularis [peroneus] tertius
----,Htf-:'-...., M. tibialis anterior, Tendo
M extensor digitorum longus ---f,""".....,H-o
!•.. -"\--l'i"I-....;;;-
...t--- M. extensor hallucis longus
-
Malleolus lateralis
-----I,... �__-- Retinaculum musculorum extensorum -
M. fibularis [peroneus] brevis, Tendo
M. extensor digitorum brevis
M_ fibularis [peroneus] tertius, Tendo
M. abductor digiti minimi
inferius
----+1HII
-----JLH;
M, extensor hallucis brevis
---+--H.+-fr
----+''' ---- Mm_ interossei dorsales pedis
M. extensor digitorum brevis, Tendines
M extensor digitorum longus, Tendines
Fig. 1 362
M usc les of t h e foot; after section of the i nferio r extensor retinaculum.
1 -7 T 47, T
51,
T 53
1
�
Lowe r l i m b
S ke le t o n
S u rfa ce ���
Overview
Muscles of the foot
------=--c=-�MI.___- Lig. metatarsale transversum superficiale
Fasciculi transversi
Aponeurosis plantaris
---t�:";-:i�����iC::�--�
--dl+::'r.:iIi""_�'--'4-":""'-
(Eminentia plantaris lateral is) -----,"'"'-
9Jlllr-- (Eminentia plantaris medialis)
Malleolus medialis
Malleolus lateralis
Bursa subcutanea calcanea
Fig. 1363
Muscles of the foot; plantar aponeurosis, Apo n e u rosis plantaris.
M uscles Pelvis
Hip
To p o g ra p h y Thigh
Leg
S e ct i o n s Foot
Origins and insertions of the muscles of the foot and the leg
M. flexor digitorum brevis
M. flexor digitorum longus M. flexor hallucis longus, Tendo M. adductor hallucis, Caput transversum M. adductor hallucis, Caput obliquum Mm. i nterossei plantares M. abductor hallucis M flexor digiti minimi brevis M. abductor digiti minimi
J,jfljf-""')��--- Ossa sesamoidea
---,1J.l
, ,
M abductor hallucis, Tendo
J,!,I----�--- M . flexor hallucis brevis .;....:...-.!...-Af------4'--- M. fibularis [peroneus] longus Mm i nterossei dorsales pedis
:::::;.;�-- M. tibialis anterior
M. flexor digiti minimi brevis
--=;::.,..-- M . abductor hallucis
M. abductor digiti minimi
M, flexor hallucis brevis I I ,
M adductor hallucis, Caput obliquum
Ja._-.L--- M. tibialis posterior ,
M . fibularis [peroneus] longus, Tendo
'\
I I
I ,
J)':--t---:;1f�;;=---- M. quadratus plantae
_ _
M abductor digiti minimi
M. flexor digitorum brevis
Fig. 1364
Origins a n d i nsertio n s of the muscles at the bones of the foot; plantar view.
� T 47, T 48, T 50, T 5 2 -T 54
�
S ke le t o n
S u rfa ce
Lowe r li m b
���
Overv i ew
Muscles of the foot
Vaginae tend,num digitorum pedis
Pars crUCiformis
----!---- Pars anularis
Mm. lumbricales pedis IV-I
J-����=-lr-\.-1I1i!!t-T"tI�
-----+'-7-t,..-\l��
M. interosseus plantaris III
-c -- M. flexor hallucis longus, Tendo ...".,__-,--Jf---l-'.>1--- M flexor hallucis brevis
.. -' -....41 ------'-1
rIIt--- M abductor hallucis
mlnlml brevis
M. flexor digitorum brevis
Aponeurosis plantaris
1 -7 T 52 - T 54 1
Vagina tendinis musculi flexoris hallucis longi
�
M. adductor hallucis, Caput transversum
M. nexor diglll
j
Fig. 1365
M u scles of t h e foot; t h e plantar aponeurosis has been remove d .
M u scles P e lvis
Hip
To p o g ra p hy Thigh
Leg
Sections Foot
Muscles of the foot
-.,.,-jItiH-----M . flexor hallucis longus, Tendo Vaginae tendinum digitorum pedis
fhr-a_--- M flexor digitorum longus, Tendines
"':IIt:;:;.--- M. adductor hallucis,
M flexor digitorum brevis, Tendines
Caput transversum
'!!-!.!.11��;>t....--- M. flexor hallucis brevis
Mm , lumbricales pedis IV-I
-+.-::111---- M. flexor digitorum longus, Tendo
M. flexor digiti minimi brevis
�I---- Vagina plantaris tendinis
musculi fibularis [peronei] longi
M abductor digiti minimi
�I---- M. flexor hallucis longus, Tendo
M, interosseus plantaris III M. interosseus dorsalis pedis IV
M, fibularis [peroneus] longus, Tendo M, abductor hallucis
M quadratus plantae
M. abductor digiti minimi
Fig. 1366
M flexor digitorum brevis
M u scles of the foot; m i d d le layer after almost com plete removal of the flexor dig itorum brevis muscle .
1-7 T 50, T 5 2 -T 541
�
Lowe r l i m b
S ke le t o n
S u rfa ce ���
Overv i ew
Muscles of the foot
M. flexor digitorum longus, Tendines
--f-r.--;H---- M. flexor hallucis longus, Tendo
� :ItIt""t--'rtt-1-"""':H;---JJl..o,4�+\-\---- M , flexor digitorum brevis, Tendines
Mm. lumbricales pedis IV-I capul lransVersum M. interosseus dorsalis pedis I I I
":"';"�I!IIf+-'-"''''---- Caput obhquum
M m interossei plantares I I I e t I I M interosseus dorsalis pedis IV ---+-11..,-.�
j
M. adductor hallucls
-j---- M, flexor hallucis brevis
(M , opponens digiti minimi) ---.... 1.,\ M. flexor digiti minimi brevis
M abductor hallucis
M. abductor digiti minimi
--�;,.:--
M. fibularis [peroneusj longus, Tendo
M. flexor halluc is longus, Tendo
-----'.,....-
M. quadratus plantae
��o:--'-'i"'--- M flexor digitorum longus, Tendo' M. tibialis posterior, Tendo
Vj'tl---- Retinaculum musculorum flexorum Lig. plantare longum M. flexor hallucis longus, Tendo' M. abductor digiti minimi Aponeurosis plantaris
1-7 T 50, T 5 2 -T 541
M. flexor digitorum brevis
Fig. 1 367 M us c les of t h e foot ; deep layer.
* The site where the tendon of the flexor dig itorum longus muscle c rosses the tendon of the flexor hallucls longus muscle is commonly referred to as plantar chiasm, Chiasma p la nta re
M uscles P e lv i s
Hip
To p o g ra p hy Thigh
Leg
Sec t i o n s Foot
Muscles of the foot
Mm. interossei dorsales pedis I -IV
Fig. 1368
d o rsa l view.
--v-------�aI�-I
Dorsal interossei muscles, M m . inteross e i dorsa les ped i s ;
lWDlI--H--r-"I"-- Mm. interossei plantares 1 1 1 - 1
Fig. 1369
Plantar i nterossei muscles, Mm. i nterossei plantares; p lantar view.
�
Lower l i m b
S u rfa ce
I
S k e leton
���
Lumbosacral plexus
T1 2
N. iliohypogastricus (T1 2 , L 1) ----"y
N. ilioinguinalis (T1 2 , L 1) ---���
L2
Plexus lumbalis
L3
L4
N. femoralis (L2- 4) ------,:;;F'�". N. obturatorius (L2-4)
L5
....4 .
-
��
N. gluteus superior (L4, 5; 8 1 ) ---1C::::::C
S1
Truncus lumbosacral is
N. gluteus inferior (L5; 81 , 2) --"'7='r<''--'''' N. ischiadicus (L4, 5; 81 -3)
S2
{ N ' fibularis communis
Plexus sacralis
53
N. tibialis -.....,..6'-.�'7.
S4
N cutaneus femoris posterior (81 -3) --�;;-
85 Co
N. pudendus (82-4)
Nn. anales [rectales] inferiores
N. coccygeus
Fig. 1370
N. anococcygeus
Lum bosacral a n d coccyg eal p lexus, Plexus lum bosacralis ( P lexus lumbalis et sacralisl et coccygeus; segmental o rg a n isation of nerves.
Plexus coccygeus
Overview
I
M u s c les P e lv i s
Hip
To p o g r a p hy Thigh
Sections
Po p l i teal fossa
Leg
Foot
Nerves of the lower limb
N iliohypogastricus N . ilioinguinalis N. cutaneus femoris lateralis N. genitofemoralis N. femoralis
N obturatorius
----i----:---i--jI;,f'J.rlll
---f'--:-c'7f-#
---i--:-tf--I! --+-if-"T-H-lI P,\'R,,",';�I---T-- N. gluteus superior Nl'''''''-.f'-----T-- N. gluteus Inferior ��-lIIi'-.....J��+-- N. pudendus
---!--;.-:-<=:...
,....•t+-'II-..,,-+-:---
N. cutaneus femoris posterior
nt�...,....:.!-_ N. ischiadicus
N. saphenus
+-+-:ii-':-'''r---i
-
IIil+-f-:f---
N.
Irbulans
communis ---M�I
N
Jlbulans
profundus
--�i+.ftI.l.
If-hll'f-:---
N. flbulans superflcialls ---i� 1 N. saphenus
17---
N. cutaneus dorsalis medialis
N. cutaneus surae lateralls
N. suralis
N. cutaneus dorsalis lateralis
..../. I.
Fig. 1 371 overview.
N. cutaneus surae medialis
Ifj'f+--- R. communicans fibularis
-----::ii-#�
IIMI+---
Nn. digitales dorsales pedis
N. flbulans communis
"'"'�--=---
%J Nerves of the lower limb;
N. plantaris lateralis N. plantaris medialis
Fig. 1 372 overview.
Nerves of the lower l i m b ;
Lower l i m b
�
Ske leto n
S u rface ���
Overview
Cutaneous innervation
T1 2
T12
L1 11
L2 S4 S5
L2
L3
L3 --\--
L4
-1--- L4
--+--
L5
L5 _-1___
S1 L4
Fig. 1373
Segmental cutaneous i n nervation Idermatomesl of the lower limb.
Fig. 1374
Segmental cutaneous i n nervation Idermatomesl of the lower limb.
M u scles Pelvis
Hip
Top o g ra p hy Thigh
S e ct i o n s
P o p l i t e a l fossa
Leg
Foot
Cutaneous innervation
Nn. clunlum
1'1 cutaneus ---Io1i'""I!II femoris lateralls
N. genito lemoralis
I
R'
iliohypogastricus, cutaneus lateralis
Nn tumbales,
superlores
N. lIIohypogaslrlcus, R. CUlaneus antenor
femorahs
Nn. secrales, Nn. clunlum medii
A genltalis N. llloinguinalis,
Nn, scrotates
antenores
N. cuta neus
femoris
Iateralis
N. femoralis, -- ",",.AU�--I Rr cutanei anterio res N
J-H--- N, saphenus, R. infrapateliaris (N femoralis) N fibularis communiS, N. cutaneus surae lateralis (N. ischiadicus)
COmmUniS, 1'1 , cutaneus surae lateralis (N ischiadicus)
N. saphenus, Rr cutanei cruris mediales (N. femoralis)
N saphenus, Rr cutanei cruris mediales (N femoral is) N. suralls
(1'1. Ischiadlcus)
N flbulans
superflclalls (N. Ischladicus)
.. ..
I
N cutaneus
dorsalis Intermedius N cutaneus dorsalis medialis
.h�-- N . fibularis profundus,
Nn. digltales dorsales pedis (N ischiadicus)
Nn lumbales
Nn. sacrales
Fig, 1375
N Illohypo.. gastricus N. cutaneus lateralis .. femoris
..
Cutaneous nerves of the lower limb,
N . genitofemoralis
N. femoralis
.. Fig, 1 376
N. obturatorius
N, cutaneus femoris posterior
N. fibularis N, suralis
Cutaneous nerves of the lower li m b.
�
Lower li m b
��
Skeleton
S u rfa ce ���
Overview
Femoral and obturator nerve
N. iliohypogastricus ---l"'----K N. ilioinguinalis ---I-----T.i'---K N. genitofemoralis --+'F-H-+� N. femoralis --*-=,*---;../ N cutaneus femoris --I--H lateralis
N, oblUratoflus
,...-----+-- M psoas major r-:---\--t--- M . lllacus
r-+---t--- N. femoralls R. posterior
fT--,t-- R. anlerior
N. saphenus Rr. culanei anleriores
Membrana vasloadducloria
N Saphanus
\�:--\--.';i'"f--jlrll-- R. lnfrapatellarls
Fig. 1 377 Femoral and obt u rator nerve, N n . femoralis et obt u ratoriu s ; overview; cutaneous i n n e rvation illustrated with pu rple.
)
N obturatonus
M usc les P e Lv i s
Hip
To pography Thigh
S ect i o n s
P o p l i t e a l fossa
Leg
Foot
Gluteal nerves and sciatic nerve
N. gluteus superior -----,�
>-+---t-- Plexus sacralis
N. gluteus inferior .:t--r'-----i-t- N. ischiadicus
N pudendu5
N. cutaneus femoris posterior
N. flbularls communis
N. tibialis
Fig. 1378
Gluteal nerves, Nn. glutei, and sciatic nerve, N . ischiadicus; overview; cutaneous i n nervation illustrated with pu rple.
�
Lower li m b
��
Ske leto n
Surface ���
Overview
Tibial and fibular nerve
++"'=1"-1--- N ischiadicus
14--1+..4-'4-.f--- N. tibialis
N ischladlcus
---r--J
_IH-- N. fibularls communis
Arcus tendineus musculi solei
N. fibularls communis
--..,.,,... N. flbularis superficialls
N. culaneus ---I"l"""'''
surae latemhs
N ftbularls
prof\Jndus
N sural is
r";..;"o..,r--
N
suralis
N. culaneus --+--+H� � laleralls
M:>r---
N culaneu� dorsalis medialis
dorsallS
'100","':"'+-- N. plantaris lateralis N, fibularls
prolundus
N plantaris medialis
Fig. 1379
Tibial n e rve, N . tibialis; overview; cutaneous i n n e rvation i llustrated with pu rple.
Fig, 1380
Fibular nerve, N. fibularis; overview; cutaneous i n nervation illustrated with p u rp le,
M uscles P e lv i s
Hip
S e ct i o n s
To pog ra p hy Thigh
P o p li t e a l fossa
Leg
Foot
Arteries of the lower limb
...ri...UI------- A. femoralis
A.
A. glutea inferior
""'-....::cIIIFr---+-- A. circumflexa
circumflexa femoris lateralis
femoris medialis
R ascendens --�--����
A profunda femoris
R descendens
I-l-ll- �-+-- Aa. perforantes (1; 1 1 ; 1 1 1)
Aa perforantes ( 1 ; 11; 111)
\---1-- A. descendens genus
R. saphenus
\-----4-- R. articularis A. superior lateralis genus
A. inferior lateralis genus A. recurrens liblalis anterior
A superior medialis genus
LS����f}t- Rete articulare genus
_ _
-+-+41
A. inferior medialis genus
A. poplitea
A superior medialis genus A. suraOs A inferior medialis genus A tibialis posterior
A. tibialis anterior
A tibialis anterior
A. fibularis, R. perforans
A. malieolaris anterior lateralis
A tarsalis laterahs
(A. arcuata)
Fig. 1381
A. fibularis
A malieolaris anterior medialis A dorsalis pedis
metatarsales tll!MfHlt"l'tt-- Aa. dorsales
Arteries of the lower l i m b ; overview; ventral view. The segment of the femoral a rtery between the point where the deep a rtery of t h i g h branches off a n d the point of entry i nto the add uctor canal 1'1 is known clin ically as superfic i a l fe mora l a rtery.
�.jl.,il-- R communicans Rr. mall eo lares mediales A. plantaris medialis
Rr. malieolares laterales
1iiIIr..�H--- A. plantaris lateralis
jfJi::.·l.j��IM,lI.._ Arcus plantaris profundus
Fig. 1382
Arteries of the lower li m b ; overview; d orsal view.
�
S keleton
S u rface
Lowe r li m b
���
Overview
Veins and lymphatics o f the lower limb
k�--- Nodi Iymphoidei inguinales
/l('l-H�f\+.--- v, saphena magna
iE---:--!-f7--- V. saphena parva
a
Fig. 1383 a, b
b
Vei n s a n d lymphatics of the lower limb;
a Medial view b Dorsal view
overview.
a
b
__
-
7
2
V. superficialis --";--l-"1Il"�
"i'__�"--+--- V. communicans
Valvula --��
1IIIr------'- 3
5
Fig. 1 384
9
1 DODD's veins 2 HUNTER's vein 3 BOYD's vein 4 V. arcuata cruris posterior 5 SHERMAN'S vein 6 COCKETT'S veins 7 Deep perforating vein of HACH 8 Popliteal perforating vein 9 MAY'S vein 10 Lateral perforating vein
a, b Perfora t i ng veins, Vv. perfora ntes; overview (accord i n g to HAC H , 1 986 1 . a Medial view b D o rsal view
V. perforans ----:--r-::.ft,J"',
V. profunda
�t-:--io
-'-:-i
Fig. 1385
-.
1-+--- Valvula ...;--- Fascia
Vei n s of the lower limb; princi ple of o rg a n isation. D i st u rbances of the venous flow of the lower limb, especia lly varicosis, a re a common cause of vascular d isord e rs . I f one of the v e n o u s systems i s enti rely occluded, the perforati n g veins may be of crucial i m p o rtance to maintain the venous d rainage.
M uscles Pelvis
Hip
To pog ra p hy Thigh
S e ct i o n s
Popliteal fossa
Leg
Foot
Vessels and nerves of the thigh
R. cutaneus anterior (N. iliohypogastricus) A ; V. epigastrica superficialis • •
•
N. Ilioinguinalis
• V. femoralis
N cutaneus femoris lateral IS
• • Aa.; Vv. pudendae externae
R. femoralis (N genitofemoralis)
.---IoIIiWW"-,--i-- • V. saphena accessoria (Iateralis)
A ; V. circumflexa ilium superficialis • •
• V. saphena magna
Rr. cutanei anteriores (N femoral is)
Rr. cutanei (N. obturatorius)
R. infrapateliaris (N saphenus)
860
Fig. 1386
Epifascial vessels and nerves of the i n g u i na l reg i o n , Regio i n g u i nalis, t h e a nterior region o f t h i g h , Regio femoris anterior, and the a nterior reg i o n of knee, Regio genus a nterior.
t /� 1403
1 39 1
�
Lowe r l i m b
S ke le t o n
S u rfa ce ���
Ove rview
Lymphatics of the inguinal region
Lig inguinale V. circumflexa ilium superficial is
V. epigastrica superficiali s Nodi Iymphoidei inguinales superficiales
...._ . -- Funiculus spermaticus
V. saphena magna
Vv. pudendae externae
�,----- V. saphena accessoria (medialis)
1':.li------ V saphena magna M adductor longus
Fig. 1 387
Superfi c i a l lym phatics, lymph nodes a n d major ve ins of the i n g u i na l reg i o n , Regia i n g u inalis .
M. psoas major
.:-;>----++-- Nodi Iymphoidei iliaci interni
---+�:fiII\"':'r'r�
p........ . .; ..;..,I=--fqj:f-- A.; V. iliaca interna
Nodi Iymphoidel Iliaci externi, ---f-,� Nodi laterales
Nodi Iymphoidel iliaci externi, ---¥r'�� Nodi mediales A ; V iliaca externa
Nodi Iymphoidei inguinales superficiales, Nodi superolaterales Lig. inguinale Nodi Iymphoidei inguinales superficiales, Nodi superomediales
Rectum
--+��:--'
Ovanum Uterus
-lr----1s:::��110...
_J-----%-l��� _-l�----"ir\�� Hiatus saphenus --'-----1r-�� ., _c"'l _ ...
Vesica urinaria
Nodi Iymphoidei inguinales, (Nodi profundi) Nodi Iymphoidei inguinales superficiales, Nodi inferiores
Fig. 1 388
D ra i n i n g areas of the lymph nodes in the i n g u i n a l region, Regia i n g u i nalis, of the female ; overview. The arrows i n d icate poss i b le d i rections of the flow of lymph . •
I n some rare cases, the medial parts of the uterine tube and the fundus of the uterus may be d rained by superficial lymph nodes in the i n g u i n a l region via the round ligament of uterus.
M u s c le s Pelvis
Hip
To pog raphy Thigh
S e ct i o n s
P o p l i t e a l fossa
Leg
Foot
Vessels and nerves of the inguinal region
• M psoas major
M iliacus .
• (M. psoas minor), Tendo
N fernoralis
Arcus iliopectineus
Lig. inguinale ----"-'
Fascia lata ----::-""'_
Cornu superius -----�"" Margo falcijormis
• • A.; V. femoralis
(Nodus Iymphoideus lacunaris medialis)' Lig. lacunare**
• V. circurnflexa iliurn superflcialis
qfi::����i=== Lig pubicum superius
• V. epigastrica superficial is
��ti���--- Fascia lata
Cornu inferlus ---..:....---�
• Vv. pudendae externae
V. saphena magna .
Fig. 1389
Saphenous opening, H iatus saphenus, a n d va scular space, Lacuna vaso ru m ; after removal o f t h e a nterior abdom i n a l wa ll a n d t h e contents o f t h e abdomen, as well as d issection of the i liac fascia a n d the femora l sept u m [ CLO Q U ET ) . Al s o : R O S E N M U LLER's node Al s o : G I M B E R NAT's ligament
* **
Vagina musculi recti abdominis, Lamina anterior
M . obllQuuS extemus • ----.J�����;__;�!1� abdomlnls N cutaneus femoris lateral is Spina iliaca anterior superior
---.J�k-....,.:�9i" : .� ----1!2.��",. .:;;..--.:���iJ"\l\i .,:r::
Lig. inguinal e M. iliopsoas •
N femoralis Arcus iliopectineus --.-;...,-tI ....; H-mr.-... (Bursa iliopectinea)
Lig. pectineum
(Nodi Iymphoidei lacunares) Lig lacunare Funiculus spermaticus
Lig. inguinale �::Ii�����j���#C="C Tuberculum pubicum Symphysis pubica
Membrana obturatoria
Canalis obturatorius N obturatorius
Fig. 1390
M u scula r a n d vascular space, Lacunae musculorum et va soru m ; oblique section at t h e level o f t h e i n g u i n a l ligament.
�
Lower li m b
S ke le t o n
S u rface ���
Ove rview
Vessels and nerves of the thigh
N femoralis
N. cutaneus femoris lateralis
Lig inguinale
• A. iliaca interna
--n�lM��
A. circumilexa ilium profunda . --tr.rt-'k-�.;I M. iliacus . ---,H'Ill-�"'':'
• M. pectineus
N . femoralis
m,.---....-- • V saphena magna
A profunda femoris • _�--ft-"'r�
R. muscularis (N femoralis)
A. femoralis' •
• V. femoralis
M. tensor fasciae latae •
• M. adductor longus M rectus femoris .
• M. gracilis
• M. sartorius
R articularis . (A. descendens genus) 1 1 54 1 1 56 1 1 59
1 386
Fig. 1 39 1
�
1 407
Rete patellare • 1 3 92
Lig. patellae
Vessels a n d nerves of the anterior reg ion of thig h , Regio fe moris anterior; after removal of the fascia lata except for the iliotibial tract.
•
Clinica lly the femoral artery is commonly referred to as superficial femoral a rtery to d isti n g u i s h it from the deep a rtery of thigh.
M u scles P e lv i s
Hip
To pog ra p hy Thigh
Secti o n s
P o p li t e a l fossa
Leg
Foot
Vessels and nerves of the thigh
N. obturatorius
N cutaneus femoris lateralis
• M pectineus
N. femoralis
• R acetabularis (A obturatoria)
M. iliacus .
• R. anterior (A. obturatoria) N. obturatorius
A. circumflexa femoris lateralis •
;;,..._W_-- • A. circumflexa femoris medialis
A. profunda femoris .
r.I""''''.--- • R. superficialis
(A. circumflexa femoris medialis)
M. sartorius • ---l�Ir.!
R descendens . --- ��J,l� (A. circumflexa femoris lateralis)
• V femoralis
• A. femoralis
M rectus femoris • ------'M�
R.
N. saphenus
R muscularis (N. femoralis)
Septum intermusculare vastoadductorium*
N saphenus
M vastus medialis • --""�"'�:"';".J R. articularis (A descendens genus)
cutaneus (N. obturatorius)
• --+�"'�N�
1 1 54 1 1 56 1 1 5?
1 39 1
Fig. 1 392 Vessels a n d nerves of t h e anterior reg i o n of t h i g h , R e g i o fe moris a nterior; after partial removal of the sarto rius muscle a n d d issectio n of the pectineus muscle.
*
t /,
1 393
1 408
The entra nce i nto the adductor canal is formed by the vastus medialis and adductor longus muscles as well as by the a nteromedial I nterm uscular septum spanning between them.
�
S ke le t o n
S u rfa ce
Lowe r L i m b
���
Overv i ew
Vessels and nerves of the thigh
N
obturatorius •
A
femoralis
N
N. obluratonus •
M. iliacus .
•
A. profunda femoris . A circumflexa
femoris lateralis
A_ circumflexa femoris medialis
A obturalDria
V. femoral is
�..--- • V profunda femoris
{R. ascendens •
HMt-- • M. adductor brevis
R descendens .
•
-"-=--
Rr musculares (N femoralis)
•
M. adductor longus
A. perforans
R. cutaneus (N. obturatorius) • M. adductor longus
•
A_ perforans .
•
M vastus lateralis •
��rJ\'k�"�'fjlJl--
R muscularis (N femoral is)
M
A. descend ens genus, Rr. artlcular6S
1 1 54 1 1 56 1 1 59
1 408
•
A. femoralis
Fig. 1393
A. descendens genus. R saphenus
•
Rete ar1lCuiare genus .
1 392
• M. adductor magnus
•
N saphenus
�..
M. gracilis
� "H.-- Hiatus adductorius
M. rectus femoris .
l ·t4'
V femoralis
A poplitea
IIII� II ""'--- • A. inferior medialis genus
Vessels and nerves of the a nterior reg i o n of t h i g h , Reg i o femoris a nterior; deep layer after part i a l removal of the sartorius and rectus femoris muscles, the pect i neus a n d adductor lon g u s muscles have been d i ssected; the adductor canal is alm ost entire ly opened.
M uscles P e lv i s
Hip
Topography Thigh
Sect i o n s
Poplitea L fossa
Leg
Foot
Arteries of the pelvis and the hip
Aorta, Bifurcatio aortae A, iliaca communis
A. iliaca interna
A, IIlaca eXll;lma
A. clrcumflexa Ilium profunda
" ��E�=========
A epigastrica superficialis A . circumflexa ilium superficialis
'III
R. ascendens
A. profunda femoris
R. pubicus
---!l�===f!rr�-------- Aa. pudendae externae """'iiiJI�""""IIii;:=---- R. acetabularis
-==�t=�:S�==�; �:I'�
R. anterior
R. posterior
A. circumflexa femoris lateralis -
R. transversus
R. obturatorius
-'.----- Lig. inguinale
A. femoralis
R. ascendens et R. transversus
A. epigastrica inferior
----\-----..... �.
A. obturatoria
A�A"
_ _
R. acetabularis
A. circumflexa femoris medialis
R. profundus
R. descendens
R. superficialis
Aa perforantes
R. descendens Fig. 1 394
The branching pattern of these a rt e ries varies considera bLy. This type of origin and a rborisation of the deep a rtery of thigh occurs i n approximateLy 58% of cases.
Arteries of the h i p a n d the thigh;
overview.
Pars abdominalis aortae [Aorta abdominalisj
A. iliaca communis
---:--r-�::"",-�----:r-:.=- ..."
_ _ _ _ _ _ _ _ _ _ _ 1-
_ _
A. iliaca extern a
--------:;;It7'f
A iliaca interna
--------:--.�
_----�C--I-- A. lumbalis V
Jl------.;....--��--
;,....::-=-:---
A. sacralis mediana
A. glutea superior
A. obturatoria
A lemoralls
A profunda lemorls
Fig. 1 395 Arteries of the peLvis a n d the thigh; d ig itaL s u btraction angiography [ DSA! .
�
Lower L i m b
S keleton
S u rface •••
Overview
Veins and nerves of the thigh
Nn clunium superiores (L 1 -L3) R. cutaneus lateralis (N. iliohypogastriCuS)
Nn. clunium medii (51 -53)
Sulcus glutealis
.. _f.£ Nn. clunium inferieres (N. cutaneus femoris posterior) _-I-A-i'li-..I-
't..� .rtlf-- N. cutaneus femoris lateralis
Fascia lata R cutaneus (N. obturatoriusl
IHh-'i;f-�J-- N. cutaneus femoris posterior
V saphena magna 812
t � 1 404
V saphena parva
1 398
Fig. 1 396
EpifasciaL veins and nerves of the posterior reg i o n of t h i g h , Reg i o femoris posterior, the g LuteaL reg i o n , R e g i o g LuteaLis, and the popLiteaL fossa , Fossa popLitea.
Crista iliaca Spina iliaca anterior superior
Spina iliaca posterior superior
Crista sacralis mediana
N gluteus superior
Foramen ischiadicum majus
==�������i7.9
N. ischiadicus
N gluteus inferior,
--T-""7:-�::J.'::L
N. pudendus Lig sacrospinale
Tuber ischiadicum
Lig. sacrotuberale
Tuber ischiadicum
M piriformis Trochanter major
N cutaneus femoris posterior
Fig. 1397
SkeLeton contour and sciatic nerve, N. ischiadicus. proj ected onto the s u rface of the gLuteaL reg ion. Reg i o g Lutea Lis.
}
(Foramen supraPiriformel Foramen ischiadicum (Foramen infrapiriforme) maJ us
M u sc le s P e lv i s
Hip
To pography Thigh
Sections
P o p l i t e a l fossa
Leg
Foot
Vessels and nerves of the thigh
•
M gluteus medius, Fascia
Nn. clunium medii (St -S3)
M. gluteus maximus •
Nn clunium inferiores (N. cutaneus femoris posterior) l�--- Tractus iliotibialis
N. cutaneus femoris posterior
M gracilis .
M semitendinosus . ---It:-;IIIf.H-H.. ,mll M. semimembranosus . V. poplitea .
M. semimembranosus .
A. poplitea •
--���...:;jJ..
--iH=1RhlJJf,1 ,
M. gastrocnemius . __-+IIrl=MIL:lIo
N cutaneus surae medialis
N. tibialis
N. fibularis communis
N. cutaneus surae lateralis (N. fibularis communis) •
M. biceps femoris, Tendo 1 399
Fig. 1398
Vessels and nerves of the g luteal reg i o n , Regio g lutealis, the poste rior reg ion of t h i g h , Regio femoris posterior, and the popliteal fossa, Fossa poplitea.
1 396
?�
1 ':; 1 1
�
S k eleton
S u rfa ce
Lowe r l i m b
���
Overv i ew
Vessels and nerves of the thigh
Nn. clunium superiores (L 1 -L3)
Nn clunium medii (81-83)
(Fascia glutea)
+-rl--- • M. gluteus maximus . ... ....:.,�,...'---H ....� Nn clunium inferiores (N. cutaneus femoris posterior) N. ischiadicus N. cutaneus femoris posterior
....--ihtf-l.-fl'l---- • A. periorans �1ffl1H1-h1rli""'--- • M biceps femoris. Caput longum
N tibialis ' M. semitendinosus . ----I...
11:.:>11"""--- • Aa. periorantes N fibularis communis
M. semimembranosus .
-jM7-iI
-
M. sartorius . ---j'" V poplitea .
---+---+''''fJ'-j�''
A superior medialis genus • --�-iI--I+i...JI Rr. musculares (N. tibialis)
M. gastrocnemius, • ----I�.,.. Caput mediale
N. cutaneus surae lateralis N. cutaneus surae medialis
N. suralis
.;,. --- . M. gastrocnemius, Caput laterale ;: ,.M:;...-
1 40 0
Fig, 1 399
1 398
Vessels a n d nerves of the g luteal reg i o n , Reg i o g lutealis, the posterior region of t h i g h , Reg i o femoris poste rior, a n d t h e popliteal fossa , Fossa poplitea ; the long head of the biceps femoris m uscle has been retracted latera lly. I n t h i s spec i m e n , the medial and lateral s u ra l cutaneous nerves branch off q u ite fa r proximally.
M u s c le s P e lv i s
Hip
To p o g ra p h y Thigh
S e ct i o n s
P o p l i t e a l fossa
Leg
Foot
Vessels and nerves of the thigh
A glutea superior, R superficialis .
M. gluteus maximus •
• M obturatorius internus • M gemellus inferior
N gluteus inferior
A. glutea inferior .
A.; V. pudenda interna •
---1*""'11
• R. ascendens (A. circumflexa
-
femoris medialis)
• R. superficialis (A circumflexa femoris medialis)
•
• M. quadratus femoris
N cutaneus femoris posterior
----- •
R. profundus (A. circumnexa lemoris medialis)
.---- . A. perforans
N ischiadicus
1----- . M. adductor magnus
Rr. musculares (N tibialis)
M biceps femoris, Caput longum
•
----__
M semitendinosus . ----�••fH-':JifH
M. semimembranosus .
V poplitea .
-till-'
1::H1fIlf---- • Aa. perforantes
'----- • M. biceps femoris, Caput longum
• M biceps femoris, Caput breve
-
------,...Hh
-
N fibularis communis
N tibialis
N. cutaneus surae medialis
N . outaneus suras lalerails
�
Fig. 1400
Vessels and nerves of t h e g luteal region. Regio g lutealis, the posterior region of t h i g h , Regio femoris posterior. and the popliteal fossa , Fossa poplitea ; after d issection of the g luteus max i m u s m u scle and the long head of the biceps femoris muscle .
1 399
,
141 1 1413 1414
�
S keleton
S u rface
Lowe r l i m b
���
Overview
Vessels and nerves of the gluteal region
.,..---- Trigonum lumbale Rr profundi • (A.; V. glutea superior)
R cutaneus lateral is (N. iliohypogastricus)
•
•
M. obliquus externus abdominis
N. gluteus superior
N gluteus inferior A.; V. glutea inferior •
•
M. gluteus maxim us . --;?i:=
iI'iIIl---
N. cutaneus femoris posterior
M gluteus maximus M. piriformis
:21.......-- • M. gemellus superior
N. ischiadicus
A ; V. pudenda interna •
•
•
•
M. obturatorius internus
• •
Lig. sacrotuberale •
M. obturatorius extern us
M quadratus femoris
Trochanter minor Rr. profundi (A circumflexa femoris medialis)
•
Fig. 1401
Vessels a n d nerves of the g luteal reg i o n , Regio g lutealis; after d issection and partial removal of the g luteus maximus and medius m uscle s ; the sciatic nerve has b e e n removed after i t s passage t h ro u g h the i nfra pi riform fora m e n .
--------f- Crista iliaca �\--+--- Spina iliaca anterior superior N. gluteus superior
---;--l----'''---<:--;-'''''f:;:J.
N. ischiadicus
-/r--#-hl---30..--- M. gluteus medius
-------'\--�-J--� Trochanter major
Fig. 1402
Ventrog luteal i njection [accord i n g to v. HOCHSTEHER ] . In order to avoi d t h e superior g luteal nerve a n d , in particular, the s u perior g luteal a rtery the i njection i s made i nto the triangular field formed by the two spread fingers and the iliac c rest. The i ndex finger - o r when u s i n g the right hand, the m i d d le finger - is placed o n the anterior superior iliac s p i n e
a n d the palm of the hand on the g reater t rochanter. Since the i njected material should be deposited within the belly of the g luteus medius m uscle as fa r away a s possi ble from any vessel, the needle should not c ross the lines of the t ri a ngle. However, some risk remains for the nerve branch that runs from t h e s u p e r i o r g luteal n e rve to the t e n s o r fasciae latae m uscle.
M u scles P e lv i s
Hip
To pog ra phy Thigh
Sections
PopliteaL fossa
Leg
Foot
Veins and nerves of the leg
v.
Patella
R. infrapatellaris (N. saphen us)
saphena magna
N. saphenus
v. saphena parva N. cutaneus surae lateralis (N. fibularis communis)
N. saphenus v.
saphena magna
V perforans ----Hy'--¥\,___�
v.
Rr cutanei cruris mediales (N. saphenus)
(V. arcuata cruris posterior) ----I
Rr. cutanei cruris mediales (N saphen us) V. saphena parva
perforans'
N. suralis
Fascia cruris
Fascia cruris
Rr. cutanei cruris mediales (N. saphenus)
Rr. Qutanel cruris -��'" mediates
N fibularis superficialis
(N. saphenus)
V. marginalis lateralis
Arcus venosus dorsalis pedis
N cutaneus dorsalis lateralis (N suralis) 1 396
1 386
..-'t��
t
Fig. 1403
Epifascial ve i n s and nerves of the leg and the foot, Regiones cruri s et pedis.
Fig. 1404
Epifascial ve i n s and nerves of the leg and the foot, Regiones cruris et pedis; the deep fa scia of leg has been d i ssected prox i ma lly.
* C l i n ical term: MAY's vei n
�
Lowe r l i m b
S u r fa c e
I
���
S k e le t o n Overview
I
Vessels and nerves of the leg
V. saphena magna . v.
saphena parva •
Nodus Iympholdeus pophteus superflcialls
A. poplitea .
-----Jl-.�---N. tibialis
Nodi Iymphoidei poplitei profundi
.......,.'>1----------1--- • V. poplitea
Vasa Iymphatica superficialia
----<--- Fascia cruris M. gastrocnemius . v.
B-----------;---- • V. saphena parva
saphena magna .
Fig. 1405
Vessels a n d nerves of the popliteal fossa , Fossa poplitea ; after d issection of the deep fascia of leg a n d part i a l removal of the small sa phenous ve i n .
Compartimentum cruris anterius:
A ; V tibialis anterior N fibularis profundus M. tibialis anterior M. extensor digitorum longus M extensor hallucis longus M. fibularis [peroneus] tertius 2 Compartimentum cruris laterale:
Fascia cruris
N fibularis superficialis
M. fibularis [peroneus] longus M fibularis [peroneus] brevis
Septum intermusculare cruris anterius
3 Compartimentum cruris posterius, Pars profunda:
A. ; V. tibialis posterior A. ; V. fibularis N. tibialis M. flexor digitorum longus M. tibialis posterior M. flexor hallucis longus
4 Compartimentum cruris posterius, Pars super· ficialis:
M. triceps surae M plantaris
Septum intermusculare cruris posterius Fibula V. saphena magna Fascia cruris
�.J..;�
N. saphenus
_ _
Fig. 1406
N. cutaneus surae medialis V. saphena parva
Osteofi b ro u s tubes of the leg ; cross-section s u perior to the mi ddle of the leg . These osteofibrous tubes together with their contents a re c l i n i cally known a s compa rtments.
* Deep part of the deep fascia of leg
M u scle s P e lv i s
Hip
To pog ra p hy Th i g h
Sections
Popliteal fossa
Leg
Foot
Vessels of the leg
Caput fibulae
Tuberositas tibiae
M. fibularis [peroneusj longus • • M . tibialis anterior (Nodus Iymphoideus tibialis anterior) Vasa Iymphatica profunda Tibia. Facies medialis
Vv. tibiales anteriores •
• M. tibialis anterior, Tendo
M, extensor hallucis longus . M extensor digitorum longus .
Retinaculum musculorum extensorum inferius
Malleolus latera lis
Abb. 1407
Vessels of the anterior reg ion of leg, Regia cruris anterior; the extensor muscles s p read by retractors.
The su perticial lym phatics reg u la rly follow the major e pifasci a l ve i n s and converg e a long the g reat saphenous vei n t o the medial side of the leg. The deep lym phatics a re found within the connective tissue sheaths of the deep a rteries a n d vei n s of the leg.
�
Lowe r l i m b
S u rface
S ke le t o n ���
Arteries and nerves of the leg • A. superior medialis genus
• Rete articulare genus N fibularis communis M. fibularis (peroneus] longus .
--.".;;l- (U:...
M. extensor digitorum longus . A
• A tibialis anterior
N fibularis profundus N fibularis superficialis M fibularis (peroneus] longus . M. extensor digitorum longus .
'�jjlM-IIJ.f--- . M tibialis anterior
N. fibularis superficialis
N fibularis profundus
M fibulans (peroneus] brevis .
M. extensor digitorum longus .
Rete malleolare laterale •
-�'I;;�'JI
A malleolaris anterior lateralis •
+":":;5-- • M. extensor hallucis longus
----4IiIlk\lt-- Retinaculum musculorum extensorum inferius
N. fibularis profundus
M extensor digitorum brevis . M fibulans (peroneus] tertius, Tendo .
Nn. digitales dorsales pedis
• Aa. metatarsales dorsales 1 39 1 1 392
t
1 407
1416
Fig. 1408
Arteries a n d nerves o f t h e a nterior region o f leg, Regia c ru ri s a nterior, and the dorsum of foot, Dorsum ped is; after removal of the deep fascia of leg and d i ssecti o n of the extensor digitorum longus and fibularis [peroneusl lo ngus m uscles.
Overview
M u sc les Pelv i s
Hip
To p o g ra p h y Thigh
S e ct i o n s
Popliteal fossa
Leg
Foot
Arteries and nerves of the popliteal fossa
•
M. gracilis . M. semitendinosus •
M biceps femoris
-'4 ..fk/J ---lI'�rHlH
-
M. semimembranosus • -_�I-.:IIII
V. poplitea
•
-trl ft:1r-fN1"''rlI� '
-
---11�--'ttt�,..,f
A. poplitea .
--It:1H---'lif--IHl
A. superior medialis genus . V. saphena parva
-1
•
--+!-r-+-+-+
IO• .L.-""-T,.
-»
N. fibularis communis
III'!"-',,:!f,--''!-- • A. superior lateral is genus 46'\-:-:n-:-r-- " N. cutaneus surae lateralis _"*"w-t-- . Aa. surales
Rr. musculares (N . tibialis) N. cutaneus surae medialis M gastrocnemius, Caput mediale •
-----\:-.-+t-+-+-\-,;o
1 3 98
N. fibularis communis M . gastrocnemius, Caput laterale •
•
---+-:+:!-r-,.i\II\"
M. biceps femoris, Tendo 1 404
t/ �
1410
..
1 41 1
Fig. 1409
Vessels a n d nerves of the popliteal fossa , Fossa poplitea ; after removal of the fascia lata a n d the deep fascia of leg .
M. semimembranosus
M. semitendinosus
-'",,'WIf4:.1;:.:1:J.� M. biceps femoris
M. gracilis
Femur, Facies poplitea
A. descendens genus A. superior medialis genus
-lIH���•..JIjI!ll)l_1:i
M. semimembranosus -+-Hiit A. media genus
A. superior lateralis genus
--i--+"-fIII.�
M. gastrocnemius, Caput mediale Aa surales
M gastrocnemius, Caput laterale A. inferior lateralis genus
A. inferior medialis genus
1 399
A. tibialis anterior (Truncus tibiofibularis)
Fig. 1410
Arteries of t h e popliteal fossa , Fossa pop litea ; demonst ration of the a rterial supply after pa rtia l
M. soleus
1 409
�t;o( l 1 41 3
removal of the cove ring m uscles. This bra n c h i n g pattern is found in a bout 90% of the cases.
Lowe r L i m b
�
S ke le t o n
S u rfa c e ���
Overv i e w
Vessels and nerves of the popliteal fossa and the leg • M. biceps femoris
A. poplitea •
•
M semimembranosus . ---+lH�IU� '
A ; V. suralis
N. tibialis
V poplitea
'A--I.�l\tlt-- • V. saphena parva • M. gastrocnemius, Caput laterale
• • A.; V suralis
••
Rr museulares (N. tibialis)
N. fibularis communis
M gastrocnemius. Caput mediale • A inferior medialis genus . Vv tibiales posteriores
•
• M. soleus
Arcus tendlneus musculi solei
• M. gastrocnemius
• M. fibularis [peroneus] longus N.
tibialis
M tibialis posterior, Tendo .
•
M fibularis [peroneus] brevis
Malleolus lateral is
Retinaculum musculorum flexorum 1 400 1 398
? J
1 404
t �
1413
Tendo calcaneus
Retinaculum musculorum fibularium [peroneorum] superius
1 41 9
Fig. 1 4 1 1
Vessels a n d nerves of the popliteal fossa, Fossa poplitea, a n d the posterior reg i o n of leg, Regio cru ris posterior;
after removal of the deep fascia of leg a n d d issection of the gastroc n e m i u s m uscle.
Fig. 1 41 2 a-d
Va riations i n the b ra n c h i n g pattern of the popliteal a rtery, A. poplitea. a Common trunk of the a nterior and poste rior t i b i a l artery, Aa. tibiales a nterior et posterior, a long with the fibular a rtery, A. f i b u la ri s b T h e popliteal a rtery, A . poplitea, b ranches off p roxima lly to the superior border of the popliteal m usc le, M. popliteus. c Posteri o r t i b i a l and f i b u la r a rtery, Aa . t i bialis poste rior et f i b u laris, origi nate from a common proxi mal trunk. d The a nterior t i b i a l a rtery, A. t i bialis a nterior, passes ventra lly to the pop liteal m uscle, M . popliteus.
-4%
-3%
-
1%
M u s c le s Pelv i s
Hip
To p o g ra p hy Thigh
Sections
Popliteal fossa
Leg
Foot
Vessels and nerves of the popliteal fossa and the leg
N fibularis communis
A. popillea .
N. tibialis
V. poplltea .
A. inferior medialis genus .
A. poplitea
--\1i-'
•
•
A. fibularis
M soleus .
A. tibialis posterior .
N. tibialis
M. tibialis posterior .
M flexor digitorum longus .
• M. flexor hallucis longus ...v.--....I+. N tibialis
M. tibialis posterior, Tendo . Malleolus medialis Retinaculum musculorum flexorum
"" ".I"!r-- Retinaculum musculorum fibularium (peroneorum] superius
1 398 1 400
Fig. 1413
Vessels a n d nerves of the popliteal fossa, Fossa poplitea, a n d the posterior region of leg, Regio cruris poste rior; deep layer.
1411
t � 1 420
1414
�
Lowe r li m b
��
1L-__S_u_r_f a_c_e
Arteries and nerves of the leg
A. poplitea •
N tibialis
A. inferior medialis genus . M. popliteus .
A. tibialis anterior • (Truncus tibiofibularis)
•
---..,.+_--.;� ... ----\�....-f/
M. soleus .
--,*-H
• M. soleus
M. tibialis posterior . A. tibialis posterior .
---;,.-+.....
N. tibialis
M flexor digitorum longus .
----:-fo:l:r
• M fibulans [peroneus] longus
A tibialis posterior . "\�:.&I-- • M. fibularis [peroneus] brevis M. tibialis posterior, Tendo .
Rr malleolares mediales
•
M flexor hallucis longus, Tendo .
Rr. calcanei .
1 398 1 400
1413
t � 1 42 1
Fig. 1414
Arteries a n d nerves of the popliteal fossa , Fossa poplitea , and the poste rior reg ion of leg , Regio cruris poste rior; dee pest layer.
k_ le S_ e_ n� o_ _t_ �_
���
l e_s M u_ c_ S_
__ __
__
Overview
P e lv i s
�
__
Hip
To pog ra phy Thigh
S e ct i o n s
Popliteal fossa
Leg
Foot
Veins and nerves of the foot
N. saphenus N. cutaneus surae medialis (N. tibialis)
N. fibularis superficialis
Retinaculum musculorum ----MoIot=':;;::.=-=----f--=tr-!1"""' extenso rum Inferlus Malleolus lateralis
• V. saphena magna
Malleolus medialis
--- .a:;} l;al--- • V. saphena magna
N. cutaneus dorsalis medialis N. saphenus N cutaneus dorsalis intermedius
N. cutaneus dorsalis
lateralis
V. marginalis lateralis
"'--\-!--,,,t:\�"I--- • V perforans
•
N. fibularis profundus, Nn. digitales dorsales pedis
Arcus venosus dorsalis pedis .
Vv digitales dorsales pedis . Nn. digitales dorsales pedis
1 403
Fig. 1 4 1 5 Epifascial veins a n d nerves of t h e d o rs u m o f foot, Dorsum pedis.
.-t "
1416
�
Lowe r L i m b
S u rface
S ke leto n ���
Overview
Arteries and nerves of the foot
M extensor digitorum longus .
• M tibialis anterior, Tendo
M extensor hallueis longus .
R perforans (A. fibularis)
•
•
A malleolaris anterior medialis
A tibialis anterior . A. malleolaris anterior lateralis •
•
A. malleolaris anterior medialis
Rete malleolare laterale • N fibularis profundus
Rr museulares (N fibularis profundus) Mm , extensores digitorum et hallueis brevis .
A tarsal is lateralis .
")ot"I-- • Aa tarsales mediales
--lJ�r=:';;;;;oqlll"'t1
J.�i-r,:�- • A. dorsalis pedis
(A areuata) .
---I�:r'1.�t;,,�.,��1J,
Aa metatarsales dorsales •
•
A. plantaris profunda
- T.1iVi1jt:\i\�.!.f1it-����
• M extensor hallueis brevis, Tendo
• M. extensor hallucis longus, Tendo
Nn digltales dorsales pedis
1 408
1415
t
Fig. 1416
Arteries a n d nerves of the dors u m of foot, Dorsum pedis.
M u scles P e lv i s
Hip
To pogra phy Thigh
Sections
Popliteal fossa
Leg
Foot
Arteries of the foot
Aa digitales plantares propriae Aa. digitales plantares communes
L-�-l��Hrt-- Aa. metatarsales plantares Arcus plantaris profundus
-HP\-t--f'Ir-"'h'
AiIL--'t-lT+-- A. plantaris profunda (A. dorsalis pedis)
-
J-+-!-- R. superficialis lhP�- R. profundus
A. plantaris lateralis _-;:----+:-..0--':-.
#--;-....,<+-- A. plantaris medialis
__
""'11--1-- A. tibialis posterior Fig. 1 41 7 Planta ; overview.
Fig. 1 4 1 8 a-d Va riations in the a rterial supply of the sale of foot, Pla nta. a Dorsalis pedis artery, A. dorsalis pedis, a s major supply for the deep plantar a rch, Arcus planta ris profu ndus b Posterior tibial artery, A. tibialis posterior, as major supply for the deep plantar a rch, Arcus plantaris profundus c The fifth toe and lateral parts of the fourth toe are supplied by the posterior tibial a rtery, A. tibialis posterior, whereas the
Arteries of the sole of foot,
remaining medially located toes receive their a rterial supply through the dorsalis pedis a rtery, A. dorsalis pedis. d The fifth and fourth toe a s well as lateral parts of the t h i rd toe a re supplied by the posterior tibial a rtery, A. tibialis posterior, whereas all rem a i n i n g medially located toes receive their a rterial supply through the dorsalis pedis a rtery, A. dorsalis pedis.
�
Lowe r L i m b
S u rfa ce
I
���
S ke le t o n Overview
Arteries and nerves of the foot
Aa digitales plantares propriae
•
Nn. digitales plantares proprii
Nn_ digitales plantares communes
Aa metatarsales plantares .
----_\
N. plantaris lateralis, R superticialis
N. digitalis plantaris proprius
Aponeurosis plantaris
\\-�--';iII---- Retinaculum musculorum flexorum
Rr calcanei mediales (N. tibialis)
N. plantaris medialis •
A. tibialis posterior
N. plantaris lateralis
141 1
t
;;,
1 4 20
Fig. 1419
Arteries a n d nerves of the sole of foot, Pla nta.
I
M u scles Pelv i s
Hip
To pog ra phy Thigh
Sections
P o p l i t e a l fossa
Foot
Leg
Arteries and nerves of the foot
M. flexor digitorum brevis. Tendines .
•
Aa. digitales plantares propnae
•
Aa. digitales plantares communes
.,.J;£\l.j....-illJ-l'---- • M. flexor haliucis longus, Tendo
Nn. digitales plantares communes
Ill••U��-- • M. flexor hallucis brevis
N. plantaris laleralls
(
�",.-�---- • M. flexor digitorum longus
R. superficlalis
R. profundus
"-III�I----
•
M. abductor haliucis
':;;'��"-3----- • M. quadratus plantae A. plantaris lateralis
• ----
M. abductor digiti minimi
• ----
Aponeurosis plantaris
(R. cutaneus)
�l---- III N. plantaris medialis /.&1...--- Retinaculum
musculorum flexorum (R muscularis)
M. flexor digitorum brevis . •
A . tibialis posterior
" N. plantaris lateralis
1413
Fig. 1420
Arteries and nerves of the sole of foot. Pla nta ;
deep layer. The distal extension of the medial retro malleolar space beneath the abductor hallucis m u scle is also known as tarsal t u n nel. •
t 7. 1419
1 42 1
�
Lowe r l i m b
S k e le t o n
S u rface ���
Ov(� rv i ew
Arteries of the foot
Nn. digitales plantares proprii
��B'l\\---- • M. flexor hallucis longus, Tendo
Nn. digitales plantares communes
• Caput transversum Aa metatarsales plantares .
N plantaris laterahs
(
• Caput obhquum
1
M. adductor hallucls
r1>--t-lt--- • M, flexor hallucis brevis re-""�---j!I-TIfI---- • R perforans' R superflclahs
I.�'-�H:---- • A plantaris medialis, R superficialis
•
• M flexor hallucis longus, Tendo
R profundus
•
M adductor hallucis, Caput obliquum •
M. flexor digitorum longus, Tendo
• M quadratus plantae •
M. abductor hallucis
N. plantaris medialis Retinaculum musculorum flexorum
Aponeurosis plantaris
• A. tibialis posterior
N. plantaris lateralls M. abductor hallucls
....
1414
t
1 420
Fig. 1421
Arteries a n d nerves of t h e sale of foot, Planta ; dee pest layer.
* AnastomosIs with t h e dorsalis pedis artery
M u s cles P e lv i s
Hip
To pog ra p h y Thigh
S e ct i o n s
P o p l itea l fossa
Leg
Foot
Compartments of the foot
N. fibularis superficial is
V saphena magna
N. fibularis profundus
Fascia dorsalis pedis
M extensor digitorum longus, Tendines A. dorsalis pedis
M. extensor digitorum brevis
Ossa metatarsi
(Septa longitudinalia)
--A�'l��:::la
---nl'r"":ftl'li
051T--- M extensor hallucis longus, Tendo
Lig, plantare longum
Mm. flexores d,g i torum , TendInes Aponeurosis plantaris
M. flexor hallucis longus, Tendo
Fig. 1422
Com partments of the foot ; stepwise section.
.**.
Space of the i nterossei muscles Lateral compartment M e d i a l compartment I ntermediate compartment
�
S k e le t o n
S u rfa c e
Lower li m b
���
Thigh, oblique section
'. oJ �
• M. tensor fasciae latae
• M, gluteus minimus • M sartorius M gluteus medius . • M. rectus femoris, Tendo A.; V. glutea superior • • • M. iliopsoas N. femoralis
N. gluteus superior
Lig. iliofemorale
---+--+-''':'''''�'i-01I1--+_'''riff:';-Bursa subtendinea iliaca
M piriformis, Tendo •
�=�[J3�lil�������
M gemellus superior .
�hrh:lk--
M obturatorius internus, Tendo .
•
A. profunda femoris
N obturatorius
• M. adductor longus � �R � � � ll � � il � � �l �') ��
• M adductor brevis
N gluteus inferior M, obturatorius externus •
N ischiadicus
N cutaneus femoris posterior M. semimembranosus, Tendo .
Fig. 1423
M. biceps lemons, Capul longum, Tendo
T h i g h , Fe m u r; oblique section t h rough the h i p j o i nt .
M u scles Thigh
Leg
To p o g ra p h y
Sections
Foot
Thigh and leg, cross-sections
rectus femoris
•
Femur
Tractus iliotibialis
V. saphena magna
--����liJ��
"iiI:�
M , biceps femoris, Caput breve .
N. saphenus N. femoralis
M. biceps femoris, Caput longum
•
•
M . gracilis
N ischiadicus adductor longus •
M semimembranosus
Fig. 1424
T h i g h , Femur; c ross-secti o n t h ro u g h t h e m iddle of the t h i g h .
Fascia cruris
M. tibialis anterior . M extensor hallucis longus . M. extensor digitorum longus . N fibularis superficialis Septum intermusculare . cruris anterius
---.����
N. fibularis profundus •
M. fibularis [peroneus) brevis .
M fibularis [peroneus) longus
M, flexor digitorum longus
•
•
V saphena magna
Membrana interossea Septum intermusculare cruris posterius
•
N, tibialis •
Fig. 1425
V saphena parva
Leg. Crus; c ross-section t h ro u g h the middle of the leg.
M. gastrocnemius, Caput mediale
�
Lowe r l i m b
LI__S_u_r_fa_c_e_---'-_S_k_e_Le__t o_n---'-__M_u_s_c_te_s
��
���
Leg and foot, sections
r",
\
'
"
N fibularis profundus A dorsalis pedis . N. fibularis superficialis M extensor digitorum longus, Tendo .
Syndesmosis tiblofibularis
•
V. saphena magna
FTbula
N. saphenus
M. fibularis [peroneus] • longus, Tendo
-�:j�J'l�r
M. fibularis [peroneus] brevis •
•
M tibialis posterior, Tendo
.,�����i-- • M. flexor digitorum longus, Tendo
A fibularis .
N, tibialis M. flexor haliucis longus . • N . suraJis
Fascla CrUf�
•
A. tibialis posterior
M, plantaris, Tendo
Tendo calcaneus
Fig. 1426
Leg, Crus; cross-section j ust a bove the a n kle j o i nt.
•
M. extensor digitorum brevis, Tendo .
M. extensor digitorum longus, Tendo . M. fibularis [peroneus] tertius, Tendo .
M extensor haliucis longus, Tendo tibialis anterior, Tendo N saphenus
Lig. collaterale mediale Sustentaculum tali
Fascia pedis Proc lateralis tali
__��g
-
---l�I4Mi+.-k""
M fibularis [peroneus] brevis, Tendo . --1In--':rIlf-·.'I'I' M. fibularis [peroneus] longus, Tendo .
•
M. tibialis posterior, Tendo
" .x.--,!Ir-�..:.I:"-- • M. flexor digitorum longus, Tendo �..,J--""
N. plantaris medialis N. plantaris lateralis
Tendo calcaneus
Fig. 1427
Foot, Pes; oblique section t h rough the calca neus a n d the head of the talus.
__
Thigh
Leg
To p o g ra p hy
Sections
Foot
Foot, sagittal sections
Tlb,a Articulatio talocruralis
CapUl lall
1",-+--- Tendo calcaneus
Os cuneiforme intermedium M. fibularis [peroneusj longus, Tendo
...."'3-''r----'i++--- Articulatio subtalaris
Os metatarsi II M interosseus dorsalis pedis I
Lig. talocalcaneum interosseum
M extensor digitorum longus, Tendo
Phalanx proximalis
Calcaneus
Phalanx media
Phalanx d,stalls M. quadratus plantae
M. flexor dig ito rum longus, Tendo
N. plantaris lateralis
Lig plantare longum
Fig. 1428
Foot, Pes; sagittal section t h ro u g h the second toe.
M. tibialis anlerior, Tendo
Aponeurosis plantaris
1 -7 1315, 131 6 1
M. flexor hallucis longus
Tibia Linea ep'physialis Articulatio talocruralis
M. triceps surae, Tendo calcaneus
Talus Articulatio subtalaris
(Articulatio talonavicularis)
Lig. talocalcaneum interosseum
Os naviculare
Calcaneus
Lig. plantare longum
Fig. 1429
Foot, Pes; magnetic resonance tomog ra phy image I M R l i ; sagittal section .
1 7 1317, 13181
�
Lowe r l i m b
. . . To p o g ra p hy ���
Thigh
Sections Leg
Foot. cross-section and pedograms
M interosseus dorsalis pedis II _
Mm. extensores hallucis longus et brevis, Tendines
Mm. extensores digitorum longus et brevis, Tendines
M, interosseus dorsalis pedis I
Fascia dorsalis pedis M interosseus dorsalis pedis III
M. interosseus plantaris I
M. interosseus dorsalis pedis IV (M opponens digiti minim
i) --��
M abductor digiti minimi M. flexor digiti minimi brevis
����I��I���i�����[=�,
M. adductor hallucis, Caput obliquum
�t#--- M. abductor hallucis M. flexor hallucis longus, Tendo
(Eminentia plantaris lateralis) M Interosseus plantaris III M. interosseus plantaris II AponeurosIs plantaris
(Eminentia plantaris medialis) M. flexor hallucis brevis Mm. flexores digitorum longus et brevis, Tendines
(Eminentia plan tans Inlermedla)
Fig. 1430
Osteofibrous tubes of the foot ; f rontal sectio n thro u g h the metatarsu s.
b
Fig. 1431 a - c
a b c
Normal foot Pes cavus Flat foot
Foot prints, pedograms.
Foot
I nd ex
I nd ex
The numbers refer to the page numbers. The numbers with .r refer to the numbers of the tables in the separate booklet enclosed in Volume 1 .
A Abdomen - computed tomography 248-249, 251 , 255 - cross-section 248-251 - frontal section 244-245 - median section 242 - sagittal section 243, 246-247 Abdominal viscera 1 58, 1 62, 1 66, 1 72 - arteries 1 68 Abdominal wall 58, 66, 69-7 1 - anterior, viewed from inside 5 9 , 71 - innervation, segmental, sensory 67 - muscles 52, 54, 56-58, 60-6 1 , 66, 72-73, T 1 4-T1 6 - posterior 220-221 - skeleton projection 47 - surface anatomy 46 Acetabular floor 274 Acetabular roof 274, 280 Aceta bulum 256, 261 , 266 Achilles tendon s. Tendo calcaneus Acini pancreatici 1 53 Acromion 1 -2, 26, 47-48, 1 22 Adductor canal 357-358 Ala - ossis ilium 72, 254, 264, 266-267, 273 - - sacri 1 0 ALCOCK's canal 230, 258 Ampulla - ductus deferentis 7 1 , 1 9 1 , 1 95-1 96, 236 - IDuodenum) 1 30, 1 32, 1 34- 1 35, 1 79 - hepatopancreatica 1 35, 1 54 - recti 2 1 0, 2 1 5, 242, 252-253, 257-258 - tubae uterinae 1 40, 1 67, 201 , 203, 209, 253 Anal hiatus 230 Anastomoses, portocaval 1 8 1 , 213 Angle - between neck and shaft of the femur 276 - of antetorsion, femur 277 Angulusl-il - costae 49, 1 0 1 - inferior 1 -2, 26-27 - infrasternalis 46-47 - mandibulae 1 2 - ossis pubis 266 - sterni 46, 50 - subpubicus 268 - superior 2 Ansa subclavia 1 1 7, 1 20 Anteflexio IUterus) 203 Anteversio IUterus) 203 Antrum pyloricum 1 30, 1 33 , 1 35, 247 Anulus - femoralis 229 - fibrosus 24-25, 29, 42 - - dexter ICor) 77, 84 - - ID iscus intervertebralis) 45 - - sinister ICor) 77, 79, 84
Anulus - ing uinalis profundus 60, 7 1 , 225 - - superficialis 56-58, 60-6 1 , 70, 238-239 - umbilicalis 46, 52, 56, 58, 66, 70, 72-73, 1 40, 1 59, 242 Anus 2 1 0, 2 1 2-21 4, 230, 232-233, 235 Aorta 29, 35, 76-77, 83, 87, 1 22, 1 26, 1 74, 242, 249, 359 - abdominalis s. Pars abdominalis aortae - ascendens s. Pars ascendens aortae - congestion, collateral c i rcula tion 69 - descendens s. Pars descendens aortae - thoracica s. Pars thoracica aortae Apertura - pelvis inferior 264-265 - - superior 264-265 Apex - capitis fibulae 283, 291 - cordis 74-80, 84-85, 98-99, 101 - dentis 6 - ossis sacri 1 0- 1 1 - patellae 284, 290-291 - pulmonis 94-95, 98-99, 1 1 0, 1 23 - vesicae 1 90-1 9 1 , 252 Aponeurosis - musculi obliqui externi abdo minis 60-61 - plantaris 299, 304, 338, 340, 342, 376-379, 383-384 Appendixl-cesl - epididymidis 1 93 , 239 - epiploicae s. Appendixl-cesl omentales - fibrosa hepatis 1 42- 1 43 , 1 60, 1 66 - omentales 1 38-1 39, 1 62, 1 65, 226, 258 - testis 1 92-1 93, 239 - vermiformis 1 38-1 40, 1 63- 1 66, 1 75, 209, 251 - - projection 1 40 - - variations in position 1 40 - vesiculosae 200-20 1 , 204 Arachnoidea mater - crania lis 40 - spinalis 40-4 1 , 43-45 Arcus - anterior atlantis 6, 1 2 , 1 9 - aortae 74-75, 84-85, 89, 98-99, 1 0 1 , 1 04-1 05, 1 07-1 08, 1 1 4- 1 1 5, 1 1 8- 1 20, 1 22, 1 24 - - AP-radiograph 1 1 4 - - branches 1 1 4 - - variations 1 1 4 - cartilaginis cricoideae 90 - costa lis 3, 46-47, 52, 207 - iliopectineus 7 1 , 269, 3 1 3 , 3 1 7, 355 - plantaris profundus 35 1 , 375, 378 - posterior atlantis 6, 1 2, 1 8- 1 9 , 33, 39-40 - pubicus 268
Arcus - tendineus musculi levatoris ani 230-23 1 , 3 1 7 - - - solei 3 1 1 , 329, 350, 370 - venae azygos 1 1 6 - venosus dorsalis pedis 365, 373 - - jugularis 1 1 0 - vertebrae 5-8, 1 5, 1 7, 20, 22, 29, 32, 4 1 , 45 Areal-ael - crib rosa IRenl 1 83 - gastricae 1 30 - intercondylaris anterior 282, 293 - - posterior 282 - nuda 1 1 9, 1 42, 1 45, 242 Areola mammae 64 Arterial-ael - appendicularis 1 68, 1 74 - arcuata 1 83, 2 1 6, 35 1 , 374 - ascendens 1 76 - auricularis posterior 38 - axillaris 54, 1 1 3, 1 20, 1 22, 1 24 - bulbi penis 234, 240 - - vestibuli 234 - caecalis posterior 1 74 - carotis communis 69, 74-75, 89, 98-99, 1 04-1 07, 1 1 0- 1 1 1 , 1 1 3- 1 1 4, 1 1 7- 1 1 8, 1 20-1 24 - - externa 1 1 4 - - interna 1 1 4 - caudae pancreatis 1 68 - cervicalis profunda 39, 1 1 5 - - superficialis 66 - c i rcumflexa femoris lateralis 261 , 35 1 , 357-359 - - - medialis 260-261 , 35 1 , 357-359, 363-364 - - humeri poste rior 37, 1 22 - - ilium profunda 1 79, 2 2 1 , 227, 231 , 356, 359 - - - superficialis 66, 353, 359 - - scapulae 37, 1 22 - colica dextra 1 52, 1 68, 1 74-1 75 - - media 1 52, 1 6 1 , 1 63-1 64, 1 68, 1 74-1 77 - - sin istra 1 67-1 68, 1 75-1 77, 1 79, 2 1 7 - coronarial-ae) 84, 86 - - dextra 74-75, 78-80, 82, 84-87, 98, 1 1 9- 1 20, 1 27 - - - coronary angiography 87 - - sinistra 74-75, 79-80, 82, 84-87, 98, 1 1 9- 1 20, 1 27 - - - coronary angiography 87 - cremasterica 1 93 , 225, 238 - cystica 1 42, 1 49, 1 68, 1 70, 1 72 - descendens genus 35 1 , 353, 356-358, 369 - digitales dorsales IPesl 374 - - plantares communes 375, 377 - - - propriae 375-377 - dorsalis clitoridis 234 - - pedis 351 , 368, 374-375, 379, 382 - - penis 1 99, 227, 234, 238-240, 244 - ductus deferentis 60, 193, 197, 227
Arteria{-ael - epigastrica inferior 60-61 , 66, 69, 7 1 -72, 1 58-1 59, 1 73 , 1 75, 1 7� 1 96, 2 1 7, 221 , 225, 227, 229, 23 1 , 236, 253-254, 359 - - - collateral circulation 69 - - superficialis 66, 353, 359 - - superior 66, 69-70, 72 - - - collateral c i rculation 69 - femoralis 62, 69, 73, 2 1 8, 244, 256-257, 3 1 4, 3 1 7, 351 , 353, 355-359, 380-381 - - superficialis 3 5 1 , 356 - fibularis 351 , 366, 368-372, 381 -382 - gastrical-ael breves 1 3 1 , 1 66, 1 68, 1 70, 1 73 - - dextra 1 3 1 , 1 68, 1 70, 1 72 - - posterior 1 70 - - sinistra 1 06, 1 3 1 , 1 52, 1 55, 1 60, 1 68, 1 70-1 73, 1 78- 1 79, 2 1 8, 244, 247, 249 - gastroduodenalis 1 52, 1 68, 1 70-1 73, 242, 244 - gastroomentalis dextra 1 3 1 , 1 67-1 68, 1 70-1 73 - - s inistra 1 3 1 , 1 60, 1 68, 1 70-1 73, 247 - glutea inferior 2 1 2, 224-225, 256-257, 351 , 363-364, 380 - - superior 2 1 2, 224-225, 25� 359, 363, 380 - helicinae 1 98 - hepatica communis 1 3 1 , 1 52, 1 68, 1 70-1 73, 1 78-1 79, 2 1 8, 249 - - - AP-radiograph 1 71 - - propria 1 3 1 , 1 42, 1 46, 1 52, 1 55, 1 67-1 68, 1 70-1 72, 1 79, 243-244, 249 - - variability 1 70 - ileales 1 52, 1 68, 1 74-1 75, 251 - ileocolica 1 68, 1 74-1 75, 255 - iliaca communis 1 67, 1 79, 2 1 2, 2 1 4, 2 1 7-21 8, 221 , 224-229, 23 1 , 242-243, 254, 359 - - externa 69, 7 1 , 1 79, 1 96, 2 1 2, 221 , 224-225, 227-229, 23 1 , 236, 253, 3 1 7, 354, 356, 358-359 - - interna 2 1 2, 2 1 7, 224-225, 227-229, 23 1 , 354, 356, 359 - - - variations 224 - iliolumbalis 2 1 7, 2 2 1 , 224-225, 229 - inferior latera lis genus 289, 35 1 , 368-369 - - medialis genus 289, 3 5 1 , 358, 369-372 - intercostalisl-es) 70, 99, 1 20, 1 27 - - posteriores 45, 54, 73, 75, 1 04- 1 05, 1 1 2- 1 1 3, 1 1 5- 1 1 6 - - suprema 1 1 5 - interlobares (Ren) 1 83- 1 84, 2 1 6 - interlobula res IHeparl 1 45 - jejunales 1 52, 1 68, 1 74-1 75, 1 77, 242, 244 - lienalis s. Arterial-ael splenica - lobaris{-es) inferiores 98-99, 1 0 1 , 1 26 - - media 98 - - superiores 98, 1 25
I n d ex
Arterial-ae/
- lobi caudati 1 42 - lumbales 4 1 , 1 79 , 2 1 7, 221 , 245, 359 - malleolaris anterior latera lis 351 , 368, 374 - - - medialis 35 1 , 374 - marginalis coli 1 68, 1 74-176 - media genus 289, 351 , 369 - mesenterica inferior 1 52, 1 67-1 68, 1 74, 1 76-1 77, 1 79, 2 1 2, 2 1 4, 2 1 7, 221 , 225, 227, 250-251 - - - AP-radiograph 1 76 - - - variations 1 76 - - superior 1 1 5, 1 52- 1 54, 1 67-1 68, 1 70, 1 73-1 79, 1 87, 2 1 7-218, 221 , 242-244, 250-251 , 255 - - - AP-radiograph 1 74 - - - variations 1 74 - metatarsales dorsales 351 , 368, 374 - - plantares 375-376 , 378 - musculophrenica 69 - obturatoria 7 1 , 2 1 2, 224-225, 227, 229, 23 1 , 236-237, 256-257, 261 , 31 7, 355, 357-359 - - variability 229 - occ ipitalis 37-39 - ova rica 1 52, 1 67, 201 , 204, 209, 223, 228-229, 253 - pancreatica dorsalis 1 68, 1 7 1 - - inferior 1 7 1 - - magna 1 68 - pancreaticoduodenalis inferior 1 68, 1 73 , 1 77 - - superior anterior 1 7 1 , 1 73 - - - posterior 1 68, 1 70-1 7 1 , 1 78 - perforantes 35 1 , 358-359, 362-363, 369 - pericardiacophrenica 69, 89, 1 1 2-1 1 3 , 1 1 8 - perinealis 234, 240 - phrenica inferior 63, 1 04, 1 72- 1 73, 1 89, 2 1 7-218, 221 - plantaris lateralis 304, 35 1 , 375, 377-378, 382 - - medialis 304, 35 1 , 375, 378, 382 - - profunda 374-375 - poplitea 284, 289, 320, 329, 35 1 , 358, 361 -363, 366, 369-372 - - variations 370 - prepancreatica 1 68 - profunda brachii 37 - - femoris 256-257, 261 , 35 1 , 356-359, 380 - - penis 1 98-1 99, 226-227, 239, 244 - pudenda externa 66, 238, 353, 359 - - interna 2 1 0, 2 1 2 , 224-225, 227-229, 23 1 , 234, 236-237, 240-24 1 , 256-258, 260-2 6 1 , 363-364 - pulmonalis[-esl 1 1 2 - - dextra 74-76, 84-85, 88-89, 95, 98- 1 0 1 , 1 05, 1 07, 1 1 9, 1 25 - - sinistra 74-75 , 84-85, 88-89, 95, 98-99, 1 05, 1 07, 1 1 3, 1 24 - rectalis 2 1 2 - - inferior 1 68, 2 1 2, 227-228, 240-241 - - media 2 1 2, 224-225, 227-229 - - superior 1 67-1 68, 1 76-1 77, 1 79, 2 1 0, 2 1 2 , 2 1 7, 227-229, 254
Arterial-ae/
- recurrens tibialis anterior 35 1 , 368 - - - posterior 35 1 , 369-370 - renalis 1 52, 1 82- 1 83 , 1 85, 1 87, 1 89, 2 1 6-218, 2 2 1 , 242-243, 245-246, 250 - - accessoria 2 1 7 - - arteriography 2 1 6 - - polaris inferior 2 1 6 - - - superior 2 1 6 - - variations 2 1 6 - sacralis lateralis 224-226 - - mediana 1 77, 1 79, 2 1 2, 2 1 7, 221 , 225, 227-229, 253, 359 - segmentalis basalis anterior 98 latera lis 99 - - - medialis 99 - - - posterior 99 - segmenti [A renalisl 2 1 6 - - anterioris hepatici 1 24 - - - renalis 1 7 1 - - posterioris hepatici 1 24 - - - renalis 1 7 1 - sig moideae 1 67-1 68, 1 76-1 77, 1 79, 2 1 2, 2 1 7, 254, 258 - spinalis anterior 45 - splenica 1 52, 1 54-1 56, 1 6 1 , 1 67-1 68, 1 70- 1 73 , 1 78-1 79, 2 1 8, 245, 248-249 - subclavia 74-75, 89, 98-99, 1 04-1 07, 1 1 1 - 1 1 3, 1 1 5, 1 1 7, 1 23 - - dextra 69, 99, 1 1 4, 1 1 8, 1 20 - - sin istra 99, 1 1 4, 1 20, 1 24 - subcostalis 1 1 5-1 1 6 , 245 - subscapularis 1 24 - superior latera lis genus 351 , 366, 368-369 - - medialis genus 35 1 , 358, 362, 368-369 - supraduodenalis 1 68 - suprarenalis 1 89 - - infe rior 1 82, 1 89, 2 1 7 - - media 1 82, 1 89, 2 1 7 - - superior 1 82, 1 89 - - variations 1 89 - suprasca pu laris 1 20 - surales 35 1 , 369-370 - tarsalis[-esl lateralis 351 , 374 - - mediales 351 , 374 - testicularis 70-7 1 . 1 52, 1 79, 1 93-1 94, 1 97, 2 1 7, 221 -222, 238-239, 243, 251 , 254, 256 - - variations 2 1 7 - thoracica interna 63, 66, 69, 88, 1 1 0, 1 1 2, 1 1 4- 1 1 5, 1 1 8, 1 20, 1 24, 1 26 - - - collateral circulation 69 - - lateralis 66 - thoracoacromialis 1 20 - thoracodorsalis 1 24 - thyroidea inferior 1 06 - - su perior 1 1 0 - ti bialis anterior 283, 3 5 1 , 366-370, 372, 374, 381 - - posterior 35 1 , 366, 369-372, 375-378, 381 -382 - transversa colli 38-39 - u m bilicalis 70-7 1 . 1 59, 1 85, 207, 224-225, 227-229, 236 - urethralis 1 99 - uterina 204, 224, 228-229 - - Va riabilitat 204 - - variability 204 - vaginalis 204, 228-229 - vertebralis 24, 34, 37, 39-40, 1 06, 1 1 4, 1 20
Arterial-ae/
- vesicalis[-esl inferior 225, 227-228 - - superiores 70, 224, 227, 229, 260 Arteries, hip 359 Arteriography 2 1 6 Arthroscopy, Articulatio genus 292 Articulatio[-nesl - acromioclavicularis 1 22 - atlantoaxialis lateralis 1 7- 1 9 - - mediana anterior 1 9 - - - posterior 1 9 - atlantooccipitalis 1 7- 1 9 - calcaneocuboidea 263, T39 - capitis costae 8, 1 4, 20, 22 - costotransversaria 8, 1 4, 20 - costovertebrales 20-22 - coxae 257, 263, 268-27 1 , 273, 278-279, T39 - - AP-radiograph 280 - - LAUENSTEIN projection 280 - cu neocuboidea 263, T39 - cuneonavicularis 263, T39 - femoropatellaris 263, 284 - genus 263, 284-289, 292, 323, T39 - - AP-radiograph 291 - - arthroscopy 292 - - cross-section 284 - - frontal section 290 - - lateral radiograph 291 - - M R I 293 - - sagittal section 290 - humeri 1 22-1 23, T39 - intercune iformes 263, T39 - intermetatarsales 304, T39 - interphalangeae pedis 263, T39 - lumbosacralis 268-2 7 1 - membri inferioris 2 6 3 , T39 - - - liberi 263, T39 - men iscofemoralis 263 - meniscotibialis 263 - metatarsophalangea[-ael 263, 302, 304, T39 - - hallucis 336 - pedis 300-303 - sacrococcygea 226, 252, 264 - sacroiliaca 1 , 1 6, 1 76 , 205, 230, 254, 263-264, 268-269, 271 -273, 280, 3 1 7, T39 - sternoclavicularis 46, 5 1 , 1 1 9 - sternocostales 5 1 - subtalaris 263, 304-305, 383, T39 - talocalcaneonavicularis 263, 303-305, T39 - - AP-radiograph 305 - - frontal section 304 - - lateral radiograph 305 - - sagittal section 304 - talocruralis 263, 30 1 , 304-305, 383, T39 - - AP-radiograph 305 - - frontal section 304 - - lateral radiograph 305 - - sagittal section 304 - talonavicularis 383, T39 - talotarsalis 263, 304, T39 - tarsi transversa 296, T39 - tarsometatarsales 263, 296, 304, T39 - t ibiofibularis 263, 282, 290-29 1 , 293-294, T39 - zygapophysialis 1 2 , 1 5- 1 6 , 23, 25, 29, 35, 272
Atlas 4-7, 1 2 , 1 7- 1 9 , 3 1 , 33-34, 39-40 Atrium - cordis dextrum 74-76, 78, 82, 84-85, 89, 99, 1 0 1 , 1 1 4, 1 1 9- 1 2 1 , 1 27, 243-244, 255 - - sinistrum 75-76, 79, 82, 84-85, 89, 99, 1 0 1 , 1 1 4, 1 1 9, 1 26- 1 27 Auricula - dextra 74, 78-80, 84, 98, 1 1 4 - sinistra 74-76, 79, 84-85, 98, 1 01 , 1 1 4, 1 26 Axilla 1 22- 1 23 Axis 4, 6-7, 1 2, 1 7- 1 9 , 33 - pelvis 265 B
Back 1 , 37 - cutaneous innervation, segmental 36 - dermatomes 36 - lines of orientation - muscles 26-34 - regions 1 - surface anatomy BARTHOLIN's gland 200, 233, 235 Basis - ossis metatarsi 295, 298, 302 - - - hallucis 296 - - sacri 1 0- 1 1 , 1 5, 273 - patellae 284, 290-291 - phalangis [Pesl 295 - prostatae 1 95 - pulmonis 95 - pyramidis 1 83 Bifurcatio - aortae 1 77, 1 79, 359 - tracheae 90-9 1 , 99, 1 02, 1 04-1 05, 1 07, 1 1 9, 1 25 - trunci pulmonalis 75-76, 85, 89 BOCHDALEK's triangle 63 BOYD's vein 352 Bronchi, segmental s. Bronchus[ -il segmentalis[-esl Bronchiolus[-il 98 - terminalis 98 Bronchography/Bronchoscopy 93 - Bifurcatio tracheae 1 02 - segmental bronchi 1 02 Bronchus[-iJ 90-92, 98 - arterial supply 99 - bronchography 93 - bronchoscopy 1 02 - intrasegmentalis 1 20, 1 24 - lingularis inferior [B VI 90, 93, 1 02 - - superior [B IVI 90, 93, 1 02 - loba ris[-esl 92, 1 07 - - infe rior 1 26 - - - dexter 90-9 1 , 95, 1 20- 1 2 1 - - - sinister 90-91 , 93 , 98 - - medius 90-91 , 95, 1 2 1 , 1 26 - - superior 1 25 dexter 90-9 1 , 95, 99, 1 04, 1 25 sinister 90-9 1 , 93, 98-99, 1 02 - principalis dexter 88, 90-9 1 , 95, 99, 1 0 1 - 1 02, 1 04-1 05, 1 07, 1 09, 1 1 2, 1 1 5, 1 1 7, 1 1 9- 1 20, 1 25 - - sinister 90-9 1 , 93, 95, 99, 1 02, 1 04- 1 05, 1 1 3, 1 1 5 , 1 1 7, 1 1 9, 1 25 - projection 90
I ndex
Bronchus{-i!
Canalis{-es!
Cartilago{-ines!
Cingulum
- segmentalisl-esl 90-92, 99 - - anterior [B IIi] 90, 93, 1 02, 1 22, 1 24-1 25 - - a picalis [B I] 90 - - apicoposterior [B I + I I] 90, 93, 1 02 - - basalis anterior [B VIII] 90, 93, 1 02 cardiacus [B VI I ] s, B ronchusl-il segmentalis basalis medialis [B VII] lateralis [B IX] 90, 93, 1 02, 1 27 medialis [B VII] 90 posterior [B X] 90, 93, 1 02, 1 26 - - bronchoscopy 1 02 - - lateralis [B IV] 90 - - medialis [B V] 90 - - posterior [B I i ] 90, 1 24- 1 25 - - superior [B VI] 90, 93, 1 02 B R U N N E R's glands 1 36 Bulbus - aortae 79, 87 - penis 1 96, 1 98, 236, 252 - vestibuli 200, 228, 235, 237, 241 , 261 Bursa[-ael - a nserina 3 1 6 - iliopectinea 3 1 0 , 355 - i nfrapatellaris profunda 285, 288-289 - ischiadica musculi obturato rii interni 3 1 1 - musculi semimembranosi 329-331 - omentalis 1 57, 1 6 1 , 1 66-1 67, 247-249 - subcutanea calcanea 338 - - coccygea 3 7 - - infrapatellaris 306, 3 1 3 - - prepatellaris 284, 306 - - sacralis 37 - - spinae iliacae posterioris superioris 3 7 - - trochanterica 3 1 1 - subfascialis prepatella ris 288 - subtendinea i liaca 256, 3 1 5-3 1 6, 380 - - musculi gastrocnemii media lis 3 1 1 , 329-331 - - - obturatorii i nterni 256-257 - - - sartorii 3 1 6 - - prepatellaris 3 1 3 - suprapatellaris 285, 288, 290, 292 - trochanterica musc u l i g lutei maximi 279, 3 1 9-3 2 1 - - - - m e d i i 256, 279, 3 1 1 , 3 2 1
- ingui nalis 239 - nervi hypog lossi 1 8 - obturatorius 2 1 2-2 1 3, 230, 268, 278-279, 3 1 6-3 1 7, 355 - pudendalis 230 - pyloricus 1 30, 1 35, 1 52 - sacralis 1 0- 1 1 , 24, 227, 252, 271 , 31 7 - vertebralis 3, 24, 4 1 -43, 45, 3 1 7 - - veins 42 Capsula - adiposa 1 82, 1 88, 2 1 7, 245-247, 249 - articularis IArticulatio atlantoaxialis lateralisl 1 7- 1 8 - - [Articulatio atlantooccipitalisl 18 IArticulatio costovertebralisl 2 1 -22 - IArticulatio coxael 268, 270-27 1 - - [Articulatio genusl 285, 290, 293, 323 - - IArticulatio metatarsopha la ngea hallucisl 336 [Articulatio sternoclavicu lansl 5 1 IArticulatio zygapophysialisl 25 - - [Columna vertebralisl 42 - fibrosa I Renl 1 8 2 - 1 84, 246-247 Caput - breve 1M biceps brachiil 54 - - [ M , biceps femorisl 3 1 8 , 320-323, 363, 3 8 1 , T40, T46 - costae 8, 1 4, 22, 49 - epididymidis 1 92-1 94, 239, 252 - femoris 256, 259-26 1 , 27 1 , 273, 275-277, 279-280, 359 - fibulae 262, 282-283, 285-287, 29 1 , 293-294, 306, 3 1 3, 322, 332, 367 - humen 1 22- 1 23 - laterale 1M gastrocnemiusl 284, 286-288, 320-323, 326, 328-330, 362, 369-370, T49 - - 1 M, triceps brachiil 52 - longum 1M. biceps bra c h i i l 1 22 - - 1M biceps femorisl 3 1 7-323, 362-363, 380-38 1 , T46 - - 1 M , triceps brachiil 37, 52 - mediale 1M. gastrocnemiusl 284, 286-287, 308, 320-32 1 , 323, 326, 328-33 1 , 362, 369-370, 381 , T49 - obliquum 1M adductor hallucisl 304, 339, 342, 378, 383-384, T52 - ossis metatarsi 295, 298 - - - q u i nti 296 - pancreatis 1 34, 1 40, 1 52-1 53, 1 67, 1 73 , 1 79, 243-244 phalangis I Pesl 295 - rectum 278-279, 3 1 5 , T44 - reflexum 278-279 , 3 1 5, T44 - tali 295-298, 305, 382-383 - transversum 1M add u ctor hallucisl 339-342, 378, T40, T52 Cardia 1 09, 1 30- 1 3 1 , 1 60, 242, 247 Carina tracheae 1 02, 1 1 9 Cartilagol- inesl - articularis 284 - arytenoidea 91 - bronchiales 90, 1 02 - corniculata 9 1 - costalis 5 1 , 55, 57-58, 70, 1 1 5, 1 25, 1 27
- cricoidea 1 2, 1 1 9 - epiphysia lis 274 - fibrosa I Discus intervertebralisl 272 - hyalina [Discus i ntervertebralisl 272 - thyroidea 35, 58, 90-9 1 , 1 04, 1 1 0, 1 1 9- 1 2 0 - tracheales 90-9 1 , 1 04-1 05, 1 1 9 Carunculae hymenales 233, 235 Cauda - epididymidis 1 92-1 94, 252 - equina 24, 29, 4 1 , 43-44, 242, 250-25 1 , 254 - pancreatis 1 34, 1 52, 1 54- 1 55, 1 6 1 , 1 66-1 67, 1 79, 244, 249 Cave of RETZIUS 207, 252 Cavea - thoracis 48, 55 - - AP-radiograph 1 0 1 Caverna l -ael - corporis cavernosi 1 98- 1 99 - - spongiosi 1 99 Cavltasl-tesl - articularis IArticu latio coxael 2 7 1 , 273, 279-280 - glenoidalis 48, 1 22 - i n fraglottica 1 1 9 - medullaris 277, 281 - nasi 1 2 - pericardiaca 1 1 9, 1 25 - peritonealis 1 57, 1 67, 242-244, 247-25 1 - - development 1 57 - pleuralis 1 1 2-1 1 3, 1 1 7, 1 2 1 , 1 26, 1 55, 248-249 - serosa scroti 61 - symphysialis 272 - thoracis 1 1 9, 1 24- 1 25, 1 27 - CT 1 29 - frontal section 1 20-1 22 - median sagittal section 1 1 9 - M R I 1 20- 1 21 - transverse section 1 23 , 1 25-1 26 - uteri 201 -203, 237, 253, 259 Cavum serosum scroti 6 1 , 1 94 Centrum - perinei 230-23 1 - tendineum 55, 62-63, 73, 1 04, 1 06, 1 1 2- 1 1 3 , 242, 246 Cerebellum 40 Cerebrospinal fluid, p u n cture 44 Cervical part of the vertebral column 1 7, 43 - AP-radiograph 1 3 - CT 35 - lateral radiograph 1 2 Cervix - uteri 203-205, 237 - vesicae 1 95 Chiasma - crurale 326 - plantare 342 - tarsale 326 CHOPART's joint 296, T39 Chorda [-ael - arteriae umbilicalis 6 1 , 66, 7 1 -72, 1 58, 1 96, 229, 236, 253 - tendi neae 79-81 - urachi 6 1 , 72, 236 Cingulu m - membri inferioris s, Cingulum pelvicum - - superioris s, Cingulum pec torale
- pectorale 3, 48 - pelvicum 3, 263-264 Cisterna - cerebellomedullaris 40 - chyli 1 1 6, 2 1 8 Clavicula 3, 46-48, 5 1 -52, 90, 1 01 , 1 08, 1 1 0, 1 1 2- 1 1 3, 1 1 8, 1 20, 1 22- 1 23 , 1 59 Cleft, uncovertebral 24 Clitoris 207, 223 , 231 Clivus 1 8 COCKETT's veins 352 Coeliacography 1 71 Colliculus seminalis 1 90, 1 98 Collum 257 - costae 8, 20, 49 - femoris 259, 273, 275-280 - fibulae 283 - tali 296-298, 305 - vesicae biliaris 1 49- 1 5 1 Colon 1 38-1 39, 1 88 - AP-radiograph 1 4 1 - ascendens 1 3 8-1 4 1 , 1 58, 1 6 1 - 1 62, 1 65- 1 66, 1 80, 1 86, 244, 251 , 254 - descend ens 1 38, 1 40, 1 59, 1 65-1 66, 1 77, 1 80, 1 86, 244-245, 249-251 , 254-255 - layers of the wa ll 1 39 - projection 1 3 8 - sigmoideum 1 38, 1 40, 1 57-1 58, 1 62, 1 64-1 67, 1 75, 1 77, 1 79, 207, 209, 21 2-2 1 3 , 2 1 5, 2 1 7-2 1 8, 226, 242, 244, 251 -254, 258 - transversum 1 38- 1 40, 1 49, 1 57-1 58, 1 60- 1 62, 1 64- 1 66, 1 75, 242-244, 246-247, 249-250 - - variations i n position 1 4 1 Colonoscopy 1 41 , 2 1 1 Columnal-ael - anales 2 1 0- 2 1 1 , 242, 252, 258 - ren a les 1 83, 246 - rugarum anterior 235 - vertebralis 2-4, 42 - - nerves 42 Commissura - la biorum a nterior 235 - - posterior 235 Compartimentum - cruris anterius 366 - - laterale 366 - - posterius 366 Complexus stimulans cordis 82-83 Computed tomography [CTI - abdomen 249, 251 - cervical part of the vertebral column 35 - lumbar part of the vertebral column 35 - Mm abdomi n i s 73 - Mm dorsi 29 - pelvis 254 - - of the female 257 - - of the male 256 - thoracic cavity 1 25 Cond ucting system 82-83 Condylus - lateralis [Femurl 275, 277, 281 , 285-287, 290-293 - - [Tibial 282, 287, 290-293 - medialis I Femurl 275, 277, 28 1 , 285-287, 290-293 , 3 1 3-3 1 4 - - ITibial 282, 290-29 1 , 293, 327, 329, 33 1 -332 - occipitalis 6
c
Caecum 1 38-1 40, 1 58, 1 62- 1 66, 1 75, 209, 25 1 , 254 - projection 1 40 Calcaneus 295-30 1 , 303-304, 383 Calices renales 2 1 6 - majores 1 83, 1 86, 245 - mi nores 1 83- 1 84, 1 86, 246, 250 Calx 262 Canal of ALC O C K 230, 258 Canalisl-esl - adductorius 3 1 4 , 3 5 1 - a n a l i s 2 1 1 , 2 1 5, 252 - cervicis uteri 201 -203, 253
-
I ndex
Conjugata - anatomica 265 - diagonalis 265 - vera 264-265 Conus arteriosus 74, 84, 98 Cor 67, 74-75, 98, 1 1 4, 242 - a rterial supply 85 - atrium, left 79 - - right 78, 82 - balanced coronary artery supply 85-86 - conducting system 82-83 - coronary arteries 84, 86-87 - - coronary a ngiography 87 - dominant left coronary artery supply 85-86 - dominant right coronary artery su pply 85-86 innervation 83 - position 77 - - during exspi ratlon/inspiration 88 - projection 1 0 1 - ultrasound image 1 26 - valves, poi nts of auscultation 77 - - projection 77 - ventricle, left 79-82 - - right 78, 80-82 Cornu - anterius IMeniscus lateralisl 290, 293 - coccygeu m 1 1 - inferius I M a rgo falciformisl 306, 355 - posterius IMeniscus lateralisl 290, 293 - sacrale 1 0- 1 1 - superius IMarg o falciformisl 306 , 355 Corona g landis 1 96 , 1 98-199, 252 Coronary a n g iography 87 Coronary arteries 84, 86 Corpusl-oral - adiposum infrapatellare 285, 290, 293, 323 - - pararenale 1 88 - - IRenl 1 83 - albicans 201 - anococcygeum 207, 226, 230-233, 235, 240-241 , 252, 257 - cavernosum clitoridis 207, 235, 253 penis 1 92 , 1 96- 1 9 7, 1 99 , 222, 227, 239, 242-243, 252, 259 recti 2 1 1 - IClaviculal 46-47 - clitoridis 23 1 , 253 - costae 49, 1 0 1 - epididymidis 1 9 1 , 1 94 - femoris 2 1 5 , 275, 277, 2 9 1 - fibu lae 283 , 2 9 1 - gastricum 1 2 1 , 1 28 , 1 30, 1 32-1 33, 1 58, 1 60-1 6 1 , 245 - luteum 201 -202 - - menstruationis 202 - mammae 52 - ossis ilium 259, 267 - - ischii 266-267 - - metatarsi 295, 298, 334 - - pubis 230, 243, 266-267 - pancreatis 1 34, 1 52- 1 55, 1 6 1 , 1 66 , 1 73 - penis 1 97 - phalangis I Pesl 295 - spongiosum penis 1 92 , 1 9 6- 1 99 , 222, 232, 239, 242, 252, 259-260 -
Corpusl-orai
- sterni 3, 47, 50-5 1 , 55, 90, 1 1 9 , 1 24-1 26, 242 - tali 296-297, 304 - tibiae 282-283, 2 9 1 - uteri 201 , 203-204, 237, 253, 259 - vertebrae 5-9, 1 2-25 , 29, 35, 4 1 , 45, 72, 1 25, 1 55 , 1 88, 249, 251 - vesicae 1 90- 1 9 1 - - biliaris 1 49- 1 5 1 - - cystoscopy 1 90 Corpusculum renale 1 84 Cortex - IGlandula supra renalisl 1 89 - renalis 1 83-1 84, 1 88, 246-247, 250 Costa l-ael 2-3, 5, 8, 1 4 - 1 6 , 20-22, 27, 2 9 , 3 1 -32, 34, 4 1 , 48-49, 54, 58, 63, 69, 73, 1 03, 1 1 0, 1 1 3, 1 1 5- 1 1 6 , 1 1 8- 1 20, 1 2 2, 1 24- 1 27, 1 32 , 1 44, 1 83, 1 88 , 2 1 6-2 1 7, 220, 245-250 - fluctuantes [XI : XII] 48 - spuriae [VI I I - X I I J 48 - verae [I-VIIJ 48 COWPER's g land 226, 232, 234 Coxa - valga 276 - vara 276 Craniocervical junctions 1 7- 1 9 - AP-radiogra ph 1 9 Crista - capitis costae 49 - colli costae 49 - I liaca 1 -2, 1 5, 26-27, 37, 44, 47, 62, 73, 1 03 , 1 76 , 1 83, 2 1 6 , 220, 230, 254, 264, 266-26 7, 27 1 , 273, 307, 3 1 7 , 3 1 9-320, 322, 360, 364 - intertrochanterica 273, 275-276 - med ialis 283 - obturatoria 266-267 - occipitalis externa 6 - pubica 266 - sacralis lateralis 1 0 - - medialis 1 0 - - mediana 1 0- 1 1 , 1 5, 360 - urethralis 1 90, 1 98 C rusl-ral 263 - clitoridis 200, 235, 237, 2 6 1 - compartments 366 - cross-section 381 -382 - cutaneous innervation 350 - dextrum IFasciculus atriovent ricularisl 82-83 IPars lumbalis, Dlaphragmal 62-63, 68, 1 04, 1 06 , 1 1 6 , 1 5 5, 249, T21 - extensors 326 - flexors 326 - laterale IAnulus inguinalis superficialisl 56, 58, 60, 239 - mediale IAnulus inguinalis superficiallsl 56, 58, 60, 239 - muscles 324-332, T47-T50 - - latera l 366 - - origins and insertions 3 1 0-31 1 , 324-325 - osteofibrous tubes 366 - penis 1 96 , 1 98, 226, 236, 260 - sinistrum IFasciculus atrioventricularisl 82-83 - - I Pa rs lumbalis, Diap h ragmal 63, 1 04, 1 06 , 1 1 6, 248, T2 1 Cryptae intestinales s. G landulae i ntestina les
Cumulus oophorus 202 Cupula pleurae 1 03, 1 22 Curvatura - major 1 28- 1 30, 1 32 , 1 58-1 6 1 - m i n o r 1 28- 1 30, 1 32 , 1 35 , 1 60- 1 6 1 Cuspis - a nterior IValva atrioventricularis dextral 77-78, 8 1 -82 - - IValva atrioventricularis sinist ral 77, 79-80, 82, 1 26 - commissuralis dextra 77 - - sinistra 77 - posterior IVa lva atrioventricularis dextral 77-78 , 80-8 1 - - IValva atrioventricularis sinis tral 77, 79-8 1 , 1 26 - septalis IValva atrioventricularis dextral 77-78, 80 Cutaneous innervation, segmental - back 36 - lower limb 346 Cutaneous nerves, lower limb 349 Cutis 70, 1 88, 2 1 0 Cystoscopy 1 90- 1 9 1 o
Defaecography 2 1 5 Dens axis 6-7, 1 2, 1 8- 1 9 Dermatomes - back 36 - lower limb 346 Dia meterlsl - obliqua I 264 - obliqua II 264 Diameterlsl - lof the pelvis i n the female 265 - sagittalis 265 - transversa 264-265 - tuberalis 265 Diaphragma 54-55, 59, 62-63 , 67, 69, 73, 87, 1 0 1 , 1 04- 1 1 2 , 1 1 6- 1 2 1 , 1 42 , 1 44, 1 48- 1 49 , 1 52 , 1 57, 1 59 - 1 6 � 255, T21 - pelvis 1 88, 237, 242, 245-246, 249-250, T22 - - of the female 230-23 1 , 233 - - of the male 232, 236 - urogenitale 237, 24 1 , 243, 26 1 , T22 - - of the female 234-235 - - of the male 234 Digitusi-il - minimus IPesl 262, 295 - pediS 263 - primus IPesl s. Hallux - qua rtus I Pesl 262, 295 - quintus IPesl s, Digitus minimus - secundus I Pesl 262, 295 - tertius I Pesl 262, 295 Discus - articularis IArticulatio stern oclavicularlsl 51 - interpubicus 207, 268, 271 -272, T39 - i ntervertebralis 4, 1 2, 1 7, 1 9-25, 29 , 35 , 42, 45, 1 78 , 259, 268, 2 7 1 Distantia - intercristalis 265 - interspinosa anterior 265 - - posterior 265 - pubococcygea 265
Diverticuluml-al - a mpullae 1 9 1 - cervical 1 09 - e p l p h renic 1 09 - i lei 1 3 7 - mid-oesophageal 1 09 - of MECKEL 1 37 - of ZEN KER 1 09 DODD's veins 306, 352 Dorsum - lines of orientation 1 - of the foot, muscles 333-337, T51 -T52 - pedis 262, 368, 373-374 - penis 1 97 - regions 1 - surface a natomy 1 DOUGLAS, Pouch of 1 57, 1 67, 207, 229, 253 Duct - of MULLER 1 92 , 200 - of SANTO R I N I 1 52 - of WIRSUNG 1 52 - of WOLFF 1 92, 200 Ductulusl- i l - aberrans inferior 1 92 , 1 94 - efferentes testis 1 94, 252 - prostatici 1 90, 1 98 - transversi 200-201 Ductusl-usl - alveolares 98 - arteriosus [BOTALLO] 75 - b i liaris s. Ductus choledochus - bilifer interlobularis 1 45 - choledochus 1 42 , 1 46 , 1 50-1 54, 1 70, 1 72 , 1 79 , 243, 249 - - AP-radiograph 1 5 1 , 1 54 - - variability 1 50, 1 53 - cysticus 1 3 1 , 1 50-1 54, 1 67, 1 70, 1 79 , 249 - deferens {Vas deferensl 60-61 , 70-7 1 , 1 66 , 1 79 , 1 90- 1 92 , 1 94- 1 97, 2 2 1 -222, 226-227, 236, 238-239, 243, 252, 256, 258 - - AP-radiogra p h 1 95 - ejaculatorius 1 90, 1 92 , 1 95 - 1 9 6 , 1 98 - epoophorontis longitudinalis s, Ductus longitudinalis - excretorius 1 53 , 1 96 - g landulae bulbourethralis 1 92 , 1 98, 234 - hepaticus communis 1 3 1 , 1 50- 1 54, 1 67, 1 70, 1 79 - - dexter 1 46 , 1 50- 1 5 1 - - sinister 1 50 - 1 5 1 - lactiferi 64 - longitudinalis 200-20 1 - mesonephricus 1 92 , 200 - omphaloentericus 1 3 7 - pancreaticus 1 50, 1 52-1 54, 242-243 - - accessorius 1 52 - 1 53 - - AP-radiograph 1 54 - - variability 1 53 - paramesonephricus 1 92 , 200 - paraurethralis 235 - thoracicus 63, 1 1 3 , 1 1 5- 1 1 6, 1 2 1 , 1 24-1 27, 245, 248-249 - venosus [ARANTIUSJ 1 43 Duodenum 1 1 7, 1 28 - 1 30, 1 33- 1 36 , 1 40, 1 49- 1 54, 1 57, 1 60- 1 6 1 , 1 63 , 1 65-1 67, 1 70, 1 79- 1 80, 243-244, 255 - AP-radiograph 1 32, 1 35 - endoscopy 1 35 - layers of the wa ll 1 36
I n dex
Duodenum
Facies articularis
Fascia
Fissural-ae}
- projection 1 34 Dura mater - c ra n ialis 1 9 - spinalis 1 9 , 40-4 1 , 43-45, 1 1 9
- - -
- i nvestiens perinei superficialis s Fascia perinei - lata 306-307, 3 1 3-3 1 5 , 3 1 9, 355, 360, 381 - nuchae 39 - obturatorla 230, 232-233, 3 1 7 - pedis 382 - pelvis parietalis 253 - - visceralis 237, 252 - penis profunda 1 97, 1 99 , 238 - - superficialis 1 99 - perinei 230, 232-235, 260 - rectoprostatica 252 - rectovaginalis 207, 253 - renalis 1 88, 246-247 - spermatlca externa 60-6 1 , 70, 1 97, 239 - - i nterna 6 1 , 70, 1 93-1 94, 1 9 7, 239 - superficlalis ICanalis inguinalis) 61 - thoracolu m balis 22, 24-32, 35, 52, 72, 3 1 9 - transversalis 3 1 , 58-62 , 69, 72-73 - vesicovagmalis 207 Fasciculus[- i ) - atrloventricularis 82-84 - latera lis 1 22 - longitudinales [Lig. cruciforme atlantis] 1 8- 1 9 - medialis 1 22 - posterior 1 22 - transversi [Aponeurosis plantaris] 338 Fat pad, parathymic 111 Fem u r 3, 2 1 5 , 256-257, 262-263, 273-277, 280-28 1 , 284-287, 290-293, 3 1 3-3 1 6, 323, 328, 330, 369 , 381 - a n g le between neck and shaft of the femur 276 - - of ante torsion 277 - AP-ra diograph 274 - arteries 35 1 . 359 - - dig ital subtraction angiography [oSA) 359 - cross-section 380-381 - fascia 306-307 - muscles 3 1 0-323, T42-T46 - - origins and i nsertions 3 1 0-3 1 1 - structure o f the tra becular bone 276 - veins 352 Fi brae - intercrurales 56, 58, 60 - obliquae 1 29 Fibula 262-263, 282-283, 285-287, 294, 300-30 1 , 304-305, 330-33 1 , 335, 366, 381 -382 Filuml-a] - rad icu laria IN. spinalis] 45 - - posteriora 40 - terminale 43, 242, 252 Fimbrial-ae) - ovarica 201 - tubae uteri nae 201 , 209, 253 Fissura[-ae) - horizontalis pulmonis dextri 94-95, 1 20 - ligamentl teretis 1 42 - obliqua 94-95, 99, 1 20 - 1 2 1 , 1 24- 1 27
- portalis dextra 1 47 - - principalis 1 47 - umbilicalis 1 47 Flatfoot 303, 384 Flexio [Uterus) 203 Flexura - anorectalis 2 1 0, 226 - coli dextra 1 38, 1 55 , 1 60-1 63, 1 65-1 66, 1 75 - - sinistra 1 20- 1 2 1 , 1 32, 1 38, 1 62, 1 6 5- 1 66, 1 75 - d uodeni inferior 1 3 1 , 1 53, 1 75 - - superior 1 53 - duodenojej unalis 1 34- 1 35, 1 52, 1 66- 1 6 7, 1 77, 244 - perinealis s Flexura anorectalis - sacralis 2 1 0, 226 Foetus, ultrasound i mage 206 Fold of KOHLRAUSCH 2 1 0, 252 FoUiculus[ - i ) - atreticus 2 0 2 - ovaricus[-i1 maturus 202 - - vesiculosi 20 1 , 253 - primarii 202 Foot s. Pes Foot prints 384 Foramen[-ina) - costotransversarium 8, 2 1 - epi ploicum s Foramen omentale - infrapiriforme 3 1 7, 3 1 9-32 1 , 360, 364 - intervertebrale 4, 1 2 , 1 4- 1 5 , 22, 25, 29, 35, 4 1 , 45, 271 - ischiadicum majus 230, 265, 269-27 1 , 3 1 9 , 360 - - m i nus 265, 269-27 1 , 3 1 7, 3 1 9, 321 - magnum 6, 40 - nutricium 282-283, 3 1 1 - obturatum 229, 265-266, 269, 27 1 , 273-274, 280 - omentale 1 60, 1 66- 1 67 - ova Ie ICori 78 - papilla ria 1 83 - sacralia anteriora 1 0 , 1 6 . 3 1 7 - - posteriora 1 0- 1 1 - suprapi riforme 3 1 7, 3 1 9-320, 360 - transversarium 6-7, 35 - venae basivertebralis 9 , 2 5 - - cavae 55, 62-63, 1 04, 1 06, T21 - vena rum m in i m arum 78 - vertebrale 6-9, 35, 1 25 - W I N SLOWI 1 60 Fornix - gastricus 1 30, 1 32, 242, 247 - vag inae 202, 205, 207, 253 Fossa - acetabuli 7 1 . 230, 256, 260, 266-267, 273, 279-280 - iliaca 264, 266, 2 7 1 - inguinalis lateralis 59, 6 1 , 7 1 , 236 - - medialis 59, 6 1 , 7 1 , 236 - intercondyla ris 275, 277, 281 , 29 1 , 293 - ischioanalis 232-233, 236, 256-258 - maUeoli lateralis 283 - navicularis urethrae 1 98-1 99, 252 - ovalis 78 - paravesicalis 59, 260-261 - poplitea 262, 307, 321 , 360-363, 366, 369-372
E
Embryo, u ltrasound image 206 Eminentia - i liopubica 230, 264, 266-267, 273 - intercondylaris 282, 290-291 - plantaris intermedia 384 - - lateralis 338, 384 - - medialis 338, 384 Endocardiu m 80 Endoscopic retrograde cholangio pancreaticography [ERCP) 1 54 Epicardium s. La mina visceralis (Pericardium serosum) Epicondylus - lateralis [ Femur) 275, 281 , 284, 290-2 9 1 - medialis [Femurl 275, 277. 28 1 , 284, 287, 290-29 1 , 3 1 5 Epididymis 6 1 , 1 85, 1 9 2- 1 94, 222, 239, 242-243 Epiglottis 1 2 Epineuri u m 43 Epiorc h i u m 1 94 Epiphysis - anularis 5, 7-9 , 24-25 - of the head of the fem u r 274 Episiotomy 233 Epithelium 1 05, 1 30, 1 36, 1 39 Epoophoron 200 Erection 222 Excavatio - rectouterina 1 57, 1 67, 2 0 1 -202, 205, 207, 229, 253, 257 - rectovesicalis 1 66, 1 90, 1 96, 2 1 0 , 2 1 7, 226, 236, 243 , 252 - vesicouterina 1 57, 1 67, 202, 205. 207, 209, 237, 253 Extremitas - acromialis 47. 1 22 - a nterior [Splen) 1 56, 1 59 - inferior [ Ren) 1 64, 1 67, 1 86, 1 88, 2 1 6 - - [Testis] 1 93 - posterior [Splen] 1 56 - sternalis 3, 47, 1 08 - superior [ Ren] 1 60, 1 66, 1 88, 216 - - [Testis) 1 93 - t u baria 201 - uterina 201
F Facies - anterior [Glandula suprarenalis) 1 89 - - [ PateUa) 284-285, 290-29 1 - - [ Ren) 1 88 - anteroinferior 1 64 - anterosuperior 1 6 1 - articularis anterior [Axis) 6 calcanea 298 anterior 297 - - - media 297 - - - posterior 297 - - capitis costae 49 - fi bulae 283
c u boidea 297-298 fibularis 282 inferior (Atlas) 6 - [Tibia) 282, 294, 301 - [Vertebra lumbalis) 9 malleoli lateralis 283, 294, 301 - medialis 282, 294, 301 - - navicularis 297-298 [PateUa) 284-285 , 290, 292 - - posterior [Axis] 6 - - superior IAtlas) 6, 1 9 - - - ITibia] 282, 293 - - talaris 303 anterior 297-298 , 303 - - - media 297-298, 303 - - - posterior 297-298 , 303 - - tuberculi costae 49 - auricula ris 1 0- 1 1 , 266 - colica 1 56 - contacta hepatis 2 1 7 - costalis IPulmo] 94-95 - d i a p h ragmatica [ Hepar] 1 42 , 1 45, 1 60- 1 6 1 - - I Pulmo) 95 - - [Splen) 1 56 - dorsalis IDs sacrum] 26 - gastrica ISplen) 1 56, 1 66 - 1 67 - g lutea 267 - intervertebralis 7-9, 1 2, 1 4 - 1 6, 25 - intestinalis 201 -202 , 209, 229, 253 - lateralis [Fibula] 283 - - [Testis] 1 93 - - [Tibia] 282-283 - lunata 230, 266-267, 279 - maUeolaris lateralis 296-298 - - medialis 296-298 - medialis [ Fibula] 283 - - [Ovarium] 201 - - [Tibia) 282-283, 306, 327, 367 - pateUaris 275, 28 1 , 284-286, 290, 292 - pelvica 1 1 - poplitea 275, 277, 29 1 , 323, 328, 330, 369 - posterior IFibula] 283 - - [ Prostata] 1 9 1 - - I Ren] 1 88 - - ITibia) 282-283 - renalis [Splen) 1 56 - sacropelvica 266 - superior (Talus] 297 - symphysialis 3, 266, 27 1 , 279 - vesicalis 202, 209, 253 - visceralis [ Hepar] 1 45 , 1 60 - - (Splen] 1 56 Falx septl 79 Fascia - axiUaris 58 - bra c h i i 58 - cervicalis 1 1 0, 1 1 9 - clavi pectoralis 58 - cremasterica 6 1 , 1 93- 1 94, 1 97, 239 , 252 - c ribrosa 2 1 8, 306 - cruris 306-307, 328, 365-366, 38 1 -382 - deltoidea 26-27 - dorsalis pedis 306, 379, 384 - glutea 5 2 , 307, 3 1 9, 362 - i liaca 1 79 - i nferior d i a p h ragmatis pelvis 230 - infraspinata 26-28
I n d ex
- su pravesicalis 6 1 , 71 , 236 - trochanterica 275-277 , 279 - vestibuli vaginae 235 Fovea[-ae] - capitis femoris 273, 275-277, 279-280 - costalis Inferior 8, 20 - - processus transversi 8-9, 2 1 , 45 - - superior 8-9, 20-21 - dentis 6 , 1 9 Foveolae gastricae 1 30 FRANKENHAuSER's ganglion 223 Frenulum - clitoridis 235, 253 - labiorum pudendi 235 - ost i i ilea lis 1 39 - preputii 1 99 Fundus - gastricus 1 20, 1 28-1 30, 1 32, 1 49, 1 60 - uteri 1 67, 201 -204, 207, 209, 253 - vesicae 1 67, 1 95- 1 96 , 1 98 - - biliaris 1 49-1 50, 1 58, 1 63 , 1 66 Funiculus - spermatic us 56-58, 60, 68, 1 93 , 1 97, 2 1 8, 226-227, 238, 256, 306, 354-355 - u m b i licalis 70, 206, 208
Gland[s] - of BARTHOLIN 200, 233, 235 - of B R U N N E R 1 36 - of COWPER 226, 232, 234 Glandula[-ae} - areolares 64 - bulbourethralis 1 92 . 1 96 , 1 98, 222, 226, 232 . 234, 236 - d u odenales 1 36 - gastricae 1 30 - intestinales 1 36 , 1 39 - mammana 1 25 - 1 27 - oesophageae 1 0 5 - supra renalis 1 52 , 1 6 1 , 1 6 7, 1 79 , 1 82 , 1 85 . 1 89 , 2 1 7, 245, 249 - thyroidea 1 04- 1 05, 1 07, 1 1 0- 1 1 1 , 1 1 8- 1 1 9 - tracheales 9 1 - vesiculosa 1 9 1 - 1 92, 1 95-1 96, 222, 226-227, 236, 242-243, 256, 258 - - AP-radiograph 1 95 - vest i b ularis major 200, 233, 235. 237 Glans - clitoridis 200, 207, 233 , 235 - penis 1 92 . 1 96 - 1 99 , 222, 242-243 , 252 GLISSON, Triad of 1 45 Glomus coccygeum 253 G RAAFian follicle 2 0 1 Gubernaculum testis 7 0 , 1 9 2
G
H
Ganglion[-ia} - cardiacum 1 20 - cervicale medium 83, 1 1 7, 1 20 - - superius 83 - cervicothoracicum 83, 1 1 7 , 1 20 - coeliaca 2 1 4, 249 - of FRANKEN HAUSER 223 - mesentericum inferius 2 1 4 - pelvica 2 1 4 , 222-223 - sacralia 225 - sensoria nervorum spinalium 24, 40-43, 45 - stellatum s. Ganglion cervi cothoracicum - thoracica 1 1 3- 1 1 4, 1 1 7, 1 20- 1 2 1 - trunci sympathici 41 -43, 45, 2 1 4 , 222-223 Gaster 63, 67, 1 04. 1 06 , 1 08- 1 09 , 1 1 7, 1 2 1 , 1 28-1 35, 1 40, 1 5 5, 1 5 7- 1 6 1 , 1 66 , 1 70, 1 72 , 1 79-1 80, 2 1 7. 242-244, 246-250, 255 - AP-radiograph 1 32 , 1 7 1 - arteries, variability 1 70 - forms 1 32 - layers of the wall 1 30 - projection 1 32 Gastroscopy 1 33 Genital organs - female 223 - - development 200 external 233, 235, 241 innervation 223 i nternal 204, 209 - male 222, 239 - - development 1 92 - - external 1 97, 238. 240 - - innervation 222 Genu 263 - muscles 323 G I M B E R NAT's ligament 355
HACH. deep perforating vein of 352
Fossa
H aemorrhoids 2 1 1 Hallux 262, 295, 299 H austra coli 1 38- 1 39 , 1 4 1 , 1 63 HEAD, zones of 67 Heart - aXIs 80 - shadow 1 0 1 - shape 1 0 1 - - a o rtic knob 1 0 1 - - - o f p u lmonary artery 1 0 1 - - - o f the left/right atrium 1 0 1 - - arch o f t h e ventricle 1 0 1 - veins 85 H EISTER'S valve 1 50 Hepar 54, 67, 1 1 9- 1 2 1 . 1 3 1 , 1 42- 1 46 , 1 49- 1 50 . 1 54- 1 55, 1 57, 1 80, 1 88, 242-244. 246-250, 255 - AP-radiograph 1 7 1 - arteries, variations 1 70 - form variations 1 44 - laparoscopy 1 49 - microscopic structure 1 45 - porta hepatis 1 42 - projection 1 44 - segments 1 47 - veins, projection 1 46 - - ultrasound image 1 48 Hiatus - add uctorius 3 1 5-3 1 6 , 323, 358, 362 - aortic us 62- 63, 1 04. 1 79 , T21 - oesophageus 62-63, 1 04-1 0 5 . 1 07, 1 09, 1 79 , 2 1 7, 22 1 , T21 - sacralis 1 0- 1 1 - saphenus 306, 354-355 - u rogenitalis et a n i 230 H ilum - [Glandula suprarenalis} 1 82 - renale 1 82 - splenicum 1 56, 1 6 1 , 249
Hip - arteries 359 - muscles 3 1 0-322, T42-T43 H o rseshoe kid ney 1 85 H u merus 3, 1 24 HUNTER's vein 352 Hydatid, stalked 201 Hymen 235 Hysterosalpingography 203
I leum 1 37- 1 40, 1 57- 1 58, 1 62- 1 63, 1 66, 1 75 . 209. 2 1 5 , 242-244, 251 , 254-255 I mpotentia - coeundi 222 - generandi 222 Impressio - cardiaca 9 5 - collca 1 42 - d uodenalis 142 - gastrica 1 42 - oesophagea 1 42 - renalis 1 42 - suprarenalis 1 42 InCisura - acetabuli 266-267 - angularis 1 28 , 1 30, 1 32 , 1 35 , 1 60 - a picis cord is 84-85 - cardiaca p u lmonis sinlstri 94-9 5 , 1 03 , 1 1 0 - cardialis 1 28, 1 30 - clavicu laris 50 - costalis 50 - fibularis 282 - ischiadica major 266-267 - - m inor 266-267, 280 - jugulans [Sternum] 46, 50 - ligamenti teretis 1 42 - pancreatis 1 52 - vertebralis inferior 8, 1 2, 1 5 - - superior 1 2 , 1 5 I nfundibulum - ductus paramesonephrici 1 92 - tubae uterinae 200-201 , 204, 209, 228, 253 I n g u i n a l canal 6 1 - walls 60 I ng u i nal hernia 61 - d i rect, medial 61 - i n d i rect, lateral 61 Injection, ventrogluteal 364 I nsula pancreatlca 1 53 Interacetab u la r line 265 Interarticular portion 8 , 1 5 I ntermetatarsal joints s Articulatio[ -nesl i ntermetatarsales Intersectio tendl nea 46, 56-58 Interspinal line 265 I ntestinal development 1 57 I ntestin u m - crassum 67, 1 63- 1 6 5 - tenue 67, 1 36 , 1 59, 1 63-1 64, 252-253 - - layers of the wall 1 36 I ntroitus vaginae 223 Isthmus 8, 1 5 - g landulae thyroldeae 1 04 - tubae uterinae 201 , 209, 229, 253 - uteri 201 -202, 253
J
Jej u n u m 1 32 , 1 34-1 35, 1 37, 1 52, 1 54. 1 57, 1 6 2- 1 63 , 1 65 , 1 75 , 1 79 , 242, 244, 247, 249-25 1 , 255 Joint - of C H O PART 296, T39 - of LlSFRANC 296, T39 Junctio anorectalis 2 1 0 Juncturae cinguli pelvici 268-271 , T39 K KOHLER's teardrop 280 KOHLRAUSCH's fold 2 1 0, 252 KRISTELLER, mucous plug of 207
L Labium - anterius 202, 205 - externum 264, 266-26 7, 322 - i nternum 264, 266-267 - laterale 275, 277 - majus pudendi 207. 231 , 235, 253, 2 6 1 - mediale 275-277 - m i n u s pudendi 207, 223, 23 1 , 233, 235, 237, 24 1 , 253, 2 6 1 - posterius 202, 205 Labrum acetabuli 279 Lacuna[-ae] - musculorum 269, 355 - urethrales 1 98 - vasorum 62, 68, 269, 355 Lamina[-ael - anterior [Vagina musculi recti a bdominis} 52, 56-58, 70, 72, 355 - arcus vertebrae 7-9, 2 1 -23. 25, 29. 35, 4 1 , 44 - cartilaginis cricoideae 1 2, 9 1 , 119 - c ribrosa 68 - dextra \Cartila g o thyroidea ] 90-91 , 1 04 - hepatocyticae 1 45 - muscularis mucosae 1 05 , 1 30 , 1 36 , 1 39 - parietalis [Pericard i u m sero sum] 74-75, 85, 89, 1 1 9- 1 20 - - [Tunica vaginalis testis] 70. 1 93-1 94, 239 - posterior [Vagina musculi recti abdom i nis] 58, 69-70 - profunda [ Fascia thoracolum ba lis] 29, 32 - p ro p ria mucosae 1 05 , 1 30, 1 36 . 1 39 - superficialis [Fascia cervicalis} 1 1 0, 1 1 9 - - [Fascia thoracolumbalis} 29 - visceralis [Pericardium sero sum} 74-75, 78-80, 1 1 9- 1 20 - - [Tunica vag inalis testis] 1 94, 239, 242 v LAN Z 's polnt 1 40 Laparoscopy 1 49 Larynx 35. 90-91 , 1 09 LAU ENSTEIN projection 280 Leg s. Crus Lien s . Splen Ligament of G I M B E R NAT 355
I nd ex
Ligamentum(-al - alare 1 8 - anococcygeum s. Corpus anococcygeum - a nularia 90-91 - apicis dentis 1 8- 1 9 - arcuatum laterale 62-63, 6 8 - - mediale 62-63 - - medlanum 63 - a rteriosum 74-75 , 84, 88, 99, 1 04-1 05, 1 1 3-1 1 4 - atlantooccipitale laterale 1 7 - bifurcatum 300, 303 - calcaneocuboideum 300, 303 - - plantare 302 - calcaneofibulare 300-304 - calcaneonavic u lare 300, 303 - - plantare 299-300, 302-303 - capitis costae intraarticulare 22 - - - radiatum 20-21 - - femoris 236, 256, 260, 271 , 279 - - fibulae anterius 286, 294 - - - posterius 287, 290 - cardinale 201 , 205 - collaterale ( -Ial - - (Articulationes interphalangeae pedisl 302 - - fibula re 285-289, 293, 3 1 0-31 1 - - latera Ie 288 - - mediale (Articulatio genusl 287-288 - - - (Articulatio talocruralisl 300-304, 382 - - tibiale 284-290. 293 - coronarium 1 42- 1 43, 1 45, 1 60 , 1 67 - costoclavicu lare 5 1 - costotransversarium 20-2 1 , 32 - - latera Ie 20-22 - - superius 2 1 -22, 3 1 - costoxiphoidea 5 6 , 58 - cricothyroideum medianum 90 - cruciatum anterius 286-287, 289-290, 292-293 - - posterius 286-290, 293 - cruciforme atla ntis 1 8- 1 9 - c uboideonaviculare dorsale 300 - - plantare 302 - cuneocuboideum dorsale 303 - cuneonavicularia dorsalia 300, 303 - - plantaria 302 - deltoideum s. Ligamentum collaterale mediale (Articulatio talocru ralisl - denticulatum 40, 43, 45 - epididymidis inferius 1 93 - - superius 1 93 - falciforme 59, 7 1 -72, 1 42-1 43, 1 47, 1 50, 1 58-1 60, 1 66, 243, 248-249 - flavum 20-23, 25, 29, 32, 35, 4 1 , 43-45, 254 - fund iforme penis 58, 60, 238, 242-244, 252 - gastrocolicum 1 57-1 58, 1 60- 1 61 , 1 66, 1 73, 243, 247 - gastrophrenicum 1 67 - gastrosplenicum 1 56, 1 60- 1 6 1 , 1 66-1 67, 245, 247 - hepatoduodenale 1 3 1 , 1 50, 1 60-1 6 1 , 1 66-1 67 - h e patogastricum 1 3 1 , 1 57, 1 60-1 6 1 , 1 66, 247, 249 - iliofemorale 268-269, 278-279, 3 1 5. 380
Ligamentuml-al
Ligamentuml-al
Lineal-ael
- iliolumbale 3 1 , 4 1 , 2 1 7, 268-270, 272 - infundibulopelvicum 209 - inguinale 57, 60, 62, 69, 1 96 - 1 97, 234-235, 262, 268-270. 306, 3 1 3 , 3 1 7, 354-356, 359 - interclaviculare 5 1 - intercuneiformia d o rsalia 303 - interfoveolare 71 - interspinalia 25, 3 1 , 35, 44, 1 1 9 - intertransversarium 2 1 -22, 3 1 -32, 41 - ischiofemorale 278-279 - lacu nare 62, 3 1 7, 355 - latum uteri 20 1 , 209 - longitudinale anterius 1 7, 20-22, 24-25, 29, 42, 45, 55, 72, 1 1 6, 1 24, 268 - - posterius 20, 23-25, 42-43, 45 - lumbocostale 63 - meniscofemorale posterius 287-288 - metatarsale { -ial dorsalia 300 - - plantaria 302 - - transversum profundum 300, 302 - - - superficiale 338 - nuchae 25, 28, 34 - ova rii proprium 200-20 1 , 204, 209 - patellae 285, 287-290, 293, 306, 3 1 0, 3 1 2-3 1 5, 322-323, 327, 332, 356, 368 - pectineum 3 1 3 , 355 - phrenicocolicum 1 60, 1 66 - phren icosplenicum 247 - plantare { - ial 302 - - lon g u m 299-300, 302, 304, 342, 379, 383 - popliteum arcuatum 286, 288, 290, 329 - - obliquum 286-288, 293, 329-330 - pubicum inferius 230. 234, 268, 270- 272. T39 - - superius 234, 256-257, 268-269, 272, 3 1 4 , 355, T39 - pu bofemorale 278-279 - puboprostaticum 226, 252 - pulmonale 95, 1 1 2 - rectouterin u m 205 - reflexum 56, 58, 60 - rotundum 1 67, 201 , 204, 229 - sacrococcygeum anterius 230-231 - - posterius profu ndum 270 - - - superficiale 252, 270 - sacroiliaca anteriora 230, 268-269, 271 -272, 3 1 7, T39 - - i nterossea 230, 254, 270-272, T39 - - posterlora 270-271 , T39 - sacrospinale 224-225, 229, 240, 265, 269-271 , 278, 3 1 0, 3 1 4 , 360, T39 - sacrotuberale 3 1 , 224, 230, 232-233, 240, 265, 269-27 1 , 278, 3 1 7, 3 1 9-32 1 , 360, 364, T39 - sacrouterinum 201 , 253 - splenorenale 1 56, 245 - sternoclaviculare anterius 51 - sternocostale intraarticulare 51 - - radiatum 5 1 - supraspinale 2 2 , 2 5 , 3 1 , 33, 270
suspensorium c litoridis 235 - ova rii 1 67, 20 1 , 204, 209, 253 - penis 58, 238-239 talocalcaneum interosseum 300, 303-304, 383 laterale 300 - - mediale 301 - - posterius 3 0 1 - talofi b u lare a nterius 300, 303 - - posterius 301 , 304 - tarsi plantaria 302 - tarsometata rsalia dorsalla 300, 303, 334 - - p lantaria 300, 302 - teres hepatis 59. 7 1 -72, 1 42, 1 44, 1 47, 1 54, 1 58, 1 60-1 6 1 , 1 66, 1 70, 1 72, 249-250, 255 - - uteri 1 67, 200-20 1 , 204, 209, 228-229, 253 - ti biofi b u lare a nterius 294, 300-30 1 , 334 - - posterius 300-301 - transversum 23 - - acetabuli 230, 279 - - {Articulatio zygapophysialisl 23 - - atlantis 1 8- 1 9 - - cervicis s. Ligamentum cardinale - - genus 286, 289 - - perinei 230, 234 - triangulare dextrum 1 42 - - slnistrum 1 42, 1 47, 1 67, 244-245 - umbi licale medianum 6 1 , 72, 1 58, 1 90 - 1 9 1 , 1 96, 207, 229, 236, 252-253 - venae cavae 1 42 - 1 43, 1 47 - venosum 142, 147 - vocale 1 1 9 Li m b, lower 263 - a rteries 351 - compa rtments 366 - cross-section 381 -382 - cutaneous i nnervation, segmental 346 - cutaneous ne rves 349 - dermatomes 346 - innervation, segmental, ind icator muscles T41 - lymphatics 352 - m u scles 306-309, T42-T54 - - origins a n d insertions 3 1 0-31 1 , 324-325 - nerves 345 - skeleton 263 - surface anatomy 262 - veins 352 Limbus - acetabuli 256, 266-267 - fossae ovalis 78 Li nea{-ael - alba 46, 56, 58, 60, 72-73, 207, 242-243, 248-249, 251 -254 - anocutanea 2 1 0 - a rcuata 7 1 , 2 7 1 , 273 - - {Os iliuml 264, 266 - - {Vagina musculi recti abdominisl 58, 70, 1 58 - aspera 275-277, 323 - axillaris posterior 1 - epiphysialis 281 , 29 1 , 293, 304-305, 383 - glutea anterior 267 inferior 267 - - posterior 267
-
-
intercondylaris 275 intermed ia 264, 266-267 intertrochanterica 275 mediana posterior 1 musculi solei 282-283 paravertebralis 1 pectinea 275-276 scapularis 1 seml lunaris 58 supracondylaris lateralis 275 - medialis 275 terminalis 1 67, 230, 236, 264-265, 271 , 280 - transversa 1 0 Lingua 1 2 Lingula pulmonis sinistri 94-95, 110 LlSFRANC's joint 296, T39 Liver puncture 1 44 Lobar b ronchi 92 Lobulus{-il - g landulae mammariae 64 - testis 1 93-1 94. 252 - thymi 1 1 1 Lobus{-il - caudatus 1 42 - 1 43, 1 54, 1 6 1 , 1 66, 1 72, 244, 249 - {Glandula thyroideal 1 04-1 05, 1 07, 1 1 0 - g landulae mammariae 52 - hepatis dexter 1 3 1 , 1 40, 1 42 - 1 44 , 1 49-1 50, 1 58-1 6 1 , 1 63, 1 66, 1 72, 1 88, 244-246, 248-250, 255 - - sinister 1 20, 1 31 , 1 42-1 44, 1 49-1 50, 1 54, 1 58-1 6 1 , 1 66, 1 70, 1 72, 242-243, 245, 247-250, 255 - inferior 94-96. 98-99, 1 03, 1 1 0, 1 1 8, 1 2 1 , 1 24-1 27, 1 48, 1 59, 243, 245-247 - medius (Prostatal 1 95 - - pulmonis dextri 94-96, 98, 1 03, 1 1 0, 1 1 8, 1 26-1 27, 1 59, 245 - prostatae dexter 1 9 5 - - sinister 1 95 - pyramidalis 1 1 0 - q u a d ratus 1 42, 1 60- 1 6 1 , 1 72. 249 - superior 94-96, 98-99, 1 03, 1 1 0- 1 1 1 , 1 1 8, 1 24-1 27, 1 59, 245 - {Thymusl 1 1 1 Lower abdomen, vessels 1 75, 1 77 Lower limb s, Limb, lower Lumbar part of the vertebral column 43 - AP-radlograph 1 6 - CT 35 - lateral radiograph 1 5 - ligaments 23 - MRI 24 - vertebral joints 23 Lumbar puncture 44 Lunula valvulae semilu naris 79 Lymphatics, AP-radiogra ph 2 1 9 Lymphogra phy 2 1 9 M
Malleolus - lateralis 262, 283, 294, 300-30 1 , 304-305, 327-328, 332, 334, 336-338, 367, 370-371 , 373
I n d ex
fvlalleolus
- medialis 262, 282, 294, 301 , 304-305, 307, 327-330, 334, 336, 338, 37 1 , 373 - tertius 305 Mamma 64-65, 1 27 - lymphatic drainage 65 - radiography 65 Mammography 65 Manubrium sterni 3, 47, 50-5 1 , 55, 69, 1 08, 1 1 9, 1 24 Margo - acetabuli s. Limbus aceta bull - anterior [Fibula} 283 - - I Pulmo} 94-95, 1 1 0- 1 1 1 - - ITestis} 1 93 - - ITibia} 262, 282-283, 306 - falciform is 306, 355 - inferior [Hepa r} 1 42, 1 45, 1 63 - - [Pulmo} 94-95, 1 1 0 - - ISplenl 1 56 - interosseus IFibula} 283, 330-331 - - [Tibial 282-283 - lateralis [ Ren} 1 82, 2 1 6 - liber IOvariuml 201 - medialis [Glandula suprarenalis} 1 82, 1 89 - - [ Renl 1 82, 2 1 6 - - [Scapulal 2 - - ITibial 282-283 - mesova ricus 201 , 209 - posterior I Fibula} 283 - - ITestis} 1 93 - superior IGlandula suprarenalisl 1 82, 1 89 - - [Splenl 1 56, 1 6 1 , 1 66-1 67 Massa lateralis atlantis 6, 1 7, 1 9 MAY's vei n 352, 365 MCBURNEY's point 1 40 MECKEL'S diverticulum 1 37 Mediastinum 1 1 2-1 1 3 , 1 1 6, 1 1 9 - anterius 1 1 9 - Inferius 1 1 9 - medium 1 1 9 - organisation 1 1 9 - posterius 1 1 9, 1 2 1 - superius 1 1 9 - testis 1 93-1 94, 252 Medulla - [Glandula suprarenalisl 1 89 - renalis 1 83-184, 1 88, 246-247, 250 - spina lis 40-41 , 1 1 9, 1 23, 222-223, 248-249 Membrana - atlantooccipitalls anterior 1 7. 19 - - posterior 1 7 . 1 9 , 34 - intercostalis interna 3 1 , 55 - i nterossea cruris 283, 286, 294, 301 . 366, 381 - obturatoria 236, 260-26 1 , 268, 271 . 278-279 , 355 - perinei 252 - tectoria 1 8 - 1 9 Membrum - inferius 206, 263 - - surface anatomy 262 Meniscus[ -il - IArticulatio genusl 289 - lateralis 286-290, 292-293 - medialis 286-290 Mesenteri um 1 36-1 37, 1 64- 1 66, 252 - diverticuli 137 Mesoappendix 1 63- 1 67
Mesocolon - sigmoideum 1 64, 1 66-1 67, 1 79, 2 1 7- 2 1 8. 226 - transversum 1 39, 1 57, 1 60-1 6 1 , 1 63. 1 65-1 67, 1 73, 1 75. 1 77 Mesosalpinx 201 . 209 Metaphysis 304 Metatarsus 263. 298 Mons pubis 235 Motion segment - cervical 25 - lumbar 25 Mucous plug of KRISTELLER 207 M U LLERian d uct 1 92, 200 Muscles - origins and insertions of - of the abdominal wall 52, 54, 56-58, 60-62, 66, 72-73 - - C rus 3 1 0-3 1 1 , 324-325 - - CT 73 - - Femur 3 1 0-3 1 1 - - PelvIs 3 1 0-31 1 - - Pes 339 Muscles of the back 26-34 - autochthonous 28, 30-33, T20 - - lateral tract 29-30, 34, T20 - - medial tract 29-30, T20 - - suboccipital muscles 32-34 - deep 28-34 - superficial 26-27 M usculusl-i1 308, 3 1 2, 3 1 9 , 1 040- 1 04 1 , 1 045, 1 052 - abdominis 52, 56-58, 62. 66, 72-73, 1 88 - - CT 73 - abductor d igiti minlmi 304. 333-334, 336-337, 339-342, 377-378, 384, T40, T54 - - hallucis 299, 304, 333, 335, 338-342, 377-378, 384, T40-T4 1 , T52 - adductorl-esl 243, 259 - - brevis 244, 26 1 , 3 1 0-3 1 2, 3 1 5-3 1 6, 358, 380, T40-T4 1 , T45 - - ha llucis 304, 339-342, 378, 383-384, T40-T41 , T52 - - longus 244, 26 1 , 308, 3 1 0-3 1 7, 354, 356-358. 380-38 1 , T40-T41 , T45 - - magnus 260, 286-288, 290, 3 1 0-3 1 2, 3 1 5-3 1 7, 3 1 9-32 1 , 323, 358, 363-364, 380-38 1 , T40-T41 , T45 - - m i n i mus 260, 3 1 6 . 3 1 9-32 1 , T40 - articularis genus 285, 3 1 0, T44 - a rytenoideus transversus 1 1 9 - biceps brachii 52, 54, 1 22 - - femoris 258, 284, 286, 288, 309-31 1 , 3 1 7-324, 328-332, 36 1 -363, 369-370, 380-38 1 , T40-T41 , T46 - brach l alis 52 - bronchooeso phageus 99 - bulbospongiosus 222-223, 226, 232-233, 235, 240-242, 260-26 1 , T22 - coccygeus s. Musculus ischio coccygeus - colli 34 - constrictor pharyngls inferior 1 04, 1 20 - coracobrachialis 54, 1 22 - cremaster 56-58, 60-6 1 . 70, 1 93 - 1 94, 1 97, 226, 239, 242-243, 252
fvlusculusl-i}
fvlusculusl-i)
- cricothyroideus 1 04. 1 1 0, 1 20 - dartos 70. 226. 232, 239, 252 - deltoideus 1 , 37, 46, 52, 54, 58, 1 22-1 23 - d igastncus 3 1 , 33-34 - dorsi 26-33, 35, 4 1 - - CT 2 9 - - lateral tract 34 - epicranius 39 - erector spinae 1 , 27-29, 32, 73, 1 22, 1 25, 1 88, 243, 246-25 1 , 253-254, 3 1 9 - extensor dig itorum brevis 327, 332-337, 368, 374, 379, 382, 384, T40-T4 1 , T51 longus 306, 308, 3 1 0, 324, 326-327, 332-337, 367-368. 374, 379, 381 -384, T40-T4 1 , T47 - - halluc is brevis 306, 327. 332-337. 374. 384, T40-T41 , T51 longus 304, 306, 308, 324, 326-327, 332-337, 366-368, 374, 379, 381 -382, 384, T40-T4 1 , T47 - extremitatis inferioris 308-309 - fibularis brevis 300, 302-304, 324-325, 327, 33 1 -337, 366. 368, 370, 372, 381 -382, T40-T41 . T48 - - longus 302. 304, 308, 3 1 0 , 324-327, 329-330 , 332. 335, 339, 341 -342, 366-368, 370, 372. 381 -383, T40-T4 1 , T48 - - tertius 327. 332-337, 366, 368, 382, T47 - flbularis [peroneus] brevis 326 - flexorl-esl accessorius s. Musculus q uadratus plantae - - digiti m i n i m i brevis I Pes} 339-342, 384, T40-T4 1 , T54 - - d i g itorum 379 brevis 304, 335, 339-342, 377-378. 383-384, T40-T41 , T53 longus 304. 31 1 , 325-326, 329-33 1 , 339, 34 1 -342. 366, 371 -372, 377-378, 381 -384. T40-T41 , T50 - - hallucis brevis 339-342, 377-378, 384, T40-T41 , T52 longus 304, 325-326, 329-331 , 339-342, 366, 371 -372, 377-379, 381 -384. T40-T41 , T50 - gastrocnemius 262, 284, 286-288, 293, 307-309, 3 1 1 , 320-323, 326-332, 361 -362. 366, 369-370, 38 1 , T41 , T49 - gemellus i n ferior 3 1 1 , 3 1 8-32 1 , 363-364, 380, T43 - - superior 31 1 , 3 1 8-32 1 , 363-364, 380, T43 - g luteus maximus 1 , 37, 52, 2 1 5, 226, 232-233, 240-24 1 , 243, 254, 256-257, 259, 262, 279, 309, 3 1 1 , 3 1 7-322, 361 -364, 380, T40-T41 , T43 - - medius 72. 254, 256, 259. 279, 309. 3 1 1 , 3 1 4-3 1 6, 31 8-32 1 , 36 1 , 363-364, 380, T40-T41 . T43 - - - i njection 364 - - minimus 256, 279, 3 1 0-3 1 1 , 3 1 8, 320-32 1 . 364, 380, T40-T41 , T43
- gracilis 232-233, 26 1 , 284, 308, 3 1 0-31 7, 31 9-32 1 , 323-324, 328, 356-358, 361 -362, 369, 381 , T40-T41 , T45 - i liacus 62-63, 71 -72, 2 1 7, 220, 231 , 244, 254, 257, 259, 308. 3 1 0, 31 2-3 1 4, 3 1 7 , 348, 355-358. T42 - iliococcygeus 230, 243, T22 - iliocostalis cervicis 28, 30, 33-34, T20 - - lumborum 28, 3D, 72, T20 - - thoracis 28. 30, 37. 249. T20 - Iliopsoas 7 1 , 73, 256-257, 260-26 1 , 279, 308, 3 1 0-3 1 6, 32 1 , 355, 380, T40-T41 - infraspinatus 26-28, 37, 52, 1 23- 1 25 - intercostales 55, 72, 2 1 7, 248 - - externi 3 1 , 54-55, 57-58, 60, 1 06, 1 1 5. 1 24, 1 26-1 27, 1 44, 249, T 1 3 - - interni 3 1 , 54-58, 60, 1 06, 1 1 5- 1 1 6, 1 20, 1 22, 1 44, 249, T13 - interossei, compartments 379 - - dorsales I Pesl 304, 333-334, 336-337, 339, 341 -343. 383-384. T53 - - plantares 333, 339-343. 384, T53 - interspi nales cervicis 30-31 , 33, 40, T20 - - lumborum 30-3 1 , T20 - - thoracis 30, 1 1 9, T20 - intertransversarii anteriores cervicis 33, T20 - - laterales lumborum 31 -32, 4 1 , T20 - - mediales lumborum 3 1 -32, 4 1 , T20 - - posteriores cervicis 3 1 , 34, T20 - - - lumborum 30 - - thoracis 34. T20 - ischiocavernosus 222-223. 226, 232-233, 235. 237, 240-242, 260-26 1 , T22 - ischiococcygeus 225, 227, 230-23 1 , 256. 3 1 7 , T22, T40 - ischiocrurales 260 - latissimus dorsi 1 , 26-29, 37-38, 52. 54, 57-58, 63, 72, 1 26-127, 248-251 , 31 9 , T 1 8 - levatorl-es} a n i 2 1 0, 2 1 2-214, 226-233, 236-237, 240-243, 256-258, 260-26 1 , 3 1 1 , T22, T40 - - costa rum T20 - - - breves 31 -32 - - - longi 3 1 -32, T20 - - scapulae 27-28, 34, 37-38, T17 - longissimus capitis 28, 30-3 1 , 33-34, 37-39. T20 - - cervicis 28, 3D, 33-34. T20 - - thoracis 28, 30, 37, 72, 249, T20 - longus colli 55, T 1 2-T 1 3 - lumbri cales lPesl 340-342. T40, T53 - multifidusl-il cervicis 30, 33-34, 39, 1 020 - - lumborum 30-32, 249, T20 - - thoracis 30-32, 37, T20 - obliquus capitis inferior 3 1 , 33, 39-40, T20 - - - superior 3 1 , 33, 39-40, T20
I nd ex
Musculus!-i/ obllquus
Musculus!-I'} rectus
Musculusl-i/
Nervus!-il cutaneus
- - externus abdominis 26-29, 3 1 , 37, 46, 52, 54, 56-58, 60-6 1 , 63, 66, 68, 70-73, 1 1 0, 1 58, 2 1 7, 23 1 , 239, 248, 251 , 254, 31 1 , 322, 355, 364, T 1 5, T40 - - i nternus abdominis 27-28, 3 1 , 56-58, 60-6 1 , 66, 68, 70-73, 1 58, 2 1 7, 23 1 , 239, 251 , 254, 3 1 0, T1 5, T40 - obturatorius extern us 236, 256-257, 259-26 1 , 279, 3 1 0-3 1 1 , 3 1 6, 32 1 , 364, 380, T40-T41 , T45 - - internus 2 1 2-2 1 3, 225, 230-23 1 , 236-237, 256-261 , 279, 3 1 0-31 1 , 31 7-32 1 , 363-364, 380, T40-T4 1 , T43 - occipitofrontalis 39 - omohyoideus 1 1 0, 1 23 - opponens d i g iti m i n i m i [Pes] 334, 342, 384, T40, T54 - papi llaris anterior 78-82 - - posterior 78-81 - - septalis 78 - pectinati 78 - pect i neus 244, 256-257, 308, 3 1 0-3 1 6, 355-357, 380, T40-T41 , T45 - pectoralis major 46, 52, 54, 56-58, 60, 64, 1 1 0, 1 1 9, 1 23-1 27, T26 - - minor 54, 60, 1 20, 1 24, T26 - perinei 230 - peroneus brevis, longus bzw. tertius s. Musculus fibularis brevis, longus bzw tertius - pharyngis 1 09 - piriformis 224, 226-227, 23 1 , 243, 3 1 0-31 1 , 3 1 4-32 1 , 360, 363-364, 380, T40-T4 1 , T43 - plantaris 286, 3 1 1 , 323, 328-33 1 , 366, 369-372, 382, T40, T49 - popliteus 286-290, 293, 3 1 1 , 325, 330-33 1 , 369-370, 372, T40-T41 , T50 - psoas major 29, 35, 4 1 , 62-63, 68, 72. 1 52, 1 85-1 86, 1 88, 2 1 7, 221 , 236, 245-247, 2 5 1 , 254, 257, 259, 308, 3 1 0 , 31 2-3 1 4, 3 1 7, 348, 354-355, T42 - - minor 62-63, 72, 1 79, 2 1 7, 3 1 3, 3 1 7, 355, T42 - pubococcygeus 230, 242-243, T22 - puborectalis 230, 256, 258 - pyramidalis 56-58, 66, 70, 72, 242. T 1 4 - q uadratus femoris 260, 3 1 0, 3 1 8-32 1 , 363-364, 380, T40, T43 - - lumborum 29, 3 1 . 62-63, 66, 68, 72-73, 1 2 1 , 1 52, 2 1 7, 220-221 , 246-247, 251 , 3 1 0, T16 - - plantae 304, 339, 34 1 -342, 377-378, 382-383, T40, T53 - quadri ceps femoris 262, 285, 287-288, 290, 306, 308, 3 1 1 -3 1 2, 3 1 4, 324, 332. T40-T41 , T44 - rectococcygeus 230-231 - rectouterinus 201 - rectus abdominis 46, 56-59, 6 1 -63, 66, 69-73, 1 1 0, 1 1 9, 1 55, 1 58, 2 1 7, 226, 242-243, 246-254, 256, T 1 4, T40
- - capitis anterior T 1 2 latera lis 34, T20 - - - posterior major 3 1 , 33, 39-40, T20 - - - - m inor 3 1 . 33, 40, T20 - - femoris 244, 256-257, 269, 278-279, 308, 31 0-3 1 7, 322, 356-358, 380-38 1 , T44 - rhomboideus major 26-28, 37-39, T 1 7 - - minor 27, 38-39, T 1 7 - rotatores breves 30-3 1 , T20 - - lon g i 30-3 1 , T20 - sacrococcygeus 230-23 1 , 243 - sartorius 52, 244, 256-257, 262, 284, 308, 3 1 0-31 7, 322-324, 356-358, 362, 380-381 , T40-T41 , T44 - scalenus anterior 55, 1 1 0, 1 1 2, 1 1 7- 1 1 8 , 1 23, T1 1 - - medius 34, 40, 55, 1 20, 1 22, T1 1 - - posterior 28, 3 1 , 34, 55, T l l - semimembranosus 258, 284, 286-288, 309-3 1 1 , 3 1 7-3 1 8 , 320-323, 325, 328-330, 3 6 1 -363, 369-370, 380-38 1 , T41 , T46 - semispinalis capitis 28, 30-3 1 , 33-34, 38-40, T20 - - cervicis 28, 30-31 , 33, 39, T20 - - thoracis 3 1 , 33-34, T20 - semitendinosus 258, 284, 309-3 1 1 , 3 1 6-32 1 , 323-324, 328, 361 -363, 369-370, 380-38 1 , T4 1 , T46 - serratus anterior 27-28, 46, 52, 54, 56-58, 63-64, 70, 1 20, 1 22-1 27, T 1 7 - - posterior inferror 27-28, 37, 249, T 1 9 - - - superior 27-28, 37, T 1 9 - soleus 290, 308-309, 3 1 1 , 325-332, 369-372, 381 , T41 , T49 - sphi ncter a n i externus 207, 2 1 0, 2 1 2-2 1 4, 226, 230-233. 235, 240-242, 252, 258, T22, T40 - - - i nternus 207, 2 1 0, 23 1 , 242, 252, 258 - - pyloricus 1 35, 1 52 - - urethrae 207, 226, 23 1 , 234, T22 - - vesicae 222 - spinalis 30 - - capitis 30-3 1 , T20 - - cervicis 30, T20 - - thoracis 28, 30, T20 - splenius capitis 26-28, 30-3 1 , 33-34, 38-39, 1 22, T20 - - cervicis 27-28, 30, 33-34, T20 - sternalis 54, 60, T 1 3 - sternocleidomastoldeus 26-28, 35, 38, 54, 58, 1 1 0 , 1 1 9, 1 23 - sternohyoideus 1 1 0, 1 23 - sternothyroideus 55, 1 1 0, 1 1 9, 1 24 - subclavius 54, 60, 1 1 0, 1 1 2-1 1 3 , 1 20, 1 22-1 23, T26 - subcostales 60, T 1 3 - suboccipitales 3 1 -34, 40 - subscapularis 60, 1 22, 1 24, T26 - su praspinatus 1 22-1 23 - suspensorius d uodeni 1 35, 1 52 - tensor fasciae latae 52, 73, 244, 256-257, 262, 279, 306-308, 3 1 1 -3 1 4, 320, 322, 356, 380, T40-T41 . T44
- teres major 1 , 26-28, 37, 52, 1 22, 1 24-1 25 - - minor 37, 52 - thoracis 3 1 , 52, 54, 60 - thyrohyoideus 1 1 0 - tibialis anterior 290, 300, 302, 306. 308, 3 1 0 , 324, 326-327, 332, 334, 336-337 , 339, 366-368, 374, 381 -383, T40-T4 1 , T47 - - posterior 300, 302, 304, 3 1 1 , 325-326, 3 29-33 1 , 339, 342, 366, 370-372, 381 -382, T40-T4 1 , T50 - trachealis 9 1 - transversospina lis 29 - transversus abdominis 3 1 , 58-63, 66, 68, 70-73, 1 58, 21 7, 221 , 23 1 , 249, 2 5 1 , 254, 3 1 0, T 1 5, T40 - - perinei profundus 207, 226, 230, 232-236, 242, 252, 260, 31 1 , T22, 1 040 Ta b superficialis 230, 232-235, 240-24 1 , 260, T22, 1 040 Tab - - thoracis 55, 69, 1 1 0, 1 27, T1 3-T 1 4 - trapezius 1 , 26-28, 33-34, 38, 52, 1 22-1 26, T 1 7 - triceps brachii 37, 52 - - surae 304, 326, 333, 366, 383, T40, T49 - vastus i ntermedius 3 1 0-3 1 2, 3 1 5-3 1 6, 381 , T44 - - lateralis 257, 259, 279, 290, 293, 308, 3 1 0-3 1 6, 320-323, 332, 356, 358, 36 1 , 381 , T44 - - medialis 290, 308, 3 1 0-3 1 6 , 323, 356-358. 3 8 1 , T44 Myocard i u m 76, 78-80. 1 1 9
- - dorsaliS intermedius 345, 349, 365, 373, T40 lateralis 345. 349-350, 365, 373, T40 medialis 345, 349-350, 365 - - femoris lateralis 36, 68, 7 1 , 73, 1 79, 2 1 7, 220-22 1 , 3 1 7, 344-345, 348-349, 353, 355-357, 360, T40 posterior 36, 240-24 1 , 257, 344-345, 349, 360-364, 380, T40 - - surae lateralis 345, 349-350, 361 -363, 365, 369, T40 - - - medialis 345, 3 6 1 -363, 365-366, 369. 373, T40 - d i g itales dorsales pedis 345, 349, 368, 373-374, T40 - - plantares communes 376-378, T40 - - - proprii 376, 378, T40 - dorsalis clitoridis 223, 234, 241 , T40 - - penis 222, 234, 238-240, T40 - - scapu lae 38-39, T 1 7 - e rigentes s. Nervus[-i] splanchnici pelvici - femoralis 66, 68, 73, 1 79, 2 1 7-2 1 8, 220-22 1 , 236, 244, 256-257, 31 7, 344-345, 348-349, 353, 355-358, 380-381 , T40, T44-T45 - fibularis communis 284, 344-345, 349-350, 361 -363, 365, 368-37 1 , T40, T51 - - profundus 345, 349-350, 366, 368, 373-374, 379, 381 -382, T40, T47, T51 - - superficialis 345, 349-350, 365-366, 368, 373, 379, 381 -382, T40, T48 - gen itofemoralis 60, 66, 68, 1 79, 1 97, 2 1 7, 220-22 1 , 225, 229, 236, 238, 256, 3 1 7 , 344-345, 348-349, 353, 355, T 1 5 , T40 - gluteus inferior 257, 344-345, 349, 360, 363-364, 380, T40, T43 - - superior 344-345, 349, 360, 364, 380, T40, T43-T44 - hypogastricus 2 1 4 , 222-223 - iliohypogastricus 36-37, 66, 68, 73, 1 1 5, 1 1 7, 1 79, 2 1 7, 220-22 1 , 344-345, 348-349, 353, 364, T 1 5, T40 - ilioinguina lis 60, 66, 68, 73, 1 79, 2 1 7-2 1 8, 220-22 1 , 238-239, 344-345, 348-349, 353, T 1 5 , T40 - i ntercostales 36, 38, 4 1 , 54, 66, 70, 73, 1 1 2- 1 1 3, 1 1 5-1 1 7, 1 20, 1 24, 1 27, 220, 247-248, T 1 3-T1 7 - intercostobrachialis 37 - interosseus c ruris T40 - ischiadicus 256-257, 284, 344-345, 347, 349-350, 360, 362-364, 380-38 1 , T40, T43, T46-T50 - - projection 360 - labiales 223 - - anteriores T40 - - posteriores 223, 241 , T40 - laryngeus recurrens 83, 88-89, 1 1 1 - 1 1 3, 1 1 5, 1 1 7-1 1 8, 1 20 - lumbales 66, 226, 349
N
Neck. m u scles 34 Neck-shaft angle of the femur s. Angle between neck and shaft of the femur Nephros s. Ren Nervous system, autonomous 1 1 7, 1 20- 1 2 1 Nervus!-i] - accessorius [XI) 38-39, T 1 7 - anales 2 1 4 - - i nferiores 225, 240-241 , 344, T40 - anococcygeus 225, 240-241 , 344, T40 - a u ricularis m a g nus 36-38 - axillaris 36-37, 1 22 - card iacus cervicalis inferior 83 - - - medius 83, 1 20 - - - superior 83 - cavernosi clitoridis 223 - cervi calis 1 9 , 40, 1 20, T19-T20 - clunium inferiores 36, 240-241 , 349, 360-362. T40 - - medi i 36, 349, 360-362 - - superiores 36-37, 349, 360, 362 - coccygeus 225, 344, T40 - cutaneus brachii lateralis inferior 36-37 - - superior 36 posterior 36-37
I n d ex
Nervusl-iJ
Nodusl-il lymphoideusl-il
- obturatorius 68, 7 1 , 220-22 1 , 225, 229, 23 1 , 236-237, 256-257, 2 6 1 , 3 1 7, 344-345, 348-349, 353, 355, 357-358, 360, 380, T40, T45 - occi pitalis major 37-40 - - minor 36-38 - - tertius 37, 40 - pectoralis latera lis 60, T26 - - medialis 60, T26 - perineales 234, 240-241 , 260-26 1 , T40 - phrenicus 63, 89, 1 1 0- 1 1 3, 1 1 5, 1 1 8, 1 20-1 2 1 , 1 24- 1 27, T21 - - course 1 1 8 - plantaris latera lis 304, 345, 350, 376-378, 382-383, T40, T52-T54 - - medialis 304, 345, 350, 376-378, 382, T40, T52-T53 - pudendus 2 1 4, 222-223, 225, 234, 236, 240-24 1 , 257, 260-26 1 , 344-345, 349, 360, T22, T40 - radialis 36-37 - rectales i nferiores s. Nervusl-il a nales inferiores - sacrales 223, 225-226, 243, 349, T22 - saphenus 345, 348-349, 353, 357-358, 365-366, 373, 381 -382, T40 - scrotales a nteriores T40 - - posteriores 222, 240, T40 - spinales 36, 41 , 43, 45, 251 - spinalis 24, 29 - spina lisl-esl 24, 35, 40-4 1 - splanchnici lumba les 2 1 4 - - pelvici s Radix parasympathIca - splanchnicus major 63, 1 1 2- 1 1 3, 1 1 5-1 1 7, 1 20- 1 2 1 , 220-22 1 , 245, 249 - - minor 63, 1 1 5, 1 1 7, 1 2 1 , 245, 249 - subcostalis 68, 73, 1 1 5- 1 1 7, 2 1 7, 220-22 1 , 344 - suboccipitalis 37, 39-40, T20 - subscapulares 37, T26 - supraclavicula res 66 - - laterales 36-37 - suprasca pularis 1 23 - suralis 345, 349-350, 362, 365, 382, T40 - thoracici 37, 60, 66, 70, 1 1 2-1 1 3, 1 1 5- 1 1 7, 1 20-1 2 1 , 220, 249, T 1 5, T 1 9-T20 - thoracicus longus 1 22, 1 24- 1 26, T17 - thoracodorsalis 1 22, T 1 8 - tibialis 284, 344-345, 349-350, 361 -363, 365-366, 369-373, 376, 381 -382, T40, T49-T50, T52-T53 - vag i nalls 223 - vagus [Xl 83, 88-89, 1 1 1 - 1 1 3, 1 1 5, 1 1 7 - 1 1 8, 1 20-1 2 1 , 1 23- 1 27, 220 Node of RosEm,,1(j L LER 355 Nodulusl-il - lymphoideusl-il aggregati 1 37, 1 39 - - solitarii 1 30, 1 36-1 37, 1 39, 1 50, 2 1 0 - valvulae semi lunarls 79 Nodusl-il - atrioventricularis 82-83 - lymphoideusl-iJ aortici laterales 229 - - axi llarisl-esl 65, 1 22, 1 24 - - - a picalls 1 24
-
-
bra c h i a les 65 bronchopulmonales 1 25-1 27 cervicales anteriores 65 - - profun d i 65 - laterales 1 20 - - profundi i nferiores 1 20 deltopectorales 65 gastrici 1 3 1 , 2 1 8 gastroomentales 1 3 1 , 249 hepatici 1 3 1 i leocolici 243 iliaci commu nes 2 1 8, 229 externi 2 1 8, 229, 236, 354 - laterales 229, 354 - mediales 229, 354 interni 2 1 8, 229, 354 - - i nfraclaviculares 65 - - i n g u i na les 352 profundi 2 1 8, 354 superficiales 2 1 8-21 9, 354 inferiores 2 1 8, 354 superolaterales 2 1 8 , 354 superomediales 2 1 8, 256, 354 - - j uxtaoesophageales 1 07, 1 27 - - lacu narisl-esl 355 - - - medialis 355 - - ligamenti arteriosi 88 - - lumbales dextri 2 1 8 - Intermedii 2 1 8 - - mediast i n a les anteriores 88, 1 1 1 , 1 13 - - - posteriores 1 07, 245 - - obturatorii 229 - - pancreaticus 250 - - para mammarii 65 - - pararectales 1 22, 229 - - parasternales 65 - - paratracheales 88, 1 20, 1 24 - - parietales 2 1 8 - - phrenici i nferiores 2 1 8 - - - superiores 88, 1 1 9 - - popliteus profundus 366 - - - superficialis 366 - - preaortici 229, 251 - - precavales 229 - - promontorii 2 1 8 - - pylorici 1 3 1 - - rectalis superior 229 - - retroaortici 229 - - retrocavales 243 - - splenici 245, 249 - - submammarii 65 - - supraclaviculares 65 - - thoracis 1 07, 1 20 - - tibialis anterior 367 - - tracheobronchiales 95, 98-99, 1 1 3, 1 22 i nferiores 88, 95, 1 07 , 1 1 9, 1 27 superiores 88, 1 07, 1 1 9 - sinuatrialis 82 N u cleus pulposus 24-25, 29 o
Oesophagoscopy 1 08, 1 33 Oesophagus 62-63, 67, 1 04- 1 09, 1 1 2- 1 1 3, 1 1 5- 1 1 7, 1 1 9- 1 2 1 , 1 23- 1 30, 1 32-1 33, 1 57, 1 80, 220, 242, 245 - constrictions 1 08-1 09 - d iverticulum 1 09 - radiography 1 08
Olisthesis 9 Omentum - majus 1 2 1 , 1 3 1 , 1 39-1 40, 1 49, 1 57-1 66, 1 72, 242-243, 245-247, 249, 252, 254 - minus 1 60-1 6 1 , 1 66, 247, 249 Orchis s, Testis O rganuml-al - gen italia femlnina externa 223, 233, 235, 241 - - - interna 204, 209 - - masculina 222, 239 - - - extern a 1 97, 238, 240 - pelvis in the female 237 - - i n the male 236 - u rogenitalia fem i n i na, development 200 - - masculina, development 1 92 Orifi c i u m d uctus pancreatici 1 50 Osl-sal - coccygis 2-4, 1 1 , 207, 2 1 5, 230, 232-233, 242, 252, 256-257, 271 , 273 - coxae 2, 1 6, 4 1 , 263, 266-267 - - AP-radiograph 1 6 - - development 267 - c u boideum 295-296, 298-299, 303, 383 - cuneiformel - i a l 299 - - i ntermed i u m 295-296, 298, 304, 383 - - laterale 295, 298 - - mediale 295-296, 298, 302 - d i g itorum I Pesi 263, 295-296 - hyoideum 1 2 - i l i u m 3, 1 5-1 6, 4 1 , 7 1 , 73, 230, 244, 258, 264, 272, 274, 280 ischii 236, 256, 264, 274 - metatarsi 263, 295-296, 298-299, 303-304, 379, 383 - navicu lare 295-296, 298-299, 303-305, 383 - occi pitale 6, 1 2, 1 7- 1 9 - ped is 295-296, 299 - - structure chara cteristics 299 - pubis 1 96, 2 1 5, 226, 234, 242, 244, 256-257, 264, 274, 279 - sacrum 2-5, 1 0-1 1 , 1 5, 23, 26, 4 1 , 2 1 5, 226, 230, 242-243, 252-254, 262, 264, 271 -273, 3 1 7 - - sex d ifferences 1 1 - sesamoidea I Pesi 295-296, 302, 339 - tarsi 263, 295-296, 298 - tempora le 40 Ost i uml-ai - abdominale tu bae uterinae 20 1 , 204, 209 - appendicis vermiformis 1 39 - atrioventriculare dextrum 78 - - sinistrum 79, 1 26 - cardiacum 1 08, 1 2 1 , 1 30, 1 66- 1 67, 244-245, 247 - i leale 1 39 - pyloricum 1 35 - sinus coronarii 78, 82, 84 - ureteris 1 90-1 91 , 195, 1 98, 205, 252-253, 260 - urethrae externum IUrethra fem i n i n a i 200, 23 1 , 233, 235, 237, 241 , 253, 261 - - - I U rethra masculinal 1 98 - 1 99, 252 - - internum IUrethra femininal 205, 253 I U rethra masculinal 1 90, 1 95, 1 98, 252. 260 -
Ostium{-al
- uteri 201 -202, 205, 207, 253 - uteri n u m tubae uterinae 20 1 , 203 - vaginae 200, 233, 235, 237 - venae cavae inferioris 82 - - - superioris 82 Ovarium 1 40, 1 67, 200-202, 204, 209, 223, 228, 253, 354 p
Palatum osseum 1 2 Pancreas 1 2 1 , 1 3 1 , 1 34, 1 52 - 1 53, 1 57, 1 63-1 64, 1 72, 1 77, 242-243, 245, 249-250 - computed tomography 1 55 - low magnitude enlargement 1 53 - projection 1 34 - ultrasound image 1 54 Pancreatocyticus exocrinus 1 53 Panniculus a d i posus 58, 72, 2 1 0, 232, 239 Papillal-ael - duodeni major 1 35, 1 50, 1 52-1 53 - - m i nor 1 52- 1 53 - i lealis 1 39 - mamma ria 52, 64, 1 27 - rena les 1 83-1 84, 1 86, 245 - of Vater s. Papillal-ael duodeni major Paracystium 260-261 Paradidymis 1 92 Parametriu m s. Ligamentum card i na le Paraproctium s. Spatium pararec tale Parasympathetic nervous system 2 1 4 , 222-223 Paries - anterior IGasterl 1 33, 1 60 - 1 6 1 - membra naceus ITracheal 9 1 , 99, 1 07, 1 1 9 - posterior IGasterl 1 33, 1 55 Paroophoron 200 Pars - a bdomi nalis aortae 35, 62-63, 69, 1 04, 1 1 5, 1 1 7, 1 48, 1 54-1 55, 1 57, 1 68, 1 72, 1 74, 1 77- 1 79, 1 85, 1 87- 1 89, 2 1 2, 2 1 4 , 2 1 6-21 8, 221 , 225, 227, 229, 242, 245, 250-251 , 359 - - - u ltrasound image 1 78 - - autonomica 220 - - 1M. pectoralis majorl 52, 54, 56, 58, 60, T26 - - 10esophagusi 62-63, 1 04, 1 06, 1 08-1 09, 1 1 7, 1 28, 1 30 - - IUreteri 1 63, 2 1 6 - a nterior I Facies diaphragmatica hepatisl 1 45 - - IFornix vaginael 202, 205 - a n u laris vaginae fibrosae 340 - ascend ens aortae 75, 78-80, 84, 1 09, 1 1 4- 1 1 5, 1 1 7, 1 1 9-1 2 1 , 1 25-1 26, 255 - - IDuodenuml 1 34, 1 39-1 40, 1 52, 1 65, 1 67 - - 1 M . trapeziusl 26, T1 7 - atlantica IA. vertebralisl 34, 40 - basalis IAa . lobares i nferiores dextrael 98 - - iAa. lobares i nferiores sin is traei 98-99 - basilaris lOs occipita lei 1 7-1 9
I nd ex
Pars
- card iaca 63, 1 04, 1 2 1 , 1 30- 1 3 2, 1 79, 2 1 7, 242 - cervicalis [Columna vertebralisl 2 - - [Oesophagusl 1 04, 1 06-1 08, 119 - clavicularis [ M pectoralis ma jorl 54, T26 - costalis diaphragmatis 54, 62-63, 73, 1 48, 1 79 , 246-250, T21 - - [Ple u ra parietalisl 54, 1 1 0, 1 1 2- 1 1 3 , 1 20- 1 2 1 , 1 24, 1 59 , 246-250 - cruciformis vaginae fibrosae 340 - descendens aortae 75, 1 0 7, 1 09 , 1 1 4, 1 25 - 1 27 [Duodenuml 1 28, 1 30, 1 32, 1 34- 1 35 , 1 40, 1 52- 1 54, 1 6 7, 1 79 [Lig. i liofemoralel 278 [M. trapeziusl 26, T 1 7 - d iaphragmatica 54, 63, 89, 1 1 0- 1 1 3, 1 1 8 , 1 59 , 245, 248-250 - horizontalis [ D uodenuml 1 34-1 35, 1 52-1 53, 1 63, 1 65 , 1 6 7, 1 79 - i n fraclavicu laris 54, 1 1 2- 1 1 3 - i ntermedia [ U rethra mascu linal 1 9 5 - 1 9 6 , 1 98 , 252 - i ntramuralis [ U rethra masculinal 1 98 - i ntrasegmentalis 1 20, 1 22 - lateralis [Os occi pitalel 1 7 - - [Os sacruml 1 0- 1 1 , 4 1 , 254, 264, 273 - llbera membrl Inferioris 263 - lumba lis [Columna vertebralisl 2 diaphragmatis 62-63, 68, 1 04, 1 06 , 1 1 5-1 1 6 , 1 1 9 , 1 2 1 , 1 48, 1 5 5, 1 72, 242-243, 245, 248-250, T 2 1 - mediastinalis 89, 95, 1 1 1 - 1 1 3, 1 25, 1 59 - mem branacea [Septum i nterventricularel 79-80 [ U rethra mascu linal s. Pars i ntermed ia [ U rethra masculi nal - muscularis [Septum i n terventricu larel 78-80 - occlusa 229, 236 - patens 225, 227-229 - pelvica [Ureterl 7 1 , 1 66-1 67, 221 - posterior [ Fornix vaginael 202, 205, 207, 253 - profunda [Compa rtimentum cruris posteriusl 366 - prostatica 1 90, 1 9 5, 1 98 - pylorica 1 1 7, 1 30, 1 3 2- 1 35 , 1 58, 1 60, 1 66 , 247, 255 - spong iosa 1 98- 1 99 , 252 - sternalis d i a p h rag matis 62-63, 1 1 0- 1 1 1 , 1 1 9, 243, T21 - sternocostalis [M . pectoralis majorl 52, 54, 56, 58, 60, T26 - subcutanea [ M , sphi ncter a n i externusl 2 3 5 , T22 - superficialis [Compartimentum c ruris posteriusl 366 - superior [Duodenuml 1 28, 1 30, 1 34- 1 36 , 1 49 , 1 53, 1 60-1 6 1 , 1 66- 1 67, 1 79 , 244 [Facies d l a p h ragmatica hepatisl 1 42
Pars
- terminalis 1 3 7, 1 63 - thoracica aortae 63, 69, 87, 99, 1 04- 1 06 , 1 09 , 1 1 3- 1 1 5, 1 1 7, 1 2 1 , 1 24, 1 52 , 1 57, 1 78, 248 - - autonomica 1 1 7, 1 20-1 2 1 - - [Columna vertebralisl 2 - - [ Ductus thoracicusl 1 1 3 , 1 1 5-1 1 6 - - [Oesophagusl 63, 1 04- 1 09 , 1 1 3, 1 1 5- 1 1 7, 1 1 9, 1 2 1 , 245 - t i biocalca nea 300-302, 304 - t ibionavic u laris 300 - ti biotalaris anterior 300 - - posterior 300-301 - transversa [Lig. iliofemoralel 278 - - [ M. trapeziusl 26, T 1 7 - transversaria [A. vertebralisl 40 - uterina [Tuba uterinal 201 Patella 262-263, 284-285, 287, 290-293, 306, 3 1 4-3 1 5 , 322-323, 327, 332, 365 - ridge of the 292 Pecten - analis 2 1 0 , 23 1 , 252 - ossis pubis 62, 23 1 , 264, 266-267, 271 , 3 1 4-3 1 5 , 3 1 7 Ped iculus a rcus vertebrae 5, 7-9, 1 2, 1 4- 1 6 , 20-2 1 , 23-25, 29, 35, 273 Pedograms 384 Pelvic aperture 264 Pelvic a rteries, d igital su btraction angiography [DSAI 359 PelvIc constriction 265 Pelvic diaphragm T22 - of the female 230-23 1 , 233-235 - of the male 232, 234, 236 Pelvic organs - in the female 228 - in the male 226-227 Pelvic width 265 Pelvis 264, 268 - AP-rad lograph 273-274 - CT 254 - of the female 265 - - cross-section 257 - - CT 257 - - median section 253 MRI 253, 259 - - oblique section 261 - - pelvic d imensions 265 - joi nts of pelvIc g i rd le 268-271 - lum bosacral passage 268-269, 271 - major 264 - of the male. cross-section 254, 256 - - CT 256 - - frontal section 258 - - median section 242, 252 - - MRI 252, 259 - - oblique section 260 - - sagittal section 243 - minor 1 67, 264 - muscles, origins and I nsertions 3 1 0-3 1 1 - renalis 1 7 1 , 1 82 - 1 84 , 1 86 , 1 88, 1 9 2, 200, 2 1 6, 245-246, 250 - - ampu llar type 1 86 - - AP-radiograph 1 86 - - dendritic type 1 86 - sex d ifferences 264, 268-2 71 Penis 1 9 7, 1 99, 222, 244, 260 Perforating vein, lateral 352
Pericard i u m 63, 74-75, 85, 89, 98-99, 1 1 0, 1 1 8, 247 - fl brosum 74, 89, 1 07, 1 1 1 - 1 1 3 , 1 2 1 , 1 59 - serosum 74-75, 78-80, 84, 89, 1 1 9- 1 20 Perineal laceration 233 Perineum 235 - of the female 230, 233, 241 - of the male 232, 240 Periorc h i u m 1 94 Periosteum 43 Peristalsis 1 3 2 Peritoneum 1 43 - parietale 54, 59, 6 1 -62, 75, 1 20, 1 49 , 1 58, 1 67, 1 79 , 1 90, 1 96 , 2 1 7 , 226, 242, 248-25 1 , 253, 258 - u rogenitale 202, 2 1 0 , 260-2 6 1 - viscera Ie 5 4 , 7 0 , 1 20, 1 36 , 242, 246, 248-249 , 2 5 1 Pes 263 - anserinus superficialis 3 1 3 , 323 - cavus 384 - compartments 379 - cross-section 382 - frontal section 384 - joi nts 300-303, T39 - ligaments 302 - longitudinal section, MRI 383 - muscles 333-343, 384, T 5 1 -T54 - - origins and Insertions 333, 339 - osteofibrous tubes 384 - sagittal section 383 - tendon sheaths 334-335 - valgus 303 - vault 299 PEYER·s patches 1 37 Phalanx[-gesl - dlstalis[-esl [Pesl 263, 295-296, 383 - media[-ael [Pesl 263, 295-296, 383 - [Pesl 263, 296, 299, 304 - proximalis [ Pesl 295-296, 383 Pharynx 1 33 Pia mater spinalis 4 1 , 43 Placenta 207-208 Planta 262, 375-378 - arteries 375 - - va riations 375 Plantar aponeurosis s. Aponeurosis plantaris Platysma 58 Pleura - parietalis 54, 63, 89, 95, 1 1 0- 1 1 3 , 1 1 8, 1 20- 1 2 1 , 1 23- 1 2 5, 1 59, 245-250 - p u lmonalis s, Pleura viscera lis - visceralis 54, 1 1 2, 1 20-1 24, 246-247 Pleural borders, projection 1 03 Pleurocentesis, puncture of the pleural cavity 54 Plexus - a o rticus thoracicus 89, 1 1 3, 1 1 7, 1 2 1 - brachia lis 54, 60, 1 1 1 - 1 1 3, 1 20, 1 22- 1 23, 1 28, T l l , T 1 7 - cardiacus 83, 1 1 3, 1 1 7- 1 1 8 - caroticus communis 1 1 0 - cervicalis 36-37, 40, T l l -T 1 2 , T 1 7 . T21 - coccygeus 225, 344, T40 - coeliac us 2 1 � 220 - deferentialls 1 97. 222
Plexus
- hypogastricus inferior 222-223 - - superior 2 1 4 , 222-223 - lumbalis 29, 36, 66, 68, 254, 344, T1 5 , T40, T42, T45 - lumbosacralis 68, 220, 344, T40 - mesentericus inferior 220, 222 - - superior 222-223 - oesophageus 1 1 2, 1 1 7, 1 2 1 , 220 - ovaricus 223 - pampiniformis 60, 70, 1 93-1 94, 1 97, 238-239, 243 - prostati cus 222 - pulmonalis 1 1 2- 1 1 3 , 1 20-1 2 1 - recta l i s i nferior 2 1 4 - - medius 2 1 4 - - su perior 2 1 4 - renalis 223 - sacralis 68, 2 1 4 , 220, 223, 225, 344, 349, T22, T40, T43, T46 - testicula ris 1 97, 222 - uterovaginalis 223 - venosus areolaris 66 prostaticus 236, 260 - - recta lls 2 1 3 - - submucosus 1 06 , 1 8 1 - - vag inalis 228 - - vertebralis externus anterior 42 - - - - posterior 42 i nternus 1 23 - - anterior 4 1 -43, 45, 242 - - posterior 4 1 -44, 1 1 9 - - veskalis 227, 236-237, 256 Plica[-ael - alares 285 - circu lares 1 30, 1 32 , 1 3 5, 1 3 7, 1 50, 1 52 - d uodenalis inferior 1 65, 1 67 - gastricae 1 30, 1 33 - gastropancreatica 1 6 1 , 1 66- 1 67 - ileocaecalis 1 62- 1 63, 1 67 - interureterica 1 90- 1 9 1 , 1 98, 260 - longitudinalis d uodeni 1 50, 1 52 - m ucosae 1 50, 1 90, 1 98 - pa lmatae 20 1 , 253 - rectouterina 20 1 , 228-229 , 253 - semilunares coli 1 39 , 1 4 1 , 1 63 - spiralis 1 50- 1 5 1 - synovialis 301 - - infra patellaris 285 - - mediopatellaris 284 - transversa recti 207, 2 1 0-2 1 1 , 242, 252-253 - tuba riae 201 - umbilicalis lateralis 59, 7 1 -72, 1 58- 1 59, 227, 236 medialis 59, 7 1 -72, 1 58-1 59, 1 96 , 209, 2 1 7, 227, 236, 253 mediana 59, 7 1 -72, 1 58-1 59, 1 96 , 209, 2 1 7, 236, 252-253 - vesicalls transversa 7 1 , 236 Point - of v. LANZ 1 40 - of M C B U R N EY 1 40 - of SUDECK 1 76 , 2 1 2 Polus urinarius 1 84 Popliteal perforating vein 352 Porta hepatis 1 42 Portio - supravagi nalis cervicis 201 -202 - vaginalis cervicis 20 1 , 205, 207, 253 - - - n ullipara 205 Portocaval a nastomoses 1 8 1 , 2 1 3 Positio [Uterusl 203
I n d ex
Preputium - cLitorid is 233, 235 - penis 1 97 - 1 9 9 , 242-243 , 252 Processusl-usl - accessorius 5 , 8-9 - a rticula ris i nferior 6, 8-9, 1 2, 1 5- 1 6 , 22-23, 25, 29, 35, 254
- - superior 105 sacruml 1 0- 1 1 , 4 1 , 230 , 254
IVertebrael 5-9, 1 2, 1 5- 1 6 , -
-
20-2 1 , 23 , 25, 29, 35, 4 1 , 45, 248, 273 caudatus 1 42 coracoideus 47-48, 1 22 costalls 5, 9 , 1 6 , 23, 30, 32, 35, 48, 63, 2 1 6, 269, 272-273 falciformis 270 lateralls tali 295, 297-298, 382 - tuberis calcanei 295, 297-298 mamillaris 8-9 , 3 5 mastoideus 1 2 , 3 3 , 40
- medialis tuberis calcanei 295-298, 302
- papillarls 1 42 , 1 66, 249 - posterior tali 296-298, 305 - spi nosus 1 , 5-9, 1 2- 1 6 , 1 9 , -
22-26, 28-29, 32-35, 4 1 , 44, 1 1 9, 1 23-1 24, 1 27, 1 88, 249, 25 1 , 273 styloideus 105 temporalel 33-34 tra nsversus 6-8, 1 3- 1 4, 20, 22 , 3 1 , 34-35 , 40, 1 2 5 - IAtlasl 34, 40 - IAxisl 34 u ncinatus I Pancreasl 1 52-1 53, 1 73, 1 79, 243
- [Vertebral 5 U ncus corporis vag inalls peritonei 61 - - persistens 61 x i phoideus 47, 50, 55, 63, 70, 1 1 9 , 1 27, 1 32, 207, 242, 248
Promontorium 105 sacruml 3-4, 1 0- 1 1 , 1 5, 6 2, 1 77, 1 85 , 2 1 7, 227, 242, 253, 264, 3 1 4
Pronatio IArticulatio talotarsalisl T39
Prostata 7 1 , 1 90 - 1 9 1 , 1 95- 1 96, 1 98, 222, 226-227, 236, 242-243, 252, 259-260
Protuberantia occipitalis externa 2 6 , 39
Psoas arcade 63 Pu bes 1 97 Pulmo 54, 92, 94- 1 00, 1 1 0 - a rteries 1 00 - dexter 89, 94-98, 1 1 0- 1 1 1 , 1 1 8, 1 20- 1 2 1 , 1 23 - 1 27, 1 48, 1 59 , 243, 245-246 - organisation 98 - sinister 89, 94-99, 1 1 0- 1 1 1 , 1 1 8, 1 20-1 22, 1 24, 1 26-1 27, 1 59 , 2 4 5 , 247 - veins 1 0 0 Pulmonary angiogra phy 1 00
Pulmonary borders, projection 1 03
Pulpa splenica 1 56 Pyelography, intravenous 2 1 6 Pylorus 1 28- 1 3 1 , 1 35 , 1 60- 1 6 1 Pyramides renales 1 83-1 84, 1 88 , 245
a
Quadra ngular space 37
R
Radixl-cesl - anterior I N spinalisl 4 1 , 43 , 45,
Ramus{-il cutaneus{-il
- - medialisl-esl lN spinalisl 36, 41
- - I N . obturatoriusl 349, 353, 357-358, 360, T40
214
- mesenterli 1 40, 1 63, 1 66- 1 67, 1 77 - motoria s. Radix anterior [N spinalisl - parasympathica 2 1 4, 222-223 - posterior [N. spinalisl 4 1 , 43, 45 Ramusl-il - acetabularis [A. circumflexa femoris medialisl 359 - - IA. obturatorial 357, 359 - anterior [A. media genusl 289 - - IA. obturatorial 357, 359 - - IA. renalisl 1 82 - - I N. cervicalisl 1 20 - - IN lumbalisl 4 1 , 226 - - [N. obturatoriusl 68, 348, T39-T40
- - [N. sacralisl 226 - - [ N . spinalisl 40-41 , 45 , T20 - - [Truncus n spinalisl 42-43, 45
- - [V. portae hepatisl 246 - articulares [A. descendens genusl 35 1 , 356-358 - ascendens [A. c i rcumflexa femoris lateralisl 35 1 , 358-359 - - [A. c i rcu mflexa femoris medialisl 363 - atriales [A. coronaria dextral 84, 86
-
- [A. corona ria sinistral 86 atrioventriculares 86-87 bronchiales 99 - [Aortal 1 05- 1 06, 1 1 2, 1 1 5 , 121
- - I N . vagusl 1 1 5, 1 1 7, 1 20- 1 2 1 - calcanei IA. t i bialis posteriori 372
- - med iales IN tibialisl 376, T40
- cardiacus cervicalis inferior 376 - - - - [N vagusl 83 - - thoracicus i nferior IN vagusl 83, 1 1 8
[ N vagusl 1 1 2- 1 1 3, 1 1 8 - - - [Truncus sympathicusl 113 - c l rcumflexus IA. corona ria sinis tral 74-75 , 84-87 - comm unicansl-tesl lA fibularisl 351
-
-
albus 42 fibularis 345, 365, T 40 griseus 42 ITruncus n. spinalisl 4 1 , 43, 45
- - [Truncus sympathicusl 45, 1 1 2- 1 1 3, 1 1 6- 1 1 7, 222
- coni arteriosi 84, 86-87 - cutaneus[-il anterior{-esl a b dominales 66 IN femoralisl 66, 68, 348-349, 353, T40
[N iliohypogastricusl 66, 349, 353
- - c ru ris mediales IN saphenusl 349, 365, T40 - - lateralisl-esl [ N . i liohypogastMcusl 36, 349, 360, 364 I N , spinalisl 36, 4 1 I N n. thoracicil 344 pectorales I N n . inter costalesl 38. 66
- - I N . plantaris media lisl 377 - - posteriorl-esI INn. cervicales, Rr. posterioresl 38 - - - [ Nn. thoracici, Rr. posteri oresl 38 - descendens IA c i rcumflexa femoris lateralisl 35 1 , 357-359 - - IA. c i rcumflexa femoris m e d i alisl 359 - dexter IA. hepatica proprial 1 46, 1 7 1 , 249
Ramus{-il
- oesophageales lA, gastrica sinistral 1 06, 1 3 1 , 1 68 IA. thyroidea inferiorl 1 06 - - [Aortal 1 06, 1 1 5 - - IGanglion thoracicuml 1 20 - - [ N, laryngeus recurrensl 1 1 5, 1 21
- - [V. gastrica sinistra l 1 69 , 1 8 1 - omentales IAa. gastroomentalesl 1 3 1 , 1 72 - - [Vv. gastroomentalesl 1 3 1 , 1 60 - ossis ischii 234, 257, 26 1 , 266-267, 273, 3 1 7, 3 1 9 - ovaricus 204
- perforansl-tesl [A. fibularisl 3 5 1 , 368, 374
- - [V portae hepatisl 1 46, 244, 246, 248-249
- dorsalis IA. lumbalisl 41 - - [V. lumbalisl 4 1 - femoralis 66, 68, 2 1 7, 2 2 1 , 3 1 7,
- - [A thoracica internal 69 - - [Arcus plantaris profu ndusl 378
- pericardiacus [ N phrenicusl 1 18
344, 349, 353, 355, T40
- fundi uteri IA. uterinal 204 - gastrici anteriores ITru ncus vagalis a nteriorl 1 1 7 - - IV gastroomentalis dextral
- perinea les 240-241 - p h renicoabdominales [ N. p h renicusl 63, 1 1 8 - posteriorl-esl IA. media genusl 289
1 60
- gen italis 60, 68, 1 97, 2 1 7, 22 1 , 225, 238, 256, 344, 349, T40 - helicini 204 - iliacus 2 1 7, 2 2 1 - i nferior OSSIS pubis 1 96, 2 1 5, 234, 260, 266-267, 272-273, 3 1 7, 319 - infrapatellaris 348-349, 353, 365, T40 - intercostales a nteriores 69, 247 - interganglionares 45
- I nterventricularisl-esl anterior IA coronaria sinistral 74, 79-80, 84, 86-87, 98, 1 27
- - posterior IA. coronaria dex tral 75, 80, 84-87, 1 20 - - septales IA coronaria dextral 86
- - - [A. coronaria s i nistral 86-87
- labiales posteriores 2 4 1 - lateralis [A. coronaria sinistral 86
- - [ N . spinalis, R posteriori 4 1 -43
- I N . thoracicusl 37 malleolares laterales 35 1 , 372 - mediales 351 , 372 mandibulae 1 2 marginalis dexter 80, 84, 86-87 - sinister 80, 84, 86-87 mastoideus IA occipitalisl 38 medialis IN spinalis, R posteriori 41 -43 - - [N. thoracicusl 37 - meningeus [Truncus n spinalisl
-
4 1 -43, 45
- muscula ris[ -esl I N . femoralisl 356-358, T40
- - I N . fibula ris profu nd usl 374 - - [N. plantaris medialisl 377 - - I N. t iblallsl 362-363, 369-370
- nodi atrioventricularis 86 - - slnuatrialis 84, 86 - obturatorius IA. epigastrica i n feriorl 2 2 5 , 359 - occi pitalisl-esI IA. a uricularis posteriori 38 - - [A occipitalisl 38
-
-
- -
- - -
IA, obturatorial 359 IA. renalisl 1 82 laterales I N n . thoracicil 37 mediales [ N n. thoracicil 37 I N , a uricu laris magnusl 36 I N, cervica lisl 37-40 I N, obturatoriusl 348, T40 IN, sacralisl 37 [N, spinalisl 36-3 7, 40-41 , 45 [ N n. thoracicil 37-38, T20 ITruncus n spi nalisl 4 1 -43 , 45
- [V. portae hepatisl 248 - ventriculi sin istri 85-86 posterolateralis dexter 86-87 profu ndus IA. c i rcumflexa femoris medialisl 359, 363-364 - - IA. g lutea superiorl 364 [A. plantaris medialisl 375 IA. transversa colli I 38-39 - - [N plantaris lateralisl
-
377-378
- - IV glutea superiorl 364 - pubicus [A. epigastrica inferiorl 225, 359
- - [A. obturatorial 225 - rad icularis anterior [A. spinalis anteriorl 45 - saphenus [A. descendens genusl 351 , 358 - scrotales anteriores 238 - - posteriores 227, 240 - sinister IA. hepatica proprial 1 46 - - IV. portae hepatisl 1 46, 1 54 - spinales [A, intercostalis posteriori 45 - - [A. sacralis lateralisl 226 - splenici 1 73 - subendocardiales 83 - superfici a lis IA. c i rcumflexa femoris medialisl 357, 359, 363 - - IA. g lutea superiorl 363 - - IA. plantaris medialisl 375, 378
- - IA transversa collil 39 - - I N plantaris lateralisl 376-378
- - [ N . tibialisl T40 - superior ossis pubis 1 96, 234, 264 , 266-267, 272-273, 3 1 7
I n d ex
Ramusl-i/
- tracheales I N. laryngeus recurrensl 1 20 - transversus 359 - tubarius IA uterinal 204. 228 - vag inales IA. uterinal 204 Raphe - perinei 232-233. 235 - scroti 1 94. 239 Recessus - axillaris 1 2 2 - costodiaphragmaticus 54. 1 0 1 , 1 03, 1 1 0, 1 1 8, 1 20-1 2 1 , 1 60, 246-248, 250 - costomediasti nalis 1 1 0, 1 1 3, 1 24, 1 27 - duodenalis inferior 1 64, 1 66 - 1 67 - - superior 1 64, 1 66- 1 67 - ileocaecalis inferior 1 63-1 67 - - superior 1 63, 1 65-1 67 - inferior bu rsae omentalis 1 6 1 - intersigmoideus 1 64, 1 67 - p h ren lcomed iastinalis 1 2 1 , 243 - pi riformis 1 08 - retrocaecalis 1 66 - splenlcus 1 61 , 1 67, 249 - subpopliteus 290, 331 - superior bu rsae omenta lis 1 6 1 , 1 67, 249 - suprapatellaris 292 - vertebromediastlnalls 1 24, 1 26 Rectoscopy 2 1 1 Rectum 62, 1 38, 1 65-1 67, 1 77, 1 80, 1 85, 1 90, 205, 209- 2 1 4, 220-22 1 , 226, 228-229, 23 1 , 237, 243 , 256-257, 354 - AP-radiograph 1 4 1 - arteries 2 1 2 - colonoscopy 2 1 1 - i n n e rvation 2 1 4 - lateral radiograph 2 1 5 - rectoscopy 2 1 1 - vei n s 2 1 3 Reglol-nesl - calcanea s. Calx - cervicalis posterior 1 , 38-40 - cruris 365 - - a nterior 262, 367-368 - - posterior 262, 370-372 - deltoidea 1 - femoris anterior 262, 353, 356-358 - - posterior 262, 360-363 - genus anterior 262, 353 - - posterior 262 - g lutealis 1 , 262, 360-364 - infrascapularis 1 - ingulnalis 262, 353-354 - lumbalis 1 , 41 - - AP-ra d i o g raph 2 1 9 - occipitalis 38-39 - pedis 365 - perinealis of the female 241 - - of the male 240 - sacralis 1 - sca pu laris 1 - vertebralis 1 Ren 29, 35, 67, 1 52, 1 54- 1 55, 1 60, 1 64, 1 66 - 1 67, 1 77, 1 79, 1 82- 1 86, 1 88, 1 92, 200, 2 1 6- 2 1 7 , 245-247, 249-250, 255 - AP-radiog ra p h 1 86, 2 1 6 - computed tomography 1 88 - development 1 88 - projection 1 83 , 1 85 - u ltrasound image 1 88
Rete - articulare genus 35 1 , 358, 368 - calcaneum 372, 377-378 - malleolare laterale 368, 374 - - mediale 374 - patellare 353, 356 - venosum dorsale pedis 365 Retinaculuml-al - musculorum extensorum in ferius 306, 332, 334-337, 367-368, 373 - - - superius 306 - - fibula r i u m inferius 304, 332, 334-336 - - - superius 304, 327, 329-332, 335, 370-371 - - flexorum IPes] 304, 329-33 1 , 335, 342, 370-3 71 , 376-378 - - peroneorum inferius/su peri us s. Retinaculum m us c u lorum fibularium inferius/superi us - patellae latera le 284-285, 306, 3 1 0-3 1 1 - - mediale 284-285, 323 Retroflexio IUterusl 203 Retroperitoneal organs 1 52 Retroperitoneal space 1 79 Retroperitoneal structures, position of the 2 1 7-2 1 8 Retroversio IUterus] 203 RETZIUS, Cave of 207, 252 Rima - g lottid i s 1 1 4 - pudendi 235 Rims 5, 25 ROSEN M O LLER's node 355 Rugae vag i n a les 201 , 205, 233 5
Sacral puncture 44 Sacroiliac joint s. Articulatio sacro i liaca Sacrum, width of the 265 Salpinx s. Tuba uterina SANTO R I N I 's d uct 1 52 Scalenus muscles Tl l Sca pula 1 -3, 26-27, 48, 1 0 1 , 1 08, 1 22- 1 25 Scrotu m 1 94, 1 97, 252 Segmentuml-a] - anterius i nferlus lRenl 1 87 - - laterale dextrum [VI] I Hepar] 1 47 - - - sinistru m [ l 1 1 ] I Hepar] 1 47 mediale dextru m [V] I Heparl 1 47 - - [S 1 I 1 ] I Pulmo] 96 - - superius I Ren] 1 87 - a picale [S I] 96 - apicoposterius [S 1 -IIl IPulmo] 96 - basale anterius [S VIII] IPulmo] 96 - - laterale [S IX] [Pulmol 96 - - mediale [S VIIl I Pulmo] 96 - - posterius [S X] [Pulmol 96 - bronchopu lmonalia 96-97 - cardiacum s, Segmentum basale mediale [S VII] [Pulmol - [1] I Heparl 1 47 - inferius IRenl 1 87 - laterale [S IV] [Pulmol 96 - lingulare inferius [S V] [Pu lmo] 96 - - superlus [S IV] [Pulmol 96
Segmentuml-a/
Spinal-ae/
- mediale [S V] [Pulmo] 96 - - sinistrum [IV] 1 47 - posterius laterale dextrum [VI I] [Hepa r] 1 47 - - - sinistrum [ I I ] [ Hepar] 1 47 - - mediale dextrum [VI I I] [ Hepar] 1 47 - - IRen] 1 87 - - [S I I] [ Pulmo] 96 - renalia 1 87 - superius [ Renl 1 87 - - [S VI] I Pu lmo] 96 Septula testis 1 93- 1 94, 252 Septum[-a] - atrioventriculare 82 - femorale 355 - glandis 1 99 - interatriale 78-79, 1 1 9 - i ntermuscu lare cruris anterius 327, 332, 366, 381 - - - posterius 329, 366, 381 - - vastoadductorium 3 1 4, 357 - i nterventriculare 78-80, 83, 1 26 - longitudinalia 379 - penis 1 99, 243 - rectovaginale s, Fascia rectovag i nalis - scroti 6 1 , 1 94, 239, 242 - vesicovaginale 207, 253 SHERMAN's vein 352 Sinus - anales 2 1 0- 2 1 1 , 252 - aortae 79-80, 82, 1 27 - coronarius 75-76, 85, 99 - epididymidis 1 93- 1 94 - lactiferus 64 - maxillaris 1 2 - obllquus pericardii 75, 89 - prostaticus 1 90 - renalis 1 83- 1 84, 1 88, 250 - sag lttalis superior 40 - tarsi 296, 305 - transversus 40 - - pericard i i 75, 84, 89, 1 1 9, 1 26 - trunci pulmonalis 76, 82, 98 - vena rum cavarum 85 Situs - cordis 88 - retroperitonealis 1 79, 2 1 7-2 1 8 - viscerum 1 58- 1 59, 1 62, 1 66, 1 72- 1 73, 1 75 Sole of the foot, muscles 338-343, T53-T54 Spatium[-al - e p i d u rale 24, 4 1 , 43, 248, 252 - pararectale 205, 2 1 0 - paravesicale 205 - retropubicum 70, 205, 207, 252, 257 - retrorectale 205 - subarachnoideum 4 1 , 43, 45, 1 1 9, 1 23, 252 - subdurale 4 1 , 43 Spina [-ae] - l liaca anterior inferior 230, 264-267, 271 , 273 superior 3, 46-47, 52, 56-58, 7 1 , 1 32, 1 40, 1 97, 207, 230, 255, 262, 264-269, 2 7 1 , 273, 306, 3 1 5, 3 1 7, 322, 355, 360, 364 - - posterior i nferior 266-267, 273 superior 2, 3 1 , 52, 1 83, 230, 254, 264, 266-267, 270, 273, 360
- ischiadica 3 , 2 1 2-2 1 3 , 230, 256, 264, 266-267, 273, 280, 3 1 9 - scapulae 1 -2, 26, 52, 1 03 , 1 23 Spinal anaesthesia 44 S p le n 1 40, 1 55-1 57, 1 59-1 6 1 , 1 66 - 1 67, 1 70, 1 72, 1 80, 245, 247-249, 255 - AP-radiograph 1 71 - H i lum 1 56 SpondylolistheSIS 9 Spondylolysis 9 Squama occipitalis 1 9 Sternoclavicular joint s , Articu latio sternoclavicu laris Sternum 5, 48, 50-52, 1 1 1 , 1 1 9, 1 25, 1 27, 1 32, 207, 242 Stratum - basale endometriale 202 - circulare 1 05, 1 29-1 30, 1 36, 139 - functionale endometriale 202 - long itudinale 1 05, 1 29-1 30, 1 36, 1 39, 2 1 0, 228 Stroma ovarii 201 Suboccipital muscles 3 1 -34, 40, T20 Substantia - com pacta 277 - spongiosa 277, 281 Subtraction angiography, d i g ital IDSA] 359 - a rteries of femur 359 SUDECK's point 1 76, 2 1 2 Sulcus[-i] - a nalis 262 - a rteriae splenicae 1 53 - - su bclaviae 49 - - vertebralis 6, 1 7 - calcanei 297-298 - coronarius 75-76, 85 - costae 49 - g lutealis 262, 307, 3 1 9 , 360 - interventricularis a nterior 76, 80 - - posterior 76, 80, 85 - malleolaris 282-283, 301 - nervi spinalis 7 - obturatorius 266 - paracolici 1 62- 1 64 - popliteus 281 , 29 1 , 293 - sinus sigmoidei 1 8 - s u p raacetabularis 266-267 - tall 297 - tendinis m usculi fibularis longi 295, 297-298, 300, 302 flexoris hallucis longi ICalcaneus] 296-298, 302 - - longi ITalus] 297-298 - terminalis cordis 75, 85 - venae subclaviae 49 Sura 262 Sustentaculum tali 295-298, 300, 302, 305, 382 Sympathetic nervous system 2 1 4 , 222-223 Symphysis - manubriosternalis 50-51 - pubica 73, 1 90, 205, 207, 225, 230, 234-235, 244, 252-253, 256-257, 264, 268, 271 -274, 3 1 7, 355, T39 - xiphosternalis 50 Synchondrosis costae 51 Syndesmosis t i biofibularis 263, 294, 304-305, 382, T39
I n dex
Systema - conducente cordis 82-83 - skeletale IColumna vertebralisl 2
T
Taenia - libera 1 38 - 1 4 0 , 1 58, 1 6 1 - 1 65 - mesocolica 1 39 , 1 6 1 - omentalis 1 39, 1 58, 1 60- 1 6 1 , 1 63 Talus 295-299, 30 1 , 304-305, 383 Tarsal joint - s Articulatio cuneonavicularis, Articulatio cuneocuboidea, Ar ticulatlol- nesl intercunellormes - transverse s. Articulatio talocalcaneonavic u la ris, Articulatio calcaneoc u boidea Tarsal tunnel 377 Tarsometatarsal joints s. Articulatiol-nesl tarsometatarsales Tarsus 263 Tela - subcutanea 58, 74, 2 1 0 , 232, 239 - submucosa 1 0 5, 1 30 , 1 36 - 1 37, 1 39
- su bserosa 1 30 , 1 36, 1 39 Tendo calca neus 300-30 1 , 304, 307, 309, 328-333 , 335, 370-372, 382-383 Testis 61 , 67, 1 85. 1 92- 1 94, 222, 242-243. 252
Thigh s. Femur Thoracic muscles 52-55. 57-58. T 1 3 Thoracic organs 1 1 8 Thoracic part 0 1 the vertebral column - AP-radiograph 1 4 - lateral rad iograph 1 4 Thoracic wall 58, 66, 69 - i n n e rvation, segmental 67 - muscles s. thoracic muscles - skeleton projection 47 - su rlace a natomy 46 Thorax - c ross section 1 2 5 - lrontal section 1 1 8, 1 2 1 - median section 1 1 9 Thymus 1 1 0 - 1 1 3 , 1 1 9 , 1 59 T i b i a 262-263, 282-283, 285-287, 290-294, 300-30 1 , 304-306, 327, 329-33 1 , 366-367, 3 74, 3 8 1 -383
Trabeculal-ael - carneae 79-80 - corporum cavernosorum 1 98 - septomarginalis 78, 80-81 - splenicae 1 56 Trachea 1 3 , 89-9 1 , 98-99, 1 0 1 . 1 04, 1 06- 1 07, 1 09 , 1 1 1 , 1 1 4- 1 2 1 , 1 23-1 24 - bifurcation 9 0 - cross-section 9 1 - projection 9 0 Tractus I llotibialis 279, 306-307, 3 1 2-3 1 3 , 3 1 8-3 1 9 , 322, 324, 327, 332, 36 1 , 3 8 1 TREITZ, M uscle of 1 35 , 1 52 Triad of GLISSON 1 45 Triangle of BOCHDALEK 63 Triangular space 37
Trigonuml-al - clavI pectora Ie 58 - fibrosum dextrum 77, 84 - - sinistrum 77, 84 - lumbale 26-27, 37. 52. 364
Trigonum/-a}
- lumbocostale 63, T21 - sternocostale 63, T21 - vesicae 1 90- 1 9 1 . 1 95. 1 98 Trochanter - major 256, 262, 268. 273-280, 3 1 9-3 2 1 , 360, 364
- minor 273-280. 3 1 6. 3 2 1 . 364 - tertius 275 Trochlea - fibularis 296-297 - tali 295-298, 305 Truncusl-il - brach iocephalicus 74-75 , 89, 98-99, 1 04- 1 05 , 1 07, 1 09 . 1 1 1 , 1 1 4- 1 1 5, 1 1 8- 1 2 1 , 1 24 - coeliacus 62, 1 04, 1 06, 1 1 5 , 1 52 , 1 55 , 1 68, 1 70 - 1 73, 1 78- 1 79 , 1 87, 2 1 4 , 2 1 7- 2 1 8 , 220-221 - - variations 1 78 - costocervicalis 1 1 5 - IEmbryol 206 - gastrosplenicus 1 78 - hepatomesentericus 1 78 - i ntestinalis 2 1 8 - lumbalis 2 1 8-2 1 9 - lumbosacralis 68, 220-22 1 , 225, 344 - nervi spinalis 4 1 -43 , 45 - pulmonalis 74-76, 79, 82, 84, 98, 1 0 1 , 1 1 4, 1 20 - 1 2 1 , 1 25- 1 26 - sympathicus 4 1 , 45, 63, 68, 83, 1 1 2- 1 1 3 , 1 1 5- 1 1 7, 1 20- 1 2 1 , 1 24- 1 25, 1 27, 220-223, 225, 245, 248, 250-251 - tlbiofibularis 369 , 372 - vagalis anterior 63, 1 1 7 - - posterior 63, 1 20- 1 2 1 Tru nk-arm muscles 26-27, T 1 8 - deep layer 2 7 - superficial layer 26
Tru nk-shoulder g i rd le muscles 26-27, T 1 7
- pubicum 47, 230, 234-235, 264, 266-267, 27 1 , 273, 355 - q u a d ratum 275-276
Tuberositas - g lutea 275-276. 278, 3 1 9 - iliaca 264, 266 - musculi g lutei maximi 267 - - serrati anterioris 49 - ossis c u boidei 295-296, 298, 302 - - metatarsi primi 295, 298 - - - q U l nti 295-296, 298, 302-303, 334
-
- navic u la ris 295, 298, 302 - sam 1 0- 1 1 phalangis distalis I Pesl 295 tibiae 262, 282, 285-287, 29 1 , 294, 327, 332, 367
Tubulus - d istalis 1 84 - proximalis 1 84 Tunica - adventitia 1 05 - - ITracheal 9 1 - albuginea 1 93 , 244 - - corporis spong iosi 1 99 - - corporum cavernosorum 1 97 - 1 9 9 , 242, 252
- dartos 70, 1 94, 1 97, 226. 232, 239, 242, 252
- II brosa 1 53
- mucosa 1 05 , 1 2 1 , 1 30 , 1 36, 1 39 ,
1 50, 1 90 , 2 0 1 -202 - - IGasterl 1 08 - - ITracheal 9 1 - muscularis 1 05, 1 1 9 , 1 29 - 1 30, 1 35-1 37, 1 39 - 1 40 , 1 90-1 9 1 , 2 0 1 -202, 2 1 0 , 226, 228, 230, 2 6 1 - serosa 1 30 , 1 36-1 37, 1 43 , 1 50 , 1 53, 2 0 1 -202 , 226 - - IColonl 1 39 - vaginalis testis 70, 1 93-1 94, 239, 242
- deep layer 2 7 - superficial layer 26 Tuba - uterina 1 6 7, 200-20 1 , 203-204, 209, 223 , 228, 259
- - AP-radiogra p h 203 Tuber - calcanei 296-298, 300-302. 304-305 , 328-330, 332, 340-341
- ischiadicum 3 , 2 1 2- 2 1 3, 2 1 5 , 230, 232-235, 257-258, 265-268, 270, 273, 280, 3 1 7, 3 1 9-320, 360 - omentale 1 42 , 1 6 1 Tubercle o f VATER 1 35 , 1 50 , 1 52
Tuberculuml-al - adductorium 275, 277 - a nterlus IVertebra cervicalisl 6-7, 35, 55
- costae 8, 20, 22, 49 - iliacum 264, 267 - intercondylare laterale 282, 291
-
- mediale 282, 2 9 1 i ntervenosum 78 latera Ie ITalusl 296-298 majus I H umerusl 47 mediale ITa lusl 296-298 minus I H umerusl 47 musculi scaleni a nterioris 49 obturatorium anterius 267 - posterius 266-267 posterius IAtlasl 34 IVertebra cervicalisl 6-7, 1 2, 1 7, 3 1 , 33, 35
v
Tuberculum{-al
Vaginal-ael 200-205. 207. 223, 228, 230-23 1 , 234. 237. 253, 257 - communis tendinum musculo rum fibularium 304. 334-335 - musculi recti a bdominis 52, 56-58. 69-70. 72. 249. 355
- plantaris tendinis musculi flbularis longi 341 - tendi nis/tendinum dig itorum pedis 335, 340-341 - - muscu li/-orum extensoris d i gitorum longi 334-335 - - - - hallucis longi 334-335 flexoris d l g itorum longi 304. 335
- - - - hallucis longi 335. 340 tibi a lis anteriorls 334-335 - - - - posterioris 3 04. 335 - - I Pesl 334-335 Valval-ael - aortae 77, 80, 82. 85. 1 1 4. 1 1 9- 1 20, 1 26-1 27
- atrioventricula ris dextra 77-78, 80-82, 1 1 9- 1 20 , 1 27
- - sinistra 77. 79-82. 1 26 - 1 2 7 - cordis 7 7 - m itralis s. Valva atrioventricu la ris sinistra - tricuspidalis s. Va lva atrioventricularis dextra - trunci pulmonalis 77. 82. 84 Va lye of HEISTER 1 50 Valvulal-ael - a n a les 2 1 0 - fora minis ovalis 79 - fossae navicularis 1 98 - semilunaris a nterior 77 - - - IValva trunci pulmonalisl 84 - - dextra IVa lva a o rtael 77, 79, 82, 84, 1 1 9 , 1 26
- - - IValva trunci pu lmonalisl 77. 84
- - posterior IVa lva aortael 77, u
U mbilical cord 208 Umbilicus 59, 72, 1 97 Uncovertebral clefts 24 Uncus corporis 7, 1 3, 24-25, 35 Upper abdomen - vessels 1 72- 1 73 - viscera 1 60 Urachus 70, 1 59 , 1 85 , 1 92 . 200 Ureter 7 1 , 1 52 , 1 63 - 1 64, 1 66 - 1 67, 1 7 1 , 1 79 , 1 9 1 - 1 92, 2 1 6-2 1 8, 236, 245,
1 82- 1 83, 1 85 - 1 87, 1 96, 200-20 1 , 205, 209, 2 2 1 -222, 226-229 , 231 , 2 5 1 , 253-254, 258 - AP-radiograph 1 86 Urethra 1 90 , 1 96, 1 98 , 252-253 - feminina 200, 207, 230, 234, 237. 2 6 1 - masculina 1 90 , 1 95-1 96. 1 98-1 99. 222, 234, 239, 244, 259-260 Uterus 1 40 , 200-203, 205, 207, 209, 223, 228-229 , 253, 354 - AP-radiograph 203
- mucosa, phase of proliferation 202
- position 203 - pregnant 206-207 - - u ltrasound image 206 - ultrasound image 206 Utriculus prostaticus 1 90 . 1 92 , 1 98 Uvula vesicae 1 90. 1 98
79-80, 82, 84. 1 1 9 . 1 26
- - sinistra IValva aortael 77, 79-80 . 82. 84. 1 1 9 . 1 26
- - - IValva trunci pulmonalisl 77. 82. 84
- sinus coronarii 78. 82. 84 - venae cavae i nferioris 78. 82 Vasl-al - deferens s. D u ctus deferens - lymphaticuml-al 1 97. 2 1 9 - - afferentia 2 1 9 - - AP-radiog raph 2 1 9 - - centra le 1 36 - - efferentia 2 1 9 - - profunda 367 - - su perficialia 366 - testiculares 7 1 VATER, Papilla o f 1 35. 1 50 . 1 52-1 53 Veinlsl - deep perforating of HACH 352 - of BOYD 352 - of COCKETT 352 - of DODD 306, 352 - of H U NTER 352 - of MAY 352, 365 - of S H E RMAN 352 Venal-ael - anterior IV. pulmonalis dextra su periorl 98, 1 20. 1 22 - apicalis 98 - a p icoposterior 98 - appendicularis 1 69 . 1 80
I n d ex
Venal-aef
-
a rcuata cruris posterior 365 atriales s i nistrae 75 auricularis posterior 38-39 axillaris 54, 1 1 3, 1 20 , 1 22 , 1 24 azygos 63, 75, 99, 1 05 - 1 07, 1 1 2,
1 1 5- 1 1 6 , 1 2 1 , 1 24-1 27, 1 8 1 , 249 - basalis inferior 1 27 - basivertebralis 42, 1 1 9, 242 - brachiocephalica 75, 89, 98, 1 05- 1 06 , 1 1 0- 1 1 3, 1 1 6, 1 1 8- 1 1 9 - bronchialis 1 1 2 - bulbi penis 234 - - vesti buli 241 - cardiaca magna 74-75 , 79-80, 84-85, 1 27 - - media 75, 84-85, 99, 1 1 9 - - parva 74, 8 5 - cava i nferior 35, 63, 75-76, 78, 83, 85, 89, 99, 1 0 1 , 1 0 5-1 07, 1 1 4, 1 1 6, 1 2 1 , 1 42- 1 43, 1 46- 1 48 , 1 52 , 1 54- 1 55 , 1 67, 1 69, 1 72-1 73, 1 79- 1 8 1 , 1 85 , 1 87 - 1 89, 2 1 0, 2 1 3, 2 1 7- 2 1 8, 22 1 , 243-244, 248-25 1 - - superior 74-78, 82, 84-85, 89, 98-99, 1 0 1 , 1 05-1 07, 1 1 1 - 1 1 2, 1 1 4, 1 1 � 1 1 8, 1 20, 1 24- 1 26 - centralis 1 45 , 1 89 - - [Glandula suprarenalisl 1 89 - cephalica 58, 66, 1 22 - cervicalis profunda 39 - - superficialis 66 - c i rcumflexa femoris latera lis 261 - - - medialis 256, 260-261 - - humeri posterior 37 - - ilium profunda 1 79 , 2 2 1 , 227, 231 - - - superficialis 66, 353-355 - - scapulae 37 - colica dextra 1 5 2, 1 69, 1 75, 1 80 - - media 1 52, 1 6 1 , 1 63- 1 64, 1 69, 1 75 , 1 77, 1 80 - - sinistra 1 6 7, 1 69, 1 75 , 1 77, 1 80- 1 8 1 - cordis 8 5
-
- media s Vena cardiaca media cremasterica 238 cystica 1 49, 1 69, 1 72 , 1 80- 1 8 1 digitales dorsales pedis 373 dorsalis profunda clitoridis 23 1 , 234
- - - penis 1 99, 227, 234, 238-239, 252
- - superflcialis penis 1 99, 238, 252
- duodenales 1 69 - epigastrica i nferior 60, 66, 69,
-
-
-
71 -72, 1 58-1 59, 1 73, 1 75 , 1 79, 1 8 1 , 1 96, 2 1 7, 2 2 1 , 227, 229, 23 1 , 236, 253 - superficia lis 66, 1 8 1 , 353-355 - superior 66, 69-70 , 72 femoralis 62, 73, 2 1 8, 244, 256257, 3 1 4 , 353, 355-358, 380-381 femoropoplitea 366 fibularis 366 gast rica[-ae[ breves 1 3 1 , 1 66, 1 69, 1 80 - dextra 1 3 1 , 1 69 , 1 80 - sinistra 1 06, 1 3 1 , 1 52 , 1 60, 1 69, 1 72 . 1 79-1 8 1 , 244, 249 gastroduodenalis 1 5 2 gastroomentalis dextra 1 3 1 , 1 60, 1 67, 1 69 , 1 72 - 1 73, 1 80 - sin istra 1 06, 1 3 1 , 1 60 , 1 69, 1 72 - 1 73, 1 80 glutea inferior 2 1 3, 256, 364, 380
Venal-aef glutea - - superior 2 1 3, 254, 380 - hemlazygos 63, 1 06, 1 1 6, 1 1 9, 1 8 1 , 245, 249 - - accessoria 1 06, 1 1 3, 1 1 6 - hepaticae 63, 89, 1 20- 1 2 1 , 1 43 , 1 48 , 1 6 7, 1 69, 1 79- 1 8 1 , 2 1 7-2 1 8 - dextrae 1 46, 1 48, 243, 246, 248 - - intermediae 1 46, 1 48 - - projection 1 46 - - sinistrae 1 46, 1 48, 243-244 - - ultrasound image 1 48 - ileales 1 69 , 1 75 , 1 80, 2 5 1 - ileocolica 1 69, 1 80 - iliaca communis 1 6 7, 1 79, 1 8 1 , 2 1 0, 2 1 3, 2 1 7-2 1 8 , 22 1 , 225, 227-228, 23 1 , 242-243, 254 - - externa 7 1 , 1 79 , 1 96, 2 1 0 , 2 1 3 , 22 1 , 226-229, 23 1 , 236, 253-254, 3 1 7, 354, 356, 358 - - i nterna 1 8 1 , 2 1 0 , 2 1 3 , 2 1 7 , 226-228, 23 1 , 254, 258, 354 - iliolumballs 2 1 7 - i ntercostalis[-esl 70, 1 26- 1 27 - - anteriores 247 - - posteriores 54, 73, 1 06, 1 1 2- 1 1 3 , 1 1 5-1 1 6 - interlobularis 1 45 - interventricu laris a nterior 74, 80, 84 - - posterior 75, 80, 84-85 - i n tervertebralis 42 - jejunales 1 52 , 1 69, 1 75 , 1 77, 1 80 - jugularis a nterior 1 1 9 - - extern a 38 - - interna 89, 1 05-1 06, 1 1 0, 1 1 8, 1 2 1 - 1 22 - lobi medii 98 - lumbales 4 1 , 1 79, 2 1 7, 243, 245 - lumbalis ascendens 42, 1 1 5- 1 1 6 , 221 - marg i nalls coli 1 69 - - lateralis 365, 373 - - medialis 365, 373 - mesenterica inferior 1 52, 1 67, 1 69, 1 77, 1 79 - 1 8 1 , 2 1 3 - - superior 1 52- 1 53 , 1 6 7, 1 69, 1 73, 1 75, 1 77, 1 79- 1 8 1 , 242-244, 2 5 1 - musculo phrenica 69 - obliqua atrii sinistri 85 - obturatoria 7 1 , 2 1 3 , 227, 229, 23 1 , 236, 256-257, 2 6 1 , 3 1 7, 355 - occipitalis 37-39 - oesophageae 1 06, 1 69, 1 80 - ovarica 1 52 , 1 67, 1 82 , 1 87, 20 1 , 209, 228-229, 253 - pancreaticae 1 69
- pancreaticoduodenalisl-esl
Venal-ae} portae hepatis
- - - ultrasound image 1 48 - posterior IV. pulmonalis dextra superiorl 98 - prepylorica 1 72 - profunda[-ael brachii 37 - - femoris 26 1 , 352, 358 - - interna 2 1 3 , 227-228 - pudenda[-ael externae 66, 1 97, -
-
-
1 69 , 1 80
-
- superior posterior 1 69 paraumbilicales 66, 72, 1 8 1 perforantes 306, 352, 365, 373 pericardiacophrenica 89,
1 1 1 - 1 1 3, 1 1 8 - perinealis 234
- phrenicae inferiores 63, 1 06, 181 , 21 7
- plantaris lateralis 304 - - medialis 304 - poplitea 284, 329, 3 6 1 -363 , 366, 369-371
- portae hepatis 1 06, 1 3 1 , 1 42 - 1 43 , 1 46, 1 48 , 1 52 - 1 54, 1 67, 1 69- 1 70 , 1 72 - 1 73 , 1 79-1 8 1 , 243-244, 246, 248-250 - - - projection 1 46
-
-
238, 353-355 - interna 227, 23 1 , 234, 236, 240-24 1 , 256-258, 260-26 1 , 363-364 pulmona lis[-esl 1 1 2, 1 20 - dextra[-ael 75-76, 78-79, 85, 88-89, 95, 98, 1 00, 1 05, 1 07, 1 1 2, 1 2 1 , 245 i nferior 99, 1 26 - 1 2 7 - - superior 98-99, 1 20, 1 24, 1 26 - sinistra[-ael 75-76, 85, 89, 1 05 , 1 07, 1 1 3, 1 1 9, 245 i nferior 79, 88, 95, 98-99, 1 26- 1 27 superior 79, 88, 95, 98-99, 1 0 7, 1 25 rectalis[-es} inferiores 1 69, 1 8 1 , 2 1 0 , 2 1 3 , 227-228 - mediae 1 69, 2 1 0 , 2 1 3 , 227-229 - superior 1 69, 1 77, 1 80- 1 8 1 , 2 1 0 , 2 1 3 , 227-229 renalis 1 52, 1 54, 1 8 1 - 1 85 , 1 87-1 88, 2 1 7, 2 2 1 , 242-243, 245-246, 250 sacralis lateralis 226 - mediana 1 79 , 2 1 0 , 2 1 7, 22 1 , 229 saphena accessoria lateralis 353 - - medialis 354 - magna 66, 68, 2 1 8, 257, 284, 306, 352-356, 358, 360, 365-366, 373, 379, 381 -382 - parva 284 , 352, 360-36 1 , 363, 365-366, 369-370, 373, 381 -382 sigmoldeae 1 69, 1 77, 1 79- 1 8 1 , 2 1 0, 2 1 3 spina lis posterior 4 1 splenica 1 52-1 56, 1 6 1 , 1 67, 1 69, 1 73 , 1 77, 1 79- 1 8 1 , 244-245, 248-250 subclavia 89, 1 05-1 06, 1 1 1 - 1 1 2, 1 1 6, 1 1 8, 1 2 1 , 1 23 subcostalis 1 1 5- 1 1 6 subcutaneae abdominis 66 su prarenalis 1 82 , 1 87, 2 1 7 suralis 370 testicularis 7 1 , 1 5 1 , 1 79, 1 82 , 1 87, 1 93, 2 1 7 , 2 2 1 , 238, 2 5 1 thoracica interna 6 3 , 6 6 , 6 9 , 88-89, 9 8 , 1 1 0- 1 1 1 , 1 24 - latera lis 66 thoracoepigastricae 66 thyroidea inferior 88-89, 1 06, 1 1 0- 1 1 1 , 1 1 6 - superior 1 1 0 tibiales a nteriores 366-367 - posteriores 366 , 370 transversa colli 38 u m b i licalis 70-7 1 , 1 43, 1 59, 207 uterina 228-229 ventriculi dextri anteriores 84 - sinistri posteriores 75, 85 vertebralis 39, 75, 1 06 vesicalisl-es} 70, 228 - inferior 227
Venal-ae} vesicalisl-es} - - su perior 227
Venter - occipitalis 39 - posterior 3 1 , 33-34 - superior 1 1 0 Ventriculusl-i} - cordis dexter 74-76, 78, 80-82, 85, 98-99, 1 1 4, 1 20-1 2 1 , 1 26-1 27, 244 - - sinister 74-76, 79-82, 85, 98, 1 0 1 , 1 05, 1 20- 1 2 1 , 1 26 - 1 2 7 Versio IUterus} 203
Vertebra[-ae} - cervicales 3-5, 7, 1 2- 1 3 , 1 7- 1 9 , -
35, 40, 4 8 , 55, 1 03, 1 1 9 - AP-radiograph 1 3 - lateral rad i o g raph 1 2
coccygeae s Osl-sa} coccygis development 5, 2 4 epiphyses 5, 25 lumbales 1 , 3-5 , 8-9, 1 5- 1 6,
23-24, 32 , 4 1 , 44, 48, 62-63, 72, 1 54, 1 78 , 2 1 6 , 249-252, 254, 268-269, 2 7 1 -273, 3 1 7 - - AP-radiogra p h 1 6 - - lateral radiogra p h 1 5 - ossification centres 5 - prominens 1 -4, 7, 26, 34, 1 03, 1 1 9 - regional characteristics 5 - sacrales 2 , 274 - structure characteristics 8 - thoracicae 3-5, 8-9, 20, 26, 48, 1 2 1 - 1 27, 1 86, 248-249 - - AP-ra d io g raph 1 4 - - lateral radiograph 1 4 Vertebral column 3-4 - ligaments 20-2 1
Vesica - biliaris 67, 1 40 , 1 42 , 1 44 , 1 46-1 47, 1 49 - 1 5 1 , 1 54, 1 60- 1 6 1 , 1 70, 1 72 . 1 80, 250 - - AP-ra d i o g raph 1 5 1 , 1 54 - - laparoscopy 1 49
- fellea s. Vesica biliaris - urinaria 62, 67, 70-7 1 , 1 40, 1 59, 1 65-1 67, 1 98, 200, 226-229, 252-253,
1 79, 1 85, 205, 207, 236-23 7, 256-257, - - puncture 1 90
1 90 - 1 92, 1 96, 209, 2 1 7, 222, 242-243, 259-26 1 , 354
Vestibulum - bursae omentalis 1 6 1 , 1 66 - vaginae 235 Villi intestinales 1 36 Viscera - of the neonate 1 59 - upper a bdomen 1 60- 1 6 1 Vortex cordis 76 w WINSLOW, Foramen of 1 60 WIRSU N G , Duct of 1 52 WOLFFian d uct 1 92, 200
z ZENKER, Diverticulum of 1 09
Zona - fasciculata 1 89 - orbicularis 256, 27 1 , 279 - reticularis 1 89 Zygapophysis s. Processus articu laris superior/inferior IVertebra}
